[Intrascopic predictors of favorable outcomes after ventriculoperitoneal shunting in Hakim-Adams syndrome: a single-center retrospective non-randomized study]. / Intraskopicheskie prediktory udovletvoritel'nogo iskhoda likvoroshuntiruyushchei operatsii pri sindrome Khakima­Adamsa. Rezul'taty odnotsentrovogo retrospektivnogo nerandomizirovannogo issledovaniya.

The main feature of idiopathic normal pressure hydrocephalus is reversible clinical manifestations after timely ventriculoperitoneal shunting. However, the effectiveness of such interventions does not exceed 85%. Invasive diagnostic methods are used to select candidates for surgery. At the same time, literature data indicate neuroimaging symptoms predicting postoperative outcomes without invasive examination. OBJECTIVE: To identify intrascopic predictors of favorable outcomes after ventriculoperitoneal shunting in Hakim-Adams syndrome; to present a model for evaluating MRI data and selecting candidates for surgery. MATERIAL AND METHODS: A single-center retrospective non-randomized study enrolled head MRI data in patients with idiopathic normal-pressure hydrocephalus who underwent ventriculoperitoneal shunting between September 2020 and March 2022. There were 34 patients including 15 ones in the main group (significant improvement after surgery) and 19 ones in the control group. We analyzed quantitative neuroimaging features: ventriculocranial indices, DESH syndrome (DESH score), angle of corpus callosum at the level of anterior and posterior commissures, dimensions of temporal horns of lateral ventricles, the number of lacunar infarcts in basal ganglia and white matter of hemispheres. RESULTS: We identified the most significant predictors of favorable outcomes after ventriculoperitoneal shunting: Evans index, indexed longitudinal size of lateral ventricles, angle of corpus callosum (at the level of anterior and posterior commissures) and DESH score. We created a classification model using discriminant analysis. This model allows us to predict the outcomes after ventriculoperitoneal shunting. CONCLUSION: A comprehensive assessment of intrascopic symptoms allows us to predict the outcomes after ventriculoperitoneal shunting in patients with Hakim-Adams syndrome. In the future, we can avoid invasive diagnostic manipulations in some patients.

[Metallic foreign bodies of brain ventricles]. / Metallicheskie inorodnye tela zheludochkov golovnogo mozga.

Head injuries are often associated with intracranial foreign bodies that require decision making on the need for certain surgical treatment. Intraventricular foreign bodies are rare, so the question of surgical tactics is still open. OBJECTIVE: To summarize the experience of treating the wounded with intraventricular foreign bodies. MATERIAL AND METHODS: Treatment outcomes in victims with foreign bodies in lateral ventricles are presented. Searching in the e-Library, PubMed, Google Scholar databases included the following keywords: «penetrating wounds¼, «foreign bodies¼, «cerebral ventricles¼, «gunshot injury¼, «ventricular foreign bodies¼. We analyzed data on the treatment of victims with intraventricular foreign bodies. RESULTS: Three victims underwent surgery, and foreign bodies were removed from the occipital horn of the lateral ventricle, third ventricle and temporal horn of the lateral ventricle. Conservative approach was preferred in 1 case. Follow-up ranged from 1 month to 7 years, GOS score - 3-4 points. Disability was due to severe injury and not associated with surgical treatment per se. We found 16 publications matching the searching criteria. Treatment methods varied from standard surgical approaches to stereotactic management. The indication for removal of foreign bodies was their migration through the ventricular system and occlusive hydrocephalus. None patient had neurological aggravation. CONCLUSION: Intraventricular foreign bodies are rare and present certain difficulties in choosing the method and timing of treatment. Indications for their removal are migration, occlusive hydrocephalus and infectious complications. The method of removal is determined depending on location, magnetic properties, nature of injury, surgical preferences and other factors.

Measurement of the Charge-Averaged Elastic Lepton-Proton Scattering Cross Section by the OLYMPUS Experiment.

We report the first measurement of the average of the electron-proton and positron-proton elastic scattering cross sections. This lepton charge-averaged cross section is insensitive to the leading effects of hard two-photon exchange, giving more robust access to the proton's electromagnetic form factors. The cross section was extracted from data taken by the OLYMPUS experiment at DESY, in which alternating stored electron and positron beams were scattered from a windowless gaseous hydrogen target. Elastic scattering events were identified from the coincident detection of the scattered lepton and recoil proton in a large-acceptance toroidal spectrometer. The luminosity was determined from the rates of Møller, Bhabha, and elastic scattering in forward electromagnetic calorimeters. The data provide some selectivity between existing form factor global fits and will provide valuable constraints to future fits.

[Cysts of septum pellucidum, cavum vergae and cavum veli interpositi. Meta-analysis of 368 cases]. / Kisty prozrachnoi peregorodki, polosti Verge i promezhutochnogo parusa. Metaanaliz 368 klinicheskikh sluchaev.

OBJECTIVE: To review and systematize literature data on the incidence of cysts of septum pellucidum, cavum vergae and cavum veli interpositi, their clinical manifestations, indications for surgical treatment and optimal surgical approach. MATERIAL AND METHODS: An analysis included 72 manuscripts devoted to epidemiology, pathophysiology, clinical symptoms and results of surgical treatment of brain cysts. Case reports, series of cases, reviews and original studies were analyzed. RESULTS: Septum pellucidum cavity is always formed throughout an embryogenesis and persists in 20.34% of adults. Cavum vergae is observed in 2.32% of adults. Cyst of septum pellucidum is detected in 0.04% of adults. Analysis of 368 cases of cysts of septum pellucidum, cavum vergae and cavum veli interpositi has shown that clinical picture consists of headache (50% of cases), convulsive syndrome (23.6%), reduced intelligence (20.1%), behavioural disorders (15.8%), dizziness, nausea and vomiting (10.9%). Hydrocephalus occurs in 16.6% of cases. Endoscopic wall fenestration is preferred for cyst management. CONCLUSION: Brain cysts are rare and characterized by non-specific clinical manifestations. Symptomatic cyst is an indication for surgical treatment. Surgical treatment usually ensures regression of symptoms and low risk of complications.

Hard Two-Photon Contribution to Elastic Lepton-Proton Scattering Determined by the OLYMPUS Experiment.

The OLYMPUS Collaboration reports on a precision measurement of the positron-proton to electron-proton elastic cross section ratio, R_{2γ}, a direct measure of the contribution of hard two-photon exchange to the elastic cross section. In the OLYMPUS measurement, 2.01 GeV electron and positron beams were directed through a hydrogen gas target internal to the DORIS storage ring at DESY. A toroidal magnetic spectrometer instrumented with drift chambers and time-of-flight scintillators detected elastically scattered leptons in coincidence with recoiling protons over a scattering angle range of ≈20° to 80°. The relative luminosity between the two beam species was monitored using tracking telescopes of interleaved gas electron multiplier and multiwire proportional chamber detectors at 12°, as well as symmetric Møller or Bhabha calorimeters at 1.29°. A total integrated luminosity of 4.5 fb^{-1} was collected. In the extraction of R_{2γ}, radiative effects were taken into account using a Monte Carlo generator to simulate the convolutions of internal bremsstrahlung with experiment-specific conditions such as detector acceptance and reconstruction efficiency. The resulting values of R_{2γ}, presented here for a wide range of virtual photon polarization 0.456<ε<0.978, are smaller than some hadronic two-photon exchange calculations predict, but are in reasonable agreement with a subtracted dispersion model and a phenomenological fit to the form factor data.

[Pathological changes in human brain biopsies from patients with idiopathic normal pressure hydrocephalus]. / Patologicheskie izmeneniia v bioptatakh golovnogo mozga patsientov pri idiopaticheskoi normotenzivnoi gidrotsefalii.

AIM: To analyze specific changes in brain tissue of patients with idiopathic normal pressure hydrocephalus at cellular and subcellular levels. MATERIAL AND METHODS: Brain biopsies from 32 patients with idiopathic normal pressure hydrocephalus were investigated by light and electron microscopy. Biopsies were made in 3 points (the cortex, subcortical and periventricular white matter during ventricular catheter positioning). RESULTS: A number of pathological features of idiopathic normal pressure hydrocephalus were identified. Most frequent were the exhaustion of brain tissue, enlargement of perivascular spaces, aseptic necrosis, and amyloid and Lewy body's formation. CONCLUSION: The changes in brain tissue of patients with idiopathic normal pressure hydrocephalus transform our views on its mechanisms. It becomes clear that idiopathic normal pressure hydrocephalus is part of common neurodegenerative process that has characteristic features affecting clinical manifestations of the disease.

Real time calorimetric characterisation of clay - drug complex dispersions and particles.

Isothermal titration calorimetry (ITC) along with attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX) and high-performance liquid chromatography (HPLC) were employed to investigate the process of adsorption of propranolol hydrochloride (PPN) onto magnesium aluminium silicate (MAS) and to characterise the MAS-PPN particles formed upon complexation. The composition of MAS was confirmed by infrared (IR) spectroscopy and a calcimeter. The calorimetric results confirmed the binding between PPN and MAS at various pHs and temperatures. The overall change in enthalpy was found to be exothermic with a comparatively small entropic contribution to the total change in Gibbs free energy. These findings suggest that the binding process was enthalpically driven and entropically unfavourable (lower affinity) suggesting hydrogen bonding and electrostatic interactions dominating the interaction. The variation of pH and temperature did not have a great impact on the thermodynamics of the binding process, as observed from the similarity in enthalpy (ΔH), entropy (ΔS) or Gibbs free energy (ΔG). A slight reduction in the binding affinity (Ka) with varing pH and temperature was however observed. SEM/EDX studies showed the occurrence of changes in the microstructural properties of MAS following complexation which may explain the potential of MAS-PPN complexes for controlled drug release promoting pharmaceutical innovation.

Double-hadron leptoproduction in the nuclear medium.

The first measurements of double-hadron production in deep-inelastic scattering within the nuclear medium were made with the HERMES spectrometer at DESY HERA using a 27.6 GeV positron beam. By comparing data for deuterium, nitrogen, krypton, and xenon nuclei, the influence of the nuclear medium on the ratio of double-hadron to single-hadron yields was investigated. Nuclear effects on the additional hadron are clearly observed, but with little or no difference among nitrogen, krypton, or xenon, and with smaller magnitude than effects seen on previously measured single-hadron multiplicities. The data are compared with models based on partonic energy loss or prehadronic scattering and with a model based on a purely absorptive treatment of the final-state interactions. Thus, the double-hadron ratio provides an additional tool for studying modifications of hadronization in nuclear matter.

[Symptomatic arterial hypertension in lupus nephropathy]. / Niakoi prouchvaniia vurkhu simptomatichnata arterialna khipertoniia pri lupusnata nefropatiia.

Sixty six patients with lupus nephropathy with hypertonic syndrome are examined. In patients with latent (inactive) lupus glomerulonephritis hypertonic syndrome developed 3--8 months after the initiation of the corticosteroid treatment, advancing with fluctuations, in some of the patients the arterial pressure being normalized after the discontinuation of that treatment. In patients with chronic active lupus glomerulonephritis without nephrotic syndrome, the hypertension develops before the initiation of the corticosteroid treatment, fluctuating at the beginning, and gradually assumes a stable character 3--5 months after the beginning of such treatment, sometimes with a malignant course and rapid development of renal insufficiency. The hypertonic syndrome advances most severely and malignantly in chronic lupus glomerulonephritis with nephrotic syndrome and is resistant to the active antihypertensive treatment. In 18, out of 25, such patients, the hypertonic syndrome is manifested in parallel with nephropathy before the inclusion of the cortocosteroid treatment. The grave and malignant course of the hypertonic syndrome is associated with the peculiarities of the clinical form and histomorphological type of that lupus nephropathy. In the patients with nephrosclerosis, the hypertonic syndrome is with a gradually progressing evolution, in parallel with the progress of the renal insufficiency.

[Nephroptosis in the etiopathogenesis of vasorenal hypertension]. / Nefroptozata v etiopatogenezata na vazorenalnata khipertoniia.

Forty three patients with nephroptosis, complicated by hypertension were examined (4 males and 39 females), aged from 18 to 60. Permanent hypertension was found in nine of them (21%), and renovasographically--organic renal-arterial stenosis at the nephroptosis side was established. After the failure of the conservative treatment, those patients had all the indications for operation. Seven of the patients underwent the operation and only in one woman patient--nephrectomy was performed, and in all the rest six patients--reconstructive revascularization and nephropexy. The follow-up of the operated patients so far reveals a very favourable effect upon the hypertension syndrome after the operation.

[Changes in the cellular-humoral immune reactivity of patients with lupus nephritis and chronic glomerulonephritis treated with corticosteroids or corticosteroids and imuran]. / Promeni v kletuchno-khumoralnata imunna reaktivnost na bolni s lupus nefrit i khronichen glomerulonefrit, lekuvani s kortikosteroidi ili kortikosteroidi i imuran.

The changes in cellular-humoral immune reactivity were followed up in 13 patients with lupus nephritis and 10 patients with chronic glomerulonephritis, treated with corticosteroids or with corticosteroids and imuran. A tendency to correction of lymphocyte and T-lymphocyte deficiency, inhibition of FsG- and FsM-receptor lymphocytes and of T-gamma and T-mu lymphocyte subpopulations was established in the patients with lupus nephritis, treated only with corticosteroids. The treatment with corticosteroids and imuran inhibited more sharply T gamma- and T-mu lymphocytes than with corticosteroids alone. It was established, in the patients with chronic glomerulonephritis, treated with corticosteroids, that GsG- and FsM-receptor lymphocytes were with significantly lower values than the non-treated ones. No significant changes were established in B-cellular reactivity and serum level of immunoglobulins (IgG, IgM, IgA) with the treatment with corticosteroids and corticosteroids and imuran in both nosological entities. C3- fraction of the complement in the lupus patients treated was with lower values than in the non-treated. The authors conclude that the corticosteroids and corticosteroids and imuran, inhibiting the reactivity of T-lymphocytes, regulating the immune-biological balance, should be cautiously used and under the control of the cellular populations, exposed to their effect.

[Cellular and humoral immunological characteristics of chronic pyelonephritis]. / Kletuchno-khumoralna imunologichna kharakteristika na khronichniia pielonefrit.

The following indices were studied in 21 patients with chronic pyelonephritis: T-lymphocytes - early and late, their TG and TM subpopulations; B-lymphocytes: complement-receptor, antibody (hemolysin) synthesizing, carring surface immunoglobulins (sIg+) and cytoplasmatic immunoglobulins (cIg+); immunoblasts in peripheral blood; serum level of immunoglobulins and of C3 - fraction of complement. The authors established a tendency to increase of early T-lymphocytes and their TG - subpopulations in the patients. TM - subpopulations were considerably lower, as compared with those of the healthy subjects. The complement - receptor and immunoglobulin-containing B cella in the patients with chronic pyelonephritis were increased as compared with the same in healthy subjects. Only IgM level in serum of the patients studied was higher than in the healthy subjects from the humoral factors of immune reactivity. Chronic pyelonephritis, was concluded, by the authors, to participate in the cellular-humoral immune mechanisms with a predominating activation of B-populations and IgM synthesis.

[Use of luminescent analysis for studying the characteristics of the virus-inhibiting action of polyene antibiotics]. / Ispol'zovanie liuminestsentnogo analiza dlia izucheniia osobennostei virusingibiruiushchego deistviia polienovykh antibiotikov.

The inhibitory effect of flavopentin was shown on the models of infectious and oncogenic viruses. Flavopentin is a polyenic antibiotic belonging to pentaenes. The characteristic features of the polyene interaction with the plasma membrane of the host cell were defined with the use of the luminescence analysis, when the antibiotic was applied with the therapeutic or prophylactic purposes in experimental influenzal infection.

[Clinico-therapeutic and microbiologic studies of the Bulgarian antibiotic cephalothin in patients with active pyelonephritis]. / Kliniko-terapevtichni i mikrobiologichni prouchvaniia na bulgarskiia antibiotik tsefalotin pri bolni s aktiven pielonefrit.

A total of 38 patients with active pyelonephritis and significant bacteriuria were treated with the Bulgarian antibiotic cephalotin, the bacteria isolated from their urine manifesting susceptibility to the Bulgarian broad-spectrum antibiotic cephalotin. Twenty six from the patients were with preserved renal function, and 12 with various stages of renal insufficiency. The subjective complaints, febrility, leukocyturia and bacteriuria were best affected. The highest anti-bacterial effect was observed in the patients with uroinfections caused by E. coli, Proteus mirabilis, Klebsiella and staphylococci. Cephalotin has a good tolerance and has no adverse effects. Painful infiltrations were established in some of the patients in the region of the site of intramuscular application, with a transitory character. Cephalotin was assessed, on the base of the study, to be a good and prospective broad-scpectrum antibiotic, deserving to be widely applied in the therapeutic practice.