Evaluation of functional and oncological outcomes of localized prostate cancer after different minimally invasive therapeutic methods: A single center experience

OBJECTIVES

To study the functional and oncological results of minimally invasive treatment methods: cryoablation, brachytherapy, and high-intensity focused ultrasound (HIFU) therapy of localized prostate cancer in a single hospital.

METHODS

One hundred sixty patients with localized prostate cancer were treated with minimally invasive methods (53, 52, 55 patients with cryoablation, brachytherapy and HIFU therapy, respectively). Prostate-specific antigen and evaluation of post-procedure biopsies were used as an assessment. The review of functional indicators and quality of life was made with International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), quality of life (QoL) questionnaires.

RESULTS

Patients after cryoablation showed worse results of oncological control according to positive repeat biopsies, best indicators were observed after brachytherapy. When considering the IPSS results, there were statistically significantly worse scores in the brachytherapy group in the early postoperative period, these differences do not reach statistical significance in the late period in the brachytherapy and cryoablation groups. Patients in the cryoablation group showed worse indicators of IIEF-5; in the early postoperative period; in the late follow-up period, the indicators of erectile function in patients in the cryoablation group did not statistically significantly differ from those in patients after brachytherapy. Patients after HIFU therapy showed fewer cases of de novo erectile dysfunction during the follow-up period of 3 years, higher average IIEF-5 scores, lower IPSS scores and better QoL results.

CONCLUSION

The recurrence of prostate cancer was statistically significantly higher in the International Society of Urological Pathology (ISUP) 3 grade group. HIFU therapy had better urination indicators compared to other groups, that can be associated with the laser enucleation of prostatic hyperplasia. The advantage was noted in patients after HIFU therapy when comparing the parameters to the IIEF-5 thus, HIFU treatment had a better impact on patients' QoL with localized prostate cancer.

[Application of optical coherence tomography in the assessment of the posterior lens capsule during anti-angiogenic therapy]

Intravitreal injection (IVI) of anti-angiogenic drugs is one of the most common therapeutic procedures in ophthalmology. In recent years, a new non-contact study method has been developed - anterior segment optical coherence tomography (AS-OCT), which allows the formation of three-dimensional images of the lens and provides more detailed information about its structure and morphology.

PURPOSE

This study uses optical coherence tomography method to analyze the risks of developing changes in the posterior lens capsule in patients after IVI of an anti-angiogenic drug.

MATERIAL AND METHODS

The study involved 100 people (14 men and 86 women) with a natural lens and neovascular age-related macular degeneration (nAMD). The average age was 70.57±7.98 years. During the study (12 months), all patients underwent IVI of an anti-angiogenic drug aflibercept in the treat-and-extend (T&E) mode. All subjects were divided into 2 groups: with a total number of IVI less than 10 - group 1 (50 patients), and more than 10 IVI - group 2 (50 patients, of which 49 were included in the study). All patients underwent OCT using the Optopol REVO NX device (Poland) with the Anterior B-scan Wide protocol before inclusion in the study, as well as after 3, 6 and 12 months.

RESULTS

It was found that the risk of developing a posterior lens capsule rupture, visualized using OCT, depends on the total number of IVI (correlation coefficient 0.473 p=0.001): the more IVI, the higher the probability that damage to the posterior capsule will occur after the next IVI, and after the 15th injection the risk of developing damage to the posterior capsule increases sharply.

CONCLUSION

The astudy analyzed the risk factors for the development of posterior lens capsule damage that can be detected using OCT, and presented three risk groups for the development of rupture (or damage) of the posterior lens capsule depending on the number of intravitreal injections performed.

[Shaping approaches to standardization of oropharynx mucous membrane assessment of immunological parameters]

Basis of acute pharyngitis pathogenesis is an inflammatory process at the entrance gate of the infection. Therefore, local immunity study proves to be the most informative. Difficulty in making that type of assessment is lack of generally accepted reference values and biological sampling techniques.

OBJECTIVE

Validation of biological sampling techniques to study the parameters of local mucosal immunity in oropharynx acute inflammatory diseases.

MATERIAL AND METHODS

30 people with acute catarrhal pharyngitis with intoxication syndrome were examined. The sampling was carried out in 7 different ways. 1. Collect saliva samples using the passive drool collection method. 2. Collect saliva, using cotton swabs placed into the mouth for 3 minutes. 3. Cotton swabs wrapped around a metal probe was placed on palatine tonsils and lateral walls of the oropharynx. 4. Instead of a cotton swab, a disc of laboratory filter paper with a diameter of 0.7 cm was used. 5. Scrape by the mucous membrane of the palatine tonsils and lateral walls of the oropharynx were made with a cytobrush. 6. Using a cytobrush, scrapings were made from the mucous membrane of only the posterior pharyngeal wall, excluding the region of the palatine tonsils. 7. Using a cytobrush to make scrapings from the only palatine tonsils mucous membrane. RT-PCR was used to determine IL-1β mRNA.

RESULTS

Minimal IL-1β mRNA values were detected in saliva collected by passive flow (0.095 [0; 3.45] units) and on a cotton swab (0.21 [0.1; 3.82] units). IL-1β mRNA in the material collected by methods No. 3 and No. 4 on a cotton swab and a paper disk did not differ significantly from each other. Its level was higher than in saliva and lower than in scrapings. The maximum result was revealed with method No. 5 when simultaneously taking scrapings from the palatine tonsils and posterior pharyngeal wall mucous membrane (4.76 [0.92; 8.13] units). The expression of IL-1β mRNA in the material obtained by methods No. 6 and No. 7 did not differ significantly from each other.

CONCLUSION

Separated scrapings collecting from the palatine tonsils or posterior pharyngeal wall mucous membrane will allow assessing the inflammatory response autonomously in the lymphoid tissue and separately on the mucosa of the posterior pharyngeal wall. The mucosal scraping technique was the most effective for assessing cytokines in the oropharyngeal mucosal membrane.

[Age determination by microstructural features of human cricoid cartilage]

THE AIM OF THE STUDY

Was to develop the age determination's technology by the morphometric features of the human cricoid cartilage using a regression analysis method. Cricoid cartilages of 65 variously-aged males were examined. The number of histomorphometric parameters equal 16 for each sample were determined and measured on the histological sections. A descriptive statistical processing of data using the regression analysis method was done, as a result of which the model of age determination was developed. This model has a high predictive accuracy, where the prediction error was less than 5 years in 64.62% of cases. The practical use of this model may be limited by the morphometric parameters' number translating complication to calculate the formula. The developed method can be improved while increasing the sample and conducting further statistical processing, and in the future it can be used in the age determination in forensic medical examination.

[Statistical analysis of performance indicators of medical forensic departments of the FME bureaux in the Russian Federation]

This article presents the results of the study of the quantitative performance indicators of medical forensic departments of state forensic medical expert institutions in Russia as a whole and in individual federal districts from 2009 to 2018. Medical statistics methods were used. We analyzed absolute and intensive indicators, their percentages, and correlation relationships. Trends and patterns were studied to identify causal relationships and assess the effect of various factors. A steady trend of reducing the total number of expert examinations performed in the medical forensic departments was shown. However, their share of the total number of violent death cases is increasing. The labor intensity of medical forensic examinations and the number of examination methods used are increasing. Regional differences in the studied indicators are revealed. The presented metadata can be used to improve the workflow management of forensic medical departments and monitor the effectiveness of improvements. The findings confirm the need to modernize and adapt the regulatory and procedural framework of the expert work.

[Correction of halitosis in chronic inflammatory diseases of the oropharynx in adults]

Approximately 25% of the world population suffer from halitosis, making it a significant medico-social issue. It is one of the clinical signs of chronic inflammatory diseases of the oropharynx and is commonly caused by the persistence some bacteria in the oral cavity and in the oropharynx. These in turn facilitate formation of volatile sulphur compounds.

OBJECTIVE

To evaluate the effectiveness and safety of the probiotic strain Streptococcus salivarius K12 in the Bactoblis product in exacerbation of chronic inflammatory diseases of the oropharynx.

MATERIAL AND METHODS

45 patients diagnosed with a diagnosis of exacerbation of chronic pharyngitis were studied, gastroesophageal reflux disease was found in 33 patients. After a microbiological testing, all patients were prescribed probiotic strain Streptococcus salivarius K12 in the amount of 1×10⁹ colony-forming units (CFU) in the form of tablets for resorption as monotherapy for 14 days. The assessment of the therapy was based on physical examination data and on the subjective estimation of the clinical symptoms using a 10-point visual analog scale (VAS) before the start of the treatment and on the 5th and on the 7th day of the therapy.

RESULTS

According to the microbiological analysis was revealed the growth of Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus agalactiae, Streptococcus viridans which was seen within 10³-10⁵ CFU. A significant clinical progress was achieved for all three analyzed signs of diseases (the severity of pain when swallowing, a feeling of perspiration (foreign body) in the pharynx, halitosis), within the statistical significance between the 1st and the 7th day and the 7th and the 14th day of the surveillance. The pain severity was decreased from 5.69±0.39 points to 2.69±0.34 points on the 7th day and to 0.08±0.05 point on the 14th day from the start of the therapy, itchy throat (foreign body sensation) was relived from 6.88±0.23 points to 3.54±0.29 points on the 7th day and to 0.69±0.12 point on the 14th day of the therapy. In addition, there was a decline in the severity of halitosis from 6.16±0.31 points to 2.47±0.44 points on the 7th day and to 0.68±0.29 point on the 14th day of the therapy.

CONCLUSION

Topical application of a drug containing a probiotic Streptococcus salivarius K12, in case of chronic inflammatory diseases of the oropharynx of various etiologies, showed satisfactory effectiveness in the regression of the main symptoms of the exacerbation of the inflammatory process, expressed through pain in the throat when swallowing, halitosis and the foreign body sensation in the oropharynx.

Impact of thrombophilia and waist circumference on the risk of venousthromboembolism

Background

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) represents a major health problem. In the general population, the absolute risk of any kind of VTE is 0.1%–0.2% per year, and it increases with age. VTE is an important and preventable cause of morbidity and mortality, with almost a third of survivors experiencing long term effects. Obesity is well-known risk factor of VTE. The extent of the effects of obesity on VTE depends not only on total body fat, but also on the distribution of adipose tissue (e.g., central obesity) and the interplay among risk factors for VTE, such as genetic mutations, and other risk factors.

Thrombophilia, venous thromboembolism, obesity, waist circumference

Purpose

The aim of this study is to investigate the impact of waist circumference on the risk of venous thromboembolism

Methodology

The study involved 68 patients with VTE (33 females and 34 males, mean age 56.8 years ±15.3) and 84 patients without VTE (38 males and 46 females, 44.4 years±18.6). From 2015 to 2017, data have been collected from records of patients admitted to department of internal medicine. All subjects were recruited to the study during their stay in the hospital. The reasons for hospitalization were: acute event of DVT or PE for the main group, the absence of acute event or history of VTE for the control group. DVT was diagnosed by ultrasonic Doppler examination, and PE was confirmed by intravenous radiocontrast computed tomography. Anthropometric measures were performed with subjects wearing short-sleeved garments and no shoes; waist circumference was measured in centimeters at the umbilical line. For all patients genetic testing for inherited thrombophilia – Factor V Leiden G1691A, Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism – was performed by real-time PCR technique.

Results

Factor V Leiden G1691A increase the risk of VTE in 2.11 (CI: 1.79–2.48), p=0.049, prothrombin G20210A in 3.21 (CI: 1.66–6.211), p=0.049. MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism also increase the risk of VTE, but it was no significant. Study have shown that waist circumference >80 cm increase the risk of VTE in 3.19 (CI: 1.35–7.58), p=0.019. Combination of inherited thrombophilia (Factor V Leiden G1691A, Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1 (SERPIN1) 4G/5G polymorphism) and waist circumference >80 cm increase the risk of VTE in 3.51 (CI: 1.76–7.04), p<0.001.

Conclusion

Previous results of our work indicate influence of waist circumference >80 cm on the risk of VTE, especially risk of thrombosis is higher in patients with combination inherited thrombophilia and waist circumference >80 cm.

Funding Acknowledgement

Type of funding sources: None.

[Retrograde intrarenal surgery using a 1.94 m superpulsed thulium fiber laser]

INTRODUCTION

surgical treatment of urinary stone disease plays an important role in urological practice. Stone fragmentation can be performed using various lithotripters, from which Holmium fiber laser (Ho: YAG) has currently taken the main place. According to the current literature, a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W showed in vitro higher efficiency compared to Ho: YAG, while having the same safety profile. The use of a thulium fiber laser with a pulse energy of 0.025-6 J and a high repetition rate (up to 1600 Hz) allows to most effectively perform stone dusting during retrograde intrarenal surgery (RIRS).

AIM

to improve the performance of RIRS using the 1.94m superpulsed thulium fiber laser.

MATERIALS AND METHODS

a total of 152 patients with renal stones who were treated during the period from February 2018 to July 2019 were included in the study. The analysis of the laser settings, their effect on retropulsion and visibility when performing RIRS using a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W, a peak power of 500 W, as well as an assessment of the stone-free rate the first postoperative day and 3 months after the procedure was done.

RESULTS

The most frequently used settings were as following: 0.5 J, 30 Hz, 15 W (No. 1), 0.15 J, 200 Hz, 30 W (No. 2), 0.8 J, 31.25 Hz, 25 W (No. 3), 0.8 J, 37.5 Hz, 30 W (No. 4). The statistical analysis of the influence of the settings on the quality of endoscopic imaging and retropulsion was carried out. In addition, the features of each settings were analyzed. The stone-free rate on the first postoperative day was evaluated using low-dose CT.

CONCLUSION

A superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power of 500 W has shown high efficiency in clinical practice when performing RIRS, since it allows to have good endoscopic imaging, minimal retropulsion, and to perform stone dusting, which had a positive effect on the stone-free rate. Optimization of the settings of thulium fiber lithotripsy may improve the results of surgical treatment of urinary stone disease.

[Epidemiological analysis of violent death and cases of not established death cases in Russian Federation (2009-2018)]

The paper presents the results of an epidemiological analysis of statistical data on the number of deaths from violent deaths, which cause has not been established; unidentified and unclaimed corpses in forensic medical expertise in Russia as a whole and in individual federal districts for the period from 2009 to 2018. Percentage indicators and share values of the circumstances due to which the death cause was not established are given. It was found that on the basis of a steady decreasing trend in number of violent deaths, the number of corpses with an unknown death cause is growing, mainly due to putrefactive changes in corpses of adults and due to the burning of children corpses. The presence of a strong correlation between the number of unclaimed and unidentified corpses with the number of forensic medical expertise, when the cause of death was not established, was shown. Based on the analysis results at the macro level (federal districts), some interregional differences in the structure of the analyzed indicators were revealed. The results obtained make it possible to confirm the relevance of existing clusters of scientific research and to form new ones, to place accents in the directions of the postgraduate education of specialists.

[Argumentation for use of laser fluorescence spectrometry in identification of inflammatory diseases of pharynx]

OBJECTIVE

The article demonstrates the experience of using laser fluorescence spectrometry (LFS) in the diagnosis of inflammatory diseases of pharynx, describes a method for recording spectra of pharyngeal tissues using the EnSpectr L405 hardware-software complex operating on the basis of laser radiation with a wavelength of 405 nm, and identifies characteristic features of spectral curves.

PATIENTS AND METHODS

The authors presented the characteristics of the spectra from the surface of the pharynx tissue of healthy volunteers, patients with chronic tonsillitis and granular pharyngitis.

RESULTS

The most informative parameters of the spectral curves were calculated, analyzing which it is possible to identify the morphometric, metabolic, functional features of the tissue of the tonsils and posterior pharyngeal wall in normal and pathological conditions.

CONCLUSION

The article illustrates the importance of developing highly sensitive and highly specific methods for the rapid diagnosis of inflammatory diseases of the pharynx. The presented technology can be used in clinical practice in future.

[The glucagon test in diagnosis of secondary adrenal insufficiency after craniospinal irradiation: the feasibility of application, the features of performing the test, and its diagnostic informativity]

BACKGROUND

The glucagon test (GT) is a promising alternative to the insulin hypoglycemia test (IHT) in diagnosis of secondary adrenal insufficiency (SAI).

AIM

To study the feasibility of using the GT in patients after craniospinal irradiation and to determine the cut-off value to rule out SAI.

METHODS

A total of 28 patients (14 males and 14 females) with the median age of 19 years (17; 23) who had undergone combination treatment (surgery, craniospinal irradiation (35 Gy) with boost to the tumor bed, and polychemotherapy) of extrapituitary brain tumors no later than 2 years before study initiation and 10 healthy volunteers of matching sex and age were examined. All the subjects underwent the GT and IHT with an interval of at least 57 days. The cortisol, ACTH, and glucose levels were measured.

RESULTS

Twelve out of 28 patients were diagnosed with SAI according to the IHT results. ROC analysis revealed that cortisol release during the GT 499 nmol/L ruled out SAI [100% sensitivity (Se); 62% specificity (Sp)], while the absence of a rise 340 nmol/l verified SAI (Sp 100%; 55% Se). For GT, the area under a curve (AUC) was 93.6%, which corresponds to a very good diagnostic informativity. In 19 patients, the IHT and GT results were concordant (in ten patients, the release of cortisol occurred above the cut-off value in both tests; no release was detected in nine patients). In nine cases, the results were discordant: the maximum cortisol level detected in the GT was 500 nmol/l, but the IHT results ruled out SAI (the GT yielded a false positive outcome). Contrariwise, in three (10.7%) patients the release of cortisol detected in the GT was adequate, while being insufficient in the IHT test. Adverse events (nausea) were reported during the GT test in 9 (25%) subjects; one patient had hypoglycemia (1.8 mmol/l).

CONCLUSION

GT is highly informative and can be used as a first-level stimulation test for ruling out SAI in patients exposed to craniospinal irradiation performed to manage brain tumors. The cortisol level of 500 nmol/L is the best cut-off value for ruling out SAI according to the GT results. The insulin hypoglycemia test is used as the second-level supporting test in patients with positive GT results.

[Acute Coronary Syndrome Registry of High Risk Patients: 30-Day Outcome]

AIM

The aim of the study is to evaluate important additional cardiovascular (CV) risk factors of major adverse cardiac events (MACE) in patients with acute coronary syndrome (ACS) during the first 30 days after index event.

MATERIALS AND METHODS

Overall 750 patients with ACS were enrolled in the single center prospective registry from 2012-2015yy. 569 patients received dual antiplatelet therapy and in 425 cases platelet function testing (PFT) were performed. Most of the patients characterized as high risk elderly patients with multiple CV risk factors and high comorbidity index.

RESULTS

At 30-day follow-up the mortality rate was 10,1%. Singlevariate analysis showed strong association between MACE and age, atrial fibrillation, stroke, chronic kidney disease, low ejection fraction, type 2 myocardial infarction (T2MI). Multivariate analysis showed that high-on-treatment platelet reactivity (PFT> 45%) with odds ratio 4.418 (p=0.0001), chronic kidney disease (OR 6.538 p=0.001) and T2MI (OR 1.925 p=0.0001) were significantly associated with adverse outcome.

CONCLUSION

ACS registry showed high mortality level in real-life practice compared with randomized clinical trials due to the high prevalence of elderly patients with high comorbidity index. Patients with T2MI have significantly more severe prognosis and chronic kidney disease associated with increased MACE. PFT in this category of patients is reasonable for more accurate risk stratification.

[Clinical features and diagnosis of secondary adrenal insufficiency followed complex treatment nonpituitary brain tumors]

BACKGROUND

The most of the current studies include patients who are different by the etiology of secondary adrenal insufficiency (SAI), or investigate SAI among other late effects of the radiation therapy.

AIMS

To describe the features of SAI and to select the best method of screening SAI in adult patients followed complex treatment of nonpituitary brain tumors in childhood.

MATERIALS AND METHODS

It was the retrospective cross-sectional study. 31 patients after the complex treatment of nonpituitary brain tumors in childhood and 20 healthy volunteers were examined. Age and sex ratio were comparable between the groups. Biochemical and clinical blood tests, levels of cortisol, ACTH, DHEA-C were evaluated. The insulin tolerance test (ITT) was performed for all patients and 11 volunteers.

RESULTS

The prevalence of SAI by ITT was 45.2%. The levels of basal cortisol (BC) were significantly higher in patients without SAI in comparison with the SAI group and volunteers (505 [340; 650] vs 323 [233; 382] and 372 [263; 489] nmol / l; pSAI- without_SAI=0.001; pwihtout_SAI-healthy = 0.04). The SAI group had DHEA-C significantly lower than in other groups one (3.1 [1.8; 3.4] vs 5.1 [2.5; 6.4] and 6.8 [4.1; 8.9]; рSAI- without_SAI = 0.036; pSAI-healthy = 0.001). ROC analysis showed that BC and DHEA-S can be used as high-quality screening tests for SAI (AUC = 89.3% and 88.3%). The maximum level of cortisol (656 [608-686] vs 634 [548-677]; p = 1) and the time of its increase (45 and 60 min) did not differ during ITT in patients without SAI and volunteers. Side effects: delayed hypoglycemia occurred in 4/14 patients of the SAI group 4090 minutes late of injection 60-80 ml of 40% glucose solution for stopping hypoglycemia in the test.

CONCLUSIONS

45.2% of patients followed craniospinal irradiation had SAI that is characterized by a decrease in DHEA-C levels. A highly normal level of basal cortisol was observed in 45% of patients without SAI. DHEA-C and blood cortisol can be used for SAI screening.

[Relation of Functional Activity of Platelets to Prognosis of Unfavorable Cardiovascular Events in Patients with Acute Coronary Syndrome. Results of a Registry Study]

AIM

to assess relation ofhigh functional activity ofplatelets to prognosis ofunfavorable cardiovascular events in patients with Acute Coronary Syndrome (ACS).

MATERIALS

The study was based on the data of a single center ACS registry conducted in the Central Clinical Hospital of the Presidential Affairs Department of Russian Federation. Of 529 included patients in 425 without contraindications to double antiplatelet therapy we carried out analysis of dependence of 30 days level of unfavorable events on parameters of functional activity of platelets.

RESULTS

High on-treatment platelet reactivity (HTPR) was found to be associated with 3.5 increase of mortality in the group of patients with high cardiovascular risk. Logistic model of prognosis of unfavorable events based on multifactorial analysis of data from patients with measured platelet aggregation included chronic kidney disease, type of myocardial infarction, and degree ofplatelet aggregation >45%. C -statistic was equal to 0.77. We also present in this paper discussion of problems related to studying approaches to individualization of anti-aggregation therapy in real clinical practice and problems of organization ofsimilar studies.

CONCLUSION

The study showed that patients with ACS increased platelet aggregation, as well as chronic kidney disease and type 2 MI are associated with a 30 day prognosis of adverse events.

[Treatment of patients with lower urinary tract symptoms in Moscow]

INTRODUCTION

In recent years, there has been a persistent tendency to a decrease in surgical treatment of patients with lower urinary symptoms (LUTS). This fact can be explained by variety drugs which have acceptable safety and high efficiency for treatment of urinary disorders. As part of our survey of men in Moscow region, the trends in prescribing the different drugs for the LUTS was studied. In addition, the duration of therapy and patient adherence were analyzed.

MATERIALS AND METHODS

A prospective multicenter epidemiological study "Characteristics of lower urinary tract symptoms in men in the Moscow region" was carried out using data obtained from April 1 to May 31, 2017 with anonymous survey of 525 men with mean age of 64.2+/-9.93 years, living in Moscow and went to the urologist with urinary disorders. All respondents answered questions from specially designed questionnaire consisted from 140 items. All medical data were analyzed, including received drugs, the duration of the therapy and subjective assessment of efficiency.

RESULTS

A total of 419 patients from 525 (79.8%) received any kind of therapy. The most commonly used drugs were -blockers, which consisted 65% of all prescriptions. Other drugs were administered significantly rarely. It is surprisingly, that 85.6% of respondents in Moscow region received the original -blockers, not generic drugs. Satisfaction rate was 74.3%. Most of patients (58.3%) had received -blockers for 1-3 years and 33.3% administered these drugs for more than 3 years. Combined drug therapy was the second most popular (25.5%). The most commonly used combination included -blockers and inhibitors of 5-reductase. In 90.6% cases the appointment was made by urologist.

CONCLUSION

Drug therapy is the most popular treatment in patients with LUTS. Our data suggest that -blockers as monotherapy or in combination with inhibitors of 5-reductase is the most often prescribed therapy. These results are in concordance with the main conclusions of international studies dedicated to this issue.

[General characteristics of morphometric and morphoscopic signs of liver rupture with different localizations]

The aim of this study was to compare the morphoscopic and morphometric features of local and remote liver ruptures under various external influences. It was found that the local main ruptures were formed in the case of impact trauma more often in the right side of the liver on its diaphragmatic surface, in the anterior third of the organ. They were linear and located in the longitudinal direction. The size of the ruptures increased as the impact force increased. Local additional ruptures were associated with impact and compression trauma and were located only on the diaphragmatic surface of the liver, more often in the right half, in the middle third of the organ. These ruptures were linear, co-directional and small in size under various external influences. Central ruptures were formed by impact and compression trauma, were located more often in the middle third of the right side of the liver and were slit-shaped with a longitudinal direction. The size of central ruptures was associated with falls on the stomach and compression trauma. Peripheral ruptures were formed in the case of impact and compression trauma, were located more often in the right half of the liver on its diaphragmatic surface, mainly in the middle third of the organ and were linear with a slanting direction. The relative constancy of the average sizes of peripheral ruptures was noted. Anti-shock ruptures were observed resulting from shock trauma and were located more often in the right side of the liver, on its visceral surface, in the rear third of the organ. They were linear and curvilinear, and longitudinally and obliquely oriented. Ruptures were relatively constant in size with different types of impact.

[Intersphincteric resection for stage I-III low rectal cancer is an oncologically safe alternative to extralevator abdomino-perineal rectal resection]

AIM

To compare oncologic efficiency of intersphincteric resections and extralevator abdominoperineal excisions in surgical treatment of low rectal cancer.

METHODS

Between 2006 and 2015 in Department of colorectal and pelvic floor surgery (Russian scientific center of surgery n.a. acad. B.V. Petrovsky) and in Clinic of Colorectal and Minimally invasive surgery (Sechenov First Moscow State Medical University) 40 consecutive patients underwent intersphincteric resection (ISR) and 31 underwent extralevator abdominoperineal excision (EAPE). All patients had low rectal cancer staged I-III within 5 cm from the anal verge.

RESULTS

Circular resection margin >1 mm was achieved in 95% and 84% of patients after ISR and EAPR correspondingly (p=0.002), negative distal resection margin was achieved in 95% of ISR patients. In ISR group mean distance from the lower tumor edge to the distal resection margin was 1,17±0,78 cm. Colo-anal anastomosis leak rate was 17%. The 3-year disease-free survival in ISR group was 97%, 5-year disease-free survival was 93%. The 5-year disease-free survival in stage III for ISR group was 71,4%. In 98% of ISR patients complete restoration of bowel continuity was performed.

[Comparative characteristics of injuries to individual body parts of the driver and passengers inside the passenger compartment of a moving vehicle in a traffic accident]

The purpose of this study was to investigate the general nature of injuries sustained in a moving passenger car during an accident. The study investigated the nature of injuries in drivers (99 cases) and passengers in the front seat (64), rear right seat (15), rear middle seat (29) and rear left seat (22) who died in an accident due to frontal collision with an obstacle. The general characteristics of the resulting damage were determined with regard to their type, quantity and localization. Drivers were found to have predominantly left-sided injuries to the head and chest, as well as right-sided abdominal and pelvic injuries, frequent neck injuries, smaller limb and permanent foot injuries. The injuries sustained by front seat passengers were characterized mainly by right-sided localization of head and neck injuries, maximum left-sided injury of the upper and lower limbs, and an absence of injuries to the feet. Passengers in the rear right seat were predominantly characterized by right-sided localization of injuries to the head, chest, stomach, pelvis and limbs, an absence of injuries to the feet and a relatively high frequency of damage to the internal organs of the thoracic and abdominal cavities. Passengers in the rear middle seat were characterized by uniform distribution of injuries on the left and right sides of the body, a relatively high frequency of injuries to the head, upper limbs, chest, abdomen and pelvis, a relatively low frequency lower limb injuries and an absence of injuries to the feet. Passengers in the left-hand rear seat were characterized by maximum left-sided localization of injuries to the head, chest and left extremities and minimum traumatization of the internal organs of the thoracic and abdominal cavities.

[Forensic medical determination of the age based on the analysis of CT-scanograms of the skull and the craniovertebral region in the sagittal projection]

The objective of the present study was to determine the biological age of the unrecognized individuals based on the analysis of CT-scanograms of the skull and the craniovertebral region in the sagittal projection. We investigated the structure of the spongy substance of the clinoid plate of the sella turcica and the clivus of the cranium, involution of the vertebrae configuration in the medial atlantoaxial articulation, frontal and sphenoidal sinuses. A total of 80 skulls of Caucasoid individuals at the age ranging from 4 to 84 years belonging to an Eastern Slavonic population (free from the pathological lesions in the above cranial structures) were available for the examination. The results of the multifactorial analysis gave evidence of the possibility to estimate the age of individual subjects based on the comprehensive aggregate qualitative and quantitative characteristic in the framework of the linear regression model by making use of the age-related changes in the frontal and sphenoidal sinuses, the sella turcica and the clivus of the cranium, the first and the second cervical vertebrae with an accuracy to within 6 years. It is concluded that the application of the systems for the automated statistical analysis of the images for the purposes of forensic medical expertise would allow to obtain the results of great practical and scientific value.

[Specific features of lower urinary tract symptoms in men living in the moscow region. Results of the epidemiological study]

INTRODUCTION

Voiding disorders in men are manifested by various symptoms associated with impairment of the urinary flow along the urinary tract and worsening of the urinary bladder storage function. There is a considerable lack of data on the prevalence of LUTS, their severity, and correlation with data from objective studies in men in the Russian Federation in general and in the Moscow region in particular.

MATERIALS AND METHODS

A prospective multicenter epidemiological study "Specific Features of Lower Urinary Tract Symptoms in Men Living in the Moscow Region" was conducted based on data acquired from April 1 to May 31, 2017 by an anonymous survey of 525 men (mean age 64.2+/-9.93 years old), residing in Moscow and presenting with complaints of urination disorders. The respondents answered questions of a specially developed 140-item questionnaire. All demographic and medical information was taken into account, including concomitant diseases and ongoing therapy. The patients filled out the IIEF, I-PSS, QoL, and AMS (Aging Male Screening) questionnaires.

RESULTS

Analysis the I-PSS scores showed that symptoms of the emptying phase predominated over the symptoms of the filling phase in all age groups. The most frequent complaints were "frequent urination" and "weak urine stream". Forty and 30% of respondents had moderate and severe LUTS, respectively. The remaining 30% of men had mild LUTS. Prostate volume was significantly greater than that reported in similar studies conducted in Asia, Europe and North America (mean 55.27 cm3). The level of total prostate-specific antigen (PSA) was known in 98.8% of patients over the age of 50 and averaged 3.87+/-4.41 ng/ml. The mean age at the first testing for total PSA in Moscow is 56.7+/-9.0 years.

CONCLUSION

This study is the first epidemiological study of this scale and focus. Its findings can be used to compose a "portrait" of a standard patient and identify patterns that limit the extrapolation of international epidemiological studies to the population of Russian patients. It seems necessary to develop an updated LUTS management strategy, taking into account the identified national characteristics.

[COMPARATIVE CHARACTERISTICS OF EPIDEMIC SEASONS OF INFLUENZA 2015-2016AND 2009 -2010]

AIM

Analyze epidemiologic and- clinical features of influenza epidemic seasons 2009 - 2010 and 2015 - 2016. Materials and methods Forms of federal state statistic observation No.4 , 2, 5, and 6; information from the official web-site of the Research Institute of Influenza of the Ministry of Health of Russian Federation; materials of various conferences and congresses on problems of influenza; information-analytical certificates of the Ministry of Health .of Russian Federation.

RESULTS

Epidemic morbidity increases in the season 2009 - 2010. and 2015 - 2016 started at various time and had different duration. Children younger than 14 years of age predominated in the structure of patients in the 2009 - 2010 epidemic season, the main mass of patients were presented by individuals aged 45 - 59 years in the 2015 - 2016 season. The number of lethal outcomes with laboratory confirmed influenza diagnosis in 2009 - 2010 was 687-cases, and in 2015 - 2016 - 663 cases. Almost all the deceased from influenza were not vaccinated against this infection. Cardiovascular system diseases were noted in 484 individuals of the total number of deceased. Most of the deceased were late to seek medical aid.

CONCLUSION

Influenza epidemic season 2015 - 2016 differs from 2009 - 2010 season by dynamics of morbidity development and a lower amount of severe forms of the disease and lethal outcomes. This may be-due to an increase of population immunity against pandemic strain A(H1N1)pdm09 via pro-epidemizing in the recent years as well as an increase of influenza vaccination coverage.

[Growth disorders after treatment for acute lymphoblastic leukemia in childhood]

AIM

To evaluate the character of growth disorders and risk factors of their development after treatment of acute lympho- blastic leukemia (ALL) patients in childhood.

MATERIALS AND METHODS

In this study 25 patients (16 women and 9 men) who had undergone treatment for ALL in childhood were assessed. Patients underwent polychemo- therapy and cranial irradiation. Average age at the time of the survey - 21,2±3,9 years; average age at the time of treatment - 6,9±3,4 years; average follow-up - 13,8±4,9 years. Healthy volunteers were included in the control group (10 women and 6 men) at the age of 25,9±3,6 years. Patients' anthropometric and laboratory parameters were measured.

RESULTS

SDS of the final height in ALL survivors was significantly lower in comparison with the control group (p=0,009). ALL survivors had significantly higher difference between final and target height compared to control (p=0,049). 4 of 8 men (50,0% CI: 24,5% - 75,5%) and 13 of 15 women (86,7% CI:68,1-95,7%) have reached the target height. 73,9% (CI: 56,3% - 86,8%) of ALL survivors have reached target height which is significantly lower than in the control group (p<0,001). We found a significant backward correlation be- tween the age at the time of treatment and reaching of the target height (r=-0,415, p=0,049). ALL survivors also suffered from obesity - 12%, dyslipidemia - 36,8%, insulin resistance - 66,7%.

CONCLUSION

Treatment for ALL in childhood causes a de- crease of final height. Its main risk factor is the age at the time of the treatment. ALL survivors are diagnosed with the other endocrine disorders and they need an endocrinologist's observation.

[ASSESSMENT OF THE RISK OF INCIDENTAL PROSTATE CANCER PROGRESSION]

At present, methodology based on the stage T1a or T1b is used to determine the risk of incidental prostate cancer (IPC) progression. This approach was developed before the introduction of prostate-specific antigen (PSA) into the practice of the urologist, and does not account of the degree of IPC. For the prediction of IPC progression, multifactorial prognostic model was created. This model is based on the analysis of two parameters--the total PSA level before the surgery and the Gleason score according to the results of morphological examination after transurethral resection of the prostate hyperplasia. This model has a high predictive value (AUC 86.6%) and can be easily used in practice. For the interpretation of the calculated results special table is formed that allows to assess the risk of progression over the next 3.5 years.

[Comorbidity of depression and nonaffective - schizophrenia spectrum disorders: the clinical-epidemiological study EDIP]

AIM

To explore the association between depression and heterogenic nonaffective symptom complexes in the study EDIP (Epidemiology of Depression and nonaffective Psychiatric disorders).

MATERIAL AND METHODS

The study consisted of two stages. The first stage (91 patients) aimed to resolve organizational and methodological issues, the second stage was performed in the epidemiological sample of 705 patients.

RESULTS AND CONCLUSION

The heterogeneity (inequivalence and bidirectionality) of associations between depression and heteronomous nonaffective disorders have been identified. The associations are distinguished in three types: 1) affinity (agonism); 2) repulsion (antagonism); 3) lack of selective interaction (inertness) between depression and nonaffective disorders. The results obtained are discussed in a context of two conceptually polar psychopathological models of comorbidity between depression and nonaffective disorders: 1) based on a nosological dichotomy «affective disease - schizophrenia» and 2) denying the abovementioned dichotomy. The first model places depression among disorders of a mild psychiatric register. The second model supposes the integration of depression with syndromes typical for schizophrenia in a common "affect-symptoms" space and considers the increase of depression frequency proportionally to duration and severity of schizophrenia. Our own results have shown that depression is observed not only among disorders of mild psychiatric registers, but also in schizophrenia, though with a significantly lower frequency (as a nonobligatory compound of a syndrome). Thus, depression influence in comorbid delusional, schizophrenic and other severe nonaffective disorders is greatly diminished.

[NEWLY-DIAGNOSED CHRONIC KIDNEY DISEASE IN PATIENTS OF A THERAPEUTIC CLINIC: THE ROLE OF GFR CALCULATION BY THE CKD-EPI FORMULA]

AIM

to estimate the prevalence of newly-diagnosed chronic kidney disease (CKD) and its risk factors in patients of a therapeutic clinic, to evaluate the importance of GFR calculation using the CKD-EPI formula. Materials and methods: the study included 275 patients (275 (31.1%) men and 610 (68.9%) women) aged 18-89 (mean 59.5 13.95) years. GFR of 60ml/min/l.73 m3 or signs of kidney lesions were diagnosed as CKD. Possible risk factors of CKD were elucidated based on the results of a questionnaire that provided information on complaints, metabolic disorders, family histoty compliance with a healthy lifestyle. Arterial pressure and serum creatinine level were measured, BMI and GFR calculated in all patients.

RESULTS

Medical histories of 58% of the 885 patients contained signs of CKD. Among the remaining 372 (42%) ones, 7.2% had proteinuria and 20.1% GFR of 60ml/min/1. 73/m3. The prevalence of newly diagnosed CKD was 27.3%. The use of the CKD-EPI formula allowed to diagnose CKD in 18% of the patients having the serum creatinine level within normal values. The overall prevalence of CKD in the study group was 14%.

CONCLUSION

the prevalence of newly diagnosed CKD in patients of a therapeutic clinic was 2 7.3%. The use of the CKD-EPI formula facilitates diagnostics of CKD.

[The magnitude of fatigue and its association with depression, pain, and inflammatory activity in rheumatoid arthritis]

AIM

To analyze the rate of clinically significant fatigue and to search for its predictors in patients with rheumatoid arthritis (RA).

SUBJECTS AND METHODS

The investigation included 95 patients with a valid RA diagnosis. The majority of the patients were women (87.4%); mean age was 46.7 +/- 1.2 years; mean disease duration was 135.5 +/- 11.6 months. The authors evaluated RA activity by the Disease Activity Score (DAS28), magnitude of fatigue by the Fatigue Severity Scale (FSS), that of pain by the Brief Pain Inventory, and functional status and quality of life by the Health Assessment Questionnaire and EQ-5D. A psychiatrist diagnosed mental disorders in accordance with ICD-10 and using the psychiatric and psychological scales and procedures.

RESULTS

80% of the patients felt clinically significant fatigue (FSS scores of > or = 4). Multivariate analysis yielded a prognostic model that made it possible to state that clinically significant fatigue was primarily associated with the magnitude of depression by the Hospital Anxiety and Depression Scale, the presence of a depressive episode, the duration of anxiety and depressive spectrum, the magnitude of pain (Ritchie index), DAS28, and the presence of osteoporosis.

CONCLUSION

The presence and magnitude of depression along with the magnitude of pain are an important factor that influences the formation of fatigue in RA, which gives rise to evident functional failure and a low quality of life. Combination therapy for RA may be effective when mental disorders, mainly the anxiety and depressive spectrum, are timely diagnosed.

[Perception of pain in rheumatoid arthritis: relation to inflammation, psychic disorders, functional status, and quality of life]

Pain perception was analyzed depending on the inflammatory activity of rheumatoid arthritis (RA), variants and manifestations of psychic disorders (including depressive, anxious and moderate cognitive ones), chronic fatigue, changes in the functional status and quality of life. The study included 125 patients (mean age 47.4 +/- 1.01 yr) with definitive diagnosis of RA 138.4 +/- 10.1 months in duration. RA activity was estimated from the DAS28 index, pain intensity and degree of fatigue by BPI and FSS scales respectively, the functional status and life quality by HAQ and EQ-5D. Psychic disorders were diagnosed by a psychiatrist in accordance with ICD-10 with the use of relevant psychiatric and psychological scales and methods. Pain perception was unrelated to the patients' age and RA duration. The multifactor analysis provided a basis for the prognostic model suggesting that the most severe pain in RA is related to the functional status and quality of life (VAS of general health status), hsCRP level, inflammatory activity index RA DAS28, peripheral platelet count, degree of fatigue (FSS) and depression (YADS), female sex. Depression and its severity is one more factor influencing pain perception in RA and accounting for functional insufficiency and low quality of life. Early diagnostics of psychic disorders (in the first place anxious and depressive ones) is mandatory to ensure effective combined therapy of pain in RA patients.

[Statistical analysis of the occurrence of relapse in epilepsy]

For obtaining of reliability data it is important to use adequate statistical techniques. We have analysed probability of occurrence of relapse at a long current of an epilepsy by means of the survival analysis on Kaplan-Meyer, risk factors of relapse by means of Cox regression.

CONCLUSIONS

relapse occurrence at an epilepsy equiprobably at any stage of a current of disease, and a major factor of risk for relapse is a disease current.

[Mechanism of development of epidemic process of group A streptococcal infection in children collectives]

AIM

To study the characteristics of group A streptococcal infection epidemic process in children aged 12 - 14 years arrived to summer camp "Orlenok" (Tuapse) from different regions of Russia.

MATERIALS AND METHODS

Epidemiological (retrospective analysis of incidence of acute respiratory infections, tonsillitis, and scarlet fever), microbiological (isolation and identification of group A streptococci [GAS]), and molecular biological (pulse-electrophoresis, analysis of spe and emm genes) methods were used for the study. Objects of the study were GAS strains isolated from patients and carriers.

RESULTS

Performed genotyping showed that cases of GAS infection in newly formed children collectives were caused by 2 - 3 epidemically important clones, which were genotypically heterogenous.

CONCLUSION

Performed molecular biologic studies demonstrated polyclonal structure of GAS that determines the features of development of epidemic process.

[Mathematical models and epidemiological analysis]

The limited use of mathematical simulation in epidemiology is due not only to the difficulty of monitoring the epidemic process and identifying its parameters but also to the application of oversimplified models. It is shown that realistic reproduction of actual morbidity dynamics requires taking into account heterogeneity and finiteness of the population and seasonal character of pathogen transmission mechanism.

[Demographic structure and dynamics of morbidity due to anthroponosis infections]

A fall in the incidence of both preventable and non-preventable or partly preventable infections with different modes of transmission has recently been documented in Russia and worldwide; it parallels marked changes in the demographic structure of the population. Simulation based on parasite-host mathematical models confirmed that demographic structure is a key factor responsible for the incidence of anthroponosis infections producing long-standing or lifelong immunity. It was shown that differences in the frequency of these diseases between countries may be due to different age structure of their populations. The lowered incidence of preventable and non-preventable infections in Russia appears to be associated with changes in the country's demographics. We have developed prognosis of further dynamics of anthroponosis diseases that predicts reversal of the mean morbidity rate toward that recorded in the 1980s and the shift of its higher values to senior age-groups.

Probability density functions for axial ratios of sectioning profiles of anisotropically arranged elliptical microvessels

The article theoretically regards probability density functions (PDFs) for axial ratio (X/Y) of sectioning profiles of elliptical microvessels (MVs) arranged with anisotropy in a biological tissue volume. A technique for the PDF(X/Y) calculations in anisotropy of the elliptical MVs is described. The essence of this technique is introducing anisotropy in PDF(alpha,phi), i.e. the function of the joint distribution of the polar and planar angles alpha and phi, which define mutual orientation of the elliptical MVs and sectioning planes. With the aid of this technique, the anisotropy cases are studied with PDF(alpha,phi) given by pair combinations of the following distributions: (i) a uniform distribution of the angles alpha and/or phi, (ii) the angle alpha distribution with PDF(alpha)=sin alpha(alpha in [0,pi/2]), and (iii) Gaussian distributions of the alpha or phi values. Specifically, PDF(X/Y) curves are obtained for MVs with the true, or three-dimensional, axial ratio X(0)/Y(0)=2.0, and the anisotropy effects on the X/Y expected frequencies are analysed. Conclusions of this analysis, the PDF(X/Y) calculation technique, and the PDF(X/Y) curves obtained are useful for stereological reconstruction of anisotropically organised microcirculatory networks, with an ellipticity of their MVs being taken into consideration.

The efficiency of calcitonin transport across the C-cell-blood barrier in rat thyroid

This paper studies calcitonin (CT) transport across the C-cell-blood (CCB) barrier in normal rats. The efficiency of this transport is expressed as endogenous calcitonin bioavailability (F(CT)), i.e., that portion of CT molecules extruded by the thyroid C-cell basal pole that enters the circulating blood. Because currently F(CT) cannot be estimated directly, a novel methodology was used for its estimation. The essence of this methodology is to assess the CT level before and after the CCB barrier, to study these input-output CT relationships mathematically, and to find the F(CT) range allowed by the relationships. In this context, the subplasmalemmal granule numerical density in the C-cell basal pole (X) and the CT concentration in the right ventricular blood (Y) were found to be highly correlated: r(xy) = 0.922, P < 0.001; the covariance coefficient rho(xy) = 0.9980, P < 0.0001. Clearly, the overall variance of these input-output relationships in the covariance model (square root Var(xy) = 6.32) is explained, specifically, by CT retention (R(CT)) variability at the CCB transport stages. The greater the R(CT) mean value in the studied rats, the greater is the impact of R(CT) variability on Var(xy). The estimated variance caused by R(CT) (Var(CCBR)) makes it possible to determine R(CT) and F(CT) (F(CT) = 100% - R(CT)). Thus we estimated Var(CCBR) as Var(CCBR) < Var(xy) - CV(RIA)(2), where CV(RIA)(2) is CT assay variance: square root Var(CCBR) = 6.00% (P > or = 0.95). We then estimated F(CT) as the value range that does not contradict the Var(CCBR) obtained: 62% < F(CT) < 100% (P > or = 0.95).

[Pulse-electrotypes of Listeria monocytogenes strains, isolated in Moscow]

The characterization of the pulse-electrotypes of L. monocytogenes, isolated in 2003-2004 in Moscow from different sources, is presented. Among the cultures, isolated from humans, one outbreak pulse electrotype was detected and from different objects in buildings where a wide variety of food products was produced several probably related and unrelated pulse-electrotypes were obtained. The conclusion was made that several independent L. monocytogenes clones existed on the territory of Moscow, and many products supplied to retail trade and public catering enterprises were contaminated with these clones. Pulse electrophoresis was shown to be the most effective method for intraspecific typing and the study of the molecular epidemiology of listeriosis. Grounds for the necessity to improve the microbiological diagnostics of L. monocytogenes infection are given.

[Characterization of Escherichia coli strains O157:H7, isolated on the territories of the Central Federal District]

The characterization of E.coli strains O157:H7, isolated from humans and animals on some territories of the Central Federal District, is presented. Among the isolates from human outbreaks, related and, probably, related cultures prevailed, while among the isolates obtained from different animals mainly unrelated cultures have been detected. A conclusion has been made concerning the existence of several independent zoonotic reservoirs of E. coli O157:H7 infection on this territory. The advantages and drawbacks of the use of pulse electrophoresis in the characterization of E. coli O157:H7 are discussed. Grounds are given for the necessity of the patients examination with hemorrhagic enetrocolitis for the presence of E. coli O157:H7, as well as for the expediency of having a special item for the registration of this E. coli infection in relevant statistical forms.

[Synchronism of a many-year dynamics of morbidity]

Synchronism of many-year morbidity fluctuations is discussed for different territories. The methods of mathematic modeling revealed that the exchange of the low-intensity infections, in populations with identical conditions results in a virtual complete morbidity dynamics, whereas, the effect from synchronism is by far less pronounced for territories with differing activity values of the transfer mechanism.

[Methodological aspects of the evaluation of epidemiological safety in maternity hospitals]

The distribution of morbidity and mortality in newborns, as well as morbidity of parturient women, in maternity hospitals of Moscow official have been analyzed according to statistical data for 1996-1999. The methods of cluster analysis (k-medium and tree classification by the method of the next door neighbours) were used. The evaluation of the stability of the distribution of morbidity and mortality in maternity hospitals was made with the use of chi 2 criterion. The specific features of the distribution of morbidity and mortality of newborns, as well as morbidity of parturient women, in the hospitals under study were detected. The methodological approach to the evaluation of epidemiological safety in maternity hospitals was proposed.

Determination of size distribution of elliptical microvessels from size distribution measurement of their section profiles

In transmission electron microscopy, microvessels (MVs) are studied as profiles on ultrathin sections. To determine MV sizes from measurements made on MV profiles, an assumption must be made about MV shape, a circular cylinder being used to approximate the latter on limited lengths. However, this model is irrelevant in case MVs have some flatness. The elliptical cylinder model is preferable, although relationships between the cylinder profile (two-dimensional; 2D) and its true (three-dimensional; 3D) sizes are not yet known. We have obtained the 2D/3D functions that express the relationships between such profile sizes as the minor radius (Y), major radius (X), axial ratio (X/Y), area (S), and perimeter (P) on the one hand, and the corresponding MV sizes (Y(0), X(0), X(0)/Y(0), S(0), and P(0)) on the other. The 2D/3D functions make it possible to derive elliptical MV sizes from section profile size distributions, probability density functions (PDFs) for the latter being determined. We have applied the 2D/3D functions in studying axial ratios of thyroid hemocapillaries. A factual X/Y frequency histogram has been constructed and fitted by theoretical X/Y PDFs plotted for different sets of capillary sizes. The thyroid capillaries have been revealed to be clustered, 72.7% of them having X(0)/Y(0) approximately 1.6, 17.6%, X(0)/Y(0) approximately 1.0, and 9.7%, X(0)/Y(0) approximately 3.2. The proposed technique is instrumental in precise modeling of microcirculatory network geometry.

[Frequency of genes speA, speB, and speC in Streptococcus pyogenes strains and the identification of the infective agent by polymerase chain reaction]

In cultures of S. pyogenes isolated from patients and carriers in different territories of the Russian Federation the genes of erythorogenic toxins A, B and C (speA, speB and specC) were detected. The possibility of the identification of S. pyogenes by means of PCR on the basis of primers to erythrogenic toxin B was determined. Gene speB was detected in all S. pyogenes cultures under study and proved to be species specific. Genes speA and speC were detected, respectively, in 29.4% and 9.35% of the S. pyogenes cultures under study. A test system for the identification of S. pyogenes on the basis of primers to gene speB was developed. The prospects for the detection of genes speA and speC for intraspecific typing of this infective agent were evaluated.

[Relationship between changes in demographic structure and incidence of anthroponotic infections]

Recent demographic shifts in Russia tell on the incidence of infectious diseases. With the aim of prediction, the authors analyzed the relationship between demographic changes in the country and the mean many-year level of anthroponotic infections with strained immunity in Moscow. Mathematical simulation methods were used. The data coincided with decreases in the incidence of scarlet fever and viral hepatitis A, observed in the nineties. On the other hand, the incidence of infectious diseases can return to the level of the beginning of the nineties irrespective of the demographic status in Russia.

[Errors in measurement of section areas and perimeters of microvessels from their profiles in sections for light and electron microscopy]

The error of measuring the section areas and perimeters of microvessels was estimated, which is due to a deviation of the section plane from the direction perpendicular to the longitudinal axis of microvessels. The estimates of the microvessel nonperpendicular sectioning error correspond to the case of three-dimensional isotropic distribution of microvessels without their own eccentricity. Only those microvessel profiles are selected for morphometry that meet the condition theta min < or = b/c < or = 1.00, where b is the minor and c is the major radii of microvessel profile on a section, and theta min is the tolerance for profile nonperpendicularity.