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Biomedical subjects

V V Kukharchuk

Publications and source records attributed to V V Kukharchuk.

At least 19 recordsLinked to original sources

[Levels of biologically active substances in the blood of patients resistant and nonresistant to antihypertensive therapy].

AIM: To clarify the role of differences in the levels of some biologically active substances (BAS) in plasma of patients with resistance to therapy or without it measured before treatment, during treatment and application of plasmapheresis. MATERIALS AND METHODS: Resistance to therapy was assessed clinically and according to 24-h monitoring in 35 patients aged 35-56 years with essential hypertension (n = 19), related to chronic pyelonephritis (n = 13) and glomerulonephritis (n = 3). Plasma BAS were studied by radio- and enzyme immunoassays. RESULTS: Blood pressure monitoring provided more precise determination of the treatment responders than clinical tests. Initially, responders to therapy had higher level of endothelin-1 and low of hydrocortisone. CONCLUSION: Responders to antihypertensive therapy were distinguished by a significant decrease of plasma aldosterone within a year vs aldosterone levels before the treatment. Nonresponders had no significant decrease of plasma aldosterone. No other marked differences in plasma BAS between the responders and nonresponders to antihypertensive treatment were found.

Adult

[Variability of the hypolipidemic action of simvastatin and fluvastatin in patients with primary hyperlipoproteinemia].

AIM: To reveal the metabolic parameters of lipoproteins (L), which determine the benefits of hypolipidemic effects of simvastatin (S) and fluvastatin (F); to trace changes in the activity of lecithin-cholesterol acyltransferase (LCA) and cholesterol (C) ester transfer (CET) from high density lipoproteins to very low density lipoproteins (VLDL) and low density lipoproteins (LDL) and the levels of apoE in the blood and in some L classes during therapy with the above drugs. MATERIALS AND METHODS: Thirty six patients took S, 10 mg/day, and 25 received F, 20 mg/day, for 3 months. The levels of lipids were measured by enzyme assays, apoprotein (apo) was determined by immunoturbidimetry and immunodiffusion. RESULTS: The hypocholesterolemic and hypotriglyceridemic effect of S (19.6 and 25.5, respectively) and F (19.0 and 30.5%) were similar. With S, the reduction in the blood levels of C and LDL C positively correlated with the baseline apoE levels. With F, it did with C and LDL C before treatment. Lower blood apoE was found with S and F and lower HDL apoE/(VLDL + LDL) ratio was detected only with F. F treatment significantly lowered the activity of CET and LCA; before and after S treatment, they did not differ significantly. CONCLUSION: Analyzing the relationship between the benefits of the hypolipidemic effect and the baseline parameters of L metabolism indicates that the changes in serum C, LDL C and HDL C are due to the composition of HDL particles and the distribution of apoE among different L classes in the patient to a greater degree.

Adult

[Clinical and biochemical features of atherosclerosis main risk factors in children of probands with primary hyperlipidemia].

AIM: Study of the incidence of hyperlipidemias and coronary atherosclerosis risk factors. MATERIALS AND METHODS: A clinical and biochemical study of 35 children (25 men and 10 women aged 6 to 27 years) from 30 families of probands with primary hyperlipoproteinemias (HLP) was carried out. Use of modified risk factors (RF) in the examined group permitted the detection of hypodynamia in 25 subjects, obesity in 4, alcohol abuse and tobacco smoking in 1, and disorders of lipid metabolism in 31 (88%) cases. RESULTS: Hypercholesterolemia was detected in 26 examinees, combined HLP in 1, hypoalphacholesterolemia in 3, and type V hyperlipoproteinemia in 1 case. The level of lipoprotein (a) was increased and positively correlated with xanthomatosis and the age of examinees. The level of basal immunoreactive insulin was within the normal range of values. Analysis of the relationship of this parameter and other coronary atherosclerosis RF revealed a correlation of the level of immunoreactive insulin and content of blood low-density lipoprotein cholesterol. In only 2 of the 30 examined families of probands with primary HLP there were no disorders of lipid metabolism and other modified RF. CONCLUSION: Children, adolescents, and young people from families with primary HLP represent a risk group; they are to be regularly examined in order to prevent coronary disease and atherosclerosis and to detect and treat it in time.

Adolescent

[Extracorporeal circulation methods in the treatment of nonspecific aortic arteritis].

AIM: Development of a protocol of multiple-modality treatment of patients with nonspecific aortoarteritis (NAA) making use of plasmapheresis and specific plasma adsorption of proteinases. MATERIALS AND METHODS: Six patients with NAA aged 15 to 58 years were examined using ultrasonic dopplerography, magnetic imaging, and angiography of the large vessels. Red cell sedimentation rate was assessed, cathepsin G activity, antitryptic activity, and content of C-reactive protein in the blood measured. Drug therapy was supplemented by repeated sessions of plasmapheresis and specific plasma adsorption on immotin. RESULTS: After sessions of plasmapheresis (n = 17) and plasma adsorption (n = 13), increased cathepsin G activity dropped by at least 30% (in 3 patients it normalized), the content of C-reactive protein decreased in the presence of normal antitryptic activity (in patients with decreased activity it normalized and in those with increased values a tendency to normalization was observed). Red cell sedimentation rate decreased, particularly so 1 and 2 months after treatment; the patients felt better. CONCLUSION: Multiple-modality treatment of NAA patients making use of plasmapheresis and plasma adsorption decreases the activity of the inflammatory process.

Adolescent

[Biochemical diagnosis of hereditary hyperlipoproteinemias].

AIM: To specify characteristics of lipoproteins (LPs) metabolism in patients with diverse forms of hereditary hyperlipoproteinemia (HLP) and determine biochemical tests for their differential diagnosis. MATERIALS AND METHODS: According to the criteria of polygenic hypercholesterolemia (PHCE), family combined hyperlipidemia (FCHL), family hypertriglyceridemia (FHTG) and family hypercholesterolemia (FHCE), 157 patients were selected aged 7 to 70 years of 192 examinees (76 patients with primary HLP and 116 their close relatives). Lipids were measured by enzyme methods, apoproteins (apo)--by immunoturbidimetry and immune diffusion. RESULTS: Compared to healthy subjects, PHCE patients were characterized by higher apoB level and proportion cholesterol (CS)/apoB in very low and low density lipoproteins (VLDL and LDL). In unchanged level of high density lipoprotein (HDL) CS and proportion HDLP CS/apoA1 there were reduced quantities of free HDLP CS, HDLP2 CS and apoA1. In FHCE and FCHL there were also low levels of HDL CS in elevated ones of apoE in (VLDL + LDL). However, in FCHL, contrary to FHCE, the proportion SC (VLDP + LDL)/apoB was as in control group. FHTG patients differed from healthy subjects by diminished HDL parameters: lower HDL CS due to free CS and its esters, apoA1 and proportion HDL Cs/apoA. There were no differences with controls by content of apoB and proportion CS (VLDL + LDL)/apoB, apoE levels in different class lipoproteins. CONCLUSION: Biochemical parameters are proposed which can differentiate various forms of hereditary hyperlipoproteinemia.

Adolescent

[Determination of lipid composition of high density lipoproteins by thin-layer chromatography on silica gel].

Unidimensional chromatography in a thin layer of silica gel with two solvent systems for separation of the lipid extract of high density lipoproteins (HDLP) detected 10 lipid fractions in subjects with normal lipidemia. Four phospholipid fractions were identified: three main (phosphatidylcholine, lysophosphatidylcholine, and sphingomyelin) and one minor, phosphatidylethanolamine. HDLP lipids include free cholesterol and its esters; three glyceride fractions are detected: mono- di, and triglycerides, and free fatty acids. The ratio of individual phospholipid fractions and of free to ester-bound cholesterol in HDLP determined by computer-aided densitometry of chromatograms coincides with the data obtained routinely. Such a method for assessing the HDLP lipid composition is useful in studies of HDLP in patients with disorders of HDLP metabolism and for assessing the changes in HDLP composition during hypolipidemic therapy.

Cholesterol

[A comparison of the hypolipidemic action of probucol at doses of 500 and 1000 mg/day in moderate hyperlipoproteinemia].

AIM: Evaluation of effectiveness of hypolipidemic action of probucol in doses 500 and 1000 mg/day and comparison of probucol blood concentrations on the treatment month 3 and 6. MATERIALS AND METHODS: Probucol (Akrikhin, Russia) was given to 41 patients with primary hypercholesterolemia in a dose 500 mg/day. 3 months later the patients were divided into two groups. Group 1 patients exhibited a > 10% decrease in cholesterol levels and continued to take probucol in the dose 500 mg/day. Group 2 patients were crossed over to higher cholesterol dose--up to 1000 mg/day. Lipids levels were measured by enzyme tests, apoproteins--by immunoturbidimetry and immunodiffusion, probucol concentrations--by high-performance liquid chromatography. RESULTS: After 3 months of treatment, cholesterol lowered by 14.3 and 9.2% in groups 1 and 2, respectively. After 6 months, by 19.7 and 12.9%, respectively. Probucol concentrations in blood were higher after 6 months of treatment than after 3 months in both groups. No significant differences existed between the groups by probucol concentrations in 3 and 6 months. CONCLUSION: Hypolipidemic effect of probucol depended on the individual features of lipoproteins metabolic disorders rather than the drug blood concentration. Larger probucol doses fail to reduce cholesterol further.

Adult

[Lipanor treatment of atherogenic hyperlipoproteinemia].

AIM: The study of the hypolipidemic efficiency, safety and tolerance of ciprofibrate (lipanor) in therapy of atherogenic hyperlipoproteinemia. MATERIALS AND METHODS: The trial included 14 hypertensive postmenopausal females, 14 patients with diabetes mellitus type II, 14 males with coronary heart disease and primary hyperlipoproteinemia (total cholesterol > 6.5 mmol/l, triglycerides < 4.5 mmol/l under low-cholesterol diet). Lipanor was given for 12 weeks in a daily single dose 100 mg in the morning. Lipids and other biochemical indices were measured in a fasting state after 1 and 3 months of lipanor treatment. RESULTS: After 1 month of lipanor treatment there was a 22-30%, 24-49% decrease in the level of low-density lipoprotein cholesterol, triglycerides, respectively. High-density lipoprotein cholesterol increased by 16%. The hypolipidemic effect of lipanor persisted for 3 months during which triglycerides continued to fall (up to 38.5%). Lipanor was well tolerated, only one patient with diabetes mellitus had hyperactivity of creatine phosphokinase manifesting with clinical symptoms (the drug was discontinued). 3 patients developed mild side effects. Alkaline phosphatase activity inhibited in all the groups by 25-41%. CONCLUSION: Lipanor is a highly effective, safe hypolipidemic drug with good tolerance. It can be recommended for correction of atherogenic hyperlipoproteinemia in patients at high risk of atherosclerosis progression.

Cholesterol

Effect of lipid peroxidation products and antioxidants on the formation of probucol radical in low density lipoproteins.

Effects of antioxidants and products of lipid peroxidation on hemin-induced formation of probucol radical in low density lipoproteins (LDL) from human plasma were studied by EPR-spectroscopy. Suppression of lipid peroxidation in LDL by probucol and other antioxidants (ascorbate, 6-O-palmitoylascorbate, and ubiquinol-10) prevents the formation of probucol radical. However, ubiquinol-10 stimulates the formation of probucol radical during advanced stages of LDL oxidation. Because the concentration of probucol radical depends on lipid hydroperoxide contents in LDL, the interaction of lipid hydroperoxides with hemin can result in the formation of probucol-oxidizing radical intermediates and ubiquinol-10 is a mediator of this process.

Anticholesteremic Agents

[A trial of long-term lovastatin treatment in patients with a heterozygous form of hereditary hypercholesterolemia].

Patients with heterozygous family hypercholesterolemia (HFH) were divided into two groups. Group 1 patients received lovastatin in a daily dose 40-60-80 mg under control of lipids and peripheral blood biochemistry. In 17 patients lovastatin was given as monotherapy, in 15 patients it was combined with plasmapheresis. No hypolipidemic therapy was given to ten patients of group 2. The treatment and follow-up lasted for 4.1 +/- 1.9 years, on the average. A marked hypolipidemic effect was seen in the comorbid therapy. 43% of the patients became resistant to lovastatin, the resistance developed more frequently in monotherapy. The blood fibrinogen fell by 40%, spontaneous and induced platelet aggregation returned to normal, being somewhat higher in subjects resistant to lovastatin therapy. The study shows that hypolipidemic therapy has reduced the risk of IHD fatal complications and progression of non-coronary atherosclerosis in patients of group 1.

Adult

[The effect of long-term Enduracin monotherapy on the clinical and biochemical status of patients with ischemic heart disease].

13 patients aged 39 to 60 years with coronary atherosclerosis confirmed at selective coronary angiography combined with primary hyperlipidemia (phenotypes 2a and 2b) received enduracin in a dose 1500 mg/day. As a result of the treatment total cholesterol (TC) and LDL cholesterol lowered by 10.3 and 13.1%, respectively, whereas HDL cholesterol rose by 15.2%. Half of the patients demonstrated activation of hepatic transaminases, but discontinuation of the drug was not necessary. In 3 out of 4 patients after 2 years of enduracin treatment stabilization of atherosclerosis was observed. Thus, long-term enduracin is able to inhibit progression of atherosclerosis in coronary heart disease patients.

Adult

[Apolipoprotein E and activity of cholesterol esters transport in type IIA and IIB hyperlipoproteinemia].

The authors studied the activity of cholesterol esters transport (CET), concentrations of apolipoprotein E in the blood and high density lipoproteins (HDLP) in parallel with other parameters of lipoprotein metabolism in 79 males and 62 females. 122 of them had ischemic heart disease (IHD) and primary hyperlipoproteinemia (HLP). 19 healthy controls were normolipidemic. Activation of CET and relative lowering of apoE content in HDLP with relevant increase in lipoproteins containing apoB were seen only in type IIB HLP. CET activity in controls was related to a significant positive correlation with concentrations of both cholesterol (CS) and CS esters (CSE) in HDLP and HDLP3 and negative correlation with the proportion free CS/CSE in HDLP. Opposite to normolipidemic subjects, in type IIB HLP there was a negative relationship between CET activity and HDLP3 CS level and positive--between free CS/CSE in HDLP but not with concentration of CSE and total CS in HDLP. In type IIA HLP patients no relationships were registered between CET activity and HDLP content of total CS and CSE as well as with HDLP3 CS level. In type IIB HLP a significant correlation was found between level of HDLP CS and CET activity. Concentration of apoE in HDLP correlated with apoB level in the serum but not with quantity of HDLP CS. Patients with type IIA HLP exhibited a significant negative correlation between CET activity and HDLP apoE. These patients had no dependence of CET activity on HDLP CS but had positive correlation between HDLP apoE and HDLP CS in the serum. Thus, defects of reverse CS transport may be induced not only by changes in CET activity but also by apoE distribution among lipoproteins of different classes.

Adult

[Familial hypercholesterolemia: involvement of cerebral major arteries (communication 1)].

Ultrasound dopplerography, MR tomography were performed to assess the brain, major cerebral arteries and audiometry was conducted to study cochleovestibular system in 38 patients aged 16-63 years with heterozygous family hypercholesterolemia. Vascular disorders and defects in the white brain matter (in patients with transitory hypertension) were registered. Complications of cerebral atherosclerosis (brain infarction, perception cochleovestibular alterations) contributed to aggravation of ischemic heart disease. Patients with heterozygous family hypercholesterolemia should be observed and treated by cardiologist, neuropathologist and psychoneurologist to prevent cardiocerebral complications.

Adolescent

[A trial of the use of the hypolipidemic preparation Lipanor (ciprofibrate) in patients with primary hyperlipidemia].

Out of 12 patients with primary hyperlipidemia (HL) included in the study ischemic heart disease was diagnosed in 4 and hypertension stage I-II in 6 patients. HL stage II B, III, IV and V was registered in 7, 2, 2 and 1 patients, respectively. Hypolipidemic therapy included hypolipidemic diet and Lipanor (Sanofi-Chinoin-Winthrop, France) in a dose 100 mg once a day after evening meal. The course lasted 3 months. Blood serum was examined for concentrations of total cholesterol (CS), triglycerides (TG), CS of HDLP, glucose, uric acid, prothrombin, fibrinogen, alanine and asparagine transaminase, alkaline phosphatase, creatinine, total bilirubin. After 1 month of lipanol treatment mean total CS concentration in the serum fell by 21.9% and remained such for 2-3 months of treatment. 1 month after the drug discontinuation mean concentration of total CS was under the initial one by 4.65%. Mean serum concentrations of TG 1 month after treatment decreased by 41.7%, after 2 months by 48.8%. Mean concentration of HDLP CS after 1 month of treatment rose by 19.2% and by 33.1% after one more month. 1 month after Lipanor discontinuation mean HDLP CS concentration exceeded the baseline level by 16%. Fibrinogen and prothrombin index declined. Hypolipidemic effect of Lipanor varied from case to case.

Adolescent