[Features of surgical treatment of renal cysts depending on the risk of malignancy].

BACKGROUND: According to national and foreign publications, renal cyst is one of the most common urological diseases with a prevalence up to 20-50%. AIM: To determine the results of surgical treatment of patients with renal cysts, depending on the risk of malignancy. MATERIALS AND METHODS: The analysis of 124 patients with symptomatic renal cysts who were treated in the Department of Urology of Regional Clinical Hospital was carried out. All patients underwent a comprehensive clinical and instrumental evaluation, including contrast-enhanced CT scan of the kidneys. To assess the risk of harboring malignant tumor, the classification of renal cysts of Bosniak (2019) was used. RESULTS: The average age of patients was 56.6+/-12 years. According to CT, Bosniak I, II, IIF and III cysts were diagnosed in 96 (77.4%), 11 (8.9%), 11 (8.9%) and 6 (4.8%) patients, respectively. The morphologic study revealed renal cell cancer in 8 patients (6.4%), four of whom had Bosniak III cysts and other four had Bosniak IIF cysts. DISCUSSION: The prediction of the harboring of malignancy is a fundamental criterion for selection of patients with renal cysts for surgical treatment. CONCLUSION: Surgical treatment of symptomatic renal cysts is a justified treatment method, and in patients with Bosniak class II or higher cysts, it is necessary to exclude the malignant lesion. Based on our data, category IIF and III cysts have a high risk of harboring malignant cells, which is 36.4% and 66.7%, respectively. In our opinion, laparoscopic partial nephrectomy is the most rational treatment method in these categories.

Isolation and identification of listeria in clinical material.

Results from research on isolation, identification, and study of biological properties of L. monocytogenes clinical isolates and Listeria spp test strains are presented. Peculiarities of modern research methods for indicating and identifying pathogenic listeria to improve the quality of laboratory studies of clinical material are studied. The culture method provides reliable results of microbiological analyses upon detecting Listeria spp. The presented list and algorithm of the laboratory diagnostic methods can be used as a basis for elaborating regulatory documents for carrying out microbiological research on any biological material for the presence of bacteria of the genus Listeria spp. and L. monocytogenes species in it.

[Plasma acid reproduces oxidative and nitrosative stress in bladder tissue in vitro: experimental study].

AIM: To analyze some effects of plasma acid in vitro on the bladder tissue obtained from laboratory animals and to evaluate the possibility of its application for in vitro modeling of IC/BPS. MATERIALS AND METHODS: The tissue samples of the bladder wall were obtained from female Wistar rats aged 3 months (n=16, weighing 180-200 g). The tissues were processed for 1 hour in the plasma acid prepared by spark discharge of water for injection in air. The immunohistochemical study of obtained samples was performed. RESULTS: The changes in the expression profile of bladder epithelial cells under the action of plasma acid in vitro were found indicating the development of oxidative, nitrosative and dicarbonyl stress, impaired expression of NADPH oxidase DUOX2 and VEGF, and a decrease in cell proliferative activity, which, in general, corresponds to the main mechanisms of urothelial alterations specific for the IC/BPS. CONCLUSION: The revealed effects of plasma acid on bladder epithelial cells confirm the possibility of using it as an inducer of urothelial cell damage typical for IC/BPS in the in vitro models.

Participation of the HIM1 gene of yeast Saccharomyces cerevisiae in the error-free branch of post-replicative repair and role Polη in him1-dependent mutagenesis.

In eukaryotes, DNA damage tolerance (DDT) is determined by two repair pathways, homologous repair recombination (HRR) and a pathway controlled by the RAD6-epistatic group of genes. Monoubiquitylation of PCNA mediates an error-prone pathway, whereas polyubiquitylation stimulates an error-free pathway. The error-free pathway involves components of recombination repair; however, the factors that act in this pathway remain largely unknown. Here, we report that the HIM1 gene participates in error-free DDT. Notably, inactivation RAD30 gene encoding Polη completely suppresses him1-dependent UV mutagenesis. Furthermore, data obtained show a significant role of Polη in him1-dependent mutagenesis, especially at non-bipyrimidine sites (NBP sites). We demonstrate that him1 mutation significantly reduces the efficiency of the induction expression of RNR genes after UV irradiation. Besides, this paper presents evidence that significant increase in the dNTP levels suppress him1-dependent mutagenesis. Our findings show that Polη responsible for him1-dependent mutagenesis.

[General anesthesia influence on cochlear implant intraoperative testing]. / Vliianie obshchei anestezii na rezul'taty intraoperatsionnogo testirovaniia kokhlearnogo implanta.

In this article, we consider the influence of combined general anesthesia on the results of electrically-involved stapedial reflex threshold (esrt) registration. We pay a special attention to the anesthesia to exclude its influence on the esrt. This study included 52 patients with bilateral chronic neurosensory hearing impairment. We conducted a retrospective (from 2014 to 2016) and prospective (from 2017 to 2018) analysis of anesthesia protocols. Even though the inhaled anesthesia (sevoflurane in this case) has a depressive effect on esrt registration (the higher the minimal alveolar concentration of anesthetic agent, the higher the reflex threshold), our study shows a possibility of using it in an extended anesthesia monitoring. Inclusion of myorelaxants in cochlear implantation anesthesia protocol not only provides a safe anesthesia, but also does not prevent a timely intraoperative cochlear implant testing.

[Current possibilities of the differential diagnosis of plaque parapsoriasis and the early stages of mycosis fungoides]. / Sovremennye vozmozhnosti differentsial'noi diagnostiki bliashechnogo parapsoriaza i rannikh stadii gribovidnogo mikoza.

Mycosis fungoides (MF) is the most common primary cutaneous epidermotropic T-cell lymphoma (80%). The accurate diagnosis of MF confirmed only by clinical, histological and immunohistochemical signs amounts to 50-75%. OBJECTIVE: To investigate genetic markers (FOXP3, STAT4, IL-12B) for the early diagnosis of MF, to estimate the informative value of used diagnostic techniques (histology, immunophenotyping), and to determine clonality by the T-cell receptor γ-chain genes. MATERIAL AND METHODS: Fifty patients with MF and plaque parapsoriasis (PP) who had been treated at the V.A. Rakhmanov Clinic of Skin and Venereal Diseases and at the National Medical Research Center for Hematology were followed up. A MF group consisted of 27 patients; a PP group included 23 patients, and a control group comprised 10 healthy individuals. The expression of the FOXP3, STAT4, and IL-12B genes was analyzed by TaqMan real time-PCR. The objectives of the study were affected skin portions from patients with MF or PP and healthy individuals. RESULTS: The investigation revealed a increase in the expression level of STAT4 mRNA transcripts by 9 times in patients with MF compared with those with PP and by 553 times in healthy individuals. There was also a statistically significant predominance of the expression level of STAT4 mRNA transcripts in patients with spotted and plaque stages of MF (180; 318) compared with those with PP and healthy individuals, as well as a sharp decrease in those with erythrodermic MF, which was statistically significant. CONCLUSION: MF cannot be diagnosed without comprehensively assessing the clinical, anamnestic, histological, immunophenotypic, and molecular genetic data. The expression level of STAT4 mRNA transcripts is of great importance for the early diagnosis of MF. Inclusion of the level of STAT4 expression in the list of diagnostic signs increases the accuracy of differential diagnosis of MF and PP from 59.1 to 81.8%, respectively.

Novel base-initiated cascade reactions of hemiindigos to produce dipolar γ-carbolines and indole-fused pentacycles.

Novel continuous-flow cascade reactions are developed for producing 1,4-diaryl-disubstituted dipolar γ-carbolines 2 that contain a carboxylate group and their two pentacyclic precursors 6, 7 from hemiindigos 1. The nucleophilic and pro-electrophilic chemistry described is new to the hemiindigos 1, and it led to the discovery of antimycobacterial scaffold characteristic of rimino-type pentacycles 6, 7 and potent drug clofazimine. The new scaffold like clofazimine appears to be useful in developing lead agents active against drug-resistant/dormant TB.

[The role of remodeling complexes CHD1 and ISWI in spontaneous and UV-induced mutagenesis control in yeast Saccharomyces cerevisiae].

Chromatin remodulators are special multiprotein machines capable of transforming the structure, constitution, and positioning of nucleosomes on DNA. Biochemical activities of remodeling complexes CHD1 and ISWI from the SWI2/SNF2 family are well established. They ensure correct positioning of nucleosomes along the genome, which is probably critical for genome stability, in particular, after action of polymerases, repair enzymes, and transcription. In this paper, we show that single mutations in genes ISW1, ISW2, and CHD1 weakly affect repair and mutagenic processes in yeast cells. At the same time, there are differences in the effect of these mutations on spontaneous mutation levels, which indicates certain specificity of action of protein complexes ISW1, ISW2, and CHD1 on expression of different genes that control repair and mutation processes in yeast.

[DNA methylation in the promoter regions of the laminin family genes in normal and breast carcinoma tissues].

Extracellular glycoproteins of the laminin family are essential components of basement membranes involved in a number of biological processes, including tissue differentiation, wound healing, and tumorigenesis. We present the first comprehensive study of promoter methylation status of the genes encoding laminin chains in normal tissues (peripheral blood leucocytes, buccal epithelial cells, autopsy breast tissue samples) and in breast carcinoma samples. Based on the results of this study, we divide laminin genes into three categories. Genes, constitutively methylated in breast tissues include LAMA3A, LAMB2, LAMB3, and LAMC2. Genes prone to abnormal methylation in breast carcinoma include LAMA1, LAMA2, LAMA3B, LAMA4, LAMB1, and LAMC3. Genes that are rarely if ever methylated in breast carcinoma include LAMA5 and LAMC1. The constitutively methylated group includes all of the genes that encode subunits of laminin-5 (the historical name of laminin 332), the promoters of which were previously considered unmethylated in normal tissues and prone to abnormal methylation in breast cancer.

[Effect of cardiovascular functional disorders on cerebral oxygenation in children].

The article deals with data of cerebral oximeter INVOS Somanetics (US) used for comparison the degree of brain oxygenation reduction, ejection fraction and stroke volume relative to age norms in children with dilated cardiomyopathy.

[Structural and functional analysis of tumor genomes and the development of test systems for early diagnosis, prognosis and cancer therapy optimization].

The article discusses results of the structural and functional analysis of molecular genetic abnormalities in various malignant tumors. Investigations have discovered more than 20 new markers for sporadic breast cancer. Several of them formed the test system, allowing the diagnosis with a specificity of 100%. Appearance of TMPRSS2/ERG4 chimeric gene is a frequent tumor-specific event, its expression is correlated with more aggressive forms of prostate cancer, may serve as a molecular marker for tumor cells and androgen assessment of tumor response to hormonal therapy. The effective systems for the early diagnosis of cervix and endometrium cancer were developed as well. Mutations in the VHL, deletions of chromosome 3 and methylation of several genes can predict the course and selection of effective therapy of clear cell kidney cancer, a number of molecular markers were identified for early diagnosis and prognosis of recurrence of bladder cancer. For diagnosis, prognosis and treatment of brain tumors we developed an effective complex system of markers. Protocol of molecular genetics investigation reveals the cause of the disease by more than 90% of patients with retinoblastoma. In order to study abnormal methylation in tumor genomes an innovative technology AFLOAT has been developed that allows to efficiently identify new markers with diagnostic value. Test systems of molecular genetic and epigenetic markers for early diagnosis and prognosis as well as for cancer therapy optimization have shown to be effective, have been approved for use in clinical practice and are being introduced into practical healthcare.

[Value of magnetic resonance imaging in the diagnosis of complicated forms of the diabetic foot].

Magnetic resonance imaging was performed in 98 patients to estimate the capabilities of radiodiagnosis in the study of complicated forms of the diabetic foot. This diagnostic technique can visualize foot changes with a high degree of validity.

[Certain aspects of the present-day diagnosis and treatment of iliopsoitis].

MR-tomography is known to be a valuable method of investigation. It allows to get a picture of thin layers of the human body in any section. In addition, it facilitates the diagnosis of inflammatory alterations to the muscles of the retroperitoneal space before the development of purulent phases of inflammation. The difficulties of the diagnosis of pyo-inflammatory diseases are leveled due to practical possibility of MRT to detect the inflammation focus.

[Validation of application of elastic tamponade of the middle ear postoperative cavities]. / Obosnovanie primeneniia élasticheskoi tamponady posleoperatsionnykh polostei srednego ukha.

It is shown that gauze turunda tamponade of the middle ear postoperative cavities provokes bacterial contamination and formation of the infection focus. Inflatable latex tampon and technique of tamponade of the postoperative middle ear cavities after hearing-preserving sanation operations on the temporal bone were designed and tested. They proved superior to the gauze turundas and allow to avoid bacterial contamination. Microscopic and histological studies confirmed that removal of the latex tampon is safe for the postoperative wound surface making postoperative relapse less probable.

[The role of antibacterial prophylaxis and therapy in pancreonecrosis]. / Rol' antibakterial'noi profilaktiki i terapii pri pankreonekroze.

The research of efficiency of different antibacterial prophylactic and therapy procedures among 89 patients suffering destructive pancreatitis is presented in the article. Determined that optimized tactics of antibacterial prophylactic and therapy with using of such medicines like carbapenems have the important value in cardinal improvement of the results of multi-stage surgical and intensive treatment of the patients suffering pancreonecrosis.

[The efficacy of cefepime (Maxipime) in the treatment of abdominal sepsis in surgical patients]. / Effektivnost' tsefepima (Maksipima) v lechenii abdominal'nogo sepsisa u khirurgicheskikh bol'nykh.

The efficacy of cefepime in the treatment of 46 patients operated for general peritonitis of various genesis and severity (APACHE II not greater than 35) was studied. Cefepime was used in a dose of 2 g administered every 12 hours as slow intravenous infusions in 0.9 per cent sodium chloride solution in combination with metronidazole administered intravenously in a dose of 7.5 mg/kg body weight. The treatment course was 4 to 15 days. 45 patients were given diflucan for the prophylaxis of fungal superinfection, 3 patients were given aminoglycoside antibiotics (netilmicin or amikacin) and 2 patients were given vancomycin per os. The favourable clinical effect of the cefepime therapy was stated in 38 patients (82.6 per cent) including 4 out of 10 patients with initial APACHE II > 15. 101 isolates of aerobic gram-negative and gram-positive microbes from 38 patients treated with cefepime in combination with metronidazole were tested to estimate the bacteriological efficacy of the therapy and it was shown that only 5.9 per cent of them was resistant. The pathogen eradication was stated in 84.2 per cent of the patients.

[A strategy and procedure for the antibacterial therapy of abdominal sepsis]. / Strategiia i taktika antibakterial'noi terapii abdominal'nogo sepsisa.

Offers a protocol of antibacterial therapy of abdominal sepsis in surgical patients. Analyzes the principal etiological agents of abdominal septic complications. Presents optimal schemes of antibacterial therapy of abdominal sepsis. Pays special attention to choice of antibiotics in different clinical situations.

[The significance of lipid peroxidation in the pathogenesis of leptospirosis and its complications]. / Znachenie perekisnogo okisleniia lipidov v patogeneze leptospiroza i ego oslozhnenii.

Lipid peroxidation (LPO) and antioxidant plasma activity were evaluated in 39 patients with leptospiral jaundice. At the height of the disease LPO proceeded more actively, being the highest in cases of severe complications. Early in the disease course general antioxidant activity of plasma was inhibited significantly more noticeably in complicated versus uncomplicated leptospirosis. This confirms pathogenetic implication of membrane LPO in leptospirosis. The approaches to prognostication of the disease course and completeness of the response are proposed.