Cardiomyocyte regeneration in pericicatricial zone of the myocardium after laser tunneling and implantation of bone marrow mononuclear cells.

Using canine model of chronic postinfarction myocardial ischemia we evaluated angiogenesis and cardiomyogenesis after combined revascularization by laser tunneling of the pericicatricial zone followed by implantation of bone marrow mononuclear cells into the channels. It was shown that the numerical density of arterioles and capillaries considerably increased 1 month after revascularization. We also observed a considerable increase in the density of cardiomyocyte nuclei in the test area, a 2-fold increase in the total area of nuclei, and an increase in the mean area of cardiomyocyte nuclei. The number of PNCA-positive cardiomyocytes significantly increased after combined revascularization. Our findings suggest that combined revascularization of the pericicatricial zone of the myocardium promoted angiogenesis and stimulates regeneration of cardiomyocytes.

[The ways of the development of clinical medicine in the XXI century].

The article raises a question of the passion by many doctors for treating the patients with a great number of medicines. Recommendations on the medicine-free therapy are given which include giving up harmful habits and on healthy mode of life.

[State of the hypophyseal-adrenal system during surgical correction of heart defects under various anesthesiological methods and at distant periods after surgery]. / Sostoianie gipofizarno-nadpochechnikovoi sistemy pri khirurgicheskoi korrektsii porokov serdtsa v usloviiakh razlichnogo anesteziologicheskogo obespecheniia i v otdalennye sroki posle operatsii.

The concentration of 11-HOCS in the blood plasma was measured in 278 patients with heart diseases operated on under various anesthesias at different stages of surgical correction of the defects and in the immediate postoperative period. Plasma ACTH level was measured in 137 of these operated on under deep hypothermia and hypothermal perfusion. The hormonal response was the most expressed in patients operated on under normothermia, whereas in patients exposed to hypothermia the reaction was minimal. 141 patients were examined in remote periods after surgery. Blood plasma 11-HOCS level was normal in the cases with good and satisfactory results of surgical treatment, whereas in those with poor results it was higher or lower than normally.

[The state of the hypophyseal-adrenal system during surgical correction of heart diseases under conditions of different anesthesia and in distant periods after surgery]. / Sostoianie gipofizarno-nadpochechnikovoi sistemy pri khirurgicheskoi korrektsii porokov serdtsa v usloviiakh razlichnogo anesteziologicheskogo obespecheniia i v otdalennye sroki posle operatsii.

Blood plasma levels of 11-HOCS were measured in 278 patients with heart diseases operated on under different anesthesia at various stages of surgical correction of the diseases and during the immediate postoperative period. Blood plasma ACTH levels were measured in 137 patients operated on under deep hypothermal protection and hypothermal perfusion. The most manifest hormonal response was observed during surgery under normothermia, whereas under conditions of hypothermal perfusion the reaction to intervention was the minimal. A total of 141 patients were examined in remote periods after surgery. Blood plasma 11-HOCS levels were normal in patients with good and satisfactory results of surgical treatment and increased for decreased in those with unsatisfactory results.

[Hormonal regulation during cardiac surgery operations on the "dry" heart]. / Sostoianie gormonal'noi reguliatsii pri kardiokhirurgicheskikh operatsiiakh v usloviiakh "sukhogo" serdtsa.

Central and peripheral compartments of hypophyseo-adrenal regulation, the state of renin-angiotensin-aldosterone system (RAAS) and thyroid-stimulating functions of hypophysis have been assessed in 72 patients with heart valve defects operated under profound hypothermal perfusion. It has been established that cardiopulmonary bypass surgery with profound hypothermia is accompanied by moderate and reversible changes in the above parameters. The activity of hypophyseo-adrenal system and RAAS reaches the maximum during a warming-up period and then gradually decreases. TSH content considerably decreases in the early postoperative period. Cardiopulmonary bypass surgery with profound hypothermia causes more pronounced changes in neurohormonal regulation than heart valve correction under hypothermal perfusion, which might be associated with blood flow arrest in major vessels causing changes in peripheral metabolic processes.