[Proton magnetic resonance spectroscopy in children with atypical autism comorbid with psychomotor disinhibition syndrome]. / Protonnaya magnitno-rezonansnaya spektroskopiya u detei s atipichnym autizmom, sochetayushchimsya s sindromom psikhomotornoi rastormozhennosti.

OBJECTIVE: To study the relationship of N-acetylaspartate (NAA) metabolism and choline (Cl) metabolism in different parts of the brain based on magnetic resonance spectrography (1H-MRS) with clinical manifestations of autism spectrum disorders (ASD). MATERIAL AND METHODS: Twenty-two children (16 boys, 6 girls), aged 2-10 years, were studied. Russian-language adapted versions of the Autism Treatment Evaluation Checklist (ATEC) and the Nisonger Child Behavior Rating Form (NCBRF) were administered. The ratio of metabolites NAA/creatine (Cr), Cho/Cr, Cho/NAA in the prefrontal cortex, postcentral gyrus and temporal lobes was studied using 1H-MRS. RESULTS: The following correlations were found: 1) between the NAA/Cr value and the Sensory/Cognitive Awareness scale in the prefrontal cortex on the left (ρ=0.479) and on the right (ρ=0.483); the Health/Physical Behavior scale in the precentral gyrus on the left (ρ=0.572) and on the right (ρ=0.463); the Sociability scale in the temporal lobe on the left (ρ=0.481) and on the right (ρ=0.796); the Speech/Language/Communication scale in the right temporal lobe (ρ=-0.552); 2) between the Cho/Cr value and the Adaptive Social scale in the postcentral gyrus on the left (ρ=-0.466) and on the right (ρ=-0.518); the Compliant/Calm scale in the prefrontal cortex on the right (ρ=0.624) and on the left (ρ=-0.541); 3) between the Cho/NAA ratio and the Speech/Language/Communication scale in the right pre-central (ρ=-0.471) and post-central gyrus (ρ=-0.507); the Self-Isolated/Ritualistic¼ scale in the left (ρ=-0.486) and right temporal lobe (ρ=-0.596). CONCLUSIONS: Thus, the predominant localization of disorders of N-acetylaspartate metabolism in communication disorders (bilaterally in the temporal lobes), cognitive, behavioral and somatic manifestations (bilaterally in the prefrontal regions) was established. Increased CI metabolism has identified deficits in interaction skills in both postcentral gyrus, and reveals bilateral differences in the effect on behavioral control in the prefrontal cortex. The results confirm the previously established numerous patterns between abnormal activation of the prefrontal cortex and neuronal dysfunction in ASD. But unlike other studies, it was possible to trace these relationships within a narrower phenotype of disorders - atypical autism comorbid with psychomotor disinhibition.

[Clinical features of «metabolism¼ diseases of the skin in patients with chronic diffuse liver diseases]. / Osobennosti klinicheskogo techeniia boleznei «obmena veshchestv¼ kozhi u patsientov s khronicheskimi diffuznymi zabolevaniiami pecheni.

AIM: To determine the clinical features of skin diseases developing in the presence of metabolic disturbances in patients with chronic diffuse liver diseases. SUBJECTS AND METHODS: A total of 368 patients with different clinical forms of hepatopathy were comprehensively examined. RESULTS: 817 cases of seborrhea, skin itch, xerodermia, xanthomatosis, and dyschromia were detected in 318 (86.4%) patients. CONCLUSION: The prevalence and intensity of cutaneous manifestations depended on the nature of the pathological liver process and indirectly testified to its severity and activity. The symptoms of skin diseases were most pronounced in patients with autoimmune liver lesions, chronic toxic hepatitis, and cirrhosis.

Cost-effective approach to the diagnostic workup of B cell lymphoproliferative disorders via optimal integration of flow cytometric data.

INTRODUCTION: The workup of lymphoproliferative disorders (LPDs) involves the combined use of flow cytometry (FC) and immunohistochemistry (IHC). This often results in duplicate immunophenotypic testing and adds costs that may not be eligible for reimbursement based on the Medicare National Correct Coding Initiative. We aimed to establish a cost-effective diagnostic algorithm based on initial FC categorization to reduce repetitive immunophenotyping. METHODS: We retrospectively reviewed 242 cases of suspected LPDs with concurrent FC and IHC testing over a 12-month period. We correlated FC with surgical diagnoses and evaluated the frequency of repeat IHC testing. RESULTS: Repetitive immunophenotyping was common; overall, 85% of cases had at least one marker repeated. Concordant cases were significantly less likely to have markers repeated than discordant cases. Of concordant B cell malignancies, 57% represented recurrent disease; however, repeat marker usage was not decreased as compared to new diagnoses. The most frequently repeated markers were CD3, CD5, CD10, and CD20. CONCLUSIONS: We propose that in concordant cases, CD5 and CD10 should not be repeated by IHC; this would decrease the use of these markers by 80% and 76%, respectively. We developed an algorithmic approach to IHC usage that has improved incorporation of FC data at our institution and may reduce healthcare costs.

[The clinical effectiveness of the application of interferential currents for the combined treatment of onychopathies associated with psoriasis and eczema]. / Klinicheskaya effektivnost' primeneniya interferentsionnykh tokov v kompleksnom lechenii onikhopatii pri psoriaze i ekzeme.

The frequency of the development of clinically significant changes in the nail plates was estimated in the present study that included 454 patients presenting with psoriasis and 140 patients with eczema characterized by the localization of the pathological process on the skin of the wrists and/or feet. The changes in the nail plates were shown to occur in 56,2% of the patients with psoriasis and in 90,7% of those suffering from eczema. The capillaroscopy of the microvessels feeding the affected nails was carried out to determine the type of the capillaroscopic picture. The patients with onychopathies were largely characterized by the spastic-atonic type of the changes in the microcirculatory bed. The changes of this type were documented in 86,5% of the patients with psoriatic onychopathy and in 83,9% of those presenting with onychodystrophy associated with eczema. The effectiveness of the combined treatment including the application of interferential currents was estimated in comparison with that of standard therapy. It was shown that the use of interferential currents for the treatment of the patients with psoriasis results in a decrease of the severity index of nail damage by 47,8% in comparison with 18,1% in the case of standard medicamentous therapy. Similarly, a 77,2 and 51,3% decrease of the index of severity was documented in the patients with eczema after their treatment with the use of interferential currents and standard medicamentous therapy, respectively.

DIAGNOSTIC SIGNIFICANCE OF SKIN "SIGNS" IN CHRONIC DIFFUSE LIVER DISFASES.

AIM: Frequency Estimation of registration of various skin changes in patients with chronic diffuse liver diseases (CDDL). SUBJECTS AND METHODS: A cross-sectional observational study in patients with CDDL and dermatological changes. The basis of this study - the results of clinical and laboratory findings 468 patients with various liver diseases (viral, toxic, parasitic). RESULTS: A detailed analysis of dermatological manifestations of"dermal signs" in the studied group has allowed both to expand their roster, and refine clinical description of some of them. Specifically, that patients can simultaneously generate multiple dermatological stigmata. CONCLUSION: The results suggest that skin extrahepatic "marks" is very variable. Their various combinations available to patients is a high screening signs of liver disease. The data can be used by physicians gastroenterologists and dermatologists.

A critical role for complement in maintenance of self-tolerance.

The role of complement in the maintenance of self-tolerance has been examined in two models: an immunoglobulin transgenic model of peripheral tolerance and a lupus-like murine model of CD95 (Fas) deficiency. We find that self-reactive B lymphocytes deficient in complement receptors CD21/CD35 or transferred into mice deficient in the complement protein C4 are not anergized by soluble self-antigen. In the second model, deficiency in CD21/CD35 or C4 combined with CD95 deficiency results in high titers of anti-nuclear antibodies leading to severe lupus-like disease. These findings suggest a novel role for the complement system in B cell tolerance and provide insight into the genetic association of complement deficiency with susceptibility to systemic lupus erythematosus.