[Prospective analysis of inflammatory markers and perioperative clinical data in children with craniosynostosis undergoing reconstructive surgery]. / Prospektivnyi analiz dinamiki laboratornykh markerov vospaleniya i klinicheskoi kartiny perioperatsionnogo perioda pri rekonstruktivnykh operatsiyakh u detei s kraniosinostozami.

BACKGROUND: Craniosynostosis (CS) is a group of skull malformations manifested by congenital absence or premature closure of cranial sutures. Reconstructive surgery in the second half of life is traditional approach for CS. The issues of surgical stress response after reconstructive surgery for CS in children are still unclear. OBJECTIVE: To evaluate clinical and laboratory parameters in children undergoing traumatic reconstructive surgery for CS. MATERIAL AND METHODS: Inclusion criteria were CS, reconstructive surgery, age <24 months, no comorbidities and available laboratory diagnostic protocol including complete blood count, biochemical blood test with analysis of C-reactive protein, procalcitonin, ferritin and presepsin. The study included 32 patients (24 (75%) boys and 8 (25%) girls) aged 10.29±4.99 months after surgery between October 2021 and June 2022. Non-syndromic and syndromic forms of CS were observed in 25 (78.1%) and 7 (21.9%) cases, respectively. RESULTS: There were no infectious complications. We analyzed postoperative clinical data, fever, clinical and biochemical markers of inflammation. CONCLUSION: Early postoperative period after reconstructive surgery for CS in children is accompanied by significant increase of inflammatory markers (C-reactive protein, procalcitonin, ferritin). However, these findings do not indicate infectious complications. This is a manifestation of nonspecific systemic reaction. Severity of systemic inflammatory response syndrome with increase in acute phase proteins indicates highly traumatic reconstructive surgery for CS in children. Analysis of serum presepsin allows for differential diagnosis between infectious complication and uncomplicated course of early postoperative period.

[Difficulties in differential diagnosis of sagittal synostosis (scaphocephaly)]. / Trudnosti differentsial'noi diagnostiki sagittal'nogo sinostoza (skafotsefalii).

Craniosynostosis is characterized by congenital absence or premature closure of skull sutures. The most common form of craniosynostosis is synostosis of sagittal suture followed by scaphocephaly. There are some head deformities similar to scaphocephaly such as positional and constitutional dolichocephaly, etc. These patients have no sagittal suture synostosis. However, there are difficulties in differential diagnosis between these deformities and scaphocephaly. OBJECTIVE: To develop differential diagnostic criteria between dolichocephalic head deformities and true scaphocephaly following sagittal synostosis. MATERIAL AND METHODS: The study included 33 patients with dolichocephaly (25 (75.8%) boys and 8 (24.2%) girls) between December 2013 and August 2022. The inclusion criterion was available CT or ultrasound data confirming or excluding sagittal synostosis. Age of patients was 8.62±7.71 (1.77-36) months. We analyzed anamnestic, clinical and radiological data. Radiological data was compared with diagnostic findings in 20 patients with scaphocephaly. Both groups were comparable in age, gender and cranial index. RESULTS: We present clinical and radiological signs, as well as algorithm for differential diagnosis between scaphocephaly and dolichocephaly. CONCLUSION: There are objective difficulties in differential diagnosis between scaphocephaly following sagittal synostosis and dolichocephalic head deformities. In most cases, we cannot establish the cause of congenital forms of dolichocephaly. The most likely causes may be pre- and postnatal compressive and positional effects. Ultrasound of skull sutures is preferable for differential diagnosis between these abnormalities. Correction of dolichocephaly can be carried out according to aesthetic indications with individual cranial orthoses.

[Changes in adipokines in the blood of patients with the first episode of schizophrenia during treatment with haloperidol and risperidone]. / Izmenenie soderzhaniya adipokinov krovi u bol'nykh s pervym epizodom shizofrenii v protsesse terapii galoperidolom i risperidonom.

OBJECTIVE: To study plasma adipokines (adiponectin, leptin, adipsin) in patients with the first episode of schizophrenia treated with haloperidol and risperidone. MATERIAL AND METHODS: Two hundred and twelve patients with the first episode of paranoid schizophrenia (F20.09) were examined. Patients were divided into the haloperidol group (n=107) and the risperidone group (n=105). The control group included 132 healthy people. Body mass index was recorded at baseline and in 2, 4, 6, 8 week of treatment. Adiponectin, adipsin and leptin were determined by the multiplex analysis. Blood test was conducted prior to therapy and after 8 weeks of treatment. RESULTS: An increase in body mass index is recorded in both clinical groups, with no statistically significant differences between groups. Before treatment with antipsychotics, the levels of adiponectin and adipsin increase in both clinical groups. In the course of therapy, the levels of adiponectin and adipsin significantly increase in the haloperidol group and the levels of adiponectin and leptin in the risperidone group. CONCLUSION: The increase in body weight is not the only mechanism of changes in adipokines in blood during treatment with antipsychotics. Further studies on the relationship between the levels of adipokines and pharmacogenic metabolic disorders are required.

The physiological reaction of Siberian hamsters (Phodopus sungorus, Cricetidae) to chemical signals of perspective mating partners before and during courtship.

In this investigation we assessed the physiological reaction of hamsters in response to chemical signals from potential sexual partners, and also after a private meeting with them, which allowed us to ascertain the type of mating system for this species. The reception of olfactory signals led to an increase in peroxidase activity in the blood for both sexes, indicative of activity of a non-specific line of immune defense in recipients. The increase in blood cortisol level in response to the chemical signals of a partner was only observed in females. Males spent more time near samples of estrous females, with elevated levels of cortisol in the urine. In olfactory tests, an hour after grouping all the individuals in pairs there was a significant increase in blood peroxidase activity, which indicates the reaction of a non-specific link in the immune system of partners. This increase was greater in the pairs with a mutual preference. Females from these pairs demonstrated a substantial decrease in stress hormone levels in the plasma after an hour of mating in comparison to females prior to mating, and in non-preferred coupling.

[Circulating endothelial cells in patients with alcohol withdrawal syndrome (uncomplicated and complicated delirium)]. / Éndotelial'nye kletki, tsirkuliruiushchie v krovi bol'nykh alkogolizmom, pri sindrome otmeny alkogolia (neoslozhnennom i oslozhnennom deliriem).

AIM: To study the content of circulating endothelial cells in the blood of patients with alcohol withdrawal syndrome (uncomplicated and complicated delirium). MATERIAL AND METHODS: Thirty patients, aged from 18 to 40 years, with the diagnosis of 'alcohol withdrawal, uncomplicated' (F10.302) or 'alcohol withdrawal complicated by delirium' (F10.40) were examined in the acute state and after 2 weeks of therapy. The control group consisted of 22 normals. The content of circulating endothelial cells (CEC) in the blood was measured by flow-cytometry. RESULTS AND CONCLUSION: Significant changes in the CEC content were observed in alcohol withdrawal syndrome: a multiple increase in the number of CECs due to the CEC-Living subpopulation, the appearance of CEC-Dead, which characterized the pronounced damage to the endothelium; the compensatory growth of ECP (CD146+CD34+) and AEC (CD146+CD105+). Patients with uncomplicated abstinence after 2 weeks of therapy showed positive changes in the form of a decrease in CEC level due to the CEC-Living. The CEC level remained high in patients with alcohol delirium after 2 weeks of treatment, the decrease in the content CEC-Living with a significant growth CEC-Dead and a slight compensatory increase in ECP (CD146+CD34+) was observed.

[Microcirculation in patients with paranoid schizophrenia]. / Sostoianie mikrotsirkuliatsii u patsientov s paranoidnoi formoi shizofrenii.

AIM: To study microcirculation in patients with paranoid schizophrenia by laser Doppler flowmetry. MATERIAL AND METHODS: Fifty-three patients at the age from 18 to 38 years with a diagnosis of 'paranoid schizophrenia' (F20.0) were examined in the acute psychotic state and after 3 weeks of therapy. The control group consisted of 20 healthy volunteers. To assess microcirculation, the noninvasive technique of laser Doppler flowmetry using a laser blood flow analyzer was used. RESULTS AND CONCLUSION: Significant changes in the microcirculation persisting even over three weeks of therapy in patients were identified. The total microcirculation index was increased by 1.4 times which indicated the acceleration of blood flow. An increase in the average fluctuations of perfusion by 3.7 times and in the coefficient of variation by 1.9 times, which reflect the excessive strengthening of local mechanisms of regulation of microcirculation, were found. There were an increase in the myogenic tone and neurogenic tone of metarteriole and precapillary sphincters as well as bypass index.

[Modern diagnosis and treatment in children with congenital basal encephalocele]. / Sovremennye metody diagnostiki i lecheniia detei s vrozhdennymi bazal'nymi cherepno-mozgovymi gryzhami.

Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach. Two children had no surgery due to minimal symptoms and a lack of cerebrospinal fluid leak. RESULTS: Application of the algorithms for diagnosis and treatment of encephalocele, suggested by the authors, enabled making the timely diagnose, defining the optimal surgical tactics, and achieving good treatment results. CONCLUSION: A differentiated approach to the choice of a surgical technique for basal encephalocele, the use of auto-tissues for skull base reconstruction, intraoperative and postoperative lumbar drainage, and simultaneous elimination of deformity of the fronto-naso-orbital region enable avoiding complications and achieving good functional and aesthetic results.

[Endoscopic endonasal diagnosis and treatment of skull base meningoencephalocele]. / Éndoskopicheskaia éndonazal'naia diagnostika i lechenie meningoéntsefalotsele osnovaniia cherepa.

PURPOSE: The study purpose was to determine the successful outcome rate of endoscopic endonasal reconstruction of skull base CSF fistulas with removal of meningocele as well as analyze disease relapses. The second purpose of the study was to describe the treatment outcomes, depending on the type, location, and size of meningocele as well as on a technique used to reconstruct the skull base defect. MATERIAL AND METHODS: Three hundred and eleven patients diagnosed with cerebrospinal fluid (CSF) rhinorrhea who underwent surgery at the Burdenko Neurosurgical Institute in the period between 2007 and 2014 were retrospectively analyzed. Meningocele was detected in 141 (45.3%) of all patients with CSF rhinorrhea. The diagnosis was made before surgery and verified during endoscopic endonasal reconstructive closure of skull base defects. Therefore, the analysis group included all cases of meningocele and meningoencephalocele verified during surgery. The study analyzed the gender, age of surgery, follow-up period, comorbidities, use of lumbar drainage, etiology of the defect, localization, type of reconstructive material, complications, and disease relapses. We defined the efficacy of endoscopic endonasal meningocele resection with fistula reconstruction as the absence of signs of CSF rhinorrhea and a hernia sac based on the data of control CT and endoscopy performed in the late postoperative period. The follow-up period ranged from 1 month to 5 years. RESULTS: All patients underwent endoscopic endonasal reconstruction of the skull base defect. The treatment efficacy was 110 (78%) patients for primary surgery and 26 (84%) patients for repeated surgery. CONCLUSION: Endoscopic endonasal surgery is a safe, effective, and minimally invasive technique for treatment of meningocele and meningoencephalocele, which enables resection of a hernia sac and reconstruction of dura mater and skull base defects.

Use of primary human fetal chondroblast culture for xenotransplantation into rat articular cartilage defect.

The possibility of xenotransplantation of human fetal chondroblasts was studied. Filling of the rat articular cartilage defect with a tissue-engineering construction based on primary culture of human fetal chondroblasts and chitosan gel caused no immune rejection over 60 days and provided the formation of organotypical regenerate due to proliferation and differentiation of donor fetal chondroblasts and their integration in the recipient cartilage tissue.

Study of morphofunctional peculiarities of fibroblasts isolated from human vertebral growth plates during in vitro culturing.

We studied structural and functional peculiarities of growth zone chondroblasts isolated from human fetal spines on gestation week 12 and cultured in vitro over 4 passages. The morphology of chondroblasts of different differentiation degree was described. It was found that the population of chondroblasts had certain features determined by changes in the relative content of cells of different differentiation degree. The data suggest that culturing conditions affect cell differentiation and the possibility of using primary human chondroblast culture as the experimental model of differentiating human vertebral growth plate chondroblasts in vitro.

[Growth plate structure of the vertebral body in children of different age groups].

The purpose of this study was to investigate the regularities of formation and functioning of the structural components of the growth plate (GP) of the vertebral body in children during the postnatal period of ontogenesis: in newborns and in children aged 1, 3-5- 6-10- and 12-14-years. GP samples of were studied using histological, histochemical (demonstration of oxidation-reduction enzyme activity, polysaccharides, glycosaminoglycans) and electron microscopic methods with special reference to the age changes of the cells and matrix in different GP zones of the vertebral body. The process of chondrogenic differentiation is described, which includes the successive stages of cellular modifications starting from an undifferentiated chondroblast through a highly differentiated chondrocyte to a degrading and dying chondrocyte. The changes in synthetic activity of cartilage cells are noted as well as the nature of matrix components that are produced by them in the course of differentiation. Regular age-related changes of spatial distribution of mitotically active cells, forming cellular columns, and of isogenous groups are characterized in relation to the alterations of matrix quantity and chemical content in GP of the vertebral body.

[Effect of truncal subdiaphragmatic vagotomy on the pain syndrome in patients with chronic recurrent pancreatitis]. / Vliianie stvolovoi poddiafragmal'noi vagotomii na bolevoi sindrom u bol'nykh khronicheskim retsidiviruiushchim pankreatitom.

Truncal subdiaphragmatic vagotomy with pyloroplasty was used in 28 patients with chronic relapsing pancreatitis, 19 of them were inclined to alcohol abuse. In 27 patients followed-up during 3 years, 18 were delivered from pain attacks resulting from chronic pancreatitis, the attacks became rarer and less intense in 4 patients, 3 patients had single attacks of pancreatic colic. In 2 patients the results of treatment were assessed as unsatisfactory due to often admission to the hospital for pain attacks. They were not found to have increased excretory and endocrine insufficiency of the pancreas in this period, but had mental disorders.