REVIEWS
The review examines the historical aspects of the hippocampus nomenclature. Its anatomical study began by the ancient Greeks, who called the unusual–looking structure a “ram’s horn” – cornu ammonis. The term “hippocampus” (ancient Greek: ἱππόκαμπος, from ἵππος, “horse” and κάμπος, “sea monster”, or “sea-horse”) was first introduced in the sixteenth century by anatomist J.C. Arantius. The term “hippocampal formation” is currently applied to a group of cytoarchitectonically different adjacent areas, including, along with the hippocampus itself, the dentate gyrus, subiculum, presubiculum, parasubiculum and entorhinal cortex. The reason for including these six regions in the “hippocampal formation” group is that they are connected to each other by unique and largely unidirectional pathways. The review is devoted to the spatial, morphological and cyto- and myeloarchitectonic organization of all departments of the rat hippocampus formation and the distinctive neuroanatomic characteristics of its departments. Comparative features of the structure of the hippocampus formation of a rat, monkey and human are described. Although the volume of the hippocampus is about 10 times larger in monkeys and 100 times larger in humans compared to rats, the basic architecture of the hippocampus formation is common, although there are some species differences. The relatively simple organization of the main cellular layers in combination with the highly organized laminar distribution of hippocampal neuron processes contributes to its use as a model system in modern neuroscience.
The review presents an analysis of publications devoted to the identification of biological activity, component composition, pharmacological properties and therapeutic potential of various components of the Curcuma longa plant. This publication was prepared using mostly articles in PubMed, Scopus, and Web of Science. The analysis showed that Curcuma longa contains a wide range of biologically active substances, including curcuminoids, volatile oils, resins, alkaloids. Numerous in vivo and in vitro studies have demonstrated anti-inflammatory, antioxidant, antibacterial, antitumor, neuroprotective, antiproliferative and a number of other effects. Thus, Curcuma longa has a high therapeutic potential and can be a promising type of raw material for the development of drugs effective in various diseases.
Surfactant proteins SP-A and SP-D, which belong to the family of collagen-containing type C lectins, are used as diagnostic and prognostic markers for many acute and chronic respiratory diseases. The aim of the study is to assess the impact of conventional risk factors for chronic non-infectious diseases on SP-A and SP-D protein levels by means of systemic and structural analysis on the basis of relevant publications from international databases and official WHO reports. This analytical review concludes that widespread expression of SP-A and SP-D is documented in numerous studies, and, although the lungs remain the main site of synthesis of surfactant proteins, one can expect its significant impact on the immune and inflammatory response in many organs and tissues. The authors note that there are several known extrapulmonary effects of these proteins. However, many mechanisms of additional cellular effects of SP-A and SP-D outside the bronchopulmonary system still remain unstudied, which indicates the prospects for further research in this area.
PHYSIOLOGY
In modern physiology, the priority direction is the study of the influence of various types of stress, leading, as a rule, to the development of depressive states, on the physiological systems of the body. The main methods for assessing the neuroprotective effect, which is the main component of defense against stress, include the study of behavioral reactions that reflect motor, emotional, and cognitive changes. The study of drugs based on regulatory peptides is promising. Semax (ACTH4-7PGP) is a representative of a new synthetic peptide engineering, practically devoid of a hormonal effect and completely preserving the neurotropic activity of adrenocorticotropic hormone. The aim of the work was an experimental study of the effect of semax on the behavior of animals under the influence of experimental depression based on “social” stress. Material and methods. The study was carried out on 50 outbred male rats aged 6 months. Semax effects were studied under conditions of sensory contact - a model of experimental depression based on the formation of aggressive and submissive behavior in animals, using the multicomponent model the Suok test (“ropewalking”) and the Porsolt test to assess the depressive behavior of rats. Results and its discussion. Intermale confrontations led to a decrease in the time spent in the light half of the test, the number of “exploratory” downward glances, directional head movements; a decrease in the number of visited segments in the light section in victims and aggressors. As a whole, the study of behavioral reactions in animals in the Suok test and the Porsolt test in the model of experimental depression (sensory contact) showed the formation of an anxious-depressive state in animals, which was confirmed by a decrease in the motor and exploratory activity of rats. The results were obtained during the Porsolt test, indicating the formation of a depressive state in animals, which was confirmed by an increase in the total period of immobility in both aggressors and victims, an increase in the time of passive swimming, and a decrease in the time of active swimming. With a comprehensive assessment of animal behavior indicators in the Suok test, against the background of a decrease in the level of anxiety under the influence of semax, an improvement in the parameters of exploratory behavior was observed, in the Porsolt test – of motor activity indicators. Conclusions. Investigation of semax effect on the behavioral reactions of animals under conditions of sensory contact indicates that this drug exhibits an anxiolytic and antidepressant effect, eliminating pathological changes in the psycho-emotional status of animals.
ANATOMY
A fairly common trauma in the population of developed and developing countries is traumatic brain injury, with a significant proportion of patients of the elderly and senile age due to objective reasons. However, anatomical and morphological features of the dura mater (DM) are extremely poorly covered in the scientific medical literature. The aim of the study was to investigate the age-related features of the structure and thickness of the dura mater of a person in the elderly and senile age.
Material and methods. The work was based on the analysis of the results of a comprehensive morphological examination of the DM of 127 deceased (65 men and 62 women) of adolescent, elderly and senile age. Autopsy material was taken from the parietal bones in the projection of the sagittal suture. Hematoxylin and eosin and van Gieson staining was used. The thickness of the DM was determined.
Results. The age morphometric features of DM consist in its statistically significant increase in its thickness in both sexes (p < 0.01). The most pronounced changes are in senile age compared to adolescent: men have 60.7 % more thickness (p < 0.01) and women 63.5 % (p < 0.01). There are no statistically significant differences in the thickness of the DM between men and women in each age period studied (p > 0.05).
Conclusions. The results of the study can serve as a foundation for the future study of age-related changes in the human DM, as well as for use by physicians of such clinical specialties as forensic medicine, neurosurgery, trauma and rehabilitation, gerontology.
BIOMEDICINE
Cells of innate immunity, mainly monocytes/macrophages, form a long-term nonspecific immunological memory during the initial encounter with the pathogen, the so-called trained immunity. Mevalonate pathway metabolites play an important role in the formation of trained immunity. The aim of this investigation was to study the effect of modulators of mevalonate pathway, mevalonate and zoledronate, on the formation of trained immunity in human and animal monocytes/ macrophages.
Material and methods. Human monocyte-like cell lines THP-1 and U-937, peritoneal macrophages of BALB/c mice were used. Trained immunity was induced in vitro by incubation of THP-1 and U-937 monocyte-like cell lines for 24 and 72 hours with inactivated Mycobacteria of BCG vaccine strain, and in vivo by intraperitoneal administration of BCG to BALB/c mice with isolation of peritoneal macrophages on day 7 after infection (lag phase). Cell hyperreactivity was assessed by response to a second stimulus with bacterial lipopolysaccharide (LPS) and mevalonate, zoledranate in the presence or absence of LPS. Lactate, cytokine (IL-1β, TNF-α, IL-10), nitric oxide and glucose level was measured in conditioned media from cells.
Results and discussion. The study showed that monocyte-like cell lines THP-1 and U-937 responded differently by cytokine production, lactate, and glucose consumption to BCG stimulus in the presence or absence of lag phase. Mevalonate and zoledronate alone or in combination with LPS also stimulated cytokine production in different ways. The presence of lag phase for human monocyte-like cells is essential for the level of cytokine production and glucose consumption. Peritoneal macrophages have been shown to enhance pro-inflammatory cytokine production in response to LPS, mevalonate, and zoledronate.
Conclusions. Mevalonate and zoledronate induce trained immunity in monocytes/macrophages.
CLINICAL MEDICINE
Recently, the frequency of treatment of patients with various deformities of the anterior abdominal wall has increased dramatically. Abdominoplasty is a large-scale surgical intervention that entails a number of complications, such as impaired lymphatic drainage, chronic seroma, the formation of “dog ears”, displacement of the navel from the central line. A technology of Scarpa’s fascia preservation (SFP) has been developed to prevent these complications. The aim of this work is to study the effectiveness of treating patients with correction of the tissues of the anterior abdominal wall using SFP technology in comparison with standard abdominoplasty.
Material and мethods. The study involved 30 males and females aged 35 to 60 years with class I-II obesity who underwent complex plastic surgery of the anterior abdominal wall. Patients were divided into 2 groups of 15 people: in the 1st group, classical abdominoplasty was performed, in the 2nd, complex plastic surgery of the anterior abdominal wall using SFP technology. Observation of the patients took place in the early and late postoperative periods.
Results. Group 2 patients lacked both early postsurgical and chronic seromas, did not develop so-called “dog ears”, which indicates the most favorable course of the postoperative rehabilitation period and the achievement of the best aesthetic results. Also, when using the SFP technology, there were no longterm inflammatory processes, the amount of postoperative exudative fluid in the drains decreased, the pain syndrome was significantly lower, and earlier restoration of the sensitivity of the anterior abdominal wall was noted in comparison with patients who underwent classical abdominoplasty. Complex plastic surgery of the anterior abdominal wall using SFP technology makes it possible to reduce the intensity of pain on the first day by 1.75 times (to 4 ± 1 points, p ≤ 0.05), to speed up the removal of drains (reduce the duration of exudation) by 3 times (to 16 ± 1 h, p ≤ 0.05). According to the BODY-Q scale, in the main group, satisfaction with the aesthetic result was 2 times higher than in the comparison group.
Conclusions. Complex anterior abdominal wall plastics with Scarpa’s fascia preservation has a number of significant advantages over classical abdominoplasty.
An original study was conducted and risk factors predisposing to the development of acute renal dysfunction (ARD) were identified, the frequency and consequences of ARD after revascularization operations on the lower extremities were established, and data from scientific articles on this topic were studied and summarized. The aim of the study was to investigate the circumstances of the risk of ARD in patients who underwent revascularization due to peripheral arterial disease.
Material and methods. The signs of ARD development were prospectively studied in 101 patients operated on the aorto-iliac segment for peripheral atherosclerosis, including aneurysmal disease. Manifestations of ARD registered according to RIFLE recommendations were observed in 40 patients. Hemodynamic parameters, creatinine levels, diuresis, concomitant diseases, and the course of the postoperative period were analyzed.
Results. The incidence of ARD was significantly higher in persons with diabetes mellitus, cardiac pathology and manifestations of generalized atherosclerosis, as well as after emergency interventions. The probability of ARD is especially high against the background of hemodynamic instability and blood loss of more than 1000 ml, including with manifestations of centralization of blood circulation.
Conclusions. Massive blood loss with manifestations of hemodynamic instability, as well as cardiac disorders, has a decisive influence on the development of ARD after operations on the aorto-iliac segment.
CASE REPORT
Merkel cell carcinoma is a rare, rapidly progressive, aggressive skin tumor with frequent metastasis and high mortality. The disease is a multifactorial pathology resulting from the interaction of endogenous and exogenous risk factors. Timely detection of Merkel cell carcinoma is important in the management and prognosis of the patient, because the disease is often associated with other neoplastic processes not only in the skin but also in other organs. This article presents a clinical case of Merkel cell carcinoma and deals with the issues of its etiopathogenesis, differential diagnostics and therapy.
A rare clinical case of successful treatment of an interrupted ovarian pregnancy (ОР), the incidence of which is 0.4– 1.3 % of all ectopic pregnancies (ЕР), is described. The exact etiopathogenetic mechanism of OP development is still unknown. The rupture of OP mainly occurs in the first trimester of pregnancy 91.0 %, in the second trimester it is 5.3 %, and in the third it’s 3.7 %. Untimely diagnosis of EP in the ovaries can be fatal with massive bleeding and is associated with the risk of ovariectomy with a subsequent decrease in fertility in patients of reproductive age. It is very difficult to diagnose OP. Differential diagnosis should be carried out with interrupted tubal pregnancy, rupture of the ovarian cyst, as well as with torsion of the ovarian cyst. The article presents the results of a pathomorphological study confirming the diagnosis and adequacy of the performed therapeutic measures. The algorithm of OP diagnosis, justification and decision- making on the method of patient’s management and treatment are shown. The presented clinical case will allow physicians of various specialties to know about this EP rare form, to suspect and successfully diagnose OP in the early stages of gestation, which will avoid severe, and sometimes life-threatening, complications or reduce their development.
HEALTHCARE MANAGEMENT
Variability and heterogeneity of digital medical data requires establishing of modern algorithms which provide appropriate data processing. The aim of the study was to delineate the main steps in formation of a clinical dataset of patients with brain aneurysms from the stage of producing primary mining specifications to formation of a final version.
Material and methods. Data collection, crosschecking of the cases and analyses of dataset has been carried out in Turku University Hospital. Within last two decades available medical data at our hospital have been stored in digital data lake thus allowing automatized data mining. In frame of our study, data mining was performed by a data scientist utilizing R software. Inclusion criteria were based on a set of diagnosis which were coded in medical charts according to international classification of diseases (ICD 10).
Resutls and Discussion. Primary data mining identified 3850 patients with brain aneurysms treated at our hospital from January 2000 till May 2018. After independent manual crosschecking of medical charts of these patients, we found 1218 (32 %) cases, which had no aneurysm (false-positive). Data of remaining true aneurysm-cases were divided into clinical and intensive care unit subsets where every event linked to particular date of treatment was defined as an info-unit. All the data in both subsets were structured into separate Excel files and presented in chronological order for each particular patient. Altogether, dataset included 70 000 000 rows of info-units found in 2632 patients.
Conclusions. Data mining allowed establishment of detailed clinical dataset of patients with brain aneurysms. Produced mining algorithm had limitation regarding false-positive cases (32 % patients). Based on that, we recommend manual crosschecking of automatically collected dataset before statistical analysis.
PREVENTIVE MEDICINE
Introduction. Lifestyle factors, including smoking, alcohol (AU) and drug use (DU), can affect male fertility. The aim of the study was to investigate the frequency and characteristics of smoking, AU and DU in men from infertile couples, to identify the most significant associations of disorders of spermatogenesis and social risk factors.
Material and methods. At the 1st stage of the study, the case histories of 1198 men from infertile couples were analyzed to determine the frequency of smoking, AU and DU, at the 2nd stage, a more detailed questionnaire of 239 patients from the general sample was conducted for detailed characteristics of smoking and/or AU and/or DU, at the 3rd stage, a comprehensive analysis of ejaculate from men who consumed strong alcohol, but did not smoke or use DU (n = 46) was performed in comparison with men without bad habits taken into account (n = 60).
Results. In the general sample, the frequency of AU was 73 %, smoking – 41 %, DU –17 % (mostly in anamnesis). 47.9 % of AU men consumed beer (1.5 (1–2.5) liters per week, 25.6 % – strong alcohol (250 (100–500) ml per week), 7.6 % – champagne/wine (500 (250–725) ml per week); 92.7 % of smokers used cigarettes, 7.3 % – electronic cigarettes (smoking experience was 15 (10–20) years, the number of cigarettes per day was 15 (10–20) pieces); more than 90 % of DU men have a history of non-injection DU. Men who consumed only strong alcohol, but did not smoke and did not use drugs, increased sperm DNA fragmentation compared to men without bad habits taken into account: 16.0 (13.5–19.6) and 12.8 (8.8–19.4) %, respectively, p = 0.018.
Conclusions. Among men from infertile couples, a high frequency of AU was revealed with the predominant use of beer or strong alcohol, the use of the latter increases sperm DNA fragmentation; smoking is characterized by a long experience; active DU is rare. Given the specifics of the requirements for the state of reproductive health of men applying to reproductive medicine centers, it is important to have knowledge about the frequency and severity of smoking, AU and DU among them, as well as about the relationship of risk factors of infertility with the parameters of ejaculate.
The expeditionary-shift method of organizing labor involves an increase in the intensity of work during the shift, a longer work shift, a decrease in inter-shift rest in the absence of days off and minimal social and domestic provision, and, accordingly, a pronounced impact of chronic social stress factors. Aim of the study was to investigate the parameters of stress at work and in the family among men aged 25–54, employed in expeditionary-shift work in the arctic territories of the Tyumen region.
Material and methods. A cross-sectional epidemiological study was conducted on an organized population of men aged 25–54 years, employed in expeditionary-shift work for more than five years at one of the industrial enterprises of the Tyumen region (n = 203). The comparison group consisted of an organized population of men in the same age range working permanently in the city of Tyumen (n = 239). Determination of stress at work and stress in the family was carried out according to the standard WHO questionnaire MONICA-psychosocial.
Results and discussion. Among men employed in the expeditionary-shift form of work, most often over the previous 12 months, a change in specialty was established, an increase in the load and responsibility at the workplace, a more negative attitude towards work, an increase in conflicts with subordinates, but also the possibility of rest after a working day with a decrease in ‘other” changes at work; according to the parameters of stress in the family, among them a change in marital status, an increase in conflicts in the family and at the same time opportunities for a relaxing home rest were most often determined.
Conclusions. Thus, the results of the pilot study, which determined a significantly higher prevalence of some factors of chronic social stress after five years of work in the arctic territories of the Tyumen region, should become a scientific basis for the formation of a socially oriented preventive program to reduce the risks of developing cardiovascular diseases among workers in the oil and gas production complex employed by the expedition-shift form of work.
The aim of the study was to analyze the incidence of malignant neoplasms of the organs of the reproductive system of the population aged 15 to 39 years within the Russian Federation.
Material and methods. The data of specialized forms of state reporting No. 7 “Information on diseases of malignant neoplasms” and data of the Federal State Statistics Service of the Russian Federation on the size and sex and age composition of the population for the period from 2011 to 2021 were used.
Results. In the dynamics of changes in the incidence of malignant neoplasms of the reproductive organs of the young population of the regions of the Russian Federation for the period from 2011 to 2021, multidirectional trends are observed. The highest incidence rates are in the Siberian and Far Eastern Federal Districts, namely in the Trans-Baikal Territory and the Magadan Region, the smallest – in the regions of the North Caucasian Federal District.
Conclusions. Regional differences in incidence rates in the constituent entities of the Russian Federation were established, changes in trends were found for the age group of people from 15 to 39 years old, which may be associated with lifestyle changes, environmental factors, as well as improved detection of cancer.
OBITUARIES
ISSN 2410-2520 (Online)