[Modern approaches to studying the molecular mechanisms of lung functioning in normal and pathological conditions]. / Sovremennye podkhody k izucheniyu molekulyarnykh mekhanizmov funktsionirovaniya legkikh v norme i pri patologii.

Problems with breathing and lung function are caused by the development of various lung diseases associated with lifestyle, harmful environmental factors and genetic predisposition. Knowledge of the molecular mechanisms of the development of the pathological process will allow on time identification of the disease or the development of targeted therapy. The article provides an overview of modern methods that make it possible to most accurately reproduce the structural, functional and mechanical properties of the lung (organ-on-a-chip), to perform non-invasive molecular studies of biomarkers of bronchopulmonary pathology using saliva diagnostics, as well as using DNA and RNA aptamers, verify tumor markers in biological samples of human tissue. Analysis of alterations in the pattern of protein glycosylation using glycodiagnostic methods makes it possible to detect lung cancer in the early stages.

[Right upper lobe pulmonary sequestration as a rare cause of recurrent spontaneous pneumothorax]. / Sekvestratsiya verkhnei doli pravogo legkogo ­ redkaya prichina pravostoronnego retsidiviruyushchego spontannogo pnevmotoraksa.

A 19-year-old patient after previous wedge resection of the right upper pulmonary lobe a year ago urgently admitted with recurrent right-sided spontaneous pneumothorax. According to standard management of spontaneous pneumothorax, we performed diagnostic thoracoscopy and drainage of the right pleural cavity with regular X-ray examinations. However, these measures were ineffective. The patient was scheduled for surgery, and we intraoperatively observed an unusual cause of pneumothorax. Thus, we present spontaneous pneumothorax following right upper lobe pulmonary sequestration. The uniqueness of this case is associated with unusual manifestation and non-standard localization of rare lesion. A few cases of pneumothorax in similar patients are described in the world literature. The key limiting factor in diagnosis of such defects (identification of aberrant vessel supplying abnormal lung parenchyma) is the lack of routine CT angiography in patients diagnosed with pneumothorax. That is why CT changes were interpreted as postoperative ones, and the true cause was established only during redo surgery. A thorough inspection of the pleural cavity and alertness regarding unusual appearance of the right upper pulmonary lobe made it possible to suggest a non-standard diagnosis, avoid complications (bleeding from afferent vessel) and perform adequate lung resection.

Organized Structure of Ventricular Fibrillation during Prolonged Heart Perfusion in Dogs.

The aim of the study was to identify the organized ventricular fibrillation (VF) activity in the dog heart and characterize its quantitative parameters during prolonged heart perfusion. MATERIALS AND METHODS: A total of four experiments on isolated dog's hearts perfused with the blood of a supporting dog were performed. Episodes of VF were recorded in the form of an electrogram followed by a spectral analysis by the fast Fourier transform in the range of 0.5-15 Hz. The frequency, spectral power (amplitude), and relative weight (%) of the 1st, 2nd, and 3rd highest amplitude oscillations were determined (frequency - mode; amplitude, relative weight - M±SEM; n=120). RESULTS: In the perfused dog heart, VF was characterized by an organized activity, as evidenced by the dominant structure of the oscillation frequencies. Oscillations with a frequency of 9-10 Hz (occurring in 1/10 of the 0.5-15 Hz range) represent 42-44% of the spectral power and dominate the structure of the oscillation frequencies. The frequency and spectral power of the dominating oscillations proved to be stable thus indicating that under perfusion, VF did not cause disturbances in the heart organized activity. CONCLUSION: Our experimentation with isolated perfused hearts revealed the patterns of VF that could not be revealed in situ under conditions complicated by nerve factors and ischemia in VF. The results of the work are protected with a patent which is applicable for VF diagnosis in implantable defibrillators.

[Morphological characteristics of pulmonary tuberculosis concurrent with lung cancer]. / Morfologicheskie osobennosti sochetaniya tuberkuleza i raka legkikh.

The pathogenetic relationship between pulmonary tuberculosis and lung cancer in their concurrence is now still the subject of discussion. OBJECTIVE: To study the pathogenetic relationship between pulmonary tuberculosis and lung cancer. MATERIAL AND METHODS: The investigators examined surgical material from 51 patients (41 men) aged 41-73 years (mean age, 63.7 years) with pulmonary tuberculosis concurrent with lung cancer. They also studied tumors, tuberculous caverns, infiltrates, and foci with surrounding macroscopically intact lung tissue, as well as fibrotic changes by histological, histochemical and immunohistochemical examinations. RESULTS: Previous tuberculosis can be considered as a risk factor for lung cancer. Central cancer was more common in patients with inactive, chronic tuberculosis with a predominance of fibrotic processes in the root of the lung and in its hilar zones. Fibrous-cavernous tuberculosis and cavernous tuberculosis were more frequently concurrent with central cancer; peripheral tumors mainly occurred in infiltrative tuberculosis and tuberculomas. CONCLUSION: The findings suggest that in a number of cases, cancer and tuberculosis may be anatomically close, developing in the same anatomical unit - the lung. However, this does not indicate an unambiguous etiopathogenetic relationship between pulmonary tuberculosis and lung cancer. The relationships between pulmonary tuberculosis and lung cancer are much more complex and do not fit into the simple scheme of cause-and-effect relations.

Interaction of ceruloplasmin, lactoferrin, and myeloperoxidase.

When lactoferrin (LF) and myeloperoxidase (MPO) are added to ceruloplasmin (CP), a CP-LF-MPO triple complex forms. The complex is formed under physiological conditions, but also in the course of SDS-free PAGE. Polyclonal antibodies to both LF and MPO displace the respective proteins from the CP-LF-MPO complex. Similar replacement is performed by a PACAP38 fragment (amino acids 29-38) and protamine that bind to CP. Interaction of LF and MPO with CP-Sepharose is blocked at ionic strength above 0.3 M NaCl and at pH below 4.1 (LF) and 3.9 (MPO). Two peptides (amino acids 50-109 and 929-1012) were isolated by affinity chromatography from a preparation of CP after its spontaneous proteolytic cleavage. These peptides are able to displace CP from its complexes with LF and MPO. Both human and canine MPO could form a complex when mixed with CP from seven mammalian species. Upon intravenous injection of human MPO into rats, the rat CP-human MPO complex could be detected in plasma. Patients with inflammation were examined and CP-LF, CP-MPO, and CP-LF-MPO complexes were revealed in 80 samples of blood serum and in nine exudates from purulent foci. These complexes were also found in 45 samples of serum and pleural fluid obtained from patients with pleurisies of various etiology.

One-stage allotransplantation of thoracic segment of the trachea in a patient with idiopathic fibrosing mediastinitis and marked tracheal stenosis.

The authors observed a 24-year-old female with idiopathic fibrosing mediastinitis affecting the thoracic segment of the trachea and producing marked stenosis. Taking into consideration the common occurrence of cicatricial stenosis and the inefficacy of its conservative treatment, an attempt at one-stage allotransplantation of the trachea with omentopexy of the graft and the lines of anastomosis was made. In spite of immunosuppressive therapy (cyclosporine and azathioprine), signs of rejection appeared on the 10th postoperative day, which were arrested by antithymocyte globulin and loading doses of corticosteroids. Subsequently, the condition of the patient became stable. By the end of the 2nd month the graft appeared vital, its lumen being about 10 mm, the lines of anastomoses were epithelialized. Four months after operation signs of the graft stenosis appeared, possibly caused by progressive fibrosing mediastinitis. Because of this complication a silicon stent was used for the prophylaxis of further graft stenosis. This satisfactory result of tracheal allotransplantation is thought to be related to adequate selection of the donor-recipient pair, modern immunosuppressive therapy and utilization of omentopexy for early graft revascularization.