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The purpose of this work was to examine the dependence of human cerebellar mass and its age dynamics on the body length and body-build type. The study was carried out on 295 objects--the corpses of the individuals of both sexes (173 males and 122 females) who died at the age of 20-99 years. The length of the body, the transverse diameter of the chest and the cerebellar mass were measured. Somatotype was determined by the Rees-Eysenck index. It was found that human cerebellar mass ranged from 103 to 197 g (with the average of 144 ± 1.0 g) and was significantly greater in men than in women (150.5 ± 1.3 g vs. 133.9 ± 1.2 g, P0.001). Age affected cerebellar mass in men (R = -0.46) more, than in women (R = -0.43). In men, a period of relative stability of the cerebellar mass lasted up to about 50 years and then was followed by a period of its decrease. In women, the stable period was observed until approximately 70 years. The cerebellar mass was related to the body length (R = 0.35 for men and R = 0.36 for women). The dependence of the cerebellar mass on the body length was greater in men (1.0 g/cm) greater than in women (0.5 g/cm): with the increase of the body length the difference in the values of the cerebellar mass between men and women was found to grow. The cerebellar mass in the individuals with various body-build types was not significantly different

The literature data on using intravenous forms of AEDs that expand treatment possibilities for patients with epilepsy are presented. AEDs can be used in different situations, when patients are not able to take AEDs in per os. These situations can include seizure emergencies (recurrent seizures, clusters, status epilepticus), caused by disease decompensation; acute symptomatic seizures; perioperative preparation in the case of surgery; dysphagia; gastrointestinal problems; psychiatric disorders, and others. This article is based on a review of International and Russian expert consensus practice guidelines for management of clinical situations mentioned above. The authors present data on available Russian parenteral forms of drugs used today (valproats, levetiracetam, lacosamide, diazepam, midazolam, propofol, thiopental potassium). It has been concluded that an ideal intravenous AED should be highly effective, acts fast, has no severe adverse effects, has low drug-drug interactions, does not require frequent plasma concentration monitoring, and should be easily switched to a per os form without any additional titration. The importance of separate treatment approaches on different stages of medical help is emphasized. The choice of drug used can be influenced by a particular clinical situation, indications/contraindications, the recommended infusion speed, side effects, possible drug-drug interactions with other AEDs and other drugs used for the treatment of concomitant diseases, availability of a particular drug at the moment and the level of a physician's knowledge of usage of intravenous forms of AEDs.

Magnetoencephalography (MEG) in combination with structural MRI (magnetic source imaging, MSI) plays an increasingly important role as one of the tools for presurgical evaluation of medically intractable focal epilepsy. The aim of the study was to compare the MSI and commonly used video EEG monitoring method (vEEG) in their sensitivity to interictal epileptic discharges (IED) in 22 patients with drug resistant epilepsy. Furthermore, the detection and localization results obtained by both methods were verified using the data of electrocorticography (ECoG) and postsurgical outcome in 13 patients who underwent invasive EEG monitoring and surgery. The results showed that MSI was superior to vEEC in terms of sensitivity to IED with difference in sensitivity of 22%. The data also suggested that MSI superiority to vEEG in detecting epileptic discharges might, at least partly, arise from better MEG responsiveness to epileptic events coming from the medial, opercular and basal aspects of cortical lobes. MSI localization estimates were in the same cortical lobe and at the same lobar aspects as the epileptic foci detected by ECoG in all patients. Thus, magnetic source imaging can provide critical localization information that is not available when other noninvasive methods, such as vEEG and MRI, are used.

The aim of the study was to reveal MRI features of focal cortical dysplasia and sclerosis of the hippocampus in patients with symptomatic epilepsy. Twenty-four patients who underwent the surgery with symptomatic epilepsy were studied. The results of pre-surgical MRI and histological studies of the removed cortex were compared. The signs of focal cortical dysplasia in the lesion area were found in patients with oncologic and non-oncologic lesions. In patients with sclerosis of the hippocampus, such specific sign as the T2-signal elevation was not seen in all cases. Though MRI is a highly sensitive method for detecting cortical dysplasia, it does not allow to differentiate significantly different types of this pathology. Even in the presence of typical signs of focal cortical dysplasia, its real boundaries may spread beyond the clearly visualized lesion. In the absence of typical signs of focal cortical dysplasia, one should take into account non-specific signs in the comparison with clinical and neurophysiologic data. In sclerosis of the hippocampus, the changes in the signal intensity were not constantly seen and the decrease in the volume of the structure was a main diagnostic sign. In the cases of so-called "medial temporal epilepsy", any changes in hippocampus volume may be diagnostically important.

The review contains brief description of modem anesthetic approaches used in intractable epilepsy surgery. The authors describe main types of neurosurgery operations for intractable epilepsy, as well as the basic anesthetics and anesthetic plans and their influence on the intraoperative ECoG. Another issue raised is awake craniotomy - an anesthetic method with intraoperative emergence for verbal contact between patient and psychologist. We conclude that epilepsy surgery is one of the neurosurgery fields where anesthesiologist can significantly affect the outcome of the operation.

The author presents a review of literature focusing of state-of-art of surgical management of epilepsy. The second part of review discusses basic principles of selection of patients with localization-caused epilepsy for surgical treatment, preoperative examination, substantiation of resection procedures, results of treatment. Special attention is given to controversial aspects of tactics of surgical management: neurophysiological and neuroimaging signs of epileptogenic zones, determination of required resection volume, value of preoperative invasive examination and intraoperative electrocorticography. Surgical complications, especially concerning medial temporal procedures, are also described.

The paper analyzes the use of a method of thromboelastography (TEG) as a screening technique of diagnosing hemostatic disorders in risk-group neurosurgical patients: hemostatic disorders detectable from the data of routine laboratory tests; the administration of anticoagulants and desaggresants, the use of anticonvulsants causing impairments in the hemostatic system, hematological diseases, and hepatic cirrhosis. As compared with the routine laboratory tests, TEG is shown to diagnose hemostatic disorders accurately and promptly and to monitor the efficiency of their therapy.

An objective of the study is an analysis of the results of surgical treatment and influence of resection volume on the treatment outcome. Sixty-four patients, aged 7-46 years, with an epileptic focus in a temporal lobe have been studied. Patients have been stratified into 2 groups. The first group included 55 patients with epileptogenic lesions of a temporal lobe (monoregional lesions) and the second one--9 patients who, along with the lesion of one temporal lobe, had the signs of lesions in other brain areas (multiregional lesions). In the group of patients with monoregional lesions, a resection of the affected area has been performed. In other patients, the techniques of resection of frontal-medial temporal lobe regions within the scope of the area of steady epileptiform activity have been used. The results have been assessed with the modified Engel scale: class I--an absence of clinically manifested seizures (auras are possible); class II--seizures that do not impact quality of life; class III--a decrease of seizures frequency by more than 80%; class IV--an absence of substantial improvement. In the monoregional lesions, the satisfactory results (I-II classes) were observed in 39 patients (74%), including outcomes of class I (28 patients). In other 16 cases outcomes of classes III and IV were observed. In the multiregional lesions and cryptogenic (possibly symptomatic) partial epilepsy, outcomes of classes III and IV were observed in all patients, regardless of the resection volume. In conclusion, the highest efficacy with regard to frequency and severity of seizures is achieved by resections including the whole area of visualized lesion and border-line area of steady epileptic activity, the identification of which demands the intrasurgery neurophysiologic study. In the extensive and multiregional lesions, the resection surgery confined to one temporal lobe has low effect.

Kinetic characteristics of model enzymes and physicochemical properties of globular proteins modified by chemical analogues of low-molecular-weight microbial autoregulators (alkylhydroxybenzenes, AHBs) have been studied. C7 and C12 AHB homologues were used, differing in the length of the alkyl radical and the capacity for weak physicochemical interactions. Both homologues affected the degree of protein swelling, viscosity, and the degree of hydrophobicity. The effects depended on the structure of AHBs, their concentration, and pH of the solution, which likely reflects changes in the charge of the protein globule and its solvate cover. Variations of hydrophobicity indices of AHB-modified enzymes (trypsin and lysozyme) were coupled to changes in the catalytic activity. The values of K(M), measured for the enzymes within both AHB complexes, did not change, whereas V(max) increased (in the case of C7 complexes) or decreased (C12 complexes). Possible molecular mechanisms of changes in the physicochemical and catalytic parameters of enzymatically active proteins, induced by modification with structurally distinct AHBs, are described, with emphasis on targeted regulation of functional activity.

The results of treatment were analyzed in 40 patients aged 5 to 43 years who had been operated on for symptomatic temporal lobe epilepsy, among them there were 29 patients with low-grade intracerebral tumors. Local and regional lesions were observed in 27 and 13 cases, respectively. Thirteen patients with local lesions had also a local type of epileptiform activity; the remaining had a regional type. The involved area was removed in 10 patients; in 15 cases that was removed, with the areas wherein epileptform activity persisted; 15 patients underwent temporal lobectomy adapted to the data of neurophysiological study made before resection. Magnetic resonance imaging indicated that the involved area was completely removed; in 18 patients the resection borders exceeded the involved area. In local lesions accompanied by local epileptic activity, there were no significant differences between the removal in the borders of a lesion and that in a greater extent (p0.05). In patients with regional epileptiform activity, the results of treatment with removal in the greater extent were significantly better (por = 0.01). In these patients, an association was found between the significant disturbances of normal cortical rhythm outside the visualized involved area and the severe impairments in the cortical cytoarchitectonics in these areas. Persistent epileptic activity along with cortical rhythm disturbances on an electrocorticogram may be as a sign of lesion spread outside the visible borders and an indication for additional resections.

Examples are considered of the involvement of low-molecular-weight autoregulators in the development of resistance of proliferating microbial cultures to unfavorable environmental impacts of various intensity, including impacts programmed to occur in the developmental cycle ("new medium stress," starvation stress) and nonprogrammed impacts. It was shown that extracellular adaptation factors control the reversible adhesion of cells in submerged cultures and the processes of cell reactivation in the poststress period and are involved in the stabilization of cellular biopolymers (proteins and DNA) and subcellular structures (membranes); the adaptogens of the phenolic type also act as efficient scavengers of reactive oxygen species. The protective effect of the adaptogenic autoregulators is manifested in the increase of resistance of microbial cells to stressors of various nature and in the preservation of the cell proliferative capacity.

The results of treatment were analyzed in 37 patients with drug-resistant symptomatic temporal lobe epilepsy among whom there were 22 patients with low-grade intracellular tumors, 2 with cavernomas; 6 with cortical malformations, and 9 with residual organic lesions. Double pathology was noted in 4 patients. Mono- and multiregional lesions were observed in 30 cases. Removal of the site of lesion, extended medial resections, and temporal lobectomy were performed in 7, 5, and 25 cases, respectively. There was an association of the quality of outcomes with the scope of an intervention: the best results were achieved when the affected area with adjacent cortical portions was completely removed within the eliptogenic area. Resections for multiregional lesions are low effective.

The paper deals with the development and substantiation of various neurophysiological procedures during preoperative examination of patients with symptomatic epilepsy. The neurophysiological findings of 133 patients with drug-resistant temporal lobe epilepsy were applied. Unprogressive damage to the medial portions of the temporal lobe was verified in 18 patients. Low- and higher-grade malignancy of the temporal lobe was confirmed in 91 and 24 patients, respectively. This yielded an algorithm of the optimum neurophysiological preoperative examination. Emphasis is laid on the differences in applied procedures depending on the side of organic lesion location. Thus, the use of the developed algorithm makes it possible to lighten the selection of candidates for surgical treatment of drug-resistant symptomatic epilepsy and to optimize the examination of epileptic patients with different types of brain damage.

The response of the gram-positive bacterium Micrococcus luteus to heat shock (45 degrees C, 15 min) and the adaptogenic activity of alkylhydroxybenzenes (AHB), which are extracellular growth-regulating substances of these bacteria, were studied. The perception of stress and the postshock behavior of M. luteus cells proved to depend on the growth phase and medium. The magnitude of stress response was more pronounced in cultures grown on synthetic medium than in cultures grown on rich medium (nutrient broth). During exponential or linear growth, the cells were more sensitive to the temperature effect than during decelerated growth. In linearly growing M. luteus cultures, the amount of total intra- and extracellular alkylhydroxybenzenes, the anabiosis inducers, increased in response to heat shock. AHB redistribution between cells and culture liquid occurred in the course of stress and after stress. In micrococci exposed to heat shock, an increase in the AHB concentration both in cells and culture liquid is likely a defense reaction of stress resistance. This conclusion was confirmed in the experiments with the addition 30 min before the heat shock of a chemical analogue of the anabiosis inducer, C7-AHB (12 mM), which protected M. luteus cells so that their intense growth was observed after shock without any lag. The protective effect of AHB is a result of their ability to form complexes with enzyme macromolecules and stabilize them. The data obtained extend the knowledge of the stress-protective functions of low-molecular-weight autoregulators and of the role of intercellular communications in the stress response of bacterial cultures.

The present study involves the analysis of the results of surgical treatment in 35 patients with drug-resistant epilepsy caused by local temporal lobar lesions: glioma without growth (n = 31), gliosis (n = 1), and cavernoma (n = 3). The medial location of neoplasms involving the hippocampus was noted in 25 cases, their extrahippocampal location was observed in 10 cases. The history of seizures was 2 to 18 years; the duration of a postoperative follow-up was 1 to 6 years. Electrocorticographic and EEG findings indicated that in all cases the eliptogenic zone was located in the medial portions of the temporal lobes at the site of lesion. The first stage of surgery was to remove a neoplasm; the adjacent portions of an epileptogenic zone were resected only with preserved convulsive activity in the surrounding areas. Good results (Classes I-II) were observed in cases of the medial location of a lesion in both total removal of a neoplasm and additional resections; in the group of patients the results were better than in routine removal (seizures ceasing in 4 of 5 and in 3 of 12 patients, respectively). Bad results (Classes III-V) were noted with partial removal of a neoplasm from the medial portions (n = 4), there were much better results (Classes I-II) with its total removal from the medial portions and with its partial removal from other areas. With total removal of extrahippocampal neoplasms, seizures were retained (Classes III-IV); additional resections of neocortical zones (n = 2) failed to improve the results of treatment. With resections in the entorial cortical area, the results were better (Class II). Our findings confirm that hippocampal removal plays an important role in symptomatic temporal epilepsy for an adequate monitoring of seizures.

The effects of C7-alkylhydroxybenzene (C7-AHB) and p-hydroxyethylphenol (tyrosol), chemical analogs of microbial anabiosis autoregulators, on the viability of yeast cells under oxidative stress were investigated. The stress was caused by reactive oxygen species (ROS) produced under gamma irradiation of cell suspensions using doses of 10-150 krad at an intensity of 194 rad/s or by singlet oxygen generated in cells photosensibilized with chlorin e6 (10 micrograms/l). C7-AHB was found to exert a protective effect. The addition of 0.05-0.16 vol% of C7-AHB to cell suspensions 30 min before irradiation protected yeast cells from gamma radiation (50 krad). The protective effect of C7-AHB manifested itself both in the preservation of cell viability during irradiation and in the recovery of their capacity to proliferate after irradiation. In our studies on photodynamic cell inactivation, the fact that the phenolic antioxidant C7-AHB protects cells from intracellular singlet oxygen was revealed for the first time. The analysis of difference absorption spectra of oxidized derivatives of C7-AHB demonstrated that the protective mechanism of C7-AHB involves the scavenging of ROS resulting from oxidative stress. The fact that tyrosol failed to perform a photoprotective function suggests that the antioxidant properties of microbial C7-AHB are not related to their chaperon functions. The results obtained make an important addition to the spectrum of known antioxidant and antistress effects of phenolic compounds.

It has been shown that one of alkyl hydroxybenzenes, C7-AHB, can be used in malting for regulating barley growth. Depending on concentration (0.01-1.0%) and duration (10 min to 6 h), treatment of barley with a C7-AHB solution stimulates embryo development (0.01-0.02%) or suppresses the growth of vegetative organs (0.5%) and modulates enzyme activities in germinating grains. Stimulation of the activities of the amylolytic and protein-proteinase complexes in barley depending on C7-AHB concentration improves malt quality by increasing both the degree of its saccharification and protein dissolution.

A comparative study was performed of the processes of autolytic degradation of the cells of Saccharomyces cerevisiae and Schizosaccharomyces pombe under conditions simulating the phase of cell death in microbial cultures: (1) during autolysis induced by oleic acid, which is the chemical analogue of factors d2 (autolysis autoinducer), (2) under the effect of extracellular microbial proteinases (enzymatic lysis), and (3) under concomitant effect of the enzymes of the endogenous autolytic complex and exogenous proteinases (heterolysis). Regulatory mechanisms controlling the rate and profundity of autolysis were elucidated, relying on the stabilization of hydrolytic enzymes and enhancement of their activity in their complexes with a chemical analogue of microbial autoregulatory factors d1, which belong to alkylhydroxybenzenes and fulfil functions of chemical chaperons. The changes in the activity of proteinases and enzymes of the autolytic complex were shown to be dependent on the concentration of the analogue at the moment of complex formation.

Fifteen patients with focal lesions of temporal epilepsy were examined before and 6 months to 4 years after surgery. There were low-grade gliomas in 13 cases, muscle tissue heterotopy in 1 case, and medial temporal sclerosis in 1. Epileptogenic lesions were localized in the medial structures of the temporal lobe in 10 cases and in the lateral temporal regions in 5 cases. Comprehensive neurophysiological study, including intraoperative electrocorticography, was used to identify an epileptogenic zone (EZ). EZs were found in the medial structures on the affected side in all patients. Lesionectomies were performed in all cases. It was combined with medial resection in 12 cases (it was done in 10 patients until epileptic activity disappeared). Nine patients stopped having seizures after surgery. One patient had only auras. Improvements were slight in 5 patients. A relationship was found between the surgical outcomes and the site of a lesion and EZ. They authors conclude that complete recovery may occur in cases with medial locations of a lesion and EZ. The outcomes of surgery are much poorer in cases with the lateral sites of an lesion and in those with the medial site of EZ.

The paper gives the results of using selective dorsal rhizotomy at the lumbosacral level in 15 children with infantile cerebral paralysis, 12 of whom were at the age of 6 to 15 years. It also discusses surgical techniques, the use of intraoperative stimulation, and the impact of selective dorsal rhizotomy on muscle tone. The paper provides evidence for the benefits of surgery reducing the muscle tone at the expense of its spastic component. Based on the relationship between the number of cut fibers as part of each root and the degree of decreased muscle tone, a procedure is proposed for conservative surgical interventions to be used in patients employing spasticity for support.