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.     

Pathobiology of familial hypercholesterolemic atherosclerosis

Many factors play a role in the development of atherosclerotic lesions. One of the leading risk factors for development of atherosclerosis is familial hypercholesterolemia (FH). FH is a genetic disease characterized by a deficiency, and/or mutation, of receptors for low density lipoprotein (LDL) on the plasmalemma of endothelial cells (EC), a high level of low density lipoprotein in the plasma, and early, spontaneous development of atherosclerosis and skin xanthoma. In this review we describe Watanabe heritable hyperlipidemic (WHHL) rabbits, which represent such an animal model for human FH. This strain of the rabbits is characterized by a genetic deficiency or mutation of functional LDL receptors and develops severe atherosclerosis, which is pathologically similar to familial homozygous hyperlipidemic patients. The most completely characterized animal model is the Watanabe rabbit, a model of homozygous and heterozygous type IIa hypercholesterolemia related to an LDL receptor deficiency. Additional manipulation such as aortic injury in this rabbit model induces the development of atherosclerotic lesions that are structurally similar to those found in humans. Thus, this model of hypercholesterolemia fulfils the above criteria set, i.e. it is able to provide new insights for a better understanding of the pathogenesis of atherosclerosis and for testing new treatment strategies.     

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.     

Stem cell niches as clinical targets: the future of anti-ischemic therapy?

This article provides context for the research presented by Napoli et al., reported in this journal. Treatment strategies that target stem cell niches are promising avenues for stimulating inducible angiogenesis in many vascular diseases, such as diabetes mellitus and atherosclerosis. Here we discuss the study carried out by Napoli and colleagues--an analysis of the effects of parathyroid hormone on the vascular stem cell niche in peripheral ischemia. Napoli et al. demonstrate that parathyroid hormone administered in combination with granulocyte colony-stimulating factor induces angiogenesis in a hindlimb ischemia mouse model. This treatment seems to mobilize and localize endothelial cell progenitors specifically to ischemic vascular cell beds. We explore the mechanisms through which the multiple cells within the vascular niche respond to ischemia. The interaction between parathyroid hormone and granulocyte colony-stimulating factor in humans is also discussed. Further assessment is needed to elucidate the factors involved in migration and differentiation of endothelial cell progenitors in ischemia-damaged tissues.     

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.     

Mapping Pathways by Which Genetic Risk Influences Adolescent Externalizing Behavior: The Interplay Between Externalizing Polygenic Risk Scores,Parental Knowledge,and Peer Substance Use

Genetic predispositions and environmental influences both play an important role in adolescent externalizing behavior; however, they are not always independent. To elucidate gene–environment interplay, we examined the interrelationships between externalizing polygenic risk scores, parental knowledge, and peer substance use in impacting adolescent externalizing behavior across two time-points in a high-risk longitudinal sample of 1,200 adolescents (764 European and 436 African ancestry; M_age = 12.99) from the Collaborative Study on the Genetics of Alcoholism. Results from multivariate path analysis indicated that externalizing polygenic scores were directly associated with adolescent externalizing behavior but also indirectly via peer substance use, in the European ancestry sample. No significant polygenic association nor indirect effects of genetic risk were observed in the African ancestry group, likely due to more limited power. Our findings underscore the importance of gene–environment interplay and suggest peer substance use may be a mechanism through which genetic risk influences adolescent externalizing behavior.