[Study of the influence of etoxidol on expression of follistatin-like protein-1 (FSTL-1) in myocardium after experimental infarction in rats]. / Issledovanie vliianiia étoksidola na ékspressiiu follistatin-podobnogo belka-1 (FSTL-1) v miokarde posle éksperimental'nogo infarkta.

In heart attack, FSTL-1 is actively secreted by cardiomyocytes, accelerates growth of heart myofibrils and stimulates of vascular endothelial growth factor expression. The aim of this work was to investigate the effect of Etoxidol on synthesis of FSTL-1 in rats after myocardial infarction. The experiments were performed on Wistar rats weighing 250-350 g with simulated myocardial infarction or intact (group 5). Animals of control groups (groups 1, 2) were treated with saline for 7 and 14 days; Ethoxidol (24 mg/kg) was injected to animals of experimental groups (group 3, 4) (the daily dose was 6.36 mg/animal) for 6 or 14 days. The injection volume was 0.2 ml. At the beginning and at the end of the study plasma concentrations of FSTL-1 were determined by the ELISA method. Myocardial FSTL-1 gene expression was determined by real-time PCR. At the end of the experiments, the hearts were also used for histochemical analysis. To determine the size of the scar formed after the modeled heart attack, we used the classic Mallory staining method. The results show that the development of experimental acute myocardial infarction is accompanied by a significant increase in FSTL-1 expression in the heart, which was detected on the 7th day and stored increased by 14 days after a heart attack. After therapy with Ethoxidol, a tendency to a decrease in the expression of FSTL-1 by the 14th day was observed; it coincided with the dynamics of the plasma protein FSTL-1 level. It can be assumed that the downregulation trend in the FSTL-1 expression is associated with a more effective repair process after a heart attack, since FSTL-1 increases precisely in response to myocardial damage and decreases when the incentives for its expression from damaged heart tissue are reduced. Indirectly, this assumption is confirmed by the detected tendency to reduce the size of post-infarction fibrosis in the treatment with Ethoxidol. The results indicate the ability of Ethoxidol to influence FSTL-1 synthesis of in rats after myocardial infarction.

[Carboxytherapy - an innovative trend in resort medicine]. / Karboksiterapiia - odno iz innovatsionnykh napravlenii v kurortologii.

Carboxytherapy (the treatment based on carbon dioxide injections) is a multipurpose and widely used medical technology. The use of CO2 injections (intracutaneous, subcutaneous, and pneumopuncture) have substantially supplemented and increased the practical relevance of carboxytherapy as a method for the treatment of many diseases. Thanks to it physiological properties, CO2 has antihypoxic, antioxidant, vasodilatory, anti-inflammatory, analgesic, and spasmolytic activities; moreover, it improves blood viscosity, stimulates neoangiogenesis, and regenerative processes. Carbon dioxide is a sort of biochemical 'peacemaker' in tissue oxygenation: when blood cells are exposed to high CO2 concentrations (Bohr effect), the rate of gas exchange (CO2 and O2) increases. The human organism interprets carboxytherapy (local hypercapnia) as oxygen deficiency and responses to it by boosting not only the blood flow, but also the vascular endothelial growth factor which stimulates neoangiogenesis and in the long run improves blood supply and tissue trophism. The multiple mechanisms of action, polymodal efficacy, a tool kit with a wide range of detectors and various modes of treatment make carboxytherapy a popular medical technology all over the world, namely in cosmetology, dermatology, aesthetic medicine, angiology, orthopaedics, cardiology, neurology, pulmonology, gynaecology, urology, proctology, plastic and general surgery, and other areas. Carboxytherapy provides a perfect example of the off-label usage in medicine that made it one of the most extensively applied medical technology for the treatment of various diseases despite the lack of the preclinical data and scarce relevant information available in textbooks, reference books and booklets.

[Robot-assisted atrial septal defect closure in adults: first experience in Russia]. / Robot-assistirovannoe zakrytie defekta mezhpredserdnoi peregorodki u vzroslykh: pervyi opyt v Rossii.

AIM: To analyze immediate results of minimally invasive robot-assisted atrial septal defect (ASD) closure in adults. MATERIAL AND METHODS: For the period from March 2012 to November 2016 sixty patients with contraindications to endovascular procedure have undergone robot-assisted atrial septal defect closure at Meshalkin Siberian Federal Biomedical Research Center. Mean age was 34.5±11.3 years, body mass index - 24.6±4.0 kg/m2. 48 (80%) patients had NYHA class II before surgery. In 37 (61.7%) patients isolated ASD with deficiency or absence of one edge was diagnosed, isolated ASD with primary septum aneurysm - in 16 (26.7%) cases, 7 (11.6%) patients had reticulate ASD. 5 (8.3%) patients had concomitant tricuspid valve insufficiency required surgical repair (suture annuloplasty). All operations were performed under cardiopulmonary bypass with peripheral cannulation. Right-sided anterolateral mini-thoracotomy was used in the first 43 patients. Following 17 patients underwent completely endoscopic procedure. Depending on the shape, size and anatomical features of the defect we performed suturing (14 patients, 23.3%) or repair with xenopericardial patch (46%, 76.6%). RESULTS: Mean CPB and aortic cross-clamping time was 89.1±28.7 and 24.8±9.5 min, respectively. Postoperative variables: mechanical ventilation 3.3±1.5 hours, ICU-stay - 18.2±3.7 hours, postoperative hospital-stay - 13.4±5.7 days. There were no mortality and any life-threatening intra- and postoperative complications. Cases of conversion to thoraco-/sternotomy and postoperative bleeding followed by redo surgery were also absent. 23 patients were followed-up within 1 year, 6 patients - within 2 years, 3 patients - within 3 years. All patients were in NYHA class I-II with 100% freedom from ASD recanalization and redo surgery. According to echocardiography data there were decreased right heart, pulmonary artery pressure and preserved left ventricular function in early postoperative period and 1 year after surgery. CONCLUSION: In view of favorable course of postoperative period, no significant specific complications and encouraging immediate results we can talk about endoscopic robot-assisted ASD closure in adults as a safe and effective alternative to surgical treatment.

Outcomes of the Ross procedure in patients with an accompanying ascending aortic aneurysm.

Analysed in the article are the results of the Ross procedure in patients presenting with dilatation of the ascending portion of the aorta. A combination of aortic valve defects with dilatation of the ascending aorta of more than 45 mm supposes simultaneous prosthetic repair of the aortic valve and ascending aorta. The most common surgical procedure remains the Bentall-DeBono operation whose main disadvantage is associated with implantation of a mechanical prosthesis and the necessity of lifelong anticoagulant therapy. An alternative method is the Ross procedure demonstrating low risk of thromboembolic complications and freedom from anticoagulant therapy. Over the period from 2002 to April 2015, specialists of the Novosibirsk Scientific Research Institute of Circulatory Pathology named after Academician E.N. Meshalkin carried out a total of 162 Ross procedures in patients presenting with accompanying dilatation of the ascending aorta (more than 45 mm). The mean diameter of the aorta at the level of Valsalva sinuses amounted to 45.6±8.6 mm, with that of the ascending aortic portion equalling 53.4±7.8 mm. The technique of total replacement of the aortic root was used in all cases. When the aneurysm extended to distal portions of the ascending aorta, additionally performed were the following procedures: in 24 patients--reduction aortoplasty, in 6 patients--replacement of the resected aorta with an insert from xenopericardium, and in 2 patients with a vascular graft. The average duration of follow up amounted to 40.1±21.6 months. Ten patients were subjected to repeat operations for autograft dysfunction. There were no reoperations on the ascending portion of the aorta. The regression analysis revealed that predictors of the development of autograft dysfunction were the baseline dilatation of the fibrous ring (FR) of the aortic valve of more than 27 mm (p=0.04) and uncorrected arterial hypertension in the postoperative period (p=0.03). In the group of patients with the FR less than 27 mm there were no cases of allograft dysfunction. The results of the study suggest that the Ross procedure is a safe and effective method in patients with accompanying dilatation of the ascending aorta. Risk factors for autograft dysfunction are dilatation of the FR of the aortic valve exceeding 27 mm and arterial hypertension in the postoperative period.

Precision measurements of the np scattering differential cross section in the intermediate energy region.

In fast neutron cancer therapy, approximately 50% of the cell damage is caused by recoil protons from neutron-proton (np) scattering. In the intermediate energy region, there is a need for unambiguous np scattering data with good precision in both the shape of the angular distribution and the absolute normalisation. The normalisation techniques have been reviewed for np scattering measurements as well as recent experimental results, particularly the data obtained at The Svedberg Laboratory at 96 and 162 MeV. In addition, to what extent systematic uncertainties in the np differential cross section might affect the determination of proton recoil kerma coefficients is investigated.

Kerma coefficients for neutron scattering on 12C and 16O at 96 MeV.

Recently, many new applications of fast neutrons are emerging or under development, like dose effects due to cosmic ray neutrons for airplane crew, fast neutron cancer therapy, studies of electronics failure induced by cosmic ray neutrons and accelerator-driven incineration of nuclear waste and energy production technologies. In radiation treatment, the kerma (Kinetic energy release in matter) coefficient, which describes the average energy transferred from neutrons to charged particles, is widely used. The kerma coefficient can be calculated from microscopic nuclear data. Nuclear data above 20 MeV are rather scarce, and more complete nuclear data libraries are needed in order to improve the understanding of the processes occurring on a cellular level. About half the dose in human tissue due to fast neutrons comes from proton recoils in neutron-proton (np) scattering, 10-15% from nuclear recoils due to elastic and inelastic neutron scattering and the remaining 35-40% from neutron-induced emission of light ions. Experimental data on elastic and inelastic neutron scattering at 96 MeV from (12)C and (16)O have been obtained recently at The Svedberg Laboratory in Uppsala, Sweden. These data are shown to be relevant for the determination of nuclear recoil kerma coefficients from elastic and inelastic neutron scattering at intermediate energies.

Elastic neutron scattering studies at 96 MeV for transmutation.

Elastic neutron scattering from (12)C, (14)N, (16)O, (28)Si, (40)Ca, (56)Fe, (89)Y and (208)Pb has been studied at 96 MeV in the10-70 degrees interval, using the SCANDAL (SCAttered Nucleon Detection AssembLy) facility. The results for (12)C and (208)Pb have recently been published, while the data on the other nuclei are under analysis. The achieved energy resolution, 3.7 MeV, is about an order of magnitude better than for any previous experiment above 65 MeV incident energy. A novel method for normalisation of the absolute scale of the cross section has been used. The estimated normalisation uncertainty, 3%, is unprecedented for a neutron-induced differential cross section measurement on a nuclear target. Elastic neutron scattering is of utmost importance for a vast number of applications. Besides its fundamental importance as a laboratory for tests of isospin dependence in the nucleon-nucleon, and nucleon-nucleus, interaction, knowledge of the optical potentials derived from elastic scattering come into play in virtually every application where a detailed understanding of nuclear processes is important. Applications for these measurements are dose effects due to fast neutrons, including fast neutron therapy, as well as nuclear waste incineration and single event upsets in electronics. The results at light nuclei of medical relevance ((12)C, (14)N and (16)O) are presented separately. In the present contribution, results on the heavier nuclei are presented, among which several are of relevance to shielding of fast neutrons.

Light charged-particle production in 96 MeV neutron-induced reactions on carbon and oxygen.

In recent years, an increasing number of applications involving fast neutrons have been developed or are under consideration, e.g. radiation treatment of cancer, neutron dosimetry at commercial aircraft altitudes, soft-error effects in computer memories, accelerator-driven transmutation of nuclear waste and energy production and determination of the response of neutron detectors. Data on light-ion production in light nuclei such as carbon, nitrogen and oxygen are particularly important in calculations of dose distributions in human tissue for radiation therapy at neutron beams, and for dosimetry of high-energy neutrons produced by high-energy cosmic radiation interacting with nuclei (nitrogen and oxygen) in the atmosphere. When studying neutron dose effects, it is especially important to consider carbon and oxygen, since they are, by weight, the most abundant elements in human tissue. Preliminary experimental double-differential cross sections of inclusive light-ion (p, d, t, (3)He and alpha) production in carbon induced by 96-MeV neutrons have been presented. Energy spectra were measured at eight laboratory angles: 20, 40, 60, 80, 100, 120, 140 and 160 degrees. Measurements were performed at The Svedberg Laboratory (TSL), Uppsala, using the dedicated MEDLEY experimental setup. The authors have earlier reported experimental double-differential cross sections of inclusive light-ion production in oxygen. In this paper, the deduced kerma coefficients for oxygen has been presented and compared with reaction model calculations.

[Contemporary aspects of aviation ophthalmic ergonomics]. / Sevremennye aspekty aviatsionnoi oftal'moérgonomiki.

The article tackle problems of ophthalmic ergonomics in contemporary aviation. The authors necessitate PC software to be put into practice of medical examination in pilots, stress efficacy of photorefraction surgery for vision rehabilitation and better occupational adequacy of pilots.