Moldovan Medical Journal

5-11

Authors: Igor Casian, Ana Casian

Background: Thymoquinone (TQ) and thymohydroquinone (THQ) are natural substances with antibacterial, antimycotic, antiviral, anticancer, antioxidant activity. Previously, was developed the method for obtaining Wild bergamot essential oil with high TQ content. The objective of this study was to create methods for obtaining individual substances TQ and THQ from Wild bergamot herb. Material and methods: Aerial parts of Wild bergamot have been collected from the plantation of the Scientific Practical Centre of Nicolae Testemitanu State University of Medicine and Pharmacy. The hydrodistillation method has been used for essential oil isolation and fractionation, and purification of individual substances. The analytical part of study has been performed by the HPLC method. Results: THQ was obtained in crystalline form by reducing TQ directly in the essential oil with ascorbic acid, sulphurous acid, or natural components of the Wild bergamot essential oil. Subsequent oxidation of THQ with hydrogen peroxide or nitrous acid gave TQ. Additionally, the yield of TQ was increased by optimising the parameters of plant material fermentation and using two-stage hydrodistillation with intermediate oxidation of the THQ formed at the first stage. Conclusions: Several technological procedures were created to obtain THQ from the Wild bergamot essential oil with a yield from 68-74% to 93-97% and TQ from THQ with a yield of 87-92%. The procedure of plant material processing has been optimised also to obtain essential oil with 48-56% TQ and not more than 12% residual phenols.

20-23

Authors: Veronica Cotelea, Natalia Corolcova, Luminița Mihalcean, Mihaela Burac, Liliana Profire, Iurie Dondiuc

Background: Preterm birth remains a leading obstetrical complication because of the incomplete understanding of its multifaceted etiology. It is known that immune alterations toward a proinflammatory profile are observed in women with preterm birth, but therapeutic interventions are still lacking because of scarcity of evidence in the integration of maternal and placental interrelated compartments. Objective: To investigate value of Lactoferrin (LF) and Interleukine-6 (IL-6) in the preterm labor. Material and methods: The study comprised 65 women with spontaneous preterm labor and 65 women with term labor. Maternal plasma concentrations of Lactoferrin and Interleukine-6 were detected by standard test system Aeskulisa Lactoferrin and Best-Vector A-8768 for Interleukine-6 Ref 3307 which (GmbH & Co, Germany) gave an analytical sensitive of 1.0 U/ml for Lactoferrin and 0.131 pg/ml for Interleukine-6. Results: Plasma levels of Lactoferrin in women with preterm labor were lower (µmedian = 0.90 U/ml) (p<0.001) than in the control subjects (µmedian = 40.68 U/ml). Plasma levels of Interleukine-6 in the plasma in women with preterm were predictably higher (µmedian = 51.90 pg/ml) than that in the control subjects with term delivery (µmedian = 21.51 pg/ml) (p<0.001). Conclusions: The study findings suggest that plasma levels of Lactoferrin and Interleukine-6 in women with preterm labor may be considered as a promising early biomarker for preterm labor.

29-35

Authors: Vitalie V. Moscalu

Background: Re-evaluation of reconstructive possibilities in the correction of degenerative mitral valve disease is of great clinical necessity nowadays. Material and methods: Analyzing the nature of the pathologies that determined the development mechanism of valve insufficiency, 136 cases of anterior cusp prolapse and 152 cases of posterior cusp prolapse were determined. Results: Cord rupture was established in 79 (58.9%) patients, cusp defects (”Cleft”) were appreciated in positions A1, A2, A3 – 15 cases (5.9%) and in P1, P2, P3 – in 92 (86.6%) cases. The surgical techniques performed were separated into: (1) resection – for the anterior and posterior cusps – 45 cases and accompanied by the slide – in 30 cases; (2) with Gore-Tex neo-chordal implantation – 115 cases, with cord transfer – 30; (3) Cusp enlargement with autologous pericardium – 5 cases, Alfieri procedure – 8. Implantation of a support ring required 130 (97.0%) patients. The correction of the associated valve disease required 125 patients (De Vega – 89.1%, ring – 8). Coronary bypass was required – 16 patients. There were no postoperative fatal cases. Conclusions: Based on the data obtained, reconstructive repair surgery can be can recommend for valves of degenerative, post-traumatic, ischemic, post-endocardial etiology as effective and sustainable techniques over time, being a superior alternative to replacement with prosthetic valves.

41-48

Authors: Olga Macagonova, Adrian Cociug, Tatiana Taralunga, Vladimir Ciobanu, Tudor Braniste, Viorel Nacu

Background: The present work describes the possibility of manufacturing biomaterials from the extracellular matrix for the treatment of the skin wounds. Biomedical collagen-based materials are clinically effective. Collagen is the most abundant and major component of the skin. Porcine collagen is almost similar to the human collagen, it is not immunogenic when used for the therapeutic purposes. Biomaterials can be obtained from the decellularized dermis, being a matrix rich in the collagen and glycoproteins. Material and methods: 3 parallel groups of biomaterials were established and the average value was calculated. To ensure the effectiveness of the decellularization process, the decellularized porcine dermis was compared with the intact sample using qualitative and quantitative criteria. Results: Histologically, the decellularized tissues revealed the presence of fewer cells. As a result, were removed approximately 80.5% of the genetic material from porcine dermal structures, demonstrated by the spectrophotometric quantification of deoxyribonucleic acid. In vitro graft degradation study in 0.01 M phosphate buffer pH 7.4 combined with collagenase, demonstrated a significant (p < 0.05) loss of collagen sponge mass by 100% over one hour in the group II compared to the decellularized dermis in group I which decreased in the weight by 91.3% during 35 hours. Conclusions: Acellular biomaterials are immunologically inert, have hydrophilic and biodegradable properties, thus they can play a key role in the wound care, exerting the transfer of the bioactive molecules and drugs directly into the wound.

56-65

Authors: Nadejda Diaconu, Irina Civirjic, Galina Sorici, Aurel Grosu, Tatiana Cuzor, Sabina Racila-Iatco

Background: Few studies have evaluated the thrombolytic treatment in patients with intermediate-high risk pulmonary embolism, making this study more valuable. Material and methods: It was a prospective, non-randomized, open-label, single-center study. Eligible patients at the age of 18 or older with an acute pulmonary embolism (PE) confirmed by CT pulmonary angiography with onset until 14 day and signs of right ventricular (RV) overload on echocardiography took part in the study. Pulmonary Arterial CT Obstruction Index Rate (PACTOIR) was used to define the localization and the expansion zone of thromboembolism. This study included 18 patients with intermediate risk and acute submassive pulmonary thromboembolism. In thrombolysis (TT) group (n=9) were used 50 mg of tissue-plasminogen activator (t-PA) administered in infusion as 0.4 mg/h for 2 hours. In the standard anticoagulation group, unfractioned heparin (UFH) was administered as a bolus of 70 units/kg or a maximum of 5000 units, followed by continuous infusion at an initial rate of 16 units/kg or a maximum of 1000 units/h. Results: The mean age for TT group was 69 vs 63 for the UFH group. PACTOIR was 100% in 3 patients in the half-dose rt-PA group and in 2 patients in the UFH group. RV/LV diameter ratio decreased from baseline to 48 h post-procedure (1.55 vs. 1.13; mean difference, -0.42; p < 0.0001). Mean pulmonary artery systolic pressure was 55 mm Hg in both groups (p < 0.05), with 53 [43–60] in TT group vs. 41.5 [37–45] mmHg in UFH group, P< 0.05). The rate of secondary endpoints was significantly higher in the UFH group with a high rate of pulmonary hypertension (0 vs. 19%, p=0.003). Conclusions: Half-dose thrombolytic therapy in patients diagnosed with submassive pulmonary embolism significantly reduced death and hemodynamic decompensation in the first 7 days compared to anticoagulant therapy only. With all that being said, it can be concluded that patients with high-intermediate risk PE could benefit from reduced-dose TT.

71-77

Authors: Ecaterina Carpenco, Veaceslav Fulga, Lilian Saptefrati, Lilia Sinitina, Valeriu David

Background: The angiopoietin/TIE system is one of the signalling pathways that regulate vascular development and remodelling during morphogenesis of the placental complex. Deregulation of the vascularization process is associated with primary placental insufficiency through destabilization of the maternal-fetal functional system. Disruption of expression of pro-angiogenic factors is associated with reduction of the microcirculatory bed and installation of circulatory dysfunction. The aim: Evaluation of Ang2 immunoexpression in early term compromised uterine pregnancies in the context of chorio-villous circulatory dysfunction in primary placental insufficiency. Material and methods: Abortion product from 67 patients with early term compromised pregnancies (stagnant pregnancies – 43 cases, early miscarriages – 11 cases, control batch that included 13 cases of pregnancies solved on social indications) were immunohistochemically evaluated with the marker for anti-Ang2 and anti-CD31. Results: The majority of sites analyzed were Ang2 negative, with the exception of syncytiotrophoblast, that reached the highest score (+3) in most cases. A maximum placental vascularisation index was achieved in the control group. The stagnant pregnacies batch has registered the lowest vascular density mean. Conclusions: The placentation period is characterized by a weak Ang2 cellular environment in the chorio-villous germinal site in the group of short-term compromised pregnancies, except a highly positive syncytiotrophoblast. The immunoexpression profile in vascular endothelium correlates statistically significantly with placental vascularization index and chorio-villous vascular density in stagnant pregnancies.

83-90

Authors: Victor Ojog

Background: Portal vein is the most enigmatic vessel of our body because it regulates own contractile performances using a special pace-maker mechanism represented by cells of Cajal. The contribution of various metabolic mediators and natural vasotropic agents in the control of the portal blood circuit is much less studied compared to the arterial system in general and the hepatic system in particular. The studies designed on the structure, function, and reactivity of the portal vein in different preconditioning have brought some common but also distinct evidence of the arterial system. Nitric oxide production is higher partly due to reduced arginase expression, but muscular media is thinner. Periodic spontaneous contractions directed towards the liver gate are characteristic for portal vein (PV), and the longitudinal muscle fibers are considered to be responsible for this phenomenon. Spontaneous rhythmic oscillations of the cells of Cajal are triggered by increasing calcium ion concentration leading to their depolarization. PV constrictor effect of phenylephrine is dependent on the activity of receptors to ET-1. For PV is characterized the acetylcholine induced contraction either in vivo or in vitro, and this effect is thought to be dependent on ET-1. Conclusions: The establishment of main particularities of portal vein reactivity of action of different paracrine, endocrine, and hemodynamical stimuli represents an important tool for prediction of contractile disorders leading plausible to portal hypertension. Likewise, a well proven interplay between cholinergic and adrenergic stimulations and on the other hand between Ang II and ET-1 actions must be a support for pharmacological modulating of portal vein reactivity disorders.

101-110

Authors: Lilia Rotaru, Oxana Grosu, Stanislav Groppa

Background: Parkinson’s disease (PD) affects more than 1% of the population aged over 65 years and manifests with both motor symptoms – bradykinesia, rest tremor, rigidity, and non-motor symptoms. Cognitive impairment and dementia are recognized non-motor symptoms that can significantly affect the quality of life of both the patient and caregivers and are a risk factor for institutionalization in nursing homes and a risk factor for early mortality. Cognitive impairment is frequent in Parkinson’s disease (PD) that can develop even before the diagnosis of Parkinson’s disease based on its motor features. Conclusions: There are several clinical, molecular, and imaging factors that constitute risk factors for the development of Parkinson’s disease dementia, in which basal cholinergic and prefrontal dopaminergic systems are involved. Histological changes are Lewy-body, Alzheimer, but also vascular pathology. Clinically can be distinguished subjective cognitive decline, mild cognitive impairment and, subsequently, Parkinson’s disease dementia. There are no remedies with a proven effect to prevent the occurrence of cognitive decline in PD. The only approved drug for already developed D-PD is the cholinesterase inhibitor – donepezil. Non-pharmacological interventions are thought to be beneficial. A multidisciplinary approach to cognitive impairment is recommended, with specific pharmaceutical treatment of the cognitive disorder and comorbidities, and appropriate rehabilitation.