[Placement of a ventricular catheter into narrow lateral ventricles. Popular navigation]. / Ustanovka ventrikuliarnogo katetera v uzkie bokovye zheludochki. Navigatsiia dlia vsekh.

Placement of a ventricular catheter is the most common and easiest procedure in neurosurgery. Usually, the procedure is performed using anatomical landmarks. However, despite the apparent ease of this manipulation, its results are not always satisfactory. According to the literature data, the rate of improperly placed ventricular catheters amounts to 10-40%, which is directly correlated with the risk of shunt dysfunction. The use of special equipment, such as ultrasound scanners, endoscopes, stereotactic devices, and neuronavigation systems, significantly increases success of surgery. However, the high cost and complexity of equipment confine its use at neurosurgical centers, and increased surgery time limits routine use of the equipment. A Thomale guide provides the accuracy comparable to that of modern navigation systems and, at the same time, is a cheap and easy-to-use device. AIM: To determine capabilities and master a technique of using the Thomale guide during placement of ventricular catheters. MATERIAL AND METHODS: Twenty seven surgeries wich Thomale guide were performed at the Rogachev Federal Research Center of Pediatric Hematology, Oncology, and Immunology in the period from April 2015 to November 2016. The Ommaya reservoir was placed in 23 cases; there were 2 ventriculoperitoneal shunting procedures; external ventricular drainage was placed in 2 cases. In 19 cases, the catheter was placed into narrow lateral ventricles. RESULTS: In all 27 cases, the ventricular catheter was successfully placed, at the first attempt, into the anterior horn of the lateral ventricle. CONCLUSION: The Thomale guide is a simple but reliable device for accurate and quick placement of a ventricular catheter into the lateral ventricles, regardless of their size.

[On prevention of post-surgery acute urinary retention].

The article highlights the issues of prevention of acute urinary retention after surgery. The authors present results of a study on the efficacy and safety of 1-blockers for the prevention of acute urinary retention after surgery. The results imply that the use of 1-blockers in pre- and postoperative period can significantly reduce the risk of postoperative ischuria, contribute to independent urination after a single urinary catheterization in patients who experience urinary retention, improve the postoperative period and promote recovery of patients.

[Placement of the Ommaya reservoir in narrow and slit-like ventricles using a neuronavigation system. Author's own experience and literature review].

In modern neuro-oncology and onco-hematology, intraventricular injection of chemotherapeutic agents (most typically, methotrexate) is an inevitable part of many protocols for treating patients with malignant tumors of the CNS, neuroleukemia, CNS lymphomas and some other disorders. A ventricular catheter system (also known as the Ommaya reservoir) is used to provide repeated injection of chemotherapeutic agents to cerebral ventricles. The use of modern neuronavigation systems allows one to place Ommaya reservoir in patients with narrow and slit-like ventricles. Material and methods. During the period between March 2012 and October 2013, 27 patients underwent stereotactic placement of the Ommaya reservoir using a Cart II optical neuronavigation system (Stryker) at the Dmitry Rogachev Federal Scientific and Clinical Center of Pediatric Hematology, Oncology and Immunology. The patients for stereotactic placement of a ventricular catheter were selected on a subjective basis (small ventricular size was the criterion for selection). In one patient, the surgery for placement of the Ommaya reservoir was combined with stereotactic biopsy. Results. In all patients, a ventricular catheter was placed in the anterior horn of the lateral ventricle on the first try; no intraoperative complications were observed. Conclusions. Frameless navigation is an illustrative, mobile, and multifunctional method. The same device can be used to perform brain, transsphenoidal, ENT, and spine surgeries, as well as orthopedic interventions. Today, neuronavigation systems are used in neurosurgical operating rooms and make it possible to avoid using stereotactic frames in most cases.

[Functional effects of transcranial electromagnetic stimulation (60 and 70 Hz) of the brain of intact rats and rats with acute brainstem damage].

Behavior and brain electrical activity of 79 male Wistar rats (intact and with acute experimental brainstem injury) were studied during the course of therapeutic transcranial electromagnetic stimulation (TEMS) with frequencies 60 and 70 Hz. In intact animals this effect was accompanied by a decrease in voluntary motor activity and increase in synchronization of the brain electrical activity, in particular, in the delta and beta1 frequency ranges. This inhibitory effect was similar to that of sleep. In the early period of acute experimental stem pathology, the TEMS course was accompanied by suppression of EEG signs of adaptive post-operative stress response and could lead to increased severity of the condition of an animal, along with the slowing of postoperative recovery. Cytomorphological evidence was obtained to the importance of vascular factor in the formation of cerebral reactions to TEMS.

Changes in spontaneous brain bioelectrical activity during transcranial electrical and electromagnetic stimulation.

The systems responses of the brain to therapeutic transcranial electrical and electromagnetic stimulation were studied and the neurophysiological criteria for assessing the efficacy of this treatment were identified using comparative clinical and experimental studies with analysis of spontaneous bioelectrical activity, along with assessment of behavioral and clinical measures. Study groups consisted of six patients with chronic post-traumatic unconscious states during courses of transcranial electrical stimulation and 17 intact Wistar rats subjected to transcranial electromagnetic stimulation. A relationship was found between the effects of transcranial stimulation and the initial level of intercenter interactions of brain bioelectrical activity assessed in terms of coherence. Hypersynchronization of biopotentials, identified as a major element in the reactivity to this type of stimulation, may be of the greatest value in the recovery of patients with cerebral pathology in cases with initially reduced levels of intercenter interactions in the absence of pathologically increased functional connections in the brain.

[Changes in the brain spontaneous bioelectrical activity during transcranial electrical and electromagnetic stimulation].

In order to study systemic brain reactions on transcranial electrical or electromagnetic medical stimulation and specify the neurophysiological criteria of its efficiency, comparative clinical and experimental examination was performed with the analysis of spontaneous bioelectric activity and behavioral or clinical parameters. We examined 6 patients with prolonged posttraumatic unconsciousness states treated with electrical stimulation and 17 intact Wistar rats subjected to electromagnetic stimulation of the brain. The effect of the transcranial stimulation was shown to depend on the initial level of the intercentral interactions of brain bioelectrical activity, estimated by the EEG coherence. Hypersynchronization of biopotentials as the main element of the brain reactivity can be the most useful for the rehabilitation of patients with cerebral pathology in cases of initially lowered level of the intercentral interactions in the absence of pathologically strengthened functional connections.

[Study of sarcoplasmic reticulum Ca-ATPase by the paramagnetic label--paramagnetic probe method]. / Issledovanie Ca-ATFazy sarkoplazmaticheskogo retikuluma metodom paramagnitnaia metka--paramagnitnyi zond.

ESR spectra of nitroxyl derivative labelling with parachlormercury benzoate bound with SH-groups of Ca, Mg-dependent ATPase in the presence of Mn2+ ions are studied. It has been concluded from the saturation curves of ESR spectra that Mn2+ is localized at the distance approximately 40 A from the SH-group of the enzyme active centre. Platinum compound (K2PtCl4) changes the spectrum of ESR 1 due to the displacement of the label from the enzyme SH-groups and disintegration of the sarcoplasmic reticulum structure. Palladium compound (Pd(NH3)4Cl2) produced no effect on the ESR 1 spectrum.

[Selection of behavioral test parameters for estimation of typological features of rat behavior]. / Vybor pokazatelei povedencheskikh testov dlia otsenki tipologicheskikh osobennostei povedeniia krys.

Behavior of 86 rats was examined in three behavioral tests, i.e., open field, forced swimming and emotionality by F. King. The results of statistical analysis of all the indices obtained with application of factor analysis suggest that the three tests characterize four relatively independent behavioral components: emotionality, locomotor-exploratory activity, olfactory performance, and resistance to adverse emotional factors. A contribution of each measured parameter to the above components was estimated. Such an approach makes it possible to reasonably select most important behavioral features when estimating locomotor activity and emotionality of animals.

[Rat brain reactions to acute brain stem lesion on dynamics of parameters of cerebral electric activity]. / Reaktsiia mozga krys na ostroe stvolovoe povrezhdenie v dinamike pokazatelei tserebral'noi élektricheskoi aktivnosti.

Despite an old history of a question, adaptive brain reactions that develop after an acute brainstem lesion have not been adequately investigated. With the aim to study the central mechanisms of compensation/decompensation and to specify the character of involvement of orbitofrontal cortex and hippocampus into these processes the spatiotemporal organization of brain electric activity was analyzed in 8 rats before and after electrolytic brainstem lesion at the level of the lateral vestibular nucleus Deiters (VND). The electric activity was recorded from symmetric frontal and somatosensory cortical areas, hippocampal areas CA1, and intact VND. Spectralcoherent analysis showed that adaptive reactions are most clearly manifested by changes in the spatiotemporal organization of the theata activity: 1) early brainstemhippocampal synchronization of the electric activity in the frequency range of 6-7 Hz with subsequent involvement of anterior cortical regions is characteristic of survived animals; 2) independent hippocampal-cortical hemispheric system of excitation in the frequency of 4-5 Hz precedes the fatal outcome. On the day before the fatal outcome the interhemispheric coherence in the orbitofrontal cortex dropped, which suggests the involvement of these brain regions into the processes of visceral regulation.

[Adrenoblockers in prophylaxis of acute urination retention after surgery]. / Adrenoblokatory v profilaktike ostroi zaderzhki mocheispuskaniia posle operativnykh vmeshatel'stv.

The results of operations on the organs of the abdominal cavity and the small pelvis in 70 men are analyzed. For evaluation of the condition of the urogenital system and urination parameters preoperatively all patients underwent ultrasound examination of the urine bladder and the prostate with the residual urine evaluation, uroflowmetry. Summary value of the symptoms was evaluated according to international system IPSS and the quality of life was assessed (QOL). 30 patients administered doxazosin according to the scheme: 2 preoperative days 2 mg/day, then 3 days--4 mg/day, and 3 postoperative days--4 mg/day. 5 patients dook tamsulosin 0.4 mg/day for 5 preoperative days and 3 postoperative days. 35 men took placebo, in this group acute anuria in postop period was detected in 4 patients (11.4%). All of them were over 60 years and had benign hyperplasy of the prostate, they initially had disturbances in urination (in average Qmax = 9.7 ml/sec, IPSS = 7, QOL = 3). Ischuria was absent in patients administered alpha 1-adrenoblockers. The authors suggest that probability of the development of acute retention of urine in postoperative period is higher in persons, suffering from benign hyperplasy of the prostate and in those, who have initial disturbances in urination. The use of alpha 1-adrenoblockers preoperatively and in early postoperative period allows minimizing probability of development of ischuria paradoxa in men.

[The effect of electrotranquilization on the hormonal indices of alcoholic patients]. / Vliianie élektrotrankvilizatsii na nekotorye gormonal'nye pokazateli u bol'nykh alkogolizmom.

The correlation between clinical signs of alcoholism dynamics and hormonal status indices was analysed in 26 patients during medical electrotranquilization sessions. Electrotranquilization (ET) was carried out by "Lénar" (Russia) apparatus. There were estimated the concentrations of the following hormones: adrenocorticotropic hormone, hydrocortisone, prolactin, follicle stimulating, luteinizing hormones, estriol, testosterone, somatotropic, thyrotropic hormones, triiodothyronine, tyrosine and insulin. The inverse correlation was observed between the estriol, testosterone and tyrosine levels on the one hand and the clinical signs of the reaction to alcohol administration on the other hand. So far as the disease severity strengthened, both the elevation of estriol and the decrease of testosterone levels were observed. The prolactin concentration correlated directly with meta-alcoholic clinical signs gravity. This confirmed the prolactin role both in postalcoholic haemostasis restoration and in pathogenesis of meta-alcoholic clinical signs. In alcoholic patients the ET normalized the serum prolactin level as well as promoted the trend to normalization of estriol and testosterone levels.