[Formation of digestive tract microflora of neonates in dynamics].

AIM: Comparative study of the microbiota of neonates in relation to vaginal and intestinal microflora state of conditionally healthy primipara pregnant women. MATERIALS AND METHODS: Bacteriological study of vaginal and intestinal microflora of 24 conditionally healthy primipara pregnant women at week 32 and 38 of pregnancy as well as bacteriological study of meconium and feces at day 5 of their neonates was performed. RESULTS: Despite detection of lactobacilli by delivery in all the pregnant women their quantity was significantly lower than normal. In colon microflora dysbiotic changes corresponding to grade 1 (46.7%) and 2 (53.3%) dysbacteriosis were detected. In 60.0% of cases of conditionally healthy neonates various microorganism species were isolated from meconium. At day 5 in feces of neonates at natural feeding lactobacilli (85.8%), bifidobacteria and escherichia (71.4% each), enterococci (100%) were detected. CONCLUSION: The course of dysbiotic changes in vagina and intestines of conditionally healthy pregnant women had subclinical level. Detection of microorganisms in meconium in conditionally healthy neonates could be explained by translocation mechanism.

[Microbial biocenoss in chronic purulent otitis media].

The objective of the present work was to study microflora in the middle ear of 100 patients aged from 30 to 70 years presenting with chronic purulent otitis media (CPOM) by microbiological and genetic (PCR) methods. An important role of persistence factors, pathogenicity, and microbial antibiotic resistance in the development of CPOM was demonstrated. The frequency of occurrence of herpes and papilloma viruses was estimated. The most common form of the mixed infection was two-component virobacterial associations (46.2%). Three-component associations of viruses with bacteria (Chlamydiae or Mycoplasmas) formed less frequently (34.6%). In 19.2% of the cases, yeast-like fungi of the genus Candida were identified in these associations.

Heterogeneity of glutamatergic and GABAergic release machinery in cerebral cortex: analysis of synaptogyrin, vesicle-associated membrane protein, and syntaxin.

To define whether cortical glutamatergic and GABAergic release machineries can be differentiated on the basis of the nature and amount of proteins they express, we studied the degree of co-localization of synaptogyrin (SGYR) 1 and 3, vesicle-associated membrane protein (VAMP) 1 and 2, syntaxin (STX) 1A and 1B in vesicular glutamate transporter (VGLUT)1-, VGLUT2- and vesicular GABA transporter (VGAT)-positive (+) puncta and synaptic vesicles in the rat cerebral cortex. Co-localization studies showed that SGYR1 and 3 were expressed in about 90% of VGLUT1+, 70% of VGLUT2+ and 80% of VGAT+ puncta; VAMP1 was expressed in approximately 45% of VGLUT1+, 55% of VGLUT2+, and 80% of VGAT+ puncta; VAMP2 in about 95% of VGLUT1+, 75% of VGLUT2+, and 80% of VGAT+ puncta; STX1A in about 65% of VGLUT1+, 30% of VGLUT2+, and 3% of VGAT+ puncta, and STX1B in approximately 45% of VGLUT1+, 35% of VGLUT2+, and 70% of VGAT+ puncta. Immunoisolation studies showed that while STX1A was completely segregated and virtually absent from VGAT synaptic vesicles, STX1B, VAMP1/VAMP2, SGYR1/SGYR3 showed a similar pattern with the highest expression in VGLUT1 immunoisolated vesicles and the lowest in VGAT immunoisolated vesicles. Moreover, we studied the localization of STX1B at the electron microscope and found that a population of axon terminals forming symmetric synapses were STX1B-positive.These results extend our previous observations on the differential expression of presynaptic proteins involved in neurotransmitter release in GABAergic and glutamatergic terminals and indicate that heterogeneity of glutamatergic and GABAergic release machinery can be contributed by both the presence or absence of a given protein in a nerve terminal and the amount of protein expressed by synaptic vesicles.

Heterogeneity of glutamatergic and GABAergic release machinery in cerebral cortex.

We investigated whether cortical glutamatergic and GABAergic release machineries can be differentiated on the basis of the proteins they express, by studying the degree of co-localization of synapsin (SYN) I and II, synaptophysin (SYP) I and II, synaptosomal-associated protein (SNAP)-25 and SNAP-23 in vesicular glutamate transporter (VGLUT) 1-, VGLUT2- and vesicular GABA transporter (VGAT)-positive (+) puncta in the rat cerebral cortex. Co-localization studies showed that SYNI and II were expressed in approximately 90% of VGLUT1+, approximately 30% of VGLUT2+ and 30-50% of VGAT+ puncta; SYPI was expressed in approximately 95% of VGLUT1+, 30% of VGLUT2+, and 45% of VGAT+ puncta; SYPII in approximately 7% of VGLUT1+, 3% of VGLUT2+, and 20% of VGAT+ puncta; SNAP-25 in approximately 94% of VGLUT1+, 5% of VGLUT2+, and 1% of VGAT+ puncta, and SNAP-23 in approximately 3% of VGLUT1+, 86% of VGLUT2+, and 22% of VGAT+ puncta. Since SYPI, which is considered ubiquitous, was expressed in about half of GABAergic axon terminals, we studied its localization electron microscopically and in immunoisolated synaptic vesicles: these studies showed that approximately 30% of axon terminals forming symmetric synapses were SYPI-negative, and that immunoisolated VGAT-positive synaptic vesicles were relatively depleted of SYPI as compared with VGLUT1+ vesicles. Overall, the present investigation shows that in the cerebral cortex of rats distinct presynaptic proteins involved in neurotransmitter release are differentially expressed in GABAergic and in the two major types of glutamatergic axon terminals in the cerebral cortex of rats.

[Viral-bacterial-fungal associations in chronic tonsillitis in children]. / Viruso-bakterial'no-gribkovye assotsiatsii pri khronicheskom tonzillite u detei.

The microflora of palatal tonsils was studied in 84 children with chronic tonsillitis in comparison with that in the control group of 38 healthy children. In most of the sick children viral-bacterial and less frequently viral-bacterial-fungal associations were detected with the prevalence of reo- and adenoviruses, Epstein-Barr viruses, coagulase negative staphylococci and Staphylococcus aureus, as well as peptostreptococci. Adhesive activity and persistence factors among the main bacterial pathogens were shown to be widely prevalent. The depth of the lesion of tonsillar tissue by the infective agents of bacterial and fungal nature, as well as their persistence potential, depended on the taxonomic position of these microorganisms.

[Videofluoroscopy study of swallowing in neurogenic dysphagia]. / Videofliuoroskopicheskoe issledovanie glotaniia pri neirogennoi disfagii.

Videofluoroscopy (VFS) was for the first time used for examining swallowing in 49 patients with nervous diseases. Disturbances in each phase of swallowing act are analyzed with evaluation of the time parameters and defects, causes of aspiration in neurogenic dysphagia are discussed, and cricopharyngeal insufficiency is described. Neurogenic dysphagia is characterized by a combination of disorders which determine the degree of dysphagia. The most severe swallowing disorders were observed in patients with multiple foci in the brain stem and in diphtheritic polyneuropathies. The authors conclude that VFS is the optimal method for the diagnosis of neurogenic dysphagia.

[The immuno-microbiological characteristics of the small intestine and the translocation of the enteral microflora in acute intestinal obstruction]. / Immuno-mikrobiologicheskaia kharakteristika tonkoi kishki i translokatsiia énteral'noi mikroflory pri ostroi neprokhodimosti kishechnika.

The complex examination of 72 patients with acute ileus (AI) of nontumor nature with different severity of endotoxicosis was carried out. The study revealed that AI was accompanied by deep suppression of the immunosecretory and motor evacuatory function of the small intestine, as well as by its pronounced bacterial contamination, mainly due to the significant quantitative prevalence of Gram-negative microflora. The combination of these factors played the key role in the increase of the permeability of the enteric barrier for symbiotic microflora and its massive translocation from the intestinal tract to the internal organs of the body (peritoneal exudate, portal bed), which directly correlated with the severity of endotoxicosis in AI patients. The deficiency of the barrier function of the liver was accompanied by the penetration of infective agents into the general blood stream, thus causing the development of endotoxic shock in AI patients. The analysis of the results thus obtained made it possible to determine the main ways for the elimination of intestinogenic intoxication in AI; they should be aimed at the bacterial decontamination of the small intestine, the restoration of its motor evacuatory and protective barrier functions, the liquidation of portal and systemic bacteremia, the correction of the functional deficiency of the liver.

[Portal and systemic bacteremia as a manifestation of the functional failure of the enteral barrier in acute intestinal obstruction]. / Portal'naia i sistemnaia bakteriemiia kak proiavlenie funktsional'noi nesostoiatel'nosti énteral'nogo bar'era pri ostroi neprokhodimosti kishechnika.

A complex investigation of 72 patients, with acute bowel obstruction (ABO) having clinico-laboratory signs and symptoms of endotoxicosis (ET), was carried out. It was proven that ABO was accompanied by profound decrease of the immuno-secretory function of the small bowel and its extensive bacterial contamination as a result of significant increase in the concentration of gram-negative symbiotic microflora, which leads to increased permeability of bowel barrier. Consequently there is massive translocation of the internal medium of the organism by enteral microflora and most of all in the portal zone and in the presence of inadequate hepatic barrier function--the systemic blood supply which corresponds to the clinical picture of endotoxic shock.

[Megabasilaris (a description of 15 cases and a review of the literature)]. / Megabaziliaris (opisanie 15 nabliudenii i obzor literatury).

The article deals with the clinical analysis of 15 cases in which angiography demonstrated an elongated and dilated basilar artery. The conditional normal width and length of this artery were determined from measurements on the angiograms in the control group. In megabasilaris the length of the artery was increased by 17% on the average and the width by 60-70% on the average. Megabasilaris causes most frequently sings of chronic vertebrobasilar insufficiency. A review of literature on this subject is presented. A conclusion is made that the setting apart of this rare vascular pathological condition as a nosological entity is substantiated.

[Regional cerebral blood flow and the infarct volume in obstruction of the internal carotid artery in relationship to the source of the collateral circulation]. / Regionarnyi mozgovoi krovotok i ob''em infarkta pri zakuporke vnutrennei sonnoi arterii v sootnoshenii s istochnikom kollateral'nogo krovoobrashcheniia.

The cerebral blood flow was examined by means of Obrist's 133Xe-inhalational method, cerebral angiography, and computer-aided tomography of the head in 100 patients with occlusion of the internal carotid artery. The findings obtained have revealed a correlation between the level of the compensatory collateral blood supply of the bed of the middle cerebral artery (MCA) and the source of collateral blood circulation. The authors have demonstrated the vulnerability of the MCA bed secondary to a low level of blood supply persisting despite the functioning of all pathways of the collateral circulation.

[Cerebral hemodynamics in stenoses of the internal carotid artery]. / Tserebral'naia gemodinamika pri stenozakh vnutrennei sonnoi arterii.

The cerebral hemodynamics was studied in 51 patients with varying severity of stenoses of the internal carotid artery (ICA) expressed in transient disorders of the cerebral blood flow or ischemic strokes. To study the cerebral blood flow (CBF), the authors used the 133Xe-inhalational method; in their analysis they also considered the findings of clinical, angiographic and computer-aided tomographic examinations, as well as the rheological parameters of the blood. It has been established that the main characteristics of the cerebral hemodynamics in patients with ICA stenoses are a moderate diffuse reduction of the CBF in both hemispheres of the brain without a clear-cut interhemispherical asymmetry, the absence of the dependence of the CBF on the degree of ICA stenoses, inverse correlation between the degree of the total narrowing of the lumen of all main arteries of the head and parameters of the CBF, as well as a sharper decrease in the CBF in cases where the total stenosis of the main arteries of the head exceeds 40%. The article deals with the pathogenesis of cerebral circulation impairments in ICA stenoses and the selection of the tactics of treating patients.

[Methods of angiography and cerebral blood flow determination in evaluating the status of the collateral circulation]. / Metody angiografii i opredeleniia mozgovogo krovotoka v otsenke sostoianiia kollateral'nogo krovosnabzheniia.

It is a known fact that the value of the cerebral blood flow (CBF) in the hemisphere where the internal carotid artery (ICA) is occluded may serve as a quantitative parameter of the collateral blood supply (CBS). Comparison of the findings obtained by cerebral panangiography (CPAG) versus inhalational studies of the CBF in 38 patients with occluded ICA has demonstrated that although CPAG is quite adequate for assessing the status of the collateral blood circulation routes, a more optimal method for evaluating the status of the CBS is measurement of the CBF since in at least half the cases CPAG yields inaccurate information about the CBS in patients with impaired cerebral blood circulation. The studied methods are not competitive but should be used in conjunction for obtaining the most complete information about the cerebral hemodynamics which is particularly important to consider in making decisions about the advisability of surgical intervention.

[Evaluation of the function of extracranial-intracranial microarterial anastomoses in occlusive diseases of the main arteries of the head (Doppler and angiographic study)]. / Otsenka funktsii ékstraintraktranial'nykh mikroarterial'nykh anastomozov pri okkliuziruiushchikh porazheniiakh magistral'nykh arterii golovy (doplero- i angiograficheskoe issledovanie).

The comparison of the results of Doppler and angiographic examinations of 82 patients with combined occlusive disorders of the major arteries of the head before and after creating an extra-intracranial microarterial bypass showed a high informative value of Doppler sonography as a noninvasive method of the diagnosis of impairments of the cerebral arteries and as a method of control of microarterial anastomosis functioning. Placement of a microanastomosis between the external carotid and middle cerebral arteries eliminated or reduced the steal-phenomenon in relation to the brain or vertebral-basilar bed in combined lesions of the major arteries of the head.

[Hemodynamic risk factors of secondary brain infarcts in patients with occlusion of the internal carotid artery]. / Gemodinamicheskie faktory riska povtornykh infarktov mozga u bol'nykh s zakuporkoi vnutrennei sonnoi arterii.

Study of the cerebral hemodynamics in 52 patients with occlusion of the internal carotid artery made it possible to ascertain the factors responsible for a bilateral decrease in the cerebral blood flow. The identification of the causes of a decreased cerebral blood supply in this pathology may contribute to timely rational treatment of patients and to reducing the risk of repeated cerebral infarction.

[Criteria for the activity of the pathologic process in multiple sclerosis (clinico-computer tomographic correlations)]. / O kriteriiakh aktivnosti patologicheskogo protsessa pri rasseiannom skleroze (kliniko-komp'iuterno-tomograficheskie sopostavleniia).

Eight patients with the clinical signs of disease exacerbation were examined using computer-aided tomography of the head with contrast intensification. In 4 patients with a clinical aggravation expressed in the appearance of new neurological symptoms the authors obtained an effect of contrast intensification. Routine examination of the zones of the white substance revealed drug accumulation in the zones of both subnormal and normal density. There was no drug cumulation in 4 patients whose clinical aggravation was connected with the previous neurological symptomatology. The data obtained are discussed.

[Electroencephalographic and computer-tomographic correlations in cerebral circulatory disorders]. / Elektroéntsefalograficheskie i komp'iuterno-tomograficheskie sopostavleniia pri narusheniiakh mozgovogo krovoobrashcheniia.

The results of electroencephalographic (EEG) and computer-aided tomographic (CT) examinations were compared in order to specify the possibilities of EEG in the topical diagnosis in cases of the compromised cerebral circulation (a hundred patients had been studied). The CT and EEG findings were closely correlated (80%) when the focus was localized in the hemispheres; discrepancies were observed (20%) in cases of extensive haemorrhages, with blood invading the ventricular system, in cases of microfoci lying in the deep portions of the cerebral hemispheres and also when foci were present in both hemispheres. In cases of the trunk localization of the focus, the EEG and CT findings were correlated in only 37%. The discrepancies of the two methods predominantly concerned impairments of the lower portions of the trunk where the EEG technique proved more informative.