[Molecular factors associated with regression of liver fibrosis of alcoholic etiology].

Liver fibrosis develops as a result of chronic liver damage of various etiologies, is characterized by excessive synthesis of connective tissue by activated stellate liver cells. The toxic effect of alcohol is one of the most significant and common etiological factors worldwide. Stellate cell activation results from the interaction of multiple molecular fibrogenic pathways triggered by intracellular and extracellular, hepatic and extrahepatic stimuli. Data analysis showed that knowledge about these abnormal pathways and biomolecular processes may further contribute to the improvement of approaches to assessment of disease prognosis and treatment of alcoholic liver disease.

Morphological signs of connective tissue dysplasia as predictors of frequent post-exercise musculoskeletal disorders.

BACKGROUND: Connective tissue dysplasia (CTD) is a risk factor for musculoskeletal disorders. Changes caused by disorganization of collagen and elastin fibers lead to the inability of withstanding heavy mechanical stress. In clinical practice, diagnosis of these disorders depends on physical and anthropomorphic evaluation. METHODS: Forty-eight patients with frequent post-exercise musculoskeletal disorders were evaluated for CTD. The control group included 36 healthy participants. Both groups were evaluated via therapeutic examination with assessment of anthropometric indicators and physical-physiological evaluation, surveying and gathering of anamnesis. Based on testing results, study participants were evaluated on CTD presence and risk factors. RESULTS: All experimental group patients had connective tissue dysplasia of moderate and severe degree, with a total score of 49.44 ± 13.1. Certain morphological characteristics showed prevalence, allowing to determine pathognomonic predictors of high predisposition to frequent post-exercise musculoskeletal disorders. Back pain (100%), asthenic syndrome and kyphotic spinal deformation (75%), high gothic palate, hypermobility of joints and the auricles, excessive elasticity (63%), varicose veins of the lower extremities (56%) and hemorrhoids (56%), changes in the shape of the legs and temporomandibular joint (50%) showed to be significant clinical factors indicating possible connective tissue dysplasia. CONCLUSIONS: The presence of these diagnostically significant morphological signs of CTD in humans is a pathognomonic predictor of a high predisposition to frequent injuries. Their early detection helps promote proper appointment of adequate physical activity regimen and develop treatment for the underlying cause.

[Anatomy of anterior craniovertebral junction in endoscopic transnasal approach]. / Anatomiya perednikh otdelov kraniovertebral'nogo sochleneniya pri endoskopicheskom transnazal'nom dostupe.

Modern achievements in endoscopic technologies ensure extending the indications for endoscopic transnasal approach in skull base surgery. Knowledge on topographic anatomy of craniovertebral junction is a prerequisite for surgical interventions in this area. Transnasal endoscopic surgery of craniovertebral junction is a relatively new field. Therefore, this manuscript and similar anatomical studies are extremely important for neurosurgeons.

[Variations of permanent teeth crowns shapes in children at the age of 14]. / Odontologicheskie variatsii form koronok postoyannykh zubov u detei 14 let.

The objective of the research was to determine odontological (odontometric and odontoscopic) and morpho-aesthetic variations of the upper central and lateral incisors in 14-year-old children residing in Udmurt Republic. 200 adolescent respondents (100 boys and 100 girls) were included in the study. We accessed morphological aspects of the permanent upper right and left central incisors (URCI and ULCI) in 14-year-old children born and permanently residing in conditionally ecologically favorable districts of the Udmurt Republic. Odontological variations of the permanent tooth crown shapes in early adolescent children (14-year-old) are shown; morphological, ethnic, age and gender, aesthetic features are determined. The determined odontoscopic and odontometric features of the permanent tooth crown shapes matter of scientific and practical terms and can be used to clarify ethnicity and possibly gender. The identified patterns can change and multiply the information-statistical interpretation of the ethnic and morpho-aesthetic features of the permanent teeth, and hence have an important impact when restoring damaged teeth crowns, which affect the permanent dentition smile harmony in 14-year-old adolescents born and permanently residing in the Udmurt Republic.

Cell therapy assisted autotransplantation of olfactory tract into the optic nerve: A potential treatment for optic neuropathy.

Optic neuropathy is an invaliding pathology with diverse clinical manifestation and varying causes. Current understanding of etiopathological aspects of optical neuropathy does not provide an effective treatment protocol. In this article we discuss existing treatment methods, and their effectiveness, evaluated depending on disease etiology. The olfactory tract is a source of olfactory ensheating cells, whose unique properties can have treatment potential in correction of nerve degeneration. Transplantation of an olfactory tract graft into the damaged optic nerve is a technically achievable intervention, though anatomical limitations exist in the proposed surgical access. Optic nerve defects can also be potentially treated with axon growth stimulating therapy (Zymosan and CTP-cAMP). Optic neuropathy can be potentially cured by autotransplantation of a portion of the olfactory tract. Neuroanatomical and histomorphological aspects of olfactory tract autotransplantation into the damaged optic nerve are provided. Feasibility, technical and anatomical features, potential setbacks and limitations are discussed. Anatomical limitations exist, but with current neurosurgical technology can be overcome. Regenerative potential of olfactory tract glial cells plays an important role in nerve restoration and can play a crucial role in further understanding of nerve degeneration treatment.

[Influence of modern dental materials on the oral mucosa]. / Vliyanie sovremennykh stomatologicheskikh materialov na slizistuyu obolochku polosti rta.

This article provides the current data of the modern literature on the question of the biocompatibility of dental materials, their influence on the local immune homeostasis of the oral cavity; influence of the method of transmission of masticatory load on the tissues and organs of the oral cavity. Thus, when installing the seal, the choice of material, the localization of carious lesions, and when prosthetics - the choice of material of the prosthetic structure and the method of transfer of chewing load is important. It should be understood that the reaction of the mucous membrane can be not only in the area of direct contact with the dental material, but also appear in remote areas of the oral mucosa.

[The influence of dental status on local immunity of oral cavity of elderly and senile patients with squamous cell carcinoma of the oral cavity mucosa.]

This article presents the results of a study of the dental status of 60 elderly and senile patients with squamous cell carcinoma of the oral mucosa. The use of removable and non-removable dentures, carious lesions of teeth, dental plaque, sharp edges of the crown seals were studied as components of the dental status.

[Surgical anatomy of liver segment iv and its importance in hepatobiliary surgery]. / Khirurgicheskaia anatomiia iv segmenta pecheni i ee znachenie v gepatobiliarnoi khirurgii.

The purpose of this article was to describe clinical anatomy of liver segment IV and determine its significance in liver resection surgery and within integrated approach in the treatment of malignancies of this area.

[Dental status as a predictive factor in the development of squamous cell carcinoma of the oral mucosa]. / Stomatologicheskii status kak prognosticheskii faktor razvitiia ploskokletochnogo raka slizistoi obolochki polosti rta.

The aim of this work was to study the influence of components of dental status on the local immunity of the oral cavity; we compared the results of the study of patients with squamous cell carcinoma (SCC) of the oral mucosa and patients without neoplasm. The study involved 136 patients with squamous cell carcinoma of the oral mucosa and 57 patients without neoplasms. In the role of the constituent characteristics of dental status were examined: the use of removable and fixed dentures, dental caries, dental plaque, sharp edges of fullings. Matrix metalloproteinases (MMPs) 2, 8 and 9, as well as their tissue inhibitors 1 and 2 were assessed in oral fluid. The results suggest the influence of all factors on local immune status of the oral cavity as proved by the significant changes in MMPs level. The use of removable dentures resulted in the pronounced decrease of MMPs and should be considered in oral SSC screening and non-invasive diagnostics.

[Acute carpal tunnel syndrome regarding clinico-anatomical point of view in personified medicine]. / Sindrom ostrogo karpal'nogo kanala s kliniko-anatomicheskoi tochki zreniia personifitsirovannoi meditsiny.

Carpal tunnel syndrome (CTS) requires special attention due to its different reasons and course. Knowledge about the variability of median nerve (MN) topography in carpal canal region, features of diagnosis and treatment extends outlooks on this pathology. Aggregating rare clinical cases from the Medline and Pubmed databases is useful to form personified approach. There are 3 types of topographic variations which should be considered to prevent false-positive diagnosis of pathology: recurrent branch location, early bi- and trifurcations of MN, anastomoses. Since acute CTS is treated only by surgery, every surgical approach is aimed at minimally invasiveness and fast recovery. Endoscopic decompression (ED) is more favorable regarding these aspects. However, this method cannot be considered as perfect due to available data about incomplete decompression and certain incidence of recurrences. The last ones are absent after microsurgical decompression as a rule. It can be concluded that only individual approach is advisable for complete release of CTS without iatrogenic damage and recurrences.

Upregulation of proteoglycans in the perilesion perimeter in ventral horns after spinal cord injury.

Spinal cord injury (SCI) results in pronounced focal tissue damage with subsequent formation of a glial scar that blocks axon regeneration and regrowth. Cellular changes and the composition of the extracellular matrix in regions distal from the injured area remain poorly characterized. In the present study, in the spinal cord distal to the damaged area (perilesion perimeter) there were minimal gross histological changes, but there were pronounced alterations in the extracellular proteoglycans even at 30 days after SCI. These abnormalities coincided with the appearance of reactive astrocytes and a reduction in main astrocytic glutamate transporter 1. Proteoglycan levels exhibited different kinetics and changes after SCI in areas near neuronal cell bodies and in areas distal from them. The results of the study suggest that SCI induces widespread changes in the spinal cord that may be responsible for neuronal dysfunction far from the damaged area and further aggravation of the SCI.

[The application of the computer technologies for the mathematical simulation of the ethmoidal labyrinth]. / Komp'iuternye tekhnologii dlia matematicheskogo modelirovaniia reshetchatogo labirinta.

The objective of the present work was to study the relationship between the dimensions of the ethmoidal labyrinth and the skull in the subjects differing in the nose shape by means of the factorial and correlation analysis with the application of the modern computer-assisted methods for the three-dimensional reconstruction of the skull. We developed an original method for computed craniometry with the use the original program that made it possible to determine the standard intravital craniometrics characteristics of the human skull with a high degree of accuracy based on the results of analysis of 200 computed tomograms of the head. It was shown that the length of the inferior turbinated bones and the posterior edge of the orbital plate is of special relevance for practically all parameters of the ethmoidal labyrinth. Also, the width of the choanae positively relates to the height of the ethmoidal labyrinth.

Matrixins in the Salivary Fluid of Patients with Tumors of the Maxillofacial Region during Orthopedic Rehabilitation with Different Prosthetic Structures.

Dental and immunological features of the influence of various prosthetic structures of orthopedic prostheses on tissues and organs of the maxillofacial region were evaluated by the parameters of expression of oral fluid biomarkers. Healthy people without tumor and somatic diseases and patients with neoplasms of maxillofacial area in need of dental rehabilitation were examined before and in 2 weeks and 3 months after treatment. Certain regularities in the reaction of biomarkers to orthopedic prostheses were observed: a decrease in activity of MMP-2 and MMP-8 and their inhibitors or an increase in MMP-9; an increase in activity of biomarkers at early terms and a decrease in delayed terms after prosthetics.

Estimation of Expression of Oral Fluid Biomarkers in the Diagnosis of Pretumor Diseases of Oral Mucosa.

Complex clinical, dental, and morphological investigation, and ELISA of levels of MMP-2, 8, 9, and TIMP-1 and 2 in the saliva was performed during primary examination of patients with premalignant lesions of maxillofacial area and practically healthy volunteers. Levels of all study MMP in the saliva significantly differed (p≤0.05) in patients with premalignant lesions and the control. These patients were also characterized by a significant (0.1≤p≤0.05) changes in TIMP concentrations (toward pathological pattern) comparing to the control. Pattern of correlations between parameters of MMP-2 expression might be a marker for early diagnostics of a premalignant lesion independently on the dental health. Observed features of biomarker expression in patients with premalignant lesions might reflect the appearance of a cascade of biochemical reactions followed by the activation of production of proteinases and their inhibitors as a response to the exposure to etiological factors. Clinical and morphological diagnosis of a premalignant lesion in the maxillofacial area was confirmed by the immunological analysis of biomarker expression in the saliva, which can be used for monitoring and screening of population.

[AGE-RELATED CHANGES IN THE MORPHOMETRIC PARAMETERS OF THE NEURONS IN HUMAN HIPPOCAMPUS].

Age-related changes in the hippocampus (HC) result in the disturbances of all types of memory and the shifts of emotional reactions. The aim of the present study was to examine the morphometric parameters of neurons of human HC during the aging process. The material was obtained at autopsy of the bodies of 43 individuals of both sexes aged 21­92 years that were divided into 4 age groups. The sections were stained with Nissl's cresyl violet for identification of neurons. The neurons were counted within the standard area and their profile field area was measured in HC proper, in the area of fields CA1 and CA3, and in dentate gyrus in the hippocampal pes. It was found that with aging human HC underwent a heterochronic loss of nerve cells, the intensity of which differed at the level of the middle part and the hippocampal pes. The degree of age-related loss of nerve cells in human HC increased in the direction: dentate gyrus → CA3 → CA1. In most compartments of HC, a compensatory increase of the neuron profile field area was observed in the period from 36 to 74 years, giving place to its reduction in individuals older than 75 years.

[MORPHOMETRIC CHARACTERISTICS OF THE ARTICULAR SURFACES OF THE TEMPOROMANDIBULAR JOINT IN DIFFERENT TYPES OF OCCLUSION IN ADULT PERSONS].

Using 200 skull specimens of adult persons, morphometric characteristics of the articular surfaces of the temporomandibular joint were studied in different types of physiological and pathological occlusion. For systematization of the skulls studied by occlusion type, the classification of V. N. Trezubov was applied. It was found that the sizes of the head of the mandible, the mandibular fossa and articular tubercle in orthognathic occlusion and transient forms were practically the same. Maximum differences in these parameters (sagittal head diameter, anteroposterior size and depth of the mandibular fossa) was found between the groups of skulls with orthognatic and abnormal types of occlusion. It is shown that in the anomalous types of occlusion not only the morphological characteristics of the articular surfaces of the temporomandibular joint were changed, but mostly the intra-articular topography of the articulating joint surfaces. These changes can serve as the major. causes of development of dysfunction of the temporomandibular joint.

[TISSUE-ENGINEERED SUBSTITUTION URETHROPLASTY BASED ON DECELLULARIZED VASCULAR MATRIX AND AUTOLOGOUS CELLS OF THE BUCCAL MUCOSA: THE FIRST EXPERIENCE].

Urethral strictures and anomalies remain a challenging urological problem. Reconstructive plastic surgery has been shown to be the most effective way to treat them. There are two main types of urethroplasty: anastomosis (anastomotic urethroplasty) and expansion of the urethral lumen using of flaps and grafts (substitution urethroplasty). Currently the ideal material for substitution urethroplasty does not exist. Tissue engineering of the urethra seems to be one of the most promising approaches to address this problem. Various tissues-engineering techniques were proposed for substitution urethroplasty. In this study, tissue-engineering design was based on the decellularized cadaveric arterial wall. The study results demonstrated the feasibility of creating stable tissue-engineered structures with autologous cultured epithelial cells of the buccal mucosa and decellularized matrix from human cadaveric arterial wall (DMCAW). There was a complete engraftment of tissue-engineering design based on DMCAW and buccal mucosa cells, used for substitution urethroplasty in a patient with the bulbar urethral stricture. Postoperatively (within 4 months after surgery) no complications and/or adverse events were observed. However, in the late postoperative period (12 months) there was recurrence of urethral stricture in the middle of the tissue-engineering design and the native urethra that warranted another surgery. Tissue-engineering design based on DMCAW and autologous buccal mucosa is safe as a material for substitution urethroplasty. Further research is required to ascertain the effectiveness of the method.

[THE CONSTITUTIONAL ANATOMICAL CHARACTERISTIC OF THE WOMEN OF MATURE AGE].

A comprehensive anthropometric and bioelectrical study of 651 women of mature age (relative norm) aged 22 to 55 years living in the Moscow region, was conducted. The somatotyping was performed according to I.B. Galant-V.P. Chtetzov-B.A. Ni kitiuk scheme. The quantitative distribution of women according to their somatotypological characteristics was obtained, the anthropometric peculiarities and the specific features of body composition in women belonging to different somatotypes were determined. It was found that among the women of mature age studied, mesoplastic (26.9%) and stenoplastici (16.7%) somatotypes were dominant. The least frequently encountered were the representatives of asthenic (1.7%) and athletic (5.2%) somatic types. Women of different somatotypes vary significantly in height and weight and other anthropometric parameters.

[Body mass index and other anthropometric parameters of the physical state in relation with age and individual-typological specific of women constitution].

The physical state of body construction of 651 practically health women 20-55 years old were studied by using a complex of anthropometric and bioelectric methods (conditional norm, slavonians, inhabitants of Moscow region). The leptosome constitutional group was established in 152 cases (23.3%), mesosome group was exposes in 259 cases (39.8%), megalosome group was revealed in 189 cases (29.0%) and indeterminate group was fixed in 78 cases (8.0%). Women of mesoplastic somatotype were established in 26.9%, sthenoplastic somatotype--in 16.7%, picnic somatotype--in 13.7%, subathletic somatorype--in 11.5%, euriplastic somatotype--in 12.3%, athletic somatotype--in 5.2% and asthenic somatotype--in 1.7%. Sizes and weight parameters were depending on type of women body construction. Norm of body mass index for asthenic women was fixed as 16.9; for sthenoplastic somatotype--20.3; for athletic somatotype--23.1; for subathletic somatotype--24.2; for mesoplastic somatotype--24.6; for euriplastic somatotype--24.7; for picnic somatotype--26.2. The length of women body was varied from 158.2 +/- 0.5 (152.0-165.0) cm for sthenoplastic somatotype and 159.6 +/- 0.4 (152.0- 164.8) cm for mesoplastic somatotype to 169.4 +/- 1.7 (162.2-187.4) cm for athletic somatotype. Body weight was also in correspondence with type of constitution. It was 47.8 +/- 0.6 (44.2-54.6) kg for asthenic somatotype, 50.6 +/- 0.4 (42.6-54.2) kg for sthenoplastic somatotype, 62.2 +/- 0.2 (56.3-64.9) kg for mesoplastic somatotype, 68.6 +/- 0.7 (64.5-82.7) kg for picnic somatotype, 66.2 +/- 1.0 (62.0-76.5) kg for athletic somatotype, 68.2 +/- 1.0 (63.4-76.5) kg for subathletic somatotype and 75.0 +/- 1.0 (68.4-92.5) kg for euriplastic somatotype. Mass of bone component was minimal for women of picnic somatotype (6.4 +/- 0.1 kg) as well as asthenic somatotype (7.3 +/- 0.3 kg) and maximal for subathletic (9.3 +/- 0.1 kg) and euriplastic (9.4 +/- 0.1 kg) somatotypes. Skeletal muscles mass was varied from 18.7 +/- 0.4 kg (asthenic somatotype) to 30.2 +/- 0.4 kg (athletic somatotype). Fat tissue mass was varied from 7.0 +/- 0.2 kg (asthenic somatotype) to 32.2 +/- 0.2 kg (euriplastic somatotype). There were established intercommunications between women constitutional characteristics and pecualiarities of their body construction.

[Pathophysiological aspects of wound healing in normal and diabetic foot].

The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabeticfoot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for affords new ground for solving the problem of ulcer healing in diabetes.