Morphometric and Metabolic Disorders in the Bone Tissue of Laboratory Rats with Chronic Toxic Hepatitis

The development of osteodystrophy in diseases of the hepatobiliary system is a known fact, but the mechanism of the formation of metabolic disorders in bone tissue in liver pathology is not fully understood. The purpose of the study was to study morphological and biochemical changes in the bone tissue of female and male rats during the modeling of chronic toxic hepatitis. Materials and methods. Modeling of toxic hepatitis was carried out on 1 month old male and female Wistar rats by intraperitoneal injection of hydrazine sulfate 50 mg / kg twice a week for 3 months. The experiment was conducted in accordance with the norms and principles of the EU Council Directive on the protection of vertebrates used for scientific purposes. Morphometric measurements (density, content of mineral-organic, mineral and organic components) were carried out on the femurs and the last lumbar vertebra. Elastase activity, acidic phosphatase (indicators of bone resorption); alkaline phosphatase activity and calcium content (indicators of the synthesis of new bone tissue) were determined in homogenates of the bone tissue of the jaws and femur. The mineralizing index was calculated from the ratio of the activities of acidic phosphatase and alkaline phosphatase. Results and discussion. A decrease in the quantities organic matrix with a preserved intensity savings of bone tissue mineral parts in females and a decrease intensity in bone tissue mineralization in males under the influence of toxic hepatitis were found. Biochemical studies of bone tissue showed the activation of the destruction of the protein matrix of the bone, the intensification of mineralization in females, as well as the activation of hydrolysis of hydroxyapatite, along with a decrease in the level of calcium in the bone tissue of animals of both sexes against the background of modeling of chronic toxic hepatitis. Conclusion. The studies carried out have established multidirectional disorders of the metabolism and structure of bone tissue in males and females, induced by prolonged administration of hydrazine sulfate: in females, suppression of the formation of an organic matrix with a preserved intensity of bone mineralization, and in males, a decrease in bone mineralization against the background of a slightly increased intensity of synthesis of the organic component. The established patterns made it possible to reduce the negative effect of Hydrazine Sulfate on the protein metabolism of rat bone tissue, indirectly through the metabolism of estrogens. The results of our study provided experimental justification for the development of a scheme for the Prevention of osteodystrophic conditions in conditions of chronic exposure to toxins or impaired liver function

PERIODONTAL STATUS IN PATIENTS WITH DISEASES OF HEPATOBILIARY SYSTEM, BURDENED WITH TOBACCO AND DRUG ADDICTION

The aim: To study the effect of drug addiction and smoking on the status of periodontal tissues in patients with hepatobiliary pathology. Materials and methods: 58 smokers, 63 drug addicts with hepatobiliary pathology were examined and 92 persons of comparison group (with inflammatory periodontal diseases affected by hepatobiliary pathology, without addiction). Examination of patients included determination of iodine number by Svrakov, S-L and Stallard hygiene indices, PMA index and index PBI. Results: The results of examination of smokers are worse in patients with cirrhosis than in patients with chronic toxic hepatitis and non-alcoholic steatohepatitis and also the results of these two groups was significantly worse than that of the comparison group (iodine number by Svrakov – 1,4 times and 1,3 times higher, PMA index – 1,7 times and 1,4 times worse, in accordance). The results of the study showed that drug addicts patients are worse values in patients with cirrhosis than in patients with chronic toxic hepatitis and non-alcoholic steatohepatitis and also the results of these two groups was significantly worse than that of the comparison group (iodine number by Svrakov – 1,5 times and 1,4 times higher, PMA index – 1,7 times and 1,5 times worse, in accordance). Conclusions: Presence of hepatobiliary pathology in smokers and drug addicts increases the risk of periodontal diseases.

Development features of periodontal tissues inflammatory diseases of nicotine-dependent patients with chronic toxic hepatitis

Introduction. Liver diseases and pathology of the organs of mouth cavity are interconnected. Smoking, usually increases the manifestations of the underlying disease and affects the course. The aim. To investigate the effect of chronic toxic hepatitis of nicotine-dependent patients and of patients without a bad habit on their periodontal status. Materials and methods. During the clinical examination of the oral cavity of 86 patients, the depth and incidence of inflammation of the gum were determined using the number of the Svrakov's number (SN); the conditions of hygiene of the oral cavity were estimated using the Silness-Loe (S-l) index; Periodontal Index (PMA) and Bleeding Index (PBI). General histomorphology was studied on drugs stained with hematoxilin-eosin and by the method of Gerlich and van Gieson. Results. It is established that the indicator of SN had the highest value among patients of group II (2,15±0,13), it was probably (p < 0.05) higher relatively to the group I and comparison group. In the smoking patients with chronic toxic hepatitis, in spinous layer of epithelium was determinanted karyorhexis, karyolysis with the formation of cell debris; basal layer cell proliferation, acanthosis, angiogenesis. We detected damage to collagen and elastic fibers of the periodontal, wich correlated with the intensity and duration of the bad habit. In areas of pronounced alterative changes colonies of bacteria were discovered. Conclusions. Thus, the results obtained in nicotine-dependent patients with chronic toxic hepatitis visualize damaging effect on the epithelium and weakening of the histohematic barrier of the oral cavity and promotes the reproduction and penetrationof pathogenic microflora into the underlying tissues.

THERAPEUTIC PLASMAPHERESIS IN A COMPLEX TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS

The aim: To determine the pathogenetic expediency, efficiency and the place of therapeutic plasmapheresis in a complex treatment of patients with chronic hepatitis. Materials and methods: It was carried out the analysis of case histories of 77 patients. In the course of treatment, the patients were diagnosed with chronic toxic hepatitis (K.71). Diagnosis was exposed in accordance with the official documentation introduced by the Gastroenterological department of Sumy Regional Clinical Hospital CH”SRCH”, Sumy Regional Infectious Diseases Clinical Hospital named after Krasovytsky ZY and Sumy Regional Center of Blood Service. Results: It was found that total protein indicator is the normal range and albumin after plasmapheresis and during conservative treatment. Markers of cytolysis and cholestasis are have great value may. The most significant changes were observed in rates indicating lesion of the hepatic parenchyma, including ALT, AsAT and alkaline phosphatase. In conservative treatment, the percentage of the alkaline phosphatase level improved by 31%, after the course of plasmapheresis – by 58%. The obtained figures of cholestasis indexes indicate the effectiveness of both methods of treatment, but treatment with plasmapheresis has a more expressed effect on the decrease of alkaline phosphatase level. The level of bilirubin improve on 38,8% after plasmapheresis and 65% in the comparison group. Conclusion: Inclusion in the complex therapy of chronic hepatitis plasmapheresis reduces the severity of cytolysis and cholestasis, increases remission and significantly improves clinical manifestations.

Development features of periodontal tissues inflammatory diseases of nicotine-dependent patients with chronic toxic hepatitis

Introduction. Liver diseases and pathology of the organs of mouth cavity are interconnected. Smoking, usually increases the manifestations of the underlying disease and affects the course. The aim. To investigate the effect of chronic toxic hepatitis of nicotine-dependent patients and of patients without a bad habit on their periodontal status. Materials and methods. During the clinical examination of the oral cavity of 86 patients, the depth and incidence of inflammation of the gum were determined using the number of the Svrakov's number (SN); the conditions of hygiene of the oral cavity were estimated using the Silness-Loe (S-l) index; Periodontal Index (PMA) and Bleeding Index (PBI). General histomorphology was studied on drugs stained with hematoxilin-eosin and by the method of Gerlich and van Gieson. Results. It is established that the indicator of SN had the highest value among patients of group II (2,15±0,13), it was probably (p < 0.05) higher relatively to the group I and comparison group. In the smoking patients with chronic toxic hepatitis, in spinous layer of epithelium was determinanted karyorhexis, karyolysis with the formation of cell debris; basal layer cell proliferation, acanthosis, angiogenesis. We detected damage to collagen and elastic fibers of the periodontal, wich correlated with the intensity and duration of the bad habit. In areas of pronounced alterative changes colonies of bacteria were discovered. Conclusions. Thus, the results obtained in nicotine-dependent patients with chronic toxic hepatitis visualize damaging effect on the epithelium and weakening of the histohematic barrier of the oral cavity and promotes the reproduction and penetrationof pathogenic microflora into the underlying tissues.

Multifocal Osteonecrosis Glucocorticoid Induced

The present study describes a 29 years old patient diagnosed with aseptic osteonecrosis with multiple localization occurred after a corticoid treatment for chronic toxic hepatitis. The clinical and para-clinical examinations determined the diagnosis of Wilson disease and avascular necrosis with multiple localizations. The evolution of the disease was favourable following the surgical treatment consisting of bilateral total hip arthroplasty with cementless prosthesis, hemi-arthroplasty of the left shoulder with cementless prosthesis, orthotopic hepatic transplantation with an entire liver from donor in cerebral death and immunosuppressive, anticoagulant, antiretroviral and gastro-protective treatment. There is an increase of the number of patients undergoing a glucocorticoids treatment for several months, years or lifelong periods. This type of treatment increases the risk of osteonecrosis depending on the dosage and the duration of the treatment.

Clinical features of «metabolism» diseases of the skin in patients with chronic diffuse liver diseases

Aim. To determine the clinical features of skin diseases developing in the presence of metabolic disturbances in patients with chronic diffuse liver diseases. Subjects and methods. A total of 368 patients with different clinical forms of hepatopathy were comprehensively examined. Results. 817 cases of seborrhea, skin itch, xerodermia, xanthomatosis, and dyschromia were detected in 318 (86.4%) patients. Conclusion. The prevalence and intensity of cutaneous manifestations depended on the nature of the pathological liver process and indirectly testified to its severity and activity. The symptoms of skin diseases were most pronounced in patients with autoimmune liver lesions, chronic toxic hepatitis, and cirrhosis.