Search

We calculate the topological susceptibility of the Yang-Mills vacuum using the field correlator method. Our estimate for the SU(3) gauge group, \chi^{1/4} = 196(7) MeV, is in a very good agreement with the results of recent numerical simulations of the Yang-Mills theory on the lattice., Comment: 5 pages (JETP Letters style)

The study was undertaken to compare measured versus calculated propofol concentrations (C(m) and C(c), respectively), by using Diprifusor technology in cardiac surgery with cardiopulmonary bypass (CPB). The study included 10 NYHA II-III patients (aged 27-45 years) undergoing mitral valve replacement. Propofol (Diprivan PFS 50 ml, AstraZeneca) was target-control infused (TCI) by the Diprifusor system (Graseby 3500). C(c) was titrated to maintain the BIS value close to 40. Propofol in doses of 2.1 +/- 0.05 mg/kg was required for induction. Anesthesia before, during, and after CPB required propofol in doses of 5.4 +/- 0.3, 3.9 +/- 0.2, and 3.1 +/- 0.2 mg/kg/h, respectively. The doses of fentanyl were 4.4 +/- 0.1 microg/kg for induction of anesthesia and 4.5 +/- 0.4, 2.4 +/- 0.2, and 0.2 +/- 0.1 mg/kg/h for its maintenance before, during, and after CPB, respectively. The patients received rocuronium in the standard doses for neuromuscular relation. C(m) was determined by high-performance liquid chromatography with ultraviolet detection (Agilent 1100, column C18, Altima). Blood propofol concentrations were measured at: 1) intubation; 2) skin incision; 3) sternotomy; 4) aortic cannulation; 5) 30 min of CPB; 6) 60 min of CPB; 7) the end of CPB; 8) 30 min following CPB; 9) skin closure; 10) awakening. Data were expressed as mean +/- SEM. The values were compared by linear regression. Student's t-test was used with p0.05. C(m) was 2 times higher than C(c) at all stages. A close correlation was found between C(m) and C(c): r = 0.83, p = 0.038. It is concluded that Marsh's PK/PD model predicts the trend in blood propofol concentrations during uncomplicated operations on the open heart satisfactorily, but C(c) was constantly 2 times less than C(m).

The advantages of xenon include its good hemodynamic profile and possible cardioprotective properties. The investigation was undertaken to study central hemodynamics, lung gas exchange, and blood oxygen-transporting function in xenon anesthesia in patients operated on under extracorporeal circulation (EC). Fifteen patients aged 41-69 years operated on for coronary heart disease were examined. The severity of the patients' baseline status corresponded to NYHA functional classes I to IV. The duration of an operation was 251 +/- 10 min; that of EC was 97 +/- 5 min; aortic ligation lasted 59 +/- 3 min. After induction of anesthesia with propofol via concentration-regulated infusion (CRI) and with fentanyl, delivery of xenon was initiated at concentrations of 47 +/- 1 to 52.5 +/- 1%, which was mixed with oxygen. Propofol CRI was used during EC. After the latter, xenon was inhaled at concentrations of 47.7 +/- 1 to 53.3 +/- 1%. The mean arterial pressure (BP(mean)), heart rate (HR), and cardiac index (CI) remained unchanged during xenon anesthesia in the preperfusion period. After EC during xenon anesthesia, CI significantly rose with a moderate increase in HR without inotropic support. BP(mean) was moderately, but statistically significantly decreased. Prior to and following EC, there were no changes in the values of blood oxygen-transporting function.

The study was undertaken to evaluate lung function, central hemodynamics, and the oxygen transport system during combined therapy with surfactant-BL ("Biodurf", Saint Petersburg) and inhalational nitric oxide (iNO) for the acute respiratory distress syndrome (ARDS) after surgery using extracorporeal circulation (EC). Twenty-three patients (18 males and 5 females) aged 43 to 71 years (mean 56.5 +/- 2.4 years) were examined. The diagnosis of ARDS was established in accordance with the criteria recommended by the USA-European Consensus Conference on ARDS. Surfactant-BL was administered endobronchially. There were 1-3 (2.1 +/- 0.2) administrations; the first administration was made 16 +/- 4 hours after the onset of ARDS. The single dose of the agent was 2.7-4.1 (3.6 +/- 0.1) mg/kg; its course dose was 2.7-11.1 (7.9 +/- 0.9) mg/kg. Following 24 hours of the initiation of surfactant-BL therapy, there was a noticeable improvement of pulmonary oxygenizing function, a significant increase in P(a)O2 and SaO2 (p0.05), and a reduction in alveolar-arterial O2 differences and Qs/Qt. Thoracopulmonary compliance dynamics increased by 8.6 ml/cm H2O (p0.05). There was a significant rise in the O2 transport index (p0.05). Two days later, the magnitude of positive changes increased. The sensitivity of pulmonary oxygenizing function to iNO was enhanced by the administration of surfactant-BL. On days 3-5 days after the detection of ARDS, there was, along with the improved gas-exchange function of the lung, a significant decrease in the severity of its damage according to the Murray scale. Total mortality was 39%. Arterial hypoxemia was not a cause of death in any cases. It is concluded that the combined use of surfactant-BL and iNO ensures significantly improved pulmonary oxygenizing function, decreased thoracopulmonary compliance, and better O2 transport.

Absorption and luminescence spectra of a 4-nitro-4-dimethylaminobutadiene molecule in binary solvents have been experimentally obtained and investigated. Formation of the absorption spectra is associated with a chromophore grouping of the molecule in a bent state, while the bathochromic shift of the band in the absorption spectrum is consistent with the theory of dipole-dipole interaction of a bipolar molecule with solvent molecules. The fluorescence spectrum and its form and bathochromic shift depend not only on the solvent polarity but also on the proportion and kind of binary mixture of solvents. For a certain proportion of the binary solvent, radiation has been generated at λ=610 nm in pumping by a nitrogen laser.

We suggest that the gauge-invariant hedgehoglike structures in the Wilson loops are physically interesting degrees of freedom in the Yang--Mills theory. The trajectories of these ``hedgehog loops'' are closed curves corresponding to center-valued (untraced) Wilson loops and are characterized by the center charge and winding number. We show numerically in the SU(2) Yang--Mills theory that the density of hedgehog structures in the thermal Wilson--Polyakov line is very sensitive to the finite-temperature phase transition. The (additively normalized) hedgehog line density behaves like an order parameter: the density is almost independent of the temperature in the confinement phase and changes substantially as the system enters the deconfinement phase. In particular, our results suggest that the (static) hedgehog lines may be relevant degrees of freedom around the deconfinement transition and thus affect evolution of the quark-gluon plasma in high-energy heavy-ion collisions., Comment: 20 pages, 13 figures, uses elsart.sty; replaced to match published version

The purpose of the study was to design and investigate the closed-loop propofol system (CLPS) with a mean arterial pressure (MAP) controller in open-heart surgery. CLPS consists of a 386 PC, a blood pressure sensor and an infusion pump. The C language computer program sets the propofol infusion rate based on an empirical algorithm including proportional component to maintain the measured MAP more closely to the target MAP (85% of patient standard MAP). The propofol concentrations were calculated by the pharmacokinetic/pharmacodynamic model differential equations solving every 30s. CLPS was used in 214 NYHA II-IV patients, aged 16-74, undergoing various open-heart procedures. The mean target MAP was 75.2 +/- 4.5 mm Hg. The measured and target MAP difference did not exceed 22% perioperatively. The bispectral index varied from 42.7 +/- 1.2 (tracheal intubation) to 41.8 +/- 0.1 (skin suture) with a variation of the propofol site effect concentration ranging from 2.9 +/- 0.09 to 1.8 +/- 0.1 microg/ml. It was a closed negative correlation (r = 0.84; p0.01) between the propofol site effect and the MAP during the initial period of anesthesia. There were not any significant changes in the blood cortisole level during the procedures. The recovery time was 1.4 +/- 1.5 min after propofol infusion; 95.5% of patients were extubated in the operating room.

Based on summarized data of the literature it is concluded that proximal resection of the duodenum in chronic pancreatitis with lesion of the pancreatic head is possible only bearing in mind variability of arterial blood supply. Experience of surgical treatment of 19 patients with chronic pancreatitis who underwent isolated resections of pancreatic head due to inflammatory changes of pancreas' proximal parts demonstrates expediency of this surgery. Maximal resection of pancreatic tissue permits to decrease risk of purulent and inflammatory complications and promotes favorable course after surgery.

Results of two surgeries--total and subtotal resection of pancreatic head in combination with selective proximal vagotomy (SPV)--performed for chronic pancreatitis and duodenal ulcer disease (DUD) are presented. In one case surgery was supplemented with circular resection of the duodenum and fundoplication. Reconstructive stage of both surgeries included creation of pacreato- and biliodigestive anastomosis on Roux intestinal loop. Choledochojejunoanastomosis was created on the same loop of the small intestine either "end-to-side" with supraduodenal part of common bile duct or "side-to-side" with its pancreatic part. The former surgery was finished with duodenoduodenoanastomosis "end-to-end" for recovery of duodenal passage. This surgery was characterized by complete removal of pancreatic head. The latter surgery corresponded to Beger's operation. There were no complications in the nearest postoperative period. Long-term results were favorable and followed up during 17.5 and 7 months, respectively. This experience testifies that resection of pancreatic head with SPV may be considered as alternative to pancreatoduodenal resection in surgical treatment of patients with chronic pancreatitis.

The study was undertaken to examine the myoplegic, hemodynamic, and histamine-releasing effects of the new aminosteroidal myorelaxant Rocuronium (esmerone, Organon firm) used to maintain anesthesia in cardiac surgical patients by orienting to early tracheal extubation. Twenty two patients aged 50 +/- 3 years operated on under extracorporeal circulation were examined. At the initial stage of maintenance, the agent in a dose of 0.6 mg/kg failed to affect cardiac pump function and to elevate plasma histamine levels. A moderate vagolytic effect was shown in 45% of cases. The incidence of myoplegia reduced in patients with significant circulatory insufficiency. In the preperfusion period, Rocuronium in a dose of 10.2 +/- 0.9 micrograms/kg/min blocked neuromuscular conduction (NMC) at a level of 5.1 +/- 1.8 to 19.2 +/- 3.5%. During hypothermic extracorporeal circulation and postperfusion period, the dosage of the myorelaxant substantially decreased. After termination of Rocuronium infusion, the time of up to 95%-recovery of NMC was 63 +/- 6 min. Early tracheal extubation was conducted in 68% of the patients 69 +/- 7.6 min after the end of the operation. Residual myoplegia was absent. The predictable recovery of NMC following the use of Rocuronium creates conditions for early activation of patients operated on under extracorporeal circulation.

Methodological approaches to evaluation of the migration activity of human peripheral blood neutrophils into a collagen matrix were worked out. The migration of neutrophils in healthy donors and in patients with severe bronchial asthma was studied. In the normal state there was practically no migration of intact neutrophils into the collagen matrix (1.1 +/- 0.4%). Following their stimulation by formyi peptide about a quarter of their population was drawn into the matrix in avalanche (22.0 +/- 5.9%). In the acute phase of severe bronchial asthma an increase in both spontaneous (3.3 +/- 1.5%, P0.01) and stimulated (35.6 +/- 4.6%, P0.001) cell migration occurred. Changes in the migration characteristics of the neutrophils of patients and those of the cells of healthy donors, treated with the polycytokine preparation at concentrations exceeding 100 g/ml, followed similar trends. In case of the standard asthma treatment along with positive disease dynamics further increase in spontaneous neutrophil migration (5.8 +/- 2.9%, P0.001) in combination with deficiency in cells reaction to formyi peptide (11.8 +/- 3.8%, P0.01) was registered. At the same time dexamethasone did not change the character of the in vitro migration of neutrophils into the collagen matrix. Thus the dynamics of the peripheral blood neutrophil migration during treatment of severe bronchial asthma was demonstrated; this dynamics could be indicative of the pathogenetic role of neutrophils in the development of this pathology.

We introduced a novel method, through mirror-image phage display, for the identification of high-affinity D-peptides to target specific cell-surface carbohydrates. Both 3-deoxy-alpha-L-manno-2-octulosonic acid (L-KDO) and L-sialic acid and an L-sialo-disaccharide have been synthesized and attached to a solid support for selection of high-affinity peptide binders displayed on phages. Our initial studies in this effort produce single-chain Fab sequences and dodecapeptides that bind to sialic acid and KDO with nanomolar and high micromolar affinity.

We describe here a new property of visual neurons: sensitivity to the magnitude and orientation of the brightness gradient vector in a test stimulus presented in the receptive field of the neuron. The brightness gradient test image was a spot (diameter 4 degrees) on the dark background of the slide. Brightness changed linearly within the spot. The absolute value of the brightness gradient varied over the range 0.4-2.7 cd/m2 /degrees in the direction of the brightness gradient. The integral brightness in the test spot containing the gradient image was identical for different values of the brightness gradient. The numbers of spikes in the on- and off-responses of on and off neurons in the lateral geniculate body of cats depended on the orientation of the brightness gradient vector in the test stimulus. The sensitivity of neurons to the orientation of the brightness gradient vector, K (the coefficient of sensitivity), was assessed as the normalized difference between the number of spikes in neuron responses in the preferred and non-preferred orientations of the brightness gradient vector in the neuron's receptive field. The mean sensitivity coefficient for 53 cells was 0.55 +/- 0.20. A 6.7-fold decrease in the brightness gradient resulted in a 3.7-fold decrease in the coefficient of sensitivity (for the preferred direction of the orientation of the gradient vector); there was no change in the latent period of responses. The preferred orientation of the brightness gradient vector in the receptive fields of neurons coincided (to within +/-22.5 degrees) with the radial direction on the map of the field of vision in 45% of cases, and with the tangential direction in 26% of cells.

The template-directed oligomerization of nucleoside-5'-phosphoro-2-methyl imidazolides on standard oligonucleotide templates has been studied extensively. Here, we describe experiments with templates in which inosinic acid (I) is substituted for guanylic acid, or 2,6-diaminopurine nucleotide (D) for adenylic acid. We find that the substitution of I for G in a template is strongly inhibitory and prevents any incorporation of C into internal positions in the oligomeric products of the reaction. The substitution of D for A, on the contrary, leads to increased incorporation of U into the products. We found no evidence for the template-directed facilitation of oligomerization of A or I through A-I base pairing. The significance of these results for prebiotic chemistry is discussed.

Nonenzymatic template-directed copying of RNA sequences rich in cytidylic acid using nucleoside 5'-(2-methylimidazol-1-yl phosphates) as substrates is substantially more efficient than the copying of corresponding DNA sequences. However, many sequences cannot be copied, and the prospect of replication in this system is remote, even for RNA. Surprisingly, wobble-pairing leads to much more efficient incorporation of G opposite U on RNA templates than of G opposite T on DNA templates.

Original method of treatment of complicated pyloroduodenal ulcers is proposed. The results of different organ-saving operations in complicated pyloroduodenal ulcers were analyzed in 136 patients aged from 15 to 89 years. Evaluation of the results was based on the data obtained during study of secretory and motor-evacuatory function of the stomach, state of gastric and duodenal mucous membrane, degree of duodenogastric reflux. Gastroscopy in remote period after organ-saving operations enabled visual evaluation of state of anew formed pyloric canal. Results of treatment of complicated pyloroduodenal ulcers by different methods of pyloroplasty demonstrate the advantages of valvular pyloroplasty.

Thermodilution volumetry of the right ventricle (RV) in the course of combined operations has demonstrated significance of RV function and identified signs of its dysfunction when other parameters of hemodynamic monitoring were low informative. Of late, introduction of updated anesthetic modalities and intraoperative monitoring have noticeably improved surgical outcomes of combined lesions of the heart as shown by decreased hospital lethality.

The oligomerization of deoxyguanosine 5'-phosphoro-2-methylimidazolide on a polycytidylate template is much less efficient than the oligomerization of the corresponding activated ribonucleotide. Nonetheless oligomers containing up to eight nucleotide residues are detected. The products are 3'-5'-linked oligodeoxyribonucleotides capped at the 5'-terminus with a pyrophosphate-linked monomer.

Effect and dose dependence of iNO as a selective vasodilator of the lesser circulation on the central hemodynamics was studied in 24 patients subjected to transplantation of the heart. iNO in concentrations of up to 20 ppm ensured objective evaluation of the reversibility of the pretransplantation pulmonary hypertension. Before transplantation iNO in a concentration higher than 20 ppm led to deterioration of left-ventricular function, associated with a 19% increase in pulmonary artery wedge pressure and a 13% decrease of cardiac index in patients with a less than 15 mm Hg transpulmonary gradient and pulmonary vascular resistance higher than 320 din.sec.cm-5. During left-ventricular bypass, iNO dose-dependently decreased the mean pulmonary artery pressure, transpulmonary gradient, pulmonary vascular resistance, pulmonary to peripheral vascular resistance ratio and the right-ventricular stroke index and increased the left-ventricular assist bypass by 17% in patients waiting for orthotopic heart transplantation. Early after transplantation, iNO in a concentration of 20 ppm notably decreased the pulmonary vascular resistance and stabilized the function of transplanted heart, increasing the cardiac index by 19% and blood pressure by 16%. During diagnostic and therapeutic manipulations at 10-20 ppm iNO the level of NO2 was no higher than 2.5 ppm, or 3 ppm at 30-40 ppm.

The authors review published data devoted to a new trend in intensive care of pulmonary hypertension: therapy of right ventricular heart failure and gas exchange disorders caused by impaired ventilation-perfusion relationship by inhalation of nitrogen oxide (NO). Mechanisms of NO effect, its metabolism, method of application and safety regulations, and doses and efficacy in various clinical situations (pulmonary hypertension in heart diseases, transplantations of the heart and lungs, respiratory distress syndrome, persistent pulmonary hypertension of the newborns) are analyzed. The first clinical experience gained by the authors demonstrated a favorable effect of NO therapy on the central hemodynamics in patients with acquired valvular defects and patients subjected to orthotopic transplantations of the heart. Approaches to research and pathogenetic validation of NO therapy are outlined.

Sixty-five coronary patients were subjected to aortocoronary bypass surgery. Three groups were distinguished: 1) controls-no filters; 2) patients in whom hemotransfusion (40 mu) and infusion filters were used during and on day 1 after surgery; and 3) in whom leukocyte filters for filtering residual perfusate from artificial circulation device were used in addition to the filters used in group 2. In the controls plasma level of leukocytic alpha-glycoprotein after artificial circulation increased 22 to 36 times, whereas in groups 2 and 3 it did not increase at all. After surgery the severity of leukocytosis, hyperthermia, and hyperenzymia assessed from the level of SGOT was reliably lower in patients in whom the filters were used. The time course of the oxygenation index (PaO2/FiO2) indicated an improvement of gas exchange due to filtration of infusion-transfusion media. The minimal values of PaO2/FiO2) and plasma content of C-reactive protein were observed in group 3. The mechanisms of systemic inflammatory reaction and organ dysfunction and some aspects of the protective effect of filters are discussed.

Interaction of immunocompetent cells with extracellular matrix is one of the main stages in their homing and circulation. In this connection we investigated quantitative and dynamic parameters of interaction between splenocytes and 3D collagen matrix in vitro. It was found out that, about 20% of mouse spleen lymphocytes exhibited ability to bind to type I collagen that reflected as their adhesion to and/or migration in collagen matrix. The number of lymphocytes capable of the interaction with collagen gained successively as far as the time of their incubation on collagen matrix was increased and reached maximum by 24 h. The lymphocyte-collagen interaction was energy-dependent and engaged collagen receptors, which probably have been already expressed on cells before spleen lymphocytes were isolated. The series of intracellular interchanges as activation of protein kinase C, assembly of actin filaments and depolymerization of tubulin microtubules were critical for lymphocytes to adhere to and further to migrate in collagen matrix. Long lasting incubation (24 h and more) of lymphocytes in adhesion excluding conditions did not reduce the number of cells able to interact with collagen, but to a great extent changed mechanisms providing their adhesion and/or migration.

Multifactorial prophylaxis on the individual basis was conducted for 5 years among the population of 2047 males aged 40-59 years with ischemic heart disease (IHD) or its risk factors. Compared to the comparison group of 2101 subjects, in the study group the investigators achieved a 37% reduction in the mean population profile of myocardial infarction risk due to less prevalence of 3 main risk factor: arterial hypertension, low physical activity, smoking. Unbalance of the groups by age and education made the effect of the prevention measures on cardiovascular mortality menostrable only at statistical Cox's model.

The human locomotor system has two main functions: moving and sensor (proprioreceptor). Both are necessary for muscle activity regulation. Knowledge about muscle morphometric characteristics (length and force arm) during motion allows analysis of: 1) regimes of muscle contraction; 2) the most effective zones of force suppling; 3) data about muscle speed ability.

A simple and efficient method of the covalent immobilization of oligonucleotides on carboxyl-containing nylon membranes was proposed. The method is based on the reaction between a postsynthetically introduced aminoalkyl group of an oligonucleotide and membrane carboxyl catalyzed by a water soluble N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide. Judging from the mechanism of carboxyl group activation by the carbodiimide, optimal conditions of the immobilization were selected, which made it possible to increase the immobilization efficiency and carrier capacity as compared with those described previously. Using a 23-unit membrane-immobilized oligonucleotide as an example, the oligonucleotides immobilized were shown to be capable of hybridizing with complementary sequences.

Forty-nine patients operated on the open heart under combined total anesthesia with nitrogen oxide, enflurane or isoflurane and propofol (group 1) and 22 ones anesthesized with high fentanyl doses (group 2) were examined. To group 1 patients fentanyl and pancuronium bromide were injected only in the preperfusion period of the operation. Early extubation was carried out in 44 (90%) group 1 patients. The duration of postoperative artificial ventilation of the lungs was 102 +/- 15 min in group 1 and 16 +/- 1 h in group 2. No grave postoperative complications or early mortality were recorded. In the morning of the first postoperative 24 h 7% of group 1 patients and 41% of group 2 ones were administered inotropic therapy (p0.05). Duration of stay in resuscitation ward was 0.96 +/- 0.05 days in group 1 and 2.04 +/- 0.09 days in group 2 (p0.01). The authors come to a conclusion on the desirability of early extubation after open-heart surgery. Indications for and contraindications against early extubation are discussed.

Recently proposed reverse hybridization method is very convenient for simultaneous detection of a set nucleotide sequences in a DNA fragment of interest (1,2). The main idea of this method is immobilization of an oligonucleotide probes set on a solid support and their hybridization with the labeled DNA fragment. Here we report on an improved non-radioactive reverse hybridization method and provide an example of its application for testing point mutations responsible for β-thalassemia.

Hot hole p-Ge masers and lasers operating in millimiter and far IR ranges (up to 100 μm) belong to a new group of tunable semiconductor generators discovered in the early ’80s(1). They are proposed to be used in solid state spectroscopy since their discovery. These generators may be preferable to other sources of the same frequency since it is possible to set the sourcer of radiation near by the sample and provide ultralow background radiation conditions in low temperature experiments.The performance of the tunable spectrometer with hote hole p-Ge emitter is demostrated by its application to studies of cyclotron resonance in strained multi-quantum-well (MQW) heterostructures (HS) Ge/Ge0.87Si0 13 and investigations of shallow impurities in these heterostructures.

A new method of covalent immobilization of oligodeoxyribonucleotides on nylon membranes which contain surface amino groups was developed. The method consists in condensation between the amino group of the membrane and the carboxyl group of modified oligonucleotide by means of 1-ethyl-3-(3'-dimethylaminopropyl)carbodiimide. The carboxyl group was introduced into the oligonucleotide by means of postsynthetic attachment of peptide (reduced glutathione) at the terminal phosphate group of the oligonucleotide, using the N-hydroxybenzotriazole method of phosphate activation. Membranes containing a covalently immobilized 23-membered oligonucleotide were tested in hybridization with complementary oligonucleotide, and with single-stranded DNA of bacteriophage M13 which has a complementary sequence. The method of covalent immobilization is very simple and convenient. The membranes with covalently immobilized oligonucleotides may be used not only in hybridization analysis, but also for purification of nucleic acids and proteins which recognize nucleotide sequences and in sense biotechnology.

The first experience of anesthesiological management of three two-step orthotopic heart transplantations is reviewed. As the first step of surgical treatment one recipient was implanted an artificial heart "POISK-IOM" (Russia), in 2 other patients left ventricular bypass was achieved using a "Biopump" ("Biomedics", USA). Anesthesia techniques, methods of infusion-transfusion therapy, and other components of intraoperative management are described. Hemodynamics, donor heart function recovery, and other homeostasis parameters have been analysed. It has been noted that high doses of fentanyl in combination with ketamine and diazepam ensured satisfactory course of general anesthesia. There were no cases of intraoperative lethality. A more complex aspect of anesthesiological management was correction of various homeostasis disturbances which progressed during surgery in patients with left ventricular bypass. In two cases the intraoperative period was characterized by the onset of multiorgan failure (heart, respiratory, renal failure, metabolic disorders, coagulopathy), which played a negative part for the postoperative period of heart transplantations. It is concluded that prediction of possible complications during temporary mechanical replacement of the cardiac function and timely determination of contraindications for the second step of two-step heart transplantations are the most important trends of investigations for anesthesiologists, intensive care specialists, and transplantologists.

A standard one-day diet questionnaire survey covered 1025 subjects (490 males and 535 females) aged 20-59 living in the city of Minsk. They were examined in the Research Cardiology Institute of Belarus within the scope of the program on integral prevention of chronic noninfectious disease. The results of the study showed the examinees' diet to be unbalanced with an atherogenic trend: excessive fat, saturated fatty acids, cholesterol against insufficient carbohydrates, starch, polyunsaturated fatty acids. Total energy value of the food and alcohol consumption of the studied population were lower than those of the matched population of Lithuania, Moscow and Tallin. No significant relationship was revealed between alimentary characteristics of the Minsk population and occurrence of ischemic heart disease in the examinees.

The program of coronary heart disease prevention among the population of the administrative district of Minsk was implemented over three years through the managerial, administrative and medical structures. The task team performed the organizational and methodological work and carried out the monitoring of the epidemiological situation with regard to coronary heart disease. 1537 persons underwent primary screening and 1112 were examined after three years. A statistically significant increase in the awareness of the population and doctors of the problems of a healthy lifestyle, improved indices of arterial hypertension control, a tendency toward decrease in the prevalence of arterial hypertension were recorded during the observation period. The behavioral risk factors could not be influenced.

Preliminary results of intraoperative monitoring of the degree of neuromuscular blockade using a portable device based on the technique of evoked electromyography are presented. The device has an analogue outlet for the connection with a computer. The technique used is simple and reliable and makes it possible to work out a computerized system for automatic graded supply of current myorelaxants on a feedback principle. Such a system does not only ensure an adequate level of myorelaxation with a minimum expenditure of expensive drugs, but also gives a new approach to the study of neuromuscular conduction during anesthesiological supply in various surgical interventions.

A prospective follow-up within 7 years was performed for 4148 males aged 40-59 from an open population of Minsk who had been subjected to cardiological screening. The frequency of myocardial infarction (MI) in patients with coronary heart disease (CHD) established at screening exceeded that of CHD-free subjects 4.1 times. For separate forms of CHD a relative risk for patients with MI history, angina pectoris of effort (by Roze questionnaire) and isolated ischemic changes on ECG at rest amounted to 8.6, 4.0 and 2.3, respectively. MI was associated with blood pressure, cholesterol levels. A multivariate analysis revealed a significant independent contribution of hypertension, hypercholesterolemia, smoking and age to the risk of MI development in subjects free of CHD at screening. Concrete values of beta-coefficients of the logistic function prognosticating the risk of MI development in the population studied have been determined.

The experience is reviewed on the use of superhigh insulin doses 1200 to 3800 U (31.4 +/- 5.3 U/kg) for the treatment of acute heart failure in 17 patients subjected to open heart surgery. Symptoms of heart failure refractory to catecholamines and vasodilators were accompanied by marked hyperglycemia (23.1 +/- 4.3 mmol/l). It was impossible to discontinue assisted circulation. In 82.3% of patients myocardial contractility upon insulin administration improved considerably, which led to discontinuation of assisted circulation with moderate inotropic support. Possible mechanisms ensuring the efficacy of massive insulin therapy in patients with acute heart failure are discussed.