[Psychotherapy in treatment and rehabilitation of patients with multiple sclerosis]. / Psikhoterapiia v lechenii i reabilitatsii bol'nykh rasseiannym sklerozom.

Presented is a review of the use of psychotherapy and psychological intervention methods in treatment and rehabilitation of patients with multiple sclerosis (MS). Main indications for psychotherapy in MS are anxiety and depression, asthenia, movement disorders, cognitive decline or sleep disturbances. The applied methods of psychotherapy refer to behavioral, cognitive, humanistic, combined or alternative approaches. Individual and group sessions are most frequently used forms of psychotherapy. Positive effects of psychotherapy in MS patients are confirmed by data of randomized studies and neuroimaging. Psychotherapy should be included into complex multidisciplinary programs of treatment and rehabilitation of MS patients.

[The importance of transcranial doppler ultrasound monitoring for prevention of intraoperative cerebral ischemia].

OBJECTIVE: To determine the possibility of using transcranial ultrasound dopplerography (TCDG) in assessment of unfavorable changes in cerebral blood circulation which lead to the development of intraoperative cerebral ischemia. MATERIAL AND METHODS: We studied 55 patients who underwent vascular surgery or neurosurgical interventions. Changes in the systemic hemodynamics of ischemic character were recorded during the surgery in all patients. To assess the state of cerebral blood circulation, we performed TCDG using a special system of monitoring. RESULTS: Intraoperative TCDG monitoring showed the absence of critical changes in cerebral blood circulation (cerebral blood flow). CONCLUSION: Complex preoperative and intraoperative ultrasound diagnosis gives the possibility to prevent intraoperative injuries of the brain.

[Immunocompetence and reproductive characteristics of male Campbell dwarf hamsters selected for low and high humoral immune response to SRBC: testing the immunocompetence handicap hypothesis].

We selected Campbell dwarf hamsters (Phodopus campbelli Thomas, 1905) for low and high humoral immune response to the sheep red blood cells (SRBC) challenge in three generations (P, F1, F2). Non-specific innate immunity and acquired T-cell immunity, resting metabolic rate, testosterone, and cortisole hormone levels, reproductive characteristics, including maturation related morphological traits, and aggressive behavior were studied within sets of males:with low (LI) and high (HI) immune response to SRBC. We found no difference between LI and HI males in cutaneous response to injection of phytohemagglutinin, (DTH test for T-cell immunity), in activity of Peroxidase - Endogenous Hydrogen Peroxide System of Neutrophils , in the white blood count, in resting metabolic rate, in body mass and ano-genital distance at the age of two months, in the blood level of testosterone before and after recurrent immunization by SRBC and in the blood level of cortisole in response to the social stressor (10 min encounter in the neutral arena). At that, LI males had significantly higher basal level of blood cortisole, were less aggressive in response to stranger male and had smaller testosterone-dependent mid-ventral specific skin gland at the age of two months. Males of two groups did not differ in the initial mating success with intact young females (time since pair formation until first litter born), although females of LI males born fewer number of pups. In fact, our results do not support the Handicap Immunocompetence Hypothesis (Folstad, Karter, 1999) which is based on the assumption of trade-off between immunocompetence and reproductive effort.

[Detection of AlpA and AlpB lytic endopeptidase propeptides of Lysobacter sp. XL1 by sandwich-enzyme immunoassay based on monoclonal antibodies].

The extracellular lytic endopeptidases AlpA and AlpB of the bacterium Lysobacter sp. XL1 are highly homologous and synthesized as precursors consisting of signal peptide, propeptide and mature form. In this work, two monoclonal antibodies against propeptide endopeptidase AlpA (ProA) and eleven against propeptide endopeptidase AlpB (ProB) were obtained to study the AlpA and AlpB endopeptidases secretion. The affinity constants of the antibodies against ProA were 2.9 x 10(9) and 3.5 x 10(9) M(-1), and the affinity constants of the antibodies against ProB were from 1.5 x 10(8) to 2.2 x 10(9) M(-1). The obtained antibodies did not have cross-reactivity between themselves, as well as mature forms of the enzymes. The monoclonal antibodies based sandwich-type enzyme immunoassay has been developed for measuring the propeptide in a native form. The linear range of determination ProA was 1.5-100 ng/mL with 6% error of measurement, and for determining ProB 0.2-6.25 ng/mL with 6% error. Using the developed assay, ProA and ProB propeptides have been detected in cell lysates of Lysobacter sp. XL1 in an amount 1.18 ± 0.03 ng and 0.096 ± 0.002 ng per 1 OD540 of the bacterial culture, respectively. The immunochemical assay for detection various forms of AlpA and AlpB lytic endopeptidases can be useful when dealing with issues related to their secretion into the environment.

[Resting metabolic rate, stress, testosterone, and induced immune response in "spring" and "fall" males of Campbell dwarf hamsters. Rearing under the long day conditions].

We have studied morphological and physiological traits of even-young males of Campbell dwarf hamsters (Phodopus campbelli Thomas, 1905) born at the end of summer ("fall males") and at the end of winter ("spring males") in a vivarium with constant 14-hour day length (14D:10N). After removal from parental cages at the age of one month, males were kept in isolation under the same light conditions. The results obained signify the statistical difference between "fall" and "spring" males in resting metabolic rate, morphological traits associated with sexual activity, some endocrine and immunologic characteristics. Spring males had higher resting metabolic rate, higher body mass in the middle of experiment, bigger testes, seminal vesicles, higher concentration of testosterone in blood and more intensive T-cell immune response to the intracutaneous injection of phytohemagglutinin. They did not differ significantly in basal level of blood cortisole and antibodies production in response to sheep red blood cells (SRBC) antigen challenge, but possessed lower adrenocortical response to the social stressor and adrenocorticotropic hormone. GLM analysis showed that cortisol level in blood after 10 min encounter of males in the open arena, and resting metabolic rate were the only factors significantly influenced humoral immune response to SRBC. When intensity of T-cell immune response was considered as dependent variable, season turned out to be the only factor in the final model that caused a significant effect.

[Role of myosins in depression of sensitivity of Helix neurons to acetylcholine in a cellular analog of habituation].

We investigated the involvement of cytoskeleton motor proteins, myosins, in the molecular mechanism of sensitivity depression to acetylcholine in Helix command neurons of defensive behavior in a cellular analog of habituation. There were analyzed the effects of several drugs disturbing myosin function: ML-7 and MLCK-IP-18--blockers of myosin light chain kinase, blebbistatin--an inhibitor of non-muscle myosin II, Y-27632--inhibitor of kinases ROCK-I and ROCK-II (activate mainly non-muscle myosin II) on the depression of acetylcholine-induced inward current. It was found that ML-7 and MLCK-IP- 18 weakened current depression; blebbistatin and Y-27632 did not change the depression. The results of experimental inhibitory analysis and mathematical modeling of the effects of inhibitors on the number of membrane-bound cholinergic receptors allow to suggest the involvement ofmyosins (excluding non-muscle myosin II) in the transports of acetylcholine receptors (endo- and exocytosis) that are responsible for sensitivity changes in neuron somatic membrane to acetylcholine in a cellular analog of habituation.

[Invasive mucormycosis in patients with hemoblastosis in St.-Petersburg].

Thirty four patients with mucormycosis in 10 hospitals of St. Petersburg were observed in 2004-2013. The most frequent underlying diseases of mucormycosis were acute leukoses (64%). In 100% of the patients mucormycosis developed as a nosocomial infection. The risk factors, etiology, basic clinical signs and strategy in the treatment of mucormycosis were analyzed.

[The role of individual stress resistance in realization of immobilization and zoosocial stress effects on pulmonary surfactant system].

The aim of the present study was to investigate the effect of chronic exposure to immobilization and psychosocial stress on surface activity, biochemical composition of pulmonary surfactant and lung fluid balance of rats with different stress-resistance. It is shown that both types of stress lead to elevation of lysophospholipids level and decrease of surface-active properties of pulmonary surfactant, more prominent in stress-vulnerable rats. Blood supply was decreased and extravascular fluid was increased under the psychosocial stress only in stress-vulnerable animals, in all rest cases the blood supply was increased and the content of extravascular fluid was not changed. Surfactant alteration was coupled on the level of 11-OCS in the blood and amount of fluid in the lungs. The obtained results indicate that different degree of impairment in the pulmonary surfactant system during immobilization and psychosocial conflicts depends on different resistance to emotional stress.

[Role of actin microfilaments in depression of acetylcholine-induced current in Helix lucorum neurons on cellular analogue of habituation].

Toxins that impair the function of actin microfilaments in cytoskeleton, cytochalasin B (disrupts microfilaments by inhibiting actin polymerization) and phalloidin (binds polymeric F-actin, stabilizing it and interfering with the function of actin-rich structures) reduce the depression of acetylcholine-induced inward current in Helix lucorum command neurons of defensive behavior during rhythmical local acetylcholine applications to soma (cellular analogue of habituation). These results and mathematical simulation allow us to suggest that the depression of cholinosensitivity of extrasynaptic membrane zones in command neurons on the cellular analogue of habituation is associated with the involvement of actin microfilaments in reduction of the number of membrane cholinoreceptors.

[Effects of flaxseed extract on rheological properties of blood in experimental ovariectomy].

The effect of flaxseed extract (FSE) containing 42% secoisolariciresinol diglucoside on the blood plasma estradiol level and theological properties of blood in female Wistar rats after ovariectomy was investigated by measuring hematocrit, fibrinogen concentration, platelet aggregation and deformability, and the whole blood and plasma viscosity. Bilateral ovariectomy in rats led (in comparison to sham-operated animals) to a decrease in the estrogen level to 59% and produced a 5-9% increase in the whole blood viscosity, which was caused by impairment of the erythrocyte deformability and aggregation. The efficacy of oxygen transport to tissues was decreased by 4-7%. The treatment of ovariectomized rats with FSE (peroral administration at a daily dose of 40 mg/kg for 14 days) reduced the whole blood viscosity by 4-11% and increased the coefficient of oxygen transport to tissues by 5-11%, but did not restore the estrogen level. Thus, the hemorheological effect of FSE reduces to the improvement of microrheological parameters (decrease in erythrocyte aggregation and increase in their deformability) without the modification ofmacrorheological parameters (hematocrit, plasma viscosity and fibrinogen level).

[Specifics of interactions of mono- and binocular mechanisms of spatial perception in cecutient children].

Interactions of mono- and binocular mechanisms of spatial perception were estimated using stereokinetic test proposed by L.N. Mogilev in 117 children with low vision and 317 healthy children aged 5-18 years old. Cecutient and healthy children had similar values of steriokinetic illusion in monocular visual conditions, while in binocular visual conditions the results were significantly different. It was shown that in children with low vision there is no increase in contribution of binocular mechanisms with aging. The mean value of coefficient K characterizing this contribution in healthy group was positive and increased from preschool age till adolescence. The mean value of coefficient K in cecutient children was negative or near zero. It is revealed that visual impairment may influence the development of mono- and binocular mechanisms of spatial perception and their interaction.

[Anticoagulant activity of extracts from cedar bark, anthocyanidins of spruce and birch bark, and cellulose of aspen, fir, and wheat straw].

We have investigated in vitro the anticoagulant (AC) activity of proanthocyanidins from the bark of birch, cedar, spruce, pine, and larch; sulfated arabinogalantan and dihydroquercetin from larch wood; extracts from birch, cedar, and spruce; microcrystalline cellulose (MCC) from aspen and fir wood and wheat straw; and methylcellulose (MC) from aspen wood. The AC properties of the investigated substances are related mostly to their antithrombin activity. The AC activity increases with the content of sulfur in MCC of wheat straw, MC of aspen wood, and arabinogalañtan of larch wood. The maximum AC activity was observed in samples of sulfated MCC from fir wood and wheat straw. Their antithrombin activity (134 +/- 8 and 96 +/- 6, respectively) is worth of carrying out model tests in vivo.

[Computer method for fusional reserves evaluation with objective control of fusion break].

A method of assessing fusional reserves using an interactive computer program, which allows to monitor the subjects report on the moment of fusion break with artificial increase of convergence or divergence of the vii sual axes in the measurement process was developed and tested. Control is achieved through the use of a purely binocular stimuli--random-dot stereograms, as well as dynamic markers, which are added to the main test object in a random order in the course of the measurement procedure to change the type of test-object. Test-object with a marker, encoded in the stereogram, is seen only at the expense of binocular mechanisms, and in violation ofifusion is no longer visible. Its disappearance helps the subject to determine when failure of fu-sion occurred, and the type of object with a marker before this point allows the experimenter to check the subject. Statistical analysis of primary and repeated measurements of fusion reserves in 72 subjects confimed the sufficient reliability of the method.

[Nursing father--myth or reality? The role of secretions of father-male specific skin glands in survival and of Campbell's hamsters offspring (Phodopus campbelli Thomas, 1905; Cricetidae, Rodentia)].

Biparental Campbell's hamster (Phodopus campbelli) were used for testing the hypothesis that secretions of father-male specific skin glands (midventral gland and additional sacculi) may promote juveniles survival in mother's absence. For the hypothesis testing, juveniles at age 7 or 8 days were left either with father or with mother till day 30, and their survival and growth rate were compared. Amongst males, there were 26 surgically operated specimens (with midventral gland and sacculi removed, group OP, rearing 128 juveniles) and 37 sham operated specimens (group SHAM, rearing 189 juveniles). Control group (where both parents were intact and present) consisted of 28 pairs with 166 juveniles. Separation from female-mother led to significant decrease in pups body weight during first days of experiment; this effect was more pronounced in OP group. The majority of OP pups (92.3% and 52.6% of those separated from mothers on 7th and 8th day, respectively) were to be returned to females due to emaciation threatening their lives ("lost"). In SHAM group the amount of "lost" pups was significantly lower (43.5 and 21.6% respectively, P < 0.001). The data obtained suggest that activity of father-male specific skin glands may be an important factor determining pups survival and growth. Apparently, the glands secretion can be a reserve source of nutritive material for deserted juveniles.

[Efficacy and safety of pancrealipase delayed-release capsules (Creon) in patients with pancreatic insufficiency due to chronic pancreatitis or pancreatic surgery].

In the article design, objectives, methods of conducting double-blind, randomized study which results prove efficacy and safety of new formulation of Creon are presented.

[Diagnostics and thoracoscopic treatment of pleural empyema in younger children].

174 children of all ages with acute destructive pneumonia complicated with pleural empyema were treated during 10 ten years using videothoracoscopic method; among them 74 children were of younger age (43%). General principles of modern diagnostics and videothoracoscopic pleural cavity sanations were formulated. Ultrasonography and computer tomography of the chest carried out in younger children give possibilities for clear differential diagnostics with other diseases. Advantages of endosurgical treatment are proved. Indications for planned recurrent pleural cavity sanations were worked out.

[Anticoagulant activity of arabinogalactane sulfate and cedar bark extract studied in vitro].

We have studied in vitro the ability of the Siberian cedar crust (SCC) extract (Pinus sibirica Du Tour) and arabinogalactan sulphate (AGS) extracted from wood of Siberiam pine-tree (Larix sibirica Ledeb.) to increase the human blood plasma coagulation time and also to inhibit the amydolytic activity of thrombin (aIIa) and the coagulation factor Xa (aXa). A method has been developed by means of which SCC increases the aXa activity by a factor of 3.7 and the aIIà activity by a factor of 2.5. The AGS preparation increased the blood plasma coagulation time in the test for activated partial thromboplastin time. An effective concentration, at which the time of plasma coagulation was increased by a factor of 2 (in comparison to the control) was 2.94 +/- 0.33 mg/ml. AGS did not exhibit the ability to inhibit the Xa activity.

[Interaction of taxifolin (dihydroquercetin) with dimyristoylphosphatidylcholine multilamellar liposomes].

Differential scanning calorimetry was used to study the influence of the flavonoid taxifolin (dihydroquercetin) on the temperature-dependent phase transition of dimyristoylphosphatidylcholine multilamellar liposomes. Taxifolin was added to organic solution of the lipid during the procedure of liposomes preparation (addition from-within) or to a suspension of prepared liposomes (addition from-without). In the first case, liposomes contained from 2 to 50 mol% of taxifolin added from-within; in the second case, lyposomes were treated with 0.001% or 0.01% taxifolin. In both cases, the effect was similar. When the concentration of taxifolin increased, the temperature of lipid melting decreased while the width of transition considerably enlarged. Freeze-fracture electron microscopy revealed that taxifolin did not rupture multilamellar liposomes, while the formation of ripple-phase was retarded in all bilayers even when the liposomes were treated from without. This suggested the ability of taxifolin to penetrate through numerous bilayers of multilamellar liposomes.

[Treatment of thorax wounds].

Results of surgical treatment of 154 patients with thorax injuries are analyzed. Most of the patients (93 ps, 60.4%) had penetrating wounds. X-ray examination remains the open most method of diagnosis. The pleural cavity drainage with prolonged aspiration was the main treatment method for the patients with closed thoracic trauma and open trauma without organs injury. Lethality was 7.8% among all the patients and 12.9% among ones with thoracic penetrating wounds. There were no postoperative lethal outcomes. The rate of postoperative complications was 22.7%. Videothoracoscopy and video-assisted mini-thoracotomy are effective methods for diagnosis and treatment, reduce the rate of postoperative complications and lethal outcomes, limit the indications to wide thoracotomy.

[The diagnosis and surgical treatment of hydatid disease of the liver in children].

An experience with the diagnosis and surgical treatment of hydatid disease of the liver included 191 patients aged from 2 through 15 years, 26 of them had a combined involvement of the liver and lung, in 7 patients there were combined lesions with other organs. Complicated echinococcosis was noted in 25 children. Ultrasonography was given the main role in the diagnosis. Videolaparoscopic hydatidectomy of the liver was performed in 62 patients. Solitary cysts of small and medium sizes located superficially were considered as indications to operation. In patients with large and gigantic cysts of special significance was capitonnage of the residual cavity. Use of albendazole as an antiparasitic agent for the recurrent disease and a prophylactic agent after operation for multiple and combined hydatid disease of the liver was found to be sufficiently effective.