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Siberian Scientific Medical Journal

2018 year, number 4

1.
STUDY OF DNA DAMAGE BY NEW NORMOTHYMIC MEDICINAL ON THE BASIS OF THE COMPLEX OF LITHIUM CITRATE, POLYMETHYLSYLOXANE AND ALUMINUM OXIDE BY DNA COMET ASSAY IN VIVO

Vladimir Iosifovich KONENKOV1, Lyubov’ Nikiforovna RACHKOVSKAYA1, Andrey Yur’evich LETYAGIN1, Tat’yana Gennad’evna BOROVSKAYA2, Anna Veniaminovna SHURLYGINA1, Margarita Vladimirovna ROBINSON1, Maksim Aleksandrovich KOROLEV1, Anastasiya Anatol’evna KOTLYAROVA1, Tat’yana Viktorovna POPOVA1, Edmund Edmundovich RACHKOVSKIY1, Anna Vladimirovna VYCHUZHANINA2, Valeriya Aleksandrovna MASHANOVA2
1Research Institute of Clinical and Experimental Lymрhology - Branch of the Institute of Cytology and Genetics of SB RAS
2Gol’dberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center of RAS
Keywords: лекарственное средство, комплекс лития цитрата, полиметилсилоксана и оксида алюминия, повреждение ДНК, метод ДНК-комет, medicinal product, a complex of lithium citrate, polymethylsiloxane and aluminum oxide, DNA damage, DNA comet asay

Abstract >>
The aim of the study was to study the effect of the normotimic drug based on a complex of lithium citrate, polymethylsiloxane and alumina on DNA damage level (DNA comet test) in vivo by alkaline gel electrophoresis. It was shown that at 3 and 18 hours after the drug administration at the highest dose (2000 mg/kg) and therapeutic dose (400 mg/kg), the percentage of DNA in the tail in the cells of the bone marrow does not differ from the negative controls. That may indicate absence of possible carcinogenic action of the lithium-containing drug. On the other hand, the amount of DNA damage in other organs (kidney, liver, large intestine) increased with an exposure time of 3 hours after administration of the drug in a toxic dose. Although, the degree of this effect expression was not high. When the dose was reduced (400 mg/kg) and the duration of the experiment was increased (up to 18 hours), this effect was not detected. That indicates the ability of the drug to enhance DNA damage repair. Given that lithium preparations have a pronounced toxic effect on kidneys, gastrointestinal tract, liver, the increase in the percentage of DNA in the tail in these organs can be a consequence of the cytostatic action of the drug.



2.
HIGH FIELD MRI OF JOINTS AND LIMBS’ TISSUES OF THE WOMAN’S MUMMY FROM BURIAL AK-ALAKHA-3 ON THE UKOK PLATEAU

Andrey Yurievich LETYAGIN1,2, Nataliya Viktorovna POLOS’MAK3, Andrey Aleksandrovich SAVELOV2, Maxim Alexandrovich KOROLEV1, Elena Alekseevna LETYAGINA1
1Research Institute of Clinical and Experimental Lymphology - a Branch of Federal Research Center of the Institute of Cytology and Genetics of SB RAS
2Institute В«International Tomographic Center» of SB RAS
3Institute of Archeology and Ethnography of SB RAS
Keywords: мумия, магнитно-резонансная томография, суставы, опорно-двигательный аппарат, mummy, magnetic resonance imaging, joints, musculoskeletal system

Abstract >>
The goal is to perform a paleoradiologic MRI study of the tissues of the musculoskeletal system of the mummy of a woman from the Pazyryk culture from the Ak-Alakh-3 burial ground on the Ukok Plateau, in which previously had been found tumor metastases (from the right breast) and the consequences of a severe trauma - a dislocation of the right hip and damage to the right brachial joints. The method is a high-field MRI on the magnetic resonance scanner (Achieva Nova, Philips, 1.5 T). Results. The manifestations of osteomyelitis of the femurs bones were revealed in the tissues of the musculoskeletal apparatus of the mummy. The signs of damage to the anterior cruciate ligament of the right knee joint and lig. bifurcatum of the right foot were revealed, which indicates the effect of unfavorable factors of traumatic genesis. There were also signs of an inflammatory process, spondyloarthritis and osteoarthritis (probably autoimmune genesis): a pronounced narrowing of both sacroiliac joints, zones of inflammatory edema of bone tissue in the projection of the left sacroiliac joint, joints of the foot, involvement of the periarticular soft tissues-achillobursitis.



3.
DIRECTED RE-PROGRAMMING OF SOMATIC CELLS: ADVANTAGES AND LIMITATIONS OF INDUCED PLURIPOTENT STEM CELLS (REVIEW)

Anastasiya Viktorovna KOREL, Sergey Borisovich KUZNETSOV
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia
Keywords: индуцированные плюрипотентные стволовые клетки, дифференцировка, соматические и эмбриональные стволовые клетки, induced pluripotent stem cells, differentiation, somatic and embryonic stem cells

Abstract >>
Stem cells are divided into embryonic and adult stem cells. The relevance of the use of stem cells in clinical practice has received new evidence in recent years however, the methods of obtaining stem cells for medical purposes cause ethical rejection. An alternative to the stem cells is the induced pluripotent cells. These cells are multipotential and comparable with features of embryonic stem cells but with additional advantages: their preparation allows to avoid many ethical problems associated with the use of embryonic material, their use reduces the risk of immune rejection. The possibility of somatic cells reprogramming into pluripotent stem cells opens the great prospects for regenerative medicine. An applying of directional reprogramming method makes possible to obtain practically any cell type from induced stem cells of the patient to use in autologous cell therapy. Induced pluripotent stem cells can also be used to model the human diseases and for screening of medicines. However, there are still a number of obstacles that need to be overcome before the use of induced pluripotent stem cells will be involved to routine clinical practice. This review examines the history of the creation of induced pluripotent stem cells and recent advances in the reprogramming of somatic cells, as well as the challenges that need to be overcome in order to apply this strategy in clinical practice.



4.
COMPARATIVE ELECTRON-MICROSCOPIC AND MICROBIOLOGICAL INVESTIGATION OF SILVER PROTEINATE PREPARATIONS

Vasiliy Aleksanrovich BURMISTROV1, Vladimir Ivanovich ZAYKOVSKIY2, Anton Vasil’evich BURMISTROV1, Lyubov’ Nikiforovna RACHKOVSKAYA3, Anna Veniaminovna SHURLYGINA3, Tat’yana Viktorovna POPOVA3, Margarita Vladimirovna ROBINSON3, Maksim Aleksandrovich KOROLEV3, Andrey Yur’evich LETYAGIN3
1Vector-Vita Ltd
2Boreskov Institute of Catalysis of SB RAS
3Research Institute of Clinical and Experimental Lymрhology - Branch of the Institute of Cytology and Genetics of SB RAS
Keywords: коллоидное серебро, протеинат серебра, размеры частиц, бактерицидное действие, бактериостатическое действие, colloidal silver, silver proteinate, particle size, bactericidal action, bacteriostatic action

Abstract >>
The purpose of this work was a comparative study of the particle sizes of commercial preparations of colloidal silver by the method of electron microscopy, in connection with the characteristics of specific antimicrobial activity of the preparations under the same conditions. Four commercial preparations of colloidal silver were investigated: Vitargol Forte (manufactured by NPC «Elusan»), Protalor (manufactured by OOO «Esko-Farm», Armenia), Sialor (manufactured by PFK «Obnovlenie»). Protargol (prescription drugstore) served as the drug of comparison. Material and methods. The silver particle sizes in the preparations were determined by high-resolution transmission electron microscopy using a JEM 2010 electron microscope (JEOL, Japan) with a resolution of 0.14 nm at an accelerating voltage of 200 kV. The antimicrobial activity of the silver protein preparations was studied by a standard serial dilution method in liquid nutrient media and diffusion method using bacterial cultures of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Results and discussion. Vitargol Forte, manufactured using advanced technology, is the most fine-dispersed and monodisperse preparation. The preparation of standard classical Protargol, prepared in pharmacy conditions, was the most coarsely dispersed and polydispersed. The conclusion. The dependence of antimicrobial activity of the preparation on the size of its silver particles was shown. Of the four investigated preparations of silver proteinate, the smallest particle size was in the Vitargol Fort preparation. The same drug showed the highest bactericidal and bacteriostatic activity.



5.
ANTIGENIC PROPERTIES OF ARTIFICIAL POLYEPITOPE HIV IMMUNOGEN

Andrey Pavlovich RUDOMETOV1, Nadezhda Borisovna ANDREEVA1, Anton Nikolaevich CHIKAEV2, Nadezhda Sergeevna SHCHERBAKOVA1, Olga Nikolaevna KAPLINA1, Larisa Ivanovna KARPENKO1
1State Research Center of Virology and Biotechnology В«Vector» of Rospotrebnadzor
2Institute of Molecular and Cell Biology of SB RAS
Keywords: ВИЧ-1, полиэпитопные ВИЧ-иммуногены, эпитопы, нейтрализующие антитела широкого спектра действия, bNAbs

Abstract >>
The development of immunogen being capable of providing protection against HIV-1 infection and progression is still topical and unsolved challenge. Since HIV-1 demonstrates strong genetic variability, an efficient vaccine should provide protection against a number of various virus strains. Design of immunogen with capacity to induce broadly neutralizing antibodies to HIV is believed to solve this issue. As distinct from usual antibodies, bNAbs interact with conservative epitopes providing protective immunity to overwhelming majority of HIV strains. Our study aims to construct and analyze antigenic features of polyepitope HIV-immunogen nTBI comprising epitopes recognized by bNAbs. Materials and methods. We used previously designed TBI protein as molecule-carrier and obtained on this basis protein’s modified variant nTBI. It includes epitopes recognized by bNAbs 10E8, 4E10, 2F5, as well as linear mimetic of conformation epitope bNAb VRC01. Immunoblotting was used to analyze antigenic properties of epitopes in composition of nTBI. To purify nTBI, we used metal chelate chromatography. To study immunogenic properties, we immunized rabbits with purified nTBI preparation. Specific activity of sera from immunized rabbits was identified using ELISA. Affine chromatography on protein A was used to obtain IgG from sera of rabbits. Virus-neutralizing activity of purified IgG was detected in neutralization test using recombinant virus HIV-1 92BR025. Results. Immunogen nTBI comprising epitopes recognized by bNAbs was constructed. We obtained protein nTBI producer providing production of target protein up to 30 % of the amount of producer cell proteins. We showed that in the context of nTBI protein linear epitopes retain their antigenic properties. When immunizing rabbits, we found nTBI inducing production of antibodies capable of neutralizing recombinant HIV-1 strain 92BR025. Conclusion. We demonstrated principal possibility of the use of artificial TBI protein as a scaffold molecule to expose epitopes recognized by broadly neutralizing antibodies.



6.
DETERMINATION OF THE TEMPERATURE FIELD DURING LASER COAGULATION of CHORIORETINAL COMPLEX WITH OPTOACOUSTIC IN VITRO

Alesya Valerevna ARDAMAKOVA1, Natalya Anatolevna FEDORUK1, Anton Pavlovich LYTKIN2, Andrey Viktorovich LARICHEV2, Vladimir Ivanovich SIPLIVYY3
1Research Institute of Eye Diseases
2Lomonosov Moscow State University
3Sechenov University
Keywords: коэффициент оптического поглощения, распределение температурного поля, лазеркоагуляция, оптоакустика, optical absorption coefficient, temperature field distribution, laser coagulation, optoacoustics

Abstract >>
The article describes a determination method of the laser radiation with specific parameters effect on the eye tissues based on optoacoustic probing. Low-power probing laser with 7-10 ns pulses generates acoustic waves at the aiming point. The waves propagate through the medium (saline in a cuvette) to acoustic receiver. The characteristics of the acoustic wave give basis for estimation of optical absorption coefficient - a parameter that determines temperature in the affected area after applying therapeutic laser. Calculation of the temperature pattern was performed using a three-dimensional thermal conductivity model that enabled determination of temperature distribution at any local point during coagulation and immediately after. To compare the results with pre-calculated temperature field values, direct temperature measurement was taken from the surface of the absorbing layer. The experiment was performed on six human chorioretinal tissue samples in vitro; the obtained optical absorption coefficient values did not exceed 120-300 cm-1 with maximum error margin of 20 %. The computational model was seen to be in good agreement with experimental thermocouple measurements.



7.
EVALUATION OF INTRACRANIAL HYPERTENSION ON DATA OF ULTRA-HIGH-FIELD MRI

Andrey Yurievich LETYAGIN1,2, Yuriy Ivanovich BORODIN1
1Research Institute of Clinical and Experimental Lymрhology - Branch of the Institute of Cytology and Genetics of SB RAS
2Scientific Research Institute of Physiology and Basic Medicine
Keywords: сверхвысокопольная магнитно-резонансная томография, внутричерепное давление, гематоэнцефалический барьер, ликворолимфатический барьер, цереброспинальная жидкость, синдром внутричерепной гипертензии, ultrahigh-field MRI, intracranial pressure, blood-brain barrier, cerebrospinal fluid-lymph barrier, cerebrospinal fluid, intracranial hypertension syndrome

Abstract >>
The goal is to evaluate the contribution of age and individual features of the cerebral cranium, foci in the CNS structures, pathomorphological changes in the liquor-containing spaces and angio-cerebral structures visualized on ultra high field magnetic resonance imaging (uhfMRI) in the formation of the syndrome of intracranial hypertension (ICH). Intracranial pressure (ICP) is the fundamental biophysical parameter of the brain, the result of perfusion and diffusion at the level of hemato-tissue, hemato-liquor, liquor-tissue contacts forming the hematoencephalic barrier (BBB), and the liquor-lymphatic contacts that form the liquor-lymphatic barrier (LLB). Violations of venous cerebral hemodynamics and liquorodynamics reduce the possibility of draining the subarachnoid space of the brain and spinal cord, and the «excess» of cerebrospinal fluid (CSF) in the static volume of the cerebral cranium causes the ICH. This is manifested in the form of violation of perfusion and diffusion processes, in the form of micro-foci in the structures of the nervous tissue of the brain and spinal cord, in changes in cerebral vessels, liquor-containing spaces and liquor-lymphatic contacts. Clinically, on the background of ICH, a symptom-complex of headache is formed, and the functional abilities of the central nervous system decrease. Direct measurement of ICP is an invasive procedure with a violation of the integrity of the dura mater. Therefore, for individual diagnosis of the mechanism of increasing ICP in 249 patients with clinical manifestations of ICH, biomarkers (pathomorphological findings with uhfMRI) were analyzed: biomarkers of hydrocephalus-hypertension-edematous syndrome, biomarkers of residual cerebral changes, biomarkers of unfavorable anatomical variants of the structure of the brain skull and brain tissue, biomarkers of the consequences of the development of hydrocephalus-hypertension-edematous syndrome, biomarkers of unfavorable variants of cerebral vascular network structure and hemodynamics. Each patient develops an individual pathogenetic scheme of development of ICH, which during life changes at least 3 times.



8.
FACTORS AFFECTING BONE REMODELING IN PATIENTS WITH HODGKIN’S LYMPHOMA (REVIEW)

Mariya Sergeevna VOYTKO1, Tatyana Ivanovna POSPELOVA1, Vadim Valerievich KLIMONTOV1,2, Elena Viktorovna MEZIT1
1Novosibirsk State Medical University of Minzdrav of Russia
2Research Institute of Clinical and Experimental Lymphology - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences
Keywords: лимфома Ходжкина, минеральная плотность костной ткани, остеопороз, денситометрия, двухэнергетическая рентгеновская абсорбциометрия, Hodgkin’s lymphoma, bone mineral density, BMD, osteoporosis, dual-energy X-ray absorptiometry, dual X-ray absorptometry

Abstract >>
Hodgkin’s lymphoma is considered a potentially curable disease. Chemotherapy-based salvage regimens can achieve responses in 90 % of patients with Hodgkin’s lymphoma. The possibility of achieving persistent disease-free survival poses a problem of ensuring a satisfactory quality of life and preventing the long-term consequences of antitumor therapy. One of those consequences may be a change in bone mineral density. Currently, a number of researchers have established that the risk of osteoporosis and osteopenia is highest in patients with Hodgkin’s lymphoma as compared to patients with other lymphoproliferative disorders. The decrease in bone mineral density can be associated with polychemotherapy including various combinations of cytostatic drugs and glucocorticoids, hypogonadism caused by toxic effects of radiotherapy and chemotherapy, tumor process, low physical activity and other factors. The high importance of the problem of osteoporosis is determined from social consequences - fractures of the vertebral bodies and fractures of the peripheral skeleton. That leads to economic risks in the health care area and causing a high level of disability. The aim of the study was to reveal the main regularities of bone remodeling in patients with Hodgkin’s lymphoma.



9.
COMPARATIVE ANALYSIS OF THE INFLAMMATORY RESPOND OF THE VASCULAR WALL AFTER IMPLANTATION OF BIORESORBABLE SCAFFOLDS AND EVEROLIMUS COVERED STENTS IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE

Natal’ya Alekseevna MUSIKHINA, Tat’yana Ivanovna PETELINA, Ivan Sergeevich BESSONOV, Natal’ya Alimgiraevna GALEEVA, Elena Aleksandrovna GORBATENKO, Alina Igorevna KOSTOUSOVA
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
Keywords: ишемическая болезнь сердца, ангиопластика, воспаление, биорезорбируемые скаффолды, coronary artery disease, angioplasty, inflammation, bioresorbable scaffolds

Abstract >>
Aim - to conduct a comparative analysis of markers of inflammatory reaction of the vascular wall in patients with stable coronary artery disease (CAD) after implantation of bioresorbable scaffolds (BS) and everolimus-eluting stents during short observation period. Material and methods. 20 patients with stable CAD and mono-vessel coronary bed lesion with indication to percutaneous coronary intervention (PCI) were studied. Group 1 consisted of 9 patients with implanted stent covered with everolimus; group 2 consisted of 11 patients with implanted BS. Biochemical inflammatory markers were defined at the admission time, in 1 day, 4 days and 1 month after PCI. Results. In 1 day after PCI both groups expectedly showed cytokine level growth, including interleukin 6 (IL-6), as a respond to the vascular wall lesion with the following decrease in 4 days to the initial level. On the second day after PCI serum content of matrix metalloproteinases 9 (MMPs-9) was increased in groups 1 and 2 of patients. Lowering of MMPs-9 with no reaching the initial level in 1 month was noticed only in group 2, whereas group 1 kept high concentration of MMPs-9. The comparable groups had the maximum content of soluble CD40-ligand (sCD40L) on the 4th day with a little lowering after 1 month only in group 2. High level of high-sensitive C-reactive protein (CRP) remained during the entire follow-up period in both groups. Conclusion: Patients with stable CAD after implantation of BS and everolimus covered stents did not have any differences in dynamics of mediators of acute inflammation phase. Persistent high levels of MMPs-9, sCD40L and also elevated concentration of CRP assume prolonged character of the vascular wall inflammatory respond, being more expressed after implantation of everolimus covered stents.



10.
BONE-PLASTIC ORBITOTOMY BY METHOD OF KRENLANE IN THE SURGICAL TREATMENT OF CAVERNOUS HEMANGIOMAS OF THE ORBIT

Ivan Viktorovich PENDYURIN1, Vyacheslav Vladimirovich STUPAK1, Igor’ Anatol’evich VASIL’EV1, Mariya Sergeevna SELYAKOVA2
1Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan of Minzdrav of Russia
2Novosibirsk State Medical University of Minzdrav of Russia of Minzdrav of Russia
Keywords: орбитотомия, опухоли орбиты, кавернозные гемангиомы орбиты, доступы в орбиту, Кренлейн, orbitotomy, tumors of the orbit, orbital cavernous hemangioma, accesses to the orbit, Krenlane

Abstract >>
The article is devoted to the description of three clinical cases of patients with rare pathology - cavernous hemangioma of the orbit cavity operated in the neurosurgery clinic of Novosibirsk Research Institute of Traumatology and Orthopedics. The aim of the study was to evaluate the results of surgical treatment of orbital masses through the example the Krenlane method of cavernous angioma orbitotomy in the neurosurgical clinic. Material and methods. 20 people with primary and secondary (growing into the orbit cavity) orbit tumors were operated in the neurosurgery clinic from 2007 to 2016. Among these 20 tumor cases (0.65 % of all brain tumors have been removed in the clinic during this period) there were 13 meningiomas (65 %); 4 gliomas of the optic nerve (20 %); 3 cavernous angiomas (15 %). 3 patients had volumetric formations localized directly into the orbital cavity without spreading into the optic nerve canal and intracranial. In all 3 cases, tumors were cavernous hemangiomas confirmed by pathomorphological studies. Results. All operated cavernous hemangiomas were removed totally. The patients’ postoperative course was smooth, wound healing went by primary tension. Visual acuity deterioration was not observed. According to the results of MSCT control, there were no tumor signs in the early postoperative period (the next day after the operation). All patients were dismissed in satisfactory condition on the seventh day. Control tests, including an MRI after 5 years from the time of the operation showed that the operated patients did not complain. Exophthalmos regressed completely. Visual acuity in all patients recovered to 1.0. Cosmetic defect was absent. All patients had a good functional result - a complete restoration of eyeball movement. Conclusions. Patients with primary volume formations of the orbit cavity in the form of cavernous hemangiomas of lateral localization can be successfully operated with the use of minimally invasive access - bone-plastic orbitotomy, by the method of Krenlane with its proper technical execution. The access is of low-traumatic nature, allows for a wide view of the orbit cavity, provides the necessary operational space and visualization of the surgeon’s manipulation zone, which allows to perform radical removal of the tumor as much as possible without damaging healthy tissues, large vessels and the optic nerve, is well tolerated by patients.



11.
APPLICATION OF PHYSICAL FACTORS TO REDUCE THE BARRIER FUNCTION OF EPIDERMIS FOR LASER RADIATION

Alexey Stanislavovich MUKHIN1, Evgeniy Anatolyevich LEONTYEV2
1Privolzhsky Research Medical University of Minzdrav of Russia
2City Clinical Hospital No. 1 of Minzdrav of Chuvashia
Keywords: тату, татуировочный пигмент, удаление тату, дермабразия, лазеротерапия, tattoo, tattoo pigment, tattoo removal, dermabrasion, laser therapy

Abstract >>
The purpose of the study is to determine the optimal technique for reducing the barrier function of skin epidermis to increase the laser radiation penetrating depth into tissues. Material and methods. The experiments were carried out with full-layer human skin samples obtained after surgical intervention. The source of laser radiation was placed on one side of the irradiated tissue and glass fiber was introduced coaxially with it on the other side to determine the depth of penetration of laser radiation into biological tissues. The radiation receiver was a photoelectric multiplier. The density of the light flux changed together with the change in the position of the fiber in the array of tissues., The depth of radiation penetration into the irradiated sample was determined after constructing the radiation intensity curve. The study of native preparations of human skin was carried out before and after exposure to physical factors. Methods of microdermabrasion, laser ablation of skin surface layers, ionophoresis and ultrasound were used to conduct the study in order to reduce the barrier function of skin epidermis. After these methods exposure, the depth of penetration of laser radiation into the tissue was measured during laser radiation with wavelengths of 532 and 1064 nm. Results and discussion. It has been established that microdermabrasion and laser ablation of epidermis stratum corneum reduced the absorption of laser radiation at the depth of up to 2.5 mm resulting in significant reducing the laser radiation power.



12.
PRIMARY HIP REPLACEMENT FOR THE RIGHT FEMORAL NECK FRACTURE IN A PATIENT ON CHRONIC HEMODIALYSIS PROGRAM AND REPEATED SURGICAL TREATMENT FOR NEUROENDOCRINE TUMOR

Svetlana Ivanovna KIRILINA1, Vladislav Vasilyevich BORIN1, Aleksandr Aleksandrovich ELISTRATOV2, Vadim Sergeevich SIROTA1, Konstantin Nikolaevich KHARITONOV1, Vitaliy Viktorovich PAVLOV1, Valentin Yuryevich ZHILENKO2
1Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia
2Autonomous non-profit organization В«Сlinic of Traumatology, Orthopedics and Neurosurgery of NRITO» (ANO В«Сlinic NRITO»)
Keywords: нейроэндокринный рак, перелом шейки бедра, эндопротезирование тазобедренного сустава, хроническая почечная недостаточность, программный гемодиализ, neuroendocrine tumor, femoral neck fracture, hip replacement, chronic kidney disease, program hemodialysis

Abstract >>
The clinical case is fairly rare combination of severe somatic pathology (neuroendocrine cancer, terminal chronic kidney disease, program hemodialysis, etc.) and orthopedic and traumatologic pathology (right femoral neck pseudarthrosis) requiring surgical intervention with high risks for patient’s life. The patient has been suffering from polyneuroendocrine cancer since 2001. The history of multiple surgical interventions for polyneuroendocrine cancer is presented. Neuroendocrine cancer is considered as the least often oncologic disease. It is very dangerous, because neuroendocrine cells are spread throughout the body and can affect almost any organ. The treatment prognosis is unknown. At present, this type of cancer is poorly researched, which precludes the introduction of new treatment options and preventive activities. In the setting of comorbid pathology that arose from neuroendocrine cancer treatment (comorbidity index 12, according to ASA IV), the patient received the right femoral neck fracture. Surgical treatment for femoral neck fracture in patients burdened with comorbid pathology is a challenge for surgeons, anesthesiologists-resuscitators, therapists, nutritiologists, and doctors of other specialties. An abandonment of surgical intervention worsens the quality of life, aggravates disability, leads to the development of trophic, thrombo-embolic and infectious complications, and increases the likelihood of adverse outcome. Surgical treatment in the setting of specialized hospital is the most expedient. Therefore, due to comorbidity of such patients, a niche-targeted approach to treatment by specialists is needed at all stages of treatment with a seamless transfer of care and consistency of treatment activities.



13.
EXPERIENCE OF HUMAN NORMAL IMMUNOGLOBULIN (PRIVIGEN, CSL BEHRING) ADMINISTRATION IN PATIENTS WITH GUILLAIN - BARRE SYNDROME IN NON-SPECIALIZED NEUROLOGICAL DEPARTMENT

Lyubov Porfiryevna SMERTINA1,2, Veli Zellabdunogly MOVSUMOV1,2
1Surgut District Clinical Hospital
2Surgut State University
Keywords: синдром Гийена - Барре, привиджен, внутривенные иммуноглобулины, Guillain - Barre syndrome, Privigen, immunoglobulins

Abstract >>
Objective - to assess the own experience of human normal immunoglobulin (Privigen, CSL Behring) administration in patients with Guillain - Barre syndrome. Material and methods. Clinical cases of patients with Guillain - Barre syndrome treated with human normal immunoglobulin (Privigen) in 2016-2017. Guillain - Barre syndrome corresponded to the disease clinical and diagnostic criteria. Efficiency of this treatment was considered by improvement of motor and pelvic functions. Besides, side effects and tolerability were assessed clinically. Results. 3 GBS patients underwent treatment. There was improvement of varying degrees in 3 cases, which included improvement in motor sphere and improvement in urination. One case was fatal because of pulmonary and cardiac failure caused by pneumonia. Expected slight side effect was in 1 case, which includes nasopharyngitis, was treated in within days. Conclusion. Results of implementation of human normal immunoglobulin (Privigen, CSL Behring) were ambiguous.



14.
CLINICAL AND FUNCTIONAL SUBSTANTIATION FOR COMPLEX TREATMENT STAGING IN PATIENTS WITH THE TEMPOROMANDIBULAR JOINT DISK DISPLACEMENT WITH REDUCTION OF BITE PATHOLOGY AND THE HYPERTONICITY OF THE MASTICATORY MUSCLES

Irina Nikolaevna BREGA, Pavel Alexandrovich ZHELEZNYY, Anzhela Vladimirovna ADONYEVA, Konstantin Sergeevich SHCHELKUNOV, Elina Denisovna PIVEN
Novosibirsk State Medical University of Minzdrav of Russia
Keywords: височно-нижнечелюстной сустав, смещение суставного диска с вправлением, гипертонус жевательной мускулатуры, релаксационная сплинт-терапия, temporomandibular joint, disk displacement with reduction, hypertonicity of the masticatory muscles, relaxation splint therapy

Abstract >>
Aim of investigation: substantiation of the complex treatment phasing of patients with the temporomandibular joint disk displacement with reduction in case of bite pathology and hypertonicity of masticatory muscles. Methods. The clinical evaluation, radiological, electromyographic, and gnathological examination of 74 patients with the reduced temporomandibular joint (TMJ) disk displacement in case of occlusion pathology and chewing muscles hypertonicity have been carried out in the treatment planning and implementation from 2016 to 2018. In order to normalize the function of masticatory muscles at the first stage of treatment, relaxing splint and drug therapy were applied. The effectiveness of the chewing muscles hypertonicity correction was evaluated under electromyography control. The installation of braces for correction of malocclusion was performed after the electromyography signs normalization, reducing the frequency, severity of clicks in the TMJ and the absence of subjective complaints of discomfort or pain. Results and discussion. After the improvement of anatomical and functional relationships, planned orthodontic treatment was carried out, during which no disorders of the temporomandibular joints were revealed. The inclusion of relaxation splint for malocclusion and masticatory muscles hypertonicity, combined with the reduction of the joint disc displacement of the temporomandibular joint in the complex therapy is aimed at preventing the development of secondary osteoarthritis and blockage of the articular disc of the TMJ.



15.
PULMONOTOXICYTY OF SYNTHETIC POLYMERS COMBUSTION PRODUCTS

Dmitriy Vyacheslavovich TRISHKIN1, Sergey Viktorovich CHEPUR2, Pavel Gennad`evich TOLKACH3, Vadim Aleksandrovich BASHARIN3, Oleg Vladimirovich CHUBAR2, Aleksandr Sergeevich GOGOLEVSKIY2, Mikhail Aleksandrovich TYUNIN2, Evgeniy Gennad`evich KRUCHININ2, Roman Olegovich VASILEV2, Evgeniy Aleksandrovich TARASOV2
1Main Military Medical Department of Minoborony of Russia
2State Research Test Institute of Military Medicine of Minoborony of Russia
3Kirov Military Medical Academy of Minoborony of Russia
Keywords: пульмонотоксиканты, горение, фосген, хлор, токсический отек легких, pulmonological, combustion, phosgene, chlorine, toxically pulmonary edema

Abstract >>
Pulmonotoxicants are the substances causing structural and functional disorders of respiratory system. The main sources of pulmonotoxicants in the environment are thermal decomposition of synthetic polymeric materials in fires. The possibility of formation of pulmonotoxicants during the combustion of synthetic polymers of different composition with regard to the conditions of combustion (temperature, time, sufficient oxygen) was analyzed. The risk of lung damage has been considered taking into account the duration of exposure to the toxicant. In addition to general toxic carbon monoxide and cyanide, the products of thermal destruction of halogen-containing and nitrogen-containing substances pose a great danger in case of fire due to their high pulmonotoxicity. The lung damage risk is considered with account for toxicants exposure duration. The pulmonotoxicants classification has been proposed according to their hazard in relation to their concentration in the air. Main mechanisms of effect of pulmonotoxicants formed during the pyrolysis of various polymeric synthetic materials have been proposed. The description of clinical manifestations as the result of intoxication with these materials under various toxodoses effect has been shown. The hazardous risk spectrum has changed depending on the toxic exposure duration that determines the variance of treatment approaches: from possible etiotropic treatment to pathogenetic therapy of toxic pulmonary edema.



16.
FORMATION OF FOOD BEHAVIOR STEREOTYPES IN CHILDREN DEPENDING ON AGE

Natalya Vasilievna TAPESHKINA1, Aleksandr Yakovlevich PEREVALOV2, Liliya Vladimirovna POPKOVA3
1Novokuznetsk State Institute for Further of Physicians - Branch Campus of Russian Medical Academy of Continuous Professional Education of Minzdrav of Russia
2Perm State Medical University n.a. E.A. Vagner of Minzdrav of Russia
3Kemerovo State Medical University of Minzdrav of Russia
Keywords: дошкольники, школьники, пищевое поведение, факторный анализ, preschoolers, schoolchildren, food behavior, factor analysis

Abstract >>
The purpose of the study was to investigate the formation of disturbances in the eating behavior of children and adolescents due to the irrational structure of food consumption through the use of factor analysis. Material and methods. A survey of 1,058 children living in the city of Mezhdurechensk of the Kemerovo Region was conducted using enquire form with a questionnaire on the frequency of consumption of the main food groups. In the questionnaires, the frequency of consumption of food groups had 5 gradations and the corresponding conditional score. To identify the latent factors that determine the frequency of consumption of specific categories of food, factor analysis - the method of principal components was used. Results and discussion. In pre-school children, two main factors were identified that determine the variability in the frequency of consumption of food. The total influence of factors was 55,5 %. The frequency of food consumption by schoolchildren aged 7-10 years and 11-13 years was different from the age groups of children 3-6 years old and was determined by 3 latent factors, the share of which was 59,6 and 60,6 %. With the increase of years the total influence of factors affecting the frequency of food consumption increases. None of the stereotypes of eating behavior can be considered as rational, since all of them have been characterized by frequent consumption of high-calorie food products against the background of the decrease in biologically valuable foods consumption. The lack of consumption of the main food groups testify to reduced nutritional status. The emerging stereotypes of eating behavior can cause a shortage of intake of nutrients in the body of both preschoolers and schoolchildren.



17.
STRESS IN THE FAMILY IN THE OPEN URBAN POPULATION, GENDER DIFFERENCES

Aleksandr Mikhaylovich AKIMOV1, Marina Mikhaylovna KAYUMOVA1, Mikhail Yurievich AKIMOV2, Vadim Anatol’yevich KUZNETSOV1
1Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS
2Tyumen Industrial University
Keywords: стресс в семье, открытая популяция, гендерные различия, stress in the family, open population, gender differences

Abstract >>
Objective: to study the interrelation of stress among men and women of 25-64 years in an open population in Tyumen. Cardiac screening was carried out on a representative sample of the population (77.7 % response). A representative sample of 2000 people was formed from the electoral lists of citizens of one of the administrative districts of Tyumen. Each of the eight sex-age groups (25-34, 35-44, 45-54, 55-64 years) consisted of 250 people. The identification of stress in the family was assessed by the WHO questionnaire «MONICA-psychosocial». The results of the study showed that changes in the marital status occurred more often among young men of 25-34 years than among women of the same age group. At the age of 55-64 years the situation is changing, there are more changes in the marital status among elderly women than among men. At the same time, changes in the marital status were significantly more frequent in men aged 25-34 years than in older age groups.