Linkage of blood pressure, obesity and diabetes mellitus with angiotensinogen gene (AGT 704T>C/rs699) polymorphism in hypertensive patients

AIMS

The study aim was to analyse the frequency of polymorphic variants of angiotensinogen gene polymorphism (AGT 704T>C, rs699) in essential arterial hypertension (EAH) patients.

METHODS

Seventy-two individuals with EAH and hypertension‑mediated organ damage (stage 2), moderate, high or very high cardiovascular risks were involved in the case-control study. Among them, 70.84 % (51) were females and 29.16 % (21) were males; mean age was 59.87±7.98 y. The control group consisted of fifty practically healthy individuals at relevant age (49.13±6.28 y) and with relevant sex distribution (62 % were females, 38 % were males). AGT (704T>C) gene polymorphism was examined by RT-PCR.

RESULTS

The distribution of genotypes in the study group was as follows: TT - 14 %, TC - 60 %, CC - 26 %, which corresponded to the distribution in the control group - 16 %, 54 % and 30 %, respectively, and did not deviate from the Hardy-Weinberg equilibrium. Smoking, type 2 diabetes mellitus (DM2) and obesity increased the relative risk of EAH in the examined population 2.5 times [OR=2.81; p=0.049], 3.75 times [OR=4.68; p=0.005] and almost twofold [OR=2.90; p=0.004], respectively. The probability of EAH increases fourfold with the angiotensin II elevation in the serum. Genotypes and alleles of the AGT (704T>C) gene were not significant risk factors for EAH and DM2 in the studied population. However, the TC-genotype (lesser T-allele) increases the risk of obesity in EAH patients more than 1.5 times [OR=2.93; p=0.03]. In addition, the T-allele increases the risk for blood pressure (BP) to elevate up to grade 2-3 [OR=3.64; p < 0.001].

CONCLUSIONS

One-way ANOVA analysis confirmed the AGT (704T>C) gene polymorphism to be associated with systolic and diastolic BP elevation (F=7.80; p < 0.001 and F=4.90; p=0.01, respectively), especially in TT-genotype carriers (p < 0.05), and with body mass index increase, albeit only in women (F=13.94; p < 0.001) (Tab. 4, Fig. 3, Ref. 26). Text in PDF www.elis.sk Keywords: angiotensinogen gene (AGT 704T>C), diabetes mellitus type 2, arterial hypertension, obesity, risk.

Association of the blood serum cytokines' rate and lymphocytes' apoptosis with polymorphic variants of the BCL-2 (rs17759659), CTLA-4 (rs231775) and APO-1÷FAS (rs2234767) genes in patients with nodular goiters in autoimmune thyroiditis and thyroid adenoma

The paper analyses results of serum cytokines and lymphocyte apoptosis study in patients with nodular goiter against the background of autoimmune thyroiditis (NGAIT) and thyroid adenoma (TA) based on the cell preparedness to apoptosis (content of lymphocytes carrying apoptosis marker - CD95+-receptor), the number of apoptotic lymphocytes (annexin V+-lymphocytes) and the content of proapoptotic tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β and IL-6, as well as anti-inflammatory IL-4 cytokine in serum, considering the polymorphism of BCL-2 (rs17759659), CTLA-4 (rs231775) and APO-1÷FAS (rs2234767) genes. The results show that under the damaging action of peroxidation products in the thyroid structures, activation of Fas- and caspase-dependent mechanisms of influence on pro- and anti-apoptotic targets, the induced hyperproduction and release of TNF-α from thyroid-stimulated lymphocytes stimulate an additional synthesis of other pro-inflammatory cytokines IL-1β and IL-6, as well as compensatory anti-inflammatory proteins including IL-4. There is a synchronized increase in secretion of the soluble form of TNF-α receptor (sTNFR), which prevents binding the corresponding cytokine to a specific membranous shedding of a number of receptors and separates the apoptotic signals. The above-mentioned changes associate with the polymorphic variants of BCL-2 (rs17759659), CTLA-4 (rs231775) genes and only for some figures, they are almost three times weaker with FAS (rs2234767).

[МОRPHOLOGY OF THE DIABETIC FOOT SYNDROME]

Local morphological changes were studied in dynamics in 215 patients, suffering diabetic foot syndrome. While an adequate local treatment conduction, in accordance to the standards elaborated, the histological investigations data have shown the oedema, the cellular infiltration and microcirculatory disorders reduction in the wound boundary zone. In 1 week of treatment in biopsies a young granulating tissue was observed, consisting of big quantity of vascular loops, oriented perpendicularly towards the wound surface and multiple bundles of fibroblasts. In a period of 2 weeks an active multilayered wound defect epithelization was seen. The stratum creeps, right from the skin secured, covering the wound surface.

[SYNDROMAL APPROACH IN ULTRASONOGRAPHIC DIAGNOSIS OF THORACIC TRAUMA]

Diagnosis of the thoracic organs injuries constitute an actual problem of modern medicine. Results of examination of 96 injured persons, suffering thoracic cavity organs trauma, were analyzed. Ultrasonographic investigation conduction in complex with radiological methods, basing on syndromal diagnostic approach, have permitted to enhance diagnostic informativity significantly, to obtain objective data about character of the injury, and to establish adequate tactics of treatment for the injured persons, basing on analysis of the results achieved.

[INJECTING MATERIAL FOR SKIN REGENERATION LACERTA APPLICATION IN TREATMENT OF TROPHIC ULCERS IN PATIENTS WITH DIABETIC FOOT SYNDROME]

Examined 22 patients with diabetes mellitus (DM) type II of neuropathic form of diabetic foot syndrome (DFS). In 12 patients (comparison group) local povidone-iodine was used main in 10 (study group), except povidone-iodine, in the phase of exudation used tyrothricin in gel form, the granulation and epithelization phase, after cleaning the wounds, were injected intradermally 1 ml of injecting material for skin regeneration Lacerta. Trophic defects in 9 (90%) patients of the main group during the observation period healed completely, in the comparison group complete healing of the ulcer reached in 2 (16.7%) patients, the rest-wounds, although purified, however, were lethargic granulation, epithelization occurred very slowly. Consequently, the use of the proposed method allows to achieve more rapid healing of trophic ulcers that do not heal continued in patients of neuropathic forms of DFS.

[THE SYSTEMIC IMMUNITY CELLULAR LINK REACTION IN PATIENTS WITH TRAUMATIC ILLNESS]

The effect of trauma on parameters of cellular immunity changes is studied. The study includes 52 patients with various forms of traumatic illness, aged 18-69 years (37.91-4.28). The control group consisted of 16 patients who underwent routine surgery not related to the pathology of musculoskeletal system. All patients of the main group were divided into 3 groups according to severity of the condition. Analysis of parameters of cellular link of immune system was performed by defining subpopulations of T-lymphocytes in indirect immunofluorescence method using a panel of monoclonal antibodies for CD3, CD4, CD8, CD22 lymphocytes' receptors and calculation of integrated indicators. The highest expression (immune disorders of II-III grades) of changes of cellular immunity observed in patients with severe traumatic: illness (expand clinical picture). Surgical intervention, even without traumatic injury significantly impact cellular immunity, but in patients with traumatic illness immunity violation were significantly higher than in comparison groups patients except immunoregulatory index.

Surgical treatment of chronic colostasis in children: a ten-year experience

OBJECTIVE

To analyze our ten year experience of surgical treatment of children with chronic colonostasis of different origin.

MATERIAL AND METHODS

The study covers 353 children aged from 1 day to 17 years with colonic stasis who undergo treatment at the Department of Children's Surgery, Bukovinian State Medical University, Cernăuţi, Ukraine. Study design included case history, physical examination, routine clinical and biochemical laboratory tests, endoscopy (sigmoidoscopy, colonoscopy), X-ray (irrigoscopy, irrigography, other radiopaque techniques) methods, and sphincterometry.

RESULTS

Non-surgical treatment was effective in 261 (73.94%) patients. The group of the operated patients consisted of 92 (26.06%) children. The outcome of surgical treatment of Hirschsprung's disease (49 children), dolichosigmoid (29 children), Payr's disease (12 children), and Chilaiditi syndrome in all cases is considered to be satisfactory. The optimal methods of surgical operations are offered according to pathology of colon.

CONCLUSIONS

One-step Soave-Boley operation is considered to be the method of choice for rectal and rectosigmoid forms of Hirschprung's disease. Transversal colon resection and phrenico-colic ligament dissection in Payr's disease, hepatopexia and right colon fixation in Chilaiditi syndrome are effective treatment approaches.

[Mathematical analysis of complicated course of acute surgical diseases of abdominal cavity organs]

In this paper we analyze the results of diagnosis and treatment of 130 patients with acute surgical diseases of the abdominal cavity, complicated by peritonitis. We proposed the method of estimating the severity of the patients using a coefficient of status severity (C(SS)), developed a scale for prediction of complicated outcomes of acute surgical pathology of the abdominal cavity and abdominal sepsis, which is adapted to the working conditions of local clinics. Using the C(SS) and the scale prediction, allowed timely identification of patients' risk group with possible complicated course, assign adequate treatment, reduce postoperative complications by 5%, relaparotomies by 4.4%, decrease postoperative mortality by 3.9%.

[Endoscopic treatment of hemorrhages in patients with ulcerative lesions of the gut]

The issues of endoscopic treatment of gastroduodenal hemorrhage, including that, occurring in the injured persons with polytrauma, were analyzed. There was shown, that endoscopic hemostasis must be considered the method of choice in diagnosis and treatment of an acute hemorrhage of the erosive-ulcer genesis. The efficacy of endoscopic hemostasis significantly depends on its timely performance, the surgeon training and experience, an adequate choice of the method in a special clinical situation.

The present role of staphylococci in development of surgical hospital infection

At present the problem of staphylococcal infection appears to be highly important. The research aim was to establish the role and significance of Staphylococci, particularly methicillin resistant in development of complications in modern surgery, sources and ways of Staphylococci appearance and spread in today surgical departments. Particularly seasonal chronorythms of microflora carriage by the medical personnel and students was studied. Most of the strains were resistant to traditional antibacterial remedies. Since the begin of the half-century antibiotic era Staphylococci are still a problem in Surgery. Adequate microbiologic monitoring of stuff and students is recommended to prevent a lot of complications.