NEURODEGENERATION AND NMDA.

The N-methyl D-aspartate receptor is one of the key receptors in the human brain. As a result of radioligand analysis, it was found that the highest density of this receptor is located in the hippocampus, striatum, cortex, and amygdala. Associative memory, learning, and synaptic density are all directly related to the effective functioning of the NMDA receptor. Recent studies have shown that the number of NMDA receptors and their morphological structure decreases with age, in particular, some subunits change their shape, as well as the use of antidepressants, such as selective serotonin reuptake inhibitors, cause a delayed side effect, which manifests itself in the form of a quantitative decrease in NMDA in the brain. The antagonist of this receptor - memantine, inhibiting it can reduce the clinical picture of Alzheimer's disease, reducing tremor and papillary reflex. Another NMDA antagonist, ketamine, was used for anesthesia, but due to strong hallucinations during the period of recovery from anesthesia, it became less and less used. These substances also contribute to the work of the NMDA receptor in the future, and also affect synaptic density. Therefore, it is important to know the composition of the receptor, its downstream signaling pathways, and age-related changes in order to effectively prevent neurodegenerative diseases of the brain.

[Repeated cervical laminoplasty for progressive ossification of posterior longitudinal ligament: a case report]. / Povtornaya lyaminoplastika sheinogo otdela pozvonochnika pri progressiruyushchei ossifikatsii zadnei prodol'noi svyazki: klinicheskii sluchai.

Posterior longitudinal ligament ossification is a progressive disease resulting in severe multilevel spinal stenosis with myelopathy. Decompression via anterior or posterior approach is the main treatment option. Decompressive laminoplasty is currently considered the most effective and safest method. This procedure provides favorable outcomes with low trauma and short surgery time. Redo surgeries are rare and most often performed within 2 years after primary laminoplasty. The most common causes are progressive spinal stenosis following posterior longitudinal ligament ossification, insufficient primary decompression and progressive cervical spine kyphosis. Considering few data on redo laminoplasty, we present a patient with progressive ossification of posterior longitudinal ligament who underwent redo surgery at the same level in 10 years after primary laminoplasty.

[The effect of spinal cord stretching on development of spondylogenic cervical myelopathy associated with kyphotic spinal deformity]. / Znachenie rastiazheniia spinnogo mozga v formirovanii spondilogennoi tservikal'noi mielopatii na fone kifoticheskoi deformatsii pozvonochnika.

OBJECTIVE: The study objective was to specify the role of spinal cord stretching in the pathogenesis of spondylogenic cervical myelopathy associated with kyphotic spinal deformity. MATERIAL AND METHODS: We analyzed long-term outcomes of surgical treatment for spondylogenic cervical myelopathy accompanied by kyphotic spinal deformity. RESULTS: The surgical treatment outcomes were significantly better (p<0.000001) in the case of simultaneous decompression/correction of kyphotic deformity and spine stabilization. CONCLUSION: Spinal cord stretching associated with kyphotic spinal deformity significantly contributes to the pathogenesis of clinical manifestations of spondylogenic cervical myelopathy.

[Endovascular interventions on the arteries of the popliteal-tibial segment].

The work was based on the results of studying the potential ability and outcomes of endovascular interventions (balloon angioplasty, stenting) in treatment of patients presenting with occlusive and stenotic lesions of the arteries of the popliteal-tibial segment at the stage of chronic ischaemia of lower limbs, in whom surgical reconstruction was impossible due to the type of the lesion or severity of concomitant pathology. The study was carried out in one hundred and four patients. On a total of 108 extremities involved, we carried out 174 endovascular interventions, including 29 stenting procedures and 145 balloon angioplasties. The following parameters were studied: dynamics of the clinical status, indices of the peripheral blood flow, immediate technical outcome, limb salvage rate, as well as short- and long-term (up to 2 years) patients' survival. It was proved that endovascular treatment of patients presenting with lesions of arteries of the popliteal-tibial segment is an efficient therapeutic method to relieve chronic ischaemia of lower extremities. For patients suffering from critical ischaemia of the lower limbs and diabetic angiopathy, this technique is sometimes the only method of surgical correction of the disordered blood flow. This method makes it possible not only to save the limb involved but also to improve the patient's quality of life.