Introduction: Ronchopathy is a chronic progressive disease manifested by upper airway obstruction and chronic respiratory failure. The key process of pathological snoring is the obstructive breathing disorders. The obstructive sleep apnea syndrome (OSAS) develops on the basis of snoring. OSAS is accompanied by episodes of hypoxia and reoxygenation, which cause an increase of the level of reactive free radicals whith following development of the oxidative stress. The activation of peroxidative processes of proteins (POP) and lipids (POL) are initiated by free radicals which are noticeable components of endogenous intoxication (EI). The aim of the study was to investigate the intensity of POP and POL processes, the levels of OSAS components, and the indices EI in patients with ronchopathy and OSAS of varying severity in the dynamics of treatment. Materials and methods: 40 patients with ronchopathy and OSAS were examined at the State Institution “Institute of otolaryngology named after prof. O.S. Kolomiychenko of the National Academy of Medical Sciences of Ukraine”. All patients were divided according to the degree of snoring and hypoxia index (HI) into 4 groups of 10 persons each. Control group was formed by 10 healthy donors. The object of biochemical studies was blood serum. The intensity of POP was assessed by reaction with 2,4-dinitrophenyl-hydrazine by the Levin’s method in Reznick’s modification. POL intensity was determined by the interaction with 2-thiobarbituric acid (TBA) by Goncharenko. Catalase activity was determined by the method of Korolyuk and co-authors. The content of free thiol groups was determined by interaction with 5,5'-dithio-bis(2-nitrobenzoic acid). The content of medium weight molecules (MWM) and tyrosine-containing peptides (TCPs) were determined by spectroscopy at 254 and 280 nm, respectively. Statistical processing of the results was performed using the software package for biometric data WinPEPI. Results: Prior to the treatment in patients with ronchopathy and OSAS of varying severity, an increase in the content of MWM and TCPs were noted, that indicates the development of endogenous intoxication. In patients of all groups there was an intensification of POP, which was manifested by a significant increase of aDNFGn, aDNFGo, and kDNFGn levels. The content of TBA-positive products in patients with ronchopathy of both groups was at the level of control and increased significantly at progression of pathological process. In addition, in all groups of patients an increase of catalase activity was detected on the background of TCPs level decrease. It was found the efficacy of the offered treatment of patients with ronchopathy and OSAS of varying severity. The indices of EI, POP, POL, and antioxidant system’s were directed to improvement in contrast to the state before treatment, and some of them were improved almost to the level of control. Conclusions: It is established that the progression of hypoxia is accompanied by autointoxication, which is manifested by an increase in the content of MWM, as well as prove for the activation of catabolic reactions and excessive formation of cells’ breakdown products. It was also revealed by the intensification of POP and POL processes, the activation of which are associated with the development of insufficiency of enzymatic and nonenzymatic components of antioxidant system. The performed treatment can be considered as the effective one since on its completion all the studied indices were restored almost to the level of control.

The syndrome of obstructive sleep apnea (OSAS) is accompanied by episodes of hypoxia and reoxygenation, which causes an increase in the level of active forms of free radicals that lead to the development of the oxidative stress. The aim of this work was to investigate the intensity of peroxidation of proteins and lipids, the components of the antioxidant system and the biochemical parameters endogenous intoxication in patients with OSAS. Materials and methods: Twenty patients with OSAS were examined at the SI "Prof. O.S. Kolomyychenko Institute of Otolaryngology NAMS of Ukraine" (Kiev). They were divided into two groups: 10 of them were with apnea sleep index less than 30 episodes of respiratory arrest per hour (IA<30), another 10 ones – with more than 30 episodes (IA>30). The control group was consisted of 10 healthy persons. The object of biochemical studies was blood serum. The intensity of the oxidative modification of blood serum proteins was estimated by 2,4-dinitrophenyl hydrazine reaction by Levin in modification of Reznick. The evaluation of the intensity of peroxide processes was determined by interaction with 2-thiobarbiturac acid (TBA) by the method of Goncharenko. The activity of catalase was determined by the method of Korolyuk et al. The content of free thiol groups (SH-) was determined by interaction with 5,5'-dithio-bis-(2-nitrobenzoic acid) by the method of Sokolovsky et al. The contents of medium weight molecules and tyrosine-containing peptides (TCP) were determined spectrophotometrically at 254 and 280 nm, respectively. Statistical processing of results was carried out using a program package of biometric data WinPEPI. Results: In patients with OSAS whose IA<30, an increase of the level of TCP, oxidative modification of proteins, the content of TBA-positive products and a decrease in the level of SH-groups. In patients with IA>30, increased levels of medium weight molecules, TСP, oxidative modification of proteins, the content of TBA-positive products and the activity of catalase. A significant difference was observed in patients with syndrome of obstructive sleep apnea of varying degrees of severity of the content of aldehyde and ketone derivatives of neutral proteins; aldehyde derivatives of the main nature, the content of TBA-positive products and the activity of catalase. Conclusions: The results of the conducted studies indicate an increase in the intensity of the processes of peroxidation of proteins and lipids, the change in the components of the antioxidant system and the development of endogenous intoxication in patients with OSAS.

Introduction: Exposure to high-intensity sounds can cause significant damage to the human auditory system. Joint damage to the auditory system by high-intensity sound and shock waves causes acubarotrauma. Such lesions are systemic in nature, affecting not only the auditory system but also the entire human body. It significantly impairs the quality of life and general condition of the body, causes numerous complications. Therefore, the issues of diagnosis and treatment of hearing impairments caused by acutraumas and acubarotraumas received in combat conditions are highly relevant. Aim: to study the hemostatic indices of patients with combat-caused acoustic trauma and identify the most informative ones. Patients and methods: 22 patients with combat acoustic trauma and 10 healthy volunteers were tested. The object of the study was citrate plasma, which was obtained by standard methods. The content of fibrinogen was determined by thrombin-like enzyme Ancistron-H. Partially activated thromboplastin time and prothrombin time were determined by tests of Siemens, USA. The share of functionally inactive forms of prothrombin was determined by Ecamulin-based diagnostic test. The content of protein C activity was determined by cleavage of synthetic chromogenic substrate (Siemens, USA). The concentrations of soluble fibrin and D-dimer were evaluated by immunodiagnostic test systems "DIA-soluble fibrin" and "DIA-D-dimer" (Diaprof-Med, Ukraine). Statistical processing of the results was performed by WinPEPI package for biometric statistical processing with Student's t-test for evaluation of the difference between patients and the control group. Results and discussion: It was found that fibrinogen’s level in 25% of patients remained at the level of control. In 27% of patients this index decreased on the level of the trend, and in 50% - increased 1.6 times. The elevat ion of fibrinogen’s level proves for a risk of thrombotic complications, since this acute phaseprotein is well-known index of hypercoagulability. Partially activated thromboplastin time index in 14% of the tested group remained at the level of control values. In 14% of patients it was probably 1.4 times shorter, and in 73% of patients it was 1.6 times longer than control. Prolonged partially activated thrombin time may prove for the increased level of circulating coagulation factor VIII. In 82% of patients the index of prothrombin time was probably 2.4 times prolonged, where as in 18% of patients was almost at the level of control. It may prove for an imbalance between the components of blood clotting system. The indices of Ecamulin-based test were multidirectional. In 18% of patients it was on the level of control, in 55% of patients it was slightly shorter, and in 27% of patients - probably elongated 1.4 times. The level functionally inactive forms of prothrombin in 50% of patients didn’t differ of control values, in 23% it was tended to decrease, and in 27% it was 1.6 more. The latter proves for the activation of the blood coagulation system. Protein C is a physiological inhibitor of the blood coagulation system. Its’ level in 50% of patients was reduced by 2.2 times in contrast to control, in 14% it remained on the normal level. As well-known, a decrease in protein C level proves for imbalance between coagulation and anticoagulation in the direction of the first one and is associated with thrombosis. The content of D-dimer in 33% of patients was on the level of control, while the level of soluble fibrin was increased 4 times. In 42% there was a 1.4-fold decrease in D-dimer content at a slight increase of soluble fibrin level. In 25% of patients the indices of D-dimer and soluble fibrin were increased in 4 and 7 times, respectively. Elevated level of soluble fibrin is an early prognostic index of the activation of blood clotting system. Comprehensive determination of the content of soluble fibrin and the level of D-dimer allows to estimate the correlation between the accumulation and destruction of the soluble fibrin. Conclusion: From the above data it follows that the determination of the single index is not enough for adequate assess of the risk of thrombosis and the effectiveness of antithrombotic therapy. On this reason the comprehensive definition of the noted indices should be included into the clinical practice a mandatory algorithm for the diagnosis of prothrombotic conditions in patients with acoustic trauma hearing disturbances.

Aim: to investigate the intensity of proteins and lipids peroxidation, the state of the antioxidant system and biochemical indices of endogenous intoxication in patients with snoring. Materials and Methods: Blood serum of 20 patients with snoring and 19 healthy persons without any manifestation of respiratory complications at sleeping were studied. All patients were divided into two groups. Group I included 10 patients with moderate manifestation of snoring, and group II with the hard one. Results: An increase of the proteins’ oxidative modifications in patients with snoring without obstructive apnea at sleep were moderate and severe, that is reflected by an increase of the levels of neutral- and basiccharacter aldehyde-dinitrophenyl-hydrazones and basic-character ketone-dinitrophenyl-hydrazones has been established. The level of thiobarbiturate-positive products in patients with the moderate degree of snoring was in the value of control group. At progression of this pathology this index increased, too in compare to control group. The level of catalase activity in patients of both group was increased where as the content of free thiol groups was decreased. The content of medium weight molecules in patients of both groups was on the level of control, but at progressing of the disease it increased. The content of tyrosine-containing peptides was increased in the serum of patients in both groups. Our data prove for the intensification of the proteins’ and lipids’ peroxidation, for the changes in antioxidant system and for the development of endogenous intoxication in patients with severe level of snoring.