[Correlations between clinical features of bipolar affective disorder and serum concentrations of ANKRD12 gene product, coagulation factor XIII, and cadherin 5]. / Svyaz' kontsentratsii belka-produkta gena ANKRD12, XIII faktora koagulyatsii i kadgerina 5 v syvorotke krovi s klinicheskimi osobennostyami bipolyarnogo affektivnogo rasstroistva.

OBJECTIVE: To determine the serum concentrations of some proteins identified in the blood serum of patients with bipolar affective disorder (BD) and to evaluate the relationship of their concentrations with clinical characteristics of BD. MATERIAL AND METHODS: Protein concentrations of cadherin 5, coagulation factor XIII and ANKRD12 gene product in the blood serum of patients with BD and healthy individuals were determined using commercial ELISA kits. The severity of current depression and the main clinical manifestations of BD were assessed by SIGH-SAD and CGI upon admission to the hospital before the prescription of therapy. Data analysis was carried out using the Kruskal-Wallis and Mann-Whitney tests. RESULTS: Comparison between subgroups of BD patients, selected in accordance with the current affective episode (hypomanic, manic, depressive and mixed), and control group by the Kruskal-Wallis test has shown the significant difference in ANKRD12 protein product concentration (p=0.0448). When comparing pairwise each subgroup with the control group, the significant difference in ANKRD12 product concentration was found only in the case of a subgroup of BD patients with current depressive episode (Mann-Whitney test, p=0.006). Pairwise comparison of the ANKRD12 product concentrations in subgroups of BD patients with different disease duration (<5 years, 6-10 years, and >11 years) and in the control group by the Mann-Whitney test has revealed significant differences (p=0.04, p=0.01, p=0.02, respectively), the maximum protein concentration was found in patients with disease duration >11 years. Significant negative correlation of cadherin 5 concentration with the severity of atypical depressive symptoms assessed by SIGH-SAD (r=-0.69, p=0.038) and the decrease in cadherin 5 concentration in BD patients with greater severity of the current depressive episode were revealed. Significant negative correlation was found between factor XIII concentration and CGI scores (r=-0.62, p=0.032). CONCLUSION: The results indicate a possible link of the studied proteins with BD pathogenesis. Further study of these proteins may contribute to the development of new therapeutic and diagnostic techniques.

[Transvesical correction of recalcitrant vesicourethral anastamotic stenosis with buccal graft fixed by automated V-LOC suture].

We present a clinical case of a patient with a post radical robot-assisted prostatectomy recurrent vesicourethral anastamotic stenosis. Successful simplified transvesical correction with buccal mucosa graft fixed by self-anchoring automated V-Loc suture through the needle for epidural anestesia without knot formation was the unique feature of case presented.

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications.

The aim of the investigation was to study the issue of making challenging decisions concerning abandonment or removal of non-infected superfluous leads during lead revisions or cardiac implantable electronic device upgrades. Materials and Methods: From 2010 to 2019, a total of 482 patients who had undergone cardiac implantable electronic device implantation in the past were admitted to hospital for generator replacement or lead revision. In 126 patients, 155 malfunctioning leads were found. Mean age of the patients was 59.2±16.7. Total venous occlusion was found in 10 cases of these patients. All patients were divided into two groups: extracted leads group (n=83) and abandoned leads group (n=43). The main factor which influenced our strategy was the mean age of the lead. In group 1 the mean age of the lead was 6.9±5.6 years. In group 2 it was about 12 years. Results: Lead extraction was performed by manual traction in 69 (61.7%) leads, by lead locking device in 32 (28.5%) leads, and 11 (9.8%) leads were removed using TightRail rotating dilator sheath. In 1 case of total occlusion of the superior vena cava, we performed a video-assisted thoracoscopic lead extraction at the time of vein occlusion recanalisation and electronic device reimplantation. In abandoned leads group 3 patients had lead-related complications. Conclusion: Transvenous lead extraction with the mean age of the lead less than 10 years is an effective and safe strategy. Preventive transvenous lead extraction of non-infected leads allows avoiding lead-related complications in the long-term period.

[Simultaneous laparoscopic bilateral nephrectomy as a preparation for kidney transplantation in patients with autosomal dominant polycystic kidney disease].

AIM: to study the possibility and safety of performing simultaneous bilateral laparoscopic nephrectomy in symptomatic patients with autosomal dominant polycystic kidney disease (ADPKD) as a preparation for kidney transplantation. MATERIALS AND METHODS: From May 2018 to September 2019, six symptomatic patients with end-stage renal disease caused by ADPKD, who had hemodialysis, underwent simultaneous bilateral laparoscopic nephrectomy. The mean vertical kidney size according to CT data was 211.67+/-37.15 mm, the mean horizontal size was 145.36+/-19.53 mm. In 5 cases, the hand-assisted procedure was performed. RESULTS: The average duration of the procedure was 225.1+/-40.37 minutes. Postoperative complications were recorded in 2 (33.2%) patients. The average length of stay was 8.83+/-2.13 days. There were no clinical manifestations of adrenal insufficiency. All patients are alive. In two patients, cadaveric kidney transplantation was performed after laparoscopic bilateral nephrectomy. CONCLUSION: Laparoscopic bilateral nephrectomy in patients with chronic renal failure associated with ADPKD is feasible, safe and is associated with a short length of stay. This procedure improves the quality of life of patients and facilitates subsequent kidney transplantation.

[The effectiveness and safety of Omnik OCAS in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia in the routine clinical practice in the Russian Federation (prospective multi-center observing program)].

AIM: To investigate changes in the IPSS after a six-month treatment with Omnic Ocas and its effect on the quality of life of patients in routine urological practice in the Russian Federation in a prospective, multicenter, observational study. PATIENTS AND METHODS: The study comprised 7000 patients with a verified diagnosis of lower urinary tract symptoms/benign prostatic hyperplasia who received Omnic Ocas (tamsulosin) administered by 700 urologists in various Russian medical institutions. The mean age of the patients was 63 years. The study program involved three visits. At the baseline visit, patients filled out the IPSS and EQ-5D-5L questionnaires, provided a blood sample for PSA, and underwent a digital rectal examination. At visits 2 and 3 scheduled at 3 and 6 months after visit 1 the patients were assessed for the outcomes of the prescribed therapy. RESULTS: During the 6-month treatment, the patients showed an improvement in the IPSS in the study's age groups. There was a gradual improvement in the storage and voiding symptoms subscale scores of the IPSS. The assessment of the EQ-5D-5L questionnaire results showed significant changes in the quality of life regarding various aspects of life. Adverse events were reported in 0.51% of patients during the study follow-up. CONCLUSION: The study findings suggest that Omnic Ocas is highly effective in all age groups of patients with LUTS/BPH and has a favorable safety profile.

[Lipid spectrum changes and ECG in patients with paranoid schizophrenia in the course of therapy with atypical antipsychotics].

OBJECTIVE: To study correlations between parameters of lipid metabolism and ECG in patients with schizophrenia in light of therapy with atypical antipsychotics. MATERIAL AND METHODS: We examined 42 patients with paranoid schizophrenia. All patients received atypical neuroleptics - seroquel, zyprexa, and rispolept. A group of controls included 25 healthy people. RESULTS: There was a significant increase (p=0.0002) in body mass (in average by 1.5 kg) in 88% patients. A significant increase in the concentration of serum triglycerides was identified as well. The concentration of VLDL in the patients with schizophrenia was 2 times higher compared to controls. After treatment, VLDL concentration increased even more considerably An increase in atherogenic index (AI) was up to 3.1 in patients with schizophrenia compared to 2.2 in controls. After treatment, Al increased up to 4 that demonstrated the high risk of development of atherosclerosis. A significant increase in QT interval in the ECG and heart rate (p=0.03) was revealed only in patients receiving rispolept. In patients receiving zyprexa and seroquel only heart rate was increased. CONCLUSION: The antipsychotics studied increase the risk of development of cardiovascular pathology.

[Antegrade endopyelotomy in the treatment of patients with pelvicoureteral segment stricture in combination with urolithiasis].

A total of 17 urolithiasis patients (12 males, 5 females aged 29-65 years, mean 47 +/- 8.2 years) with pelvicoureteral segment stricture (PUS) received percutaneous surgical treatment in the clinic of urology and surgical andrology from 2005 to 2009. The treatment consisted in endopyelotomy combined with nephrolithotomy and/or contact lithotripsy. Bilateral concrements were detected in 4 (23.5%) patients. Of them, 1 (5.9%) had PUS strictures in both kidneys. Good short-term results were achieved in 14 (82.4%) patients, satisfactory results - in 2 (11.8%) patients, unsatisfactory - in 1 (5.9%) patient. After long-term follow-up examination (mean follow-up 14 months after the operation) of all 17 patients it was found that 14 (82.4%) patients improved PUS condition (by the data of excretory urography and multislice computed tomography). Urological complaints were absent in 16 (94.1%) patients.

[Prognostic implications of GP3a glucoprotein gene PLA1/PLA2 allele in prostatic cancer: pilot results of the study].

We studied the role of integrins, primarily, the role of allele distribution of GP3a gene in development of prostatic cancer (PC) and assessment of its prognostic significance. From November 2003 to May 2004 we examined 32 patients with PC: 11 patients with local PC T1-2N0M0; 14 patients with locally advanced cancer T3N0M0 and 7 patients with invasive and/or metastatic cancer T3-4N10-1 or T3-4N0-1M1. The blood from all the patients we studied with PCR for alleles of GP3a gene, PSA. Seventeen patients were found to have alleles PLA1A1, 14(44%)--alleles PLA1A2, 1(3%)--alleles PLA2A2. Alleles PLA1A2 occurred significantly more often than in the population (p < 0.005). The group analysis has found that 8 patients with local PC had alleles PLA1A1, 3 patients--alleles PLA1A2 (27%). We discovered alleles PLA2A2, PLA1A1 and PLA1A2 in 1(7%), 5(36%) and 8(57%) patients with locally advanced PC, respectively. Among patients with metastatic and/or invasive prostatic cancer, there were 4 (57%) and 3 (43%) cases of alleles PLA1A1 and PLA1A2, respectively. Our study demonstrated influence of carriage of PLA2 allele on occurrence of PC risk (5-fold higher) and its invasive forms (10-fold higher and more). Probability to develop local invasion among patients with prostatic cancer--carriers allele PLA1A2 is 6 times higher than among carriers of alleles PLA1A1. A PC course in carriers of alleles PLA1A2 may be characterized by faster development of local invasion and metastasizing vs carriers of alleles PLA1A1. These findings can be used in design of nomograms for prognostication of invasion of clinically small tumors in verification of significance on greater number of the patients.

[Surgical correction of congenital arteriovenous aneurysms of the lungs]. / Khirurgicheskaia korrektsiia vrozhdennykh arteriovenoznykh anevrizm legkikh.

The authors have analyzed results of the surgical treatment of 24 out of 26 patients observed at the clinic for arterio-venous aneurysms of the lungs. It was found that the reduction of efficiency of the gas exchange function of the lungs before operation manifested itself by arterial and venous hypoxemia with an increased arterio-venous oxygen difference and pronounced decrease of blood oxygen strain. Good results of the operative treatment, rapid recovery of blood oxygenation, disappearance of hypoxemia symptoms make the surgical method the only radical one in treatment of such patients. The operation of choice was lobectomy. No lethal outcomes followed.