1H multiple quantum NMR in alternating quasi-one-dimensional spin chains of hambergite.

Multiple quantum (MQ) dynamics was investigated in quasi-one-dimensional 1H zigzag spin chains in hambergite (Be2BO3OH) single crystals. Due to the non-linear arrangement of the spins, dipolar coupling strengths alternate along the chain. To solve the problem of MQ NMR experiments taking too much time due to extremely long 1H spin-lattice relaxation times, the samples were exposed to gamma irradiation to produce the defects accelerating the relaxation. The influence of the radiation dose was investigated. The experimental dependencies of MQ coherence intensities on the MQ excitation time in alternating spin chains were obtained and compared with the theory for inhomogeneous spin chains with nearest neighbor interactions developed earlier. The correspondence of the observed MQ dynamics to the alternating spin chain was demonstrated.

[Clinical results and prospects for the use of phenosanic acid in patients with focal epilepsy]. / Klinicheskie rezul'taty i perspektivy primeneniya fenozanovoi kisloty u vzroslykh patsientov s fokal'noi epilepsiei.

OBJECTIVE: To study the efficacy and safety of using a new original synthetic antioxidant - phenosanic acid as an adjunct therapy in patients with focal epilepsy. MATERIAL AND METHODS: A randomized, double-blind, placebo-controlled, parallel-group study evaluated the efficacy and safety of phenosanic acid as an adjunct therapy to basic antiepileptic drugs in 120 patients with focal epilepsy. Primary purpose: to study the dynamic of seizure frequency. Secondary purposes: to study the dynamic of seizure-free days, the dynamics of bilateral tonic-clonic seizures, the results of questionnaires and scales (General Dynamics Assessment, Visual Analogue Scale (VAS), Quality of Life in Epilepsy (QOLIE-31-P), European Quality of Life Questionnaire (EQ-5D), Hospital Anxiety and Depression Scale (HADS), Frontal Asstssment Battery (FAB), Mini-Mental State Examination (MMSE)). RESULTS: Phenosanic acid (Dibufelon) showed statistically significant benefit over placebo in the primary indicator of efficacy (reduction in the frequency of epileptic seizures by at least 50%) and in the secondary indicators. The drug was safe and well tolerated by the patients. CONCLUSION: The addition of phenosanic acid (Dibufelon) to base antiepileptic drugs seems to be perspective because of its positive effect on reducing the number of epileptic seizures, as well as on comorbid disorders in the emotional and cognitive spheres.

1H NMR in a quasi-one-dimensional zig-zag spin chain of hambergite, Be2BO3(OH).

One-dimensional spin chains are important testbeds for the investigation of quantum many-body systems. Here, we introduce a new quasi-one-dimensional chain of spin-1/2 1H nuclei in hambergite (Be2BO3(OH)) crystal. The distinctive feature of hambergite is the zig-zag arrangement of the spins in the chains compared to the systems reported earlier. A single crystal of hambergite was investigated experimentally using 1H nuclear magnetic resonance at different orientations in the external magnetic field. The experimental spectra were compared with the Van Vleck's second moments calculated from the structural data. For the orientation of the chain along the external magnetic field the resonance resembles that of the linear spin chains and the calculated contributions to the second moment from spins within one chain of hambergite amount to 96%. For other orientations the spectra demonstrate features specific to the zig-zag chain. Our results show that 1H nuclei in hambergite crystals could serve a good model of a well-isolated zig-zag spin chain.

Evaluation of Stromal Vascular Fraction Properties and Histological Changes of Regenerating Tissue during Healing of Radiation-Induced Lesions in the Rectum.

We analyzed the main properties of autologous adipose-derived stromal vascular fraction (SVF) used for the treatment of radiation-induced lesions in the rectum. No statistically significant correlation between the main characteristics of the cell product (cell number, viability) and patient's age or donor area were revealed. The stages and peculiarities of histological changes in the regenerating tissue after injection of autologous adipose tissue cells were analyzed. Morphological changes at the stages of granulation, early and complete epithelialization, and tissue maturation were described.

[Use of Detravenol in treatment of chronic venous insufficiency of lower limbs]. / Primenenie preparata Detravenol pri lechenii khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei.

AIM: The purpose of this study was to prove that Detravenol is not inferior by clinical efficacy to Detralex® in the course administration in patients presenting with chronic venous insufficiency of the lower extremities caused by lower limb varicose veins. PATIENTS AND METHODS: Ours was a prospective randomized open-liable comparative trial aimed at determining efficacy and safety of the two drugs in parallel groups with active control. The trial enrolled a total of 106 patients with chronic venous insufficiency of the lower extremities secondary to lower limb varicose veins. The patients took the drug during 60 days twice daily. The primary outcome measure of efficacy was reduction of the malleolar circumference upon completion of treatment as compared with the baseline values, with the secondary outcome measures being the dynamics of parameters according to the Venous Clinical Severity Score (VCSS), CIVIQ-2 quality of life questionnaire, and the findings of ultrasonographic duplex scanning. RESULTS: The obtained findings demonstrated efficacy of therapy with the use of Detravenol in treatment of patients with chronic venous insufficiency of the lower limbs. The 60-day therapy with the study drug resulted in decreased oedema of the lower extremities: the malleolar circumference reduced averagely by 4%, the composite index of the venous clinical severity score diminished averagely by 50%, and the subjective measure of quality of life increased. Patients taking the study drug demonstrated positive dynamics according to the findings of ultrasonographic duplex scanning, with no serious adverse events during the trial observed. CONCLUSION: By the primary outcome measure of efficacy (reduction of the malleolar circumference) therapy using the investigational drug proved to be not inferior to therapy with the comparator drug. By the secondary outcome measures the compared therapies appeared equally effective. The study drug and the comparator were found to have a similar safety profile.

Orientational dependencies of dynamics and relaxation of multiple quantum NMR coherences in one-dimensional systems.

Dynamics and relaxation, or decoherence, of multiple quantum (MQ) coherences are investigated experimentally and theoretically for different orientations of a single crystal of fluorapatite with respect to the external magnetic field. Dynamics of MQ coherences is studied as a function of the preparation period of the MQ NMR experiment. Their relaxation, or decoherence, during the evolution period is also investigated. Universal curves for dynamics and relaxation are obtained and describe the experimental data for different orientations of the investigated sample. Those curves prove the dipolar nature of the observed relaxation process. The contribution of the heteronuclear interactions to the dipolar relaxation is also investigated. The source of discrepancies between experimental data and theoretical results in the experiments with a large angle between the nuclear spin chains and the external magnetic field are discussed.

EXPERIENCE OF APPLICATION OF VOLUME FORMING AGENT «DAM+¼ IN TREATMENT OF ANAL INCONTINENCE ASSOCIATED WITH INCOMPETENCE AND TRAUMA OF ANAL SPHINCTER.

The attempts of introduction of volume forming agent in submucous layer started at the beginning of 1990th. The aim of these innovations was to rise of basal pressure. This research has been performing since 2007. It included experimental and clinical phases with participation of 41 patients with anal incompetence aged 3­26 years old. The agent «DAM+¼ was introduced in submucous layer of anal сanal in four points. The basal pressure was risen in 2­3 times after implantation and it was at the average more 65% of age standards. The application of volume forming agent «DAM+¼ is effective method of correction of anal incontinence. It'll require the re-introduction procedure in longterm period.

[Methylation status of line-1 retrotransposon in chromosomal mosaicism during the early stages of human embryonic development].

Early stages of human embryonic development are characterized by spatio-temporal coincidence of events of total epigenetic genome reprogramming and elevated level of mosaic forms of numerical chromosome abnormalities. It is possible that the abnormal reprogramming of various regions of the genome can lead to violations of local epigenetic chromatin organization and gene expression, affecting the correct chromosome segregation during mitosis. In this study, a comparative analysis of the methylation index of LINE-1 retrotransposon, which is largely reflecting the methylation profile of the genome, is performed in placental tissues of spontaneous abortions with complete and mosaic forms of aneuploidy, and with a normal karyotype, as well as in the control group of induced abortions of the first trimester of pregnancy. It was shown that extraembryonic mesoderm and chorionic cytotrophoblast of spontaneous abortions with chromosomal mosaicism are characterized by the highest index of LINE-1 methylation among all groups studied. At the same time excessive hypomethylation of transposable genetic element recorded in spontaneous abortions with normal karyotype. It is suggested that violations of parental genomes demethylation during epigenetic reprogramming at preimplantation stages of development may be associated with an increased frequency of mitotic errors in chromosome segregation, leading to the formation of a mosaic karyotype.

[Hypercoagulation syndrome in multiple myeloma].

AIM: To determine the frequency and pattern of blood clotting disorders in patients with multiple myeloma (MM) and to evaluate the adequacy of preventive anticoagulant or antiaggregant therapy. SUBJECTS AND METHODS: The prospective study conducted at the Department for High-Dose Chemotherapy and Bone Marrow Transplantation, Hematology Research Center, Ministry of Health of the Russian Federation, in March 2012 to May 2013, enrolled 25 patients (13 men and 12 women) aged 29-72 years (median age 54 years) with new-onset MM. The latter was staged using the Durie-Salmon classification: Stages I, II, and III were determined in 2, 10, and 13 patients, respectively. Seven patients were found to have renal dysfunction (which corresponded to Substage B). The hemostasis was evaluated from the results of the following tests: activated partial thromboplastin time (APTT), thrombin time (TT), Xlla-dependent fibrinolysis time, Quick prothrombin index, international normalized ratio (INR), and fibrinogen and D-dimer concentrations. The investigators used new hemostatic techniques, such as thrombin generation test, thromboelastography, as well as thrombodynamics, a novel method to determine the characteristics of spatial clot growth. Induction therapy was performed using the PAD and VCD regimens. Thromboses were prevented by using 24-hour infusion of unfractionated heparin (500 U/hr) or by administering aspirin (100 mg/day). RESULTS: Hypercoagulability was identified in 17 (68%) patients. Eleven (44%) patients had elevated D-dimer concentrations. The level of D-dimer was statistically significantly positively correlated with the endogenous thrombin potential and the amount of beta2-microglobulin. The thrombodynamic technique revealed an inverse relationship between the level of paraprotein and the optimal density of a fibrin clot. A thrombotic episode was seen in one elderly (71-year-old) patient after aspirin discontinuation during long-term immobilization. CONCLUSION: Nearly 50% of the primary patients with MM were ascertained to be more prone to thrombosis. Infusion of unfractionated heparin in a dose of 500 U/hr or administration of aspirin (100 mg/day) was the adequate prevention of thrombotic events.

[The phenomenon of vascular microthrombosis in mucoperichondrium associated with plastic closure of nasal septum perforations].

The objective of the present study was to identify specific hematological features characterizing the pathophysological processes of clinical significance associated with plastic closure of nasal septum perforations. Changes of clinical, biochemical, and coagulation-related blood characteristics developing as a result of the surgical treatment of the patients with ENT pathology were analysed. It was shown that D-dimer is a specific hematological characteristic that reflects the phenomenon of postoperative vascular microthrombosis in mucoperichondrial-periosteal flaps associated with plastic closure of nasal septum perforations. Based on the results of this study, the authors recommend to prescribe low-molecular weight heparins for prophylactic purposes to the patients undergoing plastic closure of nasal septum perforations.

[The ways of improvement of direct results of surgery of patients with rectal cancer].

The data of 1740 patients (during 20 years) with rectal cancer were analyzed. Planned operations were performed in 95.8% of patients. The adenocarcinoma was verified in all patients. Accompanying pathology was detected in 84.9% of patients and the pathology of cardiovascular system was more frequent (76.6%). Complicated course of tumourous process was revealed in 4.5% of patients (cases of bowel obstruction, the perifocal inflammation). The majority of patients had the II, III stage of the oncologic process. All operations were performed by conventional (open) way. The number of anterior resection of the rectum increased and the number of abdominoanal resection with bringing down reduced. The specific weight of sphincter preserving operations, which were completed by forming a colostomy decreased. The quantity of performed abdominoperineal extirpation was constant.

[Correction of metabolic disorders during treatment of alcohol-induced liver injuries in patients with acute alcoholic intoxication].

A total of 103 patients with acute alcoholic intoxication were examined and treated for alcohol-induced hepatic lesions. It was shown that remaxol reduced severity of metabolic disorders associated with hypoxic conditions and active lipid peroxidation and thereby decreased the frequency of alcoholic delirium to 10.8% (n=7) compared with ademetionine (10.8%, n=22). Improvement of metabolism resulted in the reduction of stay in the intensive therapy ward by 5.6+/-0.3 and 7.3+/-0.6 days after remaxol and ademetionine therapy respectively). The total duration of treatment decreased by 9.0+/-0.4 and 11.8+/-1.1 days. The use of remaxol reduced the cost of the treatment by 21.7% compared with ademetionine.

[Cryodestruction in neurosurgery].

The study aimed to work out the method of cryodestruction of brain tumors. 10 patients with neuroepithelial brain tumors were prospectively operated on with the use of cryodestruction. MRI was performed before and after the operation. The operation strated from tumor biopsy under the ultrasound control with further injection of cryoprobe with further destruction. The study demonstrated that ultrasound navigation is an effective means of the cryodestruction control on all stages. The cryodestruction itself is a miniinvasive, easily controlled and effective method, applicable for tumors, located in functionally important regions of the brain, where major surgery could be mutilating.

[A case of favourable outcome of the treatment of extremely severe acute poisoning with methanol].

A case of favourable outcome of the treatment of extremely severe acute poisoning after prolonged exposure to lethal doses of methanol is reported. The complex treatment included urgent and effective elimination of the poison (multiple gastric lavage, hemodialysis), antidote therapy (administration of ethanol), correction of decompensated metabolic acidosis (alkali therapy and infusion therapy with reamberin). These measures had beneficial effect on the clinical course of poisoning and ensured its favourable outcome.

[Experience with outpatient treatment for thromboses and thrombophilias].

AIM: To evaluate the efficiency of diagnosis and treatment of thromboses in patients with thrombophilia in an outpatient setting. SUBJECTS AND METHODS: One hundred and seventy-two patients with different forms of thrombophilic states were examined. One hundred and thirty-two patients were found to have genetic mutations, of them 125 patients had multiple mutations. Thromboses were diagnosed in 130 patients with genetic disorders. RESULTS: The most common laboratory markers of thrombophilias were hyperhomocysteinemia (55%), sticky platelet syndrome (41%), and laboratory findings of antiphospholipid syndrome. Thrombogenic mutations, such as plasminogen activator plasminogen inhibitor-1 (73%), methylene tetrahydrofolate reductase (60%), platelet glycoprotein 1a receptors (50%), and fibrinogen (42%), were most often diagnosed. The efficiency of treatment was shown to largely depend on the duration of an initial thrombotic process. CONCLUSION: Outpatient treatment for thromboses is more economical and comfortable for patients. To avoid hospital admissions, it is necessary to time detect the disease and to start its treatment as soon as possible. The concurrent use of ultrasonography, genetic and laboratory diagnostic methods accelerates the identification and localization of the pathology, which facilitates its treatment and frequently rules out the need for patient hospitalization.

[The use of remaxol in combined intensive therapy of acute mushroom poisoning].

A case of very severe mushroom poisoning is reported. Traditional hepatoprotective therapy with ademethionine, ornithine-aspartate, and essential phospholipids failed to ensure positive dynamics of the hepatic and general functional state. Hepatic insufficiency was complicated by cerebral oedema and swelling, bilateral pneumonia, and acute respiratory distress of mixed genesis. Combined therapy with remaxol and ornithine aspartate produced beneficial effect, resulted in the improvement of the patient's condition and favorable outcome of the life-threatening intoxication.

[Features of clinical way and treatment of old and senile patients with severe poisoning with carbon monoxide and the products of combustion].

The article presents the materials obtained in the course of treatment of 64 patients with severe poisoning with carbon monoxide and the products of combustion. It is established that acute carbon monoxide poisoning and combustion products in elderly and senile age is accompanied by more pronounced metabolic disorders, higher frequency of complications and lethality. Intensive therapy of severe poisoning with carbon monoxide has its own peculiarities. The use of Cytoflavin with antihypoxic purpose can lead to the development of metabolic desynchronization. To correct the hypoxic disorders in elderly and senile patients is more appropriate to use Reamberine, not having a negative effect on the indices of central hemodynamics and effectively reducing the depth of metabolic disorders.

[Characteristics of perioperative period in Xenon-based combined general anaesthesia in neurosurgery].

Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. Xe in concentration 65% was used to maintenance of anesthesia, other medication was avoided. As a resuIt there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n = 3), hyperdynamic reaction (n = 8), PONV (n = 8) were detected in early postoperative period. An analysis of this study suggests a conclusion that studied method of Xenon-based anesthesia is inexpedient for neurosurgery.

[The problem of hemorrhagic syndrome in its treatment with vitamin K antagonists (a review of literature)].

Vitamin K antagonists (warfarin, syncumar, phenylin, etc.) are commonly used to treat and prevent thrombotic diseases. The risk for varying degrees of hemorrhagic syndrome (intracranial hemorrhage in particular) is the most important problem in the use of drugs from this group. The rapid neutralization of the effects of used anticoagulants, which is verified by correcting the international normalized ratio (INR), is required in these cases and when emergency surgical interventions are needed. Transfusions of prothrombin complex concentrates (PCCs) in combination of vitamin K preparations are optimal for this purpose. The reason for the rational use of PCCs to promptly correct INR is the balanced composition of this transfusion medium (a combination of blood coagulation factors and biological anticoagulants). This regimen for emergency correction of INR minimizes the risk of thrombotic events.