Correction on congenital heart defects under conditions of hypothermia without perfusion and non-inhalation anesthesia

The clinical and pathophysiological indices were determined in the operative and immediate postoperative periods in 221 patients with various congenital heart diseases, with consideration for the degree of preoperative disorders of hemodynamics. The operations were conducted under conditions of non-inhalation anesthesia and various-level hypothermal protection without perfusion, with exclusion of the heart from circulation for up to 52 minutes. The main complications developing in the operative and postoperative periods were determined. It is proved that the processes of metabolism and blood oxygen-transport function are interlinked in operations conducted under these conditions. It is also proved that the operations are safe and effective.     

Pulmonary aspergillosis and its treatment

The authors had 85 patients with various forms of bronchopulmonary aspergillosis under observation; 45 of them were treated by various types of operative interventions. Forty patients were given mycostats. The article describes the indications and contraindications for surgical treatment, the volume of the operative interventions, the postoperative complications and their management.     

Surgical management in complicated sigmoid cancer

The results of operative treatment of 242 patients aged from 30 to 85 years with complicated cancer of the sygmoid colon have been analyzed. It is shown that in the choice of the method for surgical intervention essential are the character of complications, peculiarities of tumor growth, as well as the stage of the disease and general condition of the patient. The removal of the tumor followed by forming of decompression colostomy, without restoration of bowel continuity results in achievement of better initial results. Resection of the tumor with one stage placement of the anastomosis is advisable as an elective procedure, after elimination of acute symptoms of complications and substantial preoperative preparation. The application of U-shaped terminolateral anastomosis allows to form a primary colonic anastomosis in acute bowel obstruction due to the tumor of the sygmoid colon.     

Hormonal and immunological status of children with thymus hyperplasia

The state of the adrenocortical system, cellular and humoral immunity was studied in 152 infants, suffering from thymomegaly, associated with virus-bacterial pneumonia. The results obtained allow one of to consider the hormonal and immunological state of the patients with thymomegaly to be inhibited and the adrenocortical hypofunction to be secondary. Therefore, the infants with thymomegaly should be separated into a special "risk" group, according to their immunodeficient states, respiratory allergies, acute and chronic adrenocortical deficiency.     

Hemorheological and antioxidant effects of Ascovertin in patients with sclerosis of cerebral arteries

The clinical trials on 31 patients with arteriosclerosis and I-II stage discirculatory encephalopathy to assess an ability of Ascovertin to limit hemorheology abnormalities were carried out. In patients with discirculatory encephalopathy was a distinct increase in blood viscosity which was induced by disturbances of cell rheological factors: increase in aggregation of erythrocytes and decrease in their deformability were observed in comparison with indices in the group of healthy volunteers. No difference in plasma viscosity and fibrinogen was found. The treatment with Ascovertin in patients with discirculatory encephalopathy improved their attention, memory, mental performance, normalized sleep, releaved headache, decreased fatiquebility, led to the decrease in blood viscosity values, the reduction of pathological erythrocyte hyper aggregation and the improvement of erythrocyte deformability. We partly connect this clinical effect and hemorheology activity of Ascovertin with its antioxidant property--there was found impressive lipid peroxidation suppression. No significant changes in hemorheological and lipid peroxidation indices were observed in patients without Ascovertin.     

Genome-wide association data suggest ABCB1 and immune-related gene sets may be involved in adult antisocial behavior

Adult antisocial behavior (AAB) is moderately heritable, relatively common and has adverse consequences for individuals and society. We examined the molecular genetic basis of AAB in 1379 participants from a case–control study in which the cases met criteria for alcohol dependence. We also examined whether genes of interest were expressed in human brain. AAB was measured using a count of the number of Antisocial Personality Disorder criteria endorsed under criterion A from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Participants were genotyped on the Illumina Human 1M BeadChip. In total, all single-nucleotide polymorphisms (SNPs) accounted for 25% of the variance in AAB, although this estimate was not significant (P=0.09). Enrichment tests indicated that more significantly associated genes were over-represented in seven gene sets, and most were immune related. Our most highly associated SNP (rs4728702, P=5.77 × 10⁻⁷) was located in the protein-coding adenosine triphosphate-binding cassette, sub-family B (MDR/TAP), member 1 (ABCB1). In a gene-based test, ABCB1 was genome-wide significant (q=0.03). Expression analyses indicated that ABCB1 was robustly expressed in the brain. ABCB1 has been implicated in substance use, and in post hoc tests we found that variation in ABCB1 was associated with DSM-IV alcohol and cocaine dependence criterion counts. These results suggest that ABCB1 may confer risk across externalizing behaviors, and are consistent with previous suggestions that immune pathways are associated with externalizing behaviors. The results should be tempered by the fact that we did not replicate the associations for ABCB1 or the gene sets in a less-affected independent sample.     

Metabolic control of contractile performance in isolated perfused rat heart. Analysis of experimental data by reaction:diffusion mathematical model

The intracellular mechanisms of regulation of energy fluxes and respiration in contracting heart cells were studied. For this, we investigated the workload dependencies of the rate of oxygen consumption and metabolic parameters in Langendorff-perfused isolated rat hearts.(31)P NMR spectroscopy was used to study the metabolic changes during transition from perfusion with glucose to that with pyruvate with and without active creatine kinase system. The experimental results showed that transition from perfusion with glucose to that with pyruvate increased the phosphocreatine content and stability of its level at increased workloads. Inhibition of creatine kinase reaction by 15-min infusion of iodoacetamide decreased the maximal developed tension and respiration rates by a factor of two.(31)P NMR data were analyzed by a mathematical model of compartmentalized energy transfer, which is independent from the restrictions of the classical concept of creatine kinase equilibrium. The analysis of experimental data by this model shows that metabolic stability-constant levels of phosphocreatine, ATP and inorganic phosphate-at increased energy fluxes is an inherent property of the compartmentalized system. This explains the observed substrate specificity by changes in mitochondrial membrane potential. The decreased maximal respiration rate and maximal work output of the heart with inhibited creatine kinase is well explained by the rise in myoplasmic ADP concentration. This activates the adenylate kinase reaction in the myofibrillar space and in the mitochondria to fulfil the energy transfer and signal transmission functions, usually performed by creatine kinase. The activity of this system, however, is not sufficient to maintain high enough energy fluxes. Therefore, there is a kinetic explanation for the decreased maximal respiration rate of the heart with inhibited creatine kinase: i.e. a kinetically induced switch from an efficient energy transfer pathway (PCr-CK system) to a non-efficient one (myokinase pathway) within the energy transfer network of the cell under conditions of low apparent affinity of mitochondria to ADP in vivo. This may result in a significant decrease in the thermodynamic affinity of compartmentalized ATPase systems and finally in heart failure.     

Renal blood flow before and after portosystemic shunt in children with portal hypertension

Introduction

Variceal haemorrhage in children with extrahepatic portal hypertension is best controlled by an effective decompressive shunt, but long-term follow up of children who have had splenorenal shunt due to extrahepatic portal hypertension (EHPH) gave evidence for assuming the risk of renal venous hypertension (RVH).

Purpose

To study renal hemodynamic before and after portal decompression.

Methods

The results of 144 portosystemic shunt operations were followed from 2005 to 2013. Seventy-two patients applied central splenorenal shunt (CSS) with splenectomy, ten side-to-side splenorenal shunt without splenectomy (SRSss), ten patients assessed the distal splenorenal shunt (DSS). Forty-three iliacomesenterial anastomosis (IMA) and in nine cases performed mesocaval anastomosis (MCA). Children had a standard pre- and postoperative work up including gastrointestinal endoscopy, Doppler ultrasonography (US), multi-slice computed tomography (MSCT) and renography.

Results

In 11 (15.2 %) patients after CSS on duplex, Doppler study revealed signs of impeded venous outflow on the left renal vein (LRV). At long-term follow-up PI and RI of left renal artery remained at high numbers (1.48 ± 0.17 and 0.72 ± 0.19, p ≤ 0.05, respectively) after the CSS. Venous blood flow in the LRV at the hilum showed slower speed performance in groups of CSS and after IMA. After DSS, these signs have not been detected. Four patients after IMA on US Doppler and CT angiography revealed dilated left testicular and ovarian veins, with retrograde blood flow in them, which clinically manifested as left flank pain, macro- and microhematuria, varicocele and ovaricocele.

Conclusion

The study shows that CSS and IMA more negatively effect on hemodynamics of left kidney and symptoms of RVH obviously due to shunting the large amounts of blood from a system of high pressure to a low.     

Spleen stiffness measurement as a non-invasive test to evaluate and monitor portal hypertension in children with extrahepatic portal vein obstruction

Pediatric Surgery International - The aim of the study was to test the feasibility of spleen stiffness measurement (SSM) by two-dimensional shear wave elastography (2D-SWE) and compare data on its...     

Receptors for the epidermal growth factor and estrogens in primary bone tumors

The content of receptors for the epidermal growth factor and estrogens is studied in primary human bone tumors: osteogenic sarcoma, chondrosarcoma, malignant fibrous histiocytoma, and giant cell tumor. In all of these tumors, radioligand analysis reveals receptors for epidermal growth factor in the membrane fraction and receptors for estrogens in the cytosolic fraction without any statistical differences in the mean receptor content. The vast majority of osteogenic sarcomas, chondrosarcomas of the 2nd–3rd degree of anaplasia, and one third of giant cell tumors are characterized as growth factor receptor-positive and estrogen receptor-negative, which probably reflects the common tendency of receptor-positive malignant tumors towards rapid growth. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 7, pp. 78–82, July, 1996