[Purulent iliopsoitis: etiology, pathogenesis, diagnosis and surgical treatment]. / Gnoinyi iliopsoit: etiopatogenez, diagnostika, khirurgicheskoe lechenie.

Purulent iliopsoitis is a quite rare and difficult disease regarding diagnosis and treatment. However, treatment outcomes are not so favorable, incidence of sepsis and mortality are still extremely high. Original up-to-date studies devoted to this issue were analyzed. The authors discuss the actual problems of etiology, pathogenesis, classification, clinical features, diagnosis and surgical treatment of iliopsoitis. Considering these data, they conclude that timely diagnosis and adequate surgical treatment are essential for favorable outcomes. Prevention of relapse is based on detection of possible cause of disease and its possible correction.

[LAPAROSCOPIC SURGERY FOR EARLY OVARIAN CANCER: EXPERIENCE AT THE P. A. HERZEN ONCOLOGY RESEARCH INSTITUTE].

For the period from 2003 to 2014 at the Oncogynecology Department laparoscopic surgery for ovarian cancer was performed in 49 patients aged 19 to 76 years. During the surgical interventions special attention was paid to the principles of oncological radicalism and ablastics, the volume of surgery depended on the extent of tumor process, morphological characteristics of tumor, a patient's age and the desire to preserve reproductive function. In 42 (85.7%) cases laparoscopic procedures were conducted to restaging (after non-radical operations in gynecological hospitals). In all 49 patients a histological form of ovarian tumor corresponded to adenocarcinoma. Mean operative time was 140 ± 10,5 minutes, the average blood loss--80,2 ± 14,3 ml. Postoperative complications (bleeding from the omentum) were recorded in 1 (2%) patient, the need for conversion was occurred in 4 (8.2%) cases due to the adhesive process or signs of dissemination. As a result of laparoscopic surgery an increase in staging of disease was fixed in 14 cases (28.6%). Follow-up median was 45 months, relapses occurred in 5 (10.2%) patients. Of 49 patients 2 (4.1%) died from disease progression. Disease-free and overall survival rates were 89.8% and 95.9%, respectively. Thus, data of world literature and our own experience indicate the potential equivalent of laparoscopic and laparotomy approaches in treatment for early ovarian cancer.

[Organ-sparing therapy for patients with borderline ovarian tumors].

Contemporary possibilities of organ-sparing therapy for borderline ovarian tumors are considered. World data was analyzed on recurrence rates and fertility rates after different methods of conservative surgery. The experience with ultra-conservative surgery in patients with bilateral borderline ovarian tumors at the Onco-Gynecological clinic of the P.A. Herzen Moscow Research Oncology Institute is presented.

[On the mechanism of radioprotective effect of NO-synthase inhibitors].

We studied the influence on hemodynamics and radioprotective activity of two inhibitors of NO-synthase (NOS)--isothiourea derivatives with different NOS isoform selectivity: T1023--a selective inhibitor of endothelial and inducible NOS; and NTT2--a highly selective inhibitor of neuronal NOS. Both compounds at a dose of 1/7 LD50/15 caused a vasopressive effect and baroreflex response in normal Wistar rats. However, the nature of hemodynamic changes was qualitatively different. T1023 caused a prolonged elevation of vascular tone and reflex shift resulted in a significant and lasting reduction in the systemic blood flow (35-45%), which created conditions for the development of circulatory hypoxia. The use of NTT2 caused a reflex change in hemodynamics accompanied by vasodilation; and systemic blood flow was maintained at the initial level. T1023 effectively protected mice subjected to 10 Gy γ-irradiation and their bone marrow stem cells irradiated with 6 Gy, not yielding to the radioprotective effect of cystamine. NTT2 at these doses did not show any radioprotective effect. The obtained results support the leading mechanism of the radioprotective effect of NOS inhibitors is the induction of hypoxia. With this mechanism of action a significant radioprotective activity can be expected for the inhibitors which effectively suppress primarily endothelial NOS.

[Radioprotective properties of isothiourea derivatives with NO-inhibitory mechanism of action].

The study of the radioprotective activity of S-[2-alkyl (aryl) sulfonyl]-S-ethyl derivatives of (vinyl)-isothiourea in (he model of the survival of mice exposed to gamma-radiation at a dose of 10 Gy has shown that the incorporation of additional sulfur-containing groups does not increase the radioprotective properties of compounds. In contrast to aminoalkil thiols, the effectiveness of the radiation protection action of the isothiourea (ITU) derivatives studied clearly correlates with the NO-inhibitory activity. This fact allowed us to assume that the radioprotective effect of S-substituted ITU caused inhibition of the endogenous synthesis of NO, which promotes the development of circulatory hypoxia, and that a further search for the radioprotective agents in this class of chemicals should be considered as the search for effective inhibitors of NO-synthase (NOS). The theoretical analysis of the conformity of molecular structures to the composition and topology of the active center of NOS-inhibitors allowed us to prognosticate a number of new ITU derivatives with the potential NOS-inhibiting ability. As a result of further theoretical and experimental studies, four S,N-disubstituted ITU derivatives - active non-selective NOS-inhibitors, were first identified and synthesized. These compounds exhibited a pronounced and prolonged vasopressive effects at doses of 0.01-0.05 LD50/15 in the models of severe hemorrhagic and endotoxic shock, and provided 65-100% 30-day survival at doses of 0.2-0.3 LD50/15 in the mice irradiated by gamma-rays at a dose of 10 Gy (LD98/30).The findings suggest the pronounced radioprotective effect of NOS-inhibitors among the ITU-derivatives.

[Radical abdominal tracheolectomy: technical aspects].

P.A. Herzen Research Institute of Oncology, Moscow The paper presents our experience with radical tracheolectomy carried out in 54 patients with invasive cervical carcinoma to preserve fertility. An original procedure designed to assure adequate uterine blood supply was used. Short-term oncological and functional results are discussed.

Effect of cell therapy on recovery of cognitive functions in rats during the delayed period after brain injury.

We studied the effect of systemic transplantation of human stem cells from various tissues on cognitive functions of the brain in rats during the delayed period after experimental brain injury. Stem cells were shown to increase the efficacy of medical treatment with metabolic and symptomatic drugs for recovery of cognitive functions. They accelerated the formation of the conditioned defense response. Fetal neural stem cells had a stronger effect on some parameters of cognitive function 2 months after brain injury. The efficacy of bone marrow mesenchymal stem cells from adult humans or fetuses was higher 3 months after brain injury.

Morphofunctional study of the therapeutic efficacy of human mesenchymal and neural stem cells in rats with diffuse brain injury.

We studied the effect of transplantation of human stem cells from various tissues on reparative processes in the brain of rats with closed craniocerebral injury. Combined treatment with standard drugs and systemic administration of xenogeneic stem cells had a neuroprotective effect. The morphology of neurons rapidly returned to normal after administration of fetal neural stem cells. Fetal mesenchymal stem cells produced a prolonged effect on proliferative activity of progenitor cells in the subventricular zone of neurogenesis. Adult mesenchymal stem cells had a strong effect on recovery of the vascular bed in ischemic regions.

Evaluation of psychoemotional status of rats after brain injury and systemic transplantation of mesenchymal stem cells.

We studied the effects of systemic transplantation of mesenchymal stem cells obtained after culturing of autologous bone marrow on psychophysiological status of Wistar rats after diffuse brain trauma. Two months after systemic injection of mesenchymal stem cells we observed a decrease in manifestations of emotional behavioral reactions (anxiety and excitability) and shortening of the time of realization of drinking behavior in a T-maze. A significant positive effect of systemic transfusion of mesenchymal stem cells on avoidance conditioning in a shuttle box was observed 3 months after brain injury.

Morphofunctional study of the therapeutic effect of autologous mesenchymal stem cells in experimental diffuse brain injury in rats.

Effects of systemic transplantation of mesenchymal stem cells obtained by culturing of autologous bone marrow on proliferative activity of cells and functional morphology of neurons after diffuse brain injury were studied in Wistar rats. Comparative analysis of the results indicated that systemic injection of mesenchymal stem cells in a syngeneic organism produced proliferotropic, angiogenic, and, presumably, neurotrophic effects. The therapeutic effect visually manifested on day 2 after intravenous injection of mesenchymal stem cells during the early period of reparative regeneration of ischemic cell and tissue structures of the brain. The neuroprotective effect of mesenchymal stem cells was more pronounced against the background of basic therapy.

[Brain beta-adrenergic and GABA-ergic receptors in rats after exposure to high doses of ionizing radiation]. / Sostoianie beta-adrenergicheskikh i GAMK-ergicheskikh retseptorov mozga krys posle vozdeistviia vysokikh doz ioniziruiushchei radiatsii.

The radioactive ligands, [3H]dihydroalprenolol and [3H]muscimol, were used to estimate the condition of beta-adrenoreceptors of the brain cortex and GABA-receptors of the cerebellum during transient neurologic disorders caused by irradiation of rats with high-energy (20 MeV) electrons of 200 Gy. No significant changes were observed in the GABA-ergic brain system while the changes in beta-adrenoreceptors of the brain were pronounced and manifested by the loss by the receptors of their ability to bind the specific ligand, dihydroalprenolol. The changes observed were reversible and correlated with the development of neurologic disorders.

[Antiheparin properties of synthetic polycations]. / Antigeparinovye svoistva sinteticheskikh polikationov

The toxicity of differently structured polymeric compounds for mice (intravenously) and their antiheparin properties in in vitro and in vivo tests were studied. The antiheparin activity display polymers containing amino groups or onium atoms of nitrogen, sulphur and phosphorus in various structures. The antagonism to heparin is due to the polymers being endowed with polycationic properties.