[Prediction of myocardial contractility after coronary bypass surgery according to preoperative contrast-enhanced magnetic resonance imaging and echocardiography]. / Prognozirovanie dinamiki sokratitel'noi funktsii miokarda u patsientov posle koronarnogo shuntirovaniya po dannym predoperatsionnykh magnitno-rezonansnoi tomografii serdtsa s kontrastnym usileniem i ekhokardiografii.

OBJECTIVE: To establish the criteria for reversibility of myocardial contractility in patients with coronary artery disease (CAD) after coronary artery bypass grafting considering data of cardiac magnetic resonance imaging (MRI) and echocardiography. MATERIAL AND METHODS: We studied the results of coronary artery bypass grafting in 186 patients with CAD complicated by reduced left ventricular ejection fraction (<30%). All patients underwent cardiac MRI and echocardiography before surgery. Immediate and long-term results were evaluated according to echocardiography and MRI data. RESULTS: We confirmed the previously established predictors of improvement in left ventricular contractility: diastolic IVST ≥10.5 mm and PWT ≥9.5 mm, score of LV myocardium damage according to MRI with delayed contrast enhancement (p<0.05). Multivariate analysis makes it possible to calculate prognostic index and obtain information about further myocardial contractility after revascularization with an error of 6%. CONCLUSION: Echocardiography and contrast-enhanced cardiac MRI are valuable to assess morphological and functional state of the left ventricle in patients with ischemic cardiomyopathy and preoperatively determine functional reserve of the myocardium.

[Status epilepticus in a pregnant patient with a previously unrecognized POLG-associated disease]. / Epilepticheskii status u beremennoi patsientki s vpervye vyyavlennym POLG-assotsiirovannym zabolevaniem.

POLG-associated diseases are rare causes of pharmacoresistant epilepsy and status epilepticus, especially in adult patients. Phenotypic and genotypic variability in these conditions causes the complexity of their diagnosis. In the study, we report a case of a 33-year-old female patient who developed recurrent convulsive status epilepticus with focal clonic onset at the week 22/23 of pregnancy. Intensive anti-seizure therapy was administered, including the use of valproic acid, as well as the treatment of somatic complications. Given the acute onset, the semiology of seizures, the presence of psychopathological symptoms, autoimmune etiology of the disease was initially suspected. A month after the withdrawal of valproic acid, the patient began to show signs of toxic hepatitis, which eventually led to death. According to the results of whole-exome sequencing obtained later, the patient was a carrier of a pathogenic homozygous variant c.2243G>C (p.W748S) in the POLG gene. The presented case highlights the importance of molecular genetic testing and the risk associated with valproic acid hepatotoxicity in patients with cryptogenic epileptic status.

Ground-State g Factor of Highly Charged

A method is proposed to determine the M1 nuclear transition amplitude and hence the lifetime of the "nuclear clock transition" between the low-lying (∼8 eV) first isomeric state and the ground state of ^{229}Th from a measurement of the ground-state g factor of few-electron ^{229}Th ions. As a tool, the effect of nuclear hyperfine mixing in highly charged ^{229}Th ions such as ^{229}Th^{89+} or ^{229}Th^{87+} is used. The ground-state-only g-factor measurement would also provide first experimental evidence of nuclear hyperfine mixing in atomic ions. Combining the measurements for H-, Li-, and B-like ^{229}Th ions has a potential to improve the initial result for a single charge state and to determine the nuclear magnetic moment to a higher accuracy than that of the currently accepted value. The calculations include relativistic, interelectronic-interaction, QED, and nuclear effects.

Anthropogenic emissions from the combustion of composite coal-based fuels.

Composite fuels made of waste from coal, petroleum and wood processing industries have a high environmental and economic potential. In this research, we experimentally studied the concentrations of the most hazardous gaseous anthropogenic emissions (CO2, SO2, NO) from waste-based fuel combustion. Using two techniques operating in complementary temperature ranges, we obtained data on SO2 and NO emissions in the temperature range from 300 °C to 1000°C, including all the stages of thermochemical conversion of fuels. A quasi-stationary technique was used, based on a setup of thermogravimetric analysis with mass spectrometry, to obtain information in a low-temperature range (300-600°C). This technique allows the conversion at a low controlled rate of heating a sample together with the furnace. To obtain data in a high-temperature range (700-1000°C), a non-stationary technique was used, where the sample was introduced into a pre-heated furnace. The conditions were established in which it was possible to reduce the concentration of flue gases from the combustion of the compositions under study (replacement of the coal part with water, injection of water vapor, addition of biomass, selection of the temperature range). The impact of water vapors was determined when they were injected into the chemical reaction zone together with air and when they were formed naturally by evaporation from the fuel sample. Unlike biomass that reduces the emissions of sulfur oxides from composite fuels due to the mechanical dilution of the mixture, water vapor present in the heterogeneous reaction zone decreases the gaseous anthropogenic emissions through chemical reactions and conversion of a part of fuel sulfur and nitrogen to an inactive form (neutral to the environment).

[Clinical significance of different assesment methods of myocardial fibrosis in patients with hypertrophic cardiomyopathy.]

Objective To evaluate prospects for clinical use of circulating biomarkers for characterizing fibrotic changes in the myocardium of patients with hypertrophic cardiomyopathy (HCMP) with left ventricular (LV) outflow tract obstruction.Materials and Methods This was a prospective study with a 12-month follow-up period. The study included 47 patients (29 females and 18 males) with obstructive HCMP who were selected for septal reduction. Echocardiography (EchoCG), cardiac magnetic resonance imaging (MRI) and measurements of serum C-reactive protein, N-terminal pro-brain natriuretic peptide, and relevant circulating markers of fibrosis (TGF-ß1, MMP-2,-9, TIMP-1, galectin-3, sST2, CITP, PICP, and PIIINP) were performed for all patients. All patients were evaluated at baseline and at 7 days, 6 and 12 months following surgical treatment. Morphometrical analysis of intraoperative biopsy samples was performed for evaluation of the degree of fibrotic changes. Patients received beta-blockers (95.7%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (34%), loop diuretics (68.1%), aldosterone antagonists (34%), and statins (66%).Results Women with HCMP were older and more frequently had additional risk factors (arterial hypertension). Men had a higher risk of sudden cardiac death. Histological study of intraoperative myocardial biopsy samples showed that the area of fibrotic changes was 13.9±6.9%. According to cardiac MRI mean area of delayed contrast enhancement was 8.7±3.3% of LV myocardial mass. No association was established between traditional cardiovascular risk factors and severity of myocardial fibrotic changes or levels of circulating fibrosis markers. Perhaps that was due to the modifying effect of the drug therapy received by HCMP patients. According to EchoCG maximum pressure gradient in the LV outflow tract before the surgical treatment was 88 (55; 192) mm Hg, and interventricular septal thickness was 22 (16; 32) mm. A considerable decrease (p=0.0002) in the LV outflow tract gradient was observed after myectomy in all patients. At the same time, the left ventricular dimension, which tended to decrease in the early postoperative period, returned to baseline values by the 6th month of follow-up.Conclusion The study confirmed the increase in relevant circulating markers of fibrosis in patients with obstructive HCMP. At the same time, no correlation was observed between levels of circulating biomarkers and severity of fibrosis according to data of histology and cardiac MRI, which was probably due to the modifying effect of drug therapy and limited sampling.

Perspectives of using pulmonary arterial stiffness indicators to evaluate the prognosis of patients with pulmonary arterial hypertension.

AIM: The aim of the study was to characterize the mechanical properties of the pulmonary arterial wall (PA) in patients with pulmonary arterial hypertension (PAH) using magnetic resonance imaging (MRI) of the heart, and to determine their diagnostic and prognostic value. MATERIALS AND METHODS: 57 patients with PAH were examined. The diagnosis of PAH was verified according to the recommendations of the ERS/ESC from 2015. All patients underwent a detailed echocardiographic (ECHO) study, MRI of the heart and right heart catheterization (RHC). To calculate the stiffness of the pulmonary artery wall, the MRI and RHC data were used. RESULTS: We identified a correlation between the functional class of PAH and the parameters of hemodynamic, physical performance, ECHO parameters of the right chambers. There were no differences in the stiffness of the pulmonary artery wall, depending on the functional class of PAH. Among the six stiffness indicators, only pulsation index was associated with the structural and functional parameters of the right ventricle and pulmonary vascular resistance. CONCLUSION: The MRI pulsation index is the simpleststiffness index of the pulmonary artery wall and the most promising one for evaluating the prognosis of patients with PAH.

[Perspectives of using pulmonary arterial stiffness indicators to evaluate the prognosis of patients with pulmonary arterial hypertension].

OBJECTIVE: the aim of the study was to characterize the mechanical properties of the pulmonary arterial wall (PA) in patients with pulmonary arterial hypertension (PAH) using magnetic resonance imaging (MRI) of the heart, and to determine their diagnostic and prognostic value. MATERIALS AND METHODS: 57 patients with PAH were examined. The diagnosis of PAH was verified according to the recommendations of the ERS/ESC from 2015. All patients underwent a detailed echocardiographic (ECHO) study, MRI of the heart and right heart catheterization (RHC). To calculate the stiffness of the pulmonary artery wall, the MRI and RHC data were used. RESULTS: We identified a correlation between the functional class of PAH and the parameters of hemodynamic, physical performance, ECHO parameters of the right chambers. There were no differences in the stiffness of the pulmonary artery wall, depending on the functional class of PAH. Among the six stiffness indicators, only pulsation index was associated with the structural and functional parameters of the right ventricle and pulmonary vascular resistance. CONCLUSION: The MRI pulsation index is the simpleststiffness index of the pulmonary artery wall and the most promising one for evaluating the prognosis of patients with PAH.

[Hygienic assessment of conditions of the exploitation of facilities of the urban drainage system].

The aim of the study was the hygienic characteristics of the location of sewage pumping stations (SPSs) in the residential area of the city and the assessment of working conditions for the staff. The features of the technological process at the SPSs resulted in the formation of specific working conditions characterized by the presence of a cooling microclimate, noise production, technological vibration, air pollution by microorganisms. The assessment of working conditions has allowed to refer them to the 3 class (harmful working conditions) of the 2 and 3 degree. Preventive measures for SPSs should include the use of equipment for cleaning the air of working zone, having a combined odourremoving and microbicidal action; the automation of the labor process; the installation of additional equipment for filtering air circulating in workplaces and emitting into the atmosphere; provision of sealing equipment with the use of noise insulating materials.

[SPECT/CT radiation in treatment of bone metastases of osteosarcoma].

The aim of this study was to demonstrate the diagnostic ca- pabilities to control effects of radiotherapy treatment in patient with osteosarcoma bone metastases by SPECT-CT method. There was conducted SPECT/CT treatment monitoring of the patient with bone metastases of osteosarcoma after external radiotherapy and cyber knife. There were detected changes in the SPECT/CT-pictures of treated bones osteosarcoma metasta- ses. The SPECT/CT has proven as a reliable method of dynam- ic control at radiotherapy. Treatment effect all of these methods was to reduce or to get absent accumulation of bone-tropic radiopharmaceutical labeled with 99mTc-technetium. SPECT/ CT study was a demonstrative method for early determination of pathological metabolism degree in bone metastases of os- teosarcoma. SPECT/CT was an effective method of treatment monitoring of bone metastases after radiotherapy.

[Value of Two Dimensional Echocardiography for Assessment of Disease Severity in Patients With Pulmonary Hypertension].

AIM: To carry out complex assessment of the right ventricular (RV) function with two-dimensional echocardiography (2D-EchoCG) for detection of most informative markers of the disease severity in patients with pulmonary hypertension (PH). MATERIAL AND METHODS: We examined 63 patients with PH (38 with idiopathic PH, 7 with corrected congenital heart defects, 6 with systemic scleroderma, 12 with chronic inoperable thromboembolic PY). Examination included right heart catheterization, 2D-EchoCG, and cardiac magnetic resonance tomography (MRT). RESULTS: 2D-EchoCG revealed dilation of right chambers of the heart, hypertrophy of RV anterior wall, increase of ratio of right to left ventricular end-diastolic dimensions (RV:LV), reduction of LV stroke volume, diminution of amplitude and velocity of tricuspid annular plane systolic excursion, and significant increase of myocardial performance index Tei. MRT data evidenced for lowering of RV ejection fraction. Canonical correlation was found between integral characteristic of 2D-EchoCG and integral hemodynamic characteristic (r=0.77; p=0.007). We also determined threshold values of RV: LV to be used for stratification of risk in patients with PH. CONCLUSION: In patienns with PH calculation of simple 2D-EchoCG parameters provides information important for determination of disease severity, selection of optimal method of treatment, and monitoring of patients condition.

[Pulmonary Hypertension in Takayasu Arteritis].

Takayasu arteritis is well-known rare form of large vessel vasculitis. Pulmonary involvement is observed in 50% of cases. However, pulmonary hypertension is a rare complication of pulmonary artery stenosis. In this article we present a rare clinical case of Takayasus arteritis with typical stenosis of subclavian, carotid arteries, and involvement of pulmonary arteries with development of severe pulmonary hypertension. The article also contains discussion of current methods of diagnosis and treatment of pulmonary artery stenosis in Takayasus arteritis with special focus on effectiveness and complications of angioplasty and surgery.

Assessment of modeled mercury dry deposition over the Great Lakes region.

Three sets of model predicted values for speciated mercury concentrations and dry deposition fluxes over the Great Lakes region were assessed using field measurements and model intercomparisons. The model predicted values were produced by the Community Multiscale Air Quality Modeling System for the year 2002 (CMAQ2002) and for the year 2005 (CMAQ2005) and by the Global/Regional Atmospheric Heavy Metals Model for the year 2005 (GRAHM2005). Median values of the surface layer ambient concentration of gaseous elemental mercury (GEM) from all three models were generally within 30% of measurements. However, all three models overpredicted surface-layer concentrations of gaseous oxidized mercury (GOM) and particulate bound mercury (PBM) by a factor of 2-10 at the majority of the 15 monitoring locations. For dry deposition of GOM plus PBM, CMAQ2005 showed a clear gradient with the highest deposition in Pennsylvania and its surrounding areas while GRAHM2005 showed no such gradient in this region; however, GRAHM2005 had more hot spots than those of CMAQ2005. Predicted dry deposition of GOM plus PBM from these models should be treated as upper-end estimates over some land surfaces in this region based on the tendencies of all the models to overpredict GOM and PBM concentrations when compared to field measurements. Model predicted GEM dry deposition was found to be as important as GOM plus PBM dry deposition as a contributor to total dry deposition. Predicted total annual mercury dry deposition were mostly lower than 5 µg m(-2) to the surface of the Great lakes, between 5 and 15 µg m(-2) to the land surface north of the US/Canada border, and between 5 and 40 µg m(-2) to the land surface south of the US/Canada border. Predicted dry deposition from different models differed from each other by as much as a factor of 2 at regional scales and by a greater extent at local scales.

[Effect of complex vaccination against pneumococcal, Haemophilus type b infections and influenza in patients with chronic obstructive pulmonary disease].

AIM: Determination of the effect of complex vaccination with Pneumo-23, Hiberix, Grippol plus on sputum bacterial content 6 months after the vaccination of patients with chronic obstructive pulmonary disease (COPD) compared with unvaccinated patients. MATERIALS AND METHODS: Bacteriological analysis of sputum obtained for 6 months from 80 patients with COPD was carried out. The first group of 31 patients with COPD was immunized simultaneously with Pneumo-23, Hiberix, Grippol plus (mean age--59.25 +/- 1.12). The second group consisted of 49 unvaccinated patients with COPD (mean age--57.16 +/- 0.98). Classical microbiological method was used in the study. RESULTS: 6 months after the complex vaccination a significant decrease to 35.48 +/- 8.59% of vaccinated patients, that expectorate sputum with Streptococcus pneumoniae, compared with 80.65 +/- 7.1% in unvaccinated patients with COPD was observed. CONCLUSION: A combined vaccination against pneumococcal, haemophilus type b infection and influenza carried out with a prophylactic and therapeutic goal is recommended for patients with COPD as a part of the treatment and prophylaxis complex measures.

[Strontium-89 diagnosis and therapy of bone metastases]. / Radionuklidnaia diagnostika i radionuklidnaia terapiia 89-Sr metastazov v kosti.

A clinical test of strontium-89 chloride effect was carried out in 150 patients with bone metastases and bone pain from different patterns of tumor. Different types of bone lesions were considered. Pain-relieving effect was reported in 77%, irrespective of lesion gravity. There was no response to strontium-89 chloride in 150 patients with bone metastases. It mostly occurred in cases of lysis. Strontium-89 chloride therapy contributed to partial bone tissue repair. It is indicated as a component of complex treatment for bone metastases.

[Automated x-ray exposure metering systems]. / Sistemy avtomaticheskoi rentgenovskoi éksponometrii.

The authors suggest a classification for the existing systems and instruments intended for automated X-ray exposure metering developed by the Moscow Scientific Production Association "Spektr" and prospective ones. Demonstrate trends in the development of the main performance of these instruments and systems in terms of years and designs. Consider requirements for the performance of X-ray units not only in terms of anode voltage fluctuations but also in terms of time parameters. Review trends in the design of the systems for automatic sampling of filming parameters during angiography.

[Antibodies to Forssman antigen in patients with cancer of the gastrointestinal tract and breast]. / Antitela k antigenu Forssmana u bol'nykh rakom zheludochno-kishechnogo trakta i molochnoi zhelezy.

Blood sera of 103 normal persons, 104 patients with malignant and 33 patients with benign tumors of different sites, 28 patients with inflammatory diseases of the gastro-intestinal tract and female sexual organs were examined to demonstrate antibodies to Forssman's antigen (FA) by means of the microhemagglutination test with sheep red blood cells. It was established that reduction in the amount of antibodies to FA was the most characteristic for gastro-intestinal carcinomas and to a lesser degree for breast cancers and that it was sporadically encountered in normal persons with non-cancerous pathology. The number of patients with low titres of antibodies to FA increased as the cancerous process progressed.