[A role of neurosteroids in the pathogenesis of psychiatric disorders]. / Rol' neirosteroidov v patogeneze psikhicheskikh rasstroistv.

Despite the proven importance of neurosteroids in many physiological processes, their role in the pathogenesis of the most of psychiatric disorders remains relatively understudied. This article reviews the current clinical evidence on the effects of neurosteroids on the formation and treatment of anxiety disorder, depression, bipolar disorder, and schizophrenia. In particular, the article points out the ambivalent nature of the effects of neurosteroids on GABAA- and other receptors. We are especially interested in the anxiolytic and anxiogenic effects of some neurosteroids, the antidepressant effect of allopregnanolone in treating postpartum and other forms of depression, and the nature of short- and long-term mechanisms of antidepressant effects of neurosteroids of different types. The currently unproven hypothesis about the effect of changes in the level of neurosteroids on the course of bipolar disorder is also discussed, with an analysis of the scientific evidence on the development of schizophrenic symptomatology in relation to changing neurosteroid levels in the context of positive and cognitive symptoms.

Direct Observation of Incommensurate-Commensurate Transition in Graphene-hBN Heterostructures via Optical Second Harmonic Generation.

Commensurability effects play a crucial role in the formation of electronic properties of novel layered heterostructures. The interest in these moiré superstructures has increased tremendously since the recent observation of a superconducting state (Nature 2018, 556, 43-50) and metal-insulator transition (Nature 2018, 556, 80-84) in twisted bilayer graphene. In this regard, a straightforward and efficient experimental technique for detection of the alignment of layered materials is desired. In this work, we use optical second harmonic generation, which is sensitive to the inversion symmetry breaking, to investigate the alignment of graphene/hexagonal boron nitride heterostructures. To achieve that, we activate a commensurate-incommensurate phase transition by a thermal annealing of the sample. We find that this structural change in the system can be directly observed via a strong modification of a nonlinear optical signal. Unambiguous interpretation of obtained results reveals the potential of a second harmonic generation technique for probing of structural changes in layered systems.

Strong thermo-induced single and two-photon green luminescence in self-organized peptide microtubes.

Diphenylalanine peptide nano- and microtubes formed by self-assembly demonstrate strongly enhanced and tunable single-photon and two-photon luminescence in the visible range, which appears after heat- or laser treatment of these self-organized peptide microtubes. This process significantly extends the functionality of these microstructures and can trigger a new interest in the optical properties of structures based on short peptides.

Bioinspired peptide nanotubes: deposition technology, basic physics and nanotechnology applications.

Synthetic peptide monomers can self-assemble into PNM such as nanotubes, nanospheres, hydrogels, etc. which represent a novel class of nanomaterials. Molecular recognition processes lead to the formation of supramolecular PNM ensembles containing crystalline building blocks. Such low-dimensional highly ordered regions create a new physical situation and provide unique physical properties based on electron-hole QC phenomena. In the case of asymmetrical crystalline structure, basic physical phenomena such as linear electro-optic, piezoelectric, and nonlinear optical effects, described by tensors of the odd rank, should be explored. Some of the PNM crystalline structures permit the existence of spontaneous electrical polarization and observation of ferroelectricity. The PNM crystalline arrangement creates highly porous nanotubes when various residues are packed into structural network with specific wettability and electrochemical properties. We report in this review on a wide research of PNM intrinsic physical properties, their electronic and optical properties related to QC effect, unique SHG, piezoelectricity and ferroelectric spontaneous polarization observed in PNT due to their asymmetric structure. We also describe PNM wettability phenomenon based on their nanoporous structure and its influence on electrochemical properties in PNM. The new bottom-up large scale technology of PNT physical vapor deposition and patterning combined with found physical effects at nanoscale, developed by us, opens the avenue for emerging nanotechnology applications of PNM in novel fields of nanophotonics, nanopiezotronics and energy storage devices.

Interns' perceptions on medical ethics education and ethical issues at the Dokuz Eylul University School of Medicine in Turkey.

AIM: In Turkey and its neighboring countries, few studies have investigated medical students' reactions to ethics education and ethical issues they encounter. The aim of this study was to investigate interns' perceptions of medical ethics education and ethical issues. BACKGROUND: In students' first three years at the Dokuz Eylul University School of Medicine, various teaching methods are used in ethics education, including problem-based learning, interactive lectures and movies. During the clinical years, the curriculum helps students consider the ethical dimension of their clinical work, and during the internship period a discussion on ethical issues is held. MATERIAL AND METHODS: Data were collected through a questionnaire distributed to interns in the 2005-2006 academic year. Its questions asked about interns' perceived adequacy of their ethics education, any interpersonal ethical problems they had witnessed, their approaches to ethical problems, obstacles they believe prevented them from resolving ethical problems and whether they felt themselves ready to deal with ethical problems. 67.2 % of interns were reached and all of them responded. RESULTS: In the assessment of the adequacy of ethics education, the most favorable score was given to educators. Students' most often mentioned ethical problems encountered were between physicians and students and between physicians and patients. Interns believed that difficult personalities on the team and team hierarchy were important obstacles to resolving ethical problems. There were significant differences between the approaches students currently used in dealing with ethical problems and how they anticipated they would approach these problems in their future professional lives. CONCLUSION: We obtained information about students' perceptions about ethics education and ethical problems which helped us to plan other educational activities. This study may assist other medical schools in preparing an ethics curriculum or help evaluate an existing curriculum.

Sexual attitudes and behaviors among medical students in Dokuz Eylul university, Turkey.

Gaining a healthy sexual attitude and behavior and being able to show appropriate approaches to patients in terms of sexual issues are important acquisitions for medical students. The aim of the present study was to determine, compare, and evaluate the sexual attitudes and behaviors of Dokuz Eylul University Faculty of Medicine students. An anonymous questionnaire was filled in by first- and sixth-year students in order to determine their sexual attitudes and behaviors. While information sources in the adolescence period for both genders were friends in the first place, these sources were mostly mothers, books, newspapers--magazines for females, and newspapers--magazines and television for males. The opinion of males about having sexual intercourse before marriage for males was positive, and females were more tolerant about males having this experience before marriage as compared to females having sexual experience before marriage. Rates of expression of having sexual intercourse and masturbation were found to be higher for male students. The first sexual experience with a sex worker or sentimentally insignificant partner was high among males. In general, the rate of condom use was lower, and the rate of coitus interruptus was found to be higher than in foreign studies. All the students declared 'my own will and values' as the most frequent factor affecting their sexual attitudes and behaviors, and high rates for 'social factors', 'religious requirements', 'the expectations of families', and 'protection from sexually transmitted diseases' were observed. The findings lead to the conclusions that gender differences exist in the sexual attitudes and behaviors of medical students; the enhancing effect of the traditional structure on gender discrimination is still continuing; students are not provided with sufficient scientific approach or training prior to the university education; and beyond biomedical training, they should receive more support in those fields during their medical education.

[Surgical treatment of certain forms of secondary glaucoma]. / Khirurgicheskoe lechenie nekotorykh form vtorichnoi glaukomy.

The technique of penetrating deep sclerectomy with suprachoroidal explanto-drainage as well as the results of postoperative follow-up, exceeding 2 years, and of the early-described sinustrabeculectomy with regulated filtration are presented in the article. Operations were made on 59 eyes (58 patients aged 13 to 70) with the below forms of secondary glaucomas: new-vascular, postuveal, dystrophic (at retinal detachment), posttraumatic (contusion-type), phakotopic, postoperative (aphakic), and hemolytic. The below goals were set while elaborating the methods: the possibility to regulate postoperatively the intraocular pressure, elimination of the pain syndrome, the organ-preserving effect, stabilization of the clinical cause and shaping-up of reliable drainage paths. The authors registered a positive effect in 87.5% of cases.

[Apheresis of immunoglobulins - new approach to the treatment of severe dilated cardiomyopathy]. / Aferez immunoglobulinov - novyi podkhod k lecheniiu tiazhelykh form dilatatsionnoi kardiomiopatii.

Two courses of immunoadsorption with 'Ig Adsopak' were used in the treatment of a patient with dilated cardiomyopathy (DCM) during which all class G and partially class M and A immunoglobulins were removed. Every course consisted of 5 daily procedures and resulted in removal of 98% of immunoglobulins. This was associated with complete removal of autoantibodies to beta1-adrenoreceptor. After the end of a course loss of immunoglobulins was replenished by intravenous infusion of Pentaglobin and Oktagam. Echocardiographic study carried out before, during and after second course of apheresis revealed reduction of left and right ventricular and atrial volumes and dimensions, improvement of contractility of anterior part of interventricular septum and of anterolateral left ventricular wall. As efficacy of drug therapy of dilated cardiomyopathy is low and facilities of cardiac transplantation are limited the method of therapeutic apheresis reveals novel perspectives of the treatment of dilated cardiomyopathies.

The influences of drug companies' advertising programs on physicians.

This study investigates the influences of drug companies' advertising programs on physicians. Of the 446 physicians interviewed, 53.9 percent were visited by pharmaceutical company representatives at least once a day, and 43.5 percent spent 15 minutes or more per day on these visits. With respect to the information delivered by the pharmaceutical company representatives, 67.7 percent of physicians thought it was not reliable, and 62.8 percent reported that it had no effect on their prescription writing. The promotional gifts had little effect on prescriptions for 43.9 percent of physicians, and 80.3 percent reported that these gifts were distributed unequally among doctors according to the drugs they prescribed. Only 23.5 percent of physicians supported the prohibition of promotion programs; 90.6 percent of physicians agreed that drugs are too expensive, and 82.9 percent agreed on the presence of overprescription. The authors evaluate these results and provide some suggestions for improving the sources of information for drug prescribing.

[Sinusotrabeculectomy with regulated filtration in the treatment of secondary glaucoma]. / Sinusotrabekuléktomiia s reguliruemoi fil'tratsiei pri lechenii vtorichnykh glaukom.

A new method for surgical treatment of secondary glaucoma (neovascular, postuveal, traumatic, and aphakic) is described. The aims of the new method are as follows: regulation of ophthalmic tone in the postoperative period, pain relief, organ preservation, stabilization of the process, and creation of reliable routes of intraocular fluid discharge with formation of a stable diffuse functional pad. Seven patients (8 eyes) aged 13-70 years were operated on and followed up for up to 6 months. Preliminary results are presented. Positive shifts were observed in all cases.

The number and distribution of computerised tomography scanners in Turkey.

The goal of this study was to investigate the number and distribution of CT scanners in Turkey. Our results show 173 CT scanners in Turkey in 1994, which equals 2.9 scanners per million people. All of the scanners are located in 45 cities, where 81 % of the population resides. The other 31 cities in Turkey have no scanners. Of the 173 scanners, 103 (59.6 %) are owned by the private sector and the other 70 are owned by the public sector. Of Turkey's CT scanners, 49.2 % are located in private health centres, 21.9 % in university hospitals, 16.7 % in Ministry of Health (MOH) hospitals, 10.4 % in private hospitals and 1.8 % in social security hospitals.

Induced abortion: a method for birth control?

Despite the recent improvements in services and an increase in available funds, the expected increase in usage of effective contraceptive methods and decrease in number of induced abortions has not been seen in Turkey. This study investigates the causes of this situation and argues whether induced abortion is being used as a birth control method. Eight-five subjects were involved in the study, all of whom came to a family planning clinic for an induced abortion. Forty-seven (55.29%) of the participants had had at least one induced abortion prior to this. Eight-four (98.8%) had knowledge of at least one contraceptive method, and 80 (94.1%) had knowledge of at least one effective contraceptive method. Eighty (94.1%) participants had used some form of contraception at some time in their lives; 52 (61.17%) had used an effective contraceptive method at some time in their lives. When they became pregnant, 60 (70.6%) were using ineffective methods or were not using any contraceptive method. Both the participant and the spouse wanted the abortion in 68 (80%) cases.

The growing dependency in health care. Recent changes in medical technology imports and exports in Turkey.

This study investigates recent changes related to the import and export of medical technology and their results in Turkey. Between 1980 and 1993 the number of medical technology imports in Turkey rose, and there was a parallel rise in its ratio to total imports and health expenditures. In contrast the ratio of medical technology exports to total exports decreased significantly in the same period. The liberalization of foreign trade and the changes of health services toward free market policy has caused growing import of medical technology in Turkey.

[Effect of manual therapy on blood pressure in hypertensives with cervical osteochondrosis]. / Vliianie manual'noi terapii na arterial'noe davlenie u bol'nykh gipertonicheskoi bolezn'iu c sheinym osteokhondrozom.

The efficacy of drug (inderal, corinfar) treatment in combination with manual therapy (the course was 4-7 sessions) was examined in hypertensives with cervical osteochondrosis. The latter was evidenced by X-ray studies. Clinically, cervical osteochondrosis appeared as vertebrobasilar insufficiency. The vertebral artery bed displayed circulatory disorders documented by rheoencephalography, electroencephalography, ultrasound Doppler echography of the head and neck vessels. Treating the patients with drugs in combination with manual therapy resulted in improved circulation in the vertebral artery bed, lower clinical signs of vertebrobasilar insufficiency. There was a more persistent and more pronounced decrease in blood pressure with small-dose antihypertensive agents.