[Investigation of the metabolic features of primary glioblastomas by Tc-MIBI SPECT/CT and evaluation of their effect on disease prognosis]. / Issledovanie metabolicheskikh osobennostei pervichnykh glioblastom metodom OFÉKT-KT s Tc-MIBI s otsenkoi ikh vliianiia na prognoz zabolevaniia.

OBJECTIVE: To study the effect of metabolic characteristics of the tumor determined by 99mTc-MIBI single-photon emission computed tomography (SPECT) and various molecular genetic features on the outcomes of combination treatment of hemispheric glioblastomas. MATERIAL AND METHODS: This single-center prospective cohort study involved 68 patients aged 25-78 years (38 males and 30 females) with primary glioblastomas. Hypermetylation of the promotor region of the MGMT gene was observed in 24 (42%) out of 57 patients. The IDH1 mutation was revealed in two (3.5%) patients. The catamnestic data were available for 66 out of 68 patients. The first SPECT/CT study was carried out before chemoradiation therapy; the second SPECT/CT study was performed after the chemoradiation therapy. In each study, quantitative measures were calculated for the early (15-30 min after the patient had received a radiopharmaceutical) and late (after 45-60 min) phases. RESULTS: The actuarial survival rates after 12 and 24 months were 69.6 and 29.1%, respectively. The median overall survival rate was 17.5 months (95% CI 12.9-20.3). Favorable prognostic factors for overall survival included the higher uptake index (UI) in the late phase compared to UI in the early phase of the first SPECT/CT study (p=0.0444), dynamics of changes in UI during the second SPECT/CT compared to baseline over 10% (p=0.0436), MGMT hypermethylation (p=0.0003), and duration of the period between surgery and initiation of chemoradiotherapy being <1 month (p=0.0008). No statistically significant correlations were revealed between the absolute UI values in the tumor and its molecular genetic features. CONCLUSION: The 99mTc-MIBI SPECT/CT can be used to predict overall survival and to plan radiation therapy of glioblastoma as it is more readily available at primary healthcare facilities than amino acid PET.

[Clinical features of ischaemic stroke with cerebral venous insufficiency and its risk factors.]

Current research aimed to reveal clinical and neurological features of ischaemic stroke (IS) in patients suffering from cerebral venous insufficiency (CVI) combined with arterial hypertension (AH) and to identify its risk factors. Examination data of 112 patients with IS (aged 60-93 years old; mean age 72,1±2,6 years old, males - 39 (34,8%), females - 73 (65,2%), admitted at regional vascular center of St. Elizabeth City Hospital in Saint Petersburg, highlighted that cephalgic syndrome and vestibulocerebellar dysfunction occurred more frequently in stroke patients with CVI. Also CVI was more commonly diagnosed in patients with vertebrobasilar stroke. More severe disease course was registered in cardioembolic stroke, as compared to atherothrombotic stroke and patients without CVI. Following risk factors of CVI development in patients with IS and AH were detected: constitutional venous insufficiency and also chronic cerebrovascular insufficiency due to arterial hypertension, cerebral atherosclerosis and cervical dorsopathy.

[Role of Radionuclide Technologies in Medicine].

The paper describes the role of radionuclide technologies among the nuclear-physical methods used in medicine. The condition and prospects of the development of nuclear technology with use of radionuclides in medicine, and in particular, the method of brachytherapy are analyzed. The analysis of the current state of applying radionuclide facilities in medicine is provided.

URGENT DIAGNOSTICS OF CEREBRAL VENOUS TROMBOSIS.

Investigations were carried out in 24 patients in order to evaluate information value of the data of clinical, laboratory, neuroradiological methods of research and develop the diagnostic algorithm in case of cerebral venous thrombosis (CVT). The main group consisted of 11 patients (7 male, 4 female, average age 49,1±4,3) with CVT. The comparison group included 13 patients (6 male, 7 female; average age 68,1±9,5) with ischemic stroke (IS) of moderate severity. There were revealed changes in blood and cerebrospinal fluid (CSF) as form of leukocytosis of blood and moderately increased cell count with elevated protein in CSF and blood in case of CTV. The authors noted an elevated protein in CSF and blood and leukocytosis with predominant lymphopenia in blood and neurophilic predominance in CSF within the reference range of CSF in patient with ischemic stroke. The epileptic attacks, meningeal syndromes, headaches were more often among clinical syndromes at CTV than in case of ischemic stroke. The algorithm of neuroimaging research methods and modes of MRI were determined and allowed an effective diagnostics of damages of venous sinuses, superficial and deep cerebral veins in case of urgent hospitalization of patients. It was possible to suggest the venous pathology in 7 (63,6%) cases due to SKT (without contrast) and in case of application of MR venography (2D TOFmode), there were revealed 100% of cases.

[Alkaline phosphatase in mixed saliva in abdominal inflammatory diseases and gestoses].

By applying enzyme electrophoresis in the agar gel prepared on veronal-medinal buffer (pH 8.6) (the substrate was naphthol AS phosphate; the dye was fast blue B or PP), the authors first revealed mixed salivary alkaline phosphatase (AP) that differed in physicochemical properties from the known serum AP isoforms, in 63% of patients with cholecystitis or pancreatitis, in 90% of those with appendicitis, and in 55.3% of pregnant women with second- and third-degree gestoses. After treatment, the detection rate for salivary AP significantly decreased to 16.6, 40.0, and 6.4%, respectively. This noninvasive test may be useful for the additional diagnosis and monitoring of treatment for abdominal inflammatory diseases and gestational toxicosis.

[Research of interactions in the dopamine-serotonin-somatostatin system promises new outlook in fundamental and practical respects].

Dopamine and serotonin are the two important key neurotransmitters, which participate in the formation and regulation of various physiological parameters in the normal and pathological states. It is very interesting and important in both fundamental and practical respect to analyze interactions of dopamine and serotonin with somatostatin--a peptide hormone suppressing the secretion of many other regulatory peptides and various bioactive substances. In the present work, a huge amount of experimental data on the interactions of dopamine and serotonin with somatostatin was collected and analyzed. Literature sources mainly cover the period of 1970 - 2006. Compilation of an information database on dopamine/serotonin--somatostatin interactions has been the next stage. Analysis of the effects of dopamine and somatostatin revealed unilateral influence of these endogenous regulators and also of the induced and/or inhibited peptides on the level of depression, stress, food intake, angiogenesis and cancerogenesis, thus making it possible to increase and prolong their effects via cascade mechanisms. Potentially possible combinations of somatostatin and dopamine analogs, and chimeric somatostatin/dopamine molecules are proposed for the treatment and correction of different pathological states, including acromegaly, prolactinemia, and hyperinsulinism.

[The features of myocardial infarction clinical course at gene of endothelial NO-synthase polymorphisms].

81 patients were included in the research into study of acute myocardial infarction (AMI) clinical course features in patients with various polymorphism of gene. These patients besides traditional examination, received genetic examination for determination of of NO-synthase gene in intron 4 (eNOS 4a/4b polymorphism) and mutation in position 298 of protein sequence leading to replacement of rest of glutamine acid by asparaginic acid (Glu298Asp). Patients with allele 4a polymorphism of endothelial NO-synthase gene in intron 4 (genotypes 4a/4a and 4a/4b) had low level of high-density lipoprotein cholesterol (HDLC) in comparison with 4b homozygote patients. Inverse association of 4a allele with HDLC did not depend on the AMI therapy character. Besides, it was detected that AMI patients with 4a/4a polymorphism had bronchial asthma and chronic hepatitis more frequently than patients with 4b/4b genotype. AMI patients with 4a allele had early postinfarction angina and gastroesophagoreflux disease. The relation of allele 4a carriage with development of early postinfarction angina depended on presence of bronchial asthma in AMI patients. AMI patients with Glu298Asp polymorphism Asp/Asp genotype did not have significant differences in AMI and concomitant pathology course in comparison with Glu/Glu genotype patients.

[The epidemiology of epilepsy in the rural areas of the Republic of Sakha-Yakutia].

The epidemiological study of the prevalence of epilepsy in the population, consisted of 93.6% of Sakha nationality, aged over 14 years, of the rural areas of the Republic of Sakha-Yakutia has been carried out. The prevalence of epilepsy standardized by sex and age is 4.57 per 1000 people, being higher in men (5.12) compared to women (4.09). Out of 92 patients identified in the study, 79.35% were diagnosed with focal epilepsy. The predominate types (51.09%) were partial simple seizures or complex seizures with secondary generalization. The main etiologic factors of focal epilepsy were cranial/brain traumas, intra perinatal pathology and cerebral vascular diseases. Only 4.35% of patients had no seizures over one year of pharmacological therapy and in 77.17% the frequency of seizures was 1-12 per year. More than 90% received the monotherapy, phenobarbital was prescribed in about 80% of cases. The education level of primary school had more than half of patients, 57.61% were recognized as disabled, 41.30% worked or studied.

[The interaction of serotonin and dopamine systems with the systems of the regulatory peptides oxytocin, vasopressin, and prolactin under normal conditions and during pregnancy].

The authors studied a vast volume of unsystematized literature data (between 1970 and 2006) on the interaction of the neurotransmitters serotonin and dopamine with the hormonal peptide regulators prolactin, oxytocin, and vasopressin. Analysis of the results of studies made it possible to create a data base and analyze complex induction interactions between serotonin and dopamine and the three regulatory peptides under various physiological conditions: non-pregnancy, early and late stages of pregnancy, lactation, and maternal behavior. The roles of serotonin and dopamine in the formation of reproductive and maternal behavior were determined. The article presents possibilities for research into positive intervention into the hormonal status of a pregnant woman via a range of psychotropic drugs.

[Susceptibility to endothelium-dependent vasoactive agents in patients with coronary artery calcinosis].

Coronary artery calcinosis was measured with ECG-gated multislice spiral CT in 68 patients, mean age 57.54+/-1.04 (M+/-m), including 47 men (69.1%) and 21 women (30.9%). Vascular reactivity of microcirculatory bed was assessed with laser Doppler flowmetry after acetylcholine and histamine administration. Coronary artery calcinosis correlated negatively with vascular susceptibility to acetylcholine (r=-0.380, p=0.002). This correlation did not depend on sex, age and concomitant drug therapy. Smoking was shown to affect significantly microvascular reactivity to histamine in persons free from coronary atherosclerosis. History of smoking determined the disturbances of vascular reactivity to histamine in patients with coronary artery calcinosis.

[Interactions between dopamine, serotonin and other internal reinforcement factors].

The big volume of odd literature data (period 1960-2005) was investigated for analysis and estimation of interactions between dopamine (DA), serotonin (5-HT), reward factors and basic members of regulatory peptide (RP) families. Database, which includes information about physiological effect directions, doses and administration types of RP and biological active compounds, organism types, organ-tissues systems and receptor mechanisms was created. The complex cascade interactions between DA, 5-HT, reward factors and RP were investigated and systemized. Based on analysis of correlated functiong of DA and 5-HT-systems, the opponent-reciprocal interactions were established and their integrative characteristics were estimated.

[Vegetovascular dysfunction as an integral parameter of high risk for cardiovascular diseases development in young subjects]. / Sindrom vegetososudistoi disfunktsii kak integral'nyi pokazatel' vysokogo riska razvitiia serdechno-sosudistykh zabolevanii u lits molodogo vozrasta s otiagoshchennoi nasledstvennost'iu.

AIM: To study manifestations of vegetative dystonia in children of probands from families with hereditary IHD load regarding the main risk factors. MATERIALS AND METHODS: 44 individuals aged 21 +/- 0.7 years were selected out of 111 children from 103 examined families the fathers of which had transmural or macrofocal myocardial infarction at the age under 50. 22 of 44 examinees had syndrome of vegetovascular dystonia (VVD). RESULTS: Children of probands with family history of cardiovascular disease and having VVD had levels of cholesterol, triglycerides and apoB higher, but HDLP cholesterol lower than those free of VVD. In daughters of the probands insulin and hydrocortisone levels were high whereas sons with VVD had only insulin levels higher. CONCLUSION: Children of probands of both sexes had high coefficients of hormonal and metabolic adaptation dependent on the severity of VVD syndrome.

[Ischemic heart disease and metabolic syndrome X (family study)]. / Ishemicheskaia bolezn' serdtsa i komponenty metabolicheskogo sindroma X.

AIM: To evaluate prevalence of metabolic syndrome "X" (MS) components in the families of probands and their wives regarding the presence of hyperinsulinemia and in probands' children of both sexes regarding their having vegetovascular dystonia. MATERIAL AND METHODS: 92 families were selected by the proband who survived acute myocardial infarction (MI) at the age under 50: 92 probands (mean age 47 +/- 1.1 years), 57 probands' wives (mean age 47 +/- 0.7 years), 20 sons (mean age 18.3 +/- 0.8 years), 24 daughters (mean age 19.1 +/- 1.0 years). Two groups were formed: group 1 of 48 probands and 25 wives (the presence of hyperinsulinemia in the proband); group 2 of 44 probands and 32 their wives (controls with normal insulin levels). Anthropometric, arterial pressure and lipid-hormonal measurements were made by standard techniques. Nutrition was studied by random reproduction of 24-h diet. RESULTS: More factors of risk to develop atherosclerosis and MS"X" components in probands and their wives were found in group 1. More frequent in the parents were the following MS components: hypoalphacholesterolemia, overweight, arterial hypertension, hyperapolipoprotein-B-emia. Vegetovascular asthenia in the probands' children predisposed to cardiovascular diseases is closely linked with the presence of hypoalphacholesterolemia, hypertriglyceridemia, overweight and arterial hypertension. CONCLUSION: MS "X" for probands and their wives is a "malignant" risk factor for cardiovascular diseases; in the presence of IHD in father, vegetovascular asthenia in children is a risk factor of cardiovascular disease.

[Relationship of vascular reactivity to blood lipid spectrum and lipid peroxidation in unstable angina]. / Sootnoshenie sosudistoi reaktivnosti s lipidnym spektrom krovi i sostoianiem perekisnogo okisleniia lipidov pri nestabil'noi stenokardii.

AIM: To examine the relationship between the vascular response of the microcirculatory bed to vasoactive agents and lipid peroxidation (LPO) and antioxidative defense in patients with unstable angina pectoris. MATERIALS AND METHODS: Thirty male patients (mean age 58.0 +/- 2.4 years) were examined. The patients were divided into 2 groups: 1) those with high alpha-cholesterolemia alone and 2) those with high alpha-cholesterolemia concurrent with hyperglyceridemia and elevated total cholesterol levels. Photoplethysmographic determination was used to evaluate vascular responses to norepinephrine (vasopressor function) and histamine (vasodilating function), the blood levels of cortisol, LPO products, antioxidative protection components, histamine, and serotonin. RESULTS: Vascular dilating function was found to be most pronounced in Group 1. Moreover, Group 1 patients had a significant depression of the antioxidative defense system and the highest blood levels of cortisol, and serotonin. The levels of LPO products did not differ significantly in both groups though they were significantly higher than those in healthy individuals. CONCLUSION: Impairment in the antioxidant system and in coordination of vasodilating function to histamine stimulation are typical of patients with unstable angina.

[The characteristics of the blood lipid composition in northern Selkups and in the immigrant population of northern Siberia and the problems of miscegenation]. / Osobennosti lipidnogo sostava krovi severnykh sel'kupov, prishlogo naseleniia Severa Sibiri i problemy metisatsii.

Blood lipid composition was studied in 507 Selkups, native population of Tyumen Province (199 males and 308 females), 245 Slavs living in the north for more than 5 years (97 males and 148 females), 189 first generation métis born in mixed marriages (68 males and 121 females). Three age groups were analyzed: 10-19 (group 1), 20-39 (group 2), 40-59 (group 3). Male métis from groups 1, 2 and 3 had the highest levels of HDLP cholesterol, the lowest of apoB and atherogenic index. Group 2 métis were in the intermediate position between Slavs and Selkups by concentrations of total and LDLP cholesterol and triglycerides. Group 3 métis males had the lowest levels of triglycerides and intermediate levels of total and LDLP cholesterol. Group 1 and 2 métis females had the highest levels of LDLP, the lowest of apoB and low atherogenic index. In group 3, levels of total cholesterol, LDLP cholesterol, apoB and atherogenic index were as high as in non-aboriginal Slavonic population.

Relationships between left hemisphere predominance and disturbances of lipid metabolism in different ethnic groups.

The purpose of this study was to analyze the relationships between brain hemisphere predominance and disturbance of lipid metabolism in atherosclerosis in different ethnic groups. Three groups of subjects were examined: 52 healthy Selkups (the isolated ethnic population of the Far North), 50 healthy Russian men, living in Novosibirsk, and 78 Russian men, living in Novosibirsk, who had myocardial infarction before the age of 50. Blood cholesterol, low density lypoprotein (LDL) and high density lypoprotein (HDL) levels of the subjects with different brain functional asymmetry were compared. The lack of either hemisphere predominance is the most common among the Selkups. The population of Selkups as a whole showed low concentrations of cholesterol and LDL in comparison with both Russian groups. For all examined groups the pattern of lipid metabolism has been worsened for the subjects showing the left hemisphere predominance. The changes of lipid metabolism indices in subjects with the dominant left hemisphere is discussed.

[Effects of hypothalamic mediator systems on the hormonal changes in rabbit blood during prolonged electric stimulation of emotiogenic zones of the hypothalamus]. / O vliianii mediatornykh sistem gipotalamusa na gormonal'nye izmeneniia v krovi krolikov pri dlitel'noi élektrostimuliatsii émotsiogennykh zon gipotalamusa.

Changes in the blood hormonal levels were studied in 36 rabbits with electrodes implanted to the area of the dorsomedial nuclei of the hypothalamus in the course of a 5-cycle electrostimulation experiment. After each period blood hormonal levels were correlated to the activities of the hypothalamic catecholamine-, GABA-, and serotoninergic systems. The first two cycles of the experiment were associated with a high activity of the hypothalamic mediator systems and with increased levels of all hormones in the blood. The functional activity of the hypothalamus was reduced due to the predominance of stress-limiting systems. The initial reduction of GABA, and then of serotonin in the hypothalamus caused be the end of experiment a reduction of the blood levels of the tested hormones, except the Ca-regulating ones and active renin. Disturbances in the regulatory mechanisms of hypothalamic mediator systems leads to an increase in its excitability and to transformation of the adaptive pattern of hormonal changes into pathological mechanisms of prolonged emotional stress.

[The characteristics of the lipid-hormonal interrelations in young men with a history of myocardial infarct (based on family registry data in Novosibirsk and Bishkek)]. / Osobennosti lipidno-gormonal'nykh vzaimosviazei u molodykh muzhchin, perenesshikh infarkt miokarda (po materialam semeinykh registrov v Novosibirske i Bishkeke).

Altogether 226 male probands who suffered large-focal or transmural myocardial infarction (MI) before reaching 50 years were examined in Novosibirsk and Bishkek in one stage according to the unified program. In Novosibirsk all the probands were Russians whereas in Bishkek 75 probands were Kirghizs and 71 were Russians. The probands were examined within a period of 1 to 3 years after MI. The lipid and lipoprotein plasma content was determined by standardized methods on a Tekhnikon AAP autoanalyzer. The content of thyroid hormones, insulin and cortisol was measured by means of RIA-kits and that of apolipoprotein B (ApoB) by radial immunodiffusion. It turned out that the patients from Novosibirsk demonstrated the highest content of cholesterol, low density lipoprotein cholesterol, the highest index of atherogenicity, the highest concentration of ApoB, and hyperinsulinemia. In the probands of both nationalities from Bishkek, the lipid spectrum did not differ substantially from the populational norm, the content of ApoB in the Russian probands was slightly lower than in those from Novosibirsk whereas in Kirghizs, the least content of thyroxin was recorded.

Prognosis of myocardial infarction and brain functional asymmetry.

Seventy-eight men (mean age, 47.0 +/- 1.1 years) who had suffered from myocardial infarction were examined. Blood cholesterol, lipoproteins, triglycerides, insulin and cortisol concentrations were compared in patients with left hemisphere or right hemisphere cerebral dominance. Patients with left hemisphere dominance had more serious disease and much higher levels of blood cholesterol and lipoproteins. Patients with right hemisphere dominance had the highest levels of blood cortisol and insulin. The brain's functional asymmetry may be one of the risk factors for coronary atherosclerosis in subjects under the age of 50 years.