[Surgical treatment of cerebral aneurysms in the Russian Federation]

OBJECTIVE

The objective of this study was to evaluate the results of surgical treatment of cerebral aneurysms in the Russian Federation.

MATERIAL AND METHODS

We analyzed performance indicators in neurosurgical departments of regional and federal health institutions of the Russian Federation for 2017. The results of surgical treatment of cerebral aneurysms (CAs) were analyzed in 19 regional vascular centers (RVCs) in several federal districts and in 3 federal centers (FCs) with the most dynamically developing vascular neurosurgery and smoothly running system of statistical data processing.

RESULTS

The study included 3160 patients hospitalized to 22 medical institutions in 2017. Of these, 1808 patients were treated in RVCs, and 1352 patients were treated in FCs. We analyzed factors affecting the treatment outcome in CA patients. We identified features of CA treatment in clinics with a different amount of surgical intervention.

CONCLUSION

An increase in the surgical activity in centers and simultaneous development of microsurgical and endovascular treatments for cerebral aneurysms reduce postoperative mortality. Due to the presence of a RVC network in the Russian Federation, many patients could receive necessary specialized treatment. The number of operations for cerebral aneurysms has increased 6-fold for the past 10 years.

[Immunological and pathogenetic aspects of imunofan administration in aged patients with duodenal ulcer]

AIM

To specify immunological and pathogenetic aspects of imunophan use in aged patients with duodenal ulcer (DU).

MATERIAL AND METHODS

Imunophan was given to 24 DU patients (mean age 62.0 +/- 1.5 years), in whom the size of ulcer varied from 0.6 to 2.1 cm.

RESULTS

The patients on anti-ulcer therapy plus imunophan had a pain relief median 6.2 +/- 0.2 days (p < 0.001), control ones--11.8 +/- 0.1 days. The median of scarring duration in the test group was 16.2 +/- 0.2 days (p < 0.001), in the controls--23.8 +/- 0.3 days. In 3 (30.0%) cases the scars were rough. The count of T-lymphocytes in the study group increased from 53.1 +/- 0.6 to 65.1 +/- 0.2% (p < 0.001), of T-helpers/inductors--from 27.8 +/- 0.2 to 38.5 +/- 0.3% (p < 0.001), of cytotoxic T-lymphocytes--from 18.5 +/- 0.5 to 27.3 +/- 0.3 (p < 0.001), of B-lymphocytes--from 12.3 +/- 0.2 to 19.1 +/- 0.1% (p < 0.001). The therapy including imunophan reduced concentration of malonic dialdehide by 23.5%, trienic conjugates by 61.6%; raised the level of superoxide dismutase 1.6-fold, catalase 1.4-fold, glutathione reductase by 41.9% (p < 0.001). Neither immune status nor LPO-AOD changed significantly in patients on the basic therapy alone.

CONCLUSION

The results obtained evidence for a positive action of imunophan on inflammation, immune status and antioxidant defense. Therefore, imunophan can be recommended as an adjuvant of basic anti-ulcer therapy in elderly and senile patients.

[Response of microbial communities of Lake Baikal to extreme temperatures]

The survival rate, metabolic activity, and ability for growth of microbial communities of Lake Baikal after exposure to extremely low temperatures (freeze-thawing) for different lengths of time have been first studied. It has been shown that short-term freezing (1-3 days) inhibits the growth and activity of microbial communities. The quantity of microorganisms increased after 7- and 15-day freezing. In the periods of maximums, the total number of microorganisms in the test samples was twice as high as in the control. It was established that after more prolonged freezing the microorganisms required more time after thawing to adapt to new conditions. In the variants with 7- and 15-day freezing, the activities of defrosted microbial communities were three or more times higher than in the control. The survival rate and activity of Baikal microorganisms after freeze-thawing confirms the fact that the Baikal microbial communities are highly resistant to this type of stress impact.

[Identification of the proteins interacting with neuroprotective peptide humanin in a yeast two-hybrid system]

Humanine is a human neuroprotective peptide with a wide action spectrum. To analyze molecular mechanisms of humanin functioning, a search for proteins interacting with this peptide was conducted using yeast two-hybrid system. Screening of human fetal brain cDNA library identified seven proteins with different functions that specifically interacted with humanin.

[Medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer]

The purpose of the study was to evaluate medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer (PU). The subjects of the study were 60 day-case patients with duodenal ulcer aged 18 to 60, who underwent clinical and instrumental examination including esophagogastroduodenoscopy with biopsy and Helicobacter pylori (HP) detection. The patients received 7-day eradication therapy, which included omeprazol in a dose of 20 mg twice a day, clarithromycin--500 mg twice a day, and metronidazole--500 mg twice a day. There was a control group, which included 60 inpatients treated in Gastroenterology Division of the hospital. The use of the three-component medication in the day-case patients and the inpatients led to disappearance of pain syndrome 7.4 +/- 0.3 and 8.6 +/- 0.2 days after the beginning of the treatment, respectively; dyspepsia disappeared in the day-case patients and the inpatients 7.6 +/- 0.2 and 8.8 +/- 0.3 days after the beginning of the treatment, respectively. HP eradication was effective in 86.7% of the day-case patients, and in 88.3% of the inpatients. The course of the disease was recurrence-free during two years in 80% of the day-case patients, and in 76.4% of the inpatients; the cost of the treatment was 2.1 times higher in the group of inpatients. The results show that high effectiveness of the three-component medication, judging by the results of HP eradication, terms of disappearance of pain syndrome and ulcer healing, allows recommending this regimen for wide clinical application in day-case patients with PU.

[Clinical efficiency of course and long-term therapy with the angiotensin-converting enzyme inhibitor perindopril in patients with chronic obstructive lung disease and cor pulmonale]

AIM

to evaluate the clinical efficiency of course and long-term therapy with the angiotensin-converting enzyme (ACE) inhibitor perindopril in patients with chronic obstructive lung disease (COLD) and chronic cor pulmonale (CCP).

MATERIALS AND METHODS

Forty patients aged 40 to 56 years (mean 45.0 +/- 2.0 years) who had COLD and CCP were examined. Hemodynamic parameters were recorded by M- and B-mode and Doppler echocardiographies.

RESULTS

Addition of perindopil to course therapy in patients with COLD and CCP ameliorated pulmonary hypertension, positively affected central and peripheral hemodynanic parameters, and failed to have a negative impact on external respiratory function and renal and hepatic function. The long-term use of perindopril in individually adjusted doses in the outpatient setting showed pronounced beneficial clinical effects and considerably improved the morphofunctional parameters of the right cardiac cavities and patients' life quality.

CONCLUSION

It is advisable to include the ACE inhibitor perindopril into complex therapy in patients with CCP in order to correct pulmonary and central hemodynamic disorders.

[Comparison of the effectiveness of tri- and quadricomponent eradication therapy in patients with peptic ulcer]

The purpose of the study was to compare the effectiveness of tri- and quadri-component therapy of Helicobacter pylori (HP)-associated peptic ulcer (PU). The subjects were 65 patients with duodenal ulcer (DU), divided into two groups. The first, OKM/A group, included 35 patients receiving omeprazole in a dose of 20 mg twice a day, clarythromycin--500 mg twice a day, and metronidazole--500 mg or amoxicillin--1,000 mg twice a day. The second, OBTM group, included 30 patients receiving omeprazole in a dose of 20 mg twice a day, colloid bismuth subcitrate (de-nol)--120 mg four times a day, tetracycline--500 mg four times a day, and metronidazole--500 mg twice or 250 mg four times a day. The study demonstrated high effectiveness of these regimens in HP eradication, time of coping with pain syndrome, and time of ulcer healing. Although the difference between the results in the groups was insignificant, there were certain trends observed. On the one hand, the regimen including clarythromycin seemed to be more effective vs. the regimen including tetracycline. On the other hand, the cost of the clarythromycin regimen is about 1.8 times higher than the tetracycline regimen, due to high cost of clarythromycin. The study shows that quadri-therapy in patients with a DU relapse allows maintenance of the intragastric acidity at the level which is optimal for quick coping with pain and dyspeptic syndromes, lowering of the degree of inflammatory alterations in the gastric and duodenal mucosa, HP eradication, and ulcer healing.

[Use of the ACE inhibitor perindopril in patients with chronic obstructive lung diseases, complicated by cor pulmonale]

The purpose of the study was to evaluate hemodynamic effects and safety of the ACE inhibitor perindopril in treatment of secondary pulmonary hypertension (PH) in patients with chronic obstructive bronchitis (COB). The subjects were 42 patients with COB and secondary PH (functional class (FC) III-IV), whose treatment included 4-week administration of perindopril. Studied were hemodynamic parameters and day profile of blood pressure (24-hour monitoring). Treatment of these patients with perindopril resulted in improvement of PH, positive changes in the right heart, and normalization of blood pressure day profile. Both course treatment and prolonged administration of perindopril were effective in COB patients with clinical manifestations of FC III and IV PH. Long outpatient administration of perindopril in individual doses led to good clinical results and significant positive hemodynamic changes. According to the authors, the ACE inhibitor perindopril may be recommended for correction of hemodynamic disturbances in cases of chronic cor pulmonale in patients with chronic obstructive lung diseases.

[Visual associative memory and the orientation-contingent color after-effect]

The traditional explanation of the McCollough effect (ME) by selective adaptation of single detectors selective to color and orientation suffers from a number of inconsistencies: 1) the ME lasts much longer (from several days up to 3 months) than the ordinary adaptation, the decay of the effect being completely arrested by night sleep or occluding the eye for a long time; 2) the strength of the ME practically does not depend on the intensity of adapting light; and 3) a set of related pattern-contingent after-effects discovered later required for such an explanation new detectors, specific for other patterns. These properties can be explained, however, in the framework of associative memory and novelty filters. A computational model has been developed, which consists of 1) an input layer of two (left and right eyes) square matrices with two analog receptors (red and green) in each pixel, 2) an isomorphic associative neural layer, each analog neuron being synaptically connected with all receptors of both eyes, and 3) an output layer (novelty filter). The modification of synaptic efficacies conforms to the Hebb learning rule. The function of the model was examined by simulation. After a few presentations of colored gratings, the model displays the ME that is slowly destroyed by subsequent presentations of random pictures. With a sufficiently large receptor matrix, the effect lasts a thousand times longer than the period of adaptation. Continuous darkness does not change the strength of the effect. Like in real ME, the model does not display interocular transfer. The model can account for different pattern-contingent color after-effects without assuming any predetermined specific detectors. Such detectors are constructed in the course of adaptation to specific stimuli (gratings).

[Indications of pathogenic viruses in water of Lake Baikal and its tributaries]

The waters of 25 large rivers falling into the Baikal Lake, their mouth water areas and open Baikal Lake areas to a depth of 500 m were for the first time in the practice of researches on the Baikal Lake were investigated for markers of hepatitis A virus and rotaviruses. The investigations showed an insignificant contamination of surface waters with pathogenic viruses. The antigens of all studied viruses and high values of bacteria from the Escherichia coli group were recorded in the areas exposed to chronic man-made pollution. Data on the seasonal changes in the distribution of enteroviruses indicated their absence in the annual cycle in the pelagic area of the lake, which suggests that viral particle would not accumulate under the conditions of the Baikal Lake over a long period.

[The classification and the monitoring of the state of mouth riverine and lacustrine ecosystems in lake Baikal based on the composition of local microbiocenoses and their activity]

The paper presents the results of the long-term investigation of microbial communities in the technogenically vulnerable mouth riverine and lacustrine ecosystems of Lake Baikal. The structural and functional parameters of the microbial communities were analyzed from the standpoint of developing destructive processes. The analysis showed that the total number of microorganisms (TNM), the number of saprophytic bacteria (NSB), and bacterial production (BP) were greater in the river-mouth water than in the near-mouth lake water. In the offshore direction, TNM and NSB decreased by a factor of 1.5 to 2, and BP decreased by a factor of 4 to 7. Based on TNM, NSB, and BP data, we classified the Lake Baikal rivers with respect to the degree of the impact of human activities on them. The degrading capability of the riverine microbial communities was found to be such that they degrade daily from tenths of a percent to 3.5% of the total amount of organic compounds polluted the river waters.

[Comparative analysis of the level of gene transcription in two types of HIV-associated lymphoma]

In order to characterize the molecular mechanisms of lymphoma formation in HIV-infected humans, a method of two-staged substractive cloning was used, which adequately detects genes whose expression is increased in cells of one lymphoma in comparison with another. Using this method, we determined the spectrum of genes whose expression was increased in centroblastic non-Hodgkin's lymphoma in comparison with immunoblastic non-Hodgkin's lymphoma. Several gene groups were distinguished in this spectrum; their probable involvement in lymphogenesis is discussed.

[Electrical feedback in the chemical synapses]

Electrical feedback in chemical synapses and the efficacy of synaptic transmission grow with the increase in the gap resistance, so they should be higher in invaginated synapses than in the flat ones. So the plastic changes in the invagination depth may provide a morphological basis for long-term changes in synaptic efficacy: long-term potentiation (LTP) in brain and retinal synapses. In retinal photoreceptor triad synapses, the electrical feedback can provide an "operational" (instantaneous) control of synaptic transmission.

[Increase of seizure threshold and resistance to stress in rats after immunization against fragment of diazepam-binding inhibitor]

White rats were immunized against fragment of diazepam-binding inhibitor octadecaneuropeptide (ODN) with conjugate ODN bovine serum albumin. This rats have reduced reactions of fear and anxiety in stress model of "open field" and in conflict Vogel test; their pain sensitivity ("tail flick" test) was lowered. The number and intensity of generalized seizure reactions after injection of pentylenetetrazole were decreased. The results show that active immunization to endogenous ODN has stress--protective and anti-seizure effects.

Long-term changes of striatal D-2 receptors in rats chronically exposed to morphine under aversive life conditions

Chronic morphine treatment has been shown to cause the development of hyperreactivity of the dopamine system detected as the increased behavioral and biochemical responses to the action of specific dopamine agonists. Furthermore, inverted changes in animal behavioral reactivity to the stimulation of presynaptic, proposed D-2 receptors by apomorphine in a low dose was found in our previous study when morphine was chronically used in animals under conditions of restraint. To estimate the nature and proposed receptor mechanisms of changes found in behavioral reactivity due to chronic morphine administration in aversive life conditions at the level of highly sensitive D-2 receptors, the density and affinity of [3H] spiroperidol binding sites was studied in these animals two weeks after the last opiate administration. Increased density and affinity of D-2 receptors probably indicating their hypersensitivity was found in animals chronically exposed to two-hour restraint stress, while a significant decrease in density accompanied by increase in affinity of these receptors was typical to rats chronically exposed to morphine under conditions of restraint. The data are discussed in aspects of quantitative and qualitative changes in D-2 receptors, and their proposed mechanisms and functional significance in the mediation of modified organism's functional state due to chronic opiate administration in different environmental conditions.

[Structure of the arterial bed in human lymph nodes]

Blood vessels, that bring blood to various areas of the human superficial inguinal lymph nodes are predominantly arterioles and precapillaries. They are often arranged radially from the hilus to the capsule and from the capsule towards the portal thickening. The arteries and arterioles of the portal and capsular trabeculae reach the paracortical zone, occupying an intermediate position between the medullary cords and the cortex of the lymph node. The arterioles of the paracortical zone, passing between the cortex and the medullary cords, acquire an arcuate appearance. In both directions from them (into central and peripheral areas of the node) precapillaries branch off at a right angle. The cortex is supplied with blood by the arteriolar branches of the paracortical zone and the capsule of the node. The cortical precapillaries branch into capillaries either within the lymphoid nodules, or along their periphery. In the medullary cords those arterioles branch, that get from the portal thickening, portal trabeculae and paracortical zone.

[Bronchopulmonary and pleural complications in middle-aged and old patients operated on for acute cholecystitis]

Broncho-pulmonary-pleural complications in elderly and senile patients operated for acute cholecystitis make 20,6%. The most effective means for prophylaxis and treatment of complications on the respiratory organs are considered to be ultrasonic inhalations in combination with sanitary-therapeutic fibrobronchoscopies.

[Structure of the tunica vaginalis of the human testis and its microcirculatory bed during the pubertal period]

The microvascularization of the layers of the tunica vaginalis propria testis in juveniles and youths is different in morphological parameters which is responsible for their participation in metabolic processes. The distribution of vessel diameters is based on the regularity of random variation. The number of classes for each link of the microcirculatory bed in the tunics studied practically coincide. In any microvascular part of the parietal and visceral layers of the vaginal tunic of the testis a class (a leading functional group of vessels) may be established which has substantially greater density than that of other classes of the variation line presented. The results of morphometry show the prevalence of the venular portion over the arterial one in each of the layers under study. However, the difference between the venular and arterial portions of the microcirculatory bed is more considerable in the parietal layer which is sure to influence the degree of its outflow from the microvascular system.

[Perception of color and volumetric shape of objects]

The problem of recognition of coloration of volume objects, illuminated simultaneously with bright point ans weak diffuse sources (having arbirary and previously unknown spectra) is considered. A mathematical model, in which a process of recognition of coloration is accompanied by determining orientations of surface elements relatively the point source is described. The information on orientation allows in many cases to calculate the volume shape of objects of the external world form their monocular ""retinal"" image.