[EMBOLIZATION OF BRONCHIAL ARTERIES IN ACUTE PULMONARY BLEEDING IN CHILDREN].

Children with acute pulmonary bleeding (8 cases) due to different pathology of trancheobronchial tree were followed-up at the period from 2008 to 2014. Diagnostic angiography and X-ray endovascular occlusion of bronchial arteries were performed in the case of insufficiency of conservative and endoscopic methods of hemostasis. Microembolic spheres were used for embolization of distal vessels. The embolization coils and micro-coils were applied for occlusion of great vessels. Children (5 cases) were discharged from the hospital after embolization at the terms of 6-12 months. They hadn't any ischemic complications associated with bronchial artery occlusion. The sequelae of main disease caused deaths of 3 other kids. The X-ray occlusion is a low-invasive and highly effective method of arrest of all types of bleeding from pool of bronchial arteries. The method could be applied even in extremely severe condition of the patients.

[Results of transcatheter closure of the secundum atrial septal defects in children].

Immediate and long-term results of transcatheter closure of defects of interatrial septum (DIAS) with occluder Amplatzer were analyzed. An attempt of transcatheter closure of DIAS was undertaken in 62 children aged from 2 through 17 years (mean age 10.93 +/- 4.57 years), among them there were 19 boys (30%) and 43 girls (70%). Successful implantation of the occluder was fulfilled in 60 patients, but in 2 patients there were failures. Complete occlusion of DIAS by the data of transthoracic echocardiography (TTE) fulfilled immediately after implantation of the occluder was noted in 57 patients (92%), 3 patients had insignificant (1) and small (2) residual flow, in 2 patients--directly through occluder and in 1--along the lower border of the occluder. TTE with Doppler mapping made 24 hour after the procedure has demonstrating the absence of residual flow in 59 patients (98%), including 2 patients out of 3 with a residual shunt immediately after implantation of the occluder. In 1 child there was a negligible shunt left along the lower border of the occluder which disappeared within a month in control TTE. Complications during performing transcatheter closure with DIAS occluder Amplatzer appeared in 3 patients. In 2 patients there was arrhythmia, in 3 patients during implantation of the occluder with diameter 34 mm the right atrial auricle was damaged that required sternotomy and suturing the auricle wound. Long term results were followed up in 40 patients during 1-3 years. None of the patients had residual shunts or erosions of the atrium walls or aorta, or disturbed heart rate.

[Failures and complications of transcatheter coil occlusion of patent ductus arteriosus]. / Neudachi i oslozhneniia chreskateternoi spiral'noi okkliuzii otkrytykh arterial'nykh protokov.

An analysis of fails and complications of transcatheter coil occlusion of patent ductus arteriosus (PDA) was made. An attempt to close PDA with Gianturco coils was undertaken in 132 patients. Fails were noted in 4 (3.1%) children, 3 of them failed to hold the coil in PDA due to its greater width, and in 1 patient the catheter could not be delivered through a narrow duct. Complications were noted in 9 patients (7%): migration of the coils into the pulmonary artery branches took place in 8 patients, and in 1 patient there appeared haemolysis due to a large residual shunt. Snare-assisted removal of the migrating coils was carried out in 7 children, in 1 girl the coil could not be extracted from the peripheral branch of the left pulmonary artery. In 7 patients reocclusion of PDA was made, in 1 case no reembolization was performed. Haemolysis was liquidated by an additional implantation of the coils in repeated procedure. Risk of fail and complications was associated with great minimal diameter of patent ductus arteriosus.

[The potentials of echocardiography in the diagnosis of interatrial communications and in the determination of surgical treatment indices]. / Vozmozhnosti ékhokardiografii v diagnostike mezhpredserdnykh soobshchenii i opredelenii pokazanii k khirurgicheskomu lecheniiu.

The authors have examined 550 patients (210 men and 340 women) with the suspected diagnosis of interatrial communication. The age of the patients was from 4 to 53 years (80% of the patients were 10-20 years of age). An original method of prolonged infusion contrast echocardiography and catheterization of the heart were used in 186 patients. Respiration tests were performed in 88 of them. A great defect of the interatrial septum (DIAS) was diagnosed in 31 patients, 15 patients had small DIAS, 40 patients had potent foramen ovale, 464 patients had functional noise. The prolonged infusion contrast echocardiography allowed the right-left shunt to be detected in all the patients with great DIAS, in 86.7% of the patients with small DIAS and in 87.5% of the patients having potent foramen ovale (false positive result was noted only in 2% of the patients with functional noise). The respiration test in patients with functional noise was (21.4 +/- 4)%, with foramen ovale (20 +/- 8)%, with small DIAS (17 +/- 6)% and with great DIAS (8.3 +/- 3)%. The prolonged infusion contrast echocardiography and the respiration test are though by the authors to be indicated to all patients with the suspected diagnosis of the interatrial communication. They allow making the exact diagnosis, estimating the degree of hemodynamic disturbances and determining indications to surgical treatment.

[Prolonged contrast infusion echocardiography with hydrogen peroxide]. / Prolongirovannaia infuzionnaia kontrastnaia ékhokardiografiia s perekis'iu vodoroda.

A new method of prolonged C-echo-CG with HP implies intravenous administration of 0.3% HP solution for continuous contrasting of right heart chambers for 5-20 minutes. A new technique of C-echo-CG was introduced in 277 patients with innocent cardiac murmur (93), interventricular septal defects (19), interatrial septal defects (26), open oval foramen (42), tricuspid regurgitation (56), pulmonary artery regurgitation (41). Prolonged C-echo-CG with HP was combined with respiratory stress tests. The technique is simple, more effective than short-term C-echo-CG, free of severe side effects and complications.

[The "flickering" phenomenon in the right atrium]. / Fenomen "mel'kaniia" v pravom predserdii.

To specify characteristics and reasons of flickering in the right auricle (FRA) detected at two-dimensional ECG, 278 patients with innocent cardiac murmur (ICM) and 93 patients with congenital heart disease (CHD) underwent clinical and ECG examinations. FRA was found in 34.5% of ICM and 57.0% of CHD patients. Topographic-anatomical, ECG, intraoperative comparative investigations suggested that FRA may result from the eustachian valve movements and fenestration-filament structure of the endocardium at the opening of the inferior vena cava, interatrial septum, coronary sinus valve, base of the atrioventricular cusps. The movement of the eustachian valve was followed through the cardiac cycle. It is thought advisable that FRA characteristics should be taken into consideration for valid understanding of right atrial circulation in normal and CHD conditions.

[Dynamic interaction of membrane transport of cations and biosynthesis in the regulation of animal cell growth. A theoretical model]. / Dinamicheskoe vzaimodeistvie membrannogo transporta kationov i biosinteza v reguliatsii rosta zhivotnykh kletok. Teoreticheskaia model'.

Possibility of direct participation of the cell volume stabilization system in biosynthesis and growth control in animal cells is postulated and theoretically treated in terms of general membraneous cell model. The states of proliferative quiescence or proliferative activity were attributed, respectively, to the states of stability or non-stability of dynamical interactions between ion-dependent volume regulating system and biosynthetic apparatus which controls metabolic renewal and current number of ion transporters. The results showed that in the case of fixed Na+/K+ pumping ratio the cellular steady-state is quite stable. Necessary conditions are described when labialization of Na+/K+ exchange stoichiometry must initiate metabolic instability and cellular growth. The loss of the cell membrane ability to link together different fluxes may thus be accounted for the uncontrolled cellular and tissue growth. Quantitative criteria for the cell growth capacity are obtained depending on the high enough requiring level of transmembrane ion asymmetry and low enough value of intracellular electric potential.

[Reversible amytal-induced depolarization of perfused rat liver cell membranes]. / Obratimaia amital-indutsirovannaia depoliarizatsiia membran kletok perfuziruemoi pecheni krys.

Prompt, completely reversible and deep (to 75%) depolarisation was obtained in perfused rat liver, treated wih amobarbital sodium to 10 mM. Kinetically the main effect developed in a relatively narrow concentration interval 3-4 mM. Administration of amobarbital in 12-15 mM may produce a progressive reduction of membrane potentials to null and positive values followed by a loss of reversibility. One of the possibilities deduced was that of amobarbital unique ability to induce cooperative-like membraneous "conservation", enabling the cells to support their ionic gradients in spite of severe metabolic inhibition.

[Electroosmotic superstability in living cells. Unified model of the morphologically active membrane cell-unit with electrogenic K+, Na+-transport]. / K analizu elektroosmoticheskoi usto=56ichivosti v zhivotnykh kletkakh. Unifitsirovannaia model' morfoligicheski aktivnoi membrannoi oblockhi s electrogennym K+, Na+-transportem.

A mathematical model of electroosmotic homeostasis in mammalian cells is developed. The need for the transmembrane ionic heterogeneity follows the requirement of the system's stability under varying conditions. The quantitative stability criterion is proposed, useful for estimating the physiological state of cells in experiment. The membrane growth in the case of stable cell-units promotes the development of surface invaginations into the internal volume. An invasive metastatic growth suggests the loss of stability.