Vol 8, No 2 (2014)

Study objective: to study the adipokines content and echocardiography indicators of women with hypothyroidism.

Materials and methods. 30 women with hypothyroidism were included into the study with the average age of 55.2 ± 2.2 years old and the duration of disease of 8.53 ± 0.84 years. Anthropometric parameters of all patients were measured. Levels of leptin, resistin, adiponectin were investigated with enzyme multiplied immunoassay. Morphometric parameters of the left ventricle (LV) were assessed with echocardiography.

Results. The examined patients with hypothyroidism displayed increased concentration of leptin and resistin, as well as decreased concentration of adiponectin. Concentric and eccentric hypertrophy of the left ventricle is revealed in more than half of cases with patients with the hypofunction of the thyroid gland.

Conclusion. Evident decreasing of the level of adiponektin and increasing of the level of leptin and resistin was revealed with examined patients on the background of the excessive body weight. Hypertrophy of the left ventricle and diastolic dysfunction of the myocard with its relatively preserved contractile ability was revealed with women that suffer from hypothyroidism. Age, excessive body weight, increasing of arterial blood pressure, and hypoadiponectinemia play a significant role in the left ventricle myocardial remodeling.

Objective: to study the activity of proapoptotic signal protein caspase-3 for determination of peculiarities of apoptosis regulation under liver chronic diseases.

Subjects and methods. The immunohistochemical analysis of caspase-3 activity in 5 liver biopsies of the patients with mono infection of chronic hepatitis B and 5 liver biopsies of the patients with mixed infection of tuberculosis, chronic hepatitis C and human immunodeficiency virus was fulfilled. Morphological and morphometric analysis of serial microphotographs was performed using an image analysis system (microscope Leica DM 2500, digital camera Leica DFC320 R2 and a computer).

Results. The activity of caspase-3 as dark brown granularity was revealed in all tis-sue components of liver (hepatocytes, epithelium of bile ducts, endotheliocytes, Kupffer cells of sinusoids, in compositions of lymphohistiocyte infiltrations). The maximal activity was discovered in hepatocytes nuclei. The expression of caspase-3 was significantly higher in liver biopsies of the patients with mixed infection. It is typical that the immunoreactive hepatocytes had not any morphological marks of apoptosis.

Conclusion. The caspase-3 expression of proapoptotic signal protein caspase-3 may serve as an early marker of liver damage including the possibilities of apoptosis development.

Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC) developing under the "mask" of the ischemic heart disease not diagnosed for a long period.

Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG), echocardiography (EchoCG), Holter ECG monitoring, coronary angiography (CAG), ventriculography.

Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV) hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6), EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg.), CAG (stenotic lesions of coronary arteries were found), ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicates
expressed apical hypertrophy of the LV myocard). AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.

Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

The relationship between renal damage and malignant neoplasms is one of the most actual problems of the medicine of internal diseases. Very often, exactly availability of renal damage determines the forecast of cancer patients. The range of renal pathologies associated with tumors is unusually wide: from the mechanical effect of the tumor or metastases on the kidneys and/or the urinary tract and paraneoplastic manifestations in the form of nephritis or amyloidosis to nephropathies induced with drugs or tumor lysis, etc. Thrombotic complications that develop as a result of exposure to tumor effects, side effects of certain drugs or irradiation also play an important role in the development of the kidney damage. The most frequent variants of renal damage observed in the practice of medical internists (therapists, urologists, surgeons, etc.), as well as methods of diagnosis and treatment approaches are described in the article. Timely and successful prevention and treatment of tumor-associated nephropathies give hope for retaining renal functions, therefore, a higher life standard after completion of anti-tumor therapy. Even a shortterm episode of acute renal damage suffered by a cancer patient must be accompanied with relevant examination and treatment. In the case
of transformation of acute renal damage into the chronic kidney disease, such patients need systematic and weighted renoprotective therapy and correct dosing of nephrotoxic drugs.

The article describes the mechanisms of development of cardiovascular disorders and dyslipidemia with hypothyroidism. Reference data are presented that are devoted to the study of adipokines content with hypothyroidism and their effect on echocardiographic indicators.