[Paradoxical embolism: clinical situation and approaches to treatment].

The authors describe two clinical cases of paradoxical embolism of greater-circulation vessels in patients with thrombosis of deep veins of the lower extremities and patent foramen ovale, also discussing different variants of clinical course of paradoxical embolism, as well as approaches to treatment and prevention.

[Short and long-term results of endovascular treatment of bifurcational coronary stenosis].

Short and long-term results of endovascular treatment of true bifurcational coronary stenosis were analyzed in 229 patients. 68 patients received a "provisional-T" stenting on the first stage of the study. On the next stage 40 patients received the same "provisional-T" stenting, a total bifurcational stenting was conducted in 37 patients. Only coated stents were used. Independent risk factors of "provisional-T" stenting conversion to total bifurcational stenting were revealed. There were no differences between "provisional-T" and total bifurcational stenting considering the short-term treatment results. Long-term results (12-18 months) were analyzed in 70 patients. There were no restenosis of the main artery, whereas restenosis of the lateral branch was noticed in 5.5 and 2.94%, respectively, in the groups of "provisional-T" and total bifurcational stenting. Late thrombosis was registered in 1 case from the group of total bifurcational stenting.

[Hermetization of aortic sutures - the comparative analysis of methods].

Leakage of the ascending aortic sutures after the aortic valve replacement with the use of various methods of surgical hemostasis was studied. Results of 244 operations were analyzed. Thus, aortic leakage took place in 50 (20,5%) patients. One- or two-fold sewing was successfully used in 16 (32%) cases. The rest benefited from aortic suture fixation with the use of pericardial flap. Algorythm, implying usage of the auto- or xenopericardial flap after two-fold sewing failure, enabled exclusion of repeated aorta cross-clamping, decrease of the blood loss and hemotransfusion, and, therefore, decrease of postoperative complication and lethality rates.

Acute iliac artery thrombosis and pulsatile femoral and popliteal veins in the same extremity: a case report.

Systemic venous pressure is elevated in right heart failure, and this elevation may be reflected in pulsatile venous flow when there is significant tricuspid regurgitation. The presence of this systolic reversed flow in the femoral and popliteal veins may result in major difficulties for diagnosis and treatment. We report the case of a patient with signs and symptoms of acute ischemia of the right lower limb with palpable pulse in the groin and popliteal fossa. Tricuspid regurgitation was suspected by clinical examination, and Doppler ultrasonographic examination of the extremity revealed pulsatile flow in the femoral and popliteal veins while the iliac arterial axis was occluded. A preoperative angiogram revealed an underlying iliac artery thrombosis, which was successfully treated.

[Left ventricular ruptures after the mitral valve replacement].

7 cases of left ventricular rupture after the mitral valve replacement, which occurred per 900 operations performed in our clinic, were analyzed. A successful closure of the defect has been managed in 2 cases. In all cases the external closure with liners and patch plasty was used. In two cases the autopsy revealed a transmural myocardial infarction, underdiagnosed preoperatively, which had caused a rupture.

The Bulgarian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ).

We report herein the results of the cross-cultural adaptation and validation into the Bulgarian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Bulgarian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. 137 subjects were enrolled: 77 patients with JIA (36% systemic onset, 30% polyarticular onset, 4% extended oligoarticular subtype, and 30% persistent oligoarticular subtype) and 60 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Bulgarian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

A new catalytic reaction of rhenium and its analytical application.

Small amounts of perrhenate in fairly concentrated sulphuric acid media and in the presence of tin(II) chloride are found to catalyse the acid hydrolysis of alpha-furildioxime, with production of a new absorption peak at 320 nm, due to the di-alpha-furildiketone produced. The catalytically active species is a sulphate complex of rhenium(IV). The catalytic action of rhenium is promoted by citric acid. Rhenium can be determined in the range 0.0005-0.5 mug/ml. Interferences are eliminated by a preliminary extraction. The method has been applied to the determination of rhenium in copper concentrates of low rhenium content, copper ores and rocks. On the basis of the inhibitory effect of molybdenum the reaction can be used for determination of this element as well.

[Specificity of the chromatin changes in viral infections]. / Spetsifichnost' izmenenii khromatina pri nekotorykh virusnykh infektsiiakh.

Nine microdensitometric signs (MDMS) of chromatin in cell cultures have been investigated after injecting with 11 viruses of three taxonomic groups. The technics of numeric comparison of systems demonstrated a high specificity of chromatin alterations in relation to the taxonomic position of viruses. The cultures of different groups differ in their MDMS. The group-to-group relations in respect to MDMS are expressed by even more numerous differencies. A test value is suggested to appreciate the specificity in groups of alterations measured upon the great number of signs.

[Accelerated measurement of the volume of condensed chromatin from electron microscopic photographs]. / Uskorennoe izmerenie ob"ema kondensirovannogo khromatina po élektronnomikroskopicheskim snimkam.

The fraction of condensed chromatin (C. C., %) in cell nuclei images was determined by the aid of the "random step grid". 100 random points were thrown on every electron microscopic images. The number of points in C. C. images was counted. Lymphocyte nuclei in spleen and lymph nodes of normal cows have a higher content of C. C. (61 +/- 1.6%) Than those of cows suffering from lympholeucosis in haematological (49 +/- 21%) and in tumor (44 +/- 1.1%) stages. The counting procedure takes about 2 hours for 90 images. The random step grid can be easily available in every day practice.

[Study of the hypothalamus of neonatally castrated rats by the karyometric method]. / Issledovanie gipotalamusa neonatal'no kastrirovannykh krys medotom kariometrii

The sensitivity of different hypothalamic regions to the effect of androgens has been studied during the period of the brain sex differentiation. The castration of animals during the first week of life was shown to result in the marked increase of size of the neuron nuclei in the preoptic, suprachiasmatic, arcuate and ventromedial nuclei of the hypothalamus; the size of neuron nuclei in the dorsomedial nucleus suffered no changes. The dynamics of size of the cell nuclei was followed in different hypothalamic regions with respect to the time of castration.

[Seasonal differences in the pathomorphological reactions of monkeys to poliomyelitis vaccine]. / Sezonnye razlichiia patomorfologicheskikh reaktsii obez'ian na vaktsinu protiv poliomielita.

Weak pathomorphological reactions in a group of animals are assessed by 3 scores of severity which depend on the total number of animals in the group, number of animals with pathomorphological reactions, number of body areas involved in these reactions, and the intensity of reaction expressed by crosses. Conditionally, these scores of severity characterize virulence, pathogenicity, and local pathogenicity of virus. All the 3 scores of severity for the 3 virus types were found to be highest in the winter-spring period (average for 18 years).

[Chronic rabies infection in mice intracerebrally infected with street virus]. / Khronicheskaia rabicheskaia infektsiia u myshei, zarazhennykh v mozg ulichnym virusom.

Experimental white mice inoculated intracerebrally with street virus developed the clinical form of chronic rabies infection. The duration of clinical manifestations in the animals with the chronic course of the disease was 55 days. In all the cases the disease was fatal. Virological, immunofluorescent and electron microscopic examinations of the brains of these mice have shown that in the chronic form of rabies, in contrast to the acute form, (a) the infectious virus titre is by 4-5 orders lower; (b) the number of fluorescent antigen corpuscules is significantly higher; (c) there is a considerable accumulation of virus "matrices" (aggregates of viral nucleocapsids) in which single virus particles and numerous tubular forms can be detected. No virions of rabies forming on intracellular membranes were found.

[Quantitative comparison of the ultrastructures of the blood capillaries and muscle fibers in all stages of obliterating endarteritis]. / Kolichestvennoe sravnenie ul'trastruktur krovesnosnykh kapilliarov i myshechnykh volokon na vsekh stadiiakh obliteriruiushchego éndarteriita.

The time course of quantitative changes in the ultrastructure of capillaries and muscle fibrers was studied by the totality of morphological signs in 33 patients with obliterating endarteritis of the lower extremities. As the disease develops, the area of luminal surface and the volume of basal membrane of the capillaries and mitochondria of muscle fibers increase progressively; the volume and number of micropinocytotic vesicles, the volume of myofibrills and the ratio of myofibrill to the mitochondria volume decrease. In early stages of the disease the size of capillary lumen decreases and subsequently increases along with a decrease in the volume of endothelial cells. An increase in the number of mitochondria in a unit of area of muscle fiber at early stages with subsequent decrease was noted. All the values of observed changes are statistically significant. None of the examined features of the structure can be considered pathognomonic separately, but the totality of the quantitative alterations gives a whole picture of the progressive disease.

[Traumatic surgeries on organs of gastrointestinal tract without components of donor's blood]. / Travmatichnye operatsii na organakh pishchevarutel'nogo trakta bez ispol'zovaniia komponentov donorskoi krovi.

The authors propose a complex program aimed to refuse completely using donor's blood components in surgeries on organs of digestive tract. This method was used in 25 patients who underwent surgeries with 380-1500 ml of blood loss. No patients received transfusion of donor's blood components before, during and after surgery.

[One-stage esophagoplasty without transfusion of donor blood components]. / Odnomomentnaia plastika pishchevoda bez ispol'zovaniia komponentov donorskoi krovi.

Six patients aged from 27 to 62 years were operated for subtotal burn strictures, cancer and glandular polyp of a low-thoracic part of the esophagus using a complex program of non-blood surgery. The following methods were used: collection of autoplasma before surgery by plasmapheresis, collection of autologic packet red cells, normovolemic hemodilution during surgery, use of perftoran for oxygen transport and recombinant human erythropoetin to stimulate erythropoiesis and raise preporative level of hemoglobin. Components of donor blood were not used in these patients. There were no complications associated with these methods. Partial failure of esophagol-colonic anastomosis on the neck was seen in 1 patient. The complex program permits one to avoid completely transfusion of donor blood components in esophagol surgery.