Diagnostic technique for disturbed endometrial receptivity in patients suffering uterine myoma and infertility
SUBSTANCE: technique consists in measuring a pinopod count in the germinal epithelium, an expression level of progesterone and oestrogen alpha receptors in the endometrial stroma, calculating their ratio, and determining an expression level of implantation LIF factor on the 21st-24th day of the menstrual cycle ('implantation window'). If the pinopod count is less than 35%, the expression ratio of progesterone and oestrogen alpha receptors in the endometrial stroma less than 3.5, as well as the LIF expression level of less than 2 points, disturbed fertility associated with uterine myoma is diagnosed.
EFFECT: technique enables applying the differentiated approach to managing the patients planning pregnancy, suffering uterine myoma undeforming the uterine cavity, as well as with myomatous nodule up to 5,0 cm in diameter.
2 ex, 4 dwg
List of abbreviations:
LM - uterine leiomyoma
LIF - leukemia inhibitory factor
PR - progesterone receptors
ER - estrogen receptors
IHC - immunohistochemistry.
The invention relates to medicine, namely to gynecology, and is intended for the diagnosis of disorders of reproductive function in patients with LMM.
Infertility affects 55.3% of women with uterine myoma, and the share of primary infertility accounted for 23.3% secondary 32% . The population observations, among women with primary infertility LM reveal every third, every fifth woman with LM suffers from infertility .
According to the literature of suffering from infertility in 12-20% of cases, ovarian cancer is the only cause of reproductive failures .
At the moment there is no consensus about the impact of uterine fibroids on reproductive function, few studies on the mechanisms of fertility disorders in uterine fibroids. The role of uterine fibroids in the development of infertility is still not certain, as there are numerous cases of pregnancy with successful outcome when multiple uterine fibroids, even large ones.
Essential in the process of implantation is the fact that the state is monotonically increasing since the mid-late secretory phase. LIF localized in the glandular epithelium  it Was shown, the expression of LIF reaches the maximum value during the window of implantation  that can be attributed to this factor is a biochemical marker of endometrial receptivity . Some researchers note that in the endometrium of women with infertility reduced expression of LIF, and it was also shown that when unexplained infertility is significantly reduced expression of LIF in the middle secretory phase endometrium .
Object of the invention is to improve the effectiveness of forecasting of infertility associated with LM, on the basis of determination of endometrial receptivity during the window of implantation by means of immunohistochemical study of endometrial biopsy on day 21-24 of the menstrual cycle (in the "window of implantation"), to evaluate the morphological and immunohistochemical characteristics of the endometrium: the number of pinopodia, the level ratio of the expression of progesterone and estrogen receptors in the stroma of the endometrium and the expression level of LIF for diagnosis of fertility disorders associated with uterine cancer.
The problem is solved in that on the basis of determining the level of expression of PR and ER, and their ratio, determining the level of expression of LIF in the endometrium during the window of implantation it is possible to predict fertility disorders associated with impaired receptivity defects in patients with uterine myoma, and the decision�Oia further tactics of conducting patients.
Definition of endometrial receptivity is needed in patients:
1. Planning pregnancy who do not show complaints of pain, heavy periods, bleeding, dysuria, constipation, having uterine fibroids not distorting the cavity.
2. Presenting complaints of infertility (with unspecified infertility - N97.9 to ICD 10) having a uterine cancer up to 5 cm in diameter, not distorting the cavity.
Practically the method is as follows:
Assessment of endometrial receptivity, including morphological and immunohistochemical examination of the endometrium on day 21-24 of the menstrual cycle (in the "window of implantation"), evaluated the morphological and immunohistochemical characteristics of the endometrium: when the number of pinopodia less than 35%, the level ratio of the expression of progesterone and estrogen receptors in the stroma of the endometrium less than 3.5, and the expression level of LIF less than 2 points diagnose impaired fertility associated with uterine cancer.
Material for study is the endometrium. The capture of the endometrium for the research is performed by curettage of uterine cavity mucosa at 7-11 after ovulation, i.e. on day 21-24 classic 28 day menstrual cycle. Pre-hysteroscopy used for visual evaluation of the cavity and the mucous membrane of the uterus.<> Materials of biopsy specimens are fixed in 10% neutral formalin for 24 hours. The samples are processed by conventional standard methods, and enclosed in paraffin. The sections with a thickness of 4 μm are prepared on a rotary microtomes and stained with hematoxylin and eosin.
The study of histological preparations is carried out under a light microscope with magnification of up to X400 X50.
The IHC reaction is conducted at deparaffinizing the sections with a thickness of 4-5 microns according to standard protocols (DAKO protocols). For the determination of steroid receptors are used murine monoclonal antibody to alpha-estrogens receptors (ER) (clone 1D5 "DAKO", Denmark, RTV) and progesterone receptors (PR) (clone 636 "DAKO", Denmark; RTV). To detect the expression of the BODICE are used primary mouse antibodies to the BODICE (R@D Systems, USA, clone:9824).
To analyze the results of the IHC reactions used histological method accounts H-score by the formula: HS=1A+2b+3C, where a is % weakly stained cells, b - % moderately stained cells, with - % strongly stained cells, 1, 2, 3 - staining intensity, expressed in points. The results of the IHC reaction for the BODICE are evaluated semi-quantitative method in scores by the standard technique: the lack of immunoscreening cells (-) - 0 points; less than 5% immunoscreening cells (j,:) - 0.5 points, less than 20% immunoscreening cell transplantatio� (+) - 2 points; 20 to 40 percent of stained cells (++) - 4 points; more than 40% of stained cells (+++) - 6 points.
We also consider the ratio of PR/AR. The ratio PR/ER is calculated by the stroma, as modern representations suggesting that the stroma plays a crucial role in the successful implantation of the embryo and subsequent development of pregnancy (M. T. Mazur, 2005).
The test results
In the study of histological preparations under a light microscope at magnification ×400 was conducted to study the surface epithelium of the endometrium and the estimate of the number of cells containing pinopodes ( % ) required for successful implantation.
In patients of group 1 the number of pinopodes in the surface epithelial cells ranged from 7 to 12% and on average amounted to 9.3=1,7% (figure 1A), while in patients of group 2 this figure ranged from 30 to 40% to an average of 34.6%±3,1% (figure 1B). Thus, we identified a statistically significant difference between the number of pinopodes in patients with infertility and patients without infertility amid uterine fibroids (P<0,05).
Were immunohistochemically investigated material from 52 patients. Of these, 25 patients with uterine myoma and infertility (group 1), 14 patients with uterine myoma without infertility (group 2). In patients of all groups the morphological pattern of the endometrium corresponded to early and mid� secretory phase. In patients of group 1 were mainly observed moderate and severe PR expression in all cells of the endometrium. The level of PR in the glands ranged from 30 to 220 to an average of 167, 2±55,33. The level of PR in the stroma varied from 30 to 180 and on average reached 154.8±46,65. In the study of the level of estrogen receptors-alpha in the first group of patients was found moderate and low expression of receptors. The level of ER in the glands ranged from 10 to 180 and averaged 35,68±11,85. The level of ER in the stroma varied from 10 to 80 and on average amounted to 9.96±3,4.
We also evaluated the ratio PR/ER in the stroma. According to the literature normally, this figure should be in the range from 2 to 4. The ratio PR/ER were calculated according to the stroma, given current views on the decisive role of stroma plays a crucial role in successful embryo implantation and subsequent development of pregnancy.
In group 1 patients (with uterine myoma and infertility), this indicator ranged from 27,15 to 66,27 and averaged for 46.71±9,48. This result is due to a decrease in ER-alpha in the stroma.
Immunohistochemical study of the level of steroid hormone receptors in the endometrium in group 2 (with uterine myoma without infertility) level of PR in the glands ranged from 10 to 180 and averaged 58,21±17,72. The level of PR in the stroma varied from 120 to 220 and averaged 162,86±24,63. The level of estrogen �of eception in the endometrium of the patients of the second group was higher than in patients of the first group. So, the level of ER-alpha in the glands ranged from 10 to 220 to an average of 69, 29±17,43. The level of ER-alpha in the stroma ranged from 30 to 100 and averaged 50,36±5,15. The ratio of progesterone receptor and estrogen receptor alpha in the stroma in the second group averaged 3,49±0,79. Thus, assessment of the endometrium of patients of group 2 shows that the majority of patients with uterine myoma without infertility are characteristic of the "window of implantation" secretory manifestations, which were detected by histological examination. There was pronounced expression of PR (>200 points), reaching maximum values in the cells of the stroma. The level of ER-alpha in stroma cells was low, and the cells of the glands moderate (figure 2).
In the study marker receptivity defects LIF in the second phase of the menstrual cycle showed a reduction in the level of LIF in patients with uterine myoma and infertility.
So, the patients of the 1st group the LIF level ranged from 0 to 3 and averaged 1.96±0.98 m. Among patients of group 2, the expression level of LIF in the endometrium varied from 1 to 3 and averaged 2,71±0,73. When comparing patients
In both groups the level of expression of LIF obtained statistically significant results. So, when comparing the results of groups 1 and 2, the level of LIF in female patients with myoma� of the uterus, without infertility was almost 1.5 times higher than in patients with infertility, and amounted 2,71±0,73 and 1.96±0.98 m, respectively (p=0,061) (figure 3). We identified a correlation between the number of fibroids and the level of LIF. Thus, the LIF level was higher in patients with isolated cases of fibroids, the more myomatous nodes, the lower the expression level of LIF, indicating the negative impact of uterine fibroids on the endometrium (figure 4).
We obtained data confirming the impaired expression of steroid hormones in the endometrium in women with uterine fibroids, infertility. According to our research, the ratio PR/ER-alpha in patients with infertility amid uterine fibroids averaged for 46.71±9,48, whereas in patients with uterine myoma, infertility, the figure was 3,49±0,79. From the above data it follows that the cause of infertility in women with uterine cancer may be associated with impaired expression of steroid receptors in the endometrium.
Thus, we have verified data the impaired expression of steroid hormones in the endometrium in women with uterine fibroids, infertility. Conducting morphological and immunohistochemical evaluation of the endometrium in patients with uterine myoma allows you to select a group of patients with an imbalance in the expression of PR and ER-alpha, which is necessary and �LeSabre conducting myomectomy even with a small size of fibroids.
The following is an example that illustrates the method of the invention.
Patient K., age 26 went to the Center in 2010 with complaints of absence of pregnancy within 2 years of regular sexual life without contraception.
Clinical diagnosis: uterine Fibroids. Infertility I.
Illness in the immediate family: the grandmother has diabetes.
Somatic diseases were not identified. General surgery denies.
Gynecological diseases: cervical erosion (laser-coagulation in 2007). Uterine fibroids since 2006.
Gynecological surgery: denies.
Menstruation 11 years, were established immediately. Regular, 4 days, 28 days, moderate, painless.
Fertility - infertility I (2 years). The total number of pregnancies - 0
Sexual life for 19 years.
Her husband's health: somatically healthy, semen - normozoospermia.
History of present illness: she came to the Center with the above complaints to prepare for pregnancy. The examination revealed uterine fibroids. Recommended surgical treatment.
Pelvic exam: external genitals are developed correctly. Body hair on the female type. The cervix is cylindrical in shape, clean. The body of the uterus is increased accordingly 9-10 weeks of pregnancy, dense, mobile, painless on palpation.The uterine appendages on both sides were not increased painless on palpation. The vaults are deep, painless on palpation. Highlight - light.
These ultrasound of the pelvic organs (16.04.2010) 9 D. m. C.: the body of the uterus size 3,8*4,0*3,8 see On the back wall is visualized mimisan-subserous myoma node with a diameter of 3.8 cm. the uterus is not enlarged. The appendages of the uterus without pathology. M-ECHO - 0.5 cm, conventional echo-structure.
Surgery: Laparoscopy, myomectomy without opening the uterine cavity, hysteroscopy, separate diagnostic curettage of the endocervix and uterine lining.
Found: the body length of the cervix is 6 cm Cavity is not enlarged, not deformed. Endometrium pale pink, thickened. Tube angles available inspection the mouth of the fallopian tube.
Laparoscopy: the body of the uterus is increased to 8-9 weeks of pregnancy, pale pink, deformed mimisan-subserous myoma node, located at the posterior wall of the uterus, with a diameter of 4.5 cm Appendages without pathology. Fallopian tubes when hromogidrotubatsii freely passable.
The results of pathomorphological studies No. 1285 - sent by nodes leiomyoma with hyalinosis. In scraping the scraps flat stratified epithelium. The number of pinoy 25%.
Immunohistochemical examination: level PR 220%; level ER 30%; PR/ER 7,3; level LIF 1 point (low).
A year after the operation step�an unassisted pregnancy, which was uneventful and ended prompt deliveries at 38 weeks pregnant. A healthy baby was born, evaluated on a scale of Apgar 8/9 points. The patient was discharged home in satisfactory condition on day 7 after birth.
Patient R., age 39 went to the Center with complaints of absence of pregnancy within 2 years of regular sexual life without contraception.
Clinical diagnosis: Multiple uterine fibroids large size. Infertility II.
Illness in the immediate family: a stroke in the mother.
Somatic diseases: autoimmune thyroiditis.
General operations: 2001 destruction of the left lobe of the thyroid gland.
Gynecological diseases: uterine fibroids since 2008
Gynecological surgery: cesarean section in 1994 (at 38 weeks of gestation, boy 3700/54).
Menstruation from the age of 12, was established at once, regular, 4 days, 28 days, moderate, painless
Fertility: the total number of pregnancies - 1; abortion, women - 0.
Birth I (CA in 1994).
Health husband of 39 years, examined, healthy.
Sexual life of 20 years.
History of present illness:
Uterine fibroids since 2008, was not observed, treatment was not conducted.
Pelvic exam: external genitals are developed correctly. Body hair on women's type�. The nulliparous vagina, the mucous is not hyperemic. The cervix subconciously shape, clean. Body increased to 13-14 weeks of pregnancy, dense, mobile, painless on palpation. The uterine appendages on both sides are not enlarged, painless on palpation. The vaults are deep, and painless. Highlight - light.
These ultrasound of the pelvic organs from 15.02.2010:
The size of the uterus: length of 10.3, the thickness of 9.4, width 9,0 cm of Myometrium - the back wall interstitial myoma node sizes 78*65*76 mm, in the bottom of the subserous on a thin base 44*27*33 mm. M ECHO 6 mm. Right ovary size 3,1*2,9*2,0 cm, left ovary size 3,8*3,7*3,0 see the Opinion of multiple fibroids of the uterus.
The Protocol operations from 19.02.2010:
Laparoscopy, myomectomy without opening the uterine cavity, hysteroscopy, diagnostic curettage of the mucous of the uterus.
Hysteroscopy: the length of the body of the uterus 10 cm Cavity is not enlarged, not deformed. Mucous is not thickened, pale pink color. Tube angles available inspection free.
Laparoscopy: the uterus is increased to 14-15 weeks of pregnancy, pale pink, deformed intramural myoma node emanating from the rear wall with a diameter of 10 cm, and subserous fibroids site that proceedeth out of the bottom with a diameter of 4.0 cm the uterus without pathology. When hromogidrotubatsii fallopian tubes are open.
Result�you pathomorphological study No. 506/3326-30.
Submitted nodes are leiomyoma. In the scrapings of the mucous stage of secretion (in some areas with the glands of various shapes and sizes). The number of pinopodia 20%.
Immunohistochemical examination: level PR 180%; level ER 5%; PR/ER 36; LIF level 2 score (moderate).
A year after the operation pregnancy after IVF and embryo transfer, which proceeded with the phenomena of threats of termination in the early stages and was completed operational birth at 37 weeks of pregnancy. A healthy baby was born, estimated Apgar 8/8 points. The patient was discharged home in satisfactory condition on day 7 after birth.
Sources of information
1. Hart R, Khalaf Y, Yeong CT, Seed P, Taylor A, Braude P 2001 A prospective controlled study of the effect of intramural fibroids can on the outcome of assisted conception. Hum Reprod 11. - 2411-2417.
2. V. I. Kulakov, G. M. Savelyeva, Manukhin I. B. Gynecology - national leadership, 2009
3. Vikhlyaeva E. M. guidelines for the diagnosis and treatment of uterine leiomyoma. // M, "Medpress-inform", 399 S., 2004
4. The effect of intramural fibroids without can cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis alien shooter Kamal Sunkara, Mohammed Khairy, Tarek El-Toukhy, Yacoub Khalaf and Am Coomarasamy Hum. Reprod. (2010) 25 (2): 418-429.
5. Parker WH 2007 Can myomas: management. Fertil Steril 88: 255-277.
6. Agajanova L, Stavreus-Evers A, Nikas Y, Hovatta O, Landgren BM. Coexpression of pinopodes and leukemia inhibitory factor, as well as its receptor, in human endometrium. Fertil Steril. 2003 Mar;79 Suppi 1:808-14.
7. Stovall, D. W., Parrish S.. Can leiomyomas reduce the efficacy of assisted reproduction cycles. Hum Reprod 1997; 13: 192-197.
8. Kontula K, Janne 0, Vihko R, de Jager E, de Visser J, Zeelen F. Progesterone-binding proteins: in vitro binding and biological activity of different steroidal ligands. Acta Endocrinol (Copenh). 1975 Mar; 78(3):574-92.
9. Immortal B. C. Morphological and immunohistochemical characteristics of endometrium in infertility. Avtoreferat Diss., Moscow, 2009.
10. Dyuzheva E. V. Hormonal preparation of the endometrium in patients with effecively attempts at IVF in history, author. to Diss., 2010
11. Gonzalez R. R., Rueda, B. R., Ramos M. P. et al. Leptin-induced increase in leukemia inhibitory factor and its receptor by human endometrium is partially also been other ideas where by interleukin 1 receptor signaling. Endocrinology 2004; 145(8): 3850-3857.
12. Cavagna M, Mantese JC. Biomarkers ofendometrial receptivitya review. Placenta. 2003; 24(Suppl B):S39-47.
13. Archives of pathology №5 2011, I. N. Kostjuchek, O. A. Witkin, S. V. Nikitin, P. V. Kuchin, N. N. Balashov, M. A. Kleshchev, G. X. tolibova, Y. P. Milyutina, I. M. kvetnoy, EXPRESSION of ESTROGEN RECEPTORS AND PROGESTERONE IN the ENDOMETRIUM of FERTILE AND INFERTILE WOMEN.
14. Hambardzumyan, E. M. the Role of factor inhibiting leukemia, in human reproduction: a Review [Text] / E. M Hambardzumyan, L. M. Agadzhanova // Obstetrics and gynecology: Scientific and practical journal. - 2004. - No. 2. P. 17 - 21: 2 ill. - ISSN 0300-9092.
Method of diagnosing disorders of reproductive function in patients with uterine cancer based on the evaluation of endometrial receptivity, characterized in that, along with the morphological study was performed immuno�histochemical study of the endometrium on day 21-24 of the menstrual cycle (in the "window of implantation"), evaluate morphological and immunohistochemical characteristics of the endometrium: when the number of pinopodia less than 35%, the level ratio of the expression of progesterone and estrogen receptors in the stroma of the endometrium less than 3.5, and the expression level of LIF less than 2 points diagnose impaired fertility associated with uterine myoma.
SUBSTANCE: method involves sampling a biological tissue, introducing a biologically active substance therein, keeping the prepared mixture in a thermostat at 37°C and incubating, performing microscopic examination for identifying the forms of trichomonads. The sampled biological tissue represents the urogenital mucosa that is incubated for 24 h in a nutrient medium. The prepared sediment is separated and added with the biologically active substance nitrosoguanidine in an amount of 500 mcg/ml. That is followed by incubating for 15 min at +37°C; a phosphate buffer with pH 5.6 heated to +37°C is added and centrifuged twice at 1000 rpm for 10 min. The material is placed into the nutrient medium for trichomonad growing, incubated for at least 24 hours, and microscopic examination is used to identify atypical nonflagellate and typical round and amoeboid forms of trichomonads.
EFFECT: using the declared invention enables the effective, fast and reliable identification of typical changed and atypical forms of trichomonads.
3 dwg, 3 ex
SUBSTANCE: method involves measuring pregnant women's blood anti-cytomegalovirus antibody titre and glutathione reductase activity in erythrocytes of the obstetric patient suffering the cytomegaloviral infection. If the anti-cytomegalovirus antibody titre is 1:1600, whereas the measured glutathione reductase activity is below 4.48±0.22 units/gHb, the aggravated cytomegaloviral infection is diagnosed.
EFFECT: higher diagnostic technique.
SUBSTANCE: group of inventions relates to medicine, cosmetology, production of food products, vitamins, food supplements, drugs and describes versions of device for realisation of non-invasive potentiometric determination of oxidant/antioxidant activity of biological tissues, which includes device for measuring potentials and double-sided electrode, made in form of plate with similar working surface, covered with electricity-conducting gel, containing mediator system. Electrodes are fixed on biological tissue in such a way that one working surface, playing role of measuring electrode, is in direct contact with biological tissue via gel, second working surface pale role of comparison electrode. Electrodes contact with each other via gel, with oxidant/antioxidant activity being determined by formulae with application of difference between final and initial potentials.
EFFECT: simplification, as well as increase of accuracy and reliability of determination, is achieved.
14 cl, 3 tbl, 4 dwg
SUBSTANCE: invention represents a method for the prediction of preeclampsia in the second trimester of pregnancy by blood examination, differing by the fact that the activity of acid and neutral proteinases is measured in blood serum of the women 7-8 weeks pregnant; if the activity of acid proteinases is more than 5.6 mcmole/l, while the activity of neutral proteinases is more than 3.9 mcmole/l, the preeclampsia progression in the second trimester of pregnancy is predicted.
EFFECT: higher accuracy and specificity of the method for the prediction of gestational toxicosis.
SUBSTANCE: invention relates to medicine, namely to a method of automated morphometric myelofibrosis diagnostics. The method essence consists in the fact that overview images of zones with different optical properties with determinable fibrous and heamopoietic properties of a biological tissue are performed. Ratios of areas of the said zones of at least three paraffin cuts of trepanobiopsy samples are calculated. The coefficient (Cop) is calculated as the ratio of the fibrous tissue area to the area of the heamopoietic tissue by formula. If the value Cop ≥14.5%, myelofibrosis is diagnosed.
EFFECT: application of the claimed method makes it possible to increase the accuracy and improve the efficiency of myelofibrosis diagnostics.
7 cl, 1 tbl, 4 dwg, 1 ex
SUBSTANCE: testicular germ cells are measured quantitatively. That is ensured by 50-day oral administration of selexen and ascorbic acid into male white rats in doses 1.5 and 500 mg/kg of animal's body weight respectively once a day. 14 days later, administering the selenium-containing biocomplex is accompanied by the 30-minute daily exposure to microwave radiation at 42 GHz (λ=7.1 mm) for 30 days. Once the experimental exposures are completed, the corrective properties of the biocomplex as having an effect on the morphofunctional state of epididymal sperm cells are assessing by formula: MFSI=A+B, wherein MFSI is a morphofunctional state index, A is a portion of normal sperm cells in relation to the reference, and B is a portion of moving sperm cells in relation to the reference. If the MFSI value is 1.3 or more, the spermatogenesis correction is considered to be ineffective, while the MFSI value being more than 1.3 shows the effective spermatogenesis correction if exposed to microwave radiation.
EFFECT: invention enables assessing the spermatogenesis correction efficacy with underlying administration of the biocorrector.
2 tbl, 3 dwg, 3 ex
SUBSTANCE: invention relates to field of medicine, in particular hepatology. Method of quantitative estimation of histological activity in liver biopsy materials in case of chronic diffuse liver diseases results in protocol of counting in absolute numbers, percent and points of pathological signs, identified in the course of morphological analysis of liver biopsy materials from patients with chronic diffuse liver diseases, by sections: necrosis of hepatocytes, globular and atomised fatty hydropic degeneration of hepatocytes, small cell dysplasia of hepatocytes, portal, periportal, intralobular and central infiltration. After that conversion of absolute values into point system is performed by means of said protocol, and histological activity is determined by number of points.
EFFECT: method makes it possible to create quantitative unification of obtained results in case of said diseases.
FIELD: veterinary science.
SUBSTANCE: method includes detection of leukocytes, protein, haemoglobin in faeces, and PH-reaction of faeces. A sample of faeces is dissolved in distilled water and applied drop by drop onto appropriate test fields of a test strip designed for urine testing. By variation of colour within 1 minute the reaction is assumed as positive. If pH is less than 7.0 or more than 7.5, and faeces contain soluble protein, haemoglobin and leukocytes at the same time, availability of the inflammatory process in the intestines is confirmed.
EFFECT: invention makes it possible to quickly and accurately diagnose inflammatory process in intestines.
2 cl, 2 ex
SUBSTANCE: invention relates to medicine and is intended for the treatment of patients with the perforation of gastric and duodenal ulcer. A laparotomy is performed, operative aid concerning the ulcer perforation is realised, during the operation an exudate is sampled from the abdominal cavity, pH of the exudate is determined. If Ph of the said material is 6.6 and lower, a conclusion about the presence in it of anaerobic flora is made and serves the basis for the administration of an antibacterial preparation, influencing the anaerobic flora, into the scheme of initial antibacterial therapy.
EFFECT: method makes it possible to administer specific antibacterial therapy without waiting for culture results.
SUBSTANCE: method involves the integrated clinical-laboratory and microbiological studies of patient's urogenital discharge to determine an agent's cytomorphotype as shown by culture analysis and evaluating a degree of manifestation of the patient's urogenital inflammation or leucocytosis.
EFFECT: invention enables improving the quality of laboratory diagnostics, provides establishing the accurate diagnosis that improves the clinical effectiveness, and reduces the rate of complication accompanying chronic trychomonad infection.
1 tbl, 2 ex
FIELD: medicine, psychiatry.
SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.
EFFECT: more objective prediction of disease development.
FIELD: medicine, urology.
SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.
EFFECT: more reliable and objective information.
1 ex, 1 tbl
FIELD: molecular biology.
SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.
EFFECT: higher efficiency.
44 cl, 4 dwg, 1 ex
FIELD: medicine, phthisiology, microbiology.
SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.
EFFECT: improved assay method.
FIELD: medicine, biotechnology, pharmacy.
SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.
EFFECT: valuable medicinal and anti-tumor properties of composition.
12 cl, 3 tbl, 3 ex
SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.
EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl
FIELD: medicine, juvenile clinical nephrology.
SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.
EFFECT: higher efficiency of detection.
7 dwg, 1 ex, 6 tbl
FIELD: medicine, urology.
SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.
EFFECT: higher efficiency of diagnostics.
FIELD: medicine, biology.
SUBSTANCE: invention relates to nutrient medium used for accumulation of cells for the following cytological and/or immunocytochemical analysis carrying out. Invention relates to medium containing salts NaCl, KCl, anhydrous CaCl2, MgSO4 x 6 H2O, MgCl2 x 6 H2O, Na2HPO4 x 2 H2O, KHPO4, NaHCO3, and also glucose and Henx's solution, 10% albumin solution and polyglucin taken in the ratio 1:1:1. Invention provides enhancing the preservation of cells.
EFFECT: improved an valuable properties of nutrient medium.