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Pacific Medical Journal

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No 4 (2013)

EDITORIALS

REVIEWS

9-16 347
Abstract
The authors review the literature data and in-house researches on arterial hypertension and smoking-related changes in cerebral vessels clinically and in experiment, and provide the data from transcranial Doppler ultrasound examination, duplex scanning and magnetic-resonance imaging of cerebral vascular bed. As shown, the arterial hypertension and smoking-related cases were characterised by decreased linear blood flow velocity, increased vascular resistance index and more evident cerebral atherosclerosis. The smoking intensity directly correlated with the prevalence of atherosclerotic plaques, including hemodynamically significant stenosis. The authors have identified evident cerebral vasomotor disorders, such as the loss of endothelium-dependent vasodilatation and increase in vasoconstrictive effects.
16-21 349
Abstract
The paper provides a project of classification of electro-encephalographic changes focused upon identification of ‘symptom-syndrome-type’ levels making respective allowance for localisation and running time of electroencephalogram (EEG). The project is based upon the use of five types of EEG identified by E.A. Zhirmunskaya (1991) and patterns of EEG analysed by H. Lüders (2000). The EEG-symptom is defined as changes likely to exhibit specific pattern (graphoelement). All symptoms are divided into two groups. These are non-pathological ones being considered as normal variant and pathological EEG-symptoms. A special consideration is given to EEG artefacts and principles of drawing up a medical assessment report. The proposed classification will facilitate differential diagnosis of the diseases that are known to cause changes in the characteristic features of brain bioelectrical activity and allow to consider EEG as a leading method of assessing brain pathology.
22-27 232
Abstract
The paper reviews the literature data and in-house researches on neurotransmitter agmatine and distribution of agmatinase defined as the agmatine-degrading enzyme in mammalian and human brain. The in-house studies are indicative of agmatinase known to occur in spinal and supraspinal motoneurons, cortical interneurons and hippocampal interneurons. The agmatinergic neurons are lacking in the posterior horn of the spinal cord. The immunocytochemical agmatinase is found in this region on neuron body and process. The authors have identified a population of initially sensitive neurons in spinal ganglions known to change the activity level, given the inflammatory and neuropathic pain. The agmatinase has been found in a small population of large neurons of rostral ventromedial medulla that formed part of endogenous monoamine analgesic systems in brain. The literature data analysis allows supposing that the antinociceptive action of agmatine arises from its rather close relationship with nitroxidergic and monoamine systems in brain and spinal cord.
27-38 262
Abstract
The paper reviews the present-day ideas of the role that the gaseous mediators like nitric oxide, carbon monoxide and hydrogen sulphide play in the central mechanisms of hemodynamic regulation, and summarises the results of in-house studies and literature data about the structure of hindbrain ‘vasomotor’ nuclei, the neurons of which are known to contribute to the exchange of these substances.
39-43 288
Abstract
The review was devoted the current understanding of the role of DNA methylation in the physiology and pathology of the human body. It was revealed the influence of genotype on epigenotype, the factors that trigger and suppress the processes of DNA methylation and histone deacetylation, the role of the state of folate metabolism in the development of pathological processes. Special attention was paid to the role of genes encoding enzymes of folate cycle, since lack of methyl groups directly linked to polymorphisms in these genes. It was shown that polymorphic variants of genes MTHFR, MTRR and MTR, causing different functional significance of protein products affect a wide range of biochemical reactions in the folate cycle, and, according to some authors, can be regarded as a risk factor for a number of diseases
44-47 246
Abstract
The paper analyses literature data about the role of biofilms in the infectious diseases pathology, discusses issues of the structure of bacterial biofilms in biological objects and medicinal products, and provides information on the studying of scanning electron microscopy of biofilms developed by gram-negative non-fermentable bacteria Acinetobacter baumannii and Pseudomonas aeruginosa in case of suppurative-septic complications in patients with burn injury. Special regard is given to the features of biofilms structure and functions in vivo, and relationship between the development mechanism and the course of the infectious process.
48-55 380
Abstract
The paper summarises the long-term studies on factors and mechanisms of psychosomatic disorders at the Department of Clinical Psychology of the Pacific State Medical University. The aggregate sampling comprised 3738 children and teenagers suffering from different forms of psychosomatic disorders, 383 healthy children and teenagers, and 1490 pregnant women and mothers. It allowed detecting relevant factors contributed to the development of psychosomatic disorders like high levels of psychology-related prenatal risk factors, labour induction with caesarean section and birth asphyxia during vaginal delivery, specific maternal-infant relations characterised by an increased attention to symptomatic physical manifestations, and inadequate types of family education. The mechanisms of psychosomatic disorders include disorders related to the development of self-consciousness from somatognosis, spatial representations, strategies for optical spatial activity down to inadequately low self-appraisal, and therefore, prevalence of deficient and destructive I-functions in a teenager’s personality structure.
55-59 224
Abstract
The paper reviews the literature data related to the treatment of early Parkinson’s disease and discusses the advantages and disadvantages of monotherapy, principles of drug selection, features of treatment of patients of different ages, and the use of new form of pramipexole with sustained release.
59-62 327
Abstract
The paper reviews the literature data about the up-to-date methods of treating amblyopia in children that is deemed as a serious medical, social and economic problem. As reported, the amblyopia treatment shall be aimed to disinhibit retinal and cortical relations under exposure to different stimulants or irritators. A wide variety of amblyopia treatment methods used in an integrated way will allow improving and normalising visual functions in most patients.

ORIGINAL RESEARCHES

63-67 185
Abstract
Severe hypoxia induces the constriction of internal carotid arteries (ICA), which worsens ischemic stroke in the brain. A few metabolites are presumably involved in hypoxic vasoconstriction, however, less is known about how such molecules provoke this vasoconstriction. We have investigated the influence of 15-hydroxyeicosatetrienoic acid (15-HETE) produced by 15-lipoxygenase (15-LOX) on vasoconstriction during hypoxia. As showed in our results, 15-LOX level increases in ICA endothelia and smooth muscles. 15-HETE enhances the tension of ICA ring in a dose-dependent manner, as well as attenuates the activity and expression of voltage-gated potassium (Kv) channels. Therefore, the down-regulation of Kv channels by 15-HETE during hypoxia weakens the repolarization of action potentials and causes a dominant influx of calcium to enhance smooth muscle tension and ICA constriction.
67-71 215
Abstract
Endostar, a novel recombinant human endostatin expressed in Escherichia coli, was approved by the State FDA in China. To investigate the effect of endostar and photodynamic therapy (PDT) on the in vivo growth of U251 glioma. Seven days after inoculation with U251 cells, nude mice with MRI-confirmed glioma were randomly assigned to 4 groups: PDT+endostar group; PDT group; endostar group and control group. In the PDT group, survival prolonged, accompanied by an increase in apoptosis, when compared with the control group. Furthermore, these changes were more pronounced in the PDT+endostar group. After PDT, hypoxia inducible factor-1a (HIF-1a) and vascular endothelial growth factor A (VEGF-A) expression was markedly increased and after endostar treatment, HIF-1a and VEGF-A expression was significantly reduced. PDT, in combination with endostar, can significantly inhibit the growth of U251 glioma. This approach may represent a promising strategy in the treatment of malignant tumors.
72-75 204
Abstract
The authors have examined 47 patients aged 36-64 waiting for lung transplantation to study relations between the adipokine level, expression of leptin and adiponectin receptors in fatty tissue and bone mineral density in case of terminal lung disease. As reported, there is a correlation between the bone mineral density and levels of lectin, adiponectin and resistin in blood serum. The tumour necrosis factor alpha concentration has been inversely related to the bone mineral density, and its receptor levels have exceeded the normal range in patients with terminal lung disease. The patients under examination had the leptin receptor activity decreased and the adiponectin receptor activity increased in skin and subcutaneous fat. Additionally, the studies have allowed to identify a relationship between the morphofunctional skin changes and striped muscles and the adipokine receptor activity and the intensity of osteopenic syndrome in patients with terminal lung disease.
76-78 354
Abstract
Clinical study of citicoline efficacy and portability in the combined treatment of Parkinson’s disease has been carried out. An assignment of citicoline (600 mg during 30 days) to patients with Parkinson’s disease, receiving the basic therapy with antiparkinsonic drugs, reduced rigidity, bradykinesia and speech disturbances.
79-81 246
Abstract
The paper analyses genetic polymorphism of thrombophilia in 68 patients with thromboembolia of the pulmonary artery (PATE) in Pimorsky Krai. The polymorphisms in genes associated with the risk factors for thrombophilia and venous thromboembolic complications was somewhat distinctive in comparison with that of the European population, and, foremost, it was represented by mutations in genes of folate cycle (97.1 % of cases) and disorders related to plasminogen activator inhibitor type 1 gene (88.2 % of cases). The genetic predisposition to hyperaggregation of platelets was recorded in more than half of the patients (55.9 %). The synergism of thrombosis risk factors was observed in all PATE cases. These changes shall be allowed for when developing programs for secondary prevention of venous thromboembolic complications. The therapy shall be continuous and likely to last throughout the life, and include drugs known to have effect on different coagulation system components, based upon both laboratory findings that are indicative of haemostatic disorders, and foremost, molecular genetic testing results.
82-84 254
Abstract
The authors have examined 162 patients aged up to 18 with chronic constipation, including that of combined with encopresis. Various abnormalities of large intestine and upper gastrointestinal tract pathology were found in 91.9 % and 56.7 % of cases, respectively. The surgery is recommended to be performed, given the ineffectiveness of conservative therapy during half a year. The paper discusses the role of connective tissue and muscular dysplasia of large intestine in causing chronic constipation in children.
84-87 577
Abstract
The authors have examined 107 patients with Kimmerle’s anomaly and identified four main groups of symptoms. These were vertebral artery circulatory disturbance syndrome, cephalgic syndrome, epileptic syndrome, and radicular syndrome. A neurological onset of these syndromes was characterised by paroxysmal symptoms. The paper identifies three severity levels of Kimmerle’s anomaly-related clinical features and determines criteria for reliable, probable and tentative indicators of poor prognosis. The authors put forward a differentiated approach to selecting drug treatment and assess efficiency of the drug treatment, depending on different courses of neurological complications associated with Kimmerle’s anomaly.
88-92 212
Abstract
The paper provides results of clinical examination and magnetic resonance imaging (MRI) of 55 patients with neurologic symptoms of hepatolenticular degeneration (HLD), and determines that the MRI-derived cerebral changes are not specific in case of hepatolenticular degeneration. Four types of images are deemed to be most representative. These are lacking changes, occurrence of altered density focuses to be mainly detected in basal ganglia, cortical atrophy, and brain structural abnormalities. It is assumed that the visualisation of brain anatomical structure abnormalities of relatively frequent occurrence is most likely to be indicative of early prenatal manifestations of congenital transmission of defective metabolism known to disturb formation of cerebral tissue structures long before the clinical symptoms of hepatolenticular degeneration occur. The author has failed to identify clear correlations between the clinical symptoms of hyperkinesis and the MRI-derived indices.
92-94 232
Abstract
The authors report clinical and laboratory results of treatment with low-dose methotrexate in 181 patients suffering from prurigo and confirm positive effects of this therapy on patients’ cytokine status. The application of methotrexate leads to restoration of cytokine production and continuous clinical remission.
95-98 248
Abstract
Clinical-neurophysiological research, psychophysiological and speech testing of 47 children with sensorineural hearing loss at the age of 4-11 years are conducted. Efficiency of a complex metabolic neuroprotector cytoflavin in children of preschool and early school age with a hearing impairment and disorder of speech development are studied. Raising the level of a brain blood-groove, reducing intracranial pressure and improving EEG indicators, the preparation made positive impact on psycho-emotional and cognitive spheres, reduced adynamy manifestations, as a whole improving the rehabilitation potential and social adaptation of such children. Collateral reactions against reception of a preparation it wasn't observed.
98-102 183
Abstract
The paper discusses results of molecular genetic testing of 42 patients with neurological symptoms of hepatolenticular degeneration living in Primorsky Krai. Mutations in Gly1267Arg, His1069Gly and DelC3402 of АТР7В gene were found in 71.4% of cases. These were mostly heterozygous ones and detected in emigrants from Ukraine and Belorussia with arythmohyperkinetic form of the disease. They were practically not found in locals. A maximum of АТР7В-gene mutations fell on a combination of Gly1267Arg and DelC3402. There were no isolated His1069Gly mutations. The authors have not revealed any correlation between the severity of hepatolenticular degeneration and heterozygous carrier of any discovered mutations or their combinations.
103-105 203
Abstract
318 students from the Pacific State Medical University were questioned with special questionnaires in 2009-2011 to study the incidence of tobacco smoking among students. 32.1 % of respondents had been smoking, among which 37.9 % were young men and 28 % - young women. With regard to the 1st and 6th years of education, the number of smokers has risen, as the period of study has advanced: from 21.9 to 43.3 % among young men, and from 10.7 to 46.0 % among young women. Despite of the fact that by the 6th year of education the degree of nicotine addiction increased, there was an increasing motivation to give up smoking.
106-107 216
Abstract
Results of surgical treatment (eversion and open endarterectomia) of 28 patients with a hemodynamical significant stenosis of an internal carotid (60-90 %) are presented. The received results were compared with results of conservative treatment at 28 other patients with similar stenoses. Substantial and long increase of an intracerebral blood flow is provided when carrying out surgical treatment. In 6 months decrease in speed of a blood flow in carotid and increase -in intracranial arteries concerning group of comparison is defined. The significant increase of a brain blood-flow reached as a result of surgery, corresponded to adequate decrease in cerebrovascular risk

PRACTICE OBSERVATIONS

107-108 306
Abstract
Type I tyrosinemia is a rare congenital disease determined as a disturbance in the tyrosine exchange caused by a genetically predisposed deficit of fumarylacetoacetate hydrolase. This disease is known to proceed very severely. More than half of the children does not live to be one year of age. The earlier stage of the disease intensifies at the age of 6 months and up, and is characterised by subacute course. Symptoms of liver and kidney lesions, as well as psychomotor retardation prevail in the clinical picture of the disease. Four cases of this disease have been confirmed in Russia. The paper describes one case of type I tyrosinemia with early clinical symptoms diagnosed in the Republic of Sakha Yakutia after an integrated examination and molecular genetic testing.

METHODS

109-110 242
Abstract
It is known that elderly patients in hospitals begin feeling unwell because of back pain that can have many causes. Traditional medicine, for example reflexotherapy, allows having stable and rapid effect in eliminating this syndrome. The paper analyses results of reflexotherapy (including pharmacopuncture) in 76 patients from the somatic in-hospital department aged 59 and up, and demonstrates its high efficiency being safest and successful techniques.
111-112 233
Abstract
The paper provides analysis of the intensity of pain syndrome after lumbar microdiscectomy for intervertebral disk disease in 12 and 60 days after surgery. The DuraSeal Xact sealant and Oxi-plex gel were used during the surgery in the first group comprised of 15 patients. The second group (15 cases) also underwent a routine surgery. By visual-analogous scale, more effects were achieved in the first group, especially during the long-term period. This can be accounted for by a creation of hydrogel adhesion barrier - postoperative epidural fibrosis.


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ISSN 1609-1175 (Print)