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Byvaltsev V.,Irkutsk State Medical University
World Neurosurgery | Year: 2014

Background Microsurgical training has become an obligatory part of many neurosurgical training programs. Objective To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models. Methods A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910. Results Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P < 0.01). The average Northwestern Objective Microanastomosis Assessment Tool score was 36 for novice and 65 for experienced participants. Conclusion The dry off-the-job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills. © 2014 Elsevier Inc.


Ogarkov O.,Research Institute of Epidemiology and Microbiology | Mokrousov I.,St Petersburg Pasteur Institute | Sinkov V.,Irkutsk Regional Diagnostic Center | Zhdanova S.,Research Institute of Epidemiology and Microbiology | And 2 more authors.
Infection, Genetics and Evolution | Year: 2012

An interaction of different human alleles and endemic bacterial strains may be clinically manifested as different outcome of the disease in different hosts infected with the same genotype. The primary objective of this study was to investigate this issue in the model of Mycobacterium tuberculosis and human DC-SIGN encoding CD209 promoter SNP (rs4804803) in Russian Siberian population. We sought to find a possible combination of M. tuberculosis lineage and human host allele/genotype correlating with unfavorable outcome of the disease. The 101 paired DNA samples from patients with pulmonary TB (human and M. tuberculosis DNA) were studied by 12-loci MIRU-VNTR typing (M. tuberculosis strains) and CD209 -336 A/G typing (human DNA). Ninety autopsy DNA samples as a source of human and mycobacterial nucleic acids from persons who died from TB were also subjected to the same genotyping procedures. A human control group consisted of 177 healthy individuals. The Beijing genotype was more frequently identified in autopsy versus patient samples, in 70.0% and 51.5%, respectively (χ 2=6.06, P=0.01). Regarding other M. tuberculosis genetic families, no significant difference in LAM family distribution among patient strains and autopsy samples has been found. In contrast, Ural genotype was significantly less frequently detected in the autopsy samples (χ 2=6.12, P=0.01). Allelic and genotypic frequencies of the CD209 -336A/G did not differ significantly under global comparison when contrasting controls versus patients versus autopsy samples. However intriguing and contrasting significant associations were found in the male subgroup under M. tuberculosis genotype-stratified comparisons. Firstly, male carriers of -336AA genotype were more frequently infected with Beijing genotype (χ 2=5.2, P=0.02). Secondly and remarkably, this association was inverted in the autopsy sample: male carriers of -336AA genotype died less frequently due to TB caused by a Beijing rather than a non-Beijing strain (χ 2=5.37, P=0.02). In conclusion, we hypothesize that although carriers of CD209 -336A allele are more sensitive to infection with a Beijing strain, a combination of human CD209 -336G allele and M. tuberculosis Beijing genotype leads more frequently to the lethal outcome in pulmonary TB male patients in Russian (Caucasian) population. © 2011 Elsevier B.V..


Laletin V.S.,Irkutsk State Medical University | Bykov Y.N.,Irkutsk State Medical University
Biomeditsinskaya Khimiya | Year: 2015

Stroke is the second leading cause of death in the world. Unfortunately, only a few drugs have been proved in clinical trials. Drug development of the last decade has been focused substantially on a promising and heterogeneous group of neuroprotective drugs. Hundreds of compounds were suggested as new putative neuroprotectors, which effectiveness was confirmed in preclinical trials only. At the present time discrepancy between results of preclinical studies and clinical trials requires careful analysis. One of the least evaluated and probably the most noticeable reasons is general anesthesiaan obligatory component of an overwhelming majority of existing animal stroke models. The aim of the review is to describe known mechanisms of common general anesthetics influence on ionotropic and metabotropic plasma membrane receptors, and key signal pathways involved in neuronal hypoxic-ischemic injury and survival.


Laletin V.S.,Irkutsk State Medical University | Bykov Y.N.,Irkutsk State Medical University
Biochemistry (Moscow) Supplement Series B: Biomedical Chemistry | Year: 2015

The success of experimental studies and failure of clinical trials of neuroprotective drugs proposed for the treatment of ischemic stroke determines the need for an analysis of existing models. Protocols of most laboratory models of stroke include general anesthesia. Inhalation and intravenous anesthetics affect the signaling pathways involved in the neuroprotective and neurotoxic mechanisms. Activation of ionotropic glutamatergic AMPA- and NMDA-receptors in the ischemic brain tissue is accompanied by necrosis and apoptosis of neurons. Certain anesthetics influence the activity of AMPA-receptors, including the phosphorylation and internalization/externalization of GluR-receptor subunits. Besides direct blockade of NMDA receptors several anesthetics affect expression and phosphorylation of NMDA receptor NR1 subunit. The mechanism of action of many inhalation and intravenous anesthetics is associated with activation of ionotropic GABAA receptors; this increases resistance of cells to excitotoxicity and reduces ischemic neuronal damage. In addition to the ionotropic receptors several anesthetics act through metabotropic transmembrane G-protein-coupled receptors. Anesthetic indirectly influence metabotropic GABAB and glutamate mGlureceptor by regulating protein-protein interactions and phosphorylation of receptor subunits. Some inhalation and intravenous anesthetics activate adenosine A1-receptor, increasing the concentration of extracellular adenosine. Anesthetic preconditioning may be accompanied by long-term neuroprotection coupled to activation of p38 MAPK, and mTOR and CREB transcription factors. A possible solution to the problem of the influence of anesthetics on the results of laboratory studies would be the use of parallel-group comparison of different general anesthetics. The effects of general anesthetics determine the need of studies of their neuroprotective potential in terms of ischemic stroke. © 2015, Pleiades Publishing, Ltd.


Kozlov Y.,Surgery Academy | Novozhilov V.,Irkutsk State Medical University
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2015

Purpose: The aim of this study was the comparison of single-port and multiport laparoscopic methods for the treatment of inguinal hernia in children during the first 3 months of life. Subjects and Methods: Between January 2002 and December 2012, we performed 260 laparoscopic operations in neonates and infants with the diagnosis of inguinal hernia. Surgical procedures were single-port endoscopic herniorraphy (Group I; 180 patients) and multiport laparoscopic herniorraphy (Group II; 80 patients). The two groups were compared for demographics of patients, operative report, and early and late postoperative outcomes. Results: We applied the single-port laparoscopic method for correction of inguinal hernia in small babies. The mean operative time (duration of one-sided and bilateral repair) in Group I was 16 minutes, whereas the mean duration of the operation in Group II was 15.73 minutes. The number of doses of postoperative analgesia was 1.19 and 1.22, respectively. The length of hospital stay was 8.12 hours in Group I and 8.27 hours in Group II. No differences between the two groups were recorded in the follow-up period: no recurrence in either group and hydrocele formation in only 1 patient in Group II. Conclusions: There are similar functional results in treatment of inguinal hernia in babies during the first 3 months of the life using single- and multiport laparoscopy. Scarless cosmetic results are seen in the single-incision laparoscopic surgery group. © Copyright 2015, Mary Ann Liebert, Inc. 2015.


Shchuchinova L.D.,Federal Service on Customers Rights Protection | Kozlova I.V.,Irkutsk State Medical University | Zlobin V.I.,Irkutsk State Medical University
Ticks and Tick-borne Diseases | Year: 2015

The Altai Republic is a highly endemic area as far as tick-borne encephalitis (TBE) is concerned. The aim of the research was to study the effect of altitude on the risk of tick-borne encephalitis infection in the Altai Republic. The paper analyzes the following data: the study of ixodid ticks collected from the vegetation in 116 sites at the 200-2383. m elevation above sea level in 2012-2014, TBE virus prevalence of these vectors, tick-bite incidence rate, and TBE incidence rate of the population.Species identification of 4503 specimens has shown that the most common species are Dermacentor nuttalli (45.3%), Ixodes persulcatus (33.1%), Dermacentor silvarum (9.4%), Dermacentor reticulatus (8.9%), and Haemaphysalis concinna (5.0%).A total of 2997 adult ixodid ticks were studied for the presence of the TBE virus; 2163 samples were examined by ELISA, while 834 specimens were tested by PCR. The TBE virus prevalence of Dermacentor spp. ticks in both reactions was significantly higher than of Ixodes persulcatus ticks (. p<. 0.001).The work shows that the altitude is an important factor in the development of the epidemiological situation of tick-borne encephalitis: the higher the elevation of the area above sea level, the smaller the range of vectors. There is also a change of a leading species: in middle altitude (800-1700. m above sea level) the virus is transmitted by ticks of D. nuttalli along with I. persulcatus, and in high mountains (above 1700. m above sea level) D. nuttalli becomes an absolute dominant species. However, these species of ticks are less effective vectors than I. persulcatus. With the increase of altitude the tick-bite incidence rate decreases (. r=. -0.78, p<. 0.05), and TBE incidence also reduces (. r=. -0.67, p<. 0.05). © 2015 Elsevier GmbH.


Kozlov Y.,Irkutsk State Medical University | Novozhilov V.,Surgery Academy
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2015

Purpose: Thoracoscopic plication of the diaphragm is an alternative to conventional surgical treatment of diaphragmatic evisceration via thoracotomy in neonates and infants. The aim of this study is to compare results of treatment by these two methods in the past 11 years. Materials and Methods: We studied the data of 35 neonates who underwent standard posterolateral thoracotomy (18 patients; Group I) or video-assisted thoracoscopic surgery (17 patients; Group II) for diaphragmatic plication. The two groups were compared for patient demographics, operative reports, and postoperative parameters. Results: The groups were similar in terms of demographics and preoperative parameters. There was a significant difference in mean operative time between the open and thoracoscopic procedure (71.67 minutes versus 51.76 minutes; P<.05). Duration of care in the neonatal intensive unit and length of hospital stay were significantly shorter in Group II (5.89 days versus 3.23 days [P<.05] and 13.06 days versus 9.88 days [P<.05]). Early postoperative complications (hemothorax, pneumothorax) were frequent in the thoracotomy group (Group I) (16.67% versus 0%; P>.05). Recurrence of diaphragmatic evisceration was observed only in the thoracotomy group (11.11% versus 0%; P=.486). Conclusions: Thoracoscopic plication of the diaphragm in infants in the first 3 months of life demonstrates better results than open surgery. © Mary Ann Liebert, Inc. 2015.


Illarionova E.A.,Irkutsk State Medical University | Nikonovich O.L.,Irkutsk State University
Bulletin of the Russian Academy of Sciences: Physics | Year: 2016

The possibility of applying spectrophotometry to the quantitative determination of metronidazole and tinidazole with pyrocatechol violet as an optical reference sample is demonstrated. The optical parameters of the absorption bands of pyrocatechol violet and the optimum regions of absorption are established. Conversion factors are determined and the equations of calibration curves are presented. © 2016, Allerton Press, Inc.


Petrov N.V.,Saint Petersburg State University of Information Technologies, Mechanics and Optics | Pavlov P.V.,Zhukovsky Gagarin Air Force Academy | Malov A.N.,Irkutsk State Medical University
Quantum Electronics | Year: 2013

Using the equations of scalar diffraction theory we consider the formation of an optical vortex on a diffractive optical element. The algorithms are proposed for simulating the processes of propagation of spiral wavefronts in free space and their reflections from surfaces with different roughness parameters. The given approach is illustrated by the results of numerical simulations. © 2013 Kvantovaya Elektronika and Turpion Ltd.


Kurenkova G.V.,Irkutsk State Medical University | Lemeshevskaya E.P.,Irkutsk State Medical University
Human Ecology | Year: 2013

The proposed conceptual approach takes into account the specific character of the formation of the radon situation in the East Siberian railway tunnels and is an effective tool in monitoring of individual doses of ionizing radiation of workers by uncontrolled natural sources in underground conditions.

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