False Aneurysm of the Proximal Sano Shunt in a Patient With Hypoplastic Left Heart Syndrome After Bidirectional Superior Cavopulmonary Connection.

The case describes the surgical treatment of a patient with a false aneurysm of the proximal anastomosis of the Sano shunt in a patient with hypoplastic left heart syndrome midterm after bidirectional cavo-pulmonary anastomosis. The diagnostic algorithm included a physical examination, echocardiography, and multispiral computed tomography. Surgical treatment included closure of the right ventricular defect and removal of blood clots from the cavity of the false aneurysm.

Resuscitation thoracotomy.

Resuscitation thoracotomy is a rarely performed procedure whose use, in France, remains marginal. It has five specific goals that correspond point-by-point to the causes of traumatic cardiac arrest: decompression of pericardial tamponade, control of cardiac hemorrhage, performance of internal cardiac massage, cross-clamping of the descending thoracic aorta, and control of lung injuries and other intra-thoracic hemorrhage. This approach is part of an overall Damage Control strategy, with a targeted operating time of less than 60minutes. It is indicated for patients with cardiac arrest after penetrating thoracic trauma if the duration of cardio-pulmonary ressuscitation (CPR) is <15minutes, or <10minutes in case of closed trauma, and for patients with refractory shock with systolic blood pressure <65mm Hg. The overall survival rate is 12% with a 12% incidence of neurological sequelae. Survival in case of penetrating trauma is 10%, but as high as 20% in case of stab wounds, and only 6% in case of closed trauma. As long as the above-mentioned indications are observed, resuscitation thoracotomy is fully justified in the event of an afflux of injured victims of terrorist attacks.

[Assessment of functional state of microcirculatory bed of the foot in patients with lower limb critical ischaemia]. / Otsenka funktsional'nogo sostoianiia mikrotsirkuliatornogo rusla stopy u bol'nykh s kriticheskoi ishemiei nizhnikh konechnostei.

The authors assessed perfusion of the foot in patients presenting with lower limb critical ischaemia before and after endovascular revascularization, as well as analysed the interrelationship between the change of perfusion and the clinical result of treatment. The study includes a total of 15 patients presenting with ulcerative-necrotic defects of the foot. All patients underwent study of 2D-perfusion of the foot before and after the endovascular intervention. The '2D-perfusion' package was used within the framework of an angiographic examination, and required neither increase in the volume of the contrast medium nor radiation load. Four parameters of perfusion were evaluated: the time of ingress, the time of reaching the peak value, the peak value and the area under the curve. After the intervention, as compared with the baseline values there were statistically significant differences by the time of ingress (a 2.4-fold decrease; p<0.0001), the peak value (a 1.8-fold increase; p<0.0001) and the area under the curve (a 2.4-fold increase; p<0.0001). No statistically significant differences were revealed while comparing the time of reaching the peak value before and after the intervention (p=0.767). Trophic defects healed in 11 (73.3%) patients, and in 4 (26.7%) patients the process of healing continued with positive dynamics at the check-up examination. Hence, our first experience of using the assessment of 2D-perfusion demonstrates simplicity of the method with no increase of the radiation load and the dose of the contrast medium. The method makes it possible to obtain important data about the state of microcirculation of the foot in patients with lower limb critical ischaemia, to evaluate alterations after the endovascular intervention. Improvement of the parameters of perfusion is associated with a good clinical outcome.

Numerical modeling of molecular-motor-assisted transport of adenoviral vectors in a spherical cell.

Viral gene delivery in a spherical cell is investigated numerically. The model of intracellular trafficking of adenoviruses is based on molecular-motor-assisted transport equations suggested by Smith and Simmons. These equations are presented in spherical coordinates and extended by accounting for the random component of motion of viral particles bound to filaments. This random component is associated with the stochastic nature of molecular motors responsible for locomotion of viral particles bound to filaments. The equations are solved numerically to simulate viral transport between the cell membrane and cell nucleus during initial stages of viral infection.

[Effect of smoking on gastric mucosa acidity and contamination with Helicobacter pylori in patients with duodenal ulcer]. / Vliianie kureniia na uroven' kislotnosti i stepen' obsemeneniia slizistoi obolochki zheludka H. pylori u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

We have compared acidity level and Helicobacter Pylori contamination rate of the mucous coat of stomach in 50 patients with duodenal ulcer at the age from 17 to 54 y.o., among which were 25 smokers and 25 non-smokers. The period of smoking varied from 5 to 21 years. In the morning Ph-measurements were carried out by means of IAS-2 device based on V. N. Chernobrov's method. We used fibrogastroduodenoscopy technique for verifying a duodenal ulcer and obtaining mucous coat material from antrum and corpus ventriculi to obtain Helicobacter Pylori contamination rate. The acid level of the stomach in the smokers was shown to be reliably lower than in non-smoking patients, what was the cause of higher Helicobacter Pylori contamination rate.

[Operative intervention as a factor provoking the ulcer formation process in patients suffering from chronic gastritis type B]. / Operativnye vmeshatel'stva kak faktor, provotsiruiushchii protsess iazvoobrazovaniia u bol'nykh khronicheskim gastrritom tipa B.

The article presents 27 cases of ulcer formation in the duodenal bulb that occurred in 8.3 +/- 0.13 days after an operative intervention carried out because of the calculous cholecystitis and coccygeal cyst. The chronic gastritis type B has been detected in all the patients in 100% of cases.