Long-Term Survival of a Patient with Giant Cell Glioblastoma: Case Report and Review of the Literature

Glioblastoma multiforme (GBM) is the most common glial tumor of the central nervous system. Overall survival is less than a year in most of the cases in spite of multimodal treatment approaches. A 45-year-old female with histologically confirmed giant cell GBM was treated at our institution. Subtotal excision of the lesion situated in the right precentral area was performed during the initial stay in August 2005. The patient improved after the procedure with no hypertension and additional neurological deficit. Radiotherapy plus concomitant and adjuvant temozolomide was performed. The patient was symptom-free for 35 months after initial surgery. From July 2008 the patient developed partial motor seizures in the left side of the body and progressive hemiparesis. Local tumor progression was demonstrated on the neuroimaging studies. In December 2008, a second operative intervention was performed with subtotal excision of the tumor. Forty-five months after the initial diagnosis the patient is still alive with moderate neurological deficit. Microarray analysis of the tumor found the following numeric chromosomal aberrations: monosomy 8, 10, 13, 22, and trisomy 21, as well as amplifications in 4q34.1, 4q28.2, 6q16.3, 7q36.1, 7p21.3, and deletions in 1q42.12, 1q32.2, 1q25.2, 1p33, 2q37.2, 18q22.3, 19p13.2, Xq28, and Xq27.3. GBMs seem to be a heterogeneous group of glial tumors with different clinical course and therapeutic response. Microarray analysis is a useful method to establish a number of possible molecular predictors

The myogymnastics complex as an element of rehabilitation in the process of adaptation to orthopedic appliances in patients after stroke

Introduction. Stroke has become the second leading cause of long-term disability and cognitive impairment. The disease can cause debilitating neurological disorders that lead to motor, sensory and cognitive deficits and impaired psychosocial functioning. Many researchers have established an association between dental status, infections, and systemic diseases such as acute cerebrovascular disorder.The aim of the research was to determine the impact of dental health on the quality of life in patients with cerebral circulatory disorders complicated with neurological deficits by hemitype before and 30 days after orthopedic treatment by questionnaire survey.Materials and methods. The study involved 25 people with the course of ACVD complicated with neurological deficiency by hemitype, aged from 40 to 65 years, who underwent prosthetics with partial removable laminar dentures with acrylic base and retaining bent, metal clasps according to clinical indications. The first group, where the process of adaptation to the orthopedic appliance was normal, consisted of 13 people, including 7 women and 6 men. In the second group, the adaptation process took place using the proposed rehabilitation complex, and it comprised 12 patients, including 7 women and 5 men.The changes that occurred 30 days after applying a partial removable laminar denture were as follows:The value of the indicator of restricted masticatory function in subjects of the first study group was worse by 1.375 points as compared to the second group. The value of the indicator of physical pain in the process of adaptation to the orthopedic appliance was noteworthy, since it decreased significantly in the second group and amounted to 14.404 points, which was by 1.335 points higher than in patients of the first group.The level of psychological discomfort in patients of the first group was 32.412 points, which was 1.183 points different from that of patients in the second group, in favor of the latter. At the same time, a comparison of the level of psychological inferiority showed that this indicator was higher in the first group than in the second study group by 0.988 points, i.e., the dynamics of changes in this indicator was better in the second one.Comparison of the level of social inferiority showed that in the first study group it was higher by 2.106 points than in the third group. Comparison of the level of disability showed a difference of this indicator by 1.226 points in favor of patients of the second groupThe above data suggest a general trend of improving the basic health indicators of patients in the process of orthopedic rehabilitation. At the same time, there was a clear difference between the results of the questionnaire survey between patients of the first and second groups, and these indicators were better in the latter.Conclusions. The effectiveness of the proposed rehabilitation complex for patients with cerebral circulatory disorders complicated with neurological deficiency by hemitype after prosthetics with partial removable laminar appliances was confirmed by a decrease in numerical data from the questionnaire survey by 15%, indicating an improvement in quality of life in this category of patients

Mitochondrial DNA Suggests a Western Eurasian origin for Ancient (Proto-) Bulgarians

Ancient (proto-) Bulgarians have long been thought to as a Turkic population. However, evidence found in the past three decades show that this is not the case. Until now, this evidence does not include ancient mitochondrial DNA (mtDNA) analysis. In order to fill this void, we have collected human remains from the VIII-X century AD located in three necropolises in Bulgaria: Nojarevo (Silistra region) and Monastery of Mostich (Shumen region), both in Northeast Bulgaria and Tuhovishte (Satovcha region) in Southwest Bulgaria. The phylogenetic analysis of 13 ancient DNA samples (extracted from teeth) identified 12 independent haplotypes, which we further classified into mtDNA haplogroups found in present-day European and Western Eurasian populations. Our results suggest a Western Eurasian matrilineal origin for proto-Bulgarians as well as a genetic similarity between proto- and modern Bulgarians. Our future work will provide additional data which will further clarify proto-Bulgarian origins; thereby adding new clues to current understanding of European genetic evolution

Influence of detection of pretreatment cytogenetic abnormalities on first complete remission and survival in adult acute lymphoblastic leukemia

Objective: Treatment of acute lymphoblastic leukemia (ALL) in adults focuses on the initial assessment of the prognostic relevant cytogenetic features as well as a response-guided therapy based on molecular data. We examined the importance of molecular-cytogenetic abnormalities for complete remission (CR) rates and the overall survival (OS) in adult ALLs.Materials and Methods: Conventional cytogenetics and fluorescence in situ hybridization were performed on bone marrow cells from 33 newly-diagnosed ALL adults. Two karyotype categories [standard- risk group- normal karyotype, hyperdiplody and other structural aberrations, and high-risk group-t(11q23)/MLL, t(9;22)/bcr-abl, t(1;19), t(8;14), C-MYC and complex karyotype] and the biologically and clinically relevant ALL ploidy subgroups were prospectively defined.Results: Chromosomal abnormalities were found in 52% of the cases with a high rate of poor-risk translocations - t(9;22), t(8q24), t(11q23), t(1;19). The total CR rate was 67% and the median time for achievement 2.33 months. Male sex, an age below 35 years and the absence of high risk translocations might have contributed to the high CR rates. Female patients, hyperdiplody, low white blood cells (WBC), and random cytogenetic aberrations had the longest OS. OS, 3- and 5-years survival periods were significantly shorter for poor-risk than standard risk group (p=.015, p=.001 and p=.005, respectively).Conclusion: This study emphasizes the lack of influence of cytogenetic aberrations on the CR and the time to achieve CR. However, our observations show that these aberrations are an independent prognostic factor in adult ALL - they allow predicting therapy resistance and the OS time after intensetreatment

Суб’єктивна оцінка студентами закладу вищої медичної освіти ефективності дистанційного ведення освітнього процесу під час карантину і пошуки шляхів його покращення

Обговорено результати опитування студентів стоматологічного й міжнародного факультетів щодо якості дистанційної освіти в умовах карантину, її гострі проблеми. Запропоновано можливі шляхи їх розвʼязання.This article conciders the results of a survey of students of stomatological and international faculties on the quality of distance education during quarantine, its main problems. The authors suggeste some possible ways of their solving

Щодо питання різних методів полімеризації базисних пластмас

Наведена порівняльна характеристика компресійного і ливарного пресування. Ураховуючи всі недолі- ки та переваги обох методів пресування, доведені вагомі переваги ливарного пресування при виготов- ленні знімних конструкцій; Приведена сравнительная характеристика компрессионного и литьевого прессования. Учитывая все недостатки и преимущества обоих методов прессования, доказаны весомые преимущества литьевого прессования при изготовлении съёмных конструкций; Тhe article describes the comparative characteristics of compressive and casting pressing. Considering disadvantages and advantages of both methods, it was proved some advantages of the usage of the casting pressing during construction of removable constructions

Offspring of parents with Balkan Endemic Nephropathy have higher C-reactive protein levels suggestive of inflammatory processes: a longitudinal study

<p>Abstract</p> <p>Background</p> <p>Despite the characteristic extensive tubulointerstitial fibrosis, Balkan Endemic Nephropathy (BEN) is usually considered a non-inflammatory disease.</p> <p>Methods</p> <p>We examined a marker of inflammation, C-reactive protein (CRP), in the offspring of patients with BEN, a population at risk for BEN, prior to development of established disease to determine if an inflammatory process could be identified in the early stages of the disease. In 2003/04, 102 adult offspring whose parents had BEN and a control group of 99 adult offspring of non-BEN patients were enrolled in this prospective study. This cohort was re-examined yearly for four consecutive years. Levels of serum CRP were measured in years 3 and 4 and compared between groups. The data were analyzed with mixed models.</p> <p>Results</p> <p>Compared to controls, offspring of BEN parents had statistically higher CRP levels in two consecutive years, suggestive of early inflammatory reactivity. Whenever the mother was affected by BEN (both parents, or mother only), serum CRP was significantly increased, but not if only the father had BEN. CRP was inversely related to kidney cortex width but not to markers or renal function.</p> <p>Conclusion</p> <p>Early stages of BEN may involve inflammatory processes. The observation of a maternal involvement supports the concept of fetal programming, which has been implicated in the pathogenesis of other chronic kidney diseases.</p

The role of recent admixture in forming the contemporary West Eurasian genomic landscape

Over the past few years, studies of DNA isolated from human fossils and archaeological remains have generated considerable novel insight into the history of our species. Several landmark papers have described the genomes of ancient humans across West Eurasia, demonstrating the presence of large-scale, dynamic population movements over the last 10,000 years, such that ancestry across present-day populations is likely to be a mixture of several ancient groups [1-7]. While these efforts are bringing the details of West Eurasian prehistory into increasing focus, studies aimed at understanding the processes behind the generation of the current West Eurasian genetic landscape have been limited by the number of populations sampled or have been either too regional or global in their outlook [8-11]. Here, using recently described haplotype-based techniques [11], we present the results of a systematic survey of recent admixture history across Western Eurasia and show that admixture is a universal property across almost all groups. Admixture in all regions except North Western Europe involved the influx of genetic material from outside of West Eurasia, which we date to specific time periods. Within Northern, Western, and Central Europe, admixture tended to occur between local groups during the period 300 to 1200 CE. Comparisons of the genetic profiles of West Eurasians before and after admixture show that population movements within the last 1,500 years are likely to have maintained differentiation among groups. Our analysis provides a timeline of the gene flow events that have generated the contemporary genetic landscape of West Eurasia

NGS Nominated CELA1, HSPG2, and KCNK5 as Candidate Genes for Predisposition to Balkan Endemic Nephropathy

Balkan endemic nephropathy (BEN) is a familial chronic tubulointerstitial disease with insidious onset and slow progression leading to terminal renal failure. The results of molecular biological investigations propose that BEN is a multifactorial disease with genetic predisposition to environmental risk agents. Exome sequencing of 22 000 genes with Illumina Nextera Exome Enrichment Kit was performed on 22 DNA samples (11 Bulgarian patients and 11 Serbian patients). Software analysis was performed via NextGene, Provean, and PolyPhen. The frequency of all annotated genetic variants with deleterious/damaging effect was compared with those of European populations. Then we focused on nonannotated variants (with no data available about them and not found in healthy Bulgarian controls). There is no statistically significant difference between annotated variants in BEN patients and European populations. From nonannotated variants with more than 40% frequency in both patients' groups, we nominated 3 genes with possible deleterious/damaging variants-CELA1, HSPG2, and KCNK5. Mutant genes (CELA1, HSPG2, and KCNK5) in BEN patients encode proteins involved in basement membrane/extracellular matrix and vascular tone, tightly connected to process of angiogenesis. We suggest that an abnormal process of angiogenesis plays a key role in the molecular pathogenesis of BEN

Апарат для лікування контрактур нижньої щелепи

Індивідуальний апарат для лікування контрактур нижньої щелепи пропонується для впровадження в лікувально-профілактичних установах практичної охорони здоров’я (обласних, міських, районних) стоматологічного профілю