[Transradial approach during percutaneous coronary interventions. Part 2. Practical guidelines and the authors' data].

The paper describes the technical features of a transradial approach; indications and patient selection for this arterial approach; and stepwise patient preparation. It depicts the anatomic variants of the origin of the radial artery, which affect the success of this approach. The suitable instruments for this approach are described. The authors give their results of the performed study comparing different types of approaches.

[No-reflow phenomenon in the practice of an endovascular surgeon].

No-reflow phenomenon is a complication of percutaneous coronary intervention and is the absence of distal coronary bed filling. The main cause of this phenomenon is distal embolism of the coronary artery by atheromatous and thrombotic masses. The paper gives different classifications for evaluation of myocardial and coronary reperfusion. The use of aspiration catheters, glycoprotein IIb/IIIa receptor inhibitors and other drugs that affect prognosis in patients with this phenomenon is also touched upon.

[Transradial approach during percutaneous coronary interventions. Part 1. Evidence base for applying a transradial approach].

The use of the radial artery as an approach to percutaneous coronary interventions is becoming increasing popular now. The success of this approach depends on both the accumulated experience of an operator and a health care facility. The paper analyzes an investigation of the comparative characteristics of both a transradial approach and a transfemoral one and the impact of the former on the success of the procedure. It considers the role of the transradial approach in the present-day practice of X-ray endovascular diagnosis and treatment specialists and discusses the problems of education and choice of optimal clinical indications.

[Embolization of mammary artery branches after mammary artery bypass surgery].

Even after performed mammary artery bypass surgery, some patients continued to have clinical manifestations of angina pectoris. This may be associated with the development of coronary stealing syndrome due to the fact that the native intrathoracic artery has large lateral branches. Current methods for embolization of arteries of different diameters make it possible to accomplish this task reasonably safely and in full measure. This paper describes a clinical case of reembolization of the lateral branch of a mammary artery shunt with an intravascular coil.

[Endovascular treatment for chronic coronary occlusions in patients with coronary heart disease].

OBJECTIVE: To analyze the angiographic results of endovascular treatment for chronic coronary occlusions in patients with coronary heart disease. MATERIAL AND METHODS: In 2009 to 2013 attempted endovascu-ar recanalization of chronic coronary occlusions in 854 patients with coronary heart disease. The patients' age ranged from3 6 to 68 years (mean 52 years). The estimated du-ation of occlusion was m1 onth to more than 3 years. There were 193 (22.6%) females and 661 (77.4%) males. 462 (54.1%) patients had a history of myocardial infarction. 738 (86.4%) and 116 (13.6%) patients had true (TIMI grade 0) and functional (TIMI grade i1 occlusions, respectively. Multi- and univascular lesions were found in 683 (79.9%) and 171 (20.1%) patients, respectively. Silent occlusions with preserved myocardial contractility were identified in 165 (19.3%) patients. RRESULTS:Blood flow could be successfully restored in 616 (72.1%) patients. Recanalization of chronic coronary occlusion failed in 238 (27.9%) patients. CCONCLUSION:Recanalization of chronic coronary occlusions is a highly effective and relatively safe technique. The efficiency of the procedure largely depends on the duration of occlusion, its X-ray morphological characteristics, and the experience of a physician.

[Advantages and disadvantages of embolic protective devices during carotid stenting].

Currently carotid stenting becomes an increasingly reliable alternative to carotid endarterectomy. But both of these treatment options do not save a patient from embolism. If there is none embolic protective device, the plaque may break off while inserting a guide or making another manipulation during stenting or angioplasty. This paper describes different embolic protective devices during endovascular treatment for carotid arteries.

[Nonpharmacological methods of prevention of thromboembolic complications in patients with atrial fibrillation].

We present in this review modern methods of prevention of thromboembolic complications in patients with atrial fibrillation and give comparative description of evidence base, efficacy and safety of available techniques.

[Clinical results of the use of new bioengineering technologies (endothelial precursor cell-capturing stents) in the treatment of coronary heart disease].

OBJECTIVE: to study the long-term results of the use of precursor cell-capturing stents (bioengineering stents) and to analyze the factors influencing late prognosis. SUBJECTS AND METHODS: The study included 447 coronary heart disease patients with primary atherosclerotic lesion in the coronary bed, damage to aortocoronary shunts, and restenosis of a previously implanted stent. The clinical and morphological risk factors for stent restenosis and late stent thrombosis were analyzed during a 2-year follow-up. RESULTS: In the first year of the follow-up, there were no fatal outcomes, evolving myocardial infarction was observed in 2.6% of cases; recurrent angina pectoris was noted in 10.7%. No late stent thromboses were identified; the incidence of stent restenosis was 8.3%. The risk of restenosis was significantly increased after interventions on arteries less than 2.75 mm in diameter and extended lesions. During the 2-year follow-up, 2 (0.4%) patients died; 14 (1.4%) patients experienced transmural myocardial infarction; 35 (3.3%) patients had non-Q wave myocardial infarction. Forty-four (9.8%) and 15 (1.5%) patients underwent repeated endovascular revascularization and coronary artery bypass grafting, respectively. Late stent thromboses were absent; the incidence of restenosis was 11.7%. CONCLUSION: Within the 2-year follow-up after implantation of bioengineering stents, recurrent angina was seen in 14.8% of the patients, which required repeated endovascular interventions in 9.8% of cases and coronary artery bypass surgery in 1.5% of cases. The incidence of bioengineering stent restenosis was 11.7%; no late thrombotic events were found. The risk factors for bioengineering stent restenosis were extended lesions and small-diameter vessel interventions.

[Efficiency of endovascular re-interventions for evolving restenosis of different types of stents].

The paper compares the results of different treatment options (balloon angioplasty and restenting) for in-stent restenosis in case of evolving restenosis of drug- and nondrug eluting stents. The investigation enrolled 496 coronary heart disease patients with clinical presentation of angina pectoris and/or signs of myocardial ischemia, as well as hemodynamic restenosis of a previously implanted stent. Of them, 216 and 280 patients had restenosis of previously implanted drug- and nondrug-eluting stents, respectively. In the patients with non-drug-eluting stent restenosis, recurrent angina pectoris and the frequency of repeated restenosis were significantly more frequently observed after balloon dilatation than after drug-eluting stent implantation (28.4 and 10.2%; p < 0.05; 19.9 and 8.7%; p < 0.05). In those with drug-eluting stent restenosis, recurrent angina pectoris and the frequency of repeated restenosis did not differ significantly between balloon dilatation of restenosis and implantation of a second drug-eluting stent.

[Surveillance measures at joint-stock company "Poultry Farm Lubinskaya" during the period of avian flu epizootia in Omsk region].

The organization of sanitary-and-epidemiologic supervision of an integrated poultry farm during epizootia of avian flu is devoted. The unsuccessful situation demands acceptance of additional measures which provided performance antiepizootic, preventive and antiepidemic measures with a view of restriction and distribution of an infection on poultry-farming enterprise. The disinfection barriers of several levels are established. Are organized a sanitary filtrates for the personnel and regular medical supervision over workers of the enterprise and their families. It is carried out the serological control over presence of specific antibodies to a virus of influenza virus among the workers contacting to a bird. Monitoring research of tests of blood of birds on antibodies to the influenza virus was carried out since August, 2005.

[Specific features of protease and antiprotease activity of blood in women with external endometriosis].

32 healthy fertile women (control group) and 94 women with different-severity external endometriosis (EE) were examined. The activity of cathepsin D, plasminogen, AT-III, protein C, acid alpha1-antitrypsin as well as the parameters of antiprothrombin, thrombin and prothrombin time were investigated in serum of venous blood. In EE, the below parameters were found to be essentially increased: thrombin time--35.69 +/- 5.77 sec (controls--20.2 +/- 0.8 sec, p < 0.05), prothrombin time--30.43 +/- 7.21 sec (controls--21.6 +/- 0.8, p < 0.05), concentration of alpha2 macroglobulin--489.3 +/- 39.71 mg/dl (controls--240.2 +/- 12.2 mg/dl, p < 0.001), and AT-III activity--127.37 +/- 7.13% (controls--98.2 +/- 2.56, p < 0.001); at the same time, the parameters of plasmin were decreased--108.00 +/- 5.28% (controls--169 +/- 18%, p < 0.01).

[Medium weight molecules in patients with external genital endometriosis]. / Molekuly srednei massy u bol'nykh naruzhnym genital'nym éndometriozom.

One hundred and fifty-three women with external genital endometriosis (EM), stages 1-4, and 30 healthy fertile women were examined. The peripheral-blood serum and daily urine were tested with the level of the mean weight molecules (MWM) being determined spectrophotometrically at lambda = 230-300 nm. The minimal MWM concentrations were detected in blood in cases of the stage-1 endometrioid process; they were significantly lower versus those observed in the healthy women at the maximal urine concentrations, i.e. well above the normal value. An increasing MWM blood content is registered in stages 2-4 EM, which exceeds the normal figure, whereas MWM was minimal in urine in stage 2, it was progressively increasing later but did not reach the value of stage 1. The external EM was associated with an enhanced MWM formation; it is noteworthy, that their concentrations in blood serum directly correlated with a stage of the endometrioid process. A reliably lower MWM level in stage 1 EM is below the normal value, while its maximal increase in urine could be regarded as a compensation-adaptation reaction aimed at removing the toxic substances from the body. A reduced MWM discharge with urine and its growth in blood plasma were observed in further progressing of the endometrioid process, which is preconditioned by the toxic impact of MWM exerted on the nephron.

[Magnesium and calcium ion levels in peritoneal fluid of healthy fertile women]. / Kontsentratsiia ionov magniia i kal'tsiia v peritoneal'noi zhidkosti u zdorovykh fertil'nykh zhenshchin.

The purpose of this study was to establish normal values of Ca2+ and Mg2+ ions in the peritoneal fluid (PF) of fertile women. PF was aspirated during laparoscopy in 19 women subjected for surgical sterilization for social reasons. The concentrations of Ca2+ and Mg2+ in PF were normal. In fertile women the peritoneal concentrations of these ions do not depend on serum concentrations. Normal range of Ca2+ concentration in PF is 0.9-1.28 mmol/liter, that of Mg2+ 0.4-0.57 mmol/liter. In genital diseases the concentrations of Mg2+ are changed in 78.8% cases and those of Ca2+ in 45.8% cases.

The role of lysosomes in the pathogenesis of unicameral bone cysts.

Unicameral bone cyst fluid possesses N-acetyl-beta-D-glucosaminidase, beta-glucuronidase, PZ-peptidase, cathepsin D, acid phosphatase, N-acetyl-beta-D galactosaminidase, and beta-galactosidase activities. The activities of lysosomal enzymes in the cyst fluid are, as a rule, higher than in the serum, whereas the total protein content is lower. The content of collagen degradation products in the cyst fluid is higher compared to the serum. In bone cavity wall tissues, the collagen content is decreased. Adenosine 3':5'-cyclic phosphate and cyclic guanosine 3,5'-monophosphate accumulate in the cyst cavity. However, in some cases, there is no correlation among the activities of lysosomal enzymes in the cyst fluid, blood serum, and cyst wall tissues. The ratios of lysosomal enzyme activities in the cyst fluid differ from those in the cyst wall tissues, cultured skin fibroblasts, and blood polymorphonuclear leucocytes. The lack of coincidence of enzymatic spectra of the cyst fluid, wall tissues, and serum is suggestive of the diversity of ways of lysosomal enzyme enter the cyst cavity, i.e., blood, cyst fluid cells, and cyst cavity walls. The cysts with different locations (i.e., active and latent cysts) have similar lysosomal lytic potentials. The presence in the cyst cavity of extracellular lysosomal enzymes and collagen degradation products testifies to the permanent corrosion of the cyst cavity walls from the inside as well as to the increase in the osmotic pressure of the cyst fluid. Lysosome destruction should be regarded as an important pathogenetic factor that requires surgical or pharmacologic correction or both in the course of bone cyst management.

[The role of antioxidants in the action of thyroxine on myocardial functional properties in rats]. / Rol' antioksidantov v deistvii tiroksina na funktsional'nye svoistva miokarda u krys.

In conditions of excessive hormones in the blood, alpha-tocopherol increases the cardiomyocytes antioxidant defence, partially prevents the enhancement of the heart tissue sensitivity to induced peroxide oxidation of lipids, and considerably diminishes disorders in the heart contractile function. Under the same conditions, reduced glutathione no only does not exert its defensive action, but even decreases the heart resistance against hypoxia.

[Relation of the outcome of disk epiphysectomy in dysplastic scoliosis and the biochemical composition of the vertebral body]. / Zavisimost' iskhoda disképifizéktomii pri displasticheskom skolioze ot biokhimicheskogo sostava tela pozvonka.

Pronounced changes in the content of collagen, non-collagen proteins and the activity of a number of lysosomic enzymes have been established in the bone tissue of the vertebral bodies obtained on diskepiphysectomy in the patients with dysplastic scoliosis. Numerous correlation links between the metabolic parameters and the spinal deformation a year after diskepiphysectomy have been determined.