Vol 67, No 10 (2012)

PROCEEDINGS OF THE RAMS SESSION
MODERN APPROACHES TO DIAGNOSTICS AND SURGICAL CORRECTION OF BRACHIOCEPHALIC ARTERIES DISORDERS IN PATIENTS WITH ISCHEMIC HEART DISEASE
Bokeriya L.A., Pirtshalaishvili Z.K., Sigaev I.Y., Darvish N.A., Serguladze T.N.
Abstract
The main causes of morbidity in Russia are ischemic heart and cerebrovascular disease. The mortality rate of these conditions accounts for almost 50% of all the lethality causes of the Russian population. The frequency of associated coronary and brachiocephalic arteries disorders varies from 18 to 54%. The complex evaluation of the anatomical and functional features of the disorder, as well as of the perfusion and functional heart and brain reserves allows to choose the appropriate methods of surgical treatment of patients with associated coronary and carotid disorders and to decrease the risk of intra- and postoperative cerebral and cardiac complications. The modern approaches of myocardium and cerebral revascularization enable to safely and effectively eliminate the myocardial and cerebral ischemia, to significantly decrease the risk of myocardial infarction and stroke development and to ensure the long ability to work among this group of patients. Over 500 patients with ischemic heart disease and associated brachiocephalic arteries disorders have been operated at the A.N. Bakoulev Scientific Centre for Cardiovascular Surgery for the last 5 years. The results of these operations are comparable to the ones of the leading European clinics.


Annals of the Russian academy of medical sciences. 2012;67(10):4-11
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CARDIOLOGY: CURRENT ISSUES
VENTRICULAR ARRHYTHMIAS AND ARTERIAL HYPERTENSION: ROLE OF INFLAMMATORY BIOMARKERS IN ARRHYTHMIA DEVELOPMENT
Vasilets L.M., Tuev A.V., Arshin E.V., Agafonov A.V., Ratanova E.A., Krivaya A.A., Trenogina K.V., Grigoriadi N.E.
Abstract

Arrhythmogenic role of proinflammatory cytokines is still unclear despite of wide discussion on inflammatory arrhythmogenic mechanisms. The main goal of study was to compare levels of tumor necrosis factor a, interleukin 6 and interleukin 4 in hypertensive patients with and without ventricular rhythm disturbances. The study included 100 cases, 50 of those had ventricular arrhythmias. Levels of tumor necrosis factor a, interleukin 6 and interleukin 4 were studied. Possible connections of above mentioned biomarkers with ventricular arrhythmias, blood pressure, echocardiography left ventricle data were evaluated. Higher level of biomarkers was associated with presence of ventricular arrhythmias; higher rate of ventricular extrasystoles was accompanied with insignificantly lower biomarker level.

 

Annals of the Russian academy of medical sciences. 2012;67(10):12-17
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CLINICAL AND MORPHOLOGICAL PARALLELS IN MITRAL VALVE DISORDERS IN INFANTS WITH ATRIOVENTRICULAR DEFECT
Sukhacheva T.V., Abduvokhidov B.U., Lashneva A.S., Serov R.A., Kim A.I., Bokeriya L.A.
Abstract

Mitral valves tissue samplings from children with complete (13 patients) and partial (6 patients) atrioventricular defects at the age of from 1 month to 3 years old were examined.  The biopsy material was received during the repeat surgical operation on mitral valve, performed due to residual mitral
valve regurgitation grade 3-4 at the period of time from 2 days to 1 year after radical defect correction.  
On histological examination the areas of myxomatous tissue degeneration occupying more than 50% of mitral valves surface were found in 6 (32%) of the 19 patients. There were dispersed star-shaped cells, architectonics disturbances, deposition of acid mucopolysaccharides and increased content
of matrix metalloproteinase 13 in such areas of myxomatous degeneration. The sizes of these areas correlated with mitral valve regurgitation grade.
After the radical correction of atrioventricular defect the sutures on the folds and fibrous ring of the mitral valve “cut through” reliably more often in patients with wider areas of myxomatous degeneration, which indicates poor prognosis.
According to the ultrastructural classification the majority of mitral valve cells regarded as fibroblasts; there also were found cells with the signs of myogenic differentiation – myofibroblasts and isolated hystiocytes.  According to the immunohistochemistry assay the cells phenotype regarded as
fibroblastic and endothelial differentiation; in some patients there were found cells of smooth muscle origin.

 

Annals of the Russian academy of medical sciences. 2012;67(10):18-28
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NEUROLOGY: CURRENT ISSUES
NAD+-CONVERTING ENZYMES IN NEURONAL AND GLIAL CELLS: CD38 AS A NOVEL TARGET FOR NEUROPROTECTION
Salmina A.B., Inzhutova A.I., Morgun A.V., Okuneva O.S., Malinovskaya N.A., Lopatina O.L., Petrova M.M., Taranunushenko T.E., Fursov A.A., Kuvacheva N.V.
Abstract

The review contains current data on molecular mechanisms which control NAD+ homeostasis in brain cells. It also deals with the role of NAD+-converting enzymes in regulation of functional activity, viability and intercellular communication of neuronal and glial cells. Special attention is paid to involvement of CD38 into regulation of NAD+ levels in brain cells in normal and pathological conditions.

 

Annals of the Russian academy of medical sciences. 2012;67(10):29-37
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TWO PATTERNS ОF CT-BRAIN PERFUSION AND DC-POTENTIALS ОF THE BRAIN EVOKED COGNITIVE TASK IN DISCIRCULATORY ENCEPHALOPATHY PATIENTS
Fokin V.F., Ponomareva N.V., Krotenkova M.V., Konovalov R.N., Tanashyan M.M., Lagoda O.V.
Abstract

In patients with discirculatory encephalopathy the influence of verbal fluency test on the characteristics of cerebral perfusion, DC-potentials of the brain, as well as on blood pressure and heart rate was investigated. Two patterns of responses to the verbal fluency test were observed. The first one is the process of generalized activation, manifested by the reduction of the TTP (time to peak) parameters of brain perfusion, the rise of the DC-potentials in all areas of brain and the modulation of blood pressure and heart rate. The second process, directly connected with cognitive processing, was manifested by the shifts of local characteristics of brain perfusion and DC-potentials in the frontal, temporal and central cortex, especially in the left hemisphere. Correlations were found between the characteristics of cerebral perfusion and DC-potentials on the one hand and the number of words during the verbal fluency test performance on the other hand.

 

Annals of the Russian academy of medical sciences. 2012;67(10):38-43
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EPIDEMIOLOGY: CURRENT ISSUES
IgE-RESPONSE AFTER ADMINISTRATION OF PANDEMIC VACCINE STRAIN A/CALIFORNIA/7/2009 (H1N1) v
Kostinov M.P., Terkacheva O.A., Zhirova S.N., Cherdanchev A.P., Erofeeva M.K.
Abstract

Changes in total and allergy-specific IgE (IgE-antibodies) in 70 healthy volunteers vaccinated with influenza vaccine subunit strain A/California/7/2009/(H1N1). Safety of this vaccine was shown. Repeated second dose administration is not accompanied by increase in IgE-antibodies to egg components. Vaccine injection results in decrease of total IgE in patients with elevated IgE at baseline.

 

Annals of the Russian academy of medical sciences. 2012;67(10):44-48
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CURRENT PROBLEMS OF COMBINED USE OF VACCINATION AND NON-IMMUNOLOGICAL METHODS FOR INFECTION CONTROL
Shandala M.G.
Abstract

Based on data analysis on the morbidity rates and dynamics of the vaccine-preventable infectious diseases in Russia in comparison with those, immune-prophylaxis methods of which have not been developed yet, the need is shown to intensify efforts on generation and application disinfectological technologies and non-specific prophylactic means in addition to the missing vaccinological ones. First of all, this is necessary to control salmonella infections, different hemorrhagic fevers, sexually transmitted diseases, lice and, especially, mass acute respiratory diseases, upper respiratory infections, multiple unrecorded localization and etiology, annual contribution of which to total infection morbidity is 86–93%. Studies and development of this area of prevention and control of «uncontrolled» infections requires efforts both of disinfectologists and professionals in hygiene, epidemiology, microbiology, chemistry, bio-technology, entomology etc. Under these conditions, all infections can and shall become «controlled» through combined application of immunological and non-immunological methods and means generated and assessed on the basis of principles of the evidence-based medicine.

Annals of the Russian academy of medical sciences. 2012;67(10):49-54
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SHORT MESSAGES
SAFETY OF RETROVIRAL VECTORS IN GENE THERAPY
Bogoslovskaya E.V., Glazkova D.V., Shipulin G.A., Pokrovskii V.V.
Abstract

Retroviral vectors are widely used in gene therapy and found to be an effective tool for the delivery of genetic constructs into cells. A unique feature of these vectors is the ability to incorporate therapeutic genes into a chromosome that ensures its passage to all progeny cells and enables to cure the diseases requiring genetic correction of dividing cells such as hematopoietic cells or skin cells. Retroviral vectors have been successfully used in gene therapy clinical trials for the treatment of 2 forms of severe combined immunodeficiencies and some other hereditary blood disorders. However, the integration of the vector into the chromosome was accompanied by genotoxicity and caused development of hematologic malignancies in several patients. Later it was shown that genotoxicity is not a general feature of retroviral vectors but it depends on many factors. In the present article we discuss safety issues concerning the use of different retroviral vectors in gene therapy. The description of modern vectors which designed to avoid the genotoxicity and other possible side effects are given.

 

Annals of the Russian academy of medical sciences. 2012;67(10):55-61
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IMPROVING EFFICACY OF FLUORESCENT DIAGNOSTICS OF SKIN AND MUCOSAL TUMORS IN OCULAR ONCOLOGY
Novikov I.A., Grusha Y.O., Kirushchenkova N.P.
Abstract

Developed in 2006 by our institute, the method of primary detection of skin and mucosal tumors based on non-induced fluorescence of endogenous protoporphyrin IX is used to estimate proliferative activity of tumor and its probable progression. This study was aimed to improve method efficacy by means of additional parameter which would quantitatively describe the interpenetration of tumor and surrounding tissues. The authors analyzed autofluorescent data of 97 patients and determined medico-biological factors which could cause controversal results (all cases were histologically controlled). The coefficient of interpenetration Kdith was proposed as a solution. It is calculated as averaged reciprocal to tumor border probability. Repeated analysis of the autofluorescent images using both the proliferative factor and coefficient of interposition revealed improvement of method specificity from 69% to 85% while sensitivity of method remained 70%. In authors’ opinion, the method can be recommended for use in general oncology and dermatology.

 

Annals of the Russian academy of medical sciences. 2012;67(10):62-69
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THE STATE OF ART, PROBLEMS AND FUTURE OF TRANSFUSIOLOGY
Ragimov A.A.
Abstract

The article specifies the main areas of modern transfusiology: blood services, transfusion immunology, clinical and industrial transfusiology. Our research work and the analysis of published data made it possible to specify a new paradigm of transfusion medicine — the transition from the doctrine of blood components transfusion to molecular transfusiology, which comprises medicamentary transfusiology based on the use of gene engineering and biotechnology components as well as blood components preparations, high-tech methods of extracorporeal molecular hemocorrection and highly specific laboratory technology. In view of this concept we develop and introduce modern methods of transfusion medicine and laboratory technologies, aimed at providing the safety of transfusion manipulations and optimizing their use in clinical practice. Transfusion immunology is a part of Transfusion Medicine, studying and implementing in practice the immunological safety and efficacy of transfusions. The article also specifies the main criteria for blood donation and blood components transfusion in patients with hereditary abnormalities of blood; a new approach to evaluation of blood donors potential in endemic foci of inherited abnormalities of blood. The results of the research work formed the basis for protocols of donors examination and the treatment of patients needing hemo transfusion, optimized the tactics of decreed research during the examination of blood donors and patients needing blood transfusion.

 

Annals of the Russian academy of medical sciences. 2012;67(10):70-76
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INTRACELLULAR TARGETS OF PROAPOPTOTIC INFLUENCE OF GASEOUS TRANSMITTERS
Tashireva L.A., Starikova E.G., Novitskii V.V., Ryazantseva N.V.
Abstract

Main molecular targets of nitric oxide, hydrogen sulfide and carbon monoxide proapoptotic action in Jurkat cells were determined in this study. Decrease of mitochondrial transmembrane potential was shown during all three gases action. Reason of this event is the Bcl-2 family members disbalance. Proapoptotic proteins release after mitochondrion membranes permeabilisation could be abolished by protein xIAP inhibition of caspase -9 and-3 activity during NO and CO application.

 

Annals of the Russian academy of medical sciences. 2012;67(10):77-81
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