Slow Course Research Articles

Cortico-muscular coherence and brain networks in familial adult myoclonic epilepsy and progressive myoclonic epilepsy

ObjectiveFamilial Adult Myoclonic Epilepsy (FAME) presents with action-activated myoclonus, often associated with epilepsy, sharing various features with Progressive Myoclonic Epilepsy (PMEs), but with slower course and limited motor disability. We aimed our study to identify measures suitable to explain the different severity of FAME2 compared to EPM1, the most common PME, and to detect the signature of the distinctive brain networks. MethodsWe analyzed the EEG-EMG coherence (CMC) during segmental motor activity and indexes of connectivity in the two patient groups, and in healthy subjects (HS). We also investigated the regional and global properties of the network. ResultsIn FAME2, differently from EPM1, we found a well-localized distribution of beta-CMC and increased betweenness-centrality (BC) on the sensorimotor region contralateral to the activated hand.In both patient groups, compared to HS, there was a decline in the network connectivity indexes in the beta and gamma band, which was more obvious in FAME2. ConclusionsIn FAME2, better localized CMC and increased BC in comparison with EPM1 patients could counteract the severity and the spreading of the myoclonus.Decreased indexes of cortical integration were more severe in FAME2. SignificanceOur measures correlated with different motor disabilities and identified distinctive brain network impairments.

Deficits in mitochondrial TCA cycle and OXPHOS precede rod photoreceptor degeneration during chronic HIF activation

BackgroundMajor retinal degenerative diseases, including age-related macular degeneration, diabetic retinopathy and retinal detachment, are associated with a local decrease in oxygen availability causing the formation of hypoxic areas affecting the photoreceptor (PR) cells. Here, we addressed the underlying pathological mechanisms of PR degeneration by focusing on energy metabolism during chronic activation of hypoxia-inducible factors (HIFs) in rod PR.MethodsWe used two-photon laser scanning microscopy (TPLSM) of genetically encoded biosensors delivered by adeno-associated viruses (AAV) to determine lactate and glucose dynamics in PR and inner retinal cells. Retinal layer-specific proteomics, in situ enzymatic assays and immunofluorescence studies were used to analyse mitochondrial metabolism in rod PRs during chronic HIF activation.ResultsPRs exhibited remarkably higher glycolytic flux through the hexokinases than neurons of the inner retina. Chronic HIF activation in rods did not cause overt change in glucose dynamics but an increase in lactate production nonetheless. Furthermore, dysregulation of the oxidative phosphorylation pathway (OXPHOS) and tricarboxylic acid (TCA) cycle in rods with an activated hypoxic response decelerated cellular anabolism causing shortening of rod photoreceptor outer segments (OS) before onset of cell degeneration. Interestingly, rods with deficient OXPHOS but an intact TCA cycle did not exhibit these early signs of anabolic dysregulation and showed a slower course of degeneration.ConclusionTogether, these data indicate an exceeding high glycolytic flux in rods and highlight the importance of mitochondrial metabolism and especially of the TCA cycle for PR survival in conditions of increased HIF activity.

No Heightened Musical Pitch Weighting For Tone Language Speakers in Early Childhood

Numerous studies suggest that speakers of some tone languages show advantages in musical pitch processing compared to non-tone language speakers. A recent study in adults (Jasmin et al., 2021) suggests that in addition to heightened pitch sensitivity, tone language speakers weight pitch information more strongly than other auditory cues (amplitude, duration) in both linguistic and nonlinguistic settings compared to non-tone language speakers. The current study asks whether pitch upweighting is evident in early childhood. To test this, two groups of 3- to 5-year-old children—tone-language speakers (n = 48), a group previously shown to have a perceptual advantage in musical pitch tasks (Creel et al., 2018), and non-tone-language speakers (n = 48)—took part in a musical “word learning” task. Children associated two cartoon characters with two brief musical phrases differing in both musical instrument and contour. If tone language speakers weight pitch more strongly, cue conflict trials should show stronger pitch responding than for non-tone speakers. In contrast to both adult speakers’ stronger pitch weighting and child and adult pitch perception advantages, tone-language-speaking children did not show greater weighting of pitch information than non-tone-language speaking children. This suggests a slow developmental course for pitch reweighting, contrasting with apparent early emergence of pitch sensitivity.

Plasma Metabolic Analysis Reveals the Dysregulation of Short-Chain Fatty Acid Metabolism in Parkinson's Disease.

Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by high morbidity, high disability rate, and slow course of disease. The clinical diagnostic method of PD is complex and time-consuming, and there is no clear biomarker for clinical use. We aimed to investigate the plasma metabolites in PD and find out potential biomarkers with diagnostic ability. In the analysis of more than 40 metabolites including short-chain fatty acids, long-chain fatty acids, amino acids, and carbohydrates, the difference of short-chain fatty acids was observed. Acetic acid concentration was higher in PD than in healthy controls, and propanoic acid and 2,3,4-trihydroxybutyric acid were lower in PD. Compared with the early stage of PD, acetic acid increased significantly in the advanced stage of PD. Propanoic acid increased significantly in medicated PD compared with drug naïve PD. ROC analysis revealed acetic acid discriminated PD from healthy controls with 100% sensitivity, 88.9% specificity, and an area under the curve (AUC) of 0.981, and propanoic acid discriminated PD from healthy controls with an AUC of 0.981, 100% sensitivity, and 94.4% specificity. Acetic acid and propanoic acid may be a potential biomarker for differentiating PD from health, and the propanoic acid was evaluated as the most potential diagnostic marker because of its extremely high sensitivity and specificity.

ADA kao glavni biohemijski marker kod bolesnika sa tuberkuloznim izlivom

Tuberculous pleuritis (TP) is one of the most common extra-pulmonary tuberculosis form. Because of tuberculous pleurisy is hard to diagnose due to slow course of disease and lack of specificity in symptoms and diagnostic methods. In that reason, we need multidisciplinary approach and efficient biomarkers. Acid-fast bacilli (AFB) staining, cultures and pathophysiological biopsy finding from the majority of patients are positive only in less than 10%. Löwenstein culture results need time about 6-8 weeks what delays diagnosis. Adenosine deaminase (ADA) is biomarker with high sensitivity and specificity (more than 90%) and considered as gold standard of biomarkers in the diagnosis of TP. It is very hard to distinguish malignant from TP with lymphocyte predomination, but in patient with malignant pleural effusion the level of ADA is decreased, opposite from TP. ADA in pleural punctate is a fast, simple, efficient and economical way for clarification the etiology of the pleural effusion as tuberculous pleurisy. Also, many studies have proved the role of ADA in the response to treatment for tuberculosis at follow up period.

Longitudinal pathologic course of older individuals with medial temporal tau deposition in the absence of amyloid‐β pathology

AbstractBackgroundAlzheimer’s disease (AD)‐like tau pathology in the medial temporal lobe (MTL) is also commonly observed in older individuals without amyloid‐β (Aβ) pathology, a condition termed primary age‐related tauopathy (PART). Little is known about the longitudinal course of this condition and its association with the AD continuum remains controversial. We used serial PET, MRI, and CSF data to study the longitudinal pathologic course of older individuals who show PET‐measured MTL tau pathology in the absence of Aβ pathology.MethodWe included older individuals with varying degrees of cognitive performance from the Alzheimer’s Disease Neuroimaging Initiative, the Harvard Aging Brain Study, and AVID’s A05 Study who had undergone baseline (n=1097) and follow‐up [18F]flortaucipir (FTP) (n=489, follow‐up: 1.83±0.84 years) and Aβ‐PET scanning (n=398, follow‐up: 2.36±0.76 years). Participants were separated into three groups according to Aβ and tau positivity (A‐T‐, A‐T+, A+T+), using a cut‐off of 12 centiloids for A+ and the 95th percentile of entorhinal (ERC) FTP SUVR values in healthy young controls (n=16, ≤39y) for T+. In complementary analyses we also assessed longitudinal changes in CSF biomarkers (n=99, follow‐up: 2.34±1.05 years) and cortical atrophy on MRI (n=650, follow‐up: 2.00±0.86 years).Result43% of A‐ individuals and 81% of A+ individuals were ERC‐tau positive. Cross‐sectionally, A‐T+ showed elevated FTP SUVR restricted to the medial/inferior temporal lobe, while A+T+ displayed a more AD‐characteristic pattern of widespread cortical FTP uptake (Fig. 1A). A‐T+ showed moderate FTP SUVR increases over time largely limited to the temporal lobe, whereas FTP SUVR increases were widespread in A+T+ (Fig. 1B). Notably, A‐T+ individuals did not increase Aβ accumulation over time (Fig. 1C). CSF analysis confirmed longitudinal tau increases in A‐T+ in the absence of increased Aβ accumulation (Fig. 1D). Compared to A‐T‐, A‐T+ individuals demonstrated accelerated MTL atrophy, whereas A+T+ showed more widespread AD‐typical cortical atrophy (Fig. 2).ConclusionElevated MTL tau‐PET signal is frequently observed in older individuals without notable Aβ pathology, reminiscent of pathology‐defined PART. These A‐T+ individuals exhibit a comparably slow course of progressive tau accumulation and neurodegeneration confined to the temporal lobe and do not appear to be on a pathologic trajectory towards AD.

Endoscopic Management of Ethmoidal Schwannoma: A Case Report.

Schwannomas of sinonasal origin are rare tumours with an incidence as low as 4% and may present with a wide range of clinical features. Due to non-specific endoscopic and radiological findings, diagnosis becomes difficult. We present a case of an ethmoidal schwannoma with nasal and nasopharyngeal extension in an elderly female patient who had a slow course of the long-standing disease. Her main complaints were nasal obstruction, nasal discharge, mouth breathing, snoring and recurrent nasal bleed. Nasal endoscopy showed a pale, firm, polypoidal mass with dilated vessels on the surface which bled on probing. It was a non-enhancing sinonasal mass with scalloping of adjacent paranasal sinuses and erosion of posterior nasal septum on contrast-enhanced computed tomography. Endoscopic excision of the mass was done in toto and histopathology report confirmed it as schwannoma. Long standing sinonasal masses especially in the elderly age group with an indolent medical history should arise suspicion of benign neoplasm especially schwannomas due to their high rate of incidence amongst benign sinonasal neoplasms.

Developmental aspects of fear generalization – A MEG study on neurocognitive correlates in adolescents versus adults

BackgroundFear generalization is pivotal for the survival-promoting avoidance of potential danger, but, if too pronounced, it promotes pathological anxiety. Similar to adult patients with anxiety disorders, healthy children tend to show overgeneralized fear responses. ObjectiveThis study aims to investigate neuro-developmental aspects of fear generalization in adolescence – a critical age for the development of anxiety disorders. MethodsWe compared healthy adolescents (14–17 years) with healthy adults (19–34 years) regarding their fear responses towards tilted Gabor gratings (conditioned stimuli, CS; and slightly differently titled generalization stimuli, GS). In the conditioning phase, CS were paired (CS+) or remained unpaired (CS-) with an aversive stimulus (unconditioned stimuli, US). In the test phase, behavioral, peripheral and neural responses to CS and GS were captured by fear- and UCS expectancy ratings, a perceptual discrimination task, pupil dilation and source estimations of event-related magnetic fields. ResultsClosely resembling adults, adolescents showed robust generalization gradients of fear ratings, pupil dilation, and estimated neural source activity. However, in the UCS expectancy ratings, adolescents revealed shallower generalization gradients indicating overgeneralization. Moreover, adolescents showed stronger visual cortical activity after as compared to before conditioning to all stimuli. ConclusionVarious aspects of fear learning and generalization appear to be mature in healthy adolescents. Yet, cognitive aspects might show a slower course of development.

Opening up the black box of recovery processes in persons with complex mental health needs: a qualitative study of place-making dynamics in a low-threshold meeting place

BackgroundThe recovery processes of persons with complex mental health needs take a slow and unpredictable course. Despite the fact that a number of essential building blocks of recovery in this population have been identified (e.g. social relationships, treatment, personal beliefs), the actual process of recovery in persons with complex mental health needs largely remains a black box. The aim of this study was to gain insight into how the recovery processes of persons with complex mental health needs take place, by applying a relational geographical approach and scrutinizing the place-making dynamics of one low-threshold meeting place in Belgium engaging with this group.MethodsData collection took place during the height of the COVID-19 pandemic by means of 11 in-depth interviews with different involved actors (service users, staff members, volunteers) and analyzed thematically.ResultsResults showed how the daily practice of the meeting place is continuously reproduced through place-making rituals that create an inclusive space of hospitality, are fueled by creative processes and form an indispensable counterweight for service users’ mental health needs.ConclusionsTo further open up the ‘black box’ of recovery in persons with complex mental health needs, it is vital to focus our analytic gaze onto recovery as a dynamic and relational practice.

Genetic Mouse Models to Study Pancreatic Cancer-Induced Pain and Reduction in Well-Being.

In addition to the poor prognosis, excruciating abdominal pain is a major challenge in pancreatic cancer. Neurotropism appears to be the underlying mechanism leading to neuronal invasion. However, there is a lack of animal models suitable for translationally bridging in vitro findings with clinical trials. We characterized KPC (KrasG12D/+; Trp53R172H/+; P48-Cre) and KPPC (KrasG12D/+; Trp53R172H/R172H; P48-Cre) mice with genetically determined pancreatic ductal adenocarcinoma (PDAC) and compared them with an orthotopic pancreatic cancer mouse model, healthy littermates and human tissue. We analyzed behavioral correlates of cancer-associated pain and well-being, and studied neuronal remodeling and cytokine expression. Histologically, we found similarities between KPC and KPPC tissue with human samples. Compared to healthy littermates, we detect nerve fiber hypertrophy, which was not restricted to a certain fiber type. Interestingly, while KPPC mice showed significantly reduced well-being, KPC mice emerged to be better suited for studying long-lasting cancer pain that emerges over a slow course of tumor progression. To address the neuroinflammatory correlate of loss of well-being, we studied cytokine levels in KPPC mice and observed a significant upregulation of CXCL16, TNFRSF5, CCL24, CXCL1, CCL22, CLL20 and CX2CL1. In summary, we demonstrate that the KPC mouse model is best suited to studying cancer pain, whereas the KPPC model can be employed to study cancer-associated reduction in well-being.

A cross-sectional natural history study of aspartylglucosaminuria.

Aspartylglucosaminuria (AGU) is a rare lysosomal storage disorder that causes stagnation of development in adolescence and neurodegeneration in early adulthood. Precision therapies, including gene transfer therapy, are in development with a goal of taking advantage of the slow clinical course. Understanding of disease natural history and identification of disease‐relevant biomarkers are important steps in clinical trial readiness. We describe the clinical features of a diverse population of patients with AGU, including potential imaging and electrophysiological biomarkers. This is a single‐center, cross‐sectional study of the clinical, neuropsychological, electrophysiological, and imaging characteristics of AGU. A comprehensive assessment of eight participants (5 Non‐Finnish) revealed a mean non‐verbal IQ (NVIQ) of 70.25 ± 10.33 which decreased with age (rs = −0.85, p = 0.008). All participants demonstrated deficits in communication and gross/fine motor dysfunction. Auditory and visual evoked potentials demonstrated abnormalities in one or both modalities in 7 of 8 subjects, suggesting sensory pathway dysfunction. Brain imaging demonstrated T2 FLAIR hypointensity in the pulvinar nuclei and cerebral atrophy, as previously shown in the Finnish AGU population. Magnetic resonance spectroscopy (MRS) showed a 5.1 ppm peak corresponding to the toxic substrate (GlcNAc‐Asn), which accumulates in AGU. Our results showed there was no significant difference between Finnish and Non‐Finnish patients, and performance on standardized cognitive and motor testing was similar to prior studies. Age‐related changes on functional assessments and disease‐relevant abnormalities on surrogate biomarkers, such as MRS, could be used as outcome measures in a clinical trial.

Enhancement mechanism of Te doping on microstructure, wettability and mechanical properties of Sn–Bi-based solder

Sn–Bi-based solder alloys have sparked tremendous research interest towards the development of low-temperature interconnecting materials in multi-level packaging interconnections electronic devices. Nevertheless, the research speed of solder is elusive to match well with the rapid development of integrated circuit design and manufacturing, which leads to the slow renewal course of electronic products. In the pursue for more effective modification strategies, Te was selected to be doped into Sn58Bi–1Sb (SBS) solder. As expected by the design, Te existed in the solder matrix in the form of solid solution and intermetallic compound simultaneously. To our satisfaction, Te enormously improved both the tensile strength and plasticity of the SBS solder. This largely circumvents the negative correlation between strength and plasticity during the modification process. Additionally, Te element significantly optimized the thermal properties, wettability, and creep resistance of SBS solder. Many tiny Bi particles embedded in Sn phase and strengthened the SBST solder matrix as the second phase. More strikingly, numerous Bi twin crystal structures were observed in the Sn58Bi–1Sb1Te (SBST) solder matrix, which occurred in Sn–Bi-based solder matrixes first time. The Bi phase twin represents preferable deformation ability of Bi phase and the plasticity of the solder matrix. It indicated that the doping of Te comprehensively enhanced the performance of SBS solder and may opened new horizons to the design route of alloying modification for Sn–Bi-based solder.

Congenital myopathies in adults: A diagnosis not to overlook.

Congenital myopathies (CM) were traditionally classified according to the muscle histopathological features, but in recent years, molecular diagnosis has become increasingly important. CM may present a wide phenotype variability, and while adult-onset CM have been increasingly recognized, substantial diagnostic delays are still reported. To describe a cohort of adult CM patients, including clinical, genetic, and histopathological features, and further characterize the subgroup of adult-diagnosed patients. We performed a retrospective observational cohort study to characterize the CM patients evaluated in our adult Neuromuscular outpatient clinic, including the subgroup of adult-diagnosed patients. We identified 19 CM patients with compatible molecular and/or histological diagnoses, of which 14 were diagnosed in adulthood. Eleven adult-diagnosed patients had symptoms since childhood and 9 had a family history of myopathy. The median age of symptoms' onset was 4 years old and the median age at diagnosis was 37 years old. The most common causative gene was RYR1, followed by TTN and MYH7. Three patients had non-specific features on muscle biopsy, all diagnosed during adulthood. In our cohort, the majority of CM were diagnosed in adulthood, despite most having pediatric-onset symptoms and positive family history. The diagnostic delay may be associated with mild presentation, slow course, atypical muscle histology, and lack of awareness of adult-onset CM. Studies with larger populations are needed.

Malignant progression of cerebellopontine angle solitary fibrous tumors following radiation: illustrative case.

BACKGROUNDIntracranial solitary fibrous tumors (ISFTs) are rare mesenchymal tumors originating in the meninges and constitute a heterogeneous group of clinical and biological behavior. Benign histotypes, such as hemangiopericytomas are now considered as a cellular phenotypic variant of this heterogenous group of rare spindle-cell tumors. IFSTs are poorly recognized and remain a diagnostic challenge due to rarity and resemblance to other brain tumors. Previously, IFSTs were thought to pursue a slow, indolent, and nonaggressive course, however, a growing body of literature based on longer follow-up demonstrates an unpredictable clinical course and an uncertain diagnosis.OBSERVATIONSA rare case report of malignant transformation of IFST following radiation therapy is reported. In this case a 60-year-old female who underwent gross total resection of the cerebellopontine angle tumor with histopathology consistent with solitary fibrous tumor followed by salvage stereotactic radiosurgery, presented with another recurrence after 2 years of surgery. The authors performed complete removal of the tumor with pathology now consistent with malignant solitary fibrous tumor. A recent follow-up magnetic resonance imaging did not show any recurrence or residual tumor, and the patient reports a generalized well-being.LESSONSThis report will help to understand the natural history and unusual clinical behavior of these intracranial tumors.

Single Cell Analysis of Reversibility of the Cell Death Program in Ethanol-Treated Neuronal PC12 Cells.

Neurodegenerative diseases are generally characterized clinically by the selective loss of a distinct subset of neurons and a slow progressive course. Mounting evidence in vivo indicates that large numbers of neurons pass through a long period of injury and dysfunction before the actual death of the cells. Whether these dying neurons can be rescued and return to a normal, functional state is uncertain. In the present study, we explored the reversibility of the neuronal cell death pathway at various stages by monitoring the dynamics of single cells with high-resolution live-cell spinning disk confocal microscopy in an in vitro neuronal cell death model. We exposed differentiated neuronal PC12 cells to ethanol as our cell death model. Results showed that exposure to 5% ethanol for 24 h induced cell death in >70% of the cells. Ethanol treatment for 3 h already induced cellular changes and damage such as reactive oxygen species generation, elevation of intracellular Ca2+ level, phosphatidylserine exposure, nuclear shrinkage, DNA damage, mitochondrial fragmentation and membrane potential loss, and retraction of neurites. These phenomena are often associated with programmed cell death. Importantly, after removing ethanol and further culturing these damaged cells in fresh culture medium, cells recovered from all these cell injuries and generated new neurites. Moreover, results indicated that this recovery was not dependent on exogenous NGF and other growth factors in the cell culture medium. Overall, our results suggest that targeting dying neurons can be an effective therapeutic strategy in neurodegenerative diseases.

Recurrences of Spheno-Orbital Meningiomas: Risk Factors and Management

The extent of resection constitutes one of the most important predictive risk factors of recurrence for spheno-orbital meningiomas; although gross total resection represents the gold standard, it is not always achievable, with a consequent high rate of recurrence. Management of these tumors is a surgical challenge and is represented by maximal safe resection with preservation of function. The aim of the present study is to discuss the risk factors for recurrence and the best management of the recurrent tumors. Eighty patients operated on for spheno-orbital meningiomas were retrospectively reviewed. Two groups were identified: group 1 comprised 30 patients (37.5%) who experienced recurrence and group 2 comprised 50 patients with no recurrence from 5 to 28 years after the initial surgery. The analyzed factors in both groups include the involvement of the skull base structures, the extent of resection, and World Health Organization grade. In the recurrence group, the pattern of tumor regrowth, the entity of resection, and the management were also analyzed. The invasion of the whole orbit, the involvement of the orbital apex, superior orbital fissure, infratemporal fossa, and sphenoidal-ethmoidal sinuses, and World Health Organization grade II are risk factors of recurrence. All 30 patients with recurrence underwent reoperation, 9 of whom had 2 or 3 reoperations. Overall, 70 of the 80 patients (88%) had tumor control and no progression after one or more reoperations. We suggest re-surgery for spheno-orbital meningioma recurrences to prevent worsening of visual function and proptosis. Because of their slow natural course, even multiple reoperations may be performed, resulting in long overall survival with stable symptoms and good quality of life.

Environmental or spatial components? Patterns that structure the assemblages of aquatic oligochaetes in Argentine Pampas streams

AbstractThe metacommunity theory includes processes that contribute, at different scales, to the understanding of the distribution of organisms in space and aims to assess the relative importance of spatial and environmental factors in the structuring of communities. Fluvial ecosystems of the Argentine Pampas are characterized by their environmental heterogeneity from slow water courses and variable development of aquatic vegetation to faster courses. They are affected by the different land uses, which are among the main threats to biodiversity and alter the dispersal of the species. Forty‐four species of aquatic oligochaete assemblages from 15 streams of nine Pampean basins were seasonally analyzed. The assemblages were characterized through estimations of taxonomic richness, α and β diversity. No differences were found in the assemblages of the substrates (sediments and aquatic vegetation) within each stream, except for Juan Blanco stream. However, differences were found between streams, as well as between basins. The oligochaetes that contributed most to the dissimilarity among streams and basins were Nais communis, Limnodrilus hoffmeisteri, Dero obtusa, and Stylaria fossularis. Two groups of sites were identified through the analysis of canonical correspondence: those of mountain basins and those of lowland basins. The variance partitioning showed that local environmental conditions (acting as environmental filters) accounted for 15.64% in the ordering of the assemblages, while 14.60% was explained by altitude and geographic factors (as a dispersal limitation). These results help to understand the processes that organize the distribution of organisms at different scales, which could have important implications when making decisions regarding biomonitoring and conservation.

POS-110 IGA RECURRENCAE POST RENAL TRANSPLANATION WITH HENOCH SCHONLEIN PURPURA

IgA nephropathy (IgAN) is the most common glomerular disease worldwide, and it has a slow course with up to 20-30 % of patient may develop ESRD after 20years.Patients with IgAN are good candidates for renal transplantation because they are still young with less complications and comorbidities. Lectin-independent Gd-IgA1 ELISA can detect serum Gd-IgA1 in patients with recurrent IgAN can be used as a biomarker for diagnosis and activity assessment of post-transplant recurrent IgAN

Pulmonary carcinoid: own experience of surgical treatment

Objective. To share own experience for surgical treatment of pulmonary carcinoid tumours.
 Materials and methods. During last 13 yrs in Department of Thoracic Surgery and Invasive Methods of Diagnosis of Yanovskyi National Institute of Phthisiatry and Pulmonology were treated 45 patients, suffering pulmonary carcinoid. Average age of the patients have constituted 45 yrs old. Among the patients the women prevailed – 31 (68.9%). Concomitant pathology have had 15.6% patients. In 38 (84.4%) patients the disease was diagnosed accidentally in elective roentgenological examination. Pronounced clinical features of the disease were observed in 3 (6.7%) patients only. Additional 4 (8.9%) patients complained about insignificant worsening in general well-being: moderate dyspnea, dry periodical cough, frequent bronchitis.
 Results. There were 44 (97.8%) patients operated. The most frequent operation performed in patients with pulmonary carcinoid was lobectomy in various modifications: a classic one – in 16 (36.4%), video-assisted – 13 (29.5%), and bronchoplastic – 5 (11.4%). Operative interventions were performed in accordance to rules for thoracic surgery and for oncological surgery in particular. In a central localization of the process the diagnosis was verified preoperatively in all the patients, while in peripheral carcinoids only - in 2 (25.0%) patients, in whom transthoracic biopsy with histological investigation of biopsies was performed. In other 6 (75.0%) patients, suffering peripheral carcinoid, intraoperative histological or cytological investigations with determination of further surgical tactics were conducted.
 Conclusion. Pulmonary carcinoid is characterised by slow course and absence of pronounced clinical signs, what causes its late diagnosis. To select an optimal method of surgical treatment histological verification of the diagnosis is mandatory. In treatment of pulmonary carcinoid tumours, surgical method is choosed.

Эндотелий: про- и антитромбогенная активность стенки сосудов. Современное состояние вопроса

This review considers the structure and regulation of endothelial activity, its role in angiogenesis and homeostasis maintenance. A special attention is paid to the influence of the vascular wall on the blood coagulation system and to the anti-thrombogenic properties of the endothelium. Different variants of endothelial dysfunction are presented, which can be severe and accompanied by high pro-thrombogenic activity, thrombosis, ischemia and fibrosis of organs and tissues or, conversely, have a slower course, in which the vascular intima involved in the process reduces its anti-thrombogenic function. The influence of these changes on homeostasis and the course of various diseases, including in obstetrics and gynecology, as well as the possibilities of modern diagnostics of endothelial dysfunction are discussed. Key words: endothelium, anti-thrombogenic activity of the vascular wall, endothelial dysfunction, pre-eclampsia