Vol 26, No 3 (2018)

Original researches
Pathomorphology of hydrocephalus associated with anomalies of development of the cerebral aqueduct
Procenko E.V., Peretiatko L.P., Fateeva N.V., Saryeva O.P.

Aim. The aim of the study was to reveal structural peculiarities of the ventricular germinal zone and of the neocortex in newborns of 22-40 weeks gestation with congenital hydrocephalus associated with anomalies in development of the cerebral aqueduct.

Materials and Methods. The main group was the brain of newborns aged 22-40 weeks of gestation with hydrocephalus, formed with the underlying developmental anomalies of the cerebral aqueduct (n=10); comparison group (n=30) was the brain of newborns without visible pathology of the CNS with the width of the lumen of lateral ventricles not exceeding 0.5 cm. A complex pathomorphological study of the ventricular germinal zone and the neocortex in the projection of field No. 6 (cortical representation of the motor analyzer) was carried out.

Results. Hydrocephalus associated with anomalies of development of the cerebral aqueduct is characterized by disorders in formation of sulci and gyri (micropolygyria, asymmetry and breakage of the gyrification sequence), by absence of signs of remodeling of the ventricular germinal zone and by retardation of differentiation of III-VI cytoarchitectonic layers of the neocortex, with the underlying increased expression of S-100 glial protein in glioblasts of white matter, decreased expression of vimentin in vessels of periventricular region, negative expression of metalloproteinases-9 in glioblasts, of reelin in Cajal-Retzius neurons, of desmin in periventricular vessels.

Conclusion. Structural peculiarities of the ventricular germinal zone and the neocortex in newborns of 22-40 weeks of gestation with hydrocephalus, associated with anomalies in development of the cerebral aqueduct, should be considered as morphological diagnostic criteria for differentiation of the given pathology with internal hydrocephalus of a different etiology.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):337-344
Construction of computer model in tissue morphometry
Vasin A.S., Davidov V.V., Svirina J.A.

Background. In a microscopic study of animal and human tissues, researchers are faced with the problem of their objective assessment. Descriptive microscopy is subjective and does not allow to make exact conclusions. A partial counting of some selective elements of tissue is often not sufficiently informative. Use of high-grade morphometry is a very laborious procedure, which is difficult to conduct, repeat and recheck. Descriptive microscopy does not allow to make a model of research for a comprehensive assessment of the results, which complicates making conclusions.

Aim. To solve the problem of objective assessment of tissue condition in histomorphological studies and accelerate their implementation with the help of computer modeling.

Materials and Methods. The whole process from making micropreparations to the end of their full analysis was divided into 4 stages: photographing the entire area of micropreparations using a video eyepiece microscope, counting histomorphological elements in the photos, construction of a computer model, analysis of the obtained data.

Results. An interactive computer model of the experiment was constructed, in which all parameters were combined into a single set, and a change of any value influenced the entire model. It was possible to visualize the obtained results, calculate new parameters, find out the relationship between them and to use additional tools, as, for example, machine training for finding non-obvious relationships between components or for speeding up further calculations.

Conclusions. The advantages of computer modeling consist in that it significantly accelerates histomorphological examinations, improves the quality of their processing, makes the procedure more transparent and provides scientists with more opportunities for in-depth analysis. An important advantage is that this technique is suitable for any histomorphological studies.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):345-350
Antidepressant-like action of diacamphe against the background stress-induced behavioral depression
Zayka T.O., Evdokimov D.V., Abramets I.I.

Background. It was find out the cerebroprotective properties of diacamphe – (±)-cis-3-(2’-benzimidazolyl)-1,2,2-trimethylcyclopentan-carbonic acid hydrochloride in vivo experiments in the some models of brain injury.

Aim. To investigate the neuroprotective and antidepressant-like activities of diacamphe.

Materials and Methods. It was investigated an impact of diacamphe on inhibition of the pyramidal neurons field synaptic potentials evoked by N-methyl-D-aspartate, procedure anoxia/neuroaglicemia, and H2O2 in the electrophysiological experiments on hippocampal slices for evaluating of diacamphe neuroprotective activity. It was explored in behavioral experiments the impacts of diacamphe and antidepressant imipramine on basic manifestations of behavioral depression evoked by five-days swimming stress – helplessness and anhedonia.

Results. It was ascertained in experiments on the hippocampal slices that diacamphe especially at conditions of systemic administration diminished of injury of the pyramidal neurons synapses induced by procedure anoxya/aglicemia, oxidative stress, but not N-methyl-D-aspartate action. The chronic administration of diacamphe in dose 10 mg/kg reduced the manifestations of induced by swimming stress behavioral depression, decrease duration of immobility in forced swimming test (helplessness) and increase preference of intake of sweet solution comparably with water (dilution of anhedonia). Antidepressant-like action of diacamphe differences from action of traditional antidepressant imipramine so far as diacamphe did not diminishes immobilization duration in swimming test after single administration and by more slow developing of action.

Conclusions. Diacamphe possesses neuroprotective action and therefore manifests antidepressant-like action against the background behavioral depression evoked by swimming stress.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):351-359
Peculiarities of electroencephalogram of left-handed individuals in imagination and realiza-tion of feet movements
Vedyasova O.A., Morenova K.A.

Background. Relevance of the study arises from a lack of knowledge about peculiarities of programming and realization of movements in individuals with different profiles of motor dominance. This knowledge is important for understanding the neurophysiological mechanisms of motor functions and for creating neurocomputer interfaces.

Aim. The analysis of electroencephalogram (EEG) patterns in lefties during imaginary and real motor acts by right and left legs.

Materials and Methods. The left-handed students were examined. They were divided into two groups on the basis of coefficients of motor asymmetry – with low (n=14) and high (n=7) degree of right-hemisphere dominance (LDRD and HDRD). EEG was recorded on neurovisor «NVX 36 digital DC EEG» in standard leads at rest and in successive imagination and fulfilment of movements by the right and left legs. Types of EEG were determined and the amplitude of the sensorimotor alpha-rhythm (mu-rhythm) was evaluated on the basis of analysis of spectral patterns of EEG.

Results. It was shown that the majority of left-handed individuals with LDRD had type I EEG, and the minority had type III, whereas all left-handed individuals with HDRD had type I EEG. In imagination and realization of leg movements in the first group the quantity of individuals with EEG of type III increased, while in the second group the type of EEG did not change. Motor tasks were associated with depression of alpha-rhythm in central and frontal areas, but with different extent of evidence in lefties with LDRD and HDRD. More pronounced desynchronization of the central mu-rhythm was observed in left-handed individuals with HDRD, while the amplitude of the frontal alpha-rhythm, on the contrary, was more decreased in left-handed individuals with LDRD.

Conclusions. The obtained data show dependence of EEG pattern in left-handed people during imagination and realization of motor acts by the leading and non-leading leg on the degree of the right hemisphere dominance that may find clinical application.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):360-368
Distribution of physiological resources and effectivity of purposeful activity of patients with epilepsy
Zorin R.A., Medvedeva Y.I., Kurepina I.S., Lapkin M.M., Zhadnov V.A.

Aim: to study distribution of physiological resources in purposeful activity of patients with epilepsy.

Materials and Methods. 70 Healthy individuals and 160 patients with epilepsy were examined. In the examined individuals purposeful activity was modeled with evaluation of its effectiveness using Schulte-Gorbov test. In the dynamics of the modeled activity, parameters of electroencephalogram, variability of heart rhythm were evaluated; in the initial condition (before Schulte-Gorbov test) parameters of evoked visual potentials, P300cognitive potentials and of a conditionally-negative deviation were estimated. Interrelations between parameters of electroencephalography and of variability of heart rhythm were studied using correlation analysis with Spearman rank correlation coefficient; the comparative analysis of variability of heart rhythm and characteristics of respiratory function was performed, and effectiveness of behavior of patients with epilepsy was predicted using logit-regression analysis.

Results. Predomination of structural-metabolic forms of epilepsy was found in the group of patients with low effectiveness of the activity. The low-effective group of patients with epilepsy showed a higher correlation of physiological parameters and a high level of characteristics refecting activation of stress-realizing systems. For effective distribution of patients with epilepsy into groups with different effectiveness of behavior, it was necessary to include characteristics of visual evoked potential, P300 cognitive potential and conditionally-negative deviation into logit-regression model, that reflects the role of afferent and association mechanisms in this task. Increase in physiological «cost» and reduction in the effectiveness of activity in the group of patients with epilepsy is associated with prevalence of structural forms of epilepsy.

Conclusion. Epileptogenic zones in patients with epilepsy are supposed to play a role not only in reduction of effectiveness of activity, but also in excessive mobilization of physiological resources and in increase in physiological cost of activity, that diminishes its effectiveness.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):369-379
Addictive behavior and alcoholism in medical students of senior courses (prevalence, comorbidity and treatment)
Lukyantseva I.S., Ruzhenkov V.A., Ponomarenko D.O.

Background. A high level of academic load and stress create risks of alcohol abuse among medical students because they use it as a method of coping with stress.

The aim of research was to verify the incidence of addictive behavior and alcoholism among medical students and their comorbidity with mental disorders, for development of therapeutic approaches.

Materials and Methods. 455 Medical students were examined using medico-sociological, psychometric methods and the author's «Methods of clinical screening-diagnostics of addictive and dependent behavior».

Results. Alcohol abuse was detected in 13.0% of cases. Addictive behavior was revealed in 11.2% of students: 14.8% among males and 9.9% among females. The 1st clinical stage of alcohol dependence was diagnosed in 1.8% of students: 6.6% among males and 1.2% among females. Individuals with addictive behavior and dependence were characterized by a high level of social frustration, negative thinking and aggressiveness, low level of self-motivation, inability to control emotions, low level of responsibility, intolerance and negative thinking. Predominating mental disorders included stress-related neurotic, somatoform and personality disorders. Individuals with addictive behavior and alcoholism exhibited a high level of asthenia, anxiety, depression, obsessive-compulsive symptoms, social phobia and dysmorphophobia which created additional difficulties in social adaptation.

Conclusion. The study revealed a high level of comorbidity of addictive behavior and alcohol dependence with mental disorders. Methods of aversion therapy in combination with development and fixation of optimal methods of coping with stress permit to achieve qualitative remission of alcoholism and to prevent its formation.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):380-387
Diagnostic significance of volume capnography in examination of patients with bronchial asthma
Subbotin S.V.

Aim: to study the diagnostic significance of volume capnography in examination of patients with severe and moderate bronchial asthma (BA).

Materials and Methods. 171 patents were examined, of them 43 patients with severe BA and 45 patients with moderate BA. The control group included 83 relatively healthy volunteers. In all the participants, along with clinical examination, parameters of spirometry and volume capnography were determined using ultrasound computer spirograph SpiroScout (Ganshorn, Germany) equipped with a volume capnography function.

Results. Volume capnography revealed the following changes in patients with BA in comparison with the control group: increase in the slope of phase III (indicates non-uniformity of ventilation and perfusion in the lung periphery due to pathology of the small airways) and increase in emphysema index (indicates hyperinflation of lung). The above indices had statistically significant differences in severe and moderate asthma. Based on the results of examination of healthy individuals, the normal values for the slope of phase III (<0.31 g/mol·L) and emphysema index (<43) were calculated. Diagnostic sensitivity and specificity of volume capnography were studied with subsequent construction of ROC-curves and calculation of AUC for the slope angle of phase III and for emphysema index. It was found that most informative in BA are parameters of specificity of the diagnostic test (slope of phase III – 90.32%, emphysema index – 96.77%). The subsequent construction of ROC-curves showed that the AUC value for slope of phase III and emphysema index was higher in severe BA compared to the moderate BA (0.74 and 0.86, respectively).

Conclusion. The obtained data demonstrate the significance of volume capnography in the functional diagnosis of respiratory disorders in BA.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):388-395
Influence of risk factors on progression of atherosclerosis of brachiocephalic artery with un-derlying treatment with statins
Zybin A.V., Pokrovsky A.V., Timina I.Y., Kharazov A.F., Adyrkhaev Z.A.

Aim. Analysis of influence of risk factors (RF) on progression of atherosclerosis of brachiocephalic arteries after unilateral carotid endarterectomy (CEA) with the underlying treatment with statins.

Materials and Methods. 262 Cases (262 patients) were analyzed. Influence of RFs on the frequency of cerebral circulation disorders (CCD), myocardial infarction (MI), survival rate, condition of the carotid arteries and on lipid profile with the underlying treatment with statins was evaluated. In the early period the results were evaluated in 100% of patients, in a long-term period – in 93.5%. Patients were arranged in groups: a group that received simvastatin – 41.6% in the preoperative period and 24.5% in the long-term period, a group of atorvastatin – 51.9% and 54.7%, a group of rosuvastatin – 6.5% and 20.8%, respectively. Predominating (83.2%) were patients with more than 3 RFs (according to SCORE scale).

Results. Lethality rate in the analyzed sample group was 6.5%, the rate of fatal cardio-vascular complications (CVC) – 7 cases (2.3%), of non-fatal CCD – 5 cases (1.9%). A significant influence on the progression of alterations in the carotid artery was found in patients with 3 RFs (p=0.03). The length of atherosclerotic plaque (ASP) was maximal in patients with 5 RFs (0.01). In the presence of more than 3 RFs, elevation of the total cholesterol (CL) and of low density lipoproteins (LDLP) was noted, p=0.001. In the long-term period in the atorvastatin group the level of LDLP decreased by 19%, p=0.0001, in the rosuvastatin group the level of HDLP increased by 3.4%, p=0.02. In the rosuvastatin group, the recommended values of CL were achieved 64.7% more often in comparison with the simvastatin group, p=0.03. The rate of CVC increased in patients >68 years of age, р=0.04. The lethality rate increased in case of body mass index (BMI) ≥25-30 kg/m2 (р=0.05) and in case of type 2 diabetes mellitus (p=0.03). The influence of the following factors on long-term results was demonstrated: smoking (p=0.04), arterial hypertension (p=0.019), chronic cardiac insufficiency (p=0.01), a tendency to bradycardia (p=0.03), atherosclerotic lesions of more than one arterial pool (p=0.006). RFs influenced the rate of development of restenosis of the internal carotid artery (ICA) >50% on the side of the operation in 4 observations (1.5%). In the atorvastatin group the most significant positive influence on lipid spectrum was observed in comparison with other groups (by 47.1%, р=0.001).Therapy with atorvastatin stabilized the wall of ICA and of the contralateral common carotid artery (CCA) 17.6% (p=0.05) more frequently in comparison with simvastatin and rosuvastatin.

Conclusion. A direct influence of RFs on the progression of atherosclerotic alterations in the carotid arteries and on the rate of development of cardiovascular complications in the perioperative and long-term periods, and also influence of underlying statin therapy on the parameters of lipid metabolism, and a higher effectiveness of synthetic statins were determined.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):396-406
Duplex scanning of veins of the lower limbs and of paraarticular tissues after arthroscopic reconstruction of the anterior cruciate ligament
Dolganova T.I., Menshchikova T.I., Karaseva T.I., Dolganov D.V., Menshchikov I.N., Karasev A.G.

Aim. Evaluation of paraarticular tissues and of venous outflow by the data of ultrasound duplex scanning (USDS) after arthroscopic plasty of the anterior cruciate ligament (ACL).

Materials and Methods. Analysis of the results of examination of 32 patients with ACL injury at the age of 18-50 (mean age 32.62±1.1 years). The technology of transtibial arthroscopic reconstruction of ACL was applied with use of RigidFix and Biointrafix systems of fixation. USDS of veins, paraosseous and paraarticular tissues was performed using «HITACHI» HI Vision Avius device.

Results. The performed studies permitted to reveal a group of patients (with the share of 12%) in whom, by the moment of discharge from hospital to the outpatient treatment, hemodynamic signs of dysfunction of the valves of deepleg veins were recorded. According to sonography data, the volumes of the upper and lateral torsions remained increased, and tissue edema and hematomas along the anteromedial and posteromedial surfaces of the leg persisted. Taking into account the temporary character of these changes withtheir absenceon the follow-up examination after 1.5 months, we think, they were associated with increased traumatization of m. Semitendinosus and m. Gracili due to the anatomical peculiarities of the structure of tendinous-muscular complex (pes anserinum) in certain patients.

Conclusions. The technique of USDS of vein and paraarticular tissue after arthroscopic reconstructionof ACL permits to identify a group of patients at risk for prolongation of rehabilitation period. The dysfunctions of the valves of the deep veinsof legs, the presence of hematomas at the stage of fibrotization require additional rehabilitation measures including medicinal treatment, physical therapy and exercise therapy under control of USDS.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):407-416
Neurobiological mechanisms of transcranial magnetic stimulation and its comparative efficacy in tension headache and migraine
Sorokina N.D., Pertsov S.S., Selitsky G.V.

Transcranial magnetic stimulation (TMS) is one of the nonpharmacological methods to affect the central nervous system. This approach allows a noninvasive stimulation of the cerebral cortex. The method is based on the ability of magnetic fields to penetrate the bone and muscle structures. The induced magnetic field depolarizes the neuronal membrane, and the generated action potential propagates through the conducting pathways. In the review, the biophysical effects of TMS, as well as its neural, immune, mediator and macro effects are analyzed. The main contraindications to TMS and its side effects are considered. Nonpharmacological treatment of tension headache (TH) and migraine is a promising direction, since the incidence of these types of primary headaches reaches 40-65 and 11-22%, respectively. In the article the current state of study of various modes and durations of TMS procedure, and the site of exposure in TH and migraine are considered. In recent years there is noted an increase in the number of evidence-based randomized, placebo-controlled studies on the effectiveness of TMS in migraine therapy. Much attention is given to evaluation of the effect of TMS in migraine. There is much evidence of the positive effect of this procedure. However, the amount of examined volunteers does not provide the highest level of evidence. Experiments on animals and use of functional neurovisualization techniques contribute to understanding of the mechanisms of TMS effect. Active participation of physiologists, neurophysiologists and biophysicists in these research works will permit evaluation of the effectiveness of TMS in nonpharmacological treatment of patients with pain syndrome. This approach will improve the working capacity and quality of life in TH and migraine.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):417-429
Role of risk factors in development of chronic posttraumatic instability of ankle joint
Kurov M.A., Gоlubev V.G.

Injuries of the ankle joint (AJ) are the most common traumas of musculo-skeletal apparatus and a common reason for seeking medical advice. Overstrains of the ligament apparatus of AJ are the most common mechanism of traumas in running, sporting activity, in unexpected fallings into rough surfaces or getting with a heel into ribbed coverings of metroescalators, in a sharp stoppage of public transport, in wearing footwear on high heels, etc. 20-40% Of patients develop a clinical presentation of a chronic instability of the ankle joint. In the article the analysis of the literature data on the role of risk factors in development of a chronic posttraumatic instability of the ankle joint is given. In result the authors make the conclusion that the influence of the internal risk factors on development of a chronic posttraumatic instability of the ankle jointis studied insufficiently, and further investigations in this direction are required. This scientific trend is important and is of high practical significance, since its results could be used for elaboration of the algorithm of organ-saving operations which will permit to optimize medico-surgical approach, to reduce the number of patients with disability and to return patients to their professional and sporting activity.

I.P. Pavlov Russian Medical Biological Herald. 2018;26(3):430-439

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