[Russian study on brain aneurysm surgery: a continuation (RIHA II)]. / Rossiiskoe issledovanie po khirurgii anevrizm golovnogo mozga: prodolzhenie (RIKhA II).

OBJECTIVE: To assess the main performance indicators of neurosurgical departments in surgical treatment of cerebral aneurysms in the Russian Federation. MATERIAL AND METHODS: We analyzed 22 neurosurgical departments (19 regional and 3 federal hospitals) in 2017 and 2021. The study enrolled 6.135 patients including 3.160 ones in 2017 and 2.975 ones in 2021. We studied the features of surgical treatment of cerebral aneurysms in different volume hospitals and factors influencing postoperative outcomes. RESULTS: The number of surgeries for cerebral aneurysms decreased from 2.950 in 2017 to 2.711 in 2021. Postoperative mortality rate was 6.3% and 5.6%, respectively. The number of microsurgical interventions decreased from 60% in 2017 to 48% in 2021. The share of endovascular interventions increased from 40% to 52%, respectively. Endovascular embolization was accompanied by stenting in 55% of cases. Simultaneous revascularization was carried out in 2% of cases. In 2021, the number of patients undergoing surgery in acute period of hemorrhage increased to 70% (in 2017 - 61%). The number of hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased from 14 in 2017 to 17 in 2021. CONCLUSION: Certain changes in neurosurgical service occurred in 2021 compared to 2017. Lower number of surgical interventions for cerebral aneurysms, most likely caused by the COVID-19 pandemic, is accompanied by lower postoperative mortality. Endovascular interventions and revascularization techniques became more common. The number of surgeries in acute period after aneurysm rupture and hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased.

[Surgical treatment of cerebral aneurysms in the Russian Federation]. / Khirurgicheskoe lechenie tserebral'nykh anevrizm v Rossiiskoi Federatsii.

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.

Registration of Alfvén resonances in TCABR tokamak by the scanning reflectometer at sideband frequencies.

A frequency scanning O-mode reflectometer was used for studies of plasma density oscillations during local Alfvén wave (LAW) excitation in the Tokamak Chauffage Alfvén Brésilien (TCABR) at the frequency f(A) = 5 MHz. It was found that the spectrum of the reflectometer output signal, which consists mainly of the "beat" frequency f(B), is modified by the LAW excitation, and two additional frequency peaks appear, which are symmetrical in relation to the LAW excitation frequency f = f(A) ± f(B). This result opens the possibility to improve the efficiency of studying the LAW induced density oscillations. The symmetry of these frequency peaks yields the possibility of finding the microwave frequency at which the reflectometer cutoff layer coincides with radial position of the LAW resonance zone in the TCABR tokamak.

[The state of thyroid system in patients with non-traumatic supratentorial hematomas].

Concentrations of thyroid hormones (thyrotrophic - TTG, T3, T4) were measured with radioimmunological assay in the blood serum of 69 operated patients with supratentorial stroke interbrain hematomas. Hematomas were removed using a puncture/ aspiration method with local fibrinolysis. The lethality was 19%. It has been shown that medial hematomas lead to the decrease in TTG secretion while lateral and lobar ones inhibit T4 and T3 synthesis. Replacement therapy with thyroid hormones is needed to improve results of operative treatment of non-traumatic interbrain hematomas.

Regulation of hemodynamic parameters under conditions of systemic administration of angiotensin II and angiotensin IV to rats after carotid glomectomy.

Systemic administration of angiotensin II was followed by an increase in systolic BP and HR in rats with carotid glomectomy, the time of attaining maximum values in treated animals was much higher than in sham-operated controls. Injection of angiotensin IV slightly reduced systolic BP in sham-operated animals and increased it in rats with carotid glomectomy. The involvement of the local renin-angiotensin system of the carotid body in systemic mechanisms of hemodynamics regulation is discussed.

[The levels of thyroid hormones in hemorrhagic stroke].

Radioimmunoassay using was used to study the blood concentrations of thyroid hormones (thyroid-stimulating hormone (TSH), T3, and T4) in patients with hemorrhagic stroke as intracerebral hematoma. The authors analyzed two patient groups: 1) those operated on for intracerebral hematoma removal; 2) those receiving medical treatment. Surgical intervention resulted in local fibrinolysis of a hematoma remnant. The level of thyroid hormones was studied over time from the 1st day to the 28th day of therapy. Each group was then divided into 2 subgroups: survivors and dead patients. Mortality group was 77.2% in the medical treatment group and 17.2% in the surgical treatment group. The performed studies established elevated concentrations in cases of good outcome of stroke. All the patients were found to have low T3 concentrations that were more pronounced in patients with a poor outcome. The level of T4 did not differ from the control values in patients with good results. Hematoma removal contributed to an increase in the concentrations of TSH and triiodothyronine.

Reduction of alcohol dependence in rats after carotid glomectomy.

Carotid glomectomy significantly reduced the degree of alcohol addiction in rats, which was induced over 12 weeks. After glomectomy, the mean weekly volume of alcohol consumed by alcoholic animals over 4 weeks was lower compared to the preoperation level, while water consumption significantly increased by the 3rd and 4th weeks after surgery. Control sham operation had no effect on ethanol and water consumption in alcoholic rats. Possible involvement of the local renin-angiotensin system in chemoreceptor cells of the carotid body into systemic mechanisms of alcohol dependence is discussed.

[Hypoxic training -- effective method of raising skin vitality in cases of local plastic operations].

In spite of the complications after expander use the advantages of local plastics predetermine constant return to the method. Systemic use of hypoxic training produces stimulating effect on the skin microcirculation and can be used widely in clinical surgical practice in cases of local plastic operations to prevent possible complications reducing consequences of blood supply disturbance and tissue oxygen provision. The method of hypoxic adaptation let us receive as non-medicamentous mean to prepare for shorter period of time more vital flap.

Comparative analysis of dipsogenic effects of systemic and intracerebral injection of angiotensin II to rats after carotid glomectomy.

Systemic administration of angiotensin II after carotid glomectomy produced a less pronounced dipsogenic effects (consumption of water and NaCl solution) compared to sham-operated control animals. Injection of angiotensin II into the lateral cerebral ventricles of the same glomectomized rats increased water and NaCl consumption to a level surpassing that of sham-operated animals. The number of drinking acts and comfortable grooming acts decreased in glomectomized animals after systemic administration of angiotensin II, but increased after its intracerebral injection compared to the control. The results confirm the hypothesis that carotid chemoreceptors, as the peripheral component of the renin-angiotensin system, participate in the mechanisms of angiotensin-induced thirst, "salt appetite", and associated behavioral forms (comfortable grooming) synergically with the central cerebral receptors.

Water and salt consumption and suppression of Angiotensin-induced thirst in rats after carotid glomectomy.

Carotid glomectomy in rats reduced daily water consumption and increased daily consumption of NaCl solution. Sham operation did not modify water and salt consumption. Intraperitoneal injection of angiotensin-II did not stimulate drinking motivation in the majority of rats subjected to carotid glomectomy. Injection of angiotensin-II to sham-operated and intact animals induced active consumption of both fluids during one hour. These results attest to the involvement of the carotid body in the regulation of consumption of water and sodium ions (the main elements of osmotic blood pressure) and the involvement of angiotensin-sensitive receptors of carotid body cells in the formation of thirst and salt appetite motivation, regulated by the renin-angiotensin system.

[Role of carotid chemoreceptors in formation of adaptive reactions in animals]. / Rol' karotidnykh khemoretseptorov v formirovanii adaptivnykh reaktsii zhivotnykh.

After surgical denervation of sinocarotid reflexogenic zones and bilateral glomectomy in white laboratory rats oxygen consumption, rectal temperature, rate of cardial contractions and thermoregulatory activity of skeletal muscles display authentic increase. Glomectomy results in decreasing calorigecic effect of noradrenaline. Compensatory increase of thermoregulatory activity of sceletal muscles in response to beta-adrenogenic blocade with inderal in post-glomectomic animals is authentically less, than before inactivation of carotid receptors. In animals after carotid glomectomy resistance to acute hypoxia is clearly reduced. True reduction of number of erythrocytes, of hemoglobin concentration, of hematocrite parameter in post glomectic animals was found, which indicates anemisation phenomena. It was found that glomectomy after adaptation of animals in the mountains of Tien Shan at the height of 3200 m during 30 days didn't substantively change resistance to acute hypoxia. Resistance to acute hypoxia of animals living on mountains (susliks, marmots) is higher than of animals living on plains. Glomectomy performed on animals living on mountain resulted in an insignificant decrease in resistance to acute hypoxia. Resistance to acute hypoxia in postglomectic animals was found to be directly linked with absolute amount of hemoglobin concentration and erythrocyte number. In that way denervation of sinocarotid reflexogenic zones and bilateral glomectomy is an adequate method of comparative research of functions regulation mechanism during formation of adaptive responses in animals in dependence of various factors of external environment in norm, as well, as in pathology.

[Functional homology in response of human cardiorespiratory system to effects of hypoxia and hypercapnia under different environmental conditions]. / O funktsional'noi gomologii v reaktsii kardiorespiratornoi sistemy cheloveka na vozdeistvie gipoksii i giperkapnii v razlichnykh usloviiakh sredy obitaniia.

The authors studied physiologic peculiarities associated with cardiorespiratory response to hypoxia and hypercapnia in various climate and geographic conditions, to combined effects of hypoxia, hypercapnia and physical burden, in artificial atmosphere with various velocity of hypoxia and hypercapnia increase. The studies were based on a hypothesis of universal mechanism that describes regulation of gas-transporting system and is aimed to supply oxygen to the body under ecologic hazards. The authors revealed similarity of circulatory and respiratory responses to hypoxia and hypercapnia in various ecologic circumstances.

[Diurnal dynamics of red blood indicators after carotid glomectomy in rats]. / Sutochnaia dinamika pokazatelei krasnoi krovi u krys posle karotidnoi gloméktomii.

After bilateral carotid glomectomy the rat resistance to acute hypoxia reduces and phenomena of anemia arise. There appear correlations between resistance to hypoxia and red cell count, hemoglobin and hematocrit. The diurnal fluctuation of rat resistance to acute hypoxia after the glomectomy does not change while hemodynamics undergo marked changes.

[The microcirculation of patients with arterial ischemia of the lower extremities during laser therapy]. / Sostoianie mikrotsirkuliatsii u bol'nykh s arterial'noi ishemiei nizhnikh konechnostei v protsesse lazeroterapii.

Microcirculation in the patient's foot skin with different stages of arterial ischemia, was examined with the aid of TV-capillaroscopy, laser dopplerography, polarography of transcutaneous oxygen tension. The effect of semiconductor laser (wave length 0.98 mcm) on microcirculation system was studied. The dependence of capillary blood flow on the transcutaneous oxygen tension was determined. The laser therapy proved to be successful in the patients with the II and III stages of arterial ischemia.