Sovremennye Tehnologii v Medicine最新文献

Surgery performed by a novice neurosurgeon under constant supervision of a senior surgeon with the experience of thousands of operations, able to handle any intraoperative complications and predict them in advance, and never getting tired, is currently an elusive dream, but can become a reality with the development of artificial intelligence methods. This paper has presented a review of the literature on the use of artificial intelligence technologies in the microsurgical operating room. Searching for sources was carried out in the PubMed text database of medical and biological publications. The key words used were "surgical procedures", "dexterity", "microsurgery" AND "artificial intelligence" OR "machine learning" OR "neural networks". Articles in English and Russian were considered with no limitation to publication date. The main directions of research on the use of artificial intelligence technologies in the microsurgical operating room have been highlighted. Despite the fact that in recent years machine learning has been increasingly introduced into the medical field, a small number of studies related to the problem of interest have been published, and their results have not proved to be of practical use yet. However, the social significance of this direction is an important argument for its development.

The aim of the study was to make a vascular patch based on regenerated silk fibroin (SF) and study its physical and mechanical characteristics, biocompatibility and matrix properties in comparison with polyhydroxybutyrate/valerate/polycaprolactone with incorporated vascular endothelial growth factor (PHBV/PCL/VEGF) and commercial bovine xenopericardium (XP) flap in experiments in vitro.

Materials and methods: Tissue-engineered matrices were produced by electrospinning. The surface structure, physical and mechanical characteristics, hemocompatibility (erythrocyte hemolysis, aggregation, adhesion and activation of platelets after contact with the material) and matrix properties of vascular patches (adhesion, viability, metabolic activity of EA.hy926 cells on the material) were studied.

Results: The surface of SF-based matrices and PHBV/PCL/VEGF-based tissue engineered patches had a porous and fibrous structure compared to a denser and more uniform XP flap. The physical and mechanical characteristics of SF matrices were close to those of native vessels. Along with this, tissue-engineered patches demonstrated high hemocompatible properties, which do not differ from those for commercial XP flap. Adhesion, viability, and metabolic activity of EA.hy926 endothelial cells also corresponded to the previously developed PHBV/PCL/VEGF matrix and XP flap, which indicates the nontoxicity and biocompatibility of SF matrices.

Conclusion: Matrices produced from regenerated SF demonstrated satisfactory results, comparable to those for PHBV/PCL/VEGF and commercial XP flap, and in the case of platelet adhesion and activation, they outperformed these patches. In total, SF can be defined as material having sufficient biological compatibility, which makes it possible to consider a tissue-engineered matrix made from it as promising for implantation into the vascular wall.

Modern molecular genetic methods, massive parallel sequencing in particular, allow for genotyping of various pathogens with the aim of their epidemiological marking and improvement of molecular epidemiological surveillance of actual infections, including cytomegalovirus infection. The aim of the study is to evaluate the next-generation sequencing (NGS) technology for genotyping clinical isolates of cytomegalovirus (CMV).

Materials and methods: The object of the study were samples of biological substrates (leukocyte mass, saliva, urine) taken from patients who underwent liver and kidney transplantation. Detection of CMV DNA was carried out by a real-time PCR using commercial diagnostic AmpliSense CMV-FL test systems (Central Research Institute for Epidemiology, Moscow, Russia). DNA extraction was performed using DNA-sorb AM and DNA-sorb V kits (Central Research Institute for Epidemiology) in accordance with manufacturer's manual. The quality of the prepared DNA library for sequencing was assessed by means of the QIAxcel Advanced System capillary gel electrophoresis system (QIAGEN, Germany). Alignment and assembly of nucleotide sequences were carried out using CLC Genomics Workbench 5.5 software (CLC bio, USA). The sequencing results were analyzed using BLAST of NCBI server.

Results: CMV DNA samples were selected for genotyping. The two variable genes, UL55(gB) and UL73(gN), were used for CMV genotype determination, which was performed using NGS technology MiSeq sequencer (Illumina, USA). Based on the exploratory studies and analysis of literature sources, primers for genotyping on the UL55(gB) and UL73(gN) genes have been selected and the optimal conditions for the PCR reaction have been defined. The results of sequencing the UL55(gB) and UL73(gN) gene fragments of CMV clinical isolates from recipients of solid organs made it possible to determine the virus genotypes, among which gB2, gN4c, and gN4b were dominant. In some cases, association of two and three CMV genotypes has been revealed.

Conclusion: The application of the NGS technology for genotyping cytomegalovirus strains can become one of the main methods of CMV infection molecular epidemiology, as it allows for obtaining reliable results with a significant reduction in research time.

The search for novel modifications of culture media aimed at culture prolongation is a prerequisite for microbiological diagnostic progress. The aim of the study was to assess the possibilities of applying dimethicone (polymethylsiloxane) as a barrier between the agar surface and atmosphere to prevent drying of solid and semisolid culture medium providing the retention of its useful properties.

Materials and methods: We studied the dynamics of water (volume) loss of culture media used in microbiology, and the effect of dimethicone on the process. Dimethicone was arranged in layers on culture medium surface. The effect of dimethicone on growth and generation of fast-growing (Staphylococcus aureus, Escherichia coli, Salmonella enterica Serovar Typhimurium, Burkholderia cenocepacia) and slow-growing (Mycobacterium avium) bacteria was studied, as well as on bacterial mobility (Pseudomonas aeruginosa and Escherichia coli) in semisolid agars.

Results: The dynamics of water loss in culture media showed the weight loss in all media without dimethicone (control) in 24 h to be statistically significant (p<0.05); 7-8 days later, they lost 50% of weight, and 14 days later they lost approximately 70%. The weight of media under dimethicone underwent no significant changes during the observation period. Growth index of fast-growing bacteria (S. aureus, E. coli, S. Typhimurium, B. cenocepacia) on control culture media without applying any substance, and on culture media under dimethicone had no significant differences. Visible M. avium growth on chocolate agar in controls was recorded on day 19, under dimethicone - on days 18-19. The number of colonies on culture day 19 under dimethicone tenfold exceeded the control values. The mobility indices of P. aeruginosa and E. coli on semisolid agar under dimethicone 24 h later were significantly higher than under control conditions (p<0.05 in both cases).

Conclusion: The study confirmed marked deterioration of culture media properties under prolonged cultivation. The suggested protection technology of culture media growth properties using dimethicone showed beneficial effects.

The aim of the study is to evaluate the suitability of STRs for molecular characterization and forensic applications in unrelated Brahmins of Rajasthan and Haryana states, India.

Materials and methods: A total of 203 male DNA samples from various districts of Haryana (n=104) and Rajasthan (n=99) were genotyped using the GlobalFiler^® PCR Amplification Kit. Allelic frequencies and different forensic parameters like PD, PE, PIC, PM, Ho, He, UHe, and TPI were calculated with different software.

Results: More than 200 alleles were present in both populations, ranging from 6.0 to 35.2 and SE33 was the most polymorphic marker. The combined power of discrimination was 1. To know the relatedness with other Indian Brahmin populations, the UPGMA dendrogram and principal component analysis plot were visualized to show that both populations are close to each other and in nearby Saraswat Brahmins of Himachal Pradesh. This study showed a genetic relationship and forensic examination in the Haryana and Rajasthan Brahmin populations and various ethno-linguistically diverse populations of India.

Conclusion: The results imply that the highly polymorphic 21 autosomal STR loci might be applied for individuals' forensic identification and parentage testing. This study also suggests that the kit having both autosomal and Y-STR markers is appropriate for a better understanding of the genetic and forensic examination in the Brahmin population of Haryana and Rajasthan.

Patient-specific in vitro tumor models are a promising platform for studying the mechanisms of oncogenesis and personalized selection of drugs. In case of glial brain tumors, development and use of such models is particularly relevant as the effectiveness of such tumor treatment remains extremely unsatisfactory. The aim of the study was to develop a model of a 3D tumor glioblastoma spheroid based on a patient's surgical material and to study its metabolic characteristics by means of fluorescence lifetime imaging microscopy of metabolic coenzymes.

Materials and methods: The study was conducted with tumor samples from patients diagnosed with glioblastoma (Grade IV). To create spheroids, primary cultures were isolated from tumor tissue samples; the said cultures were characterized morphologically and immunocytochemically, and then planted into round-bottom ultra low-adhesion plates. The number of cells for planting was chosen empirically. The characteristics of the growth of cell cultures were compared with spheroids from glioblastomas of patients with U373 MG stable line of human glioblastoma. Visualization of autofluorescence of metabolic coenzymes of nicotinamide adenine dinucleotide (phosphate) NAD(P)H and flavin adenine dinucleotide (FAD) in spheroids was performed by means of an LSM 880 laser scanning microscope (Carl Zeiss, Germany) with a FLIM module (Becker & Hickl GmbH, Germany). The autofluorescence decay parameters were studied under normoxic and hypoxic conditions (3.5% О₂).

Results: An original protocol for 3D glioblastoma spheroids cultivation was developed. Primary glial cultures from surgical material of patients were obtained and characterized. The isolated glioblastoma cells had a spindle-shaped morphology with numerous processes and a pronounced granularity of cytoplasm. All cultures expressed glial fibrillary acidic protein (GFAP). The optimal seeding dose of 2000 cells per well was specified; its application results in formation of spheroids with a dense structure and stable growth during 7 days. The FLIM method helped to establish that spheroid cells from the patient material had a generally similar metabolism to spheroids from the stable line, however, they demonstrated more pronounced metabolic heterogeneity. Cultivation of spheroids under hypoxic conditions revealed a transition to a more glycolytic type of metabolism, which is expressed in an increase in the contribution of the free form of NAD(P)H to fluorescence decay.

Conclusion: The developed model of tumor spheroids from patients' glioblastomas in combination with the FLIM can serve as a tool to study characteristics of tumor metabolism and develop predictive tests to evaluate the effectiveness of antitumor therapy.

The aim of the study is to evaluate the efficacy of approaches to sampling during periodic quality control of the artificial intelligence (AI) results in biomedical practice.

Materials and methods: The approaches to sampling based on point statistical estimation, statistical hypothesis testing, employing ready-made statistical tables, as well as options of the approaches presented in GOST R ISO 2859-1-2007 "Statistical methods. Sampling procedures for inspection by attributes" have been analyzed. We have considered variants of sampling of different sizes for general populations from 1000 to 100,000 studies.The analysis of the approaches to sampling was carried out as part of an experiment on the use of innovative technologies in computer vision for the analysis of medical images and their further application in the healthcare system of Moscow (Russia).

Results: Ready-made tables have specific statistical input data, which does not make them a universal option for biomedical research. Point statistical estimation helps to calculate a sample based on given statistical parameters with a certain confidence interval. This approach is promising in the case when only a type I error is important for the researcher, and a type II error is not a priority. Using the approach based on statistical hypothesis testing makes it possible to take account of type I and II errors based on the given statistical parameters. The application of GOST R ISO 2859-1-2007 for sampling allows using ready-made values depending on the given statistical parameters.When evaluating the efficacy of the studied approaches, it was found that for our purposes, the optimal number of studies during AI quality control for the analysis of medical images is 80 items. This meets the requirements of representativeness, balance of the risks to the consumer and the AI service provider, as well as optimization of labor costs of employees involved in the process of quality control of the AI results.

Apoptosis and necrosis during reperfusion after ischemia are key mechanisms at the cellular level leading to damage. The development of pathological conditions is preceded by intracellular calcium ion overload both at the stage of ischemia and at the stage of reperfusion. In this regard, one of the strategies aimed at reducing damage during ischemia/reperfusion is associated with the use of calcium channel blockers. The aim of the study was to study the effect of a peptide toxin, a calcium channel blocker ω-hexatoxin-Hv1a, on different types of epithelial cell death during in vitro reconstruction of ischemia/reperfusion conditions characteristic of organ transplantation.

Materials and methods: In this study, we used CHO-K1 epithelial cell culture. Changes in apoptosis, necrosis, cell index, and calcium ion concentration were assessed when modeling ischemia/reperfusion processes in vitro with the addition of a calcium channel blocker toxin. Ischemic and reperfusion injury was achieved by oxygen and nutrient deprivation followed by reperfusion in a complete nutrient medium. The measurements were performed using a multimodal plate reader-fluorimeter.

Results: An increase in apoptosis, necrosis, and the concentration of calcium ions was recorded when modeling ischemia/reperfusion processes. A decrease in the level of apoptosis and necrosis, as well as the concentration of calcium ions to a physiological level or a level close to physiological, was noted when the toxin was added at a concentration of 50 nM at the reperfusion stage. The cell index showed a faster restoration in the presence of the toxin.

Conclusion: The experimental data confirm the hypothesis of a beneficial effect of peptide calcium channel blockers on the state of epithelial cells during reperfusion after ischemia and can be considered for further study as a strategy for organ adaptation before reperfusion.

The aim of the study was to identify different degrees of dermal lesions in vulvar lichen sclerosus (VLS) using cross-polarization optical coherence tomography (CP OCT) based on attenuation coefficient to detect disease early manifestations and to monitor the effectiveness of treatment.

Materials and methods: The study included 10 patients without pathology and 39 patients with VLS diagnosed histologically. CP OCT was performed in vivo on the inner surface of the labia minora, in the main lesion area. From each scanning point, a 3.4×3.4×1.25-mm3 3D data array was obtained in 26 s. CP OCT examination results were compared with histological examination of specimens stained with Van Gieson's picrofuchsin.Quantitative analysis of OCT images was performed by measuring the attenuation coefficient in co-polarization and cross-polarization. For visual analysis, color-coded charts were developed based on OCT attenuation coefficients.

Results: According to histological examination, all patients with VLS were divided into 4 groups as per dermal lesion degree: initial (8 patients); mild (7 patients); moderate (9 patients); severe (15 patients). Typical features of different degrees were interfibrillary edema up to 250 μm deep for initial degree, thickened collagen bundles without edema up to 350 μm deep for mild degree, dermis homogenization up to 700 μm deep for moderate degree, dermis homogenization and total edema up to 1200 μm deep for severe degree.Pathological processes in dermis during VLS like interfibrillary edema and collagen bundles homogenization were visualized using CP OCT method based on values of attenuation coefficient in co- and cross-polarization channels. However, CP OCT method appeared to be less sensitive to changes of collagen bundles thickness not allowing to distinguish thickened collagen bundles from normal ones with enough statistical significance. The CP OCT method was able to differentiate all degrees of dermal lesions among themselves. OCT attenuation coefficients differed from normal condition with statistical significance for all degrees of lesions, except for mild.

Conclusion: For the first time, quantitative parameters for each degrees of dermis lesion in VLS, including initial degree, were determined by CP OCT method allowing to detect the disease at an early stage and to monitor the applied clinical treatment effectiveness.