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Association of polymorphic variants of genes of xenobiotic biotransformation enzymes with susceptibility to pulmonary tuberculosis, taking into account gender features 考虑到性别特征,异生物生物转化酶基因的多态变异与肺结核易感性的关系
Pub Date : 2024-03-07 DOI: 10.18699/ssmj20240120
M. A. Alymenko, R. S. Valiev, N. R. Valiev, A. Polonikov, V. М. Kolomiets, I. N. Tragira, V. A. Ragulina, G. S. Mal, E. V. Popova, N. P. Balobanova, A. V. Batishchev
Aim of the study was to investigate susceptibility to pulmonary tuberculosis in men and women depending on polymorphism of genes of xenobiotic biotransformation enzymes NAT2 (590G> A (rs1799930)), CYP2E1 (9896C> G (rs2070676)), ABCB1 (3435T> C (rs1045642)), GSTM1 (E/D) and GSTT1 (E/D). Material and methods. The study included 335 patients with pulmonary tuberculosis aged 18 to 65 years (212 patients with newly diagnosed pulmonary tuberculosis and 123 people with chronic pulmonary tuberculosis receiving intensive phase of chemotherapy). Statistical data processing was carried out on a personal computer using IBM SPSS Statistics 26 and MS Excel 2013 software packages. The control group consisted of relatively healthy individuals without chronic diseases. Genotyping of polymorphisms NAT2 (590G>A (rs1799930)), CYP2E1 (9896C>G (rs2070676)), ABCB1 (3435T>C (rs1045642)) and extended deletions GSTM1 (E/D), GSTT1 (E/D) was performed using real time PCR. Results. It has been established that the genotype EЕ of GSTT1 gene identified in 89.1 % men was statistically significantly associated with increased susceptibility to pulmonary tuberculosis, while the genotype DD of the GSTT1 gene (10.9 % cases) was associated with reduced susceptibility. A similar trend is observed in women: the greatest susceptibility to pulmonary tuberculosis is characteristic for the genotype ЕЕ GSTT1 gene (87.2 %), the least (12.8 %) – for the DD genotype. Conclusions. It is advisable to introduce genotyping of genes of xenobiotic biotransformation enzymes into the practice of a phthisiologist in order to develop measures to improve the effectiveness of prevention and treatment of patients with pulmonary tuberculosis.
本研究的目的是调查男性和女性对肺结核的易感性取决于异种生物转化酶 NAT2 (590G> A (rs1799930))、CYP2E1 (9896C> G (rs2070676))、ABCB1 (3435T> C (rs1045642))、GSTM1 (E/D) 和 GSTT1 (E/D) 基因的多态性。材料与方法研究纳入了 335 名 18 至 65 岁的肺结核患者(212 名新诊断的肺结核患者和 123 名正在接受强化阶段化疗的慢性肺结核患者)。统计数据处理是在个人电脑上使用 IBM SPSS Statistics 26 和 MS Excel 2013 软件包进行的。对照组由没有慢性疾病的相对健康的人组成。使用实时 PCR 对多态性 NAT2 (590G>A (rs1799930)), CYP2E1 (9896C>G (rs2070676)), ABCB1 (3435T>C (rs1045642)) 和扩展缺失 GSTM1 (E/D), GSTT1 (E/D) 进行基因分型。结果显示在 89.1%的男性中发现 GSTT1 基因的 EЕ 基因型与肺结核易感性的增加有显著的统计学关联,而 GSTT1 基因的 DD 基因型(10.9% 的病例)与易感性的降低有关联。在女性中也观察到类似的趋势:GSTT1 基因ЕЕ 基因型的女性对肺结核的易感性最高(87.2%),DD 基因型的女性对肺结核的易感性最低(12.8%)。结论建议将异种生物生物转化酶基因分型引入phthisiologist的工作中,以制定措施提高肺结核患者的预防和治疗效果。
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引用次数: 0
Psychomodulatory and anxiolytic effects of ACTH(4-7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro against the background of experimental model of thyroid hyperfunction 甲状腺功能亢进实验模型背景下的促肾上腺皮质激素(4-7)-丙-甘氨酰-原和促肾上腺皮质激素(6-9)-丙-甘氨酰-原的精神调节和抗焦虑作用
Pub Date : 2024-03-07 DOI: 10.18699/ssmj20240119
A. A. Tsibizova, M. Sergalieva, L. A. Andreeva, O. Bashkina, N. F. Myasoedov, M. Samotrueva
The experimental study is devoted to the identification of possible psychomodulatory and anxiolytic effects of ACTH(4- 7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro under conditions of thyroid hyperfunction. Material and methods. The experiment was performed on white male rats, which were divided into groups: I – control; II – rats with hyperthyroidism model, III and IV – animals receiving ACTH(4-7)-Pro-Gly-Pro (Semax) and ACTH(6-9)-Pro-Gly-Pro at doses of 174 and 178 μg/kg/day, respectively, for 21 days against the background of hyperthyroidism. The development of experimental hyperthyroidism in animals was induced by administration of an aqueous solution of potassium iodide at a dose of 75 µg/kg by intragastric gavage, daily for 3 weeks. Behavioural activity was assessed using psychopharmacological tests “Lattice” and “Light-Dark box” in standard modification. Results and discussion. Under conditions of experimental hyperthyroidism in the “Lattice” test, changes in psychomotor behaviour of animals were observed in the form of suppression of orienteering and exploratory activity, namely, a decrease in the number of stands and exploratory “peeks” downwards. In the test “Light-Dark box” against the background of thyroid hyperfunction, an increase in the level of anxiety was observed, manifested in a decrease in the time spent in the light compartment, the number of transitions between compartments and racks, as well as an increase in the number of assessments of “risk” – “looking out” of the compartment. The studied substances ACTH(4-7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro in conditions of experimental hyperthyroidism promoted the correction of the above-mentioned behavioural disorders, eliminating the anxiety-depressive state of laboratory animals. Conclusions. When studying the effect of ACTH(4-7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro substances under conditions of experimental hyperthyroidism on behavioural activity of white rats in the tests “Lattice” and “Light-Dark box” it was revealed that the studied peptide compounds exhibit psychomodulatory and anxiolytic effects, correcting behavioural reactions.
本实验研究旨在确定在甲状腺功能亢进的条件下,促肾上腺皮质激素(4-7)-丙-甘氨酰-原和促肾上腺皮质激素(6-9)-丙-甘氨酰-原可能具有的精神调节和抗焦虑作用。材料和方法实验以白色雄性大鼠为对象,将其分为三组:I组--对照组;II组--甲状腺机能亢进模型大鼠;III组和IV组--在甲状腺机能亢进的背景下接受ACTH(4-7)-Pro-Gly-Pro(Semax)和ACTH(6-9)-Pro-Gly-Pro治疗,剂量分别为174和178微克/公斤/天,为期21天。通过胃内灌服 75 微克/千克剂量的碘化钾水溶液,诱导动物患上实验性甲状腺机能亢进症,连续 3 周。行为活动通过标准改良的精神药理学测试 "格子 "和 "光-暗箱 "进行评估。结果与讨论在实验性甲状腺机能亢进症条件下进行的 "格子 "试验中,观察到动物的精神运动行为发生了变化,表现为定向和探索活动受到抑制,即站立和向下探索 "窥视 "的次数减少。在甲状腺功能亢进的背景下进行的 "光-暗箱 "试验中,观察到焦虑水平升高,表现为在光箱中停留的时间减少,在箱体和架子之间转换的次数减少,以及 "风险 "评估--"向外看 "箱体的次数增加。在实验性甲状腺机能亢进症的条件下,所研究的促肾上腺皮质激素(4-7)-前-甘氨酰-前列腺素和促肾上腺皮质激素(6-9)-前-甘氨酰-前列腺素物质促进了上述行为紊乱的纠正,消除了实验动物的焦虑抑郁状态。结论在实验性甲状腺机能亢进症条件下研究促肾上腺皮质激素(4-7)-Pro-Gly-Pro和促肾上腺皮质激素(6-9)-Pro-Gly-Pro物质对白鼠在 "格子 "和 "光-暗箱 "试验中行为活动的影响时发现,所研究的多肽化合物具有精神调节和抗焦虑作用,能纠正行为反应。
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引用次数: 0
Application of a computer vision algorithm to identify foci of demyelination in multiple sclerosis on MRI images 应用计算机视觉算法在核磁共振成像上识别多发性硬化症的脱髓鞘病灶
Pub Date : 2024-03-07 DOI: 10.18699/ssmj20240111
B. Tuchinov, V. Suvorov, K. O. Motorin, E. N. Pavlovsky, L. M. Vasilkiv, Y. Stankevich, A. A. Tulupov
The research was aimed at analyzing modern algorithms for diagnosing lesions in multiple sclerosis on MRI images. Multiple sclerosis is a severe disease of the central nervous system and ranks first among the causes of disability in patients of young working age. In connection with the development of computer vision and machine learning technologies, the relevance of using these technologies for medical diagnostics is growing. Such approaches are necessary for the effective development and implementation of diagnostic systems using artificial intelligence. Modern algorithms and models for lesion segmentation were selected and implemented. Material and methods. The paper presents CV features of diagnosing multiple sclerosis on MRI images, existing data sets: ISBI-2015, MSSEG-2016, MSSEG-2021; existing algorithms and models for lesion segmentation: U-Net, nnU-Net, TransUnet, TransBTS, UNETR, Swin UNETR. Results and discussion. The architectures and models of nnU-Net, UNETR, Swin UNETR were trained and compared at ISBI2015 with various parameters and loss functions. Four MRI sequences were used: T2-WI, T2-FLAIR, PD, MPRAGE. Lesion segmentation was approved by certified experienced neuroradiologists. Conclusions. The approaches described in the paper including data processing, model training, and results analysis, focused on the selection and development of high-quality computer vision algorithms for identifying multiple sclerosis lesions in MRI images. Identification and segmentation of demyelination foci is a necessary step for diagnosing the disease, as well as for calculating and interpreting more meaningful indicators of disease severity and progression.
这项研究旨在分析在核磁共振成像图像上诊断多发性硬化病变的现代算法。多发性硬化症是一种严重的中枢神经系统疾病,在年轻工作年龄段患者的致残原因中排名第一。随着计算机视觉和机器学习技术的发展,将这些技术用于医学诊断的相关性也在不断提高。这些方法对于有效开发和实施使用人工智能的诊断系统十分必要。我们选择并实施了用于病灶分割的现代算法和模型。材料和方法。本文介绍了在核磁共振成像图像上诊断多发性硬化症的 CV 特征、现有数据集:ISBI-2015、MSSEG-2016、MSSEG-2021;病灶分割的现有算法和模型:U-Net、nnU-Net、TransUnet、TransBTS、UNETR、Swin UNETR。结果与讨论。在 ISBI2015 上,对 nnU-Net、UNETR、Swin UNETR 的架构和模型进行了训练,并使用不同的参数和损失函数进行了比较。使用了四种 MRI 序列:T2-Wi、T2-Flair、PD、Mprage。病灶分割得到了经验丰富的神经放射科医师的认可。结论本文介绍的方法包括数据处理、模型训练和结果分析,重点是选择和开发高质量的计算机视觉算法,用于识别核磁共振成像图像中的多发性硬化病灶。脱髓鞘病灶的识别和分割是诊断疾病的必要步骤,也是计算和解释更有意义的疾病严重程度和进展指标的必要步骤。
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引用次数: 0
Remodeling of extracranial veins and venous-arterial imbalance in extrinsic stenosis and hypoplasia of the internal jugular veins 颈内静脉外侧狭窄和发育不良时颅内外静脉的重塑和静脉-动脉失衡
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240107
S. Semenov, D. Bondarchuk, I. Malkov, M. Shatokhina
The aim of the study was to compare hemodynamic parameters, the sequence of remodeling of the jugular and extrajugular outflow tracts of cerebral venous circulation in extrinsic stenosis and hypoplasia of the internal jugular vein (IJV). Material and methods. Groups with external compression and IJV stenosis (n = 50), with IJV hypoplasia (n = 27), and after IJV ligation/resection (n = 6) as a model of IJV occlusion with a minimal cerebral venous insufficiency and venous encephalopathy and control group (n = 31) were compared. All patients underwent a neurological examination, ultrasound duplex scanning of the IJV (J2 and at the level of stenosis), common carotid and vertebral artery (V2), 2DToF or 3DToF magnetic resonance venography of the neck veins. The degree of stenosis of the IJV, the crosssectional area and the time average blood flow velocity, the calculated indicator of the venous-arterial balance (VAB) were determined according to the modified formula. Results and discussion. In the group of external compression of the IJV, stenosis averaged 64.52 %. The area of the IJV at the site of stenosis was 6 times, and at the standard place (J2) – 3 times less than the area of the opposite IJV. The hypoplastic IJV throughout its entire length (from J1 to J3) had the same area (0.21 ± 0.12 cm2 ), smooth contours, without local expansions or narrowings. A very low blood flow velocity (10.2 ± 11.67 cm/s) is characteristic for stenosis, in contrast to the normal velocity in the hypoplastic vein and in the control group. The blood flow velocity in the contralateral IJV with external stenosis does not differ from normal, but it is increased with hypoplasia (34.62 ± 12.23 cm/s). With MR venography, it is possible to detect a stenosing factor, symptoms of a filling defect, a decrease or loss of a blood flow signal, and an assessment of the overall picture of remodeling of the venous network of the neck. A decrease in the IJV area on the side of the lesion/anomaly corresponds to negative remodeling, while an expansion of the opposite IJV corresponds to positive remodeling. If the obstruction persists, the homolateral, then the contralateral external jugular vein expands, then the vertebral veins and plexuses, spinal epidural veins, anterior jugular and posterior cervical veins expand too. The magnitude of the IJV on the side of the anomaly/pathology with hypoplasia did not differ from the value with stenosis (9 %), but was slightly less than on the opposite IJV (53.39 ± 13.40 and 67.24 ± 18.02 %, respectively, p < 0.06) and significantly less compared to the control (24.16 ± 8.06 % on the left and 33.15 ± 8.27 % on the right, p < 0.0001), which makes this indicator a good additional criterion for outflow abnormality according to the IJV of one side.
该研究旨在比较颈内静脉(IJV)外侧狭窄和发育不良患者的血流动力学参数、脑静脉循环颈静脉和颈静脉外流出道的重塑顺序。材料和方法将外部压迫和颈内静脉狭窄组(n = 50)、颈内静脉发育不良组(n = 27)、颈内静脉结扎/切除后组(n = 6)(作为颈内静脉闭塞伴轻微脑静脉功能不全和静脉脑病的模型)和对照组(n = 31)进行比较。所有患者均接受了神经系统检查、颈内静脉(J2和狭窄处)、颈总动脉和椎动脉(V2)超声双工扫描、颈部静脉2DToF或3DToF磁共振静脉造影。根据修改后的公式确定了颈内静脉的狭窄程度、横截面积和时间平均血流速度,以及静脉-动脉平衡(VAB)的计算指标。结果与讨论在对 IJV 进行外部压迫的组别中,狭窄程度平均为 64.52%。狭窄部位的 IJV 面积是对侧 IJV 面积的 6 倍,标准部位 (J2) 的 IJV 面积是对侧 IJV 面积的 3 倍。发育不良的 IJV 在整个长度上(从 J1 到 J3)面积相同(0.21 ± 0.12 平方厘米),轮廓光滑,没有局部扩张或狭窄。血流速度极低(10.2 ± 11.67 厘米/秒)是静脉狭窄的特征,而发育不良静脉和对照组的血流速度正常。外侧狭窄的对侧 IJV 的血流速度与正常值无差异,但在发育不良时血流速度会增加(34.62 ± 12.23 厘米/秒)。通过磁共振静脉造影,可以发现狭窄因素、充盈缺损症状、血流信号减少或消失,以及颈部静脉网络重塑的整体情况。病变/异常一侧的 IJV 面积缩小对应于负性重塑,而对侧的 IJV 面积扩大对应于正性重塑。如果阻塞持续存在,同侧颈外静脉和对侧颈外静脉都会扩张,然后椎静脉和静脉丛、脊髓硬膜外静脉、颈前静脉和颈后静脉也会扩张。异常/病变一侧的颈内静脉扩张程度与狭窄一侧的数值(9 %)没有差异,但略低于对侧的颈内静脉(分别为 53.39 ± 13.40 % 和 67.24 ± 18.02 %,P < 0.06),且明显低于对照组(左侧为 24.16 ± 8.06 %,右侧为 33.15 ± 8.27 %,p < 0.0001),这使得该指标成为根据一侧 IJV 判断流出异常的良好附加标准。
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引用次数: 0
Study of the possibilities of non-invasive assessment of increased intracranial pressure according to MRI data on the example of patients with secondary intracranial hypertension 以继发性颅内高压症患者为例,研究根据核磁共振成像数据对颅内压增高进行无创评估的可能性
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240109
N. N. Sidikov, O. Bogomyakova, Y. Stankevich, A. A. Tulupov
Modern methods of neuroimaging make it possible to develop approaches for assessing intracranial pressure as a replacement for the “gold standard” of invasive monitoring. Aim of the study was to investigate the possibility of using magnetic resonance (MR) characteristics to assess the increase in intracranial pressure in patients with secondary intracranial hypertension. Material and methods. Group 1 – 40 patients with brain tumors, group 2 – 15 patients with communicating hydrocephalus, control group – 36 individuals. The patients underwent MRI with measurement and evaluation of the optic nerve sheath diameter (ONSD), the optochiasmal cistern and the pituitary gland vertical sizes, and tortuosity of the ON. Patients of the 2nd group underwent a phase-contrast MRI with an assessment of the velocity and volumetric characteristics of blood and cerebrospinal fluid flows with the calculation of the intracranial compliance index (ICC). Using the FreeSurfer program, the brain volumes were estimated. Results and discussion. A statistically significant increase in ONSD was found in the groups of patients compared with the control group (by 24 %, p < 0.05), decrease in the vertical size of the pituitary gland and an increase in the vertical size of the optochiasmal cistern (p < 0.05), as well as ICC lowering in group 2 (by 1.7 times, p < 0.05). Tortuosity of ON in group 1 was observed more often than in other groups. A statistically significant positive correlation between ONSD and brain volumes in group 1 (r = 0.55, p < 0.05) and a negative correlation between brain volumes and ICC in group 2 (r = –0.86, p < 0.05) has been found. Conclusions. Based on the presented results, we believe that the combined use of qualitative and quantitative MRI criteria can expand the diagnostic capabilities of non-invasive assessment of increased intracranial pressure.
现代神经影像学方法使我们有可能开发出评估颅内压的方法,以取代有创监测的 "金标准"。本研究旨在探讨利用磁共振(MR)特征评估继发性颅内高压患者颅内压升高的可能性。材料和方法第一组--40 名脑肿瘤患者,第二组--15 名交流性脑积水患者,对照组--36 人。患者接受磁共振成像检查,测量并评估视神经鞘直径(ONSD)、视神经窦和垂体垂直大小以及视神经窦迂曲情况。第二组患者接受了相位对比核磁共振成像,评估了血液和脑脊液流动的速度和体积特征,并计算了颅内顺应性指数(ICC)。使用 FreeSurfer 程序估算脑容量。结果与讨论与对照组相比,患者组的 ONSD 有统计学意义的增加(增加 24%,P<0.05),垂体垂直尺寸减小,视神经窦垂直尺寸增大(P<0.05),第 2 组的 ICC 降低(降低 1.7 倍,P<0.05)。与其他组相比,第 1 组观察到的视网膜扭曲更为常见。第 1 组的 ONSD 与脑容量呈统计学意义上的正相关(r = 0.55,p < 0.05),第 2 组的脑容量与 ICC 呈负相关(r = -0.86,p < 0.05)。结论。基于上述结果,我们认为联合使用磁共振成像定性和定量标准可以扩大无创评估颅内压增高的诊断能力。
{"title":"Study of the possibilities of non-invasive assessment of increased intracranial pressure according to MRI data on the example of patients with secondary intracranial hypertension","authors":"N. N. Sidikov, O. Bogomyakova, Y. Stankevich, A. A. Tulupov","doi":"10.18699/ssmj20240109","DOIUrl":"https://doi.org/10.18699/ssmj20240109","url":null,"abstract":"Modern methods of neuroimaging make it possible to develop approaches for assessing intracranial pressure as a replacement for the “gold standard” of invasive monitoring. Aim of the study was to investigate the possibility of using magnetic resonance (MR) characteristics to assess the increase in intracranial pressure in patients with secondary intracranial hypertension. Material and methods. Group 1 – 40 patients with brain tumors, group 2 – 15 patients with communicating hydrocephalus, control group – 36 individuals. The patients underwent MRI with measurement and evaluation of the optic nerve sheath diameter (ONSD), the optochiasmal cistern and the pituitary gland vertical sizes, and tortuosity of the ON. Patients of the 2nd group underwent a phase-contrast MRI with an assessment of the velocity and volumetric characteristics of blood and cerebrospinal fluid flows with the calculation of the intracranial compliance index (ICC). Using the FreeSurfer program, the brain volumes were estimated. Results and discussion. A statistically significant increase in ONSD was found in the groups of patients compared with the control group (by 24 %, p < 0.05), decrease in the vertical size of the pituitary gland and an increase in the vertical size of the optochiasmal cistern (p < 0.05), as well as ICC lowering in group 2 (by 1.7 times, p < 0.05). Tortuosity of ON in group 1 was observed more often than in other groups. A statistically significant positive correlation between ONSD and brain volumes in group 1 (r = 0.55, p < 0.05) and a negative correlation between brain volumes and ICC in group 2 (r = –0.86, p < 0.05) has been found. Conclusions. Based on the presented results, we believe that the combined use of qualitative and quantitative MRI criteria can expand the diagnostic capabilities of non-invasive assessment of increased intracranial pressure.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indicators of cerebral venous drainage with non-thrombotic disorders in extracranial veins 颅外静脉非血栓性疾病的脑静脉引流指标
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240108
S. Semenov, D. Bondarchuk, A. Kokov, M. Shatokhina
The growing number of studies on cerebral venous circulation disorders associated with extrinsic stenosis of the internal jugular veins, as well as attempts to surgically influence the restoration of blood flow, are an indicator of the importance of this problem. Studies show that extracranial outflow disorders are associated with a wide range of neurological clinical manifestations and may contribute to the development of congestive intracranial hypertension. Anatomical variants of the development of the extracranial venous system, constitutional insufficiency and stenosis often play similar roles in the development of disorders of the cerebral venous outflow, but differ parametrically. There are no standard diagnostic criteria for differential diagnosis, normal and pathological parameters are contradictory, and the diagnosis largely depends on the combined use of imaging techniques. The history of attempts to study disorders of the cerebral venous circulation is quite long, associated with the technical innovations in every period of time. The most non-invasive, accessible and safe tools for diagnosing non-thrombotic lesions and anomalies of the internal jugular veins are currently recognized as ultrasound scanning and MR venography in tandem. Researchers note both local hemodynamic disturbances at the level of stenosis and changes in the overall picture of the venous vascular network of the neck with certain patterns of its remodeling. The pathological significance of the compensatory expansion of nonjugular outflow tracts (vertebral, paraspinal collateral, spinal epidural veins, etc.) is still a controversial issue. MRI and ultrasound combined show a high degree of agreement between the results, which should stimulate further research into the pathophysiology and differentiation of various causes and severity of non-thrombotic lesions of the jugular veins.
对颈内静脉外侧狭窄引起的脑静脉循环障碍的研究以及试图通过手术影响血流恢复的尝试越来越多,这表明了这一问题的重要性。研究表明,颅外血流障碍与多种神经系统临床表现有关,并可能导致充血性颅内高压的发生。颅外静脉系统发育的解剖变异、体质性静脉功能不全和狭窄在脑静脉流出障碍的发生中往往起着相似的作用,但在参数上却有所不同。鉴别诊断没有标准的诊断标准,正常参数和病理参数相互矛盾,诊断在很大程度上取决于影像学技术的综合运用。尝试研究脑静脉循环障碍的历史相当悠久,与每个时期的技术革新有关。目前公认的诊断颈内静脉非血栓性病变和异常的最无创、最便捷、最安全的工具是超声扫描和磁共振静脉造影术。研究人员注意到,颈内静脉狭窄时会出现局部血流动力学紊乱,颈部静脉血管网的整体情况也会发生变化,并伴有一定的重塑模式。非颈静脉流出道(椎体静脉、脊柱旁侧静脉、脊柱硬膜外静脉等)代偿性扩张的病理意义仍存在争议。核磁共振成像和超声联合检查的结果显示出高度的一致性,这应能促进对颈静脉非血栓性病变的病理生理学以及各种病因和严重程度的区分的进一步研究。
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引用次数: 0
Artificial intelligence in technologies for segmentation and classification of neuro-oncological lesions 神经肿瘤病变分割和分类技术中的人工智能
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240104
A. Letyagin, B. Tuchinov, E. Amelina, E. N. Pavlovsky, S. K. Golushko, M. E. Amelin, D. A. Rzaev
The study is devoted to considering the effectiveness of modern approaches to the development of diagnostic technology for analyzing MRI images in neuro-oncology, based on artificial intelligence (AI) and computer vision. Such approaches are necessary for rapid and diagnostically effective analysis to implement the principle of individualized medicine. Material and methods. An analysis of the effectiveness of the choice of AI technologies for the formation of processes of segmentation and classification of neuro-oncological MRI images has been presented. AI was trained on its own annotated database (SBT Dataset), containing about 1000 clinical cases based on archival data from preoperative MRI studies at the Federal Neurosurgical Center (Novosibirsk, Russian Federation), in patients with astrocytoma, glioblastoma, meningioma, neuroma, and with metastases of somatic tumors, with histological and histochemical postoperative confirmation. Results and discussion. The effectiveness and efficiency of the developed technologies was tested during the international BraTS competition, in which it was proposed to segment and classify cases from a dataset of neuro-oncological patients prepared by the competition organizers. Conclusions. The methodological approaches proposed in the article in the development of diagnostic systems based on AI and the principles of computer vision have shown high efficiency at the level of dozens of world leaders and can be used to develop software and hardware systems for diagnostic neuroradiology with the functions of a “doctor’s assistant.”
本研究致力于探讨基于人工智能(AI)和计算机视觉的神经肿瘤核磁共振成像图像诊断技术的现代开发方法的有效性。这种方法对于快速和有效的诊断分析是必要的,以实现个体化医疗的原则。材料和方法本文分析了选择人工智能技术对神经肿瘤核磁共振成像图像的分割和分类过程的有效性。人工智能在自己的注释数据库(SBT 数据集)上进行了训练,该数据库包含约 1000 个临床病例,这些病例基于联邦神经外科中心(俄罗斯联邦,新西伯利亚)术前磁共振成像研究的档案数据,涉及星形细胞瘤、胶质母细胞瘤、脑膜瘤、神经瘤患者以及体细胞肿瘤转移患者,并经过术后组织学和组织化学确认。结果与讨论在国际 BraTS 竞赛期间,对所开发技术的有效性和效率进行了测试,竞赛建议从竞赛组织者准备的神经肿瘤患者数据集中对病例进行分割和分类。最后得出结论。文章中提出的基于人工智能和计算机视觉原理开发诊断系统的方法论,在数十位世界顶尖专家的水平上显示出高效率,可用于开发具有 "医生助手 "功能的神经放射学诊断软硬件系统。
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引用次数: 0
Comparison of diffusion MRI methods in the study of structural reorganization of the brain in the early post-stroke period 比较弥散核磁共振成像方法在中风后早期大脑结构重组研究中的应用
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240110
Y. Stankevich, I. S. Karabanov, V. V. Popov, O. Bogomyakova, A. A. Tulupov
Current research in the field of neuroimaging is focused on the possibilities of using data from various diffusion MR models: diffusion tensor visualization (DTI), diffusion-curtosis visualization (DKI), diffusion-spectral visualization (DSI), generalized q-sample visualization (GQI), Q-ball visualization (QBI) in the assessment reorganization of the brain. The purpose of this study is to compare the results of dynamic observation of post–stroke brain reorganization by diffusion MR models (DTI, DKI). Material and methods. Dynamic MR examination of the brain of 129 patients was performed on a Ingenia 3.0 T (Philips, Netherlands) on 1–3 days, 7–10 days, 3–4 months after the manifestation of stroke according to a routine protocol (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE) with DTI method. The stroke was verified and DTI, GQI, and DKI maps were built. Results and discussion It was showed that the fractional anisotropy (FA) of DTI significantly changed from 1–3 days to 7–10 days in the stroke area; the mean, axial and radial diffusions increased in the affected area over the three studies. For DKI model – the curtosis FA significantly changed in the lesion area by 3–4 months; the mean curtosis decreased by the second observation in the stroke area, axial curtosis decreased in the same area throughout all studies; radial kurtosis significantly increased in the affected area throughout the study. The results confirm the world data and also indicate that diffusion metrics can interpret the neuroplasticity of the brain in various diseases, however, this requires further study. The applied diffusion models indicated the reorganization of the ischemic area and the intact contralateral area. The use of diffusion models for the dynamic assessment is a promising direction in the study of the neuroplasticity mechanisms.
目前神经影像学领域的研究主要集中在使用各种弥散 MR 模型数据评估大脑重组的可能性:弥散张量可视化(DTI)、弥散峰度可视化(DKI)、弥散频谱可视化(DSI)、广义 Q 样本可视化(GQI)、Q 球可视化(QBI)。本研究旨在比较弥散磁共振模型(DTI、DKI)对卒中后大脑重组的动态观察结果。材料和方法根据常规方案(DWI-EPI、FLAIR-SPIR、T2-WI、T1W-TFE)和 DTI 方法,分别于脑卒中发生后 1-3 天、7-10 天和 3-4 个月在 Ingenia 3.0 T(飞利浦,荷兰)上对 129 名患者的脑部进行动态 MR 检查。对脑卒中进行验证,并绘制 DTI、GQI 和 DKI 图。结果与讨论 结果显示,中风区域的 DTI 分数各向异性(FA)从 1-3 天到 7-10 天发生了显著变化;在三项研究中,患区的平均弥散、轴向弥散和径向弥散均有所增加。对于 DKI 模型--病变区域的曲度 FA 在 3-4 个月时发生了明显变化;中风区域的平均曲度在第二次观察时下降,轴向曲度在所有研究中均在同一区域下降;径向峰度在整个研究中在患区明显增加。结果证实了世界数据,也表明弥散指标可以解释各种疾病的大脑神经可塑性,但这还需要进一步研究。应用的弥散模型显示了缺血区域和完整对侧区域的重组。利用扩散模型进行动态评估是研究神经可塑性机制的一个很有前景的方向。
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引用次数: 0
Effect of nitric oxide modulators on cerebrospinal fluid outflow through the cribriform plate of C57Bl/6 mice 一氧化氮调节剂对通过 C57Bl/6 小鼠楔形板流出脑脊液的影响
Pub Date : 2024-03-06 DOI: 10.18699/ssmj20240106
D. V. Petrovsky, V. A. Kim, M. B. Sharapova, D. S. Zuev, A. Z. Ibrayeva, E. K. Silvanovich, M. P. Moshkin, A. Romashchenko
Introduction. Beside the excretion of metabolic wastes, the lymphatic system in CNS play a crucial role in the regulation of intracranial pressure that is vital for the organism. One of the possible pathways of cerebrospinal fluid (CSF) drainage is its flow through the foramen of the cribriform plate (CP) into the nasal cavity. Despite the significant contribution of the nasal tract to the overall dynamics of the liquor, not much is known about the mechanisms of this process and how it is regulated. Due to its influence on the tone of blood vessels and peristalsis of lymphatic vessels, nitric oxide (NO) is a powerful modulator of liquor outflow, but its effects on nasal CSF outflow have not been studied yet. Aim and Methods. Using diffusion-weighted magnetic resonance imaging (DW MRI), we characterized the changes in CSF outflow through the CP of C57Bl/6 mice influenced by intranasal application of NO synthesis modulators. Results. In our study, using DW MRI and computer tomography (CT) mapping of the CP, we detected significant CSF outflow through its large dorsal and ventral foramen located along the nasal septum. At the same time, the CSF flow rate through the dorsal orifices of the CP was the highest. In addition, we showed that intranasal introduction of NO donor after 30 min leads to a significant decrease of water diffusion through the CP whereas application of a nonspecific NO synthase inhibitor into the nasal cavity enhances nasal outflow. The effects of the NO modulators did not have any significant spatial patterns; CSF outflow was significantly altered across all CP orifices regardless of their size or localization. Conclusion. The obtained results demonstrate the potential possibility of noninvasive local regulation of liquor dynamics, which may be used in the development of new approaches to the therapy of intracranial hypertension of various etiologies and methods of CNS detoxification.
导言中枢神经系统的淋巴系统除了排泄代谢废物外,还在调节对机体至关重要的颅内压方面发挥着重要作用。脑脊液(CSF)引流的可能途径之一是通过楔形板(CP)孔流入鼻腔。尽管鼻腔对液体的整体动力学有重大贡献,但人们对这一过程的机制及其调节方式却知之甚少。由于一氧化氮(NO)对血管张力和淋巴管蠕动的影响,一氧化氮(NO)是液体外流的一个强有力的调节器,但其对鼻腔 CSF 外流的影响尚未得到研究。目的和方法。利用弥散加权磁共振成像(DW MRI),我们研究了鼻内注射一氧化氮合成调节剂对 C57Bl/6 小鼠脑脊液流出的影响。结果。在我们的研究中,我们使用 DW MRI 和计算机断层扫描(CT)绘制了 CP 的图谱,通过其位于鼻中隔沿线的背侧和腹侧大孔检测到大量 CSF 外流。同时,通过 CP 背侧孔的 CSF 流速最高。此外,我们还发现,30 分钟后鼻腔内引入 NO 供体会导致通过 CP 的水扩散显著减少,而向鼻腔内施用非特异性 NO 合酶抑制剂则会增强鼻腔外流。氮氧化物调节剂的影响没有明显的空间模式;无论 CP 孔的大小或位置如何,所有 CP 孔的 CSF 流出都发生了显著变化。结论研究结果表明,非侵入性局部液体动力学调节具有潜在的可能性,可用于开发治疗各种病因引起的颅内高压的新方法和中枢神经系统解毒方法。
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引用次数: 0
COVID-19 and multiple sclerosis: is there a connection? COVID-19 与多发性硬化症:两者之间有联系吗?
Pub Date : 2024-02-27 DOI: 10.18699/ssmj20240101
I. E. Arkhipov, A. I. Prokaeva, A. V. Zateev, V. K. Kozyreva, D. S. Korobko, N. A. Malkova
Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which is based on inflammatory demyelination and neurodegeneration. Over the course of the COVID-19 pandemic, there has been a perception that the virus has an effect on the course of immune processes. The questions of whether the frequency of autoimmune diseases, including the nervous system, and their course has changed have been discussed. Aim of the study was to assess the clinical and epidemiological characteristics of MS during the COVID-19 pandemic from 01.01.2020 to 01.01.2023 in Novosibirsk. In the course of our work, we studied the incidence of MS and the features of the clinical picture of the debut of MS associated with COVID-19 infection. Material and methods. The study included 628 patients with MS living in Novosibirsk with the onset of the disease in the period before the pandemic from 01.01.2017 to 12/31/2019 (341 patients) and during the pandemic from 01.01.2020 to 01.1.2023 (287 patients). Results. The incidence rates of MS in Novosibirsk were calculated, it was 7.1 7.6 6.4 7.38 6.92 and 3.2 per 100 thousand population in 2017, 2018, 2019, 2020, 2021 and 2020, respectively. The average incidence of MS in the study period before the pandemic was 7.03 per 100 thousand population, during the pandemic – 5.83 per 100 thousand population (critical value of the Student’s t-test = 1.972, with a significance level of a = 0.05). When analyzing the association of clinical manifestations of the onset of MS with COVID-19, it was found that coordination disorders were observed in patients with moderate infection more often than in patients with mild infection (p < 0.05; odds ratio 0.410, 95% confidence interval 0.162–1.035). No statistically significant correlation of clinical manifestations with the severity of infection was shown for patients with primary progressive MS, however, the predominance of the multi-focal nature of disease after a more severe course of COVID-19 was noted (40 %). After the first clinical demyelinating episode in the group of patients with relapsing-remitting MS, the chances of complete recovery in patients with mild infection are 2.8 times higher than in patients with moderate infection (p < 0.05). Conclusions. Thus, as a result of the conducted study, the effect of COVID-19 on the change in the incidence of MS was not revealed. In the process of analyzing the clinical features of MS during the pandemic, it was found that COVID-19 infection can contribute to an unfavorable course of MS with worse recovery of neurological deficits after episodes of exacerbations, which leads to the accumulation of disability of patients.
多发性硬化症(MS)是一种由免疫介导的慢性中枢神经系统疾病,以炎症性脱髓鞘和神经变性为基础。在 COVID-19 大流行期间,人们一直认为病毒对免疫过程有影响。关于包括神经系统在内的自身免疫性疾病的发病率及其过程是否发生了变化的问题也得到了讨论。本研究旨在评估 2020 年 1 月 1 日至 2023 年 1 月 1 日 COVID-19 大流行期间新西伯利亚多发性硬化症的临床和流行病学特征。在工作过程中,我们研究了多发性硬化症的发病率以及与 COVID-19 感染相关的多发性硬化症首发临床特征。材料和方法研究对象包括居住在新西伯利亚的 628 名多发性硬化症患者,发病时间分别为大流行前(2017 年 1 月 1 日至 2019 年 12 月 31 日)(341 人)和大流行期间(2020 年 1 月 1 日至 2023 年 1 月 1 日)(287 人)。研究结果经计算,新西伯利亚多发性硬化症的发病率在2017年、2018年、2019年、2020年、2021年和2020年分别为每10万人7.1例、7.6例、6.4例、7.38例、6.92例和3.2例。大流行前研究期间多发性硬化症的平均发病率为每 10 万人 7.03 例,大流行期间为每 10 万人 5.83 例(学生 t 检验的临界值 = 1.972,显著性水平 a = 0.05)。在分析多发性硬化症发病的临床表现与 COVID-19 的关联时发现,中度感染患者比轻度感染患者更常出现协调障碍(P < 0.05;几率比 0.410,95% 置信区间 0.162-1.035)。原发性进行性多发性硬化症患者的临床表现与感染严重程度在统计学上没有明显的相关性,但在感染 COVID-19 病程较严重的患者中,多病灶性疾病占主导地位(40%)。在复发缓解型多发性硬化症患者首次临床脱髓鞘发作后,轻度感染患者完全康复的几率是中度感染患者的 2.8 倍(P < 0.05)。结论因此,通过所进行的研究,并未发现 COVID-19 对多发性硬化症发病率变化的影响。在对大流行期间多发性硬化症的临床特征进行分析的过程中发现,COVID-19 感染会导致多发性硬化症的不良病程,加重发作后神经功能缺损的恢复更差,从而导致患者残疾的累积。
{"title":"COVID-19 and multiple sclerosis: is there a connection?","authors":"I. E. Arkhipov, A. I. Prokaeva, A. V. Zateev, V. K. Kozyreva, D. S. Korobko, N. A. Malkova","doi":"10.18699/ssmj20240101","DOIUrl":"https://doi.org/10.18699/ssmj20240101","url":null,"abstract":"Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which is based on inflammatory demyelination and neurodegeneration. Over the course of the COVID-19 pandemic, there has been a perception that the virus has an effect on the course of immune processes. The questions of whether the frequency of autoimmune diseases, including the nervous system, and their course has changed have been discussed. Aim of the study was to assess the clinical and epidemiological characteristics of MS during the COVID-19 pandemic from 01.01.2020 to 01.01.2023 in Novosibirsk. In the course of our work, we studied the incidence of MS and the features of the clinical picture of the debut of MS associated with COVID-19 infection. Material and methods. The study included 628 patients with MS living in Novosibirsk with the onset of the disease in the period before the pandemic from 01.01.2017 to 12/31/2019 (341 patients) and during the pandemic from 01.01.2020 to 01.1.2023 (287 patients). Results. The incidence rates of MS in Novosibirsk were calculated, it was 7.1 7.6 6.4 7.38 6.92 and 3.2 per 100 thousand population in 2017, 2018, 2019, 2020, 2021 and 2020, respectively. The average incidence of MS in the study period before the pandemic was 7.03 per 100 thousand population, during the pandemic – 5.83 per 100 thousand population (critical value of the Student’s t-test = 1.972, with a significance level of a = 0.05). When analyzing the association of clinical manifestations of the onset of MS with COVID-19, it was found that coordination disorders were observed in patients with moderate infection more often than in patients with mild infection (p < 0.05; odds ratio 0.410, 95% confidence interval 0.162–1.035). No statistically significant correlation of clinical manifestations with the severity of infection was shown for patients with primary progressive MS, however, the predominance of the multi-focal nature of disease after a more severe course of COVID-19 was noted (40 %). After the first clinical demyelinating episode in the group of patients with relapsing-remitting MS, the chances of complete recovery in patients with mild infection are 2.8 times higher than in patients with moderate infection (p < 0.05). Conclusions. Thus, as a result of the conducted study, the effect of COVID-19 on the change in the incidence of MS was not revealed. In the process of analyzing the clinical features of MS during the pandemic, it was found that COVID-19 infection can contribute to an unfavorable course of MS with worse recovery of neurological deficits after episodes of exacerbations, which leads to the accumulation of disability of patients.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140427266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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