[The mechanical properties of the bone tissue from the middle facial region].

The objective of the present work was to study age-related features of the reaction of the maxillary sinus cavity walls to a variety of impacts associated with the surgical interventions. To this effect, a variety of stress-strain conditions were simulated that are known to arise in the maxillary sinus cavity walls under the action of different force vectors taking into consideration the age-specific peculiarities of the mechanical structure of the bone tissue. The 3D model of the maxillary sinus cavity was built up based on the results of spiral computed tomography with the use of the Solid Works 2012 software package (USA). The finite element method (FEM) was employed to construct the grid. Three variants of force application were simulated, one to the canine fossa region, another to the upper portion of the alveolar process at the border between the upper and lower walls of the sinus, and the third to the anterior part of the inferior nasal passage. The study has demonstrated that the bone wall of the maxillary sinus differently responds to the impacts of similar magnitude depending on the application point and age-related physical and mechanical properties of the bone tissue. This finding should be taken into account in the choice of the optimal surgical approach to the maxillary sinus. It was calculated that endonasal interventions should be preferred for the treatment of patients above 60 years of age as the minimally injurious ones to the bone tissue. Moreover, special caution is needed when the intervention is performed beneath the canine fossa, where the bone is extremely fragile and the risk of injury extension to the floor of the maxillary sinus is especially high.

[The combined application of thermography and local thermometry for diagnostics, prognostication, modeling, and evaluation of the effectiveness of the treatment of acute sinusitis].

The objective of the present work was to study the possibilities of the combined application of thermography and local thermometry for diagnostics of acute sinusitis, characteristic of dynamics of the clinical course of this pathology, and evaluation of the effectiveness of its treatment. The study included 23 patients presenting with acute rhinosinusitis and 21 ones free from pathology of paranasal sinuses. Contact thermometry was performed with the use of the electronic thermometer applied to the anterior surface of the inferior turbinated bone. An infrared thermovision camera was employed to carry out thermographic measurements. The study demonstrated variations in endonasal and surface temperature under effect of the treatment. Positive dynamics of the patients' conditions was manifested as a drop of endonasal temperature and relatively constant surface temperature. A rise in the surface temperature was associated with the pathological process. In the patients showing slightly positive dynamics of the disease, the surface temperature on the side of the pathological process was lower than on the unaffected side. This difference was interpreted as an indication of the reduced microcirculatory activity in this region. It was hypothesized that dynamics of the inflammatory process is to a large extent determined by the character of blood circulation in the affected region. The authors conclude that the combined application of thermometry and thermography not only improves the quality of diagnostics of acute rhinosinusitis but also facilitates the evaluation of its dynamics and the effectiveness of the treatment.

[Outlook of surgical treatment of servicemen with pathology of knee joint in the specialized orthopedo-traumatology department].

Analyzed data from annual reports of major trauma districts, chiefs of departments of hospitals and centers and reviewed the frequency and structure of surgical interventions on the knee, made in the last 5 years (2005-2010) in health care facilities the Defense Ministry. The frequency of the most typical injuries and diseases of the knee joint in different categories of servicemen. An integrated laboratory and endoscopic examination of patients with reactive arthritis, associated with latent urogenital infection and how the underlying disease and disease associated surgical pathology knee. Formulated evidence-based recommendations for improving the organization of surgical treatment of soldiers with the pathology of the knee.

Molecular typing of Mycobacterium tuberculosis circulated in Moscow, Russian Federation.

The present study investigates epidemiological diversity and multidrug resistance spreading among Mycobacterium tuberculosis strains circulating in Moscow, Russian Federation. Among 115 M. tuberculosis strains selected randomly from the sputum of epidemiologically unrelated tuberculosis (TB) patients, multidrug-resistant (MDR) strains predominated. Mutations in the RRDR of the rpoB gene were detected in 64 (83.1%) of 77 rifampicin (RIF)-resistant strains. The Ser531→Leu substitution was prevalent among them (76.5%). Aberrations in the Ser315 codon of katG and/or in the inhA promoter region were found in 79 (84.0%) of 94 isoniazid (INH)-resistant strains. Strains belonging to the Beijing family prevailed. Seventy-one different patterns were identified using the 24-VNTR loci typing scheme. Three main 24-loci VNTR clusters included 34 strains which belonged to the Beijing family. The spoligotyping and 24-loci VNTR typing combination demonstrated maximal discriminatory power. Among the Beijing strains, the MDR phenotype was revealed more frequently than among the others. High genetic heterogeneity of the studied population was shown by the assessment of VNTR loci variability in the analyzed group and in the strains from other parts of Russia. Comparison of the 24-VNTR locus typing and spoligotyping data with revealed resistance-associated mutation allows us to make a suggestion that the active transmission of MDR strains and the independent appearance of drug resistance during chemotherapy occurred in the studied population simultaneously.

[Evaluating biomarkers of exposure to electric welding aerosol].

Biologic monitoring data in electric welders revealed reliable correlation between manganese concentration in the whole blood and manganese concentrations in the workplace air. The chronic manganese intoxication patients showed reliable lower levels of urinary iron, cobalt and manganese vs. those values in the reference group.

[Pharmacological correction of Th1 and Th2 lymphocyte activity and cytokine profile in ethanol intoxicated rats].

It was established in experiments on noninbred rats that their ethanol intoxication (13 days; total dose, 2.6 LD50) significantly reduces the concentration of blood cytokines IFNgamma, IL-2, IL-4, IL-10, increases the concentration of IL-6, suppresses the immune responses, and reduces the interrelation IFNgamma/IL-4 in comparison to the control, which testifies to the greater damage of Th1 cells in comparison to Th2 lymphocytes. The immunomodulator polyoxidonium administered for four days at a daily dose of 700 microg/kg fully restores the cellular and humoral immune responses and the synthesis of cytokines IFNgamma, IL-2, and IL-4 and partly restores the production of IL-10.

[Detection of mutations in codon 306 of the embB gene for molecular genetic characterization of clinical Mycobacterium tuberculosis strains].

A total of 254 Mycobacterium tuberculosis strains were used in the study. Among them, there were 183 ethambutol (EMB)-resistant strains, 13 multidrug resistant ones, but EMB-sensitive, and 39 strains sensitive to rifampicin (RIF), isoniazid (INZ), and EMB. All the strains were analyzed for genetic changes in three loci: embB306, rpoB, and katG/inhA promoter, which were associated with the formation of resistance to EMB, RIF, and INZ, respectively. The Mycobacterium tuberculosis strains were obtained from pulmonary tuberculosis patients living in the Central Region of the Russian Federation. Resistance to RIF, INZ, and EMB was revealed by the absolute concentration test. The inhibitory concentration (IC) of EMB was determined for all the strains. Genetic changes in the above loci were estimated by mini-sequencing, followed by mass-spectrometry recording MALDI-TOF products. The relative low frequency of embB306 mutations was observed among the EMB-resistant strains (about 41.5%). Mutations in codon 306 were detected only in strains with EMB IC > or = 2 mg/L. A statistical significant association was found between the frequency of embB306 mutations and the multidrug resistant phenotype. A combination of these mutations with the traditional genetic markers of multidrug resistance may be used for the more effective detection of multidrug-resistant strains.

[Peculiarities of nervous system functional state in electric welders exposed to manganese compounds].

Peculiarities of nervous system functional state in electric welders exposed to manganese compounds. To evaluate nervous system functional state in electric welders exposed to manganese compounds, the authors conducted transverse study with matched pairs. The electric welders' tests for response rate, diadochokinesis and grasping power were not reliable. No changes were found in tremor characteristics and posture steadiness. Bradykinesia appeared to prevail in welders.

[Psychoemotional changes in patients with pulmonary tuberculosis during therapy using psychological and neuropsychological methods].

Therapy for pulmonary tuberculosis in patients is complicated by their negative psychoemotional state frequently deteriorated by long inpatient stay. Enhancing the efficiency of rehabilitative measures in phthisiology requires active optimization of the patients' mental state. This problem can be solved by a package of correction measures involving psychological correction with reflex therapeutic normalization of the functional state of the cortical regions of the central nervous system in patients with pulmonary tuberculosis. One hundred tuberculosis patients with decompensated mind, including 60 with OG and 40 with KG, were examined. A noticeable psychoemotional improvement was reliably detected 5 months after complex correction psychological and neuropsychological accompaniments of standard chemotherapy in the OG study.

Detection of mutations in Mycobacterium tuberculosis genome determining resistance to fluoroquinolones by hybridization on biological microchips.

We developed a method of identification of Mycobacterium tuberculosis with simultaneous evaluation of the sensitivity to fluoroquinolones on a biological microchip array. The method of multiplex two-staged PCR followed by hybridization of a biochip makes it possible to detect 8 mutant variants of gyrA gene occurring in fluoroquinolone-resistant strains (approximately 85% all resistant forms) within 1 day. Using this method we analyzed 107 cultures isolated from patients with tuberculosis and 78 sputum samples. Mutations in gyrA gene were detected in 48 (92%) resistant strains. Natural S95T polymorphism in gyrA gene was detected in all resistant and in 76% sensitive strains. The sensitivity and specificity of the proposed method calculated on the basis of the analysis of sputum samples (n=78) were 94 and 100%, respectively.

[Changes in the toxicity and immunotoxity of tetrachloromethane and carbophos under the action of 2,4,6-triphenyl-4H-selenopyran and their connection with cytochrome P-450 dependent monooxygenase system].

It is established in experiments on noninbred rats that 2,4,6-triphenyl-4H-selenopyrane (peroral administration in a dose of 0.8 mg/kg during 3 days) induces cytochrome P450, thus increasing the toxicity and immunotoxicity of carbon tetrachloride (metabolized via "lethal synthesis"), and reduces the analogous effects of carbophos, the biotransformation of which proceeds via the formation of low-toxicity and nontoxic metabolites.

[Impact of M. tuberculosis genotype on survival in mice with experimental tuberculosis].

To study the virulence of Mycobacterium tuberculosis strains of the W cluster, C57B1/6 mice were intravenously inoculated with a lethal dose (5x10(6) CFU) of 14 clinical M. tuberculosis strains (11 drug-sensitive and 3 multidrug-resistant) belonging to different RFDP IS6110 genotypic clusters and two laboratory M. tuberculosis strains H37Rv and H37Ra. The virulence was evaluated by the survival of mice after infection and by the trends in body weight loss. The study indicated that the mice inoculated with different M. tuberculosis strains differed in survival rates and in the trend in body weight loss. A minor HD cluster strain and 2 non-clustered strains were most virulent, next were 2 AI cluster strains. W cluster strains had both higher (n = 2) and lower (n = 3), and comparable (n = 2) H37Rv virulence. A KQ cluster strain had the least virulence. An attenuated H37Ra strain caused no animal death. Inoculation with three multidrug-resistant strains belonging to the W cluster (n = 2) and one non-clustered strain demonstrated no relationship of virulence to the sensitivity of a strain to antituberculous agents. The findings argue against the opinion on W cluster M. tuberculosis strains as hypervirulent.

[Efficiency of chemotherapy of destructive pulmonary tuberculosis, based on the results of rapid detection of drug sensitivity to isoniazid and rifampicin with the "TB-Biochip" test system].

To evaluate the efficiency of chemotherapy used in patients with pulmonary tuberculosis by the results of a rapid detection of drug resistance (DR) to isoniazid and rifampicin on a "TB-Biochip" test system versus the standard treatment with its subsequent correction by the data of determination of Mycobacterium tuberculosis (MBT) resistance by the absolute concentration technique (ACT), the study included 208 patients with pulmonary tuberculosis. The patients were divided into 2 groups: 1) those in whom MBT sensitivity to antituberculous agents was determined on a "TB-Biochip" test system to detect mutations in the MBT genes rpoB, katG, inhA, ahpC that were responsible for MBT sensitivity to rifampicin and isoniazid and by ACT; 2) those in whom this was determined by only ACT. The results of a test for MBT sensitivity to rifampicin and isoniazid were obtained within 2 days before chemotherapy in Group 1 and 2 months after chemotherapy in Group 2. In Group 1, antituberculous chemotherapy was used, by taking into account MBT sensitivity to isoniazid, rifampicin, or their combination; in Group 2, the drugs were given by the standard regimens with their subsequent correction following 2 months by the results of ACT. The timely initiation of treatment with reserve drugs in the detection of drug sensitivity in MBT could achieve higher therapeutic efficiency and in a shorter space of time.

[Mycobacterium tuberculosis strain transmission caused by migratory processes in the Russian Federation (in case of populational migration from the Caucasian Region to Moscow and the Moscow Region)].

The investigation was carried out on 134 M. tuberculosis isolated from 134 patients treated at the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences. The patients were divided into 2 groups: 1) those who were natives of Moscow and the Moscow Region (MR patients); 2) those who were migrants to the Moscow Region from Azerbaijan, Daghestan, Chechnya, Ingushetia, Karachai-Cherkessia, North Ossetia (the Caucasian Region) (CR patients) who had fallen in the place of birth. Genotyping by the polymorphism of lengths of the restriction fragments containing the insertion sequence IS6110 revealed a genetic diversity of M. tuberculosis strains. The examined M. tuberculosis strains belonged to 13 genotypic families. The W and AI families were prevalent. The family W M. tuberculosis strains isolated from the Caucasians were highly clustered, as confirmed by the overwhelming predominance of the strain variant W148 (19.7%). The spectrum of the strain variants of the W family, and those of the AI family in particular, greatly differed in MR and CR patients. Only one strain variant AI12 occurring both in MR and CR patients was detected. A study of the transmission activity coefficient (TAC) of the families W and AI indicated that the transmission activity of W strains was significantly higher than that of M. tuberculosis strains of the AI family. A comparative analysis of the TAC of M. tuberculosis strains of the AI family demonstrated that the transmission activity of the strains of this family was identical no matter where a patient had fallen ill (1.59 and 1.41% in the Moscow and Caucasian Regions, respectively). Unlike M. tuberculosis strains of the AI family, the TAC of W strains isolated from the patients infected in the Moscow Region (28.17 and 19.05%, respectively), which suggests the more intensive transmission of the pathogen M. tuberculosis of the W family in the Caucasian Region.

[Examining the ex vivo growth in the macrophages of Mycobacterium tuberculosis of various genotypic clusters].

To study the specific features of replication of Mycobacterium tuberculosis (MBT) strains of the W cluster in the macrophages (MP) on the ex vivo model of peritoneal MP of MBT-infected C57B1/6 mice, the authors estimated the viability of 6 antituberculous drug-sensitive MBT strains of the W-cluster from the incorporation of 5,6-[3H]-uracil into the mycobacterial cells and their induced specific MP from the level of LDH. Eight sensitive MBT strains of other genotypes clustered by the restriction fragment length polymorphism (PDRF) IS6110 and 2 laboratory strains M. tuberculosis H37Rv and M. tuberculosis H37Ra were taken as a control. The study indicated that, cultured in vitro, MBT strains belonging to different genotypic clusters differed in the level of 5,6-[3H]-uracil inclusion. When grown in MP, the MBT population of all genotypes showed a diminished viability as compared with that cultured without MP. The MBT clusters of W and AI clusters, unclustered strains, and M. tuberculosis H37Rv displayed a higher inclusion of 5,6-[3H]-uracil and the strains of KQ and HD clusters and M. tuberculosis H37Ra exhibited a significantly lower inclusion of 5,6-[3H]-uracil. W-cluster strains, the unclustered strain R807, and M. tuberculosis H37Rv showed the highest fitness (adaptability when grown in MP). The virulent strain M. tuberculosis H37Rv and avirulent strain M. tuberculosis H37Ra differed in MP viability by almost 5 times. Evaluation of the cytopathogenic effect indicated that the clinical MBT strains led to a specific MP lysis greater than 40%, the highest effect was produced by the MBT strains of the W cluster (more than 93%) and the HD cluster (96.45%). The control laboratory strains M. tuberculosis H37Rv and M. tuberculosis H37Ra contrasted sharply in their induced specific MP lysis (93.35 and 5.93%, respectively).