[Total laparoscopic retrieval of a cava filter: case series]. / Polnost'iu laparoskopicheskoe udalenie kava-fil'tra: seriia sluchaev.

Despite the fact that prevention and treatment of venous thromboembolic complications are based on anticoagulant therapy in cases where there are contraindications, complications, as well as in case of inefficiency of the carried out anticoagulant therapy, installation of a cava filter is indicated. The necessity of subsequent retrieval of this device from the inferior vena cava is associated with a potential risk of the development of complications. Analysed herein is a case series concerning management of 4 patients undergoing treatment from February 2015 to March 2017. Attempts of endovascular retrieval of the cava filter turned out unsuccessful. The patients were therefore subjected to total laparoscopic retrieval of the cava filter. The time required for phlebotomy, retrieval of the filter, and suturing of the phlebectomy zone ranged from 32 to 45 min. The maximal blood loss amounted to 300 ml, not requiring transfusion of blood preparations. Neither was required conversion to laparotomy in any case. No significant systemic or wound complications in the postoperative period were observed. A conclusion drawn is that in case of failed attempts at endovascular retrieval, given that a surgical team has broad experience in performing laparoscopic and angiosurgical operations, total laparoscopic retrieval of a cava filter may be considered a relatively safe minimally invasive method of managing the patient cohort concerned.

[Head surgery in the pictorial art of the past]. / Khirurgiia golovy v izobrazitel'nom iskusstve proshlogo.

PURPOSE: The study purpose is to explore the early history of head surgery in terms of artistic figures, based on authentic artistic artifacts of the past. MATERIAL AND METHODS: We performed a detailed analysis of many paintings, engravings, and illustrations for medical publications of the Middle Ages and Renaissance, which were definitely related to the early development of head surgery. RESULTS: The article summarizes a variety of illustrations that present the history of head surgery through images created by painters of the past, both recognized geniuses and those whose names have not been known to a non-specialist audience. Many artifacts are presented for the first time. CONCLUSION: We demonstrate that the art works reflect ideas of the past about life and death, causes of diseases, and their surgical treatment. At the same time, painters themselves, being an advanced part of the society, contributed to medicine, actively participating in the development of not only deontological norms but also people's attitudes to their health and to those who chose medicine as their profession. Their works enable modern doctors to imagine the first neurosurgeons of the past.

[Cryoablation in urology].

Modern science opens up new potentials for the effective treatment of complex diseases using minimally invasive techniques. One of the obvious achievements of recent years is cryoablation - technology of local freezing of tissues, allowing to create a precision zone of tumor cell death in renal cancer and prostate cancer. The literature review presents historical information, highlighting the main stages in the development of cryosurgery since the XIX century. The analysis of domestic and foreign literature has shown that in urological practice cryoablation has been widely used. Based on the literature data, indications, contraindications and complications of cryoablation in renal cancer and prostate cancer, as well as long-term results of treatment are discussed. Cryoablation has been used actively abroad; in the Russia, method is developing, but without a doubt, will be actively introduced in medical practice.

[The development and testing of a molecular biological test system for DNA detection of anthrax pathogen by real-time polymerase chain reaction assay].

The paper presents the results of the development and testing of a molecular biological test system for DNA detection of anthrax pathogen (Bacillus anthracis) by real-time polymerase chain reaction assay. The test system has shown high sensitivity, specificity, and reproducibility of results of analysis, as exemplified by aqueous suspensions of daily agar cultures of Bacillus anthracis strains, related and heterologous species of microorganisms, and clinical materials of experimental animals. There is evidence for the persistence of the basic characteristics of the test system when stored at 22 +/- 2 degrees C for 12 months.

[Validation of the modified algorithm for predicting host susceptibility to viruses taking into account susceptibility parameters of primary target cell cultures and natural immunity factors].

The paper presents results of testing a modified algorithm for predicting virus ID50 values in a host of interest by extrapolation from a model host taking into account immune neutralizing factors and thermal inactivation of the virus. The method was tested for A/Aichi/2/68 influenza virus in SPF Wistar rats, SPF CD-1 mice and conventional ICR mice. Each species was used as a host of interest while the other two served as model hosts. Primary lung and trachea cells and secretory factors of the rats' airway epithelium were used to measure parameters needed for the purpose of prediction. Predicted ID50 values were not significantly different (p = 0.05) from those experimentally measured in vivo. The study was supported by ISTC/DARPA Agreement 450p.

[Autoimmune processes after long-term low-level exposure to electromagnetic fields (the results of an experiment). Part 2. General scheme and conditions of the experiment. Development of RF exposure conditions complying with experimental tasks. Animal's status during the long-term exposure].

This paper describes the conditions for handling and exposure of experimental animals (Wistar rats) and methods used in the study of immunological effects of long-term low-level (500 microW/cm2) exposure to radiofrequency (2450 MHz) electromagnetic fields, performed under auspices of the World Health Organization.

[Comparative studies of microbial strains used in biotechnology for the elaboration of biosafety standards].

Comparative studies of different microbial strains used in biotechnology as potentially hazardous for human health agents demonstrated their ability to cause adverse effects such as toxicity, immunotropic action, sensitization, and alteration of normal intestinal microflora in rats. It was shown that certain microscopic fungi of genera Aspergillus, Penicillum, and Candida as well as some gram-negative bacteria can affect the immune system and disturb the balance of microflora in rat intestines. Actinomycetes were found to produce minimal adverse effects. These observations can be used to elaborate hygienic safety standards for the work with industrial microorganisms and thereby reduce or minimize the risk of occupational infection and immune disorders.

[Quantitative assessment of in vitro neutralizing activity of secretory factors from rat lungs against influenza virus].

Secretory factors were isolated by lung wash followed by centrifugation to remove cells, dialysis of supernatant to remove NaCl salt, lyophilization of the lavage fluid and resuspention of the lyophilization product in an isotonic NaCl solution. It was shown that biological activity of influenza virus /Aichi/2/68 (3N2) significantly decreased (p = 0,01) from 8,17 +/- 0,10 to 7,14 +/- 0,20 IgEID50/ml during its incubation with secretory factors at 37 degrees C for 1 hr and to 7,92 +/- 0,17 IgEID50/ml in isotonic NaCl solution in the absence of these factors. Their concentration in the incubation medium was estimated to be 9.1 +/- 0.7% of their level in the lungs.

[Genotyping of the Bacillus anthracis vaccine strains using the multiloci VNTR-analysis].

The genotyping variety of 5 known anthracis vaccine strains using 18 variable loci of the chromosomal localization taken from a microbe culture collection of 48 Research Institute of Ministry of Defense was revealed in the research. The stability of the VNTR-loci was shown to be inherited from the B. anthracis strains with common origin and an opportunity of their gene-identification application. The gene profile of each analyzed vaccine strain using every 18 polymorphic loci was determined and the amplification products were sequenced. The variation of electrophoretic mobility of the amplifiers was found to be caused by the presence of the replication elements with various numbers of copies in their structure.

[Composite phytoadaptogens in oncology and gerontology].

The article describes results of research devoted to Phytomix-40, a mixture of plant adaptogens. It focuses on immunobiological criteria for its formulation, chemical composition and manufacture procedures, biological standartization tests, in vitro and in vivo preclinical studies, clinical trials in patients with non-malignant tumours (benign prostatic hyperplasia), precancer (oral leukoplakia), advanced cancer (malignant gastric cancer), and age-related neurodegenerative disease (parkinsonism). Prospects for the development of other plant preparations for non-toxic prevention and treatment of cancer and prolongation of life span of the affected subjects are discussed.

[Comparative analysis of the susceptibility and productivity of respiratory tract target cells of mice and rats exposed to inflienza virus in vitro].

The levels of susceptibility to influenza virus A/Aichi/2/68 H3N2 and the virus yield were determined using primary cells of the trachea and lungs of CD-1 mice and Wistar rats, and for 3 sets of cells obtained from primary lung cells of the both species by centrifugation in the gradient of density and by sedimentation on a surface. The values of ID50 virus dose for 10(6) cells and virus yield per 1 infected cell determined for primary mice cells were 4.0+/-0.47 and 3.2+/-0.27 IgEID50 (lung cells), 3.8+/-0.17 and 3.3+/-0.20 IgEID50 (tracheal cells), and those determined for primary rat cells were 4.0+/-0.35 and 2.1+/-0.24 IgEID50 (lung cells), 3.7+/-0.27 and 2.2+/-0.46 IgEID50 (tracheal cells). The values of ID50 and yield measured for mixtures of cells obtained from primary lung cells by centrifugation in gradient of density and by sedimentation on a surface differed insignificantly (p = 0.05) from the values of the corresponding parameters measured for lung and tracheal cells for both rats and mice. The analysis of data on the variation of the concentrations of different cell types in the experimental cell mixtures shows that type 1 and 2 alveolocytes possess significantly lower (p = 0.05) susceptibility and productivity vs. ciliated cells of the both species. The investigation was conducted within the frame of the ISTC/DARPA#450p project.

[Microbiocenosis of parietal mucin in gastrointestinal tract of rats with induced disbiosis].

Comparative study of qualitative and quantitative characteristics of parietal mucin microbiocenosis in rats with alimentary induced disbiosis was performed. It has been shown that disbiosis was associated with changes in parietal microflora which were observed mainly in colon mucosa. Disbiosis in parietal area, in contrast to central area manifested by changes in quantitative characteristics of microbiocenosis. Results of the study allowed to suppose that parietal mucosal microbiocenosis was more stable than gut one and that this stability was determined by endogenous homeostatic factors of the host.

[A study of possibility to predict the sensitivity of different respiratory tract divisions to influenza].

To predict a potential value of a viral ID50 for a macro-organism of interest (e.g. humans), it is necessary to determine in vitro two parameters of the interaction of the virus with susceptible cells of the host, i.e. the probability of the virus' productive absorption on a susceptible cell and the average virus yield per cell. A different macroorganism (a model animal) and primary cells obtained from it can be used to determine the value of a scale factor, which accounts for the difference between the values of the probability of the virus' absorption measured in vivo and in vitro. An original mathematical model is used to convert the above-mentioned data to ID50 for the macroorganism of interest. It was shown that the method of cultivating influenza virus (A/ Aichi/2/68) in primary suspension culture of respiratory tract cells of rats and two breeds of mice may be used to estimate potential human susceptibility to novel influenza viruses. This work was sponsored by DAPRA, USA, and performed under the contract 450p to the International Science and Technology Center, Moscow.

[Microbiologicaland immunological criteria for estimation of ureaplasmosis treatment efficacy in women].

The role of surface and parietal vaginal microbiocenosis and immunoglobulins in development of infectious process, in prediction of resistance of causative microorganism to antibiotics and treatment efficacy was demonstrated on group of women with ureaplasmosis. Evaluation of anaerobic part of vaginal microbiota contemporary with its aerobic part reliably increased informative value of microbiological test in women with urogenital diseases. There are reasons to include interferon preparations into the complex therapy of ureaplasmosis.

[Ultrastructural and immunohistochemical characteristics of the mechanism of cardiomyocytic death in arrhythmogenic dysplasia of the right ventricle].

Right ventricular endomyocardial biopsy specimens from patients clinically diagnosed as having arrhythmogenic dysplasia of the right ventricle underwent electron microscopic and immunohistochemical studies. Myocardial fibrous fatty dysplasia was found in the semi-thin sections. The TUNEL immunohistochemic test revealed apoptotic nuclei in the cardiomyocytes. In the binucleated and trinuclated cardiomyocytes, one or two nuclei might be apoptotic, one or two others nuclei being intact. Electron microscopy identified the stages of movement of cardiomyocytic nuclei to the cell periphery as well as nuclear extrusion outside the cardiomyocytes. The cardiomyocytes themselves displayed pronounced vacuolization, mitochondrial destruction, accumulation of lipid inclusions and lysosome-like masses, and myofibrillar destruction.

[The role of regulatory cells CD4+CD25+ in the development of chronic infective diseases].

Regulatory T-cells CD4+CD25+Foxp3 (Treg) present a small subpopulation of CD4+ T lymphocytes, which develop in the thymus and are disseminated into peripheral lymphoid organs on the 3rd or the 4th day of the neonatal period. Treg play a decisive role in the pathogenesis of autoimmune diseases and the development of tolerance to transplantation antigens, regulate the immune response to allergens, and suppress antimicrobial immunity. Treg suppress proliferation as well as the cytotoxic effect and the secretion of Th1 and Th2 cytokines by effectory T lymphocytes, thus limiting the strength of the immune response of effectory T-cells, which makes them impossible to adequately control viral and bacterial infections. Recognition via antigen-presenting cells and the subsequent induction of the proliferation of antigen-reactive T and B lymphocytes, directed towards infectious agent elimination, is accompanied by the activation of regulatory T cells as well, which leads to immune response suppression; repeated microbial infections are not only able to strengthen T-cell immunity by generating memory T-cells, but can also strengthen the suppressive activity of endogenous T regulators CD4+CD25+. Moreover, T reg are capable of the direct recognition of a microbial product; these cells selectively express Toll-like receptors (TLR)-2, -4, -5, -7, and -8. Under normal conditions T reg are anergic, but are capable of direct proliferation in response to stimulation by TLR ligands, expressed on microbes and parasites. Treg removal enforces protective immune response to contagious microorganisms, including bacteria, viruses, and fungi, which leads to the elimination of pathogens from the host organism. The removal of Treg population will help to accomplish infectious pathogen elimination and diminish inflammation within a short period of time.

[Study of the influence of Staphylococcus aureus on gastrointestinal tract microbiocenosis in rats].

The authors studied the modifying effect of Staphylococcus aureus on the microbial composition of gastrointestinal tract microbiocenosis. The subjects were female rats in the condition of eubiosis or dysbiosis. The species and quantitative composition of the fecal microflora and the parietal mucin in different parts of the intestine were studied after an intragastral administration of St. aureus suspension. A single introduction of St. aureus into the gastrointestinal tract of rats led to the appearance of this microbe in the feces and parietal mucin in all the parts of the intestine regardless the initial condition of the intestinal microbiocenosis. The indigenous microflora, both in eubiotic and dysbiotic conditions, practically did not respond to an intragastral administration of staphylococcus, except a little decrease in the proportion of bifidobacteria. Meanwhile, there was a significant increase in the incidence of candid detection. The indigenous parietal microflora changed more substantially, which demonstrates a higher sensitivity of the parietal microbiocenosis to a short-time exposure to an exogenous microbial factor.

[Comparative evaluation of the safety of poly- and and oligoguanidines].

The antimicrobial activity and microenvironmental safety of poly- and oligoguanidine antiseptics were compared. E. coli and St. aureus test strains were found to be more sensitive to chlorohexidine bigluconate (CHB) upon a long (24 hour) exposure and to polyhexamethylene guanidine derivatives on short (30-second) contact. It is concluded that unlike polyguanidine antiseptics, CHB is more ecologically dangerous; when used for rapid disinfection, it can provoke impairment in the microenvironmental balance outside the area of application. The findings show it expedient to assess the microenvironmental safety of antimicrobial agents in order to prevent ecological catastrophes.