[Analysis of the effectiveness of various methods of rehabilitation of patients with subacromial impingement syndrome]. / Analiz effektivnosti primeneniya razlichnykh metodov reabilitatsii patsientov s subakromial'nym impindzhment-sindromom.

INTRODUCTION: Subacromial impingement syndrome is a common pathology that leads to a persistent decrease in the functioning of the affected limb and, as a consequence, a decrease in the quality of life and work ability of patients. According to various authors, the study of the effectiveness of treatment and rehabilitation of this pathology is quite widely presented in the literature: surgical, including arthroscopic operations, rehabilitation using various factors of physical therapy, manual and other practices. However, the issue of assessing the effectiveness of movement therapy, both alone and in combination with other therapeutic methods, remains relevant. AIM: To evaluate the effectiveness of therapeutic gymnastics procedures, both monotherapy and in combination with manual massage according to the therapeutic method and extracorporeal shock wave therapy (ESWT), in patients with subacromial impingement syndrome of the shoulder, in order to reduce pain and improve the function of the shoulder joint. MATERIAL AND METHODS: The study included 70 patients whose age was 42.18±10.42 years. Patients were divided into two main groups: group 1 (n=34) and group 2 (n=36). All patients received a course of treatment, including 10 procedures of therapeutic exercises, with recommendations at the end of the course for continuation in the form of independent studies using the proven methodology. The duration of the course of therapeutic exercises (in the form of procedures with a physical therapy instructor and subsequent independent studies) was 30 days. Patients in group 2 were divided into three subgroups: subgroup 2A, in which PH procedures were combined with massage of the cervical-collar area and the upper limb area of the affected side; subgroup 2B, where PH gymnastics was carried out in combination with extracorporeal shock wave therapy (ESWT) procedures; subgroup 2C - a comprehensive program including LH procedures, manual massage and shock wave therapy. RESULTS: 3 months after the end of the course of rehabilitation measures, patients of all groups showed a significant improvement in scores on the ASES and VAS scales, but there were no reliably significant differences between the results of different groups. CONCLUSION: The study indicates that movement therapy is an effective method of rehabilitation for patients with subacromial impingement syndrome, and conducting complex programs in which PH is combined with other rehabilitation methods (massage, shock wave therapy) doesn't have statistically significant advantages over PH alone within a 3-month observation period.

[Shoulder instability: review of current concepts of diagnosis and treatment]. / Nestabil'nost' plechevogo sustava: obzor sovremennykh podkhodov k diagnostike i lecheniyu.

OBJECTIVE: To conduct a systematic review of modern literature data on the modern approaches in diagnosis and treatment of shoulder instability. MATERIAL AND METHODS: Searching for literature data was performed using the Pubmed and Google Scholar databases. RESULTS: The authors analyzed the results of conservative treatment of patients with shoulder instability and emphasized higher risk of instability recurrence, degeneration of anatomical structures and functional impairment in these patients. Surgery is advisable to restore shoulder stability and normalize its function. Several methods for stabilizing the shoulder have been proposed.The approaches to diagnosis and treatment of shoulder instability have been updated. CONCLUSION: Successful treatment of shoulder instability is based on qualitative and complete assessment of soft tissues and bone structures. An individual approach considering bone tissue deficiency and individual needs of the patient is required.

[Damage of the knee posterior cruciate ligament: biomechanics, basic diagnostics, treatment and secondary osteoarthritis prevention directions]. / Povrezhdeniya zadnei krestoobraznoi svyazki: biomekhanika, osnovnye napravleniya diagnostiki, lecheniya i profilaktiki vtorichnogo osteoartrita.

The analysis of literature data was performed on the pathogenesis, diagnosis and treatment of injuries of the posterior cruciate ligament (PCL) of the knee joint. PCL is the largest intra-articular ligament of the knee joint, can withstand the maximum loads compared with other ligaments. It was noted that, in general, in cases of damage to the PCL, it is necessary to use a set of diagnostic methods, and the basic principles for the choice of optimal treatment plan for this patient. It considered the results of the conservative treatment of PCL partial ruptures, and it is indicated that this approach increases the risk of degenerative anatomical structures and functional disorders of the joint. It was noted that it is advisable to conduct surgical treatment to restore the stability of the knee joint and normalize function, while a number of methods for the reconstruction of PCL have been proposed to date. The usage of chondroprotectors for prevention of the secondary osteoarthrosis of the knee joint affected by posterior cruciate ligament rupture was analyzed in the literature data.

[Role of dysplastic changes in the uterine tubal epithelium in the histogenesis of ovarian cancer].

OBJECTIVE: To study tubal morphological changes in different diseases of the female reproductive system and to assess its role in the histogenesis of ovarian cancer. MATERIAL AND METHODS: Surgical materials from 77 patients were examined. In all cases, the uterine tubes were studied totally. According to morphological and clinical diagnoses, the materials obtained from the patients were divided into a few groups including, among other conditions, high-grade ovarian cancer, benign ovarian neoplasms, malignancies of other female reproductive organs, etc. Serous tubal intraepithelial carcinoma (STIC), tubal epithelial dysplasia, and other changes were assessed in each case. RESULTS: In high-grade serous carcinoma (HGSC), there were precancer changes as dysplasia and STIC in the macroscopically intact uterine tubes in 30% of cases. The uterine tubes and ovaries were synchronously involved in 50% of cases. Such changes were absent in the fallopian tubes when the ovaries exhibited low-grade serous carcinoma, a borderline tumor or high-grade carcinoma of another histological form different from HGSC. In other malignancies of the female reproductive system, dysplasia and STIC were identified in 5 (10.9%) of 46 cases in the total examination of the uterine tubes. CONCLUSION: The findings support the tubal origin hypothesis for HGSC. The investigation clearly demonstrated the need for a total examination of the fallopian tubes not only in tumor lesions of the ovaries and other sites (corpus and cervix uteri, breast), but also during tumor-unassociated surgery.

Ferromagnetism and structural transformations caused by Cr intercalation into TiTe(2).

Crystal structure investigations, electrical resistivity, and magnetic measurements have been performed for polycrystalline samples of intercalated compounds Cr(x)TiTe(2) with a Cr concentration up to x = 0.65. According to the room-temperature x-ray diffraction study of Cr(x)TiTe(2), the initial hexagonal crystal structure transforms to a monoclinic one with increasing Cr content up to x≥0.5 due to the ordering of Cr ions. The intercalation results in the change of the resistivity behavior in Cr(x)TiTe(2) from metal-like at x = 0 to insulator-like above x = 0.33 and leads to ferromagnetic ordering of Cr magnetic moments at x≥0.5. For the compound Cr(0.25)TiTe(2), structural transformations and anomalous resistivity behavior are observed around 230 K, which cannot be explained only by the order-disorder transition within the subsystem of intercalated Cr ions. Structural changes within Te-Ti-Te sandwiches associated with charge density wave instability are suggested to be involved in this phase transition as well.

[Synchronous and metachronous tumors in patients with hematological neoplasms].

The study has indicated the relatively frequent occurrence of secondary tumors in hematological patients. These tumors may be both synchronous and metachronous. They generally occur in different periods after chemo- and/or radiotherapy. A secondary hematological tumor that is unilinear or heterolinear more commonly develops. The authors have not found a correlation between the intensity of the therapy and the occurrence of a secondary tumor and the impact of elderly age on the shorter occurrence of a secondary pathological process.

[Study of the capacities of magnetic resonance imaging in the diagnosis of knee joint injuries].

Joint injury is presently one of the main causes of temporary disability of an economically and socially active population. The precise preoperative diagnosis enables the planning of adequate surgical intervention, reduction of the time of disability, and improvement of quality of life. However, magnetic resonance imaging (MRI) most commonly performed in patients with knee joint injury shows a high variability in diagnostic efficiency. Based on a multicenter study, the paper analyzes main reasons for diagnostic errors in knee joint MRI and gives recommendations on how to use of this technique.

[Diagnosis of lymphoproliferative diseases by bone marrow trepanobiopsy specimens].

Based on the study of 2000 bone marrow trepanobiopsy specimens from patients with different types of lymphoproliferative diseases, the authors present the incidence and specific features of specific bone marrow lesion and the state of normal hemopoiesis and stroma. They also give data of bone marrow immunohistochemical studies using a many mono- and polyclonal antibody panels. The criteria for the differential diagnosis of reactive polyclonal lymphoid proliferation in the bone marrow that may accompany many hematological and non-hematological diseases with specific bone marrow lesion in lymphoproliferative diseases are outlined. The high diagnostic value of a study of bone marrow trepanobiopsy specimens is shown in the diagnosis of lymphoproliferative diseases.

[A case of the long course of acute intermittent porphyria].

A case of acute intermittent porphyria is described in a 37-year-old female patient treated with normasang, a drug that regulates porphyrin metabolism at the last stages of the disease. Chronic renal failure with the hypertensive syndrome, severe neurological symptoms, and vascular sclerotic changes in all organs were the symptoms of the underlying disease. Infectious complications were the cause of sepsis and favoured deteriorated multiple organ dysfunction that determined lethal exitus.

[Comparative characteristics of intervals Q-T and J-T in patients with unstable angina and myocardial infarction based on standard electrocardiography and electrocardiotopography].

We examined 94 patients (mean age 61,7 +/- 9,9 years) with unstable angina and myocardial infarction. Comparative characterization of prognostic value of Q-T and J-T intervals obtained at conventional 12-lead electrocardiography and 35-lead electrocardiotopography in assessment of risk of repetitive coronary events during follow up for 1 year was carried out. It was found that prolongation of maximal corrected Q-T interval obtained by electrocardiotopography at admission had greater prognostic significance for assessment of risk of unfavorable outcome. Increase of this parameter of Q-T interval was not related to augmentation of area and degree of subendocardial myocardial damage and left ventricular systolic dysfunction.

[Aromaphytotherapy in prevention of acute respiratory diseases in children].

The authors' studies show pathogenetic validity of using aromaphytotherapy in children predisposed to acute respiratory diseases. Courses of essential oils aromaphytotherapy produce a wide spectrum of physiological changes reducing frequency of the respiratory diseases, exacerbations of chronic ENT diseases in children.

[Prediction of interferon therapy efficacy in chronic myeloid leukemia according to data of histomorphological study]. / Prognozirovanie éffektivnosti interferonoterapii pri khronicheskom mieloleikoze po dannym gistomorfologicheskogo issledovaniia.

AIM: To investigate factors determining prognosis and efficacy of induction therapy including interferon-alpha-2b (intron-A, Schering Plough) in patients at an early chronic stage of Ph-positive chronic myeloid leukemia (CML) as shown by histomorphological examination. MATERIAL AND METHODS: The analysis covered 52 CML patients treated at an early chronic phase with intron-A in a standard daily dose 5 IU/m2 in combination with low-dose cytosinearabinoside (10 mg/m2, s.c. , daily for 10 days of each month). The treatment efficacy was assessed by the international criteria of complete and partial hematological remission and cytogenetic response. The cytogenetic study employed the direct method, even and G-differential staining, fluorescent hybridization in situ (FISH). The sections were stained with hematoxilin-eosine by Gomori, van Gieson. Histological samples were examined with histomorphometry. Immunohistochemical examination was made on paraffin sections using a panel of monoclonal antibodies CD3, CD4, CD8, CD20, NK, PCNA, Ki-67 (Dako, Denmark). RESULTS: Repeated assessment of histomorphological parameters such as erythroid lineage, degree of myelofibrosis and reduction of leukemic population indicate the treatment efficacy. Estimation of the level of leukemic population proliferation in trephine biopsies from CML patients with monoclonal antibodies PCNA and Ki-67 before the treatment is prognostically significant as it further correlates with the cytogenetic response (r = 0.821, p = 0.000000). CONCLUSION: It is valid to study histomorphological picture of CML to prognosticate and assess treatment efficacy with standard doses of interferon-alpha with high probability.

[Bone marrow alterations in sarcoidosis]. / Izmenenie kostnogo mozga pri sarkoidoze.

Trepanobiopsy of the bone marrow followed by a histological study was performed in 3 patients with sarcoidosis diagnosed in peripheral lymph node (LN) biopsies. Granulemas revealed in trepanobiopsies were identical to those found in LN. Trepanobiopsy is advisable in patients with sarcoidosis having some changes in hemogram.

Cationic aluminum alkyl complexes incorporating aminotroponiminate ligands.

The synthesis, structures, and reactivity of cationic aluminum complexes containing the N,N'-diisopropylaminotroponiminate ligand ((i)Pr(2)-ATI(-)) are described. The reaction of ((i)Pr(2)-ATI)AlR(2) (1a-e,g,h; R = H (a), Me (b), Et (c), Pr (d), (i)Bu (e), Cy (g), CH(2)Ph (h)) with [Ph(3)C][B(C(6)F(5))(4)] yields ((i)()Pr(2)-ATI)AlR(+) species whose fate depends on the properties of the R ligand. 1a and 1b react with 0.5 equiv of [Ph(3)C][B(C(6)F(5))(4)] to produce dinuclear monocationic complexes [([(i)Pr(2)-ATI] AlR)(2)(mu-R)][(C(6)F(5))(4)] (2a,b). The cation of 2b contains two ((i)()Pr(2)-ATI)AlMe(+) units linked by an almost linear Al-Me-Al bridge; 2a is presumed to have an analogous structure. 2b does not react further with [Ph(3)C][B(C(6)F(5))(4)]. However, 1a reacts with 1 equiv of [Ph(3)C][B(C(6)F(5))(4)] to afford ((i Pr(2)-ATI)Al(C(6)F(5))(mu-H)(2)B(C(6)F(5))(2) (3) and other products, presumably via C(6)F(5)(-) transfer and ligand redistribution of a [((i)()Pr(2)-ATI)AlH][(C(6)F(5))(4)] intermediate. 1c-e react with 1 equiv of [Ph(3)C][B(C(6)F(5))(4)] to yield stable base-free [((i)Pr(2)-ATI)AlR][B(C(6)F(5))(4)] complexes (4c-e). 4c crystallizes from chlorobenzene as 4c(ClPh).0.5PhCl, which has been characterized by X-ray crystallography. In the solid state the PhCl ligand of 4c(ClPh) is coordinated by a dative PhCl-Al bond and an ATI/Ph pi-stacking interaction. 1g,h react with [Ph(3)C][B(C(6)F(5))(4)] to yield ((i)Pr(2)-ATI)Al(R)(C(6)F(5)) (5g,h) via C(6)F(5)(-) transfer of [((i)Pr(2)-ATI)AlR][(BC(6)F(5))(4)] intermediates. 1c,h react with B(C(6)F(5))(3) to yield ((i)Pr(2)-ATI)Al(R)(C(6)F(5)) (5c,h) via C(6)F(5)(-) transfer of [((i)Pr(2)-ATI)AlR][RB(C(6)F(5))(3)] intermediates. The reaction of 4c-e with MeCN or acetone yields [((i)Pr(2)-ATI)Al(R)(L)][B(C(6)F(5))(4)] adducts (L = MeCN (8c-e), acetone (9c-e)), which undergo associative intermolecular L exchange. 9c-e undergo slow beta-H transfer to afford the dinuclear dicationic alkoxide complex [(((i)Pr(2)-ATI)Al(mu-O(i)()Pr))(2)][B(C(6)F(5))(4)](2) (10) and the corresponding olefin. 4c-e catalyze the head-to-tail dimerization of tert-butyl acetylene by an insertion/sigma-bond metathesis mechanism involving [((i)Pr(2)-ATI)Al(C=C(t)Bu)][B(C(6)F(5))(4)] (13) and [((i)Pr(2)-ATI)Al(CH=C((t)()Bu)C=C(t)Bu)][B(C(6)F(5))(4)] (14) intermediates. 13 crystallizes as the dinuclear dicationic complex [([(i Pr(2)-ATI]Al(mu-C=C(t)Bu))(2)][B(C(6)F(5))(4)](2).5PhCl from chlorobenzene. 4e catalyzes the polymerization of propylene oxide and 2a catalyzes the polymerization of methyl methacrylate. 4c,e react with ethylene-d(4) by beta-H transfer to yield [((i)Pr(2)-ATI)AlCD(2)CD(2)H][B(C(6)F(5))(4)] initially. Polyethylene is also produced in these reactions by an unidentified active species.

Spatial and temporal distribution of solutes in the developing carrot taproot measured at single-cell resolution.

The time-course and spatial distribution of sugars and ions in carrot (Daucus carota L.) was studied at fine resolution using single cell (SiCSA) and tissue analysis. Four phases of osmolyte accumulation in the taproot were identified: an amino acid (germination) phase, when internal sources of amino acids provide seedlings with osmotica; an ion phase, when inorganic and organic ions were the main solutes; a hexose phase, when concentrations of glucose and fructose sharply increased and reached their maximum; and a sucrose phase, when sucrose became the major solute. Spatial distribution of sugar in taproot cells showed a general trend of highest concentration on both sides of the vascular cambium (some 200 mM sucrose, 150 mM glucose) and a minimum in the pith (some 100 mM sucrose, 60 mM glucose) and in periderm. Electrolytes (e.g. potassium) followed a distribution generally reciprocal to that of sugars; minimum in the tissue adjacent to the cambium (some 10 mM) and maximum in the pith and periderm (some 60-100 mM). The cambial cells contained unexpectedly low concentrations of sugars and potassium. These spatial and temporal patterns indicate that amino acids, other electrolytes and sugars are interchangeable in the tissue osmotic balance. The nature of the solute is developmentally determined both temporally and spatially. During the accumulation of electrolytes following the initial amino acid phase, osmotic pressure to 420 mosmol kg-1 rises and then remains constant despite large changes in the concentration of individual solutes. This indicates that osmotic pressure is regulated independently of the individual concentrations of solutes.

[Clinicofunctional changes of heart in patients with clinically different variants of toxic diphtheria]. / Kliniko-funktsional'nye izmeneniia serdtsa u bol'nykh toksicheskoi difteriei s razlichnymi variantami.

A clinicofunctional examination of 72 patients with toxic diphtheria (mean age 36.8 +/- 7.1 years) has been made to study the course and outcome of diphtheria-related damage to the heart. It is shown that clinical symptoms of myocarditis became more prominent with growing severity of diphtheric infection and evidenced for diffuse affection of the left ventricle. EchoCG detected defective systolic function which in patients with unfavorable prognosis was associated with thickening of the myocardium and dilatation of the left ventricular chamber. 24-h Holter monitoring registered shifts in the end part of the ECG ventricular complex and various abnomalities in the heart rhythm. Focal myocardial lesions manifested with supraventricular and solitary ventricular extrasystoles. In diffuse myocarditis frequent ventricular extrasystoles prevailed. At autopsy, structural myocardial changes in toxic diphtheria were confirmed.

[Calculation of optic system of superfine medical endoscopes based on gradient elements]. / Raschët opticheskikh sistem sverkhtonkikh meditsinskikh éndoskopov, postroennykh na osnove gradientnykh élementov.

The application of gradient optic elements to rigid endoscopes decreases their diameter to 1.5-2.0 mm. The given mathematical dependences determine aperture and field characteristics, focus and focal segments, resolution of the optic systems based on gradient optics. Parameters of the gradient optic systems for superfine medical endoscopes are characterized and their practical application is shown.

[The effect of nitrate and nitrite on the respiration and cytochrome system of Rhizobium lupini]. / Vliianie nitrata i nitrita na dykhanie i tsitokhromnuiu sistemu Rhizobium lupini

Differential spectrophotometry and oxygen electrode were used to study the effect of nitrate and nitrite on the cytochrome system and respiration of Rhizobium lupini cultivated in the conditions of different aeration, and bacteroids of this strain isolated from lupine nodules. In the anaerobic conditions, nitrate (10(-3) M) accepts electrons from the cytochrome system in suspensions of bacteroids and bacterial cells grown in the microaerophilic conditions (12 muM O2), but does not oxidize cytochromes of the cells cultivated in the aerobic conditions (240 muM 32). Nitrate (10(-3) M) oxidizes actively only the cytochrome system of the cells grown in the microaerophilic conditions. Nitrite inhibits oxygen uptake by suspension of the bacteroids and pure culture of the cells; its necessary concentrations and the mode of action depend on the conditions of cultivation. Nitrite, like cyanide, blocks the terminal step in the cytochrome chain of Rh. lupini. Some properties of the cytochrome system are similar in the bacteroids and the bacterial culture grown in the conditions of oxygen deficiency.