Female and Male Phenotypes of Iron Deficiency in CHF. Additional analysis of the «The Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)¼ study.

Aim    To evaluate the incidence of iron deficiency (ID) in men and women with chronic heart failure (CHF) and to compare clinical and functional indexes in patient with and without ID depending on the gender.Material and methods    An additional analysis of the study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)" was performed. The study included 498 (198 women, 300 men) patients with CHF, in whom, in addition to iron metabolism, the quality of life and exercise tolerance (ET) were studied. 97 % of patients were enrolled during their stay in a hospital. ID was defined in consistency with the European Society of Cardiology (ESC) Guidelines. Also, and additional analysis was performed according to ID criteria validated by the morphological picture of the bone marrow.Results    ID was detected in 174 (87.9 %) women and 239 (79.8 %) men (p=0.028) according to the ESC criteria, and in 154 (77.8 %) women and 217 (72.3 %) men (p=0.208) according to the criteria validated by the morphological picture of the bone marrow. Men with ID were older and had more severe CHF. They more frequently had HF functional class (FC) III and IV (63.4 % vs. 43.3 % in men without ID); higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower ET. HF FC III increased the probability of ID presence 3.4 times (p=0.02) and the probability of HF FC IV 13.7 times (p=0.003). This clinical picture was characteristic of men when either method of determining ID was used. In women, ID was not associated with more severe CHF.Conclusion    Based on the presented analysis, it is possible to characterize the male and female ID phenotypes. The male ID phenotype is associated with more severe CHF, low ET, and poor quality of life. In females of the study cohort, ID was not associated with either the severity of CHF or with ET.

[CIC-rearranged sarcoma: a case report and literature review]. / CIC-perestroennaya sarkoma: klinicheskoe nablyudenie i obzor literatury.

CIC-rearranged sarcoma is a rare and extremely aggressive tumor that occurs mainly in soft tissues. Despite the fact that identification of a characteristic genetic rearrangement is necessary to verify the diagnosis, in most cases, the correct diagnosis can be made by comparing histological signs and a characteristic immunophenotype, which greatly speeds up the diagnosis. The article describes a case of CIC-rearranged sarcoma in a 14-year girl with the successful application of the CWS-2009 treatment protocol.

[Iron deficiency in Russia heart failure patients. Observational cross-sectional multicenter study].

Aim    To evaluate the prevalence of iron deficiency (ID) in Russian patients with heart failure (HF).Material and methods    Iron metabolism variables were studied in 498 (198 women, 300 men) patients with HF. Data were evaluated at admission for HF (97 %) or during an outpatient visit (3 %). ID was determined according to the European Society of Cardiology Guidelines.Results    83.1 % of patients had ID; only 43.5 % of patients with ID had anemia. Patients with ID were older: 70.0 [63.0;79.0] vs. 66.0 years [57.0;75.2] (p=0.009). The number of patients with ID increased in parallel with the increase in HF functional class (FC). Among patients with ID, fewer people were past or current alcohol users (p=0.002), and a greater number of patients had atrial fibrillation (60.1 vs. 45.2 %, p=0.016). A multiple logistic regression showed that more severe HF (HF FC) was associated with a higher incidence of ID detection, whereas past alcohol use was associated with less pronounced ID. An increase in N-terminal pro-brain natriuretic peptide (NT-proBNP) by 100 pg/ml was associated with an increased likelihood of ID (odds ratio, 1.006, 95 % confidence interval: 1.002-1.011, p=0.0152).Conclusion    The incidence rate of HF patients is high in the Russian Federation (83.1 %). Only 43.5 % of these patients had anemia. The prevalence of ID in the study population increased with increases in HF FC and NT-proBNP.

Difference in biophysical properties of cancer-initiating cells in melanoma mutated zebrafish.

Despite sharing oncogenetic mutations, only a small number of cells within a given tissue will undergo malignant transformation. Biochemical and physical factors responsible for this cancer-initiation process are not well understood. Here we study biophysical differences of pre-melanoma and melanoma cells in a BRAFV600E/P53 zebrafish model. The AFM indentation technique was used to study the cancer-initiating cells while the surrounding melanocytes were the control. We observed a statistically significant decrease in the modulus of elasticity (the effective Young's modulus) of cancer-initiating cells compared to the surrounding melanocytes. No significant differences in the pericellular coat surrounding cells were observed. These results contribute to a better understanding of the factors responsible for the initiation of cancer.

Comparative Analysis of the Expression of Glutathione Peroxidase and Glutathione Reductase Genes in Human Sperm after Cryopreservation.

We analyzed the effect of cryopreservation on the expression of glutathione peroxidase (GPX1) and glutathione reductase (GSR) genes in human sperm cells (15 sperm samples from fertile donors and 10 samples from infertile patients). The relative expression of GPX1 and GSR genes was determined by real-time PCR. The rate of post-thaw recovery was 2.1 times higher in the group of fertile donors. A significant increase in the expression of GPX1, but not GSR, was observed in sperm samples from infertile patients, while in patients with infertility, GPX1 expression significantly decreased after cryopreservation/thawing, in samples from fertile donors after the same procedure it increased to the level observed in the sperm samples from infertile patients. A positive correlation was revealed between GPX1 expression and sperm cryotolerance.

[Comparative results of preimplantation genetic screening by array comparative genomic hybridization and new-generation sequencing].

Aneuploidies as quantitative chromosome abnormalities are a main cause of failed development of morphologically normal embryos, implantation failures, and early reproductive losses. Preimplantation genetic screening (PGS) allows a preselection of embryos with a normal karyotype, thus increasing the implantation rate and reducing the frequency of early pregnancy loss after IVF. Modern PGS technologies are based on a genome-wide analysis of the embryo. The first pilot study in Russia was performed to assess the possibility of using semiconductor new-generation sequencing (NGS) as a PGS method. NGS data were collected for 38 biopsied embryos and compared with the data from array comparative genomic hybridization (array-CGH). The concordance between the NGS and array-CGH data was 94.8%. Two samples showed the karyotype 47,XXY by array-CGH and a normal karyotype by NGS. The discrepancies may be explained by loss of efficiency of array-CGH amplicon labeling.

[Blastocyst Hatching in Humans].

The human oocyte is surrounded by the zona pellucida­an elastic, transparent extracellular matrix consisting of specific glycoproteins. The zona pellucida is preserved after fertilization and surrounds the developing human embryo for a few days. The embryo needs to get out of the zona pellucida before implantation to establish cell contacts between the trophectoderm and endometrial epithelium. The release of the embryo from the zona pellucida is carried out at the stage of the blastocyst and called zona hatching. During zona hatching the blastocyst breaks the zona pellucida and performs active movements to escape through a gap formed in the zona. While microscopic description of zone hatching is well known, biochemical and cytological basis of zone hatching remains poorly understood. The break of the zona pellucida occurs under the influence of two forces: mechanical pressure of the growing blastocyst on the zone and chemical dissolution of the zone material with secreted lytic enzymes. There is only one paper (Sathananthan et al., 2003), which describes the specialized cells in the trophectoderm that locally dissolve the zona pellucida, promoting the emergence of the hole for blastocyst release. Taking into account the singleness of the paper and the absence of further development of this subject by the authors in the following decade, the existence of specialized cells for zone hatching should be assumed with great care. Lytic enzymes, secreted by cells of the trophectoderm for dissolving the zona pellucida, are different. Depending on the species of the mammal, different classes of proteases participate in the zone hatching process: serine proteases, cysteine proteases, metalloproteinases. Proteases, secreted by human trophectoderm, are not described. The mechanisms of the active movement during blastocyst hatching are investigated to a lesser degree. Only the involvement of the cytoskeleton of trophectoderm cells in the mechanism of blastocyst compression was shown, and the participation of desmosomes in the coordinated change in the form of trophectoderm cells during compression is suggested. This review summarizes literature data on the possible mechanisms of zone hatching in the development of human embryos, obtained in experiments in vitro, as well as in animal models.

Use of deep laryngeal oxygen insufflation during laryngoscopy in children: a randomized clinical trial.

BACKGROUND: Brief periods of haemoglobin oxygen desaturation are common in children during induction of general anaesthesia. We tested the hypothesis that oxygen insufflation during intubation slows desaturation. METHODS: Patients 1-17 yr old undergoing nasotracheal intubation were enrolled and randomly assigned to one of three groups: standard direct laryngoscopy (DL); laryngoscopy with Truview PCD videolaryngoscope (VLO2); or laryngoscopy with an oxygen cannula attached to the side of a standard laryngoscope (DLO2). The co-primary outcomes were time to 1% reduction in [Formula: see text] from baseline, and the slope of overall desaturation vs time. All three groups were compared against each other. RESULTS: Data from 457 patients were available for the final analysis: 159 (35%) DL; 145 (32%) DLO2; and 153 (33%) VLO2. Both VLO2 and DLO2 were superior to DL in both time to a 1% reduction in [Formula: see text] from baseline and the overall rate of desaturation (all P<0.001). The 25th percentile (95% confidence interval) of time to a 1% saturation decrease was 30 (24, 39) s for DL, 67 (35, 149) s for DLO2 and 75 (37, 122) s for VLO2. Mean desaturation slope was 0.13 (0.11, 0.15)% s(-1) for DL, 0.04 (0.02, 0.06)% s(-1) for DLO2 and 0.03 (0.004, 0.05)% s(-1) for VLO2. We did not find a correlation between decrease in [Formula: see text] percentage and BMI or age. CONCLUSIONS: Laryngeal oxygen insufflation increases the time to 1% desaturation and reduces the overall rate of desaturation during laryngoscopy in children. CLINICAL TRIAL REGISTRATION: NCT01886807.

[Changes in the mucous membrane of the patients with chronic maxillary sinusitis caused by foreign bodies].

The objective of the present work was to study the morphofunctional changes in maxillary sinus mucosa of the patients with odontogenic maxillary sinusitis (OMS) associated with the presence of a foreign body depending on its duration. A total of 105 hospitalized patients were examined and operated. Biopsy samples taken from mucosa and contents of the maxillary sinuses during surgery were investigated. The histological study included the standard sample processing followed by paraffin embedding of the material and staining of the micropreparations with hematoxylin and eosin. It was shown that foreign bodies present in the maxillary sinuses cause marked structural reorganization of the mucous membrane usually with the predominance of hypertrophic and polypous changes.

[Prohepsidin in diagnostic of iron deficiency in patients with chronic cardiac failure and anemia].

The sample for examination included 52 patients with chronic cardiac failure and 26 patients with anemia amongst. The expected increase of production of prohepsidin against the background of increased serum concentrations of anti-inflammatory cytokines was not detected. The tendency to decrease level of prohepsidin alongside with decrease of content of serum iron and ferritin in blood serum testified depletion of iron resources in organism.

[Correlation of structurally-functional cardiac condition and levels of erythropoietin, tumour necrosis factor-alpha in blood in heart failure].

Structurally-functional myocardium parameters and their interconnection with erythropoietin and tumour necrosis factor-alpha levels in blood plasma of patients with heart failure were analysed. Prevalence of erythropoietin over tumour necrosis factor-alpha in blood had positive effect on myocardium-contraction ability under acute heart failure. Improvement of pumped cardiac function was not registered under prevalence of erythropoietin over tumour necrosis faetor-a in blood of patients with chronic heart failure.

[Clinical and epidemiologic features and risk factors of occupational pulmonary diseases related to dust].

The authors demonstrated that the recent years are marked by increase in occupational pulmonary diseases related to dust. These diseases formation is influenced by various occupational and non-occupational factors. Basis of preventive measures in dust-related industries should be formed by not only by technogenic issues, but medical events participated by the workers.

[Erythropoietin in patients with chronic heart failure].

The aim of this work was to elucidate the relationship between the serum erythropoietin level, the degree of heart involvement in patients with chronic cardiac failure (CCF), characteristics of peripheral red blood cells and iron metabolism. A total of 77 patients with ischemic CCF were enrolled in the study. The control group comprised 13 subjects free from cardiovascular disorders. The analyses encompassed peripheral blood, serum iron, iron-binding capacity of serum, creatinine clearance, erythropoietin and TNF-alpha levels, echoCG data. The patients with CCF were divided into three groups based on the level of erythropoietin. Statistical analysis revealed the relationship between anemia, structural-functional changes in myocardium and erythropoietin production. Anemia appeared to be an additional stimulus for biosynthesis of erythropoietin in these patients.

[Significance of determination of gamma-interferon in the diagnosis of tuberculous exudative pleurisy].

The pleural fluid concentration of gamma-interferon (gamma-IFN) was studied in 44 patients with exudative pleurisy. The tuberculous nature of exudative pleurisy was established in 25 patients on the basis of X-ray study, a follow-up, microbiological study of pleural exudate specimens, and morphological studies of biopsy specimens obtained at video-assisted thoracoscopy or surgery. The the pleural exudate concentrations of gamma-IFN were over 300 pg/ml (mean 1019 +/- 161 pg/ml) in 19 out of 21 patients with exudative pleuritis in a phase of active inflammation. The patients with the fibrous outcome of pleurisy of tuberculous etiology and those with exudative pleurisy of non-tuberculous etiology, including that in malignancies and papapneumonic pleurisy, were observed to have lower concentrations of gamma-IFN (mean 118 +/- 16 pg/ml). With the discriminating level of above 300 pg/ml, the sensitivity and specificity of the test were 90.5 and 100%, respectively.

[Reparative regeneration of nerve fibers after sympathectomy: an experimental study].

The results of sympathectomies depend on the degree of regeneration of the sympathetic nerve trunk: the quicker the onset of regeneration the less remarkable the effect of operation. The aim of our experimental study WPS to examine the rate of regeneration of sympathetic nerve fibers softer different sympathectomy techniques (resection, electrocoagulation and cryodestruction of the part of the sympathetic nerve trunk) following 6 and 12 months. Nine random-bred rabbits were used (Central Research Laboratory, Urals State Medical Academy) to examine the rate of regeneration of the sympathetic nerve trunk contained by the vascular-nervous bundle of rabbit ear. Altogether 18 nerve sympathetic trunks were examined. The rate of regeneration was measured by morphometry. While examining the processes of reparative regeneration of the nerve fibers after resection, electrocoagulation and cryodestruction, account was taken of the changes in their quantity, diameter and degree of myelinization over time. The study of the morphologic picture during comparative analysis of regeneration made on different models of nerve derangement has demonstrated that after resection and electrocoagulation of the sympathetic trunk the process of regeneration proceeds most slowly. On cryogenic injury to the nervous tissue when only nerve fibers are damaged and connective tissue membranes preserve their anatomic integrity, there are created most favourable conditions for regeneration. Toward 12 months after cryodestruction the bundles of nerve fibers acquire an identical diameter, with predominance of the population of thick nerve fibers, and appear mature enough. After electrocoagulation the fibers contained by the bundles are different in diameter, with the predominance of medium-diameter fibers whereas the thick nerve fibers are not many. After resection the thick nerve fibers are lacking whereas the medium-diameter bundles contain myelinated nerve fibers, with the maintenance of the selective decay of the myelin membrane.

[Effects of sulfate mineral water and vetoron on the rate of radiation-induced aneuplodia in the bone marrow cells of rats]. / Vliianie pit'evoi sul'fatnoi mineral'noi vody i vetorona na chastotu vozniknoveniia radiatsionno-indutsirovannoi aneuploidii v kletkakh kostnogo mozga krys.

Experiments on non-inbred male rats have found that pretreatment with drinking sulfate mineral water and veteron reduced incidence of radiation-induced aneuplodia in bone marrow cells. The proportion of cells with normal number of chromosomes went up.

[Chromosomal aberrations and parameters of oxidative stress in Chernobyl clean-up workers in a remote period after ionizing radiation]. / Khromosomnye aberratsii i pokazateli okislitel'nogo stressa u likvidatorov posledstvii avarii na Chernobyl'skoi AES v otdalennom periode posle deistviia ioniziruiushchei radiatsii.

This investigation was performed to test a supposition about the influence of disturbances in antioxidative system on cytogenetical parameters in Chernobyl' clean-up workers. It was shown that some cytogenetical parameters straightly correlated with the parameters of oxidative stress, while other cytogenetical parameters show just reverse correlations. Apparently, these relationships are not of cause-and-effect type, but they reflect a complex processes occurring in humans for a long period after radiation exposure.

[Increase in the level of proline and osmotic pressure of cytoplasm in transformed tobacco bearing an antisense suppressor of the proline dehydrogenase gene]. / Povyshenie soderzhaniia prolina i osmoticheskogo davleniia kletochnogo soka u transformantov tabaka, nesushchikh antismyslovoi supressor gena prolindegidrogenazy.

The antisense suppressor was constructed for proline dehydrogenase gene (PDH; a fragment of PDH from Arabidopsis in antisense orientation and under the control of 35S promoter of cauliflower mosaic virus, CMV). In Nicotiana tabacum SR1 tobacco transformants bearing antisense suppressor for PDH, the proline content and the cytoplasm osmotic pressure were increased. The proline content in these transformants varied, whereas cytoplasm osmotic pressure was stable, which seems to reflect complicated relationships between these characteristics of the plant cell.

Does surgical correction of the superficial femoral vein valve change the course of varicose disease?

PURPOSE: We tested the hypothesis that the course of primary chronic venous insufficiency can be changed by correction of the incompetent valve in the superficial femoral vein. METHODS: This was a prospective, randomized, controlled study. A total of 125 extremities with reflux in greater saphenous and superficial femoral veins and belonging to clinical classes C2-C4 were analyzed. During the first 5 years, the type of clinical dynamics and changes in valvular function were determined in each patient. Patients were stratified according to the type of clinical dynamics and randomly assigned to treatment groups. Phlebectomy was performed in all extremities. In each of 64 extremities (the study group), the proximal incompetent superficial femoral vein valve was corrected as a part of the primary intervention. Patients were followed up for 7 to 8 years after surgery. RESULTS: The clinical dynamics of the extremity significantly depended on reflux changes. Increase in superficial femoral vein reflux was found in 74% of the extremities with progressive clinical dynamics but in only 47% of extremities with stable clinical dynamics (chi(2) = 9.71; P <.01). After surgical treatment, 65% of the extremities in the control group showed stable improvement; in 11%, recurrent varicosity was found; in 24%, the disease was aggravated. Of the extremities in the study group, 86% had stable improvement, 5% had recurrent varicosity, and 10% were aggravated (P <.05). Extremities with the progressive type of clinical dynamics were main contributors to this difference (chi(2) = 7.86; P <.05). In 92% of the extremities with corrected valves and in 50% of the extremities with increase in reflux after valvuloplasty, clinical improvement was observed (chi(2) = 11.5; P <.01). Extremities with corrected valvular function demonstrated superior results in comparison with extremities with stable valvular function in the control group (clinical improvement in 92% and 66% of extremities, respectively; P <.005). CONCLUSIONS: In patients with chronic venous insufficiency, two types of clinical dynamics, stable and progressive, can be identified. The progressive type is associated with the presence of superficial femoral vein reflux and increasing greater saphenous vein reflux. Superficial vein surgery neither corrects superficial femoral vein reflux nor prevents it from progressing further. Correction of a single superficial femoral vein valve during primary intervention significantly improves the long-term results of superficial venous surgery. This improvement is associated with the prevention of reflux progression. Surgical correction of the incompetent superficial femoral vein valve changes the course of primary chronic venous insufficiency.

[Selection of surgical tactics in colonic obstruction]. / Vybor khirurgicheskoi taktiki pri obturatsionnoi tolstokishechnoi neprokhodimosti.

From 1989 to 1996, 322 patients with colonic obstruction due to tumors underwent surgery in Surgical clinic No 1 of the Ural National Medical Academy. Specimens of 283 tumors removed at surgery (n = 213) or autopsy (n = 70) were examined in 322 patients. Complications were observed after 144 operations (44.7%); in 82 cases they were fatal (25.5% postoperative mortality). Postmortem examination was performed in 70 cases of 82 (85.37%). Histological examination of the 283 specimens of the resected prestenotic colon wall provided a histological classification of colonic wall insufficiency by identifying its compensation, subcompensation and decompensation stages. For possible prediction of a high risk for death in each specific case, a correlation analysis of 23 factors presumably influencing on outcomes was carried out. A decisive rule of prediction was formulated.