[Hypothalamic hamartoma dissection using focused ultrasound under MRI control. The first successful experience in Russia]. / Pervyi uspeshnyi opyt dissektsii gamartomy gipotalamusa metodom fokusirovannogo ul'trazvuka pod kontrolem MRT v Rossii.

Treatment of motor disorders by MRI-guided focused ultrasound is an alternative to neuro- and radiosurgery such as stereotactic radiofrequency ablation and thalamotomy with a gamma knife. However, safety, efficacy and feasibility of this technology for intracranial neoplasms are still unclear. The authors report successful hypothalamic hamartoma dissection by MRI-guided focused ultrasound in a 32-year-old woman with drug-resistant gelastic epilepsy and violent laughter and crying attacks. Magnetic resonance imaging revealed type II hypothalamic hamartoma. The last one was detached from surrounding brain tissue by MRI-guided focused ultrasound without side effects. Symptoms regressed immediately after surgery. No laughter and crying attacks were observed throughout 6-month follow-up.

[Primary vitrectomy in the treatment of retinopathy of prematurity with unfavorable progression]. / Pervichnaya vitrektomiya v lechenii retinopatii nedonoshennykh neblagopriyatnogo tipa techeniya.

PURPOSE: The study aims to determine the indications and evaluate the results of primary vitrectomy in unfavorable progression of stage III active retinopathy of prematurity (ROP). MATERIAL AND METHODS: The control group consisted of 17 patients (28 eyes) with unfavorable progression of stage III ROP, who had the disease progress after coagulation of the avascular retina and underwent the second stage of treatment - vitrectomy. The main group consisted of 5 patients (10 eyes) with unfavorable progression of stage III ROP, who underwent primary vitrectomy. Gestational age at birth was 24-30 weeks, body weight ranged from 680 to 1250 g. According to spectral optical coherence tomography (SOCT) and OCT angiography (OCT-A), the initial state of the retina and vitreoretinal interface in patients of the main and control groups were identical. RESULTS: A retrospective analysis of control patients, according to SOCT and OCT-A data, showed the spread of neovascularization beyond the retinal plane, its interaction with the posterior hyaloid membrane and vitreous body structures in the early stages of the disease, traction changes in the underlying retina, areas of retinoschisis, as well as thickening of the posterior hyaloid membrane. The tactics of treating patients with unfavorable progression of stage III ROP has changed since 2020. Primary vitrectomy was performed in case the signs listed above were identified. The transition of the disease to the inactive stage was recorded in all cases one month after primary vitrectomy. After one year the pathological process did not reactivate in any of the cases, and no pathological changes were found in the projection of the former proliferation ridge. CONCLUSIONS: Extraretinal retinovitreal neovascularization, according to multimodal preoperative diagnostics, indicates the need for vitreoretinal surgery as a pathogenetically substantiated method of treatment for unfavorable progression of stage III active ROP.

[Vitrectomy technique in aggressive posterior retinopathy of prematurity]. / Tekhnika vitrék-tomii pri zadnei agressivnoi retinopatii nedonoshennykh.

AIM: to develop the methodology of early primary vitrectomy for aggressive posterior retinopathy of prematurity. MATERIAL AND METHODS: The study included 10 preterm infants (20 eyes; gestational term - 26-30 weeks, post-conceptual age - 34-39 weeks) with severe forms of aggressive posterior retinopathy of prematurity (AP-ROP). All patients underwent a complex ophthalmic examination. Their results were compared with retrospective data of earlier treated AP-ROP patients (10 preterm infants, 20 eyes), in whom laser photocoagulation (LC) was done first (gestational period at the time of LC ranged from 26 to 30 weeks, post-conceptual age - from 34 to 39 weeks). In all cases, the disease progressed despite LC, thus, second-stage vitrectomy was required. Taking into account the similarity between clinical and morphometric data of the study group and retrospective patients, laser treatment was voted inexpedient as predictably inefficient and, therefore, a decision was made to perform vitreoretinal surgery. For that, an original technique of vitrectomy without preliminary LC was designed. Follow-up periods were up to 6 months. RESULTS: In all cases, AP-ROP regression to inactive stage was diagnosed 1 month after vitrectomy. According to digital retinoscopy findings, initial sings of blood vessel growth into the previously avascular retina appeared on day 20-26 after surgery. This was confirmed by the results of fluorescein angiography. In general, complete retinal reattachment was obtained in 16 eyes (80%), partial - in 3 eyes (15%). In 1 case, the retina failed to reattach (5%). CONCLUSION: The proposed method of primary vitrectomy enables optimization of the treatment approach to severe AP-ROP and can be regarded as promising.

Effect of cold stress on expression of genes for the AhR-dependent pathway of CYP1 regulation in rat liver.

The level of mRNA for cytochromes P450 (CYP1A1, CYP1A2, and CYP1B1) and CYP1 regulatory proteins (heat shock protein, aryl hydrocarbon receptor, aryl hydrocarbon receptor repressor, and aryl hydrocarbon receptor nuclear translocator) was measured in the liver of rats after cold stress (4 degrees C). The CYP1A1 mRNA level increased and remained high for 10 days after 5-day cold exposure. The level of mRNA for CYP1A2, heat shock protein, and aryl hydrocarbon receptor nuclear translocator decreased by the 10th day. The level of mRNA for CYP1B1, aryl hydrocarbon receptor, and aryl hydrocarbon receptor nuclear translocator remained unchanged over this period.

Inhibitory effect of alpha-tocopherol on benzo(a)pyrene-induced CYPA1 activity in rat liver.

Combined treatment with benzo(a)pyrene (classic inductor of cytochromes P450 of subfamily 1A, CYPA1 and CYP1A2) and alpha-tocopherol decreased benzo(a)pyrene-induced CYP1A1 activity in rat liver. Activities of CYP1A2, NADPH-cytochrome P450 reductase, and glutathione S-transferase remained unchanged under these conditions. Addition of alpha-tocopherol to benzo(a)pyrene-induced microsomes in vitro decreased activity of CYP1A1. Immunoblotting of proteins in liver microsomes with antibodies against CYP1A1 did not reveal differences in CYP1A1 protein content in the liver of rats receiving benzo(a)pyrene alone or in combination with alpha-tocopherol. The in vivo decrease in benzo(a)pyrene-induced CYP1A1 activity did not result from free radical-produced damage to CYP1A1. The inhibition of benzo(a)pyrene-induced CYP1A1 activity with alpha-tocopherol is probably realized at the posttranslational level.

Dose- and time-dependent effects of menadione on enzymes of xenobiotic metabolism in rat liver.

We studied the effect of synthetic vitamin K analogue menadione on enzymes of xenobiotic metabolism in rat liver (total content of cytochrome P450 and catalytic activities of CYP1A1/2, CYP2B1, CYP2C, NADPH-cytochrome P450 reductase, and glutathione S-transferase). Menadione induced phase I and II enzymes for metabolism of xenobiotics, drugs, and procarcinogens. The effect of menadione depended on its dose and duration of treatment.

Transcriptional activation of cytochrome P450 1A1 with alpha-tocopherol.

Peroral administration of alpha-tocopherol in a daily dose of 150 mg/kg for 1, 4, 8, and 12 days leads to induction of cytochromes P450 1A in male rats. Activity of CYP1A1 and CYP1A2 increased most significantly one day after alpha-tocopherol administration (by 2.6 and 2.7 times, respectively). CYP1A1 was immunohistochemically detected in rat liver microsomes during this period. The content of CYP1A1 mRNA significantly increased in the liver. The amount of CYP1A2 mRNA and regulatory proteins for signal activation of CYP1A1 (AhR and Arnt) remained unchanged after treatment with alpha-tocopherol.

Dose-dependent effect of alpha-tocopherol on activity of xenobiotic metabolizing enzymes in rat liver.

Oral treatment with alpha-tocopherol for 4 days dose-dependently increased the content of cytochrome P450 (CYP), catalytic activities of CYP1A1, CYP1A2, CYP2B1, CYP2C, and activity of NADPH-cytochrome-P450 reductase in the liver of male rats, but did not change activity of glutathione S-transferase. These results suggest that alpha-tocopherol induced the enzymes of phase I of xenobiotic metabolism, including CYP1 and CYP2 families involved in the metabolism of drugs and procarcinogenes.