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Non-invasive optical registration and subsequent analysis of heart rate (HR) and heart rate variability (HRV) in transparent aquatic animals have recently been proposed as convenient toxicological endpoints, well-suited for automation data acquisition and processing. This approach was evaluated in experiments involving juvenile Daphnia magna and zebrafish (Danio rerio) embryos exposed to glyphosate solutions (20 mg/L, 2 mg/L, 0.2 mg/L, and 0.02 mg/L) and imidacloprid solutions (30 mg/L, 3 mg/L, 0.3 mg/L, and 0.03 mg/L). The findings indicate that cardiac performance assessment is a promising approach for short-term toxicity evaluation. However, the sensitivity of this physiological endpoint to various external factors may limit its broader application. Results from the two model species highlight their differing sensitivities to the tested substances, emphasizing the need for thorough preliminary studies before establishing this method as a standardized toxicological tool. The potential development and improvement of techniques for assessing heart rate in zebrafish and daphnids are discussed., Competing Interests: Declaration of competing interest The authors declare that the y have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aquatic ecosystems are increasingly affected by anthropogenic pollution, including heavy metals like mercury, which accumulate in organisms and cause harmful effects. At the same time, human activities such as industrial operations and the use of electric power lines also alter the magnetic background in natural water bodies. However, the interaction between mercury exposure and magnetic fields remains poorly understood. This study aimed to investigate the combined effects of mercury and magnetic fields on the digestive enzyme activity of common carp (Cyprinus carpio), focusing on the relevance of magnetic fields due to their increasing presence in industrialized environments. Two groups of fish were fed diets with low (0.02 mg/kg) or high (0.27 mg/kg) mercury content for 6 months and exposed to extremely low-frequency magnetic fields or hypomagnetic conditions. Results showed significant differences in mercury accumulation between groups, with higher levels in carps fed with high-mercury content diets. These fish also exhibited increased body length and weight compared to those on a low-mercury diet. The amylolytic activity (total activity of enzymes hydrolyzing starch: α-amylase, glucoamylase, and maltase) and proteolytic activity (total activity of serine proteinases) in the fish intestine were assessed. Magnetic exposure had contrasting effects on enzyme activity, depending on mercury levels in the diet. Fish fed the low-mercury diet exhibited decreased amylolytic activity following magnetic field exposure, while fish on the high-mercury diet showed increased activity. Proteolytic activity followed a similar pattern, with opposite effects observed between the two dietary groups. These findings suggest that mercury accumulation alters the biological response to magnetic fields, possibly through compensatory biochemical mechanisms. Understanding the interactions between toxic substances and magnetic fields is critical for improving environmental risk assessments., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction  The aim of this article was to assess the flow capacity of end-to-side arterial anastomosis depending on the method of its implementation. Materials and Methods  The study was conducted on 30 live Wistar rats in vivo, which were randomly divided into three groups. In each group of animals, an end-to-side microanastamosis was performed using three methods of donor artery preparation: 45 degrees (group A), 90 degrees (group B), and arteriotomy according to the "fish mouth" type (group C). The determination of flow capacity of anastomosis by measuring the blood volume flow with transonic flowmeter was performed. Results  The obtained average values after the anastomosis were, respectively, 7.335 mL/s (standard deviation [SD]: 2.0771; min: 4.05; max: 10.85), 7.36 mL/s (SD: 0.836 mi: 6.15; max: 8.75), and 6.37 mL/s (SD: 1.247; min: 5.05; max: 9.05). No statistically significant difference in the blood volume flow velocity between all types of anastomoses was obtained ( p  = 0.251). Conclusion  The flow capacity of end-to-side arterial anastomosis does not depend on the chosen method of anastomosis., Competing Interests: Conflict of Interest None declared., (Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Moyamoya angiopathy is a chronic progressive cerebrovascular disease characterized by stenosis and occlusion of the distal segments of the internal carotid arteries and/or proximal segments of the middle and anterior cerebral arteries, with a gradual compensatory restructuring of the cerebral circulation to the system of the external carotid arteries. Today, the main treatment method for Moyamoya angiopathy is surgical revascularization of the brain. A search and analysis of publications on the treatment of adult patients with Moyamoya angiopathy was carried out in the PubMed and Medscape databases over the past 10 years. We present a case of an adult female patient with a hemorrhagic form of Moyamoya angiopathy stage IV according to J. Suzuki, who underwent staged combined revascularization of both cerebral hemispheres. Surgical revascularization included the creation of a low-flow extra-intracranial shunt combined with a combination of indirect synangiosis. The combination of direct and indirect methods of surgical revascularization enables to achieve the development of an extensive network of collaterals and fully compensate for cerebral circulatory disorders both in the early and late postoperative periods, which is confirmed by instrumental diagnostic data. Combined revascularization is the most effective modern method of treating patients with Moyamoya angiopathy due to the complementary influence of direct and indirect components of revascularization.

Objective: To determine the frequency of Ponticulus posticus and Ponticulus lateralis among patients admitted to a24-hour emergency hospital., Material and Methods: The study included 2887 patients with a traumatic history who were admitted to the hospital for emergency reasons. This principle of sampling allowed us to exclude a high concentration of studies of patients with chronic neurological diseases, the cause of which could be symptomatic Kimmerle's anomaly (KA). During the period 01.01.20 to 31.12.20, primary CT was performed on an emergency basis in 7348 patients. Of these, CT scans of the brain and cervical spine were performed in 2965 patients. Some patients (78 people) were excluded from the study due to the presence of cervical vertebral fractures and metal artifacts in the craniovertebral region., Results: The Ponticulus posticus was detected in 1162 (40.2%) patients, among them class 3 and 4 was detected in 27.7%, and class 2 ossification in 12.5%. This Ponticulus posticus was significantly more common (χ 2 test, p =0.0005) in men. The Ponticulus lateralis was identified in 231 patients (8%), among them 94 patients (3.3%) had complete ponticulus on both sides, 29 patients (1%) - on one side, and 108 patients (3.7%) - two-sided incomplete ponticulus. In patients with class 2-3-4, Ponticulus lateralis were detected significantly more often (χ 2 test, p <0.0001)., Conclusion: The cumulative incidence of KA was 42%, 17% of patients are carriers of a complete KA bridge, which is significantly higher than in the European or Asian regions. The data suggest that KA is not the result of ossification of the posterior atlanto-occipital membrane, since different classes of KA occur equally often at different ages. Further studies of KA are needed, including its occurrence in patients of the neurological department and its correlation with individual neurological syndromes to determine the need for surgical treatment in the population.

Objective: To study the long-term outcomes of surgical treatment of cerebral aneurysms (CA) after using different methods of excluding the aneurysm from the bloodstream., Material and Methods: We analyzed the long-term results of surgical treatment of 311 patients for CA (on average after 3.5 years). Two hundred and one patients were operated after CA rupture, 110 for an unruptured aneurysm. Microsurgical or endovascular methods were used to isolate the aneurysm from the bloodstream. Upon admission to the hospital for surgical treatment, a clinical diagnostic examination was performed to confirm the diagnosis and determine the timing and type of intervention. In the long-term period, a clinical neurological study, including an assessment of disability with the Barthel index and the modified Rankin scale, cognitive functions (MoCA test) and the psycho-emotional sphere (HADS) was carried out., Results: In the long-term period of aneurysm surgery, symptoms of disability were identified in 49 patients (16%), severe and complete limitation of self-care in 17 (8%), and cognitive impairment in 212 (68%). Endovascular embolization performance of an aneurysm was associated with a higher proportion of favorable functional outcomes compared with the use of a microsurgical method (10% versus 17%), as well as preservation of cognitive functions (9% and 17%, respectively). Blood clots fibrinolysis was associated with severe disability and dependence in the long-term period ( p =0.04). Patients treated with extra-intracranial shunting (EICS) demonstrated better cognitive functions; fibrinolysis, on the contrary, was a predictor of dementia ( p =0.02). There was no relationship between symptoms of anxiety and depression in the long-term period and surgical treatment method., Conclusions: Disability, dependence and disturbance of cognitive functions in the long-term period of CA surgical treatment are higher in patients after microsurgical clipping compared to endovascular embolization. Performance of blood clots fibrinolysis is associated with severe disability and dementia in patients with massive basal aneurysmal subarachnoid hemorrhage. Performing EICS is associated with a favorable prognosis for the recovery of cognitive functions.

Objective: To assess the main performance indicators of neurosurgical departments in surgical treatment of cerebral aneurysms in the Russian Federation., Material and Methods: We analyzed 22 neurosurgical departments (19 regional and 3 federal hospitals) in 2017 and 2021. The study enrolled 6.135 patients including 3.160 ones in 2017 and 2.975 ones in 2021. We studied the features of surgical treatment of cerebral aneurysms in different volume hospitals and factors influencing postoperative outcomes., Results: The number of surgeries for cerebral aneurysms decreased from 2.950 in 2017 to 2.711 in 2021. Postoperative mortality rate was 6.3% and 5.6%, respectively. The number of microsurgical interventions decreased from 60% in 2017 to 48% in 2021. The share of endovascular interventions increased from 40% to 52%, respectively. Endovascular embolization was accompanied by stenting in 55% of cases. Simultaneous revascularization was carried out in 2% of cases. In 2021, the number of patients undergoing surgery in acute period of hemorrhage increased to 70% (in 2017 - 61%). The number of hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased from 14 in 2017 to 17 in 2021., Conclusion: Certain changes in neurosurgical service occurred in 2021 compared to 2017. Lower number of surgical interventions for cerebral aneurysms, most likely caused by the COVID-19 pandemic, is accompanied by lower postoperative mortality. Endovascular interventions and revascularization techniques became more common. The number of surgeries in acute period after aneurysm rupture and hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased.

This review covers the phenomenon of resonance-like responses of biological systems to low-frequency magnetic fields (LFMF). The historical development of this branch of magnetobiology, including the most notable biophysical models that explain the resonance-like responses of biological systems to LFMF with a specific frequency and amplitude, is given. Two groups can be distinguished among these models: one considers ion-cofactors of proteins as the primary targets for the LFMF influence, and the other regards the magnetic moments of particles in biomolecules. Attention is paid to the dependence of resonance-like LFMF effects on the cell type. A radical-pair mechanism of the magnetic field's influence on biochemical processes is described with the example of cryptochrome. Conditions for this mechanism's applicability to explain the biological effects of LFMF are given. A model of the influence of LFMF on radical pairs in biochemical oscillators, which can explain the frequency-amplitude efficiency windows of LFMF, is proposed.

Cavefish are vertebrates living in extreme subterranean environments with no light, temperature changes, and limited food. Circadian rhythms in these fish are suppressed in natural habitats. However, they can be found in artificial light-dark cycles and other zeitgebers. The molecular circadian clock has its peculiarities in cavefish. In Astyanax mexicanus , the core clock mechanism is tonically repressed in the caves due to the overactivation of the light input pathway. A lack of functional light input pathway but rather the entrainment of circadian genes' expression by scheduled feeding were revealed in more ancient Phreatichthys andruzzii . Different evolutionarily determined irregularities in the functioning of molecular circadian oscillators can be expected in other cavefish. The unique property of some species is the existence of surface and cave forms. Along with the ease of maintenance and breeding, it made cavefish a promising model for chronobiological studies. At the same time, a divergence of the circadian system between cavefish populations requires the strain of origin to be indicated in further research.

Objective: To study the long-term results of surgical treatment of patients operated on for cerebral aneurysms and their impact on functional recovery, independence and cognitive functions in the long-term period., Material and Methods: A multivariate regression analysis of long-term results of surgical treatment of 324 patients for cerebral aneurysms was performed (on average after 3.5 years). Upon admission of the patient to the hospital for surgical intervention, a clinical diagnostic examination was performed to confirm the diagnosis and determine the volume, timing and type of intervention. In the late period, a clinical neurological study was performed, which included an assessment of the degree of disability with the Barthel index and a modified Rankin scale, cognitive functions with MMSE, and the mental sphere with HADS., Results: The severity of the condition at admission, corresponding to grade III-IV according to the Hunt-Hess classification, was the risk factor for an unfavorable prognosis for the recovery of patients in the long-term period of cerebral aneurysm surgery. The severe condition of patients at the onset of the disease increases the risk of disability by 1.9 times ( p <0.05) and the risk of dementia by 6 times ( p <0.05). An independent risk factor for the development of cognitive impairment is the patient's age: with an increase in age by 1 year, the MMSE score decreases by 0.27 ( p <0.05). The prevalence of hemorrhage according to the Fisher classification, corresponding to grade III, is a predictor of the development of angiospasm in 91% of cases. In patients with established angiospasm, the risk of developing dementia and pre-dementia cognitive impairment was 57.3% ( p <0.05). The best predictions for recovery of cognitive functions in the long-term period were observed in patients who underwent simultaneous aneurysm clipping with extra-intracranial anastomosis (mean MMSE score 25) compared with patients who underwent only aneurysm clipping (mean score 20), endovascular intervention (average score 21) or microsurgical intervention followed by intrathecal fibrinolytic injection (mean MMSE score of 20) ( p <0.05)., Conclusion: The predictors of unfavorable recovery of cognitive functions and the development of disability in the long-term period of surgical treatment of cerebral aneurysms were the severity of the condition at admission, corresponding to III-IV st. according to the Hunt-Hess classification, the age of the patient at the time of the intervention, the prevalence of hemorrhage according to Fisher, and the choice of surgical technique.

A biophysical model for calculating the effective parameters of low-frequency magnetic fields was developed by Lednev based on summarized empirical data. According to this model, calcium ions as enzyme cofactors can be the primary target of low-frequency magnetic fields with different parameters tuned to calcium resonance. However, the effects of calcium-resonant combinations of static and alternating magnetic fields that correspond to Lednev's model and differ by order in frequency and intensity were not studied. It does not allow for confidently discussing the primary targets of low-frequency magnetic fields in terms of the magnetic influence on ions-enzyme cofactors. To clarify this issue, we examined the response of freshwater crustaceans Daphnia magna to the impact of combinations of magnetic fields targeted to calcium ions in enzymes according to Lednev's model that differ in order of magnitude. Life-history traits and biochemical parameters were evaluated. Exposure of daphnids to both combinations of magnetic fields led to a long-term delay of the first brood release, an increase in the brood size, a decrease in the number of broods, and the period between broods. The amylolytic activity, proteolytic activity, and sucrase activity significantly decreased in whole-body homogenates of crustaceans in response to both combinations of magnetic fields. The similarity in the sets of revealed effects assumes that different magnetic fields tuned to calcium ions in biomolecules can affect the same primary molecular target. The results suggest that the low-frequency magnetic fields with parameters corresponding to Lednev's model of interaction between biological molecules and ions can remain effective with a significant decrease in the static magnetic background.

In the 1960s, it was hypothesized that slow magnetic fluctuations could be a secondary zeitgeber for biological circadian rhythms. However, no comprehensive experimental research has been carried out to test the entrainment of free-running circadian rhythms by this zeitgeber. We studied the circadian patterns of the locomotor activity of zebrafish ( Danio rerio ) under different combinations of light regimes and slow magnetic fluctuations, based on a record of natural geomagnetic variation. A rapid synchronization of activity rhythms to an unusual 24:12 light/dark cycle was found under magnetic fluctuations with a period of 36 h. Under constant illumination, significant locomotor activity rhythms with 26.17 h and 33.07 h periods were registered in zebrafish exposed to magnetic fluctuations of 26.8 h and 33.76 h, respectively. The results reveal the potential of magnetic fluctuations for entrainment of circadian rhythms in zebrafish and genuine prospects to manipulate circadian oscillators via magnetic fields. The putative mechanisms responsible for the entrainment are discussed, including the possible role of cryptochromes.

The treatment of glial brain tumors is an unresolved problem in neurooncology, and all existing methods (tumor resection, chemotherapy, radiotherapy, radiosurgery, fluorescence diagnostics, photodynamic therapy, etc.) are directed toward increasing progression-free survival for patients. Fluorescence diagnostics and photodynamic therapy are promising methods for achieving gross total resection and additional treatment of residual parts of the tumor. However, sometimes the use of one photosensitizer for photodynamic therapy does not help, and the time until tumor relapse barely increases. This translational case report describes the preliminary results of the first combined use of 5-ALA and chlorin e6 photosensitizers for fluorescence-guided resection and photodynamic therapy of glioblastoma, which allowed us to perform total resection of tumor tissue according to magnetic resonance and computed tomography images, remove additional tissue with increased fluorescence intensity without neurophysiological consequences, and perform additional therapy. Two months after surgery, no recurrent tumor and no contrast uptake in the tumor bed were detected. Additionally, the patient had ischemic changes in the access zone and along the periphery and cystic-glial changes in the left parietal lobe.

Fluorescence diagnostics is one of the promising methods for intraoperative detection of brain tumor boundaries and helps in maximizing the extent of resection. This paper presents the results of a pilot study on the first use of the chlorin e6 photosensitizer and a two-channel video system for fluorescence-guided resection of pituitary adenomas. The study's clinical part involved two patients diagnosed with hormonally inactive pituitary macroadenomas and one patient with a hormonally active one. All neoplasms had different sizes and growth patterns. The data showed accumulation of chlorin e6 in tumor tissues in high concentrations: Patient 1: 2 mg/kg, Patient 2: 5 mg/kg, and Patient 3: 4 mg/kg. For Patient 1, the residual part of the tumor was not resected since it was intimately attached to the anterior genu of the internal carotid artery. For Patients 2 and 3, no regions of increased Ce6 accumulation were detected in the tumor foci after resection. Therefore, the use of the Ce6 and a two-channel video system helped to achieve a high degree of tumor resection in each case.

Background: Intracranial aneurysms (IAs) pose a high risk of spontaneous subarachnoid hemorrhage. In the most complex cases, the only way to exclude the aneurysm from the circulation is to perform a high-flow extracranial-to-intracranial bypass, thus creating a new bloodstream. This avoids severe ischemic complications; however, it requires careful consideration of individual anatomy and hemodynamic parameters. Computational fluid dynamics (CFD) can be of great help in planning such a surgery by creating 3D patient-specific models of cerebral circulation., Objective: Assessment of the perspectivity of high-flow extracranial-to-intracranial bypass planning using computational modeling., Material and Methods: In this research work, we have applied the CFD methods to a patient with a giant thrombosed IA of the internal carotid artery (ICA). Preoperative CTA images and Gamma Multivox workstation were used to create a 3D model with current geometry and three additional models: Normal anatomy (no IA), Occlusion (with ligated ICA), Virtual bypass (with bypass and ligated ICA). The postoperative data were also available. Boundary conditions were based on PC-MRI measurements. Calculation of hemodynamics was conducted with a finite element package ANSYS Workbench 19., Results: The results demonstrated an increase in the blood flow on the affected side by more than 70% after the virtual surgery and uniformity of flow distribution between the affected and contralateral sides, indicating that the treatment is likely to be efficient. Later, postoperative data confirmed that., Conclusion: The study showed that virtual preoperative CFD modeling could significantly simplify and improve surgical planning.

Objective: To conduct a systematic review and meta-analysis to determine the frequency of Kimmerle's anomaly (KA) in patients with grades III and IV vertebral artery (VA) sulcus ossification., Material and Methods: We searched the PubMed and eLIBRARY.RU databases, identified 68 articles in English, and obtained data of 29.770 patients. To date, no study in Russia has reported KA. The incidence of KA was determined using single-group meta-analysis. We used odds ratios (OR) to investigate the association between sex and the frequency of KA. Publication bias was assessed using the Egger test., Results: The pooled prevalence of complete KA was 8.6% (95%, confidence interval (CI) 7.8-9.5%); however, the Egger test confirmed publication bias ( t =2.102, p =0.022), which was eliminated by dividing the patient sample by geographic macroregions. The incidence of KA in Europe and Asia was 10.1% and 6.5%, respectively. The pooled prevalence of KA associated with grade III ossification was 7.2% (95% CI 4.9-10.4%). The OR of KA in men vs. women was 1.23 (95% CI 1.098-1.389)., Conclusion: The incidence of KA was significantly associated with the macroregion. Nearly 15.8% of the population may show grades III and IV VA sulcus ossification, and surgical treatment is required in some patients. KA formation is more typical for males. A population study is warranted to clarify the frequency of KA in the Russian population.

Objective: To present the technique of extra-intracranial bypass surgery using the orifice of maxillary artery bypass, to evaluate the advantages and disadvantages of this and alternative revascularization options., Material and Methods: Radial artery graft harvesting was performed at the 1st stage. Simultaneously, the second team of surgeons performed a combined (submandibular and anterior) access to the donor artery (mandibular segment of maxillary artery behind the ramus of the mandible). Craniotomy and mobilization of potential recipient arteries (M2-M3 segments of the middle cerebral artery) were performed at the 2nd stage. Distal anastomosis in end-to-side fashion was formed with M3 segment of the middle cerebral artery. At the 3rd stage, radial artery was passed through a subcutaneous tunnel in zygomatic region. The orifice of maxillary artery was resected together with distal external carotid artery (ECA) and orifice of superficial temporal artery. After transposition of ECA and orifice of maxillary artery, proximal end-to-end anastomosis was performed with radial artery. After that, the main surgical stage was performed, i.e. exclusion of M3 segment of the middle cerebral artery together with aneurysm., Results: Harvesting of mandibular segment of the maxillary artery as a donor vessel reduces the length of bypass graft to 12-14 cm since this branch is localized close to the skull base. You can also form optimal proximal end-to-end anastomosis for intracranial redirecting blood flow maxillary artery., Conclusion: The described method makes it possible to form anastomosis with a short bypass graft and reduce the risk of thrombosis. This procedure is effective for cerebral bypass in patients with skull base tumors, complex aneurysms, and occlusive-stenotic lesions of carotid arteries.

The influence of magnetic fields and natural geomagnetic storms on biological circadian rhythms are actively studied. This study reveals an impact of local natural perturbations in the geomagnetic field that occurred at different times of the day on circadian patterns of locomotor activity of zebrafish. A decrease in zebrafish swimming speed was observed during the geomagnetic disturbances before or after the fluctuations of diurnal geomagnetic variation. However, if the geomagnetic perturbations coincided with the fluctuations of diurnal geomagnetic variation, the decrease in zebrafish swimming speed was insignificant. This result suggests that the biological effects of geomagnetic disturbances may depend on synchronization with the diurnal geomagnetic variation. It implies that the previously published correlations between geomagnetic activity and medical or biological parameters could result from a disruption in circadian biorhythms.

Over recent decades, changes in zebrafish (Danio rerio) behaviour have become popular quantitative indicators in biomedical studies. The circadian rhythms of behavioural processes in zebrafish are known to enable effective utilization of energy and resources, therefore attracting interest in zebrafish as a research model. This review covers a variety of circadian behaviours in this species, including diurnal rhythms of spawning, feeding, locomotor activity, shoaling, light/dark preference, and vertical position preference. Changes in circadian activity during zebrafish ontogeny are reviewed, including ageing-related alterations and chemically induced variations in rhythmicity patterns. Both exogenous and endogenous sources of inter-individual variability in zebrafish circadian behaviour are detailed. Additionally, we focus on different environmental factors with the potential to entrain circadian processes in zebrafish. This review describes two principal ways whereby diurnal behavioural rhythms can be entrained: (i) modulation of organismal physiological state, which can have masking or enhancing effects on behavioural endpoints related to endogenous circadian rhythms, and (ii) modulation of period and amplitude of the endogenous circadian rhythm due to competitive relationships between the primary and secondary zeitgebers. In addition, different peripheral oscillators in zebrafish can be entrained by diverse zeitgebers. This complicated orchestra of divergent influences may cause variability in zebrafish circadian behaviours, which should be given attention when planning behavioural studies., (© 2020 Cambridge Philosophical Society.)

High-grade gliomas have a diffuse and infiltrative nature of the growth of tumor cells, due to which the achievement of radical resection is difficult. Surgical resection completeness of brain tumors is an important factor in prolonging the life of patients. An accurate definition of tumor boundaries and residual fluorescent regions is impossible due to imperfections of the equipment used for fluorescent imaging. 5-aminolevulinic acid (5-ALA) is a precursor of protoporphyrin IX (PpIX) in humans and is clinically used to detect and treat tumors. Currently, fluorescence-guided surgery with PpIX used a surgical microscope with an excitation wavelength in the blue spectrum range. Because of its low ability to penetrate into biological tissue, blue light is ineffective for providing high-quality fluorescent navigation. Also, when performing an operation using radiation in the blue spectrum range, the photosensitizer's surface layer (PS) often bleaches out, which leads to frequent errors. The use of red light emission makes it possible to slow down the PS bleaches out due to the absorption properties of PpIX, but this task is technically more complicated and requires highly sensitive cameras and specialized optical filters. The new two-channel video system for fluorescent navigation has a radiation source in the red range of the spectrum, the penetration depth of which is greater than the blue light, which makes it possible to increase the depth of probing into biological tissues. The study's clinical part involved 5 patients with high grade glioma and 1 patient with low grade glioma: grade III oligodendrogliomas (2), grade IV glioblastomas (3), and grade II diffusion astrocytoma (1)., Competing Interests: The authors declare no conflicts of interest., (© 2021 Optical Society of America under the terms of the OSA Open Access Publishing Agreement.)

Objective: To investigate the informativeness of long-term scalp EEG monitoring in patients with acute traumatic brain injury (TBI)., Material and Methods: The informativity of long-term EEG monitoring (LTM) was performed in 60 patients with acute severe TBI. Odd ratios (OR) of unfavorable outcome and non-convulsive status epilepticus (NCSE) among clinical, neurophysiological and radiological features were calculated., Results: EEG features of the unfavorable outcome are: slowing of the dominant background rhythm below q range (OR 3.5, CI 1.2-10.7), absence of frontal-occipital gradient (OR 10.2, CI 1.89-10.12), absence of reactivity (OR 8.75, CI 2.14-35.7), absence of variability (OR 6.25, CI 1.72-22.6) and absence of NREM sleep, stage 2 (OR 5.8, CI 1.79-18.91). Clinical features associated with the unfavorable outcome are: a decrease in GCS score (OR 1.25, CI 1.07-1.47), TBI severity (OR 2.46, CI 1.16-5.18), axial dislocation (OR 4.45, CI 1.08-18.29). ORs for NCSE are significant for the following EEG features: presence of rhythmic and periodic patterns (RPP) (OR 11.92, CI 1.37-103.39), stimulus induced RPP (OR 23.14, CI 2.56-209.34), "plus" modifier (OR 4.11, CI 1.13-14.91) and electrographic evolution (OR 13.05, CI 3.59-47.39). Background rhythm slowing below q range reduces NCSE probability (OR 3.33, CI 1.09-10)., Conclusion: Long-term EEG monitoring is an informative tool for prognosis of outcome and diagnosis of NCSE in patients with severe TBI. The risk of NCSE increases with Marshall score but NCSE is not associated with poor outcome that requires an individual selection of intensive care.

Epilepsy surgery is effective in 30-82% of patients with drug-resistant epilepsy. However, risk factors of unfavorable outcomes after epilepsy surgery require further study., Objective: To evaluate risk factors of favorable and unfavorable long-term postoperative outcomes in patients with drug-resistant epilepsy., Material and Methods: Postoperative outcomes in a large cohort of patients with epilepsy are reported for the first time in the Russian Federation. There were 271 patients with drug-resistant scheduled for surgery. Preoperative examination and surgical treatment were carried out between January 1, 2014 and December 12, 2019 at the Evdokimov Moscow State University of Medicine and Dentistry and Sklifosovsky Research Institute for Emergency Care. We used Engel grading system to assess postoperative outcomes after 12, 24, 48 and 60 months. We distinguished favorable (Engel I-II) and unfavorable (Engel III-IV) outcomes and analyzed the factors influencing postoperative results in these patients., Results: There were 319 surgical procedures in 271 patients (217 primary resections, implantation of vagus nerve stimulator in 31 patients, 9 redo resections and 8 radiosurgical procedures). Focal cortical dysplasia (FCD) was found in 162 (60%) patients, «dual pathology» - in 118 (44%) cases. In 12 months after surgery, favorable outcomes (Engel l-II) were observed in 69% of patients ( n =148), after 24 months - in 71% ( n =127) of patients. Postoperative complications occurred in 6 (1.9%) patients. There was no mortality. The earlier onset of epilepsy ( p =0.01), multifocal ( p =0.002) and bilateral lesions ( p =0.0038) were the most significant risk factors of unfavorable postoperative outcomes., Conclusion: Surgical resection is effective approach for drug-resistant epilepsy.

Since 2013, neurosurgeons have been guided by the RUANS recommendation protocol for surgical management of patients with acute cervical spine fractures in Russia. However, there are no studies devoted to interobserver agreement between specialists with different experience., Objective: To evaluate the role of the RUANS recommendation protocol for decision-making in patients with acute traumatic cervical spine injuries., Material and Methods: Twenty-one neurosurgeons from 5 hospitals estimated data of 64 patients with cervical spine fractures. The study implied choosing an option for patient treatment (conservative therapy; anterior, posterior and circular fusion surgery). Two evaluations of CT and MR scans with an interval of 1.5 months were conducted. In the main group (9/21), neurosurgeons strictly followed the RUANS recommendation protocol during re-evaluation. In the control group (12/21), neurosurgeons analysed data considering their own knowledge and experience. Interobserver agreement was evaluated using a Fleiss' or Cohen's Kappa (K)., Results: Among the junior neurosurgeons (up to 5 years of experience), change in consent level during re-evaluation was greater in the main group (∆ K =0.25) compared to the control group (∆ K = -0.17). Among neurosurgeons with medium level of experience (5-10 years), ∆ K was 0.19 in the main group and -0.15 in the control group. Among experienced neurosurgeons (over 10 years of experience), the main group showed an increase in Kappa (∆ K =0.24), while level of consent remained almost the same in the control group (∆ K =0.05)., Conclusion: The RUANS recommendation protocol can significantly improve interobserver agreement between specialists with various levels of experience regarding management of acute cervical spine injury.

Water fleas are a good model for ecotoxicity studies, and were proposed for this purpose by the United States Environmental Protection Agency, due to their easy culture, body transparency, and high sensitivity to chemical pollution. Cardiovascular function parameters are usually used as an indicator of toxicity evaluation. However, due to the nature of the heart and blood flow, and the speed of the heartbeat, it is difficult to perform precise heartbeat and blood flow measurements with a low level of bias. In addition, the other cardiovascular parameters, including stroke volume, cardiac output, fractional shortening, and ejection fraction, have seldom been carefully addressed in previous studies. In this paper, high-speed videography and ImageJ-based methods were adopted to analyze cardiovascular function in water fleas. The heartbeat and blood flow for three water flea species, Daphnia magna , Daphnia silimis , and Moina sp., were captured by high-speed videography and analyzed using open-source ImageJ software. We found the heartbeat is species-dependent but not size-dependent in water fleas. Among the three water fleas tested, D. magna was identified as having the most robust heartbeat and blood flow rate, and is therefore suitable for the ecotoxicity test. Moreover, by calculating the diameter of the heart, we succeeded in measuring other cardiovascular parameters. D. magna were challenged with temperature changes and a pesticide (imidacloprid) to analyze variations in its cardiovascular function. We found that the heartbeat of D. magna was temperature-dependent, since the heartbeat was increasing with temperature. A similar result was shown in the cardiac output parameter. We also observed that the heartbeat, cardiac output, and heartbeat regularity are significantly reduced when exposed to imidacloprid at a low dose of 1 ppb (parts per billion). The blood flow rate, stroke volume, ejection fraction, and fractional shortening, on the contrary, did not display significant changes. In conclusion, in this study, we report a simple, highly accurate, and cost-effective method to perform physiological and toxicological assessments in water fleas.

Background: In humans, early pathological activity on invasive electrocorticograms (ECoGs) and its putative association with pathomorphology in the early period of traumatic brain injury (TBI) remains obscure., Methods: We assessed pathological activity on scalp electroencephalograms (EEGs) and ECoGs in patients with acute TBI, early electrophysiological changes after lateral fluid percussion brain injury (FPI), and electrophysiological correlates of hippocampal damage (microgliosis and neuronal loss), a week after TBI in rats., Results: Epileptiform activity on ECoGs was evident in 86% of patients during the acute period of TBI, ECoGs being more sensitive to epileptiform and periodic discharges. A "brush-like" ECoG pattern superimposed over rhythmic delta activity and periodic discharge was described for the first time in acute TBI. In rats, FPI increased high-amplitude spike incidence in the neocortex and, most expressed, in the ipsilateral hippocampus, induced hippocampal microgliosis and neuronal loss, ipsilateral dentate gyrus being most vulnerable, a week after TBI. Epileptiform spike incidence correlated with microglial cell density and neuronal loss in the ipsilateral hippocampus., Conclusion: Epileptiform activity is frequent in the acute period of TBI period and is associated with distant hippocampal damage on a microscopic level. This damage is probably involved in late consequences of TBI. The FPI model is suitable for exploring pathogenetic mechanisms of post-traumatic disorders.

Day-night cycle is the main zeitgeber (time giver) for biological circadian rhythms. Recently, it was suggested that natural diurnal geomagnetic variation may also be utilized by organisms for the synchronization of these rhythms. In this study, life-history traits in Daphnia magna were evaluated after short-term and multigenerational exposure to 16 h day/8 h night cycle, 32 h day/16 h night cycle, diurnal geomagnetic variation of 24 h, simulated magnetic variation of 48 h, and combinations of these conditions. With short-term exposure, the lighting mode substantially influenced the brood to brood period and the lifespan in daphnids. The brood to brood period, brood size, and body length of crustaceans similarly depended on the lighting mode during the multigenerational exposure. At the same time, an interaction of lighting mode and magnetic variations affected to a lesser extent brood to brood period, brood size, and newborn's body length. The influence of simulated diurnal variation on life-history traits in daphnids appeared distinctly as effects of synchronization between periods of lighting mode and magnetic variations during the multigenerational exposure. Newborn's body length significantly depended on the lighting regime when the periods of both studied zeitgebers were unsynchronized, or on the interaction of light regime with magnetic variations when the periods were synchronized. These results confirm the hypothesis that diurnal geomagnetic variation is an additional zeitgeber for biological circadian rhythms. Possible mechanisms for these observed effects are discussed. Bioelectromagnetics. © 2020 Bioelectromagnetics Society., (© 2020 Bioelectromagnetics Society.)

Background: Assessment of rupture risk for intracranial aneurysms (IA) is a particular challenge in cases of so-called complex aneurysms due to their variable morphometric characteristics. Arterial branch arising from the dome or the neck of IA is one of the least explored features of complex aneurysms. The methods of computational fluid dynamics may be valuable to determine the influence of arterial branches of IA on local hemodynamics., Objective: To analyze local hemodynamics in IA with arterial branch arising from the cupola or the neck depending on the structure of the aneurysm and blood flow rate in the parent vessel., Material and Methods: CT angiography data of 4 patients with IA were estimated in this study. Modifications of the baseline 3D models of the aneurysms resulted 12 patient-specific models included into analysis. Hemodynamic calculations were made by using of ANSYS Workbench 19 software package., Results: Wall shear stress (WSS) was characterized by the most significant variability, especially in case of sidewall aneurysms. Small cross-sectional area of additional branch in relation to the neck of IA was not followed by considerable changes of blood flow patterns inside IA after «virtual» removal of the vessel. Otherwise, the intensity of flows was drastically reduced. Simulation of high inlet flows demonstrated substantial variation of WSS in the area of jet., Conclusion: Additional arterial branch arising from the dome or the neck of IA significantly influences local hemodynamics. This influence depends on the localization of IA in relation to the parent vessel and the diameter of additional arterial branch.

Purpose: Navigated transcranial magnetic stimulation (nTMS) provides noninvasive visualization of eloquent brain areas. The nTMS is usually applied in presurgical planning to minimize the risk of surgery-related neurological deterioration. The aim of this study was to evaluate the usefulness of nTMS data for GammaKnife treatment planning for patients suffering from brain metastases., Methods: Motor cortex mapping with nTMS was performed in eight patients with brain metastases within or adjacent to the precentral gyrus. The nTMS data set was imported into the planning software and fused with anatomical MRI. Then contouring of the target and critical structures was performed. Treatment plans with and without visualization of the functional structures by nTMS were analyzed and compared by neurosurgeon and medical physicist., Results: The primary motor cortex was successfully delineated even in all cases despite significant peritumoral edema. Beam shaping and combined isocenters were used for conformal dose distribution and steeper dose fall-off near the identified eloquent zone. Compared with plans without nTMS data, treatment plans with integration of cortical nTMS mapping data showed a 2% to 78% (mean, 35.2% ± 22.7%) lower 12-Gy volume within the motor cortex without reduction of the dose applied to the tumor., Conclusions: The presented approach allows the easy and reliable integration of neurophysiological mapping data into GammaKnife treatment plans by the standard GammaPlan software. Diminishing the dose to critical structures might help to minimize side effects and therefore improve quality of life for brain metastasis patients.

Aim: The study was aimed at developing a surgical policy for patients presenting with acute ischaemic stroke induced by lesions of the intra- and extracranial arteries., Patients and Methods: The patients were enrolled into the study resulting from the current practice of the Department of Emergency Neurosurgery of the Research Institute of Emergency Medicine named after N.V. Sklifosovsky. Sampling of patients was carried out from 1st January, 2014 to 10th October, 2017, eventually comprising all those (n=160) operated on for verified pathology of brachiocephalic arteries and acute impairment of cerebral circulation., Results: During the examination, 101 (63.1%) patients were found to have unilateral or bilateral stenosis of the internal carotid artery, 22 (10.7%) patients were diagnosed with occlusion of the internal carotid artery, and 36 (17.6%) had acute thrombosis of the internal carotid artery. All this was the cause of acute impairment of cerebral circulation. Also, 1 patient was found to have occlusion of the 1st segment of the vertebral artery. Depending on the type of the lesion to the internal carotid artery, the patients were subdivided into 3 groups: 1) patients with internal carotid artery stenosis who received carotid endarterectomy; 2) patients with occlusion of the internal carotid artery, subjected to creation of an extra-intracranial microanastomosis, and 3) those with thrombosis of the internal carotid artery, who depending on the degree of occlusion of the internal carotid artery and patency of the intracranial arteries underwent thrombintimectomy or an extra-intracranial microanastomosis. The indications for and contraindications to interventions were defined based on the existing symptomatic pathology of brachiocephalic arteries, the terms of acute impairment of cerebral circulation, perfusion of the brain, the risk for the development of malignant stroke and cerebral oedema, possible haemorrhagic transformation of the focus of ischaemia, the rehabilitational potential of the patient and the analysis of the current literature. The results of our work demonstrated that surgical treatment of patients in the cute period of ischaemic stroke makes it possible to improve the neurological outcomes in patients as compared with the preoperative status and is not accompanied by a high risk of surgical complications (with the haemorrhagic complication rate amounting to 0.6%)., Conclusion: Surgical revascularization of the brain in the acute period of ischaemic stroke is a safe and effective method of treatment in patients with different haemodynamically significant damage of brachiocephalic arteries, once the patients were correctly selected for the operation.

This study presents data collected over a 3 year period on the effects of simulated geomagnetic storms (SGMS) on Eurasian roach Rutilus rutilus embryos. Effects were studied during different stages of early development. Rutilis rutilus were raised in ponds for 4 months after exposure to SGMS. The mass, standard length and morphological characteristics of under-yearlings exposed as embryos were recorded. A decrease in length-mass indices in under-yearlings was noted after they had been exposed to SGMS during the first 2 days or during the third and fourth days of early development. Near the time point of 48 h post fertilisation, either no effect or an increased size was observed. In addition, exposure to SGMS led to a redistribution of the vertebral number between the sections of the vertebral column as well as changes in the number of seismosensory system openings in the mandibular and praeoperculum bones of under-yearlings. Observed effects are similar to previously published data on the influence of anthropogenic magnetic fields on roach, namely changes in linear-mass indices, number of vertebrae and number of seismosensory system openings in the mandibular bones of under-yearlings exposed as embryos. Possible mechanisms of magnetic influence on early development of fish are discussed., (© 2019 The Fisheries Society of the British Isles.)

The capability of Daphnia magna to adapt to artificial low-frequency magnetic fields via a maternal effect has been demonstrated previously. The current study assessed the possibility of a maternal effect in response to simulated natural geomagnetic fluctuations. D. magna lines were exposed to simulated geomagnetic storms for two, five, and eight sequential generations. Evaluations were conducted on the 3rd, 6th, and 9th generations of daphnids from experimental and control lines in order to determine the period required for the formation of an adaptive maternal effect. The evaluations showed that larger offspring were produced when maturation and reproduction occurred under the same conditions as those in which the Daphnia had lived in for generations. These observations suggest a manifestation of an adaptive maternal effect occurs in response to long-term exposure to simulated geomagnetic storms. Ecological relevance of geomagnetic storms to natural populations of daphnids is discussed., (Copyright © 2019 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.)

It has been suggested that geomagnetic storms could be perceived by organisms via disruption of naturally occurring diurnal geomagnetic variation. This variation, in turn, is viewed by way of a zeitgeber for biological circadian rhythms. The biological effects of a geomagnetic storm, therefore, could depend on the local time of day when its main phase occurs. We have assessed calpain activity in tissues of roach (Rutilus rutilus) and great pond snail (Limnaea stagnalis) after exposure to a simulated geomagnetic storm, reproduced at different times of day, in order to evaluate this hypothesis. Significant decrease in calpain activity was observed in organisms exposed to the simulated geomagnetic storm whose main phase, and initial period of a recovery phase, did not coincide with the expected peak of diurnal geomagnetic variation. The results obtained are considered an experimental confirmation of the aforementioned hypothesis. Improvement of a correlative approach for the assessment of biological effects of geomagnetic activity can be achieved by considering information on the synchronization of geomagnetic storm's main phase with diurnal geomagnetic variation.

ACTH-ectopic syndrome is a severe, multiple-symptom disease characterized by secretion of adrenocorticotropic hormone (ACTH) by ectopic tumor, increased release of adrenal cortical hormones and clinical picture of hypercorticism. Diagnosis and treatment of ACTH-ectopic syndrome is still difficult problem despite the achievements of modern medicine. There are several unresolved issues including optimal diagnostic algorithm, indications for various surgical procedures and their optimal dates. This review is devoted to these questions.

Aim: To evaluate the results of surgical treatment of patients with unilateral MRI-positive temporal forms of drug-resistant epilepsy., Material and Methods: A prospective analysis of 50 patients with unilateral MRI-positive temporal forms of drug-resistant epilepsy, who had undergone resective surgery in the Scientific Research Institute of Emergency Medicine of N.V. Sklifosovsky (Moscow) and in University Clinic of Moscow State University of Medicine and Dentistry between 01.01.14 and 12.12.17, has been performed. MRI-positive temporal symptomatic epilepsy was identified in 79 (55%) patients. MRI results showed unilateral temporal epileptogenic lesions in 50 (67%) patients. These patients were assigned to medial frontal lobectomy., Results: 82% patients become 'seizure free' 12 and 24 months after surgical treatment. In other cases, seizures become less frequent and severe., Conclusion: The results confirm the efficacy and safety of surgical treatment of drug-resistant MRI-positive temporal forms of epilepsy.

In this article we present the clinical case of 63 y.o. man with chronic occlusion of the right common, internal, and external carotid arteries, and critical stenosis of the left internal carotid artery, with complaints of muscle weakness and decreased sensitivity of the left limbs. The patient underwent a staged brain revascularization, the left carotid endarterectomy was performed at the first stage and followed by bonnet bypass, which consists in anastomosing the contralateral superficial temporal artery with the ipsilateral intracranial artery by autograft interposition. In the postoperative period, the patient's neurological symptoms regressed. This case demonstrates the possibility of using bonnet bypass as an alternative revascularization method in patients with cerebral blood circulation insufficiency.

Objective: The objective of this study was to evaluate the results of surgical treatment of cerebral aneurysms in the Russian Federation., Material and Methods: We analyzed performance indicators in neurosurgical departments of regional and federal health institutions of the Russian Federation for 2017. The results of surgical treatment of cerebral aneurysms (CAs) were analyzed in 19 regional vascular centers (RVCs) in several federal districts and in 3 federal centers (FCs) with the most dynamically developing vascular neurosurgery and smoothly running system of statistical data processing., Results: The study included 3160 patients hospitalized to 22 medical institutions in 2017. Of these, 1808 patients were treated in RVCs, and 1352 patients were treated in FCs. We analyzed factors affecting the treatment outcome in CA patients. We identified features of CA treatment in clinics with a different amount of surgical intervention., Conclusion: An increase in the surgical activity in centers and simultaneous development of microsurgical and endovascular treatments for cerebral aneurysms reduce postoperative mortality. Due to the presence of a RVC network in the Russian Federation, many patients could receive necessary specialized treatment. The number of operations for cerebral aneurysms has increased 6-fold for the past 10 years.

The review presents the methodology of electroencephalography (EEG) background analysis, sporadic epileptiform discharges classification, and description of the rhythmic and periodic patterns in patients with primary and secondary brain damage. It describes the process of decision making in starting non-convulsive status epilepticus treatment of patients with EEG-verified non-convulsive status epilepticus and the signs of 'malignant' patterns indicating the irreversibility of brain injury.

This review focuses on the role of mental and cognitive disorders in the prognosis for surgical treatment of pharmacoresistant epilepsy. The authors analyze historical aspects of the surgical treatment of epilepsy and present current data on the prognosis of operative intervention with respect to seizure control, cognitive functioning, and psychiatric disorders. The psychiatrist's role in the structure of preoperative and postoperative management of patients is considered.

Vascular diseases of the brain and heart are the main cause of death and disability of the population of the Russian Federation. The social and economic burden of acute cerebral circulation disorders necessitated the development of a national program for the care of patients with acute vascular diseases. As a result of the implementation of a set of measures to improve medical care for patients with stroke over the past decade, the regions of the Russian Federation managed to create an 'insult network', equip the departments with high-tech diagnostic and therapeutic equipment, and train medical personnel. Due to the implementation of modern methods of treatment of stroke, the rates of disability and mortality from stroke have decreased.

This review presents contemporary data on the biological effects of geomagnetic activity. Correlations between geomagnetic indices and biological parameters and experimental studies that used simulated geomagnetic storms to detect possible responses of organisms to these events in nature are discussed. Possible mechanisms by which geomagnetic activity influences organisms are also considered. Special attention is paid to the idea that geomagnetic activity is perceived by organisms as a disruption of diurnal geomagnetic variation. This variation, in turn, is viewed by way of a secondary zeitgeber for biological circadian rhythms. Additionally, we discuss the utility of cryptochrome as a biological detector of geomagnetic storms. The possible involvement of melatonin and protein coding by the CG8198 gene in the biological effects of geomagnetic activity are discussed. Perspectives for studying mechanisms by which geomagnetic storms affect organisms are suggested. Bioelectromagnetics. 38:497-510, 2017. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

Aim: To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture., Material and Methods: Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery. Outcomes after open and endovascular surgeries were similar., Results: Normal leukocyte number in the venous blood at admission was identified in 12 (24%) of patients (on average 7.3±1.4·109/L), leukocytosis in 39 (76%) (14.3±3.1·109/L) (p<0.0001). Leukocyte number in the acute stage of CA rupture was correlated with the frequency and severity of the vessel spasm. In 28 (55%) of patients with ischemic lesions of the brain matter, mean leukocyte number in the first 72 h after hemorrhage was higher by 2-24% (3±4.8·109/L) compared to patients without ischemia (11.9±2.5·109/L) (p=0.06). The level of leukocytes in survivors was lower by 3 - 28% (122±3.4·109/L) compared to patients with fatal outcome and patients with severe neurological deficit after the surgery (14.5±3.9·109/L) (p>0.05)., Conclusion: The increase in leukocyte number in the venous blood in the first 72 h after CA rupture ≥10,1·109/L is a reliable risk factor of marked vessel spasm. The level of leukocytes in patients with cerebral ischemia and poor prognosis in the first 72h after aneurysmal hemorrhage was higher by 2-28% compared to survivors without neurological impairment or mild neurological deficit.

Aim: The study was aimed at determining volumetric blood flow velocity (VBFV) through the internal carotid artery (ICA) and assessing functional outcomes of treatment of patients, taking into consideration the dynamics of VBFV before and after the operation., Patients and Methods: The study comprised a total of 53 patients subjected to examination of VBFV through the ICA before and after carotid endarterectomy (CEA) assessed by means of flowmetry. Neurological deficit was evaluated by means of the NIHS Scale (the M NIHSS prior to operation equalling 2.49), the degree of disability and functional independence of the patient after endured stroke was assessed by the modified Rankin Scale (the M mRS before operation amounting to 1.23) and the Rivermead Mobility Index, the severity of cognitive dysfunctions was determined by the Mini-Mental State Examination (the M MMSE before surgery equalling 24.85) and the Montreal Cognitive Assessment scale (the M MoCA before surgery scoring 23.3)., Results: At the first stage of examination we determined that the VBFV after the operation increased in all patients, but the highest values of the increment were observed in groups of patients with ICA stenoses of 80-89% and 90-99%. During the second stage, it was determined that with a higher value of the VBFV after carotid endarterectomy regression of neurological deficit occurred faster (the postoperative M NIHSS scoring 2.09, with the M mRS of 1.00), the patients demonstrated higher results while undergoing the tests for intellectual ability (the postoperative MMSE and MoCA equalling 25.4 and 23.91, respectively) compared with the patients showing low values of the increment of the VBFV after the operation., Conclusion: Intraoperative flowmetry is a simple and efficient method of evaluating the VBFV through the ICA, an increase in volumetric blood flow (VBF) contributes to restoration of normal perfusion of the brain and creates prerequisites for more complete and faster restoration of the lost functions after ischaemic stroke (IS) and chronic cerebral ischaemia.

The paper deals with the assessment of cerebral perfusion in patients in the acute period of acute cerebrovascular accident before and after revascularization surgery. It gives a clinical example of using contrast-free perfusion magnetic resonance imaging (MRI) in a patient with hemodynamic ischemic stroke. The use of this technique made it possible to determine indications for early carotid endarterectomy for the contralateral internal carotid artery and to evaluate positive postoperative changes in cerebral perfusion and the patient’s neurological status. The authors analyzed the current literature on this problem with a particular emphasis on the possibilities of using dynamic susceptibility contrast-enhanced and arterial spin-labeling contrast-free perfusion MRI in this category of patients. Carotid endarterectomy in the acute period of acute cerebrovascular accident can improve cerebral hemodynamics and the patient’s neurological status and prevent recurrent cerebral circulatory disorders. Indications for this surgery should be determined by taking into consideration the results of perfusion MRI techniques (single-photon computed tomography contrastenhanced and contrast-free perfusion MRI).

In the present paper, directivity patterns of laser-generated sound in solids are investigated theoretically. Two main approaches to the calculation of directivity patterns of laser-generated sound are discussed for the most important case of thermo-optical regime of generation. The first approach, which is widely used in practice, is based on the simple modelling of the equivalent thermo-optical source as a mechanical dipole comprising two horizontal forces applied to the surface in opposite directions. The second approach is based on the rigorous theory that takes into account all acoustical, optical and thermal parameters of a solid material and all geometrical and physical parameters of a laser beam. Directivity patterns of laser-generated bulk longitudinal and shear elastic waves, as well as the amplitudes of generated Rayleigh surface waves, are calculated for different values of physical and geometrical parameters and compared with the directivity patterns calculated in case of dipole-source representation. It is demonstrated that the simple approach using a dipole-source representation of laser-generated sound is rather limited, especially for description of generated longitudinal acoustic waves. A practical criterion is established to define the conditions under which the dipole-source representation gives predictions with acceptable errors. It is shown that, for radiation in the normal direction to the surface, the amplitudes of longitudinal waves are especially sensitive to the values of thermal parameters and of the acoustic reflection coefficient from a free solid surface. A discussion is given on the possibility of using such a high sensitivity to the values of the reflection coefficient for investigation of surface properties of real solids., (Copyright © 2016 Elsevier B.V. All rights reserved.)

This study presents data collected over a 6 year period on the effects of extremely low-frequency magnetic fields (MFs) (1.4-1.6 µT, 500 Hz and 1.4-1.6 µT, 72.5 Hz) and MFs in combination with other environmental stressors (elevated temperature, 0.01 mg l(-1) trichlorfon, 0.01 mg l(-1) copper sulphate pentahydrate) on roach Rutilus rutilus embryos. Effects were studied during different stages of early development. Rutilus rutilus were raised in ponds for 4 months after exposure to MFs. The mass, standard length (LS ) and morphological characteristics of underyearlings which were exposed as embryos were recorded. An increase in embryo mortality and a decrease in LS and mass indices in underyearlings were noted after they had been exposed to a combination of MFs and different adverse environmental factors. In addition, exposure to MFs led to changes in the total number of vertebrae and the number of seismosensory system openings in the mandibular bones of underyearlings. MFs of different frequency caused both increases (500 Hz) and decreases (72.5 Hz) in morphological diversity. The stressors used in this study, however, did not increase the fluctuating asymmetry of bilateral morphological characteristics. The possible microevolutionary effects of exposure to MFs alone and in combination with other adverse environmental factors upon natural fish populations are discussed., (© 2016 The Fisheries Society of the British Isles.)

Positive end-expiratory pressure is one of the main parameters of respiratory support influencing the gas exchange. However, despite the number ofpositive effects, PEEP can compromise venous outflow from the cranial cavity, increased intracranial pressure, decreased venous return and cardiac output and, consequently, reduced blood pressure and cerebral perfusion. The article presents the results of a survey of 39 patients with intracranial hemorrhage in critical state, undergoing respiratory support with different levels of positive end-expiratory pressure. Increasing of PEEP to 15 cm H2O had no adverse effect on mean arterial pressure, heart rate and cerebral perfusion pressure and led only to an clinical insignificant increase (maximum on 2.4 +/- 5.1 mmHg) in intracranial pressure. The greatest hemodynamic changes were observed with increasing PEEP up to 20 cm H2O in patients with preserved compliance ofthe respiratory system. The instability of cerebral perfusion and intracranial pressure associated with a decrease in cardiac output and preload and the exhaustion of compensatory mechanism of peripheral vascular resistance. High levels of PEEP despite the trend towards Cstat reduction will not lead to an increase in the content of extravascular lung water Thus a gradual increase of PEEP to 15 cm H2O can be safe and effective method of improving pulmonary gas exchange in patients with intracranial hemorrhage in critical state.

Aim: To evaluate the results of surgical treatment of patients with pharmacoresistant epilepsy., Material and Methods: Examination and surgical treatment of 61 patients with pharmacoresistant forms of symptomatic epilepsy were performed from 01.01.14 to 01.05.16., Results and Conclusion: The results confirmed the safety and efficacy of the surgical treatment of pharmacoresistant epilepsy. After 12 months, seizures were controlled in 69% of operated patients. The necessity of complex examination of all patients with pharmacoresistant epilepsy to make a decision about possible surgery is shown.

Background: Not less than 50% of all ischaemic strokes appear to occur resulting from pathology of extracranial arteries. Occlusions and stenoses are more commonly encountered in carotid arteries, with the incidence of occlusion of the internal carotid artery (ICA) ranging from 5 to 10% within the structure of all lesions of brachiocephalic arteries (BCA)., Aim: The study was aimed at assessing the results of a surgical procedure of extra-intracranial microanastomosis (EICMA) performed in patients presenting with occlusive and stenotic lesions of BCA at the Neurosurgical Department., Patients and Methods: During the period between January 1st 2009 to September 30th 2015, specialists of the Neurosurgery Department of the Research Institute of Emergency Medical Care named after N.V. Sklifosovsky treated a total of 1,101 patients presenting with atherosclerotic lesions of BCA, with a total of 1,038 surgical interventions performed. Of these, there were 837 operations of carotid endarterectomy and 180 operations of EICMA in the carotid basin. The indications for performing EICMA in patients from the group with occlusive-stenosing lesions of the major arteries of the head and neck were as follows: the presence of occlusion of the internal carotid artery or M1 segment of the middle cerebral artery, verified by the findings of angiographic examinations; previously endured ischaemic-type cerebral circulation impairment in the basin on the side of occlusion; a decrease in the perfusion reserve of the brain on the side of occlusion by the findings of positron emission tomography (PET), single-photon emission computed tomography (SPECT) or CT-perfusion with loading tests., Results: After performing EICMA, the neurological status in patients averagely improved by 1.2 points according to the NIH Stroke Scale; by 0.5 point according to the Rankin scale, and by 3.5 points according to the Rivermead Mobility Index (Table 1). The dynamics of functional outcomes of EICMA turned out to depend on the terms of the operation (R=2143, p<0.05) and the degree of neurological deficit prior to surgery (R=3422, p<0.05): the deeper the neurological deficiency was and the sooner after acute cerebral ischaemia (ACI) the operation was performed, the more significant restoration of the functions was at the moment of discharge from hospital. Major complications of EICMA in patients operated on at various terms of ischaemic stroke were as follows: recurrent cerebral circulatory impairments - in 6 (3.3%) patients, subdural and intracranial haemorrhage - in 2 (1.1%), temporal deepening of the neurological deficit on the background of reperfusion, confirmed by the findings of SPECT - in 2 (1.1%), pneumonia with a lethal outcome - in 1 (0.6%), fatal ischaemic stroke of the opposite hemisphere - in 1 (0.6%) subject. The lethality rate amounted to 1.1% (2 cases). The risk for the development of complications was higher in elderly and aged patients (75 years and over), in patients with pronounced neurological deficit and significant somatic disorders., Conclusion: The indications for surgical prevention of recurrent ischaemic stroke by means of EICMA should be based on the following factors: the presence of confirmed occlusion of the ICA, a history of endured acute cerebral ischaemia, and decreased cerebrovascular reserve. Performing a surgical intervention is not appropriate for patients presenting with pronounced neurological deficit and significant somatic pathology. Careful selection of patients, the use of modern methods of neuroimaging, and intraoperative control make it possible to achieve favourable functional outcomes and to decrease the postoperative complications rate.