[Association of ITGB3, P2RY12, and CYP2C19 gene polymorphisms with platelet functional activity in patients with coronary heart disease during dual antiplatelet therapy]. / Assotsiatsiia polimorfizmov genov ITGB3, P2RY12, CYP2C19 s funktsional'noi aktivnost'iu trombotsitov u patsientov s ishemicheskoi bolezn'iu serdtsa na fone dvukhkomponentnoi antiagregantnoi terapii.

AIM: To assess the association of CYP2C19 G681A, P2RY12 H1/H2, and ITGB3 T1565C polymorphisms with the extent of platelet aggregation in patients with coronary heart disease (CHD) during antiplatelet therapy. SUBJECTS AND METHODS: 166 male patients with CHD, living in the Western Siberian Region, were examined. All the patients underwent a test for platelet aggregation induced by ADP (2.5 and 5.0 µm) and epinephrine (0.2 µm). Genotyping was performed using an allele-specific polymerase chain reaction technique. RESULTS: The polymorphic variants of the P2RY12 and ITGB3 genes were ascertained to have no impact on the extent of platelet aggregation in patients receiving clopidogrel and acetylsalicylic acid. An association was found between CYP2C19 681A allele carriage and the increased extent of platelet aggregation induced by ADP. CONCLUSION: The carriage of the cytochrome P450 CYP2C19 681A allele rather than platelet receptor gene polymorphisms determines a risk for clopidogrel resistance in patients with CHD.

[Association of I/D and -786 Polymorphisms of ACE and NOS3 Genes With Features of the Course of Ischemic Heart Disease and Diabetes Mellitus Type 2].

AIM: to study relationship of ACE insertion-deletion (I/D) polymorphism and NOS3 T-786C polymorphism with characteristics of the course of ischemic heart disease (IHD) at the background of diabetes mellitus. MATERIALS AND METHODS: Were examined 114 patients with IHD, 29.8% of patients had type 2 diabetes mellitus. ACE and NOS3 polymorphisms were determined by allele-specific polymerase chain reaction with primers by "Lytech". RESULTS: Patients with combined pathology belonged to older age group, had increased frequency of obesity and predominance of functional class II chronic heart failure. In this group we detected association of D allele of the ACE gene with higher frequency of dyslipidemia and obesity. Among patients with IHD without diabetes we observed associations of ACE I/D and NOS3 T-786C polymorphisms (close and moderate, respectively) with severity of effort angina. We also found that frequency of dyslipidemia among carriers of II and TT genotypes was lower than among carriers of other genotypes. CONCLUSION: Presence of type 2 diabetes as background pathology leads to a change of character of association of ACE I/D and NOS3 T-786C polymorphisms with clinical characteristics of patients with IHD.

[Resistance to clopidogrel and polymorphism of P2RY12 and GPIIIA genes in patients with chronic coronary heart disease].

We studied the association between clopidogrel resistance, H1/NH2 polymorphism of the P2RY12 gene and T156C polymorphism of the GpIIIa gene in residents of Western Siberia suffering chronic CHD. It was shown that the occurrence of H1 and H2 haplotypes of the P2RY12 gene and 1565T and 1565C alleles of the GpIIIa gene was similar to that reported for European populations. Patients showing variable platelet response to the inhibitory action of clopidogrel were not significantly different in terms of P2RY12 and GpIIIa genotype distribution. To conclude, the study revealed no association between the risk of clopidogrel resistance and the presence of polymorphic variants of platelet receptor genes P2RY12 and GpIIIa.

[Endoscopic assistance in microvascular decompression of cranial nerves].

Microvascular decompression (MVD) is an effective method for treatment of trigeminal neuralgia (TN), hemifacial spasm (HFS), glossopharyngeal neuralgia (GPN). The aim of this study was to assess the role of endoscopic assistance in MVD for the treatment of cranial neuropathies. Since 2009 till 2011 133 patients with cranial neuropathies were treated by MVD in Burdenko Neurosurgical Institute, Moscow. In 22 patients (11 patients with HFS, 10 patients with TN, 1 with GPN) endoscopic assistance was applied during the MVD. We used minimally invasive retrosigmoid approach in a unilateral position. Cerebellopontine angle was explored by 30-degree or 70-degree telescope to visualize the root entry zone of trigeminal, facial or glossopharyngeal nerves and to locate the neurovascular conflict. In 9 patients with HFS and in 1 patient with TN and in another patient with GPN endoscopy discovered offending vessels that were not visible through the microscope. In all cases endoscope was used to exclude another site of compression and to verify decompression and to identify position of teflon and offending vessel after MVD. Immediately after the surgery excellent outcome was observed in 10 patients with HFS (89%), one patient was reoperated 1.5 years after first operation with positive effect. Relief of pain in early postoperative period was observed in patients with TN and GPN. There were no major complications and postoperative mortality in our series. Endoscopic assistance is very effective and helpful technique in MVD of cranial nerves, especially in cases with HFS. In this study the use of the endoscope allowed to identify the site of compression and to confirm the position of teflon after MVD.

[D allele of the angiotensin converting enzyme gene is a putative risk factor of restenosis after coronary stenting in patients with coronary heart disease].

We undertook a comparative analysis of allele frequency distribution and I/D polymorphism of the angiotensin converting enzyme (ACE) gene in patients with coronary heart disease (CHD) undergoing coronary stenting with and without signs of restenosis. There were no significant difference between the groups in the genotype frequency distribution of I/D polymorphism of the CAE gene (p = 0.061). The occurrence of D allele in the patients with restenosis was higher than that of I allele (chi-square test 4.117, p = 0.042). Relative risk for the carriers of D and I alleles was 0.35 and 2.83 respectively. It is concluded that the presence of D allele of I/D polymorphism of the CAE gene in patients with chronic CHD may be a risk factor of restenosis of stented coronary arteries.

Nanohyperthermia of malignant tumors. II. In vivo tumor heating with manganese perovskite nanoparticles.

OBJECTIVES: To evaluate the ability of manganese perovskite nanoparticles (lanthanum-strontium manganite) to heat the tumor tissue in vivo under action of external alternating magnetic field. MATERIALS AND METHODS: The magnetic fluid on the basis of nanoparticles of perovskite manganite was tested in the heating experiments using of alternating magnetic field of frequency 300 kHz and amplitude 7.7 kA/m. Guerin carcinoma was transplanted into the muscle of rat. Magnetic fluid was injected intramuscularly or intratumorally. Temperature was measured by copper-constantan thermocouple. RESULTS: Temperature of magnetic fluid was increased by 56 °C for 10 min of alternating magnetic field action. Administration of magnetic fluid into the muscle followed by alternating magnetic field resulted in the elevation of muscle temperature by 8 °C after 30 min post injection. Temperature of the tumor injected with magnetic fluid and treated by alternating magnetic field was increased by 13.6 °C on the 30 min of combined influence. CONCLUSION: In vivo study with rat tissue has demonstrated that magnetic fluid of manganite perovskite injected in the tumor increases the tumor temperature under an alternating magnetic field. Obtained results emphasize that magnetic fluid of manganite perovskite can be considered as effective inducer of tumor hyperthermia.

[Endoscopically assisted removal of posterior fossa meningioma combined with microvascular decompression of trigeminal nerve root (early experience)].

The article presents an example of endoscopically assisted neurosurgical removal of petrous apex meningioma associated with trigeminal neuralgia. Endoscopy was used during the operation for control of completeness of tumor removal and for identification of offending vessel and control of position of protector. Total resection of the tumor was achieved, complete regression of trigeminal pain was observed in early postoperative period.

Hypoxia level and matrix metalloproteinases-2 and -9 activity in Lewis lung carcinoma: correlation with metastasis.

AIM: To investigate the relationship between tumor hypoxia in vivo, activity of matrix metalloproteinases (MMPs), and metastatic potential of tumor. MATERIALS AND METHODS: Lewis lung carcinoma (3LL) was used in this study. Total activity of MMP-2 and -9 in tumor was measured biochemically, tumor hypoxia level was assessed by (31)P NMR spectroscopy in tissue perchloric extracts. RESULTS: It was determined that hypoxia level in primary tumor has been concomitantly increasing along with tumor growth and correlated with metastasis level in lung. The positive correlation between hypoxia level and activities of MMP-2 and MMP-9 in primary tumor was registered. Moreover, the activity of MMP-2 and -9 in 3LL (primary tumor) directly correlates with metastasis level in lung. CONCLUSION: This study demonstrated that the growth of primary tumor is distinctly accompanied by an increase of tumor hypoxia level which positively correlates both with the activity of MMP-2 and -9 in primary tumor and metastatic efficiency.

[Dynamic monitoring of the severity of brain edema and swelling by separate impedance measurement in patients with severe craniocerebral trauma]. / Dinamicheskii kontrol' vyrazhennosti oteka i nabukhaniia mozga metodom razdel'noi impedansometrii u bol'nykh s tiazheloi cherepno-mozgovoi travmoi.

The dynamics of brain edema and swelling was studied according to the indices of separate impedancemetry in the early posttraumatic period in 36 patients with severe craniocerebral trauma. Swelling of the brain predominated on the 1st and 2nd days in most patients. Later, depending on the severity of the posttraumatic period, the swelling may grow or be replaced by edema with subsequent normalization. A parallelism was revealed between the severity of brain edema and swelling, the intracranial pressure value, and the severity of the patient's condition.

[The differential diagnosis and treatment of brain edema and swelling]. / Differentsial'naia diagnostika i lechenie oteka i nabukhaniia golovnogo mozga.

Data is reported in evidence of the possibility of using separate impedancemetry for intravital diagnosis of the degree of manifestation and the dynamics of development of brain edema and swelling. The specific features of the effect of mannite, furosemide, sorbitol, dexamethasone, and thiopental sodium on brain edema and swelling were studied in the clinic under control of impedancemetry in patients with craniocerebral trauma of various severity and edema and swelling of different degree of manifestation. Experimental study on a model of intracerebral hemorrhage showed that mannite, furosemide, and dexamethasone act on the dynamics of edema and swelling in phases.

[Impedance measurement in neurosurgical practice]. / Impedansometriia v neirokhirurgicheskoi praktike.

The work deals with materials on the use of the method of impedance measurement in neurosurgical practice to determine the histological structure of the tumor, various structures of the brain, and the zone of brain freezing in stereotaxic operations. It shows the role of separate impedance measurement of ohmic resistance and total capacity of cerebral tissue in judging the degree and dynamics of the development of edema and swelling of the brain in patients with brain tumors, craniocerebral trauma, and spinal pathology. The study was conducted in experiments on rabbits, rats and in the clinic.

Tumour pH under induced hyperglycemia and efficacy of chemotherapy.

Blood glucose and insulin content, as well as tumour pH, were evaluated under induced hyperglycemia in Wistar or strain IOP rats bearing Guerin carcinoma. The average tumour pH decreased to 5.2-5.4, and could be maintained at this level for at least 24 hr. It was demonstrated that the antitumour effect of thiophosphamide was greatly enhanced under conditions of low tumour pH. The length of survival of rats bearing a Guerin carcinoma increased 6-fold when thiophosphamide was injected during the induced hyperglycemia.

[Changes in cerebral and peripheral plethysmograms in the early postoperative period of patients with supratentorial tumors]. / Izmeneniia mozgovoi i perifericheskoi pletizmogramm v rannem posleoperatsionnom periode u bol'nykh s supratentorial'nymi opukholiami.

Cerebral and peripheral plethysmograms were studied in the early postoperative period in 76 patients with supratentorial tumors. Their simultaneous recording, appraisal of the pronounced character of the pulse, respiratory, and irregular oscillations and waves of the 3rd order, their changes in dynamics make it possible to judge the state of cerebral circulation and draw prognostic conclusions. The character of correlation of cerebral and peripheral plethysmograms, particularly in the synchronism and direction of the waves of the 3rd order, attests to the intactness of disorders of autoregulation of the cerebral blood flow.

[Correlation of the angiographic, ophthalmologic and rheoencephalographic indices of the cerebral circulation in severe craniocerebral injuries]. / Sootnoshenie angiograficheskikh, oftal'mologicheskikh i reoéntsefalograficheskikh pokazatelei mozgovog krovoovrashcheniia pri tiazheloi cherepno-mozgovoi travme

The results of a study of cerebral haemodynamisc in 54 patients with severe craniocerebral injuries in the acute period and in the course of the lesion are presented. Ophthalmological, angiographic, and theoehcephalographic examinations were conducted. Distinct cerebral blood flow disorders were revealed in various cerebral vessels, consisting in a considerable increase of their tonicity, even as high as spasm, shifts, decelerations of the blood flow. Correlations between the indices of different methods were established.

[The relationship between the development of the clinical picture of the disease and the rate of development of the intracranial focus (an experimental study)]. / Razvitie klinicheskoi kartiny zabolevaniia v zavisimosti ot tempa narastaniia vnutricherepnogo ochaga (éksperimental'noe issledovanie)

Experiments on 53 dogs with a slowly increasing limited brain cavity depicted some traits in the development of intracranial hypertension and in the clinical development of the disease with regard to the rate of intensification of the focus. The rate of an increasing focus exerts great influence on the correlation between the duration of the period of larvated (compensated) and manifest development of the pathological by volume process in the brain cavity. The author distinguishes 4 types in the development of the disease: chronic, subacute, acute and stroke-like conditioned by the degree of expressiveness in the compensatory mechanisms and factors leading to a breakdown of compensation.