[A tool to assess functional communication skills and its correspondence with traditional language testing in patients with brain tumors]. / Instrument izmereniya funktsional'nykh kommunikativnykh navykov i sopostavlenie ego s traditsionnym rechevym testirovaniem u patsientov s opukholyami golovnogo mozga.

OBJECTIVE: To identify the relationship between speech impairment as measured by the Russian Aphasia Test (RAT) and functional communication as assessed by the Communicative Effectiveness Index (CETI). MATERIAL AND METHODS: RAT and CETI were administered to 87 patients at two time points, before surgery and in 3 months after brain tumor resection surgery. RESULTS: There were significant correlations between CETI and the total scores on RAT subtests for speech comprehension and production before surgery but not in the follow-up period. CONCLUSION: The present research is the first to present the Russian version of CETI and to confirm the relationship between speech disorders measured by the comprehensive standardized battery for evaluating speech function RAT and functional communication as measured by CETI.

Combination of Multimodal MRI, Neuronavigation, and Awake Craniotomy in Removing Tumors of Eloquent Areas.

The aim of the study is to assess the possibilities of the combined approach to using multimodal MRI, neuronavigation, and awake craniotomy in resecting tumors of eloquent areas. Materials and Methods: The results of 30 successive awake surgical interventions performed in 2017-2019 years in patients with tumors of eloquent areas have been analyzed. The main selection criterion for this type of operations was the location of the tumor in the projection or in the immediate proximity to the cortical centers of speech and motion. To minimize the damage, patients underwent functional MRI and DTI tractography at the prehospital stage to identify cortical regions and white matter tracts involved in the motor and language functions; immediately before the operation the acquired data was loaded into the navigation StealthStation S7 (Medtronic, USA) to plan and monitor surgery stages; during the surgery, direct cortical and subcortical stimulation was performed to identify the motor and speech centers (asleep-awake-asleep technique) with neurolinguistic testing. Karnofsky performance status, assessment of the patient's neurological status, frequency of epileptic seizures before and after the operation, the extent of the tumor resection, and the data analysis after the linguistic testing were used to determine the patients' condition and surgery outcomes. Results: Improvement of the general state after the operation has been noted in 30% of patients compared to the preoperative condition, no neurological deficit dynamics has been observed in 33% of patients. Postoperative multimodal MRI showed that total tumor removal was achieved in 37% of cases, subtotal in 40%, partial removal resection in 23% of cases. Conclusion: The combined approach to the brain tumor resection using multimodal MRI, neuronavigation, and awake craniotomy with motor and language areas mapping allows neurosurgeons to minimize the risk of persistent neurological deficit occurrence and provides the possibility to perform maximal resection possible preserving the patients' functional status. The presented methodology is reproducible, permitting one to expand the options of surgical treatment when lesions are localized in eloquent areas.

Determination of Bactericidal Activity Spectrum of Recombinant Endolysins of ECD7, Am24, Ap22, Si3, and St11 Bacteriophages.

The bactericidal activity of recombinant endolysins LysECD7, LysAm24, LysAp22, LysSi3 and LysSt11 was assayed in multidrug resistant strains (n=120) of Salmonella enterica, E. coli, Acinetobacter baumannii, Enterobacter spp., Pseudomonas aeruginosa, Klebsiella pneumoniae, and Campylobacter jejuni. The assay showed that the recombinant endolysins had a wide spectrum of bactericidal activity compared to endolysins of their progenitor phages. Among examined endolysins, we selected the active pharmaceutical substances with broad spectrum of bactericidal activity. Most strains were sensitive to LysECD7 (70.7%), LysAm24 (65%), and LysAp22 (58.6%), which seems to be promising causative agents for the development of finished dosage form.

The effect of hematocrit, fibrinogen concentration and temperature on the kinetics of clot formation of whole blood.

BACKGROUND: Dynamic mechanical analysis of blood clots can be used to detect the coagulability of blood. OBJECTIVE: We investigated the kinetics of clot formation by changing several blood components, and we looked into the clot "signature" at its equilibrium state by using viscoelastic and dielectric protocols. METHODS: Oscillating shear rheometry, ROTEM, and a dielectro-rheological device was used. RESULTS: In fibrinogen- spiked samples we found the classical high clotting ability: shortened onset, faster rate of clotting, and higher plateau stiffness. Electron microscopy explained the gain of stiffness. Incorporated RBCs weakened the clots. Reduction of temperature during the clotting process supported the development of high moduli by providing more time for fiber assembly. But at low HCT, clot firmness could be increased by elevating the temperature from 32 to 37°C. In contrast, when the fibrinogen concentration was modified, acceleration of clotting via temperature always reduced clot stiffness, whatever the initial fibrinogen concentration. Electrical resistance increased continuously during clotting; loss tangent (D) (relaxation frequency 249 kHz) decreased when clots became denser: fewer dipoles contributed to the relaxation process. The relaxation peak (Dmax) shifted to lower frequencies at higher platelet count. CONCLUSION: Increasing temperature accelerates clot formation but weakens clots. Rheometry and ROTEM correlate well.

[The Tobacco Smoking of Pregnant Women: the Role of Psycho-Social Factors].

The tobacco smoking of women during pregnancy and breast feeding represents a significant danger to public health. During pregnancy, the WHO recommends to abstain from cigarettes smoking. In spite of extensive information concerning related to smoking dangers to health of women and fetus, certain females continue to smoke during all pregnancy. The purpose of review is to identify and systematize existing data concerning prevalence, factors and modes of prevention tobacco smoking among pregnant females. In Russia, prevalence of tobacco smoking is at the level of highest European indices though in-land territorial differences are observed. The psycho-social factors significantly contribute to prevalence of smoking among pregnant women. The main social factors of tobacco smoking of pregnant women are low social economic status, unplanned pregnancy, smoking of representatives of the closest social environment (members of family and husband). The leading psychological factors effecting on success of smoking women to quit are psychological well-being, supporting relationship with significant others, high perceptible risks of smoking.

[Lipoilcarnosine: synthesis, study of physico-chemical and antioxidant properties, biological activity]. / Lipoilkarnozin: sintez, izuchenie fiziko-khimicheskikh i antioksidantnykh svoistv, biologicheskaia aktivnost'.

Synthesis of lipoilcarnosine (LipC) - a conjugated molecule based on two natural antioxidants, carnosine and a-lipoic acid, is described. Its physico-chemical, antioxidant properties and biological activity are characterized. According to reversed-phase HPLC with a UV detector, purity of the final product was 89.3%. The individuality of the obtained sodium salt of LipC was confirmed by tandem HPLC-mass spectrometry. High resistance of LipC to hydrolysis with serum carnosinase was demonstrated. The antioxidant activity of LipC measured by reaction with the formation of thiobarbituric acid reacting substances and kinetic parameters of iron-induced chemiluminescence was higher than that of carnosine and lipoic acid. LipC did not affect viability of SH-SY5Y human neuroblastoma culture cells, differentiated towards the dopaminergic type, at concentrations not exceeding 5 mM. At the concentration range of 0.1-0.25 mM LipC protected neuronal cells against 1-methyl-4-phenylpyridinium (MPP + )-induced toxicity.

Relationship between skin blood flow regulation mechanisms and vascular endothelial growth factor in patients with metabolic syndrome.

The focus of this paper is the determination of endothelial dysfunction in patients with metabolic syndrome (MetS) and the establishment of a relationship between the traditional biomarkers of endothelial dysfunction and the vascular tone regulation indices obtained from indirect cold tests in MetS patients. Our investigation was conducted on 30 patients aged 45.5±9 years. The control group comprised 14 healthy subjects aged 48.2±2.4 years. The mechanism of vascular tone regulation was investigated using the wavelet analysis of skin temperature oscillations (WAST). The degrees of microvascular vasoconstriction and vasodilatation were determined during contralateral cold tests in the endothelial (0.02-0.0095 Hz), neurogenic (0.05-0.02 Hz) and myogenic (0.05-0.14 Hz) frequency ranges. In MetS patients, vasoconstriction indices were higher and vasodilatation indices were lower than in the subjects of the control group, which is indicative of disorders in the mechanisms of microvascular tone regulation. These indices correlate with the metabolic parameters and VEGF (vascular endothelial growth factor) levels. The correlation of vasoconstriction and vasodilatation indices with the main factors of the metabolic syndrome testifies that the biological and functional aspects of the endothelial dysfunction are closely related.

Venoarteriolar reflex responses in diabetic patients.

The aim of this study was to investigate the venoarteriolar reflex (VAR) responses in type 1 (T1DM) and type 2 (T2DM) diabetes mellitus (DM) with polyneuropathy and to estimate their relationship with age, DM duration, initial cutaneous temperature and body mass index. Four groups of subjects were investigated: 1st group -20 patients with T1DM; 2nd group -50 patients with T2DM; 3rd group of 20 healthy subjects with similar age and body mass index (BMI) to the T1DM group; 4th group (Control2) of 24 healthy subjects adjusted by age and BMI to the T2DM group. The cutaneous perfusions of the big toe pulp were monitored as baseline perfusions at a temperature of 32°C in supine and sitting position with hanging legs and back in supine position. Loss of venoarteriolar reflex responses was established in 75% of T1DM patients, 78% of T2DM patients and in none of the investigated healthy controls. Reduced venoarteriolar perfusion responses were established in both T1DM and T2DM patients with polyneuropathy compared with healthy subjects. Reliable positive associations between VAR responses and the age, DM duration and initial cutaneous temperature were found.

Microvascular reactivity to thermal stimulation in patients with diabetes mellitus and polyneuropathy.

The study aimed to investigate local thermally induced microvascular reactivity in patients with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) and polyneuropathy and to compare it with healthy controls. A hundred and fourteen subjects were investigated divided into 3 groups: 1st group -20 patients with T1DM; 2nd group -50 patients with T2DM; 3rd group -44 healthy controls. The skin perfusions of the first tiptoe were monitored by laser Doppler flowmetry during thermal test. The initial (PUi) and basal perfusions at 32°C (PUb) tended to be higher in the DM groups and the PUb of T1DM group was higher compared with the healthy subjects. The perfusion responses to heating were attenuated in the patients compared with the controls. The calculated vasodilator heat-induced indices were significantly lower and the vasoconstrictor indices during relative cooling in the recovery period were significantly higher in DM patients related to the healthy subjects. The reduced cutaneous microvascular responses to local thermal stimulation in the plantar sides of the toes of both T1DM and T2DM patients with polyneuropathy were similar to those found by previous studies in other investigated sites of glabrous and nonglabrous skin of patients with DM.

Comparative study between microvascular tone regulation and rheological properties of blood in patients with type 2 diabetes mellitus.

The aim of the study is to investigate the changes of the skin blood flow responses to cold stress in patients with diabetes mellitus type 2 through wavelet analysis of the peripheral skin temperature oscillations and to estimate their relationship with the blood viscosity values. The amplitudes of the skin temperature pulsations (ASTP) were monitored by "Microtest" device ("FM-Diagnostics", Russia); the whole blood viscosity and the shear stresses were measured by Contraves LS30 viscometer (Switzerland) at a steady flow in 9 healthy subjects and in 30 patients with type 2 diabetes mellitus. Power law and Herschel-Bulkley (HB) equations were applied to describe the blood rheology. Both models include consistency (k) and flow index (m), and the HB also gives the yield stress (τ0). The Spearman rank correlations between these parameters and the ASTP in the frequency ranges, corresponding to the myogenic, neurogenic and endothelial mechanisms of the microcirculation tone regulation were calculated. The ASTP values decreased when the blood viscosity increased. The correlation analysis revealed good ASTP-m (r > 0.5) and ASTP-k (r < -0.5) relationships in the endothelial range, while the ASTP-τ0 correlation was weaker (r≈-0.4). These correlations became lower for the ASTP during the cold stress. The results prompt manifestation of endothelial dysfunction in patients with type 2 diabetes.

[Alexithymia in patients with left-hemispheric cerebral infarction in the late recovery period]. / Aleksitimiya u bol'nykh s infarktom golovnogo mozga levopolusharnoi lokalizatsii v pozdnem vosstanovitel'nom periode.

AIM: To study emotional status, including alexithymia, anxiety and depression, in patients with cerebral infarction in the area of the middle cerebral artery (on the left side) in the late recovery period and to develop a method for correction of the damage. MATERIAL AND METHODS: The study included 30 patients with cerebral infarction in the area of the middle cerebral artery (on the left side). A comparison group consisted of 10 patients with chronic brain ischemia. RESULTS AND CONCLUSION: The results have demonstrated the correlation between the level of alexithymia and the severity of neurological deficit, sex-related level of anxiety and depression. The cerebral infarction impacts on the level of alexithymia. Alexithymia in patients with cerebral infarction affects the adequate self-esteem of physical and mental condition that may complicate the rehabilitation of these patients and demands correction as a combination of pharmacotherapy and psychotherapeutic intervention.

Numerical analysis of 3D blood flow and common carotid artery hemodynamics in the carotid artery bifurcation with stenosis.

The results for blood flow in the carotid artery bifurcation on the basis of numerical simulation of Navier-Stokes equations are presented in this study. Four cases of carotid bifurcation are considered: common carotid artery (CCA) bifurcation without stenoses and cases with one, two and three stenoses are also presented. The results are obtained by performing numerical simulations considering one pulse wave period based on the finite volume discretization of Navier-Stokes equations. The structures of the flow around the bifurcation are obtained and the deformation of the pulse wave from common carotid artery (CCA) to the internal carotid artery (ICA) and external carotid artery (ECA) is traced. The axial velocity and wall shear stress (WSS) distribution and contours are presented considering the characteristic time points. The results of the WSS distribution around the bifurcation allow a prediction of the probable sites of stenosis growth.

[Immunomorphological features of chronic tonsillitis].

The objective of the present work was to overview current concepts of immunology and pathological morphology of chronic tonsillitis. Morphological aspects of embryological development of palatine tonsils are discussed in conjunction with their participation in the formation of the immune response. Morphological and immunological peculiarities of the pathological process in chronic tonsillitis are described. It is concluded that otorhinolaryngologists must in due time identify indications for radical surgical sanitation of the pockets of chronic infection by means of bilateral tonsillectomy.

Hematological changes in case of chronic cadmium intoxication and monensin detoxication. Relationship with rheological variables.

The study evaluated the affect of chronic cadmium (Cd) and monensin treatment on some hematological parameters and its relationship with the rheological variables. Adult male mice were subjected to chronic treatment with cadmium acetate [Cd(CH3COO)2 × 2H2O] (group 1), Cd(CH3COO)2 × 2H2O followed by treatment with low dose monensin (group 2) and Cd(CH3COO)2 × 2H2O followed by high dose monensin treatment (group 3). Cd(CH3COO)2 × 2H2O and deprotonated monensin were dissolved in distilled water and given daily to the experimental animals. Mice drinking distilled water served as a control group (group 4). Hematological parameters and erythrocyte morphology were evaluated in parallel with whole blood viscosity (WBV). Cd treatment reduced Hb and increased RDW. The addition of high dose monensin significantly improved erythrocytic indices compared to the control. Erythrocyte anisocytosis was observed in blood smears of Cd-treated mice corresponding to the increased RDW. WBV was significantly elevated in the experimental groups in the whole range of shear rates compared to the control group and in groups 2 and 3 was lower than in group 1 but remained higher compared to group 4. Correlations were found between WBV and RBC, Hb, Hct, MCV and RDW. The results suggest that hemorheological parameters such as WBV should be monitored in parallel with the hematological parameters when monensin is applied and heavy metal intoxication is suspected.

Experimental evaluation of mechanical and electrical properties of RBC suspensions in Dextran and PEG under flow II. Role of RBC deformability and morphology.

Mechanical and electrical properties of the normal RBCs suspensions and of hardened after treatment with glutaraldehyde (0.01-2.5%) RBCs in isotonic physiological solution and Dextran 70,000 (Dextran 70) and Polyethylene glycol 35,000 (PEG) and adjusted to hematocrit of 40%, were evaluated. Apparent viscosity and conductivity were measured under steady and transient flow regimes at low shear rates and at different local structure of the flow at 37 °C. A time course of conductivity was recorded in parallel with the rheological properties of the RBC suspensions and conductivity and apparent viscosity dependences on shear rates were studied and compared at different concentrations of Dextran 70, PEG and glutaraldehyde. Low shear viscosity decreased after RBCs treatment with glutaraldehyde and at 0.5-2.5% it is constant. Echinocytes are observed at low Dextran 70 and PEG concentrations while spherocytes are found mainly in smears treated with higher concentrations. The results show that the apparent viscosity and conductivity of RBCs suspensions in Dextran 70 and PEG are strongly influenced by flow, shear rates, concentration, cell deformability and morphology and the method is sensitive to study the mechanical and electrical properties of RBC suspension and to provide experimental description of RBCs and other cell-to-cell interactions.

Experimental evaluation of mechanical and electrical properties of RBC suspensions under flow. Role of RBC aggregating agent.

Mechanical and electrical properties of red blood cells (RBC) suspensions in dextran 70 (Dx70), dextran 150 (Dx150), dextran 500 (Dx500) and polyethileneglycol (PEG) 35,000 with different concentrations were evaluated through apparent viscosity and conductivity measurements under steady and unsteady flow conditions. RBCs suspensions of the washed RBS in PBS (control) and Dx70, Dx150, Dx500 and PEG in PBS with different concentrations, adjusted to the same hematocrit of 40% were used for the experiments. Conductivity time and shear rate dependences in parallel with the rheological properties of the samples were studied under transient flow regimes at different local structure of the uniform Couette flow. Their relationships on dextrans and PEG concentrations were evaluated too. Low shear viscosity increased and conductivity decreased of RBC suspensions, compared to non-aggregating suspensions, depending on dextrans and PEG concentrations. A time course of blood conductivity recorded under different flow conditions provides experimental description of RBC aggregation-disaggregation processes and other cell-cell interactions. The results show that the blood conductivity is strongly dependent on the considered blood factors and is influenced by flow, shear rates and concentration of dextran and PEG solutions.

Effects of ectopic pacing on repolarization of the chicken left ventricle.

Effects of ectopic pacing on left ventricular repolarization were studied in six anesthetized open-chest chickens. In each animal, unipolar electrograms were acquired from as many as 98 sites with 14 plunge needles (seven transmural locations between epicardium and endocardium in each needle). Activation-recovery intervals (ARIs), corrected to the cycle length, were used for estimating repolarization. At baseline, the nonuniform ARI distribution in the left ventricle resulted in the apicobasal differences being greater than the transmural gradient. Nonuniform ARI prolongation caused by ectopic pacing resulted in decreasing the transmural repolarization gradient and increasing the differences in the apex-to-base direction. The basal, but not apical transmural differences contributed to the total left ventricular transmural gradient. The total left ventricular apicobasal gradient was contributed by the apicobasal differences in mid-myocardial and subendocardial layers more than in subepicardial ones. Thus, in in situ chicken hearts, the transmural and apicobasal ARI gradients exist within the left ventricle with the shortest ARIs in the basal subepicardium and the longest ARIs in the subendocardium of the apical and middle parts of the left ventricle. Apicobasal compared to transmural heterogeneity of local repolarization properties contributes more to the total left ventricular repolarization gradient.

[The role of bacteriological examination in diagnosis of chronic tonsillitis].

A bacteriological examination was made in 105 patients with various forms of chronic tonsillitis. Eighteen cultures of beta-hemolytic streptococcus (BHSA) were isolated from 36 patients with paratonsillar abscesses. BHSA seeding in paratonsillar abscess was 50.0%. Eight BHSA cultures were isolated from 69 patients with chronic tonsillitis. BHSA seeding in chronic tonsillitis was 11.6%. Adequate set of culture media for BHSA growth was optimized. The technique of the sample collection from tonsillar lacunes was improved. The significance of bacteriological diagnosis of chronic tonsillitis increases considerably due to optimization of out- and intralaboratory tests at the preanalytic stage of the study.

[Cardinal problems of the regional bacteriological laboratories of tuberculosis facilities].

Restructuring the health care system and the epidemiological situation associated with tuberculosis result in an increased burden on the bacteriological laboratories (BLs) of tuberculosis facilities. At present, there are no statistical data that enable one to estimate the capacity of a laboratory service to assure the adequate quality and efficiency of bacteriological diagnosis. To assess the state of the headquarters BLs of tuberculosis facilities, the authors have worked out a questionnaire to glean necessary information on the activity of the laboratories to such an extent that suffices to reveal cardinal problems in the work of individual laboratories and the laboratory network as a whole. Out of the 48 questionnaires sent from the regional BLs, the data available from 22 laboratories that had fully answered all the questions were analyzed. The data obtained are referred to as of 2004, i.e. when the current antituberculous care projects were launched, which is of significance in organizing the monitoring of a laboratory service and in assessing the progress of the projects. The authors have identified the following cardinal problems: inadequate readiness of most laboratories to fully perform their incumbent functions; no coordination in providing data at the regional and federal levels; inefficient laboratory diagnosis that is associated with the disintegration of the curatorial institution, with neither reference relations no united external or internal quality control programs, with the lack of expertise and the undermanning of the laboratories, with the obsolete list of staff members and the obsolete standards for calculation of their loads, with the deterioration of a material and technical base, and with the unconformity of equipment to the state-of-the-art technologies. In order to solve the above problems, the authors offer a laboratory service monitoring system based on the proposed questionnaire, followed by the computerization of data collection and the compulsory supervision of regional laboratories by the officials of district and federal BLs.