Open Access Open Access  Restricted Access Access granted  Restricted Access Subscription or Fee Access

Vol 7, No 2 (2015)

Reviews

FIRST EXPERIENCE OF CELL TECHNOLOGIES IN THORACIC SURGERY

Egorov V.I., Ionov P.M., Jurkiewicz Y.V., Smolyaninov A.B., Besedina N.K., Akopov A.L.

Abstract

Bronchoscopic bronchial fistulas closing tactics, despite the merits, is not sufficiently developed and is of limited use. One of the new ways of improving this area may consist of endobronchial bronchus occlusion of the fistula using cellular technology. The purpose of this study was to evaluate the effectiveness of endoscopic treatment of postoperative bronchial fistulas using cultured allogeneic fibroblasts. The study included 10 patients with bronchopleural fistula after pneumonectomy transferred for lung cancer and infectious and destructive process. The diameter of the defect bronchial stump averaged 5 mm. Endobronchial intervention consisted of submucosal injection of a suspension allofibroblastov human bronchial stump fistula zone. Introduction of cell suspension was carried out in an isotonic saline submucosal fistula bronchus area 2-5 points total volume of 1.5 ml. Concentration allofibroblastov - 3 x 10 6 cells / ml. State of bronchial stump and residual pleural cavity to monitor the implementation of bronchoscopy, chest X-ray, CT scan. It is shown that after endobronchial administration fibroblast suspension clearance fistula was not detected in 6 cases out of 10. obturation of the lumen of the bronchus occurs within 7-9 days after cell transplantation. In the remaining patients fistula persisted, requiring re-cellular infiltration. Follow-up bronchoscopy in two cases the fistula ended blindly and do not communicate with the pleural cavity, the diameter of the fistula opening in two patients decreased significantly, but not completely closed. Thus, bronhoendoskopic submucosal administration of a suspension allofibroblasts in projection bronchial fistula should be considered as a promising method of conservative treatment failure bronchial stump after radical operations on the lungs, allowing 60-80% of cases, to avoid re-open surgery.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):7-13
pages 7-13 views

COMPARISON OF PROLIFERATION AND IMMUNOPHENOTYPE OF MSC, OBTAINEDFROM BONE MARROW, ADIPOSE TISSUE AND UMBILICAL CORD

Aisenstadt A.A., Enukashvili N.I., Zolina T.L., Alexandrov L.V., Smoljaninov A.B.

Abstract

Mesenchymal stem cells (MSC) can be applied for treatment of different diseases. Human MSC have been isolated from bone marrow, adipose tissue, umbilical cord blood. umbilical cord MSCs (uC- MSC) are obtained during birth with non-invasive, non-traumatic methods and thus seem a good candidate for clinical practice instead of bone-marrow MSC (BM-MSC). It is yet unknown wheth- er the immunophenotype and proliferation capacity of uC-MSC are similar to adipose-derived stem cells (AdSCs) or BM-MSC. The goal of this research was to study the immunophenotype and prolifer- atiion capacity of uC-MSC, AdSCs and BM-MSC. The results indicated that MSC of different origin had similar morphological and immunophenotypic characteristics with minor differences. uC-MSC differed from other cultures by constant level of Cd105 expression, the presence of minor Cd10 - and Cd13 - populations and higher proliferative activity. BM-MSC were characterized by reduced expres- sion levels of Cd90, compared with the uC-MSCs and AdSCs. These data confirm the similarity of uC-MSC with BM-MSCs and AdSCs and the possibility of their use in clinical practice instead of hard-to-obtain BM-MSC.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):14-22
pages 14-22 views

MITOGENIC ACTIVITY AND REGENERATION

Pechersky A.V., Pechersky V.I., Smolyaninov A.B., Velyaninov V.N., Adylov S.F., Shmelev A.Y., Pecherskaya O.V., Semiglazov V.F.

Abstract

After 40 years at people decrease in a pool of pluripotent stem cells and increase of risk of development of oncological diseases is observed.To 11 patients aged from 52 till 76 years with a cancer of a kidney, bladder, prostatic gland III-IV stages of disease the chemotherapy or target therapy was carried out. To 4 patients of 60-82 years for restoration of regeneration it was carried out from 4 to 7 transfusions of mononuclear fraction of peripheral blood from young donors of 18-23 years, same-gender and blood types with recipients.In 1 month after carrying out chemotherapy or target therapy after development of a leukopenia in 11 patients the level of the bFGF increased on average by 1,74 times. At 4 patients from them the increase in level of the human VEGF-A on average by 1,25 times was observed, the 3rd of them had an increase in the human EGF on average by 1,13 times. In 3-6 months after the last transfusion of mononuclear fraction of peripheral blood the maintenance of hemopoietic cells predecessors of Cd34+ in peripheral blood increased on average by 3,25 times. At 4 patients the level of the bFGF decreased on average by 1,78 times, at 2 patients from them reduction of level of the human VEGF-A on average by 1,48 times was observed, the 3rd of them had a reduction an human EGF on average by 4,12 times. At all 4 patients in a buccal epithelium to decrease in an expression of p53 on average by 6,02 times, at the 3rd of them to decrease in an expression of Bcl-2 on average by 60,0 times.Violation of updating of tissues is the main reason for development of carcinogenesis in people is more senior than 40 years. The excess stimulation of mitotic activity at them can be reduced to normal level by means of restoration of number of a pool of pluripotent stem cells at transfusion of mononuclear fraction of peripheral blood from young donors of 18-23 years of identical with the recipient by blood types and a sex (The patent of the Russian Federation № 2350340).
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):23-39
pages 23-39 views

ROLE OF THE COMPLEMENT AND CYTOKINES IN THE EARLYDIAGNOSIS OF MULTIPLE SCLEROSIS

Lobzin S.V., Serebryanaya N.B., Ischenko A.M., Golovkin V.I., Fomintseva M.V., Kula I.I.

Abstract

In the article are presented the results of the study of blood and cerebrospinal fluid for cytokines and the complement proteins in 22 patients with clinically isolated syndrome in accordance with the subsequent development of the disease. It is find out the differences between the concentration of some complement proteins in patients with the developed during the observation the definite multiple scle- rosis in comparison with the patients with clinically isolated syndrome, and cytokine status. The de- termination of immunological predictors of multiple sclerosis development may help to understand the dynamics of pathological process and to start the early treatment.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):40-44
pages 40-44 views

ORTHOSTATIC TORTUOSITIS TRANSFORMATION OF THE NECK’S MAIN ARTERIES

Zakhmatova T.V., Shchedrenok V.V., Moguchaya O.V.

Abstract

Among 350 surveyed deformations of internal carotid arteries revealed in 38.6% of cases. At pathological deformation observed acceleration of flow speed indicators from 55% to 65% in part of tortuosity, average value of systolic speeds of a blood flow was 166±28.3 cm/s at the left and 174±30.2 cm/s at the right side. In vertical position in 31.6% of cases at pathological deformation observed transfor mation of tortuosity form. deformation corners became blunt, the gradient of flow speed indicators decreased or was absent, in some cases course of internal carotid arteries became rectilinear. Artificial deformations of vertebral arteries course revealed in 79.4% of people, average value of systolic speed of a blood flow was 92±15.3 cm/s at the left and 76±12.5 cm/s at the right side. In vertical position in deformations of the vertebral arteries, which carried to pathological, in 28.8% of cases a form of deformation was transformed to unpathological tortuosity. duplex sonography in vertical position in patients with tortuosity discovered new approaches in diagnostics of pathological deformations and defines indications to operative treatment.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):45-51
pages 45-51 views

STUDY THE REGULATION OF PERIPHERAL BLOOD FLOW IN PATIENTSWITH CARDIOVASCULAR DISORDERS

Manasyan A.G., Dobkes A.L., Manasyan S.G., Ermolov S.U., Serdyukov S.V., Boldueva S.A., Lipunova A.S., Ermolova T.V., Zaxarova O.V., Nikitin D.N.

Abstract

A new approach to evaluating of the state of cardiovascular system for patients with verified diagnosis of coronary heart disease (CHd), cardiac syndrome X (COAG) and hypertension (GB) by modification of known techniques of the PAT (peripheral arterial tonometry) is represented in the article. The results of studies by the method of us PAT patients with various cardiovascular disease indicate a particular clinical significance is not only the assessment of local «endothelial dysfunction» (the known value of reactive hyperemia index RHI), but also assess the nature of the Central system response regulation of blood circulation. In the article it is shown that more convenient for this relatively simpleCtrlmeasure R(relative change in the amplitude of pulsations in case of occlusion of the blood supplyto the sample identified on the hand are not subjected to occlusion). For patients without evidenceCtrlof cardiovascular disease the index value Rwas close to unity. The hypertensive patients, as a rule,observed values of R<1, and in CHd patients, in contrast, R>1. The differences associated, pre-CtrlCtrlsumably, with the changing balance between the degree of disturbance of peripheral blood circulationand degree of preservation of the reserves of the pumping function of the heart. This allows to consider the index RCtrl as an additional feature, an essential for individual selection of therapy in patients with cardiovascular pathology.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):52-62
pages 52-62 views

POST-INFARCTION CARDIAC RUPTURE: EPIDIMIOLOGIC AND CLINICAL (BASED ON MATERIALS «ST.-PETERSBURG SCIENTIFIC RESEARCH INSTITUTEFOR EMERGENCY CARE» NAMED I.I. DZHANELIDZE)

Kovalchuk E.Y., Soroka V.V., Ryse A.V.

Abstract

Several risk factors allows us to evidentiate those patients which are highly exposed to the myocardial rupture. Whereas ponderate synthesis and analysis of the epidemiological data and of those risk factors as well, enables us to fetch out the most informative and sustainable post-infarction myocardial rupture predictors. Article contains epidemiologic and clinical information about 81 case of post-infarction myocardial rupture occurred in Saint-Petersburg Research Institute of Emergency Care n.a. I.I.Dzhanelidze in 2009-2012 years. Diagnoses were confirmed in autopsy. Analyzed comorbidity in patients with AMI complicated by rupture of the myocardium.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):63-67
pages 63-67 views

POSSIBILITIES OF CYTOLOGICAL AND IMMUNOCYTOCHEMICAL MARKERSOF INDUCED SPUTUM IN THE EVALUATION OF AIRWAY INFLAMMATION IN PATIENTSWITH DIFFERENT LEVELS OF ASTHMA CONTROL

Pospelova S.N., Sobchenko S.A., Kravtsov V.Y.

Abstract

Were analyzed cytological and immunocytochemical data of induced sputum 43 patients with dif- ferent levels of asthma controlResults of cytological research showed lack or presence of eosinophilic airway inflammation (rela- tive number of eosinophils> 3%), but were not helpful in distinguishing uncontrolled from partially controlled asthma, these data could not be used for determination of level of asthma control. Objective indicator of the severity of airway inflammation, significantly correlated with the levels of disease con- trol, is the ratio of IL-1Ra/IL-1 in AM.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):68-73
pages 68-73 views

ROLE OF CYTOKINE ACTIVATION IN THE DEVELOPMENT OF CARDIOVASCULARDISORDERS IN PATIENT WITH GRAVES DISEASE AND CHRONIC HEART FAILURE

Frolova A.V., Rodionova T.I.

Abstract

The aim of the study is to assess the ability to influence immunological changes on the formation of cardiovascular complications of hyperthyroidism by determining the level of thyrotropin-receptor antibodies (TRAb), 6,8,10 interleukins (IL-6,8,10) and tumor necrosis factor-alpha (TNF-) in patients with Graves’ disease (Gd) and chronic heart failure (CHF) and without it. 68 patients were investigated with Gd, CHF diagnosed in 38 patients (55.9%), stage 1- in 12 patients (31.6%), stage 2A - in 19 (50%) patients, stage 2B - in 7 (18,4%) patients. For the analysis, patients were divided into 3 groups: 1 - with no signs of heart failure, 2 with CHF 1 stage (because the clinical signs characteristic of heart failure stage 1 can also be symptoms of hyperthyroidism, these patients were in separate group), 3 - CHF 2A and step 2B. In all three patients groups showed a significant increase in the levels of cytokines and TRAb compared with the control group. The development of CHF in patients with Graves’ disease is associated with increasing of IL-6, IL-8 and IL-10 concentration. direct correlation between the level of TRAb, TNF- and development of the cardiovascular complications in patients with Gd have not been identified.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):74-77
pages 74-77 views

MORPHOLOGICAL CHARACTERISTICS ANd CLINICAL MANIFESTATIONSOF THE PANCREAS dISEASES IN PATIENTS WITH VIRAL HEPATITIS

Zemlanoy V.P., Syngaevskiy A.B., Sidorov R.S., Letina U.V., Labazanov V.M.

Abstract

The study analyzed the protocols autopsies of patients with decompensated forms of viral hepatitis. According to the autopsy 60% of patients with decompensated forms of viral hepatitis had pathological changes in the pancreas of which 2/3 were morphologically classified as acute pancreatitis. We performed retrospective analysis of medical records of patients who was found to have changes of the pancreas at autopsy. The clinical picture typical for pancreas involvment was scanty and concealed by severe clinical manifestations of decompensated liver failure due to progression of chronic viral hepatitis.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):78-85
pages 78-85 views

HEMODYNAMIC STATUS OF PREGNANT WOMEN WITH OBESITY

Matlubov M.M., Semenixin A.A., Ruzibaev S.A., Zakirova N.I., Kim O.V.

Abstract

In order to study the state of hemodynamics in pregnant women with obesity of varying severity were examined 84 pregnant women aged between 23 and 28 years at 36-38 weeks gestation. The control group included 21 pregnant women of similar age and gestational age with normal body weight. All observed patients, pregnancy according obstetrical consultation was recognized uncomplicated. The degree of obesity was assessed by body mass index. Researches conducted showed that overweight as its progression has a very adverse effect on hemodynamics and functional state of the cardiovascular system as a whole, reduces coronary reserve. The most pronounced violation of the functional state of the cardiovascular system occur in obesity 2nd and 3rd degree.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):86-90
pages 86-90 views

FEATURES OF HEMODYNAMICS AND PECULIARITIES OF ADAPTATION IN INDIVIDUALS WITH DIFFERENT TYPES OF EMOTIONAL BALANCE

Nikolaev V.I., Denisenko N.P., Denisenko M.D., Isakova A.V.

Abstract

Peculiarities of hemodynamics in dependence of individual psycho-physiological features are examined among patients with acute disorders of cerebral circulation and healthy volunteers remaining in the situation of emotional stress. It was demonstrated that formation of “negative” emotional balance (prevailing of personal anxiety on reactive anxiety) promoted occurrence of the excessive tension and/ or overstrain of the adaptive mechanisms. It was either revealed that “negative” emotional balance facilitated the appearance of signs of the adaptive systems overexertion regardless of the type of the initial hemodynamics. It was detected that the psycho-physiological parameters, the peculiarities of hemodynamics and the level of tension of adaptive mechanisms in patients with acute disorders of cerebral circulation were comparable with the similar indices of healthy volunteers characterized by “negative” emotional balance in the situation of the emotional stress.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):91-96
pages 91-96 views

THE COPING STRATEGIES CHOICE IN THE PSYCHO-EMOTIONAL STRESS AMONG MENAND WOMEN OUTSIDE OF MARRIAGE

Bulgakova O.S., Nikolaev V.I., Denisenko N.P., Sibilev O.P.

Abstract

The aim of this work was to study the choice of coping strategies divorced men and women in a state of emotional stress. Thus, the research identified that there are differences in men and women in the choice of coping strategies in divorce, they are socio-behavioral forms of protection, in the basis of which is the adaptation to changing environmental conditions. Survey data must be taken into account in the work of doctors and psychologists when performing correction of this type of psycho-emotional stress.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):97-101
pages 97-101 views

PARTICULAR QUALITIES OF PSYCHOSOMATIC RELATIONSHIPS IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS

Octiaborskaya I.V., Tashlykov V.A., Belyaeva I.B.

Abstract

In 120 patients with active rheumatoid arthritis evaluated psychosomatic relationships Anxiety and depressive disorders were found in 80 (66.2%) patients. There was a positive correlation relationship between the number of patients with anxiety and depressive disorders and values of activity index dAS 28, functional health assessment index НAq, disease duration and quantitative values of rheumatoid factor. Combination therapy with methotrexate and infliximab has obvious advantages over monotherapy with methotrexate in patients with active rheumatoid arthritis and leads to significant clinical improvement, increase functional ability of joints, improve the quality of life and decreased fatigue and somatization depression.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):102-107
pages 102-107 views

FIBROBLAST GROWTH FACTOR (FGF) 21 AT MULTIMORBID CARDIOVASCULAR PATHOLOGY WITH ANXIETY AND DEPRESSIVE DISORDERS IN YOUNG AND MIDDLE-AGED MEN

Partsernyak A.S., Proshyai G.A., Partsernyak S.A., Aflitonov M.A., Mironenko A.N., Topanova A.A.

Abstract

Evaluate (FGF) 21 at multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS)) with non-psychotic mental disorders (NPMd) anxiety/ depressive type. Identify the effectiveness of visual-auditory effects in the treatment of these pathologies. design and methods: The study included 70 men (mean age 37,46±6,74) with MCVP divided into 4 groups by simple random sampling, and 20 healthy men (mean age 38,3±6,73 g). Patients in Group 1 (n = 22) received standard therapy CAd, hypertension and NPMd, in group 2 (n = 25) standard therapy CAd, hypertension, NPMd and visual-auditory correction. Patients of group 3 (n =23) received standard therapy CAd, hypertension, NPMd, visual-auditory correction and psychotherapy. used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. definition of FGF21 performed by ELISA using kits BCM diagnostics SK00145-01 (BCM diagnostics, uSA). Results: Identified a two-fold increase in the concentration of serum FGF 21 after the course of standard therapy in the first group. In the other groups showed a statistically significant decrease FGF21 after psychopharmacological and visual-auditory therapy. In all groups after treatment was observed significantly change the type of NdP «severe depression»,«clinical anxiety» to «mild depression»; «subclinical anxiety» (p <0,001). Conclusions: FGF21 may be important biomarker for early diagnosis of metabolic abnormalities in this pathology. Results indicate benefits of combined therapy MCVP with the use of psychotropic drugs and visual-auditory correction method. Choose the method of complex treatment given the side effects of pharmacological agents.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):108-113
pages 108-113 views

CAPABILITIES AND PERSPECTIVES OF THE PRENATAL NEUROSURGERY(FETAL NEUROSURGERY)

Iova A.S., Garmachov Y.A., Crukov E.Y., Iova D.A.

Abstract

Capabilities and perspectives of the prenatal neurosurgery in hydrocephalus and myelomeningocele are presented, which were based on experimental and clinical studies. Reasons of the decreasing of interest for surgical treatment of hydrocephalus and «revolution» in the field of surgical treatment of fetus myelomeningocele are analyzed. Requirements to medical centers that are planing the introduction of technologies of surgical treatment of myelomeningocele are presented. Prospects of introducing of the technology in fetal neurosurgery in St. Petersburg are analyzed.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):114-122
pages 114-122 views

GLOBAL AND RUSSIAN TENDENCIES IN THE HUMAN RESOURCE MANAGEMENTIN HEALTH CARE

Hurtsilava O.G., Luchkevich V.S., Avdeeva M.V., Filatov V.N., Samodova I.L.

Abstract

The article analyses the main directions of development of human resource management in the health sector, both in Russia and abroad. Through the example of the Russian and foreign health care service it shows that the main problem is the deficit of nurses and physicians. The world experience in solving this problem is analysed in the article. The research shows the current classification of availability of medical personnel and characterises system of training of medical personnel in Russia. In conclusion the prospects of development of human resources policy and medical personnel management on the basis of strategic planning in health care are given.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):123-132
pages 123-132 views

OBITUARY O.L. TIKTINSKY (1928-2015)

- -.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):133-134
pages 133-134 views

INSTRUCTION TO AUTOR

- -.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(2):135-136
pages 135-136 views


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies