Репозиторий Университета

© 2018 Ima-Press Publishing House. All rights reservbed. CLIPPERS syndrome (Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids) is a recently described rare disease affecting the central nervous system. It is characterized by subacute development of symptoms of lesions predominantly in the brain stem and cerebellum, by specific magnetic resonance imaging (MRI) changes, perivascular lymphocytic infiltration in the brain substance and a good response to glucocorticoid (GC) therapy. The paper describes CLIPPERS syndrome in a patient who has been followed up in a clinic for 10 years. During this period, different variants of clinical diagnosis have been considered. The final diagnosis was made only when comparing the clinical course and manifestations of the disease, MRI data, as well as the reaction to GC therapy and its discontinuation. Literature data and diagnostic criteria of this disease are presented.

© 2018 Silina et al. Aim: The purpose of this study was to examine the role of free radical oxygen and peroxide-lipid processes along with conducting the study of blood flow level and oxygen saturation of facial tissues in patients of different ages with varying degrees of involutional changes in the skin of the face and neck. Materials and methods: One hundred and fifty-three people (84.3% women and 15.7% men) aged from 26 to 78 years with varying degrees of involutional changes in facial skin were examined. The clinical and laboratory evaluation was carried out dynamically and included various indicators of free radical processes, objective and subjective clinical visualization, and laser Doppler flowmetry (LDF) of the facial skin and transcutaneous oximetry (TcpO2) performed at 10 points on the face. To assess the state of free radical processes, the authors investigated the basal indicator of chemiluminescence intensity (ICb), the intensity of chemiluminescence stimulated (ICs) by zymosan, the activity coefficient (AC) of chemiluminescence, antiperoxide activity of plasma, and malondialdehyde (MDA). Results: With aging, the imbalance of the oxygen constituents of free radical processes grows with the increase in ROS. Proportional to age, the ICs increased 2.1 times on average in people older than 55 years compared to that in people younger than 30 years and ICb decreased by 1.8 times. As a result, the AC increased by 5.6 times. This correlates with involuntary skin changes and with regression of microcirculation and TcpO2. According to LDF, it was established that average total blood flow in people younger than 30 years and people older than 55 years was 8.1 and 6.4 mL/min, respectively The difference between the indicators of TcpO2 in people younger than 30 years and people older than 55 years was 1.6 times (average 56 vs 35 mm Hg). The stability of the indicators of the peroxide-lipid link of oxidative stress in different age groups demonstrated that the activation of ROS formation in mitochondria is not a cause but a consequence of microcirculation and metabolic processes in the face and neck and aging in general. Conclusion: The tissue metabolism and microcirculation parameters naturally regress with aging, which is associated with the increase of ROS. The excess of species leads to the intensification of peroxide processes. This, in turn, is reflected in the aesthetic appearance manifested by aging.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study cognitive functions, anxiety and depression levels, 24-hour blood pressure (BP) profile, cerebral blood flow (CBF) perfusion in treatment-naive middle-aged patients with uncomplicated essential arterial hypertension (EAH) depending on the white matter hyperintensities (WMH) burden. Material and methods. Forty-one hypertensive patients (mean age 46.2±4.6 years) and 41 healthy volunteers (mean age 50.3±6.7 years) were enrolled to the study. All subjects underwent brain MRI (MAGNETOM Skyra 3.0T, T1, T2 FSE, T2 FLAIR, T1 MPRAGE, ASL), Montreal cognitive assessment (MoCA), 10-word learning task, verbal fluency test, trail making test, Stroop color and word test, anxiety and depression assessment with Hamilton rating scales, 24-hour blood pressure monitoring (ABPM). Results. WMH were found in 22 (53.7%) hypertensive patients and in 3 (7.3%) healthy volunteers (p=0.0002). Hypertensive patients had the significantly lower CBF compared to controls (p<0.001). Conclusion. WMH were identified in treatment-naive middle-aged patients with uncomplicated mild to moderate EAH. There was an association between WMH and lower CBF in the cortical plate of frontal lobes, SBP variability and worse cognition. Cerebral hypoperfusion can cause cognitive impairment even in the earliest stages of EAH, which increases due to emotional disorders.

© 2018 The Author(s). The article describes the processes of collecting and adapting the diagnostic information necessary for use in automated analysis of three-dimensional images and surgical navigation. The work is carried out on the basis of the NMRC Obstetrics, Gynecology And Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation with the financial support of the Ministry of Science and Education of the Russian Federation (Agreement dated 03.10.2016 No. 14.607.21.0162, unique identifier RFMEFI60716X0162) The work is devoted to the features of collection, segmentation and description of the results of preoperative radiological diagnostics of newborn patients with congenital urinary malformations such as hydronephrosis (HN), renal duplication with uretherohydronephrosis of the nonfunctional segment (UHN) or multicystic dysplastic kidney (MC). The goal of the work is the development of standards for the collection, classification and segmentation of various diagnostic information of congenital urinary malformations in newborns necessary to use in automated three-dimensional image analysis and surgical navigation. In order to expand the scope of application, it was decided to supplement the data bank with information from the patient's phenotypic chart, compiled by the clinical geneticist when examining the patient. According to the developed and implemented algorithms we collected and segmented 978 series of images belonging to 393 patients with urinary malformations and 452 series of normal urinary System. Available text descriptions of the series are reconstructed to the original developed standard. At present, using this data bank, a subSystem of neural network analysis and reconstruction of diagnostic images of newborn patients is being developed, as well as a surgical navigation System for performing endoscopic surgical manipulations on patients for congenital malformations of the urinal System.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This article is dedicated to analysis of use PET-CT with 18F-FDG for the last 10 years. Determining the presence of metastasis in regional lymph nodes and distant sites in endometrial cancer is an important diagnostic step aimed at the choice of treatment tactics and improvement of surgical treatment results. If the process is beyond the uterus itself, it significantly worsens the prognosis of survival. In addition, in these cases, it is necessary to change the treatment and surgical tactics. Determination of stage 1 and 2 of the process gives an optimistic prognosis for the survival of patients. Currently, ultrasound, magnetic resonance imaging and, to a much lesser extent, computed tomography are used to assess the prevalence of the process. The diagnostic value of these methods according to some authors does not exceed 66-73%. In this regard, it is justified to work on finding more reliable methods that will more accurately determine the presence of metastatic disease in, both regional lymph nodes and distant organs. One of such promising methods is the use of positron emission tomography combined with computed tomography (PET/CT), using as radiotracer 18 - fluorodeoxyglucose. This article is a review of the scientific literature on this problem over the past 10 years and is devoted to the evaluation of the diagnostic accuracy of PET/CT with 18F-FDG.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This scientific review of the literature presents the most relevant discussions in the world community, aimed at improving the implementation of the diagnostic algorithm in patients with severe combined trauma. Materials and methods: The work deals with the main traumatic injuries of various anatomical zones, the criteria of the Advanced Trauma Life Support (ATLS) protocol and diagnostic methods aimed at detecting acute traumatic pathology. Conclusion: The authors consider unsolved issues, as well as the improvement of the multislice computed tomography (MSCT) algorithm in the "whole body" mode, to optimize diagnostic activities aimed at managing patients with severe combined trauma.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The purpose of this study was to determine ultrasound criteria of normal temporomandibular joint structure and function. Materials and methods. Prospective study was conducted upon normal 16 TMJs of 9 patients (4 male, 5 female with mean age of 22.9 years) without clinical or radiological signs of disc displacement. All the patients underwent high-resolution ultrasound (Samsung SONO ACE R3, 12 MHz linear probe) and MR imaging of TMJs with the mouth closed and during the maximal mandibular range of motion. Both examinations were performed and interpreted independently by blinded expert operators. Results. Mouth opening range varied from 4.4 cm to 5.4 cm, average amount was defined as 4.94 ± 0.39 cm. Also average heights of the front, middle and rear parts of disc were measured (0,42 ± 0,07 cm; 0,35 ± 0,07 cm and 0,41 ± 0,05 cm, respectively). Structure of the TMJ disc can be defined as fine-grained, hypoechoic and homogeneous. The average height of lower joint space was defined as 0,12 ± 0,03 cm. Average amount of maximal parasagittal mandible condyle movement was defined as 14.7 ± 1.38 mm. Conclusion. Obtained results of ultrasound criteria of normal temporomandibular joint structure and function correspond to the provisions of normal human anatomy and the norm values established for the MRI of the TMJ. Thus, ultrasound criteria of normal temporomandibular joint can be used for assessment of TMJ internal degenerative diseases.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The literature data and the results of our own research, which demonstrate the possibilities of using radiological research methods for the analysis of the lungs lesions in deceased patients, are presented. It is shown that the postmortem computed tomography (CT) allows to identify abnormalities of the chest bones, as well as to establish the presence, precise localization and volume of gas and air accumulations, including pneumothorax. The literature data on the comparison of postmortem CT lung characteristics, including the density of their tissue, with data of histological examination of lung preparations and causes of death in adult patients, are presented. It is noted that postmortem magnetic resonance imaging (MRI) is more expedient for the detection of the lungs pathology in dead fetuses and deceased newborns. The possibilities of postmortem MRI for the diagnosis of congenital pneumonia, hemorrhages in the lung tissue, pulmonary edema, hydrothorax, as well as for differential diagnosis of stillbirth and the death of a living newborn are shown. Differential diagnostic signs of pulmonary artery thromboembolism and postmortem blood clots are indicated. The possibilities of postmortem CT and MRI for noninvasive determination of the sizes and weight of the lungs, including for assessment of pulmonary hypoplasia in newborns with congenital diaphragmatic hernia, are described. It is concluded that the postmortem radiological methods of investigation can be used to analyze of the lung lesions and determine the causes of death. The combined use of CT and MRI is recommended for a full analysis. It is emphasized that postmortem radiological examination can not be an alternative to pathological and forensic autopsy. Radiological methods should be used as a supplement to the autopsy, including as a kind of "guide" for a better definition of pathological processes during the autopsy.

© 2018 Ima-Press Publishing House. All rights reservbed. Diffusion tensor magnetic resonance imaging (DT-MRI) is the only noninvasive technique that makes it possible to study white matter microstructure in vivo and to quantify the images obtained. Objective: to study white matter in middle-aged treatment-naïve patients with uncomplicated grade 1-2 essential hypertension (EH), by using DT-MRI. Patients and methods. The investigation enrolled 82 people aged 40-59 years (41 patients with EH and 41 healthy individuals (a control group)). Twenty-four blood pressure monitoring and brain MRI were performed in different modes (T1 MPRAGE, T2 TSE, T2 FLAIR, and DTI). Results. White matter hyperintensities (WMHs) were found in 7.3% of the healthy individuals and in 53.7% of the hypertensive patients (p=0.0002). The latter had significantly lower fractional anisotropy (FA) values in the white matter of the left inferior frontal gyrus than the healthy individuals (0.39±0.06 and 0.45±0.09, respectively; p< 0.001). FA was lower in the hypertensive patients than in the healthy individuals not only in the presence of WMHs (the left inferior frontal gyrus white matter was 0.397±0.071 and 0.45±0.09, respectively; p=0.009; the genu of the corpus callosum was 0.79±0.04 and 0.81±0.05, respectively; p=0.045), but also in the absence of WMHs (the left inferior frontal gyrus white matter was 0.378±0.073 and 0.45±0.09, respectively; p=0.0007). Discussion. The treatment-naïve patients with uncomplicated grade 1-2 EH with short-term (2,3 year) duration were found to have significantly lower FA values in the left inferior frontal gyrus white matter than the healthy normotensive subjects of the same age. Thus, the microstructural integrity of white matter is impaired in middle-aged hypertensive patients even at the earliest disease stages. Conclusion. Middle-aged treatment-naive patients with uncomplicated grade 1-2 EH have lower FA in the left inferior frontal gyrus white matter even in the absence of WMHs.

© 2018 Media Sphera Publishing Group. All rights reserved. There is an ongoing search for the molecular and biochemical mechanisms underlying the development of aging and age-associated diseases. At the same time there is growing evidence geroprotective properties of Vitamin D. In this review, described in detail the possible mechanisms by which Vitamin D affects differentiation, cell proliferation and apoptosis, and describes the potential benefits of this Vitamin in the fight against aging and age-related diseases.

© 2018 Media Sphera Publishing Group. All rights reserved. The review considers modern ideas about the clinic and pathogenesis of minimal hepatic encephalopathy (MHE). It is discussed the present of cognitive impairment in this category of patients. The data of functional MRI are analyzed, and these results allow taking a fresh look at the origin of clinical disorders in this condition. The importance of cerebral connections disruption is emphasized. It is focused on the fact that in the functioning of the central nervous system the spontaneous activity of the brain has a significant importance. Separately is analyzed "the resting state". It is concluded that MHE, despite its minimal manifestations, is a clinically significant condition requiring attention of a specialists. With that, it is often not diagnosed on time in clinical practice, which could lead to more severe damage of the cerebral functions. As evidenced by the data obtained at the present time, quite extensive changes in the neuronal activity are underlid of the cognitive deficit.

© 2018 Ima-Press Publishing House. All rights reserved. Cognitive impairment (CI) is a basis for the clinical presentation of chronic cerebral ischemia (CCI). However, the role of the mechanisms of inflammation and angiogenesis in the origin of CI is unclear, as is its relationship to the number and localization of foci during a neuroimaging examination. Objective: to investigate the relationship between the presence of CI, focal brain tissue changes, and the plasma and serum levels of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) in patients with CCI. Patients and methods. Examinations were made in 59 patients with CCI and in 20 apparently healthy individuals. The investigators evaluated the cognitive status using the Mini-Mental State Examination (MMSE) and the clock drawing test), performed brain magnetic resonance imaging (MRI), duplex scanning of cerebral vessels, and determined laboratory indicators: the serum levels of MCP-1 and C-reactive protein, and the serum and plasma concentrations of VEGF. Results. The patients with CI were found to have higher values of inflammatory markers, lower serum and plasma concentrations of angiogenic factors, and a greater number of focal changes on MRI than those without CI (5.06±0.23 and 2.36±0.3 scores, respectively; p(0.05). Imbalance of angiogenic and antiangiogenic factors can cause disease progression and moderate vascular CI in patients with CCI.

© Bionika Media Ltd. Background. Ovarian cancer develops from benign tumors in 80% of cases during long-term follow-up. According to the literature, the incidence of giant ovarian cystadenoma is extremely low. There are difficulties in verifying these ovarian tumors. Description. The paper describes a rare clinical case of a 54-year-old patient with giant ovarian cystadenoma. It depicts the patient’s clinical, medical history, laboratory, and instrumental data and demonstrates the technical complexities of surgery and the features of postoperative management. Conclusion. The early diagnosis and timely treatment of ovarian tumors will be able to avoid technically difficult surgical interventions and to minimize postoperative complications, which will substantially improve the prognosis of the disease. Such operations should be performed by a surgeon having extensive surgical experience and high qualification.

© 2018 Izdatel'stvo Meditsina. All Rights Reserved. Introduction. Alzheimer's disease (AD) is the most common neurodegenerathe disease in the population. Often, patients with AD have a combined brain lesion of vascular etiology (cerebral microangiopathy). Arterial blood spin labeling (ASL - Arterial spin labeling) is one of the most modem and promising methods for quantifying cerebral perfusion in patients with AD. Objective. To assess regional cerebral blood flow (CBF) using the ASL method in patients with AD with chronic cerebral ischemia - cerebral microangiopathy (CMA) and without it. Material and methods. A group of 20patients (mean age 66 ± 10 years), consisting of 11 patients with AD without CAIA and 9patients with AD with CMA, was examined. The study was conducted on a Siemens Magnetom Skyra magnetic resonance imaging scanner with a magnetic field induction of3T. The examination protocol included an impulse sequence of arterial blood spin labeling. Using the software for postprocessing data processing Olea Medical Sphere 3.0, the indicators of regional cerebral blood flow in various parts of the gray matter of the brain were measured in a manual mode. A neuro-psychological study was performed, confirming a presence of mild to moderate dementia in all patients. Results. A decrease of CBF was revealed in AD patients with CAIA in comparison with AD patients without CMA. The lowest CBF were found in the upper temporal; middle temporal; occipital-temporal; upper frontal and angular gyrus. No correlation was found between CBF measures and neuropsychological results. C onclusion. ASL is a sensitive method in assessing cerebral perfusion in AD patients.

© 2018 Media Sphera Publishing Group. All rights reserved. Heart sarcoidosis diagnosis presents great difficulties due to the absence of specific clinical manifestations. Most often, the diagnosis is established during autopsy. Magnetic resonance imaging (MRI) of the heart with contrast enhancement is one of the most informative methods of intravital diagnosis of cardiac sarcoidosis. In this article, two clinical cases, shows the role of MRI of the heart with contrast enhancement in the diagnosis of cardiac sarcoidosis.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To analyze the data available in the modern scientific medical literature on contemporary aspects of the diagnosis, staging and differential treatment tactics in patients with epithelial ovarian cancer. Materials and methods: Research method used in this article is the systematic analysis of the medical literature, including Pubmed and ClinicalTrials.gov. Results: This article attempts to summarize the worldwide experience of modern medicine in management of epithelial ovarian cancer. The current version of the ovarian cancer classification is described. The possibilities of imaging techniques and their place in the staging are determined. The accurate criteria for tumor resectability assessment and the main treatment tactics are given in details. The possibilities of imaging methods in treatment control and monitoring treatment response are provided. The leading imaging modalities for recurrent disease evaluation are delineated. Conclusion: Ovarian cancer is a serious diagnostic challenge in terms of differential diagnosis, staging and selection of optimal treatment strategy. Proper use of visualization modalities allows better management of primary and recurrent ovarian cancer. Moreover, it is necessary to conduct further investigations aimed at developing well-defined diagnostic protocols in monitoring during treatment in order to obtain response evaluation with minimal time delay.

© 2018 Ima-Press Publishing House. All rights reserved. Arterial spin labeling (ASL) is a promising non-invasive method to assess cerebral perfusion, which identifies a decrease in cerebral blood flow (CBF). Objective: to assess cerebral perfusion in middle-aged untreated patients with uncomplicated grade 1-2 hypertension compared to same-age healthy controls. Patients and methods. 33 patients with essential hypertension and 40 healthy individuals (a control group) at the age of 40-59 years were examined. 24-hour blood pressure (BP) monitoring and brain magnetic resonance imaging were performed in different modes (T1 MPRAGE, T2 TSE, T2 FLAIR, DTI, and ASL). Results. White matter hyperintensive changes were found in 7.5% of the healthy individuals and in 51.5% of the hypertensive patients (p = 0.0002). In hypertensive patients, CBF in the cortical plate of anterior frontal regions was significantly (p ( 0.001) lower than that in the controls: right CBF, 39.1±5.6 and 45.8±3.2 ml/100 g/min, respectively; left CBF, 39.2±6.2 and 45.2±3.6 ml/100 g/min, respectively. In hypertensive patients with white matter hyperintensive changes, CBF was significantly lower than that in the controls: right CBF, 38.5±5.9 ml/100 g/min (p = 0.0001); left CBF, 39.2±6.7 ml/100 g/min (p = 0.002), and in those without these changes, right CBF was 39.5±5.1 ml/100 g/min (p = 0.0002); left CBF was 38.9±4.3 ml/100 g/min (p = 0.00002). Correlation analysis revealed significant inverse correlations of CBF with BP and systolic BP variability. Conclusion. Lower cerebral perfusion occurs in middle-aged untreated patients with uncomplicated grade 1-2 hypertension even in the absence of white matter hyperintensity foci.

© 2018, The Author(s). Studies on the methods of nanoparticle (NP) synthesis, analysis of their characteristics, and exploration of new fields of their applications are at the forefront of modern nanotechnology. The possibility of engineering water-soluble NPs has paved the way to their use in various basic and applied biomedical researches. At present, NPs are used in diagnosis for imaging of numerous molecular markers of genetic and autoimmune diseases, malignant tumors, and many other disorders. NPs are also used for targeted delivery of drugs to tissues and organs, with controllable parameters of drug release and accumulation. In addition, there are examples of the use of NPs as active components, e.g., photosensitizers in photodynamic therapy and in hyperthermic tumor destruction through NP incorporation and heating. However, a high toxicity of NPs for living organisms is a strong limiting factor that hinders their use in vivo. Current studies on toxic effects of NPs aimed at identifying the targets and mechanisms of their harmful effects are carried out in cell culture models; studies on the patterns of NP transport, accumulation, degradation, and elimination, in animal models. This review systematizes and summarizes available data on how the mechanisms of NP toxicity for living systems are related to their physical and chemical properties.

© 2018 Frontiers in Bioscience. All Rights Reserved. We review the progression of aging as a sequential development of multiple syndromes analogous to other diseases. This generalized approach may allow practicing physicians to consider the signs of aging as manifestations of a poly-syndrome disease and facilitate prevention, diagnosis and treatment of common aging-related dysfunctions.

© 2017 Elsevier B.V. The use of polymeric carriers to deliver hydrophobic photosensitizers has been widely discussed as a way to improve both fluorescence diagnostic and photodynamic therapy (PDT) of cancers; however, the photophysical and pharmacokinetic parameters, as well as the PDT activity, of such modifications have, until now, only been poorly investigated. The purpose of the present study was to explore the efficacy of PDT with the formulation of the photosensitizer chlorin e6 (Ce6) in combination with polyvinyl alcohol (PVA) in comparison with Ce6 alone and with the clinical drug, Photodithazine in a mouse tumor model. We also investigated the photoactivity of the Ce6-PVA in a model reaction of tryptophan oxidation, analyzed the polymer–Ce6 interaction using fluorescence spectroscopy and atomic-force microscopy, and tested the phototoxicity in vitro. Using fluorescence imaging in vivo we found that injection to mice of Ce6 in a formulation with PVA resulted in a higher tumor-to-normal ratio and greater photobleaching when compared with either the use of Ce6 alone, or with the effects of Photodithazine. Tumor growth study and histological examination of CT26 tumors revealed fast, reproducible tumor regression and more advanced necrosis after PDT with Ce6-PVA. The higher photoactivity of the Ce6-PVA complex was confirmed in a model reaction of tryptophan oxidation and in cultured cells. Therefore, encapsulation of Ce6 in PVA represents a promising strategy for further increasing the selectivity and efficacy of PDT.