Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Korolev MA, Yarmak DO, Miroschnikova EA, Moldakulov JM, Skoroglyadov AV, Korobushkin GV

Delayed or missed diagnosis of foot fractures in patients with multiple or concomitant injuries often leads to the inadequate choice of treatment and causes serious long-term effects. This article reports the most common mistakes accompanying diagnostic procedures and therapy of this injury type. The study conducted in 2007–2015 enrolled 67 patients. Patients were divided into two groups: a prospective experimental group (n = 31) and a retrospective control group (n = 36). For both groups, diagnostic procedures and the range of therapeutic interventions applied were the same, but with the experimental group we used a stepped care approach, followed a specific sequence of activities and adjusted therapy considering the limb condition and the patient’s overall state. In total, we identified 40 and 69 foot fractures in the prospective and retrospective groups, respectively. In the prospective group there were 5 delayed and 3 missed fracture diagnoses; in the second group those numbers were 7 and 9, respectively. The most common factors contributing to diagnostic errors were: excluding radiographic evaluation, severity of patient’s overall condition, poor medical history. Missed fractures were often due to a combination of various factors. A one-step approach was prevalent in the controls (41 fractures); the experimental group underwent a multistep treatment (30 fractures). Therapy outcomes were assessed by Visual Analogue Scale. The results were statistically higher in the prospective group (Mann–Whitney U was 347), which indicates a better treatment applied in this group. The study also showed that using minimally invasive fixation for foot fractures improves treatment outcome.

Received: 2016-03-30

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-07

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VIEWS 4150

Zaitseva MA, Bragvadze BG, Svitich OA, Namazova-Baranova LS, Gankovskaya LV

Bronchial asthma (BA) is one of the most common respiratory system diseases. The role of innate immunity components in the pathogenesis of bronchial asthma is studied widely, with particular focus on the antimicrobial peptides. Those include beta defensins that prevent pathogen intrusion into the respiratory tract mucosa, the most active of such pathogens being β-defensin-1 (human beta defensin-1, HBD-1) encoded by the DEFB1 gene. We studied the association of three single nucleotide polymorphisms in the 5’- untranslated region of the gene, namely, rs11362, rs1799946 and rs1200972, with bronchial asthma in children. We also evaluated gene expression of toll-like receptors TLR2, TLR4 and TLR9. The experimental group included 48 patients of 3 to 7 years of age with BA and 70 healthy children. The АА genotype of the rs11362 polymorphism and the СС genotype of the rs1799946 polymorphism were reliably associated with the disease, while the GG genotype of the rs1799946 polymorphism and the АА genotype of the rs120097 polymorphism were found protective. Also, the АА genotype of the rs11362 polymorphism was associated with the reduced expression of DEFB1, the human beta defensin-1 encoding gene, while the AG genotype was associated with its increased expression. In children with BA, TLR2 expression increased 19.5 times in comparison with the controls; TLR9 expression increased 9.5 times, while TLR4 expression increased 8.3 times.

Received: 2016-06-14

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-06

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VIEWS 3960

The immunomodulatory agent Imunofan (Bionox, Russia) is widely used in clinical practice. It affects the immune and endocrine systems and enhances cell-mediated and humoral immunity. The aim of this study was to investigate the cell profile (lymphoblasts, small, medium and large lymphocytes, macrophages, mitotic cells and damaged cells) in the subcapsular and inner zones of the thymic cortex and thymic medulla of random-bred male albino rats with conspicuous age-related changes after stimulating their immune system with Imunofan. The animals in the experimental group (n = 30) were administered to intramuscular injections of the drug (0.7 mg/kg) on the 1st, 3rd, 5th, 7th and 9th days of the experiment; the controls (n = 30) were administered to the equivalent amount of normal saline on the same days. Rats were decapitated on the 1st, 7th, 15th, 30th and 60th days after the final injection. Thymic sections were studied using Olympus CХ-41 microscope, Olympus SP 500UZ camera (Olympus, Japan) and Morpholog software (Ukraine). Thymic morphology was similar in the experimental and control groups; however, cell profiles were different. On the 7th, 15th and 30th days, lymphoid cells and macrophages prevailed over damaged cells, the number of which decreased (p <0.05). Similar statistically significant trends were found in the inner zone of the thymic cortex. The number of medium lymphocytes was statistically higher on the 7th, 15th and 30th days of the observation, while the number of small lymphocytes was also higher on the 60th day of the observation. The number of damaged cells was significantly lower on the 15th and 30th days (p <0.05). The obtained results indicate conspicuous thymic response in rats with conspicous age-related changes to Imunofan administration, and partial temporary delay of age-related thymic involution.

Received: 2016-05-31

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-05

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VIEWS 4321

Trushina EV, Minkina OV, Dvornikov AS, Skripkina PA, fon Zimfer EI, Konyshev YaI

This article presents the results of an anonymous online survey on skin tattooing conducted in the community of medical students and professors. The article covers issues of tattoing from medical and sociocultural perspectives. The survey was carried out in Pirogov Russian National Research University and included 210 participants of different ages. The results demonstrate the insufficient knowledge of medical indications, contraindications and potential complications associated with tattooing. The obtained data can be a good starting point for developing programs aimed at raising awareness among young people, especially in higher medical institutions. The opinion expressed in this article is not necessarily shared by students and professors from other institutions for higher medical education and does not necessarily reflect the level of expertise in other medical communities. This work is an example of how socially oriented practical training can be organized for the 3rd- and 4th-year students of the Faculty of General Medicine at Pirogov Russian National Research University.

Received: 2016-05-23

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-10

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VIEWS 3519

Osipov LV, Dolgushin MB, Mikhaylov AI, Epel B, Rumyantsev KA, Turoverov KK, Verkhusha VV, Kulikova EYu

The rapid progress of medical sciences has brought about novel effective medications, new techniques that make surgery less traumatic, artificial materials that serve to replace tissues and organs, and robotic prostheses. Still, treatment success is largely a question of timely and accurate diagnosis and proper patient monitoring. Here, various imaging techniques come in handy. Those are often thought of as tools for anatomy visualization, but in fact, they are often highly effective for the assessment of the functional state of organs and tissues. Imaging techniques are so diverse that it is impossible to cover them all in one review. Therefore, we have decided to touch upon the most common and interesting ones, such as ultrasound imaging, tomography, oximetry and fluorescence imaging.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-01

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VIEWS 3671

Klementieva NV, Furman OE, Mishin AS, Lukyanov KA, Zagaynova EV

Structural organization of actin and actin-binding proteins can be a hallmark of aggressiveness among various populations of solid tumor cells. Here, we studied the impact of chemotherapeutic drugs (paclitaxel and cisplatin) on actin and alpha-actinin structural patterns in human cervical adenocarcinoma cell culture HeLa Kyoto using total internal reflection fluorescence microscopy and single-molecule localization super-resolution microscopy. It was shown that paclitaxel causes disruption of actin cytoskeleton in cancer cells, both for actin and alpha-actinin. We observed disappearance of stress fibers, accumulation of filaments in the cell cortex and morphological changes in focal contacts. With cisplatin, we detected a lower number of thin actin bundles and more dense arrangement of alpha-actinin. Our results suggest that the actin cytoskeleton is a potential target for antitumor chemotherapy.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-02

Comments 0

VIEWS 3630

Sirotkina MA, Kiseleva EB, Gubarkova EV, Buyanova NL, Elagin VV, Zaitsev VYu, Matveev LA, Matveev AL, Kirillin MYu, Gelikonov GV, Gelikonov VM, Kuznetsov SS, Zagaynova EV, Gladkova ND

One of the challenges faced by modern medicine is finding new methods of functional imaging of biological tissues in patients that allow detection of early tumor response to treatment. One of such methods proposed in this work is multimodal optical coherence tomography (MM OCT). It combines cross-polarization OCT (CP OCT) for visualization of tissue structure and assessment of connective tissue health, OCT-based microangiography (OCT MA) for visualization of the vasculature, and OCT- based elastography for measuring tissue stiffness. The efficacy of this method was tested during the course of photodynamic therapy (PDT), as major PDT targets are cellular and vascular components of a tumor. The experiments were carried out on the CT26 colon carcinoma transplanted into the mouse ear. It was shown that the efficacy of PDT can be assessed using MM OCT. For example, CP OCT can help differentiate between necrotic and intact tumors; OCT MA detects blood circulation defects that lead to slower blood circulation or circulatory stagnation followed by tumor death. OCT-based elastography is helpful in assessing stiffness of normal and pathological tissues.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-03

Comments 0

VIEWS 3656

Tarachkova EV, Shorikov MA, Panov VO, Kuznetsov VV, Tyurin IE, Shimanovsky NL

Knowing the histology of cervical cancer (squamos cell carcinoma or adenocarcinoma) is important in deciding on the best treatment plan. We have studied the role of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of cervical cancer. We examined 90 patients between 23 and 78 years of age (mean age was 43.5 years) with histologically distinctive stage IIb–IVb cervical cancers. Scanning was performed on Magnetom Espree 1.5T and Magnetom Skyra 3.0T scanners (Siemens, Germany) using gadobutrol (Gadavist by Bayer, Germany). On T1-weighted images, signal intensity and its rate of change were significantly higher for adenocarcinomas compared to squamos cell carcinomas (p <0.04) from the 20th second after gadobutrol had been delivered to the tumor. With squamos cell carcinomas, the time-intensity curve (showing the dependence of signal intensity on the time elapsed after gadobutrol had been delivered to the tumor) had two phases: a short phase of a relatively slow accumulation of the contrast agent with the subsequent plateau or even signal intensity reduction. The pattern of gadobutrol accumulation allows differentiating between histological types of tumors. Based on the resulting curves, a pharmacokinetic model can be described for each tumor type. Postcontrast images are useful in determining tumor differentiation grade. Specifically, the signal from a well-differentiated adenocarcinoma is the most inhomogeneous one (p <0.03). The method described in this work does not imply that histological analysis is unnecessary and can be recommended as a supplementary diagnostic tool.

Received: 2016-08-10

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-04

Comments 0

VIEWS 3673