No 31 (2014)

ARTICLES

MSCT PERFUSION IN ASSESSMENT OF BRAIN HEMODYNAMICS AND IN ANALYSIS OF SURGICAL TREATMENT RESULTS IN PATIENTS WITH CHRONIC BRAIN ISHEMIA

Basarboliev A.V., Vishnyakova M.V., Vishnyakova M.V., Kazanchyan P.O., Lar’kov R.N., Zagarov S.S.

Abstract

Background: Stenoses of the brachiocephalic arteries (BCA) are ones of the main causes of ischemic defects of cerebral circulation. From the end of the former century to the current time, the surgical cerebral revascularization in steno-occlusive BCA disturbances occupies the topical place in prevention of acute brain circulation defects. Carotid endarterectomy (CEAE) remains till now a basic method of surgical revascularization. As a result of chronic hypoperfusion, autoregulation of the cerebral circulation can be disturbed with a persistent capillary dilatation which enables development of hyperperfusion syndrome after surgical intervention. Aim: A quantitative assessment of the cerebral tissue perfusion disturbances depending on the variants of the brachiocephalic vessels lesions before and after surgical reconstructions as well as revealing possible prerequisites for hyperperfusion syndrome development during preoperative multislice computed tomography (MSCT) perfusion. Materials and methods: The results of examination and treatment of 65 patients (mean age 64.2±5.0 years) with chronic cerebrovascular IV stage insufficiency were analyzed as well as the hemodynamically significant lesion of the inner carotid arteries. CEAE was planned for all patients. All patients underwent cerebral MSCT angiography and MSCT perfusion in preoperative and early postoperative periods. Results: The majority of patients in preoperative period showed decrease of perfusion parameters at the side of the most expressed defects. The mean circulation deficiency varied from 12 to 15%. Improvement of circulation at the side of surgical intervention formed, on the average, about 12%. The best outcome was noted in patients with bilateral stenoses of the inner carotid arteries (ICA). In one case, in critical unilateral ICA stenosis in preoperative period, MSCT perfusion demonstrated persisting dilatation of the small cerebral arteries of the disturbed hemisphere which led to autoregulation defects of these arteries with a high risk of hyperperfusion syndrome development. On the second day of the postoperative period, the said hyperperfusion syndrome developed but was successfully arrested using hypotensive therapy. Conclusion: CEAE provides circulation improvement in patients with ischemic stroke. MSCT perfusion favors circulation improvement in ischemic stroke patients. MSCT perfusion allows revealing patients with high risk of hyperperfusion syndrome development in postoperative period.

Almanac of Clinical Medicine. 2014;1(31):3-6
pages 3-6 views

DEVELOPMENT OF NON-INVASIVE METHOD FOR BLOOD MICROCIRCULATION DISORDERS DIAGNOSTICS IN DIABETIC PATIENTS USING LASER DOPPLER FLOWMETRY

Glazkov A.A., Kulikov D.A., Dreval’ A.V., Kovaleva Y.A., Shumskii V.I., Rogatkin D.A.

Abstract

Background: Pathogenesis of diabetes complications is due to systemic microcirculatory disturbances, while there is a deficit in instrumental methods of objective assessment of the microvasculature. Aim: To provide diagnostics of microcirculatory disorders in patients with diabetes mellitus (DM) using laser Doppler flowmetry. Materials and methods: The study included 11 patients with decompensated type 1 and type 2 DM (HbA1c level – 9.1±2.2%), the duration of the disease being more than 5 years. The control group consisted of 11 healthy volunteers. Blood microcirculation in skin was measured using LAKK-02 system. We examined the condition of blood microcirculation during the functional testing (occlusion, heat, cold, orthostatic) in different combinations and durations of action. For analysis of the quantitative data, the mean values and standard deviations were calculated (M±SD), the differences between the groups were tested using the double-sided Student’s test. Results: The diagnostic tests using a combination of thermal and orthostatic effects were developed. The said diagnostic functional testing and transformation of perfusion units into the relative values of microcirculation (by dividing perfusion index by the average value of microcirculation during the base period) revealed significant differences in microcirculation levels between diabetic patients and the control group: for foot testing, relative microcirculation indices were 3.2±1.9 in the study group and 6.3±4.6 in the control group (p=0.05), for hand testing, the relative indexes were 3.3±1.4 and 5.3±2.8, respectively (p<0.05). Conclusion: The developed method has demonstrated the efficacy of detection of microcirculatory disorders in patients with diabetes. In future, it can be used for the early diagnosis of diabetic vascular complications and as an additional method for monitoring the effectiveness of DM treatment.

Almanac of Clinical Medicine. 2014;1(31):7-10
pages 7-10 views

INCREASE OF DRUG RESISTANCE OF ACUTE MYELOID LEUKEMIA CELLS IN MULTICELLULAR AGGREGATES IN VITRO

Zakharov S.G., Golenkov A.K., Mitina T.A., Lutskaya T.D., Belousov K.A., Fadeev R.S., Solovieva M.E., Senotov A.S., Akatov V.S.

Abstract

Background: Therapeutic efficiency in treatment of acute myeloid leukemia (AML) ranges from 20 to 45%. One of the causes of the latter is a drug resistance acquired by leukemic cells under the influence of treatment with antitumor medicines. More important cause is a development of the primary resistance of myeloid leukemic cells to induction of cellular death associated with elemental microenvironment within the bone marrow. Studying primary resistance is very important, and first of all, to prevent development of drug resistance of leukemic cells and, correspondingly, to increase the efficiency of medicamental therapy. Aim: To study the mechanisms of primary resistance of AML cells to induction of cellular death. Materials and methods: Human AML cells of THP-1 line and mononuclear cells of the bone marrow were used in the study of patients with diagnosed AML. Multicellular aggregates were formed during cell cultivating on the 1.5% agarose. To cut off intercellular adhesion, the cells were cultivated in the medium with methylcellulose (0.9%). The viability of the cells was assessed by reduction of Alamar Blue indicator. Results: Within multicellular aggregates, about 75±5% of THP-1 cells were resistant to the activity of recombinant protein izTRAIL, 70±5% – to etoposide, and 40±7% – to sorafenib. Cutting off intercellular contacts decreased the resistance to them. Within multicellular aggregates of primary mononuclear cells, 45±5% of cells were resistant to sorafenib, 57±4% – to etoposide, and all cells were resistant to izTRAIL. Cutting off intracellular adhesion reduced the resistance to sorafenib and etoposide but not to izTRAIL. Conclusion: In multicellular aggregates, AML cells of THP-1 line and mononuclear cells of the bone marrow showed increased resistance to activity of recombinant protein izTRAIL, etoposide, and sorafenib. Diminishing intracellular adhesion in the medium including methylcellulose decreases cellular resistance to cytotoxic agents.

Almanac of Clinical Medicine. 2014;1(31):11-16
pages 11-16 views

FORMATION OF LONG-LIVED REACTIVE SPECIES OF BLOOD SERUM PROTEINS BY THE ACTION OF HEAT

Ivanov V.E., Karp O.E., Popova N.R., Chernikov A.V., Gudkov S.V., Bruskov V.I.

Abstract

Background: Proteins oxidized by the action of X-rays represent long-lived reactive species, which trigger the secondary generation of reactive oxygen species (ROS). A change in the hydrogen peroxide (H2O2) content induced by various physical impacts may be an important factor of the therapeutic effect and the adaptation of the organism to unfavorable environmental conditions. Moderate hyperthermia and a number of physiotherapeutic procedures leading to a local warming of tissues are widely used in medical practice. However, the biological mechanisms of their curative effect are poorly understood. The prolonged generation of H2O2 long-lived reactive protein species (LRPS) after heating may be one of the mechanisms of activation of protective cellular mechanisms and thus to contribute to overcoming the disease. Aim: To investigate if the serum proteins bovine serum albumin (BSA) and bovine gamma-globulin (BGG) can form LRPS under moderate hyperthermia and show that heat induces LRPS, which in turn continuously generate ROS, in particular H2O2. Materials and methods: LRPS were studied by measuring the heat-induced chemiluminescence of protein solutions using a specially elaborated highly sensitive photon-counting chemiluminometer Biotoks-7 AM. The Results: Here we studied the possibility of formation of long-lived species of the blood serum proteins BSA and BGG in air-saturated solutions under the action of heat. It is shown that heat induces the generation of long-lived protein species, which in turn generate ROS (1O2, О2-•, OH•, H2O2). The formation of the long-lived reactive species of BSA and BGG with a half-life of about 4 h induced by moderate hyperthermia was revealed using the chemiluminescence of protein solutions. It was found that long-lived reactive species of BSA and BGG cause prolonged generation of H2O2. Conclusion: Thus, we found a new fundamental property of serum proteins: by the action of moderate heating, they are able to transform into LRPS that produce H2O2 over a long period of time. Therefore, it cannot be excluded that the heat treatment during physiotherapeutic procedures in clinical practice is accompanied by local heating and the formation of LRPS. H2O2 generated by these species may participate in signaling pathways and induce adaptive response in humans.

Almanac of Clinical Medicine. 2014;1(31):17-20
pages 17-20 views

EXPERIMENTAL MODEL OF THE PRIMARY MALE HYPOGONADISM

Kulikova P.A., Filyushkin Y.N., Kulikov D.A., Fedulov A.V., Mashkov A.E., Kulikov A.V.

Abstract

Background: Development of the new methods of treatment of primary male hypogonadism is an urgent medical problem. Its solution requires a suitable experimental model of the disease. Aim: The creation of new experimental model of primary male hypogonadism. Materials and methods: The study was conducted on the male Wistar rats, hypogonadism was modeled by temporary ligation of the distal part of the spermatic cord. Results: It was shown that three-day ligation of the spermatic cord led to persistent disturbance of the testosterone-producing and reproductive functions. These manifestations were reversible at shorter duration of the exposure. Conclusion: The created model of primary male hypogonadism is characterized by the persistent testosterone-producing and reproductive functions disturbance, technical availability, non-toxicity to the other organs and systems. Availability of the model provides new opportunities for the development of approaches to treating diseases of the reproductive organs in men.

Almanac of Clinical Medicine. 2014;1(31):21-24
pages 21-24 views

PREMATURE AGING MARKERS IN WOMEN OF REPRODUCTIVE AGE WITH HYPOPITUITARISM

Mikhaylova D.S., Ilovayskaya I.A.

Abstract

Background: Premature aging reduces quality of human life, leads to development of “old age diseases” in younger age, and also shortens life expectancy. Aim: Investigation of premature aging markers in women of reproductive age with central untreated hypogonadism in association with other compensated pituitary deficiencies. Materials and methods: Hormonal and biochemical parameters, body mass index (BMI) and body mineral density (BMD) were investigated in 87 women of reproductive age (median – 24 y.o.) with the central untreated hypogonadism in association with other compensated pituitary deficiencies (hypopituitarism) and in 52 healthy age-matched controls. Results: Low levels of estrogens as well as androgens (total and free testosterone, DHEA-S) were found in women with hypopituitarism as compared to the controls. Such markers of premature aging as increased BMI (р=0,025), high levels of cholesterol (р<0,001) and triglycerides (р><0,001), ionized calcium (р><0,001), alkaline phosphatase (p=0,006), and CTx (p=0,025) were revealed; low BMD was found in 87% of patients with hypopituitarism (mainly ><-2.5 SD in lumbar vertebra). Correlation analysis elucidated that hypoandrogenemia as well as hypoestrogenemia was pathogenetic basis of premature aging in women with hypopituitarism and untreated hypogonadism. Conclusion: Such markers of premature aging as BMI increase, dislipidemia, increased levels of bone metabolism markers, and low BMD were revealed in women of reproductive age with uncured hypogonadism and other compensated types of hypophysial insufficiency. Treatment of hypogonadism in this cohort of patients needs to be considered a prevention of the premature aging.

Almanac of Clinical Medicine. 2014;1(31):25-28
pages 25-28 views

BACKGROUND CHANGES OF THE DIGESTIVE SYSTEM MUCOSA IN PATIENTS WITH ACROMEGALY

Titaeva A.A., Tereshchenko S.G., Lukina E.M., Dreval’ A.V., Ilovaiskaya I.A.

Abstract

Background: Gastrointestinal tract lesions due to the growth hormone impact on mucosa of both the stomach and colon contribute to the complications of acromegaly. In this case, there is a deficiency of the objective assessment data concerning the gastrointestinal tract condition in the acromegaly patients. Aim: To reveal the character of changes in the mucosa of both stomach and colon in the acromegaly patients. Materials and methods: The study is based on the results of analysis of 107 in-patients (32 men and 75 women) with suspected acromegaly who were observed during the period of 2006 to 2012 in the MONIKI Department of Therapeutic Endocrinology. Diagnosis of acromegaly was confirmed. Distribution of patients by gender showed that women suffer from acromegaly in the majority of cases. The ratio men/women equal to 1:2.2 correlates with the literature data. All acromegaly patients underwent the fibroesophago-gastroduodenoscopy, morphological investigation of the stomach mucosa, cytological analysis in search for Helicobacter pylori as well as fibrocolonoscopy plus biopsy in case of the pathological neoplasm identification. Results: Comparative study of changes in the gastrointestinal tract mucosa demonstrated that endoscopic investigation more often showed pathological changes in the upper areas of the digestion tract. It may be explained by the Helicobacter pylori contamination or a side effect of somatostatin analogues in the given group of patients which impairs the stomach epithelium vital activity and enables development of neoplasms in the acromegaly patients. Analysis of the morphofunctional alterations of the stomach-and-colon mucosa in the acromegaly patients revealed concomitant diseases in these patients which were as follows: foveolar hyperplasia of the tegumental-foveolar epithelium, hyperplastic polyps, and tubular adenomas which are an indication for obligatory morphologic investigation of the stomach-and-colon mucosa in this group of patients. Our study proved a high degree of the stomach mucosa contamination with Helicobacter pylori in the acromegaly patients: in 81% of our patients. Conclusion: Our results showed that endoscopy with obligatory targeted biopsy and a search for Helicobacter pylori are extremely necessary for this group of patients. The results obtained are indicative of the necessity of annual gastroenterological examination of patients suffering from acromegaly.

Almanac of Clinical Medicine. 2014;1(31):29-33
pages 29-33 views

VALIDATION OF THE MECG-DP-NS-01 MONITOR IN OSCILLOMETRY AND AUSCULTATION MODES, ACCORDING TO ESH, BHS AND AAMI PROTOCOLS

Fedorova S.I., Kulakov N.V., Kulakova E.V.

Abstract

Background: Ambulatory blood pressure monitoring is one of the main methods for hypertension diagnosis. According to the recommendations of the Russian Medical Society of Hypertension and the All-Russian Society of Cardiology, only devices that passed all of the international protocols requirements can be recommended for ambulatory blood pressure monitoring. Aim: Validation of the MECG-DP-NS-01 upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd., in oscillometry and auscultation modes, for ambulatory blood pressure monitoring, in an adult population at rest according to the ESH International Protocol revision 2010 (ESH-IP2), the BHS protocol revision 1993 and the AAMI standard. Materials and methods: A group of 85 people (50 men and 35 female) aged 19 to 86 years (mean age 47.7±18.0 years) was recruited for the validation study. Expert and device blood pressure measurements were taken for each patient according to the international protocols. Results: The MECG-DP-NS-01 upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd. for ambulatory blood pressure monitoring, was validated in oscillometry and auscultation modes in an adult population at rest according to the BHS protocol revision 1993, the ESH-IP2, and the AAMI standard. The device achieved an A/A grading for the BHS protocol revision 1993 both in the oscillometry and auscultation modes. The device maintained its A/A grading throughout the low-pressure, medium-pressure, and high-pressure ranges. Conclusion: The MECG-DP-NS-01 passed all of the requirements and, fulfilling the standards of the protocols, is recommended for ambulatory blood pressure monitoring according to BHS protocol revision 1993, ESH-IP2, and AAMI standard. According to the Declaration of Blood Pressure Measuring Device Equivalence signed by the manufacturer there are no differences that will affect blood pressure measuring accuracy between the MDP-NS-02s (Voshod) upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd. and the MECG-DP-NS-01, which passed the ESH-IP2, BHS and AAMI protocols.

Almanac of Clinical Medicine. 2014;1(31):34-39
pages 34-39 views

CLINICAL SIGNIFICANCE OF EXTRACORPOREAL PHOTOCHEMOTHERAPY IN COMPLEX TREATMENT OF LOCALIZED SCLERODERMA

Fomina O.A., Molochkov A.V., Kil’dyushevsky A.V.

Abstract

Background: Scleroderma is an autoimmune disease with progressing lesions of connective tissue where fibrosclerotic and vascular disturbances prevail. Lacking of the united concept of its pathogenesis significantly hampers elaboration of pathogenetic methods of treatment. Conventional methods of treatment of localized scleroderma have insufficient clinical effectiveness, lead to remission of short duration, have a series of side effects and complications. Aim: To raise the efficiency of the focal scleroderma treatment with a complex therapy including a method of extracorporeal photochemotherapy (EPCT). Materials and methods: A total of 19 patients with plaque or linear types of localized scleroderma underwent complex treatment including EPCT. All patients had a steadfast progressing course of the disease with generalized lesions, the signs of early systemic scleroderma being revealed in 3 of them. EPCT-method is based on the photo-sensitizing effect of 8-methoxypsoralene and ultraviolet А radiation of mononuclear cells which were separated using cytopheresis further followed with reinfusion. Every course included 4 exposures implemented every other day. Repeated therapeutic course was set in 3 months. Results: All patients satisfactorily tolerated EPCT procedure without side effects and complications. After 3 therapeutic courses, the disease progression was arrested in all patients, the density of scleroderma foci was diminished, approximately, by 50% as compared to the initial level. The crown of the peripheral growth completely disappeared, and the sizes of the disease foci decreased. The more pronounced clinical effect was achieved in patients with disease duration not exceeding 3 years. Conclusion: The proposed method was efficient in treatment of localized scleroderma and might be applied as an adjuvant therapy.
Almanac of Clinical Medicine. 2014;1(31):40-46
pages 40-46 views

EXPRESSION OF GENES RESPONSIBLE FOR MULTIDRUG RESISTANCE IN RELAPSED/REFRACTORY MULTIPLE MYELOMA PATIENTS

Chernykh Y.B., Shushanov S.S.

Abstract

Background: Multidrug resistance (MDR) is a natural phenomenon in development of solid and hematologic tumors. This phenomenon significantly influences both immediate and remote outcome of treatment. In this connection, an interest arises to studying this problem in multiple myeloma (MM) patients with expressed clinical signs of tumorous progression, the main of them being an absence or loss of the response to antitumor treatment. Aim: To study the expression of messenger RNA (mRNA) of a series of MDR genes, namely MDR1, MRP1, LRP, BCRP responsible for MDR development in the bone marrow aspirate of resistant patients prior to bortezomib-containing chemotherapy. Materials and methods: Study group included 19 relapsed/refractory multiple myeloma patients. Investigation of MDR genes expression was carried out on the cells of the bone marrow mononuclear fraction containing plasmocytes. The mRNA level was analyzed by semiquantitative RT-PCR (polymerase chain reaction with reverse transcription). Patients were treated with bortezomib-containing chemotherapy hereafter. Results: mRNA expression of genes MDR1, MRP1, BCRP was revealed in all (100%) patients, and that of gene LRP – in 81% of myeloma samples. The levels of MDR genes mRNA expression were different. On this basis, two groups of patients were identified: with the levels of MDR genes expression above and beyond the average. Conclusion: 100%-expression of MDR genes (MDR1, MRP1, BCRP) mRNA was revealed in drug resistant MM patients. The median survival in group of patients with higher levels of MDR genes mRNA expression versus lower levels of MDR genes mRNA expression was statistically significant.
Almanac of Clinical Medicine. 2014;1(31):47-51
pages 47-51 views

THE SUBEPITHELIAL PIGMENT SPOTS OF TRACHEOBRONCHIAL TREE: DETECTION RATE AND ETIOLOGY ACCORDING TO BRONCHOSCOPY FINDINGS

Shteiner M.L.

Abstract

Background: The etiology of tracheobronchial tree subepithelial pigment spots, detected by endoscopic examination, has not been yet finally established. Some authors attribute them to an active tuberculous process or its outcome; other researchers suggest their association with the professional pathology. Aim: To study the detection rate and etiology of tracheobronchial tree subepithelial pigmented spots within the unspecialized bronchoscopic examination. Materials and methods: A total of 3404 primary therapeutic and diagnostic bronchoscopic data were analyzed. The examinations were conducted using bronchoscopes ВF-1T60 and MAF-TM (Olympus, Japan). Endobronchial photos were performed using a bronchoscope MAF-TM. Results: During the study, the subepithelial pigment spots were detected in 20 (0.59%) cases. In none of these cases, an active tuberculous process or professional pathology was confirmed. Fistulas in projection of subepithelial pigmented spots were found in 3 cases. Conclusions: Detection rate of subepithelial pigmented spots during the non-specialized bronchoscopic procedure is low, less than 1% (0.59% in our study). Clinical, laboratory, instrumental, and anamnestic analyses allowed us to associate the studied pathology with the previous tuberculosis of intrathoracic lymph nodes.

Almanac of Clinical Medicine. 2014;1(31):52-55
pages 52-55 views

REHABILITATION OF PATIENTS WITH APHASIA USING MODIFIED RESTORATION METHODS

Shcherbakova M.M., Kotov S.V.

Abstract

Backgroud: There is a high prevalence of vascular diseases of the brain in adult population. One of the most severe complications of the cerebral vascular diseases is an aphasia leading to patient’s disability. An extremely severe and unreversible condition for further rehabilitation is noted in a group of patients which develops an impressive speech impairment as a dominant disturbance associated with aphasia. Aim: To identify the most effective rehabilitation method for patients with complications of cerebral circulation disturbances manifesting as speech impairment in a form of aphasia. Materials and methods: Theoretical aspect of rehabilitation in post-stroke aphasia patients with a dominant impressive speech impairment was studied. All patients underwent neurologic examination, dynamic logopedic observation, and magnetic resonance imaging. The patients of the chosen group underwent rehabilitation with a modified modality of speech restoration. Results: Introduction of the modified rehabilitation methods into the logopedics practice proved their high efficiency. Significant improvement was seen in 64% of patients with acoustic-amnestic aphasia, in 57% of patients with acoustic-gnostic aphasia, and in 60% of those with semantic aphasia. Conclusion: A key moment for achievement of the high rehabilitation outcome is a complex approach needed for rehabilitation of patients with the consequences of the acute impairments of cerebral circulation.

Almanac of Clinical Medicine. 2014;1(31):56-60
pages 56-60 views

SCIENTIFIC REVIEWS, LECTURES

THE BIOANTIOXIDANTS (PART 1)

Gudkov S.V., Bruskov V.I., Kulikov A.V., Bobylev A.G., Kulikov D.A., Molochkov A.V.

Abstract

Based on the analysis of the latest scientific data, the paper suggests synthetic classification of known bioantioxidants, peculiarities of their structure and functioning. Enzymatic, phenolic antioxidants, and enzyme mimetics are described in this part of the
review.

Almanac of Clinical Medicine. 2014;1(31):61-65
pages 61-65 views

THE BIOANTIOXIDANTS (PART 2)

Gudkov S.V., Bruskov V.I., Kulikov A.V., Sharapov M.G., Kulikov D.A., Molochkov A.V.

Abstract

Based on the analysis of the latest scientific data, the paper suggests a synthetic classification of the known bioantioxidants, peculiarities of their structure and functioning. The second part of the review describes the sulfur-containing compounds, chelators
of the metal ions of variable valency, compounds containing hydroxyl or amino group, and nanoparticles.

Almanac of Clinical Medicine. 2014;1(31):65-69
pages 65-69 views

EFFECT OF OOCYTES QUALITY AND OVARIAN RESERVE ON THE THERAPEUTIC POTENTIAL OF IN VITRO FERTILIZATION IN PATIENTS OF LATE REPRODUCTIVE AGE

Krstic E.V., Krstic M., Yudaev V.N.

Abstract

The paper discusses the interference of the quality of oocytes and ovarian reserve status in the therapeutic potential of in vitro fertilization in women of late reproductive age. It was substantiated that the age factor decreased both female fertility and possibility of the successful fertilization.

Almanac of Clinical Medicine. 2014;1(31):70-75
pages 70-75 views

MAJOR INTERCELLULAR INTERACTIONS AT THE T CELL ACTIVATION IN RENAL TRANSPLANT REJECTION

Vatazin A.V., Zul’karnaev A.B., Fedulkina V.A., Krstic M.

Abstract

Currently, an organ rejection is a leading cause of kidney transplants loss. Effective therapy is impossible without a clear understanding of the rejection mechanisms. In this paper, we summarize the views of domestic and foreign authors on the role of T cell activation in kidney transplant rejection.

Almanac of Clinical Medicine. 2014;1(31):76-82
pages 76-82 views

HISTOCOMPATIBILITY SYSTEM IN RENAL TRANSPLANTATION

Dmitrieva N.G., Jakovchik O.N., Vatazin A.V., Zul’karnaev A.B., Fedulkina V.A.

Abstract

The paper presents a contemporary view on organization of genes in the major histocompatibility complex, their protein products, and nomenclature of human leukocyte antigens.

Almanac of Clinical Medicine. 2014;1(31):83-87
pages 83-87 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies