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Aim: To develop highly sensitive sandwich technique for identification of surface hepatitis B virus antigen (HBsAg) in serum and analyse of possible improvement of solid phase for immunoenzyme sandwich technique of HBsAg identification through variation of pH-dependent sorption of monoclonal antibodies on the surface of immune plates., Materials and Methods: Calibration curves for identification of HBsAg in sandwich techniques using 36 possible binary combinations of monoclonal antibodies of our panel (including high affinity antibodies to HBsAg produced by 6 hybridomas) were compared. Immobilization of antibodies on solid phase (by passive sorption) was performed at different pH values (2.8, 7.5, and 9.5)., Results: Analysis of panel of antibodies to HBsAg produced by 6 hybridomas revealed pH-dependent monoclonal antibodies (18C8), which immobilization at low pH values together with detecting antibodies F4F3 allowed to greatly improve sensitivity of the sandwich technique. Minimal credibly detectable concentration of HBsAg in sera of persons infected with hepatitis B virus was 0.013 - 0.017 ng/ml. Validation of sandwich technique was performed on certified panel of serum samples with various concentrations of HBsAg (different serotypes)., Conclusion: Highly sensitive sandwich technique for detection of HBsAg was developed. It was shown that analysis of panel of monoclonal antibodies on pH-dependence could be used as simple methodical approach for optimization of immunoenzyme sandwich techniques for detection of different antigens.

Blood serotonin concentration is thought to regulate behavior and may be implicated in the development of psychopathological symptoms as well. Serotonin transporter regulates the levels of serotonin by the reuptake of this neurotransmitter from the synaptic cleft. In this study we compare the platelet serotonin concentration and constant V(max) value in patients with schizophrenia and healthy controls with different 5-HTTLPR genotypes. The study included 60 patients and 62 controls. Biochemical parameters mentioned above were associated with a 5-HTTLPR genotype. Carriers of the LL genotype had lower serotonin blood concentration and V(max) compared to genotypes containing one or two copies of an S allele both in patients and controls. The results obtained suggest that the genetic variant may contribute to the state of serotoninergic system.

The article presents two methods of formation of the axilla cupola with saved skin from the area of hair growth, and when there are scarry changes. The first method allows exclusion of displacement of the axilla skin into not proper places. The second method gives better engraftment and better outcomes of operation. A method of two-stage treatment was worked out for severe contractures of the shoulder joint in order to avoid a transection of the tendons and muscles and overdistention of the vascular-nervous bundles. During the preoperative period a gradual liberation of the shoulder is to be fulfilled by means of a dosated distraction of the scars, contracted tendons and muscles. The dosated distraction is performed using a specially developed splint with a turnbuckle mechanism. Using the splint the full volume of movements was restored in 73.9% of the patients. In the rest of the cases operative treatment was used, and the distracted scarry tissues can be used as plasty material.

Results of surgical treatment of 479 patients with deep burns of the upper extremities on the area from 0.5 to 60% of body surface with the lesion of shoulder (398), elbow (407), radiocarpal (371) joints and hand (423) area. Early or delayed necrectomy (28.6%) with following skin grafting was performed at hospitalization of patients in early period. At IV-degree burns plastic reconstruction with skin-subcutaneous flaps was used: local (22), combined (16), pedicle flap and Filatov's graft (29), flaps with axial circulation (8) and on microsurgical anastomoses. Active surgical policy resulted in recovery of the function of the shoulder joints in 73.7%, elbow joints--in 75.15%, radiocarpal joints--in 83.4% and of hand in 50.2% cases.

Different versions on pathogenesis of Peirony's disease (PD) and erectile dysfunction in this disease made us to investigate cavernous innervation and hemodynamics in patients with fibroplastic induration of the penis. We have detected characteristic changes of cavernous electric activity and histochemical picture in biopsies of all our patients with PD. Of them, 61% had cavernous hemodynamic disorders. Our findings suggest that early affection of cavernous innervation may trigger PD pathogenesis and erectile dysfunction in this disease.

Twenty patients with psychogenic erectile dysfunction received the drug enerion (Hungary). After a 30-day course of enerion erectile function improved in 16 of the above patients. A mean value of the international index of erectile function (IIEF) increased in them from 17.5 to 24.8 points. Improvement of cavernous arterial blood flow after the treatment was seen in 3 of 6 patients with arterial disorders. As shown by electromyographic examinations, cavernous electric activity normalized in 8 patients. Thus, psychogenic erectile dysfunction can be effectively treated with enerion.

The review is devoted to sources of lipids in enteral and parenteral nutrition. The role of omega-3 and omega polyunsaturated fatty acids in metabolism of some lipid mediators is examined.

The interaction between two different monoclonal antibodies (Mabs) and their corresponding bispecific antibodies (Babs) with immobilized antigens was investigated using an optical biosensor (IAsys). The analyzed panel of affinity-purified antibodies included two parental Mabs (one of which was specific to human IgG (hIgG), and another one to horseradish peroxidase (HRP)), as well as Babs derived thereof (anti-hIgG/HRP). Babs resulting from the fusion of parental hybridomas bear two antigen-binding sites toward two different antigens and thus may interact with immobilized antigen through only one antigen-binding site (monovalently). Using an IAsys biosensor this study shows that the bivalent binding of Mabs predominates over the monovalent binding with immobilized HRP, whereas anti-hIgG parental Mabs were bound monovalently to the immobilized hIgG. The observed equilibrium association constant (K(ass)) values obtained in our last work [1] by solid-phase radioimmunoassay are consistent with those constants obtained by IAsys. The K(ass) of anti-HRP Mabs was about 50 times higher than that of anti-HRP shoulder of Babs. The dissociation rate constant (k(diss)) for anti-HRP shoulder of Babs was 21 times higher than k(diss) for anti-HRP Mabs. The comparison of the kinetic parameters for bivalent anti-HRP Mabs and Babs derived from anti-Mb/HRP and anti-hIgG/HRP, allowed to calculate that 95% of bound anti-HRP Mabs are bivalently linked with immobilized HRP, whereas only 5% of bound anti-HRP Mabs are monovalently linked. In general, the data obtained indicate that Babs bearing an enzyme-binding site may not be efficiently used instead of traditional antibody-enzyme conjugates in the case of binding of bivalent Mabs.

Forty-four patients with erectile dysfunction (ED) aged 21-72 years aged 21-72 years (mean age 61 years) were examined and treated with sildenafil and alprostadil monotherapy or combined therapy. ED was psychogenic in 9(20.5%), arterial in 12(27.2%), vein occlusive in 9(20.5%) and neurogenic in 14(31.8%) patients. Monotherapy was most effective in psychogenic ED (alprostadil--100%, sildenafil--88.9%), least effective in vein occlusive ED (alprostadil--33.3%, sildenafil--22.2%). Alprostadil was more effective in arterial and neurogenic ED (83.3 vs 66.7 and 78.6 vs 57.1%, respectively). Combination of the two drugs produced much high response: 100, 85.7 and 55.5% in arterial, neurogenic and vein occlusive ED, respectively. Thus, combined treatment with sildenafil and alprostadil is a method of choice in the treatment of ED in failure of monotherapy with these drugs or in vein occlusive ED. In the combined treatment dose of the drugs, number of side effects and cost of therapy are lower.

Aim: To try combined treatment of erectile dysfunction with viagra and alprostadil in case of failure of their monotherapy; to compare effectiveness of viagra in dynamics of treatment, in various doses and dose adjustment., Material and Methods: 82 patients with ED of different genesis received a course of intracavernous injections of alprostadil followed by a course of viagra; 25 patients received combined treatment with alprostadil and viagra. Each course lasted for 3 months. Viagra efficiency was also assessed in long-term use (12 months) and different initial doses (50 or 100 mg)., Results: Monotherapy with alprostadil or viagra was effective in 73.2 and 75.6% patients, respectively. Their combination was more beneficial--88.0%. When used for a long time, viagra lost efficiency in psychogenic ED by 17.7%, in organic ED--by 16.9%. In an initial viagra dose 50 mg efficiency reached 70.3%, 100 mg--80.0%., Conclusion: Combined treatment of ED is a method of choice in monotherapy failure and in severe ED. Lowering of viagra efficiency in long-term administration may be explained by disappearance of placebo effect.

The effect of an endotoxin from Sh. Boydii on the biotransformation of amidopyrine and acetanilide, the activity of microsomal monooxygenases, hemoxygenase, and xanthine oxidase, the lipid peroxidation (LPO) intensity, the phospholipid spectrum, and the solubilization of microsomal membrane components was studied by intraperitoneal injections (2.5 mg/kg) in rats. It was found that the endotoxin inhibits the reactions of C- and N-acetanilide hydroxylation, N-amidopyrine demethylation, acetanilide hydrolysis at the amide bond, conjugation of aminophenol metabolites with glucuronic acid and sulfate, and 4-aminoantipyrine binding to acetate. The endotoxin effect reached maximum 24 h after injection and was observed for 96 h. The inhibition of metabolism of the test preparations is related to a decrease in the content of cytochrome P-450 and in the activity of 1A2, its 2B, 2C, 3A, and 2E1 isoforms. This is obviously caused by activated LPO and enhanced nitric oxide synthesis, as evidenced by a tenfold increase in the content of NO metabolites (nitrites and nitrates) in the blood of test animals. In clinical practice, it is necessary to take into account the possibility of a significant biotransformation of drugs in the acute period of bacterial infection, which may lead to changes in the pharmacological effect and toxicity of some drugs.

The ability of bispecific antibodies (Babs) formed by fusion of hybridomas and parent monoclonal antibodies (Mabs) to interact with the solid phase-adsorbed antigens was studied. Mabs specific to the three different antigens [horseradish peroxidase (HRP), human IgG (hIgG), and human myoglobin (Mb)] as well as Babs with the double specificity [antimyoglobin/antiperoxidase (anti-Mb/HRP) and anti-hIgG/antiperoxidase (anti-hIgG/HRP)] were used. It was shown by radioimmunological and immunoenzyme assays that parent Mabs bind to solid phase-adsorbed antigens considerably more effectively than Babs. The observed equilibrium binding constant (Ka) of antiperoxidase parental Mabs to immobilized HRP is 21 and 38 times higher than Ka for Babs binding sites (anti-Mb/HRP and anti-hIgG/HRP, respectively) to peroxidase. It was calculated that about 90-95% of all bound parental antiperoxidase Mabs were associated with immobilized HRP bivalently, and only about 5-10% were bound monovalently. On the contrary, parental Mabs against hIgG bind to the sorbed antigen essentially only monovalently. It was also shown that the avidity of anti-Mb/HRP Babs significantly increased when two antigens, Mb and HRP, were simultaneously adsorbed on the solid phase. These data imply that Babs bearing an enzyme-binding site (for example, binding to HRP) cannot be more effective than standard conjugates (e.g., enzyme-conjugated antibodies) in heterogeneous noncompetitive immunoassays.

Since 1995 we have treated 18 patients (age 17-52 years) after blunt perineal injury. 14 of them suffered from erectile dysfunction (ED). All the patients underwent examination which consisted of the standard tests and modern techniques: pharmacological dopplerography, electromyography of the penis with pharmacological loading, NMR-tomography of the perineum and the penis. NMR-tomography helped in identification of anatomic structures of the penis and pelvic fundus, pathological tissue processes (hematomas, damaged tissues, fibrous scars) after blunt injury of the perineum responsible for ED. The latter resulted from arterial (100%), venous (33.3%) and neurogenic (11.1%) lesions. Basing on the formulated pathogenetic conception it was possible to design diagnostic algorithm and policy of combined treatment of patients with ED following perineal blunt injury allowing for the time of the trauma and characteristics of the injury.

28 patients with erectile dysfunction of different origin received viagra (25, 50 or 100 mg depending on the effect and tolerance). The examination on the treatment week 4, 8 and 12 stated a 85% response. It was found that patients with body mass more than 90 kg benefited most in the dose 100 mg. Maximal single dose 100 mg is recommended for patients over 65 years of age. A 100% response was observed in patients with psychogenic and arteriogenic erectile dysfunction. Low effectiveness of viagra in patients with neurogenic erectile dysfunction can be explained by damaged parasympathetic nerve fibers. Thus, in the decision on viagra dose it is advisable to consider the patient's body mass, age and etiology of erectile dysfunction.

The paper presents the technique and results of electromyography of the penis (EMP) for 68 males divided into 3 groups: 21 volunteers with erectile disorders, 20 patients with nonvasculogenic erectile dysfunction and no history of pelvic operations, 27 patients with erectile abnormalities as a result of pelvic operations (after cystectomy -11, cystoprostatectomy -1, rectal resection -7, rectal extirpation -8 patients, groups 1, 2, 3 and 4, respectively). Autonomic innervation of the penis is primarily characterized by such EMP parameters as amplitude, synchronism and frequency of potentials. Neurogenic penile disorder was identified in 3 patients of group 2 (1 patient with intervertebral disk hernia, 2 patients with lumbosacral osteochondrosis), in all patients of group 3 (electric silence was recorded in 22 patients). EMP should be included in the algorithm of examination of patients with erectile dysfunction as providing a reliable assessment of autonomic penile innervation.

The authors have operated 24 patients to repair total and subtotal defects of penile integuments due to oleogranuloma. They have performed a total of 13 transplantations of axial island cellolocutaneous inguinal flaps basing on the external pudendal, superficial epigastric or superficial circumflex iliac arteries; 3 transplantations of free axial inguinal grafts; 2 transplantations of free axial grafts from the forearm on the radial artery. Microvascular anastomoses with the recipient zone vessels were formed. 8 two-stage Reich operations were conducted. Postoperative dynamic monitoring (skin thermometry, oxygen polarography, Doppler ultrasound scanning of the vessels) of the graft has found more favourable vascular reactions in the axial flaps vs. scrotal ones. Effective contralateral grafting was performed in a patient with the transplant necrosis on the superficial epigastric artery.

The paper presents the results of diagnostic and therapeutic use of intracavernous injections of alprostadil edex (prostaglandin E1) of Schwartz Pharma AG production (Germany) in 14 patients with functional, compensated and subcompensated organic erectile dysfunction. Pharmacological test with alprostadil modelling cavernous body function extends diagnostic efficacy of doppler scanning of the penis and cavernosography. A complete effect (100% sexual rehabilitation) was achieved in 1 and partial in 3 males. Alprostadil edex kits are advocated as safe and convenient.

To evaluate cardiac effects of shock waves, 40 patients with uroliths (10 subjects with and 30 without arrhythmia) were examined during their exposure to remote electropiezolithotripsy (Piezolith-2300 unit). Arterial pressure and ECG were registered before, during (upon 1500 and 3000 impulses) and after the session. Except a slight deceleration of the heart rate, no cardiac disorders significant clinically were reported.

The paper presents the results of intracavitary chemotherapy with deposited cytostatics of advanced ovarian cancer as well experimental, morphological, biochemical and pharmacological data. Intraabdominal introduction of microspheres filled with cyclophosphamide, 5-fluorouracil, doxorubicin can be a variant of drug therapy in multimodality treatment of ovarian cancer. Combination of intracavitary chemotherapy with a systemic one has the advantage of local and regional effect which is not inhibited by mediated action of the deposited cytostatics via the systemic blood flow. The method is indicated in residual tumor dissemination after cytoreductive surgery and ovarian cancer with ascites.

The study was undertaken to examine 89 patients with acute myocardial infarction whose pulmonary pressures were measured under monitoring. The findings were compared with the time course of necrotic focal formation. The rate of the latter was found to determine central hemodynamic changes. High necrotization rates were ascertained to be directly related to the rate of pressure elevation in the pulmonary artery and the changes in stroke volume.

A change in filterability of erythrocytes through a cellulose filter with pores 7 microns in diameter was examined in 67 patients with acute myocardial infarction. Dynamic evaluation of the filterability was compared with a process of necrotic focus development in time. The filterability was ascertained to have various phases coinciding with the development phases of a necrotic focus and to be an early prognostic indicator of myocardial infarction.

The relationship between necrotic focus characteristics (weight and rate of necrotization) and the clinical pattern of myocardial infarction was examined. Necrosis weight was shown to have no significant effect on the course of myocardial infarction, while maximum necrotization rate was found to be a valuable predictive factor: the higher the necrotization rate, the higher the risk of fatal outcome and various complications. Prognosis, based on necrotization rate and patient's age, can be made, using an equation, derived for early prediction of myocardial infarction outcome.

An experience with the treatment of 158 patients with open lesions of hands and fingers under conditions of traumatological unit is described. The authors recommend such operations of skin plasty as plasty by means of translocation of local tissues including insular triangle flaps on a vascular pedicle, free skin plasty, plasty on a temporary feeding pedicle from neighbour finger or hand, plasty after Krasovitov, replantation of not completely torn terminal finger phalanges. Skin plasty operations resulted in shorter terms of treatment and better functional and cosmetic results.

A mathematical quantitative assessment technique for real-time estimation of posterior myocardial infarction weight and rate of spread is described. It is based on the variation of abdominal mapping data. A formula is derived for the calculation of necrosis weight and rate of spread.

A mathematical procedure is proposed for quantitative assessment of necrosis weight, which is based on the processing of serial measurements of peripheral MB CPK activity in patients who died of acute myocardial infarction. The method is based on statistical treatment of biochemical findings and the results of postmortem determination of necrosis weight. A formula is derived for the biochemical equivalent of necrosis weight, which can be used a real-time intravital test.

A quantitative mathematical procedure, based on precordial mapping variation, for real-time determination of myocardial infarction weight and rate of progress is described. Formulas have been derived for the calculation of necrosis weight and rate of formation.