DELAYED SURGERY FOR GIANT SPONTANEOUS RUPTURE OF THE DISTAL THORACIC AORTA CAUSED BY CYSTIC MEDIAL NECROSIS.

Spontaneous (idiopathic) thoracic aortic rupture (STAR) is uncommon and assumes a rupture of the normal-sized thoracic aorta with no visually apparent aortic disease. Since 1961 about fifty reports have been published. STAR is established in cases of thoracic normal-sized aorta rupture with no traumas, aneurysms/dissections, infection, inflammation, connective tissue diseases, aortic and adjacent organs tumors/metastases, previous surgery, and occurring during pregnancy and the peripartum. Atherosclerosis penetrated atherosclerotic ulcer, neurofibromatosis type I, peri- and postpartum estrogen-mediated elastin irregularities of the aortic media, and cystic medial necrosis (CMN) were identified as a cause of STAR when histopathological examinations were performed. A case of a 68-year-old man with giant STAR of the descending aorta in the background of CMN is reported here. The patient in terminal hemodynamic condition was successfully treated by delayed open surgery two weeks after the disease's onset.

Effect of visible light onto self-assembly in l-cysteine-silver solution.

Effects of irradiation with visible light on the process of self-assembly in an aqueous l-cysteine-silver solution (CSS) and hydrogels based on were investigated using a set of physico-chemical methods. It was found that the exposure to light of CSS and hydrogels based on l-cysteine and silver acetate colors them firstly into yellow and subsequently to brown, which is due to the plasmon resonance of free electrons at the surface of resulting silver nanoparticles (AgNPs). A mechanism involving participation of AgNPs was proposed for the self-assembly in CSS and hydrogel.

[The effect of probiotics on the secretory immunity of saliva in patients with type 2 diabetes]. / Vliianie probiotikov na sostoianie sekretornogo immuniteta sliuny u bol'nykh sakharnym diabetom 2-go tipa.

AIM: To study the effect of the use of probiotics on the state of mucosal immunity in patients with type 2 diabetes. Evaluation of the results was carried out based on immunological parameters of the saliva of 50 patients suffering from type 2 diabetes with moderate periodontitis, before and 1 month after taking a probiotic complex based on Lactobacillus. In the salivary fluid of patients, a decrease in the concentration of pro-inflammatory cytokines IL-1ß, TNF-α and IL-8 was noted, while an increase in the anti-inflammatory cytokine IL-10 was observed. An increase in local mucosal immunity was also observed, manifested in an increase in the synthesis of secretory immunoglobulin A.

[IMMUNE PARAMETERS OF SALIVA IN PERSONS OF DIFFERENT AGE RESIDING IN ST. PETERSBURG AND LENINGRAD REGION].

The article presents the estimation of indicators of saliva secretory immunity in 109 people of different ages (22-90 years) residing in St. Petersburg and the Leningrad region, with no diseases of the salivary glands. The content in saliva IgA, IgM, IgG and secretory IgA, and pro-inflammatory (IL-1ß, IL-6, IL-8, TNF-α) and anti-inflammatory (IL-1 receptor antagonist, IL-4, IL-10) cytokines was studied by ELISA. The study established that the level of sgA in saliva increases with age, reaching maximum values in a group of elderly people, but content of sIgA in saliva was falling in people of senile age. In patients of elderly and senile age we also observed changes in the content of cytokines in saliva: increased levels of proinflammatory IL-1ß and TNF-α and anti-IL-10, with a simultaneous decrease of IL-8 (the main chemotactic factor for neutrophils). These changes may cause an imbalance in the local immune response to the pathogen and development of both autoimmune and inflammatory diseases of the oral cavity.

[Resection of leiomyosarcoma of the inferior vena cava].

Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report.

Trace rare gases optical emission spectroscopy: nonintrusive method for measuring electron temperatures in low-pressure, low-temperature plasmas.

Trace rare gases optical emission spectroscopy (TRG-OES) is a new, nonintrusive method for determining electron temperatures (T(e)) and, under some conditions, estimating electron densities (n(e)) in low-temperature, low-pressure plasmas. The method is based on a comparison of atomic emission intensities from trace amounts of rare gases (an equimixture of He, Ne, Ar, Kr, and Xe) added to the plasma, with intensities calculated from a model. For Maxwellian electron energy distribution functions (EEDFs), T(e) is determined from the best fit of theory to the experimental measurements. For non-Maxwellian EEDFs, T(e) derived from the best fit describes the high-energy tail of the EEDF. This method was reported previously, and was further developed and successfully applied to several laboratory and commercial plasma reactors. It has also been used in investigations of correlations between high-T(e) and plasma-induced damage to thin gate oxide layers. In this paper, we provide a refined mechanism for the method and include a detailed description of the generation of emission from the Paschen 2p manifold of rare gases both from the ground state and through metastable states, a theoretical model to calculate the number density of metastables (n(m)) of the rare gases, a practical procedure to compute T(e) from the ratios of experimental-to-theoretical intensity ratios, a way to determine the electron density (n(e)), a discussion of the range of sensitivity of TRG-OES to the EEDF, and an estimate of the accuracy of T(e). The values of T(e) obtained by TRG-OES in a transformer-coupled plasma reactor are compared with those obtained with a Langmuir probe for a wide range of pressures and powers. The differences in T(e) from the two methods are explained in terms of the EEDF dependence on pressure.

[A comparative evaluation of myocardial protection based on criteria not associated with the quality of myocardial conservation]. / Sravnitel'naia otsenka metodov miokardial'noi zashchity na osnove kriteriev, ne sviazannykh s kachestvom sokhraneniia miokarda.

Based on the rich clinical material (405 patients), the authors have assessed the most common blood and crystalloid cardioplegic techniques by applying the criteria which do not apply to those of myocardial protection adequacy. Differences have been found between the methods in the volumes of blood loss, the number of patients operated on without utilizing donor blood, terms of aortic occlusion at one-stage operative interventions, recovery of cardiac performance after aortic occlusion. The differences found are essential in choosing the type of cardioplegia by taking into account the individual traits of each surgical intervention and an operating surgeon's opinions.

[Massive arterial air embolism--a complication of heart surgery with extracorporeal circulation (clinical picture, prevention, treatment)]. / Massivnaia arterial'naia vozdushnaia émboliia--oslozhnenie operatsii na serdtse v usloviiakh iskusstvennogo krovoobrashcheniia (klinika, profilaktika, lechenie).

Based on the literature data, the discussion covers the causes, preventive measures, and treatment of massive arterial air embolism, which is one of the most dangerous complications of artificial circulation (AC). Cerebral retroperfusion, hyperbaric oxygenation, low-temperature AC, and long-term administration of antihypoxic agents in the postoperative period have been considered most effective in the management of air embolism. The authors present their experience of successful management of four massive arterial air embolism cases, which is 0.22 percent of AC-assisted operations performed since 1984. Combined retrograde cerebral reperfusion and hypothermic AC have been used in the cases under discussion. Since it is impossible to determine the extent of embolism-associated brain damage and the limits of reliability of the applied therapy, it is essential in each embolism case to make use of all therapeutic means that are available in the given situation to combat this grave complication.

[Surgical correction of multivalvular defects in patients who had earlier undergone heart surgery]. / Khirurgicheskaia korrektsiia mnogoklapannykh porokov u bol'nykh, ranee operirovannykh na serdtse.

The article analyses the results of surgical treatment of 45 patients with multivalvular acquired heart diseases which had been previously treated by operation. Stage III (terminal) circulatory disorders were diagnosed in 11 (24.1%) patients. A pathological condition of the tricuspid valve was found in almost all patients with the terminal stage of circulatory disorders. Eleven (24.4%) patients died after the operation. The most frequent causes of the fatal outcomes were: cardiac failure (in 6 patients) and hemorrhage (in 2 patients during the operation and in 1 patients on the 6th post-operative day; the bleeding occurred from varicose veins of the stomach and esophagus). Severe initial circulatory insufficiency was the main factor of operative risk. The criteria of operability must be elaborated for this contingent of patients suffering from severe cardiac insufficiency on the eve of the operation.