Comparative Study of the γH2AX Foci Forming in Human Lung Fibroblasts Incubated in Media Containing Tritium-Labeled Thymidine or Amino Acids

We compared the formation of γH2AX foci (marker of DNA double-strand breaks) in human lung fibroblasts (MRC-5 line) during their 24-h incubation in a medium containing ³H-labeled thymidine or amino acids (glycine, alanine, and proline) with specific radioactivity from 100 to 400 MBq/liter. A linear dependence of changes in the number of γH2AX foci on the specific radioactivity of the medium was revealed. The quantitative yield of DNA double-strand breaks under the influence of ³H-thymidine was more than 2-fold higher than under the influence of ³H-labeled amino acids. Comparative analysis of the yields of DNA double-strand breaks during cell incubation with ³H-labeled amino acids showed that ³H-alanine produced more pronounced effect that ³H-proline, which is consistent with the data on the content of their non-radioactive analogs in chromatin proteins.

Radiation Inactivation of Coronavirus Infection Pathogen by the Example of Transmissible Gastroenteritis Virus

In recent years, members of the Coronaviridae family have caused outbreaks of respiratory diseases (MERS, SARS, and COVID-19). At the same time, the potential of radiation-induced inactivation of this group of viruses have been little studied, although radiation technologies can be widely used both in the processing of personal protective equipment and in the sterilization of vaccines. In the present work, the effect of 10 MeV electron beams and 7.6 MeV bremsstrahlung on the coronavirus infection pathogen (transmissible gastroenteritis virus) has been studied in vitro. In the given experimental conditions, irradiation with photons turned out to be more effective. The virus-containing suspension frozen at –86°C was the most resistant to radiation: the dose required for complete inactivation of the virus in this case was from 15 kGy, while for the liquid suspension and lyophilized form the sterilizing dose was from 10 kGy. At lower radiation doses for all samples during passaging in cell culture, residual infectious activity of the virus was observed. These differences in the efficiency of inactivation of liquid and frozen virus-containing samples indicate a significant contribution of the direct effect of radiation.

Medical management: major lessons learned from the Chernobyl accident (the review)

Thirty-five years have passed since the moment of the disaster at the Chernobyl nuclear power plant. It is quite a sufficient period to assess the correctness of the organisation of medical care for victims, to summarise the results of monitoring the health status of various groups of persons involved in the accident, including its direct participants. Radiation from a massive source of relatively uniform gamma radiation and a heterogeneous source of beta radiation can cause affected people to develop acute radiation syndrome (ARS) of varying severity, including non-curable forms of the disease ARS developed in 134 patients; 28 patients from 134 with ARS died in a short time (100 d) after exposure. Among the patients whose disease ended in death, 2/3 of the outcome could be due to radiation skin lesions (19 people). Treatment of ARS varying severity, which was combined with common skin burns with beta radiation, requires long-term specialised treatment. The experience of treating this group of patients has demonstrated that the indications for bone marrow transplantation in the curable form of ARS are limited. The percentage of victims who have absolute indications for allogeneic bone marrow transplantation and in whom this procedure will lead to an improved prognosis for life is very small. Recovery of own myelopoiesis and survival are possible after whole-body irradiation from 6 to 8 Gy, which was found after rejection of haploidentical human leucocyte antigen transplantation, as well as in patients who did not use bone marrow transplantation due to the absence of a corresponding donor. Patients who have undergone ARS need lifelong medical supervision and the provision of necessary medical care.

[Sleep and wake disorders in epilepsy]

OBJECTIVE

To summarize published data on the prevalence, characteristics and diagnostic criteria of sleep disorders in epilepsy.

MATERIAL AND METHODS

A search of published articles was performed in Medline (Pubmed), Scopus, Web of Science and e-library databases.

RESULTS

Epidemiologic, clinical and diagnostic aspects of excessive daytime sleepiness, obstructive sleep apnea and central apnea, restless leg syndrome and parasomnias related to slow-wave and REM-sleep in patients with epilepsy were analyzed.

CONCLUSIONS

Further studies are needed to gain an insight into the complex associations of sleep disorders in epilepsy to optimize diagnostic and treatment approaches and to improve the quality of life in that patient population.

ACUTE MYELOID LEUKEMIA, PROSTATE AND SKIN CANCER IN ACUTE RADIATION SYNDROME SURVIVOR AFTER THE 1986 CHERNOBYL NUCLEAR ACCIDENT: CASE REPORT

The development of hemoblastosis is often associated with the influence of various genotoxic unfavorable factors, in particular, with the effect of ionizing radiation. This article presents a case report of acute myeloid leukemia (AML) in a patient who was involved in the 1986 accident at the Chernobyl Nuclear Power Plant and suffered an acute radiation syndrome of degree II severity. Based on clinical and cytogenetic dosimetry, the average absorbed radiation dose to the whole body was estimated to be 4.3 Gy. During long-term clinical follow-up (27 years), moderate transient instability of hematological parameters was observed: lymphocytosis, leukopenia and thrombocytopenia, which was associated with chronic viral hepatitis C. Further cytogenetic investigations demonstrated a very high frequency of translocations, up to 50 times background values, that persisted over 3 decades. In 2014, the patient was diagnosed and operated on for prostate cancer and received a course of radiotherapy (total fractionated local dose of 35 Gy) in May 2015. From December 2015 through April 2016, the patient experienced general weakness and developed progressive cytopenia. A diagnosis of AML, resulting from a myelodysplastic syndrome, was confirmed by abnormal complex clones detected in 38% of metaphases by the mFISH-method, along with other chromosomal rearrangements. The patient underwent several chemotherapy treatments for AML but eventually died of bilateral pneumonia in March 2017.

[Endovascular treatment of acute ischemic stroke]

Ischemic stroke is one of the leading causes of mortality and disability in the population of developed countries. Revascularization of the affected cerebral territory improves the prognosis and reduces mortality, which has been proven by randomized studies using systemic thrombolysis protocols. Over the last ten years, endovascular mechanical thrombus extraction using stent retrievers and/or aspiration neurointerventional catheters has been introduced into the clinical treatment of ischemic stroke, and after reporting the results of randomized studies on this topic, the technique has become ubiquitous. This work objective was to systematize the results of key studies on the treatment of acute ischemic stroke in chronological order, including the latest data of 2018.

[Topical respiratory strategies in neurocritical care]

Management of the respiratory tract and maintenance of adequate gas exchange are the basic goals of critical care. Injury to the nervous system is often accompanied by development of respiratory disorders. On the other hand, changes in the gas composition of arterial blood can cause brain damage. In addition, approaches to the patient with respiratory failure, which are used in general critical care and neurocritical care, may differ. The presented literature review is devoted to modern respiratory strategies used in neurocritical care.

[Surgery for intractable epilepsy in a patient with encephalocele of the temporal lobe: a case report]

We describe a case of surgical treatment of intractable temporal epilepsy in a female patient with congenital middle cranial fossa encephalocele. We present clinical-anamnestic and neuroimaging data as well as the microscopic and macroscopic pictures of encephalocele. We analyze outcomes of surgery for this pathology, which have been reported in the literature. To date, there have been a few articles on this subject in the domestic literature. The development of neuroimaging techniques and a growing number of verified encephalocele cases promote the widespread use of surgery for treatment of intractable epilepsy. Congenital encephalocele should be considered in the differential diagnosis of intractable temporal epilepsy, and, if verified, surgical treatment is the method of choice in most cases.

[Comparative effectiveness of Marmar technique and laparoscopic clipping of testicular vein in surgical treatment of varicocele in athletes]

INTRODUCTION

Varicocele is one of the most common diseases among men and a proven cause of male infertility, which is directly proportional to its clinical prominence. The aim To evaluate the immediate and long-term outcomes of different surgical methods to treat varicocele in athletes.

MATERIALS AND METHODS

A total of 165 athletes were treated for varicocele. Of them, 82 patients (group 1) underwent varicocele surgery using Marmar technique and 83 patients (group 2) were treated by laparoscopic clipping of testicular vein (endoscopic analogue of Ivanissevitch open surgery).

RESULTS

The incidence of postoperative complications and relapse at 6 months after surgery in groups 1 and 2 was 1.2% and 8.4%, and 4.9 and 14.5%, respectively. The study findings showed a statistically significant (p<0.05) improvement in the spermogram parameters in both groups compared with preoperative values.

CONCLUSIONS

The length of hospital stay and postoperative rehabilitation period were shorter in patients after Marmars varicocelectomy than in patients of group 2. Besides, Marmar technique for varicocele was cost-effective and justified.

Local Radiolesion in X-Ray Inspection Specialists

As a result of some deviations in the installation of the X-ray inspection plant 'Extravolt-225/1600' two workers of an X-ray inspection laboratory were exposed to the radiation in a dose enough to cause an acute local radiolesions (LRs). The first patient was diagnosed with an acute LR of the hands of severe and extremely severe degree. The second patient was diagnosed with a mild LR of her right hand. The first patient received a surgical treatment followed by subcutaneous introduction of the autologous mesenchymal stem cells. The second patient received only conservative treatment. The complete epithelization of the traumatic surface was achieved. Modeling the incident with the following EPR analysis of the compact substance of the ablated bone structures made it possible to specify the spatial-temporal properties of the exposure.

[AUTONOMIC NERVOUS SYSTEM AND ITS IMBALANCE IN NEURO INTENSIVE CARE UNIT]

The autonomic nervous system (ANS) provides homeostasis due to the innervation of the secretory glands, smooth muscle and cardiac muscle. Higher centers of the ANS (primarily the hypothalamus, some centers of the brain stem and limbic system) form a integrative network, which plays a key role in coordinating the functioning of the endocrine, immune system and other parts of the central nervous system. Intracranial centers of the ANS are responsible for the consciousness, behavioral, emotional, and other components of the higher nervous activity. Thus, the significance of the ANS can't be overestimated. At the same time today in neurointensive care there are no clear criteria for ANS dysfunction, we don't have universally recognized monitoring facilities for ANS and approaches to targeted therapy of its disorders. This paradox is even more important as in the pathogenesis of some critical conditions such as neurogenic pulmonary edema, stunned myocardium, cardiomyopathy Takotsubo lies precisely ANS imbalance. This review devoted to the ANS and some problems associated with its imbalance.

[HYPOTHERMIA INFLUENCES ON OXYGEN TENSION IN THE BRAIN PARENCHYMA IN PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE]

Aneurysmal subarachnoid hemorrhage is a serious medical and social problem. The main physiological mechanisms that determine secondary brain damage in this patients are intracranial hypertension, cerebral vasospasm, dysfunction of autoregulation mechanisms, violation of liquorodynamics and delayed cerebral ischemia. The multimodal neuromonitoring for prevention and timely correction ofsecondary brain injury factors has become routine practice in neuroICU. Measurement of oxygen tension in the brain parenchyma is one of neuromonitoring options. During the years of intensive use of this method in clinical practice the reasons for reducing the oxygen tension in the brain parenchyma were revealed, as well as developed and clinically validated algorithms for correction of such conditions. However, there are clinical situations that are difficult to interpret and even more difficult to make the right tactical and therapeutic solutions. We present the clinical observation of the patient with aneurysmal subarachnoid hemorrhage, who had dramatically reduced brain intraparenchymal oxygen pressure although prolonged hypothermia were used. Despite this, the outcome was favorable. The analysis allowed to assume that the reason for this decrease in oxygen tension in the brain parenchyma could be hypothermia itself