[Features of otosurgery in children after blast injuries]. / Osobennosti rekonstruktivnoi otokhirurgii u detei posle minno-vzryvnykh ranenii.

An explosion is a process that rapidly releases a huge amount of energy in the form of heat, kinetic energy, and high-pressure shock waves. Since the organ of hearing is most susceptible to pressure changes, damage to the sound-conducting or sound-receiving systems is inevitable in case of an explosive injury. This article examines the mechanism of formation of explosive injuries of the middle and inner ear in children and adolescents, the features of diagnosis and tactics of surgical reconstructive treatment of explosive ear injuries based on the data available in the scientific literature and their own experience.

[Compression of nerves and senses: ipidacrine as the light at the end of the tunnel]. / Kompressiya nervov i chuvstv: ipidakrin kak svet v kontse tunnelya.

OBJECTIVE: To evaluate the efficacy of the AChE inhibitor ipidacrine when added to traditional therapy in outpatients with tunnel syndromes (TS) based on clinical, neurophysiological and psycho-emotional indicators. MATERIAL AND METHODS: Ninety-two patients with a verified diagnosis of TS were randomized into a main group (MG), in which ipidacrine was added to the therapy (n=50), and a control group (CG), which received conventional therapy (n=42). Clinical neurological examination, provocative (Tinel, Falen, Goldberg finger compression, elevator and tourniquet) tests, pain questionnaires (VAS, DN4, PainDetect, Pain Disability Index), Beck's depression scale, the Spielberger Trait and State Anxiety Inventory, electroneuromyography (ENMG) were used. RESULTS: Most of the examined subjects were patients with mild TS without muscle weakness or amyotrophy (80%). In the main group, there was a significant decrease in hypoesthesia, normalization of provocative tests, the increase of SNAP amplitudes, as well as nerve conduction velocities over motor and sensory fibers of the studied nerves (p<0.05). Besides, the regression of neuropathic pain syndrome was objectified according to VAS, DN4 and PainDetect scales, which indexes decreased significantly (p<0.01) in the course of therapy combined with ipidacrine. The positive dynamics, in its turn, contributed to the reduction of depression according to Beck's depression scale, comorbid chronic pain syndrome and improvement of patients' quality of life according to Pain Disability Index (p<0.05). There was no significant improvement of clinical and neurophysiological parameters in the CG (p>0.05). There were no significant differences in the assessment of pain, depression and quality of life (p>0.05), except for a decrease in VAS scores (p=0.03). CONCLUSION: In patients treated with traditional therapy in combination with ipidacrine, the follow-up study after 4 weeks showed the reliable positive dynamics of clinical, neurophysiological and psycho-emotional indicators without application of psychoactive drugs.

[An outpatient with hand numbness: old prejudices, new strategies of differential diagnosis and treatment]. / Patsient s onemeniem v rukakh na ambulatornom prieme nevrologa: starye predrassudki, novye strategii differentsial'noi diagnostiki i lecheniia.

AIM: To search for 'diagnostic masks' of tunnel syndrome (TS) of the upper limbs and evaluate the efficacy of the antiacetylcholinesterase agent ipidakrine in the treatment of TS in a polyclinic. MATERIAL AND METHODS: An analysis of outpatient cards showed that 597 people had complaints of numbness in their hands (23.9% of all neurological pathology). After exclusion of patients with vascular, demyelinating pathology, somatoform disorders, 92 people, who previously had the diagnosis of osteochondrosis, were first-time diagnosed with TS of upper limbs with mild to moderate severity. Kruskal-Wallis' nonparametric analysis of variance revealed homogeneity of clinical and instrumental manifestations in all patients. Patients were divided into 2 comparable groups: the control group (n=42), which received traditional therapy and the main group (n=50), which additionally received ipidacrine. The follow-up clinical-neurophysiological examination was carried out 4 weeks after treatment. RESULTS: A significant improvement was revealed during the use of ipidacrine in addition to the traditional therapy, despite the short period of drug administration. Positive dynamics was also observed in the group receiving traditional therapy, but no significant differences were recorded between baseline and after treatment. CONCLUSION: The key 'diagnostic masks' of TS are various syndromes caused by spinal osteochondrosis. The high efficacy of ipidacrine in the complex treatment of patients with mild to moderate TS is confirmed.

[Study of expression of cytokine genes in the process of cultivation of healthy donor leukocytes].

AIM: Study of expression of cytokine genes in the process of cultivation of healthy donor leukocytes. MATERIALS AND METHODS: RNA isolated before, after 3 and 24 hours of cultivation of leukocytes of 15 healthy donors aged 19 - 32 years was the object of the study. Study of the expression of genes of 8 cytokines by the level of their mRNA was performed by using polymerase chain reactionwith reverse transcription. RESULTS: In healthy donors among with individual differences, general regularities were traced: higher levels of IFNalpha and anti-inflammatory cytokine gene expression, as well as predominantly low expression of pro-inflammatory cytokines. CONCLUSION: In most of the cases in the process of cultivation of leukocytes isolated from blood donors the highest level of gene expression of pro-inflammatory cytokines is noted after 3 hours of cultivation, and expression of genes of anti-inflammatory cytokines remains constant for 24 hours of cultivation.

[Hormonal mechanisms of morphofunctional changes in the gastric mucosa in chronic gastritis]. / Gormonal'nye mekhanizmy morfofunktsional'nykh izmenenii slizistoi obolochki zheludka pri khronicheskom gastrite.

The authors gave morphometric assessment of the mucous membrane of the stomach (MMS), investigated the proliferative activity of its cells and the levels of cyclic nucleotides (cAMP and cGMP) in 60 patients with different types of chronic gastritis. A parallel study was made of the blood levels of cortisol, thyroxine, insulin, STH, and gastrin. 10 healthy persons were investigated for control. A decrease in MMS thickness, redistribution of the sizable lobes of the glandular epithelium and stroma in favor of the latter were shown in atrophic (but not superficial) gastritis. In patients with atrophic gastritis the proliferative activity of MMS cells was significantly raised, the blood levels of cortisol and gastrin were elevated, the level of thyroxine was lowered, and insulin and STH levels were normal. Marked MMS atrophy was accompanied by cAMP and cGMP insufficiency. The relationships between the morphofunctional status and the proliferative activity of MMS cells, on the one hand, and the activity of the hormonal-cyclase systems, on the other hand, were followed. The mechanisms of pathological regeneration of MMS cell elements was specified, and its importance in the morphogenesis of atrophic gastritis was confirmed.