Medical academic journal

Ongoing organ shortage is a crucial limiting factor of organ transplantation. Given article highlights organ donation practice in Saint-Petersburg emphasizing unsuccessful attempts of increasing the number of deceased donors. Given by analyses of neurosurgical and neurological rates of mortality last three years, the authors tried to ground the urgency of the putting in clinical practice the optimization of the transplant algorithms, organ donor's audit, and the implementation of new approach to define organ donor's process stages. In article are presented the results worked out of the metrics coefficients for estimating donation potential of emergency hospitals. The study was carried out of involvement and education in organ donation practice, legislative issues among critical care professionals, neurologists and critical care nurses. Article presented the first attempt of estimating the economical aspects of donation process in donor's hospitals. The recommendations were given for national organ donation network establishment.

Uncontrolled organ donation after circulatory determination of death could be a promising perspective, but the warm ischemic time damages restrict the use of them. Between 2009 and 2010, organ procurement service of St Petersburg, Russia, used 17 patients who had experienced unexpected circulatory death as uncontrolled donors with warm ischemic time from 45 to 91 minutes. For resuscitation kidney suffered ischemia, normothermic extracorporai abdominal perfusion in situ with leukocyte depletion was applied. Kidney transplantation was performed for 34 patients. Immediate functioning of kidney grafts was observed in 11 of the 34 cases. The 1 -year graft survival rate was 97% (n=33), rejection rate 2,9% (n=1 ). At the end of first year of observation, the average creatinine level was 1,81 ±0,05 mg/dL. Based on our experience, we posit that normothermic extracorporal perfusion can be solely considered as a resuscitation practice for kidneys from uncontrolled donors that critically expands warm ischemia time. The results of the 1 -year follow-up clinical experience with this procedure provide evidence that transplantation of organs that are "resuscitated” using this method are satisfactory and meet the generally accepted criteria for graft survival and functioning.

We examined gastric biopsies from four groups of patients with a chronic gastritis: HP and EBV-negative, HP-negative and EBV-positive, HP-positive and EBV-negative and HP and EBV-positive. EBV antigens were determined by immunohistochemical method. It is shown, that the morphological picture of gastric mucosa at availability in it VEB has essential differences from HP-positive chronic gastritis and idiopathic chronic gastritis. HP and EBV-positive chronic gastritis was more expressed, than isolated HP-positive chronic gastritis and isolated EBV-positive chronic gastritis.

The purpose of the investigation was to clear the significance of GABA and dopamine systems of the bed nucleus of stria terminalis for the reinforcing effects of a number of psychotropic drugs (opiates, opioids, psychostimulants) on self-stimulation of the lateral hypothalamus in rats. The Wistar male rats were implanted bipolar electrodes in the lateral hypothalamus to study self-stimulation reaction in the Skinner box. Simultaneously, the microcannules were implanted into the bed nucleus of stria terminalis to inject the drugs studied (1 μg in 1 μl in volume for each injection). The blockade of GABA a receptors (bicuculline 1 μg), sodium influx ionic currents (xycaine, or lidocain 1 μg) or D 1 dopamine receptors (SCH23390) by means of intrastructural administration of drugs into the bed nucleus of stria terminalis decreased, but the blockade of D 2 dopamine receptors (sulpiride) mildly increased self-stimulation reaction of the lateral hypothalamus in rats. The inhibition degree of self-stimulation was the following range: xycaine > SCH23390 = bicuculline (the drugs are located in the range of descending inhibition activity). On the background of blockade of GABA a receptors (bicuculline) in the bed nucleus of stria terminalis, only sodium ethaminal reproduced its psychostimulant effect, but amphetamine, fentanyl and leu-enkephaline did not appear it. The blockade of D 1 dopamine receptors with SCH23390 prevented the reinforcing effects of all narcogenic drugs. On the opposite side, the intrastructural administration of xycaine into the bed nucleus of stria terminalis strengthened the effects of amphetamine, fentanyl and leu-enkephaline without the effect of sodium ethaminal. At the same time, the blockade of D 2 dopamine receptors with sulpiride increased self-stimulation and strengthened positive reinforcing effects of sodium ethaminal and leu-enkephaline without effects of amphetamine and fentanyl. Therefore, the bed nucleus of stria terminalis controls the hypothalamic self-stimulation via GABA- and dopaminergic mechanisms. GABA realizes the negative (inhibitory) action. The direct positive (activating) effect on the lateral hypothalamus is realized through D 1 dopamine receptors, and D 2 dopamine receptors of the bed nucleus of stria terminalis limit the positive effects of narcogenic drugs.

Optimization of the surgical tactics of treatment of the patients with occlusive hydrocephalus through impact of algorithm of differential diagnosis and minimally invasive endoscopic lll-ventriculostomy was the main aim of the study. Clinical (including cognitive functions) and instrumental manifestation of hydrocephalus in two groups of patients differentiated by the method of surgery (ETV vs. VPSh) were analyzed. Dynamics of clinical state, CT/MRI, quality of life, restoration of cognitive functions, outcome significantly differed between groups. ETV proved to be an optimal and cost-effective method of choice in surgical treatment of occlusive hydrocephalus in patient with preserved CSF resorbtion.

The main goal of the current research was to assess memory impairment via learning curves and its restoration during the process of rehabilitative treatment of alcoholic patients with pharmacological correction. We applied a mathematical model Y = B3xexp(-B2x(X-1 ))+B4x(1 -exp(-B2x(X-1 ))), where X is the trial number; Y is the number of recalled correct words, B2 is the learning rate, B3 is readiness to learn and B4 is ability to learn. Readiness to learn and ability to learn were significantly below normal values in alcoholic patients in comparison with healthy participants. Treatment with nootropil together with vitamins returned readiness to learn up to normal values. Readiness and ability to learn in patients treated with nootropil itself or bemethyl (metaprot) was initially high so that both drugs did not exert any effect. Use of 10 words in a list of Luria's memory test is insufficient for exact assessment of the long-term memory, so that the list should be increased up to 16 words.