[Characteristics of postoperative cerebral dysfunction depending on the type and position of the implanted prosthetic heart valve]. / Osobennosti posleoperatsionnoi mozgovoi disfunktsii v zavisimosti ot tipa i pozitsii implantiruemogo proteza klapana serdtsa.

AIM: To study the prevalence and structure of postoperative cerebral dysfunction depending on the type and position of the implanted prosthetic heart valve in patients who underwent surgery for the acquired heart valve disease. MATERIAL AND METHODS: The study included 115 patients (70 men and 45 women; 64 [56; 72] years old), who underwent elective replacement or repair surgery for the acquired heart valve disease. RESULTS AND CONCLUSION: The postoperative cerebral dysfunction was diagnosed in 40.9% patients, including replacement in the aortic position (45.5%), in the mitral position (55%), in several positions (20%). Replacement surgery was accompanied by three clinical types of postoperative cerebral dysfunction and repair surgery - by deferred cognitive impairment only. Postoperative cerebral dysfunction after the replacement in the mitral position was more common (odds ratio 4.47, 95% confidence interval 1.21-18.35, p=0.041), including its acute clinical types - perioperative stroke and symptomatic delirium of the early postoperative period (p=0.029), compared to that after the repair heart valve surgery. After the replacement in the aortic position, acute clinical types of postoperative cerebral dysfunction were more common (p=0.036). After the replacement with biological prosthesis, symptomatic delirium of the early postoperative period was more common (p=0.047). The occurrence of the deferred cognitive impairment didn't depend on the type and position of the implanted prosthetic heart valve.

[Perioperative stroke in heart valve surgery: pathogenesis, clinical findings, diagnosis, prevention, treatment]. / Perioperatsionnyi mozgovoi insul't v khirurgii klapanov serdtsa: patogenez, klinika, diagnostika, lechenie i profilaktika.

AIM: To study risk factors, characteristics of clinical symptoms and diagnosis, and possibilities of prevention of perioperative stroke and other clinical types of cerebral dysfunction in main types of heart valve surgery. MATERIAL AND METHODS: The study included 83 patients, aged 63 (54; 70) years, undergoing heart valve surgery with cardiopulmonary bypass. RESULTS: Postoperative cerebral dysfunction was diagnosed in 37.3% of cases, including perioperative stroke in 3.6% of cases. In cases of aortic stenosis, the frequency of perioperative stroke was 9.5%. The cardioembolic subtype of perioperative ischemic stroke in cardiac valve surgery was most likely. The risk factors of the symptomatic delirium of the early postoperative period are: age over 75 years, preoperative frontal dysfunction, duration of artificial respiratory care more than 20 hours after the surgery. CONCLUSION: The results suggest the efficacy of preventive use of cytoflavin for reducing the frequency and severity of perioperative stroke and symptomatic delirium of the early postoperative period in heart valve surgery with cardiopulmonary bypass.

[Modern strategies of protection of hypoxic-ischemic brain damage]. / Sovremennye strategii zashchity pri gipoksicheski-ishemicheskom povrezhdenii golovnogo mozga.

Nowadays, there are two complementary approaches to treatment of patients with ischemic stroke: reperfusion and neuroprotection. The main purpose of neuroprotection is to intervene ischemic cascade at every stage of the pathological process and thus avoid the death of nerve cells and expand the therapeutic window for reperfusion therapy. The use of drugs with neurotrophic, antioxidant and neuroregenerative effects is pathogenically explained at all stages of post stroke rehabilitation. Ethylmethylhydroxypyridine succinate (mexidol) is a derivative of succinic acid with antihypoxic, membrane protective, nootropic, anticonvulsant and sedative action. The majority of researchers confirmed the positive effect of mexidol expressed as the marked regression of neurological deficit and wider opportunities for further early rehabilitation. The results of the randomized double blind multicenter placebo-controlled, parallel-group trial of the efficacy and safety of prolonged sequential therapy with mexidol in the acute and early recovery stages of hemispheric ischemic stroke (EPICA) were published in 2017. The results of the study showed the best positive dynamics of neurological function recovery in case of timely treatment with mexidol with the following two month therapy. The safety of the long-term use of mexidol was confirmed.

[Characteristics of the regulation of neurotrophic mechanisms in ischemic stroke].

AIM: To explore the endogenous and pharmacological activation of neurotrophic mechanisms in a model of brain ischemic lesion in rats. MATERIAL AND METHODS: The study was performed on 170 male albino rats (195-205 g). The model of ischemic stroke was accomplished by the electrocoagulation of the proximal segment of the left middle cerebral artery and simultaneous permanent ligation of the left common carotid artery. RESULTS AND CONCLUSION: The evaluation of NSE, NO, VEGF, NGF levels in the brain cytoplasmic lysate and plasma showed the delayed activation of neurotrophic mechanisms in astrocytes accompanied by a decrease in delayed alteration of neurons. The use of cytoflavin in the treatment of stroke was accompanied by the earlier and more intense activation of neurotrophic mechanisms in astrocytes, delayed activation of neurotrophic mechanisms in endothelial cells, which promoted neuroprotection in acute ischemic stroke.

[Brugada Syndrome: Possibilities of the Use of Noninvasive Electrocardiographic Mapping].

Patient P., 50 years old, male, with type I Brugada syndrome was examined. The patient had aborted sudden death event (2006) in his clinical history, ICD Gem III VR was implanted in 2006, ICDLumax DR was reimplanted in 2012. The patient had coved type pattern in right precordial ECG-leads. The p.E553X mutation in SCN5A gene, whish encodes the sodium channel -subunit, was found. Noninvasive electrocardiographic mapping was performed. Significant changes of local unipolar electrograms including QRS fragmentation, ST segment elevation and late ventricular potentials were identified in the epicardium of the right ventricle outflow tract. Thus, the presented case demonstrates that noninvasive electrocardiographic mapping methodology allows to determine and visualize arrhythmogenic substrate.

Detection and quantification of human herpes viruses types 4-6 in sperm samples of patients with fertility disorders and chronic inflammatory urogenital tract diseases.

Acute and chronic infections of the seminal tract are among the most common causes of male infertility. As at least half of male infertility cases are classified as idiopathic, some of these cases might be attributed to asymptomatic infection. The detection and quantification of Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpes virus type 6 (HHV-6) DNA in semen samples were performed. A total of 232 patients were divided into five groups: (i) infertile men with varicocoele; (ii) men with idiopathic infertility; (iii) infertile men with chronic inflammatory urogenital tract diseases (IUTD); (iv) fertile men with IUTD and (v) men whose partners had a history of pregnancy loss. In the study population, the prevalence of viral DNA was 17.7, 3.4% for EBV, 5.2% for CMV, 6.5% for HHV-6, 0.43% for EBV + CMV, 0.87% for EBV + HHV-6 and 1.3% for CMV + HHV-6. The median viral loads for EBV, CMV and HHV-6 were 500, 2250 and 250 copies/mL respectively. Of the sperm cell fractions, derived from infected samples 87.5% contained viral DNA. No association between EBV and fertility disorders or IUTD was found. CMV detection was much higher in the group of patients with infertility and concomitant IUTD compared with the other groups combined (18.5% vs. 5.4%, p = 0.03) and associated with reduced sperm cell count (39.5 × 10(6) /mL vs. 72.5 × 10(6) /mL, p = 0.036). Immunostaining of spermatozoa from infected samples and in vitro-infected cells detected CMV in sperm heads, tails and connecting pieces and revealed attachment to sperm membrane and intracellular localization. HHV-6 was the more common in fertile men with chronic IUTD than in the other groups combined (19% vs. 6.3%, p = 0.018) and had no effect on sperm parameters. The results suggest that both CMV and HHV-6 may contribute to the aetiology of IUTD and, moreover, CMV-associated IUTD can lead to male sterility.

Proteomic analysis of salicylate-induced proteins of pea (Pisum sativum L.) leaves.

The effect of 50 microM salicylic acid on soluble proteins of pea (Pisum sativum L.) leaves was studied by proteomic analysis. Thirty-two salicylate-induced proteins were found, and 13 of these were identified using MALDI TOF MS. Salicylate-induced increased content was shown for the first time for the family 18 glycoside hydrolase, alpha-amylase, 33 kDa protein of photosystem II, lipid-desaturase-like protein, and glutamine amidotransferase. Increased content of protective proteins of direct antipathogenic action such as chitinase and beta-1,3-glucanases was also noted.

Effect of jasmonic, salicylic, and abscisic acids on [(14)C]leucine incorporation into proteins of pea leaves.

All investigated exogenous phytohormones (jasmonic, salicylic, and abscisic acids) induced the appearance of (14)C-label in a polypeptide with molecular mass 29 kD that was not found in the control; these acids also increased [(14)C]leucine incorporation into a 25-kD polypeptide and decreased such incorporation into a 45-kD polypeptide. This can be considered as a nonspecific response of the plants to the action of these hormones. Salicylic and abscisic (but not jasmonic) acids induced the synthesis of a 19-kD polypeptide, and jasmonate induced the synthesis of a 96-kD polypeptide.

Enzymatic activity of aphroproteins.

Chitinase and proteinase activities were found in aphroproteins excreted by larvae of the cicada Aphrophora costalis Mats; this accounts for their fungicidal effect. Aphroproteins did not show DNase or RNase activities and did not exhibit properties of proteinase inhibitors. The data suggest that larval foam protects the larva and host plant from entomogenous and phytopathogenic fungi.

Central and cerebral hemodynamics and metabolism of the healthy man during head-down tilting.

Experiments on six healthy test volunteers, who underwent simultaneous catheterization of different cardiovascular compartments, were carried out to study the effect of head-down tilting at an angle of -20 degrees on the central and cerebral hemodynamics and metabolism. By the third hour of exposure, the test subjects showed a decrease in the systolic arterial pressure and increases in the systolic pressure of the right ventricle, heart rate, cardiac output, and oxygen intake. They also displayed a trend for an increase in the content of adenosine triphosphate, a decrease in the content of pyruvic acid, and essentially no changes in the concentration of lactic acid and activity of lactate dehydrogenase in the arterial blood and in the blood flowing out from the brain. The oxygen arteriovenous difference for the systemic and cerebral circulation decreased by 24% and 13%, respectively. The above circulatory and metabolic changes seem to reflect processes of adaptation of the human body to functioning under conditions of cephalad fluid shifts.

Discussion of the combined effect of weightlessness and ionizing radiation on the mammalian body: morphological data.

The combined effect of weightlessness and ionizing radiation, from the Cs137 source at 800 rads for 24 h, on the animal body was studied. The morphological examination of organs and tissues of rats flown aboard the biosatellite Cosmos-690, kept in the ground-based simulation experiment, and kept in the vivarium, indicated prevalence of radiation-induced changes in both experimental groups of rats. An exposure of animals to space flight factors did not produce a substantial aggravation of radiation-induced effects. This is indicated by the lack of significant differences in the weight of testes, thymus, and spleen of flight and simulation rats. However, this exposure affected adversely the development of reparative processes in the hemopoietic tissue of bone marrow. Inflight irradiation aggravated weightlessness-induced changes. A combined effect of weightlessness and irradiation did not result in the summation of the effects exerted on skeletal muscles by either factor alone.

Effect of space flight factors on the mammal: experimental-morphological study.

On the basis of a morphological examination of 27 rats that made a space flight and were sacrificed on the 1st-2nd and 26-27th days postflight, it has been shown that the 22-d space flight has produced no significant changes in the structural organization of vital organs of the animals. However, a space flight exposure is not indifferent for animals and leads to the development of morphologically visible changes in individual organs and systems (musculo-skeletal system, hemopoietic organs, hypothalamic-pituitary-adrenal system, renal juxtaglomerular system). The detected changes are reversible, nonspecific, and develop in animals exposed to ground-based hypokinetic and other stress experiments.