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8PEDAGOGICAL SCIENCES
PATHOGENETIC CHANGES OF IN MILD CRANIAL TRAUMA
Zhukovskyi O.
MD, PhD;
Higher State Educational Establishment "Bukovinian State Medical University "
ABSTRACT
The state of pro- and antioxidant systems in patients with mild brain contusion has been studied. The definite patterns of the functioning of these systems in this pathology have been disclosed. Keywords: pathogenesis, antioxidant systems, mild cranial trauma.
Introduction. Mild traumatic brain injury (TBI) is one of the most common types of nervous system lesions. Nearly 80% of all mild TBI cases are presented by mild brain contusion (MBC) [1]. Despite the term "mild" this type of trauma is characterized by high frequency of posttraumatic complications. The cause of it should be found in peculiarities of acute period of TBI when a cascade of irreversible changes in neural tissue is formed [2].
It has been proved that activation of lipid peroxi-dation and biopolymers is an early universal and extremely sensitive marker of injury. It is characteristic of various pathological conditions including traumatic lesions of nervous system. The complexity of this problem is determined by favorable conditions for the progression of free radical pathology in central nervous system that include high lipid content (optimal substrate for lipid peroxidation), maximum oxygen consumption, well developed system of biological membranes. These facts stipulate particular susceptibility of brain for oxidative injury of cerebral structures [3]. Given the above we considered it appropriate to assess
In the blood samples of all patients on the first day there was an increase of activity of catalase which is an enzyme of first line of defense. Catalase is one of the basic enzymes of antioxidant protection and elevation of its activity on the first day after TBI points at activation of lipid peroxidation in patients with MBC. Assessment of dynamic changes has shown gradual decrease of catalase activity which gives evidence of debilitation of proper antioxidant protection.
On the first day in patients with concussion there was insignificant elevation of glutathione as the basic component of protective glutathione system in comparison to the results of control group. However on the third day we observed sharp decline of glutathione level in compared to the original data. The component of glu-
the extent and dynamics of pro- and antioxidant imbalance in patients with MBC.
Materials and methods. We have examined 23 patients with brain contusion aged 18-43 years and the control group which comprised 15 practically healthy individuals comparable by age and sex. Mild brain contusion was diagnosed based on neurological and instrumental examination. Biochemical studies were done in plasma and erythrocytes of patients and donors. Blood sampling was performed in the morning on an empty stomach on the first, third and fifth day after traumatic injury. It included malonic aldehyde, ceruloplasmin, medium weight molecules, glutathione, HS-groups, catalase activity.
Results and discussion. The degree of activation of free radical processes was assessed by content of ma-lonic aldehyde which is one of the final products of li-pid peroxidation. On the first day the level of malonic aldehyde was practically equal to normal ranges. However on the third day and especially on the fifth day we have observed noticeable increase of plasma level of malonic aldehyde by 38.6% (Table 1).
Table 1
tathione is sulfhydryl (SH) group which plays important role in normal functioning of membrane structures. On the first day after trauma there was mild elevation of SH-groups level but then it was followed by decrease of their level.
In all patients with mild brain contusion on the first day after trauma we found increase of ceruloplas-min activity as manifestation of defense response. By the third day this level increases almost by 40% in comparison to control group, but then it significantly decreases. It has been proved that ceruloplasmin is the basic antioxidant of blood plasma both in normal and in pathology which prevents and inhibits lipid peroxi-dation by oxidation of bivalent iron. Antioxidant effect of ceruloplasmin depends on its feroxidase activity. We can assume that ceruloplasmin takes part in destruction
The dynamics of pro- and antioxidant systems indexes in patients with mild brain contusion
1st day 3rd day 5th day Control
Malonic aldehyde, ^mol/L 18,55+0,38 p<0,05 25,7+0,6 p<0,05 26,8+0,46 7,74+0,28
Ceruloplasmin, mg/L 231,8+4,2 p<0,05 212,5+2,7 184,6+2,9 186,26+2,3
Catalase activity, ^mol/min L 38,4+0,7 p<0,05 25,8+0,73 12,6+0,43 11,62+0,3
Glutathione 0,71+0,015 p<0,05 0,54+0,02 0,36+0,014 0,30+0,015
SH-groups, ^mol/ml 2,41+0,06 p<0,05 1,9+0,03 1,72+0,03 1,58+0,02
Significance of differences in comparison with control group (p): * - p<0.05; ** - p<0.01; *** - p<0.001.
of toxic free radicals of superoxide anion which is a product of aerobic metabolism.
So we can make a conclusion that mobilization of protective antioxidant mechanisms in the brain softens primary activation of lipid peroxidation. However it is followed by their further exhaustion that leads to destructive changes of nervous cells. That is why early determination, prevention and correction of secondary brain injury largely determine the results of treatment.
Conclusions.
1. In patients with mild brain contusion activation of free radical oxidation is most pronounced in five days after traumatic brain injury.
2. On the first day of trauma there is expressed activation of protective antioxidant factors (increased activity of catalase, content of ceruloplasmin, SH-groups, glutathione). The dynamic observation has shown gradual decrease of antioxidant activity.
Attention is drawn to the need of the further study of biochemical processes that lead to irreversible changes in nervous tissue, as well as development and
implementation of the drugs for correction of energetic metabolism and protection against secondary destruction of the cells.
References
1. R.J. Swatzyna, The elusive nature of mild traumatic brain injury, Biofeedback, Vol. 37, Issue 3 (2009) 92-95.
2. M. Prins, T. Greco, D. Alexander, C.C. Giza, The pathophysiology of traumatic brain injury at a glance, Dis Model Mech, 6 (2013) 1307-1315.
3. A. Rodriguez-Rodriguez, J.J. Egea-Guerro, F. Murillo-Cabezas, A. Carillo-Vico, Oxidative stress in traumatic brain injury, Curr Med Chem, 21(10) (2014) 1201-11.
4. A.M. Arent, L.F. de Souza, R. Walz, A.L. Dafre, Rerspectives on molecular biomarkers of oxida-tive stress and antioxidant strategies in traumatic brain injury, BioMed Research International, 2014(2014), Article ID 723060, 18 pages, http://dx.doi.org/10.1155/2014/723060.
CRITERIA OF RANKING OF HIGHER EDUCATIONAL ESTABLISHMENTS
Zhukovskyi O.
Higher State Educational Establishment of Ukraine "Bukovinian State medical University ",
Chernivtsi, Ukraine
ABSTRACT
The article determines the main criteria and indicators considered in compiling University ratings. The most authoritative world (Webometrics ranking, Shanghai ranking, Academic ranking, Times University ranking) and Ukrainian ("Compass", "Top-200 Ukraine", "Ukrainian University Ranking" (The Ministry of Education and Science of Ukraine), SciVerse Scopus, by the version of the journal «Correspondent») university rankings are characterized.
Keywords: ranking, university ranking, academic ranking, Webometrics ranking.
Problem statement. Nowadays rankings have become very popular. The customers are interested in them, and irrespective of the attitude of certain universities or other organizations to them they are impossible to be avoided. The Institute of Higher Education Strategy and UNESKO European Center in the sphere of higher education organized several important international forums. In 2004 the Forum held in Washington established the International Expert Group to determine university ranking - International Ranking Experts Group (IREG). IREG activity includes a careful examination of ranking assessment in university work, elaboration of procedures and approaches to evaluation of ranking systems available, making international comparative analysis etc.
Transparency of higher education today is a society challenge, reputation and necessity. A step to solve the issues concerning improvement of the quality of higher education is introduction of external and internal monitoring of higher education quality and presentation of the results of monitoring in the frame of ranking of higher educational institutions [3, p. 271-272].
A characteristic feature of higher education at the present stage is introduction of ranking of higher educational institutions (HEI). Today there are approximately ten HEI rankings in the world. Traditionally American and English universities are on top of rankings [2, p. 48].
The use of higher educational institutions rating/ranking is necessary for applicants in order to choose a higher educational institution, for the higher
educational institution authority - to manage effectively, for employers - to select high quality working resources, for the governments and politicians - to form a stable standard-legal base and provide an adequate market of educational services and labour market. Therefore, ranking system should satisfy all the customers of educational services and organizers of higher education.
The ranking pattern of higher education system is a certain reflection of a real state in which it is functioning at a certain moment. On the basis of analysis of functional branches in the university activity ten summarizing topical directions are determined in the ranking pattern: presentation of achievements on the international level; presentation of achievements on the national level; access, organization structure and management; scientific-pedagogical potential; training of scientific and scientific-pedagogical staff; integration of higher education and science; effectiveness of training specialists; financial resources; information resources; educational and social infrastructure [3, p. 272-273].
At the present stage rankings are considered as a rather objective integral quality index in HEI activity. They enable to form an impartial image about the system of higher education; promote a healthy competition between universities, promote increase of the quality in their work, and considerably satisfy the needs of the labour market, applicants and their parents. Therefore, improvement of the ranking methods has actually become a world tendency, and the main studies are con-
