Inferior alveolar nerve preservation during resection and reconstruction of the mandible for benign tumors as a factor improving patient's quality of life.

This prospective study aimed to evaluate neurosensory disturbance and quality of life in patients who underwent mandibular resection for benign tumors and whose inferior alveolar nerve (IAN) was either preserved or sacrificed. Mandibular resection was indicated owing to the presence of osteoradionecrosis in 25 patients and ameloblastoma in 15 patients. Resection was unilateral in 24 patients and bilateral in 16 patients. The authors assessed the inferior alveolar nerve's sensory dysfunction by measuring the electroexcitability of skin receptors using an electro-odontometer. Study participants' quality of life was estimated with the oral health impact profile (OHIP)-14 and short-form (SF)-36 questionnaire. All the patients in whom the inferior alveolar nerve was sacrificed experienced persistent numbness in the area of innervation with mental nerve on the affected side. The average pain threshold reached preoperative levels (point 1-22.7 ± 2.5, p-value = .025; point 2-25.8 ± 2.7, p-value = .023) 6 months after the operation in patients in whom the IAN was preserved (point 1-23.7 ± 2.3, p-value = .022; point 2-25.4 ± 2.8, p-value = .025). The results of the OHIP-14 and SF-36 showed that patients with preserved IANs had a significantly better quality of life than the patients in whom the IAN was sacrificed. The results of OHIP-14 twelve months after the operation in unilateral resection: control group - 16.0 ± 1.6, p-value = .029; study group - 8.0 ± 0.8, p-value = .029, and in bilateral resection: control group - 26.0 ± 3.2, p-value = .044; study group - 9.0 ± 0.7, p-value = .027. The possibility of sparing the inferior alveolar nerve should not be ignored when planning mandibular resection and reconstruction.

[CHANGES IN BIOCHEMICAL MARKERS ASSOCIATED WITH AORTIC STENOSIS DEVELOPMENT IN PATIENT WITH AORTIC VALVE CALCIFICATION ACCORDING TO GENDER].

The study aimed at identifying the biochemical changes associated with formation of aortic stenosis in patients with aortic valve calcification according to gender. In 109 patients with aortic valve calcification revealed during echocardioscopy clinical (age, body mass index, smoking, arterial hypertension, coronary artery disease, diabetes mellitus), laboratory and instrumental (blood lipids, including lipoprotein (a) (LP(a)), apolipoproteins A and B, C-reactive protein (CRP), uric acid (UA), glomerular filtration rate, alkaline phosphatase, deoxypyridinoline (DPD), oxyproline, fetuine A, total and ionized calcium, bone mineral density) characteristics were assessed according to gender. Increased levels of LP (a) (0,45 (0,29; 0,64) versus 0,16 (0,09; 0,34) g/l, р=0,002), CRP (5,69 (5,35; 6,70) vs 3,11 (0,97; 4,61) mg/l, р=0,0003), UA (0,338 (0,250; 0,445) vs 0,275 (0,195; 0,335) mmol/l, р=0,068), total (29,6 (23,1; 36,2) vs 23,3 (20,7; 27,9) mcmol/l, р=0,005) and free (15,1 (13,0; 18,9) vs 12,5 (11,2; 16,5) mcmol/l, р=0,019) oxyproline, DPD (8,1 (7,2; 10,1) vs 4,5 (3,8; 6,3) Pyrid nmol/creatinine mmol, р<0,0001) and decreased level of fetuine A (27,6 (25,2; 29,4) vs 29,9 (27,8; 31,1) ng/ml, р=0,073) were revealed in patients with AS in man groups; and increased levels of total cholesterol (5,36 (4,88; 5,67) vs 5,0 (4,53; 5,31) mmol/l, р=0,066), triglycerides (1,92 (1,64; 2,45) vs 1,33 (1,18; 1,71) mmol/l, р=0,0001), CRP (6,31 (5,11; 8,42) vs 3,85 (3,24; 5,14) mg/l, р=0,0002), UA (0,372 (0,281; 0,407) vs 0,236 (0,141; 0,297) mmol/l, р=0,0007), total (25,1 (23,4; 27,9) vs 23,1 (20,4; 25,6) mcmol/l, р=0,011) and free (13,7 (12,8; 15,1) vs 12,1 (10,4; 13,6) mcmol/l, р=0,002) oxyproline, DPD (10,2 (8,6; 14,3) vs 8,1 (6,1; 10,9) Pyrid nmol/creatinine mmol, р=0,013) - in woman groups.

[Thermo- and photoinduced aggregation of alpha-crystallin].

Some properties of bovine alpha-crystallin, in particular its thermo- and photoaggregation, were studied by fluorescent spectroscopy of tryptophan residues and the probe 8-anilino-1-naphthalenesulfonate and light scattering. The effective diameter of a globule of native alpha-crystallin was 90 A, as estimated from the data on the polarization and lifetime of 8-anilino-1-naphthalenesulfonate using the Levshin-Perren equation, and increases at an aggregation of no less than 140 A. The increase in the intensity of tryptophan fluorescence of alpha-crystallin during its thermo- and photodenaturation with the formation of aggregates is due to local conformational changes in the surroundings of tryptophan residues and light scattering. Tryptophan residues are buried in the interior of the aggregates. The thermoaggregation of the protein occurs not only at high temperatures. By approximating the experimental time dependence of slow spontaneous aggregation to the range of large times, the time of denaturation aggregation t(e) was found. For alpha-crystallin (at a concentration of 0.8 mg/ml in phosphate buffer at pH 8.4), t(e) at 70 degrees C is 100 h. This approach can be used in finding t(e) for any protein during its thermal treatment or long-term storage.

[Minimally invasive technologies in the treatment of cholelithiasis in high surgical risk patients]. / Maloinvazivnye tekhnologii v lechenii zhelchnokamennoi bolezni u patsientov s vysokim operatsionnym riskom.

Using minimally invasive methods of sanitation of bile ducts in 456 patients with high operative risk reduced the number of postoperative complications to 11%, lethality to 1.3%. Two-stage treatment with surgical intervention by means of laparotomy was necessary in 124 patients. In this group of patients the frequency of complications was 32.3%, and lethality--4.8%.

[Use of perfluorane in surgical interventions on hollow organs under conditions of hemorrhagic shock (an experimental study)]. / Ispol'zovanie perftorana pri khirurgicheskikh vmeshatel'stvakh na polykh organakh v usloviiakh gemorragicheskogo shoka (éksperimental'noe issledovanie).

Experiments in dogs have shown expediency of using perfluorane for prevention of incompetence of anastomosis sutures when the formation of intestinal anastomosis occurs under conditions of massive blood loss.

Hydrophobic core malleability of a de novo designed three-helix bundle protein.

De novo protein design provides a tool for testing the principles that stabilize the structures of proteins. Recently, we described the design and structure determination of alpha(3)D, a three-helix bundle protein with a well-packed hydrophobic core. Here, we test the malleability and adaptability of this protein's structure by mutating a small, Ala residue (A60) in its core to larger, hydrophobic side-chains, Leu and Ile. Such changes introduce strain into the structures of natural proteins, and therefore generally destabilize the native state. By contrast, these mutations were slightly stabilizing ( approximately 1.5 kcal mol(-1)) to the tertiary structure of alpha(3)D. The value of DeltaC(p) for unfolding of these mutants was not greatly affected relative to wild-type, indicating that the change in solvent accessibility for unfolding was similar. However, two-dimensional heteronuclear single quantum coherence spectra indicate that the protein adjusts to the introduction of steric bulk in different ways. A60L-alpha(3)D showed serious erosion in the dispersion of both the amide backbone as well as the side-chain methyl chemical shifts. By contrast, A60I-alpha(3)D showed excellent dispersion of the backbone resonances, and selective changes in dispersion of the aliphatic side-chains proximal to the site of mutation. Together, these data suggest that alpha(3)D, although folded into a unique three-dimensional structure, is nevertheless more malleable and flexible than most natural, native proteins.

[The globule diameter and various electron and conformational properties of the flavoprotein fragment of mitochondrial NADH dehydrogenase studied by fluorescence spectroscopy]. / Diametr globuly i nekotorye élektronno-konformatsionnye svoistva flavoproteinovogo fragmenta mitokhondrial'noi NADH-degidrogenazy po dannym fluorestsentnoi spektroskopii.

The globule dimensions and some electron and conformational properties of the flavoprotein (peripheral) fragment of the mitochondrial NADH dehydrogenase were determined by the time-resolved, phase-modulating, and polarization fluorescence spectroscopies, as well as correlated confocal microscopy. The rotational and the diffusion (translocation) diameters of the protein fragment were shown to be no less than 44 A and approximately 72 A, respectively. The diameter of protomitochondrial particles from the bovine heart, which were used for the isolation of the fraction of peripheral fragments, was no less than 2300 A. The fluorescence from tryptophan and flavin fluorophores in the fragment is strongly quenched by iron of the iron-sulfur clusters, which suggests that a strong electron-vibrational interaction of iron with Trp residues and flavin takes place. An overlapping of the electron clouds of iron-sulfur clusters, Trp residues, and flavin is likely to facilitate the electron transfer through the protein. The heat inactivation of the enzyme was accompanied by neither its substantial conformational changes, nor a considerable release of iron ions from the clusters located near the Trp residues.

[Proliferation and death of thymocytes caused by phospholipase A2 activator--melittin]. / Proliferatsiia i gibel' timotsitov pri deistvii aktivatora fosfolipazy A2--melittina.

The effects of mellitin, a component of bee venom activating phospholipase A2, on proliferation and death of the rat thymocytes were studied in a wide concentration range. Cell proliferation was estimated by the accumulation of colchicine metaphases, Necrosis was estimated by cell lysis and Trypan blue staining. Apoptosis was estimated by the type of DNA fragmentation, amount of fragmented DNA, and percentage of cells with hypodiploid DNA set. Low concentrations of mellitin (below 5 micrograms/ml) stimulated proliferation. At higher mellitin concentrations, the thymocytes die by the primary necrosis type. Mellitin did not induce apoptosis in the thymocytes within the concentration range used: on the contrary, at high concentrations, it inhibited apoptosis of the thymocytes in the control and after irradiation. Actinomycin D, inhibitor of RNA synthesis, exerted no effect on the thymocyte death in the presence of mellitin. It has been concluded that activation of phospholipase A2 may induce necrosis, rather than apoptosis, and consequently, activation of phospholipase A2 is not a necessary step in the signalling cascade that initiated apoptosis in the thymocytes.

[Thymogen immunocorrection in the surgical treatment of complicated forms of cholelithiasis]. / Immunokorrektsiia timogenom pri khirurgicheskom lechenii oslozhnennykh form zhelchnokamennoi bolezni.

On the basis of experimental and clinical investigations the authors showed immunity depression in complicated forms of cholelithiasis. Thymogene appeared to be efficient for immunocorrection that permitted to lower the frequency of postoperative complications and lethality.

[25-year experience with early operations in acute cholecystitis]. / 25-letnii opyt primeneniia rannikh operatsiii pri ostrom kholetsistite.

The authors made an analysis of early operations on 6076 patients. This tactics used in 84.3% of the patients allowed to reduce postoperative lethality up to 2.5%.

[Clinically conditional variants of the immune response in viral hepatitis A and B in children]. / Klinicheski obuslovlennye varianty immunnogo otveta pri virusnykh gepatitiakh A i B u detei.

The immunity characteristics of the T-, B- and A-systems have been studied on the basis of the data registered in the dynamics of the acute period of the disease and several times in catamnesis during 6-12 months of the convalescence period in 217 children with viral hepatitis A and 99 children with viral hepatitis B. The clinical course of viral hepatitis A and that of viral hepatitis B have been found to have certain parallels in their development, as well as specific features of immune response, which can be subdivided into 3 main groups: (a) immunological imbalance, (b) the phase of immunodepression and (c) secondary immunodeficiency. The distinguishing of the variants of immune response and their clinical interpretation are of practical importance for the early prognostication of the course and outcome of the processes and for the differentiated approach to the treatment of viral hepatitides in children.