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In the majority of cases, left ventricular aneurysm is a result of a sustained transmural myocardial infarction, which leads to progressive cardiac insufficiency. The overriding priority of a surgical correction is to remove the non-functional myocardium and restore the geometric configuration of the left ventricle. The aim. To analyze the immediate and long-term results after surgical correction of left ventricular aneurysm. Materials and methods. Within the period from 2012 till 2017 at the Ukrainian Children`s Cardiac Center, 88 patients with left ventricular aneurysm were operated. However, we were able to assess long-term outcomes in 71 (80.1%) patients, due to the inaccessibility of patients owing to the difficult geopolitical situation in the country. Depending on the method of surgical correction, two groups were formed: group A (Dor procedure) comprising 17 patients, group B (linear repair) including 71 patients. In group A (n = 17), the vast majority of patients were male (n = 16, 94.1%) vs. only 1 female patient (5.9%). A similar trend was observed in group B: there were 56 male (78.9%) and 15 (21.1%) female patients. The following parameters were considered during the echocardiographic examination: left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic index (LVEDI), left ventricular endsystolic volume (LVESV), left ventricular end-systolic index (LVESI), localization of the aneurysm and its prevalence. Results and discussion. During the clinical and instrumental examination, ischemic cardiomyopathy was diagnosed in 6 (35.3%) patients of group A and in 8 (11.3%) patients of group B. Long-term mortality was higher in group B (n = 10, 17.2%) than in group A (n = 1, 7.7%). Conclusion. According to our study, long-term mortality was 7.7% in group A and 17.2% in group B. The factors that could influence the results were higher Euroscore II and incorrectly chosen tactics for patients with extensive akinesis of the walls of the heart in group B. We deem appropriate to perform cardiac MRI in all patients with left ventricular aneurysm at the stage of diagnosis in order to develop clear plan for surgical tactics.

Коарктація аорти є однією з найчастіших вроджених вад серця і становить 6–7%. Коарктація аорти часто поєднана з іншими вадами серця – двостулковим аортальним клапаном, дефектом міжшлуночкової перегородки та ін. Мета роботи – висвітлити наш перший досвід одноетапної хірургічної корекції коарктації аорти і патології аортального клапана. Матеріали і методи. Чоловік, 56 років, поступив у відділення в плановому порядку із симптомами хронічної серцевої недостатності. Основними скаргами на момент госпіталізації були задишка при мінімальному фізичному навантаженні та підвищення артеріального тиску. Коарктація аорти була встановлена випадково, в ході проведення коронаровентрикулографії в іншому лікувальному закладі. Результати та обговорення. Незважаючи на велику кількість публікацій у закордонних джерелах, при огляді вітчизняної літератури не було знайдено жодного описаного випадку екстраанатомічного шунтування коарктації аорти з одночасною корекцією серцевої патології у дорослого пацієнта в Україні. Згідно із досвідом іноземних фахівців, наш пацієнт мав протипоказання до екстраанатомічного анастомозу із серединної стернотомії у зв’язку зі своєю конституційною особливістю – бочкоподібною грудною кліткою. Однак використання міні-інвазивного інструментарію дало можливість успішно виконати операцію і скоротити тривалість формування дистального анастомозу. Висновки. Екстраанатомічне формування анастомозу при коарктації аорти в комплексі із серцевою патологією є хорошим альтернативним методом лікування для дорослої когорти пацієнтів.

Aortic coarctation is one of the most frequent congenital heart defects; the frequency is in the range of 6-7%. Aortic coarctation is often associated with other heart defects, namely: a bicuspid aortic valve, an interventricular septal defect, and others. Purpose: to highlight our first experience of one-stage surgical correction of aortic coarctation and aortic valve pathology. Material and method. A 56-year-old man was hospitalized in the department in a planned manner with symptoms of chronic heart failure. Upon admission, the main complaints were shortness of breath with minimal physical stress and increased blood pressure. Aortic coarctation was diagnosed accidentally during coronary angiography in another medical institution. The thoracic aortic CT angiography with intravenous contrast diagnosed: sharp narrowing of the aorta in a typical place. Results and discussion. Despite a large number of publications in foreign sources, the literature review showed no cases of extra-anatomic bypass surgery of aortic coarctation with correction of a cardiac pathology in adult patients in the territory of Ukraine. The main indications for surgical correction of aortic coarctation using the technique of extra-anatomic bypass surgery include: aortic coarctation or re-coarctation in combination with a cardiac pathology requiring correction via median sternotomy; complex aortic coarctation or re-coarctation associated with technical difficulties upon choosing the method of direct anatomical correction. Based on the experience of foreign institutions, our patient had contraindications to extra-anatomic anastomosis via median sternotomy due to a constitutional peculiarity, namely a barrel chest. However, the minimally invasive surgical instruments made it possible to perform the operation successfully with reduced time required for distal anastomosis. Conclusion. Extra-anatomic creation of anastomosis in aortic coarctation in combination with a cardiac pathology is a good alternative of treatment for an adult cohort of patients.

Background: The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Results: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking "nature" to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory. © 2019 The Author(s).

Bone disease is prevalent among patients with inflammatory bowel disease (IBD), though bone density screening remains underutilized. We used CT scans performed for other indications in IBD patients to identify and monitor osteopenia using CT attenuation values at the lumbar spine. Significant rates of bone disease were detected which would have otherwise gone undiagnosed.Osteoporosis affects about 14-42% of patients with IBD. Though screening is recommended in IBD patients with risk factors, it remains underutilized. In patients with newly diagnosed IBD, we used CT scans performed for other indications to identify and monitor progression of osteopenia.Using the Ocean State Crohn's and Colitis Area Registry, we identified adult patients with one or more abdominal CT scans. Each patient had two age- and gender-matched controls. Radiologists measured attenuation through trabecular bone in the L1 vertebral body recorded in Hounsfield units (HU). Generalized estimating equations were used to measure how HU varied as a function of gender, type of IBD, and age.One hundred five IBD patients were included, and 72.4% were classified as "normal" bone mineral density (BMD) and 27.6% as potentially osteopenic: 8.6% with ulcerative colitis and 19.0% with Crohn's disease. We found a decrease in bone density over time (p 0.001) and that BMD decreases more in Crohn's disease than in ulcerative colitis (p 0.004). Sixty patients had two CT scans, and mean loss of 9.3 HU was noted. There was a non-significant decrease in BMD over time in patients exposed to 31 days of steroids and BMD was stable with 30 days of steroid exposure (p 0.09).Using CT scans obtained for other indications, we found low rates of osteopenia and osteoporosis that may otherwise have gone undiagnosed. Refinement of opportunistic screening may have advantages in terms of cost-savings and earlier detection of bone loss.

A numerical simulation is used to study the distribution and flux of red blood cells in capillary networks. The relationship between the motion of an individual cell in a single capillary and the overall transport of cells throughout a network is investigated. Interpretation of results is greatly facilitated by the use of a computer graphics representation of the simulation. Steady-state and certain time-dependent cell distribution problems are studied, with a special focus on the sensitivity of the results to the presence of a small number of white cells.

We present evidence for a new mechanism by which two major actin monomer binding proteins, thymosin beta 4 and profilin, may control the rate and the extent of actin polymerization in cells. Both proteins bind actin monomers transiently with a stoichiometry of 1:1. When bound to actin, thymosin beta 4 strongly inhibits the exchange of the nucleotide bound to actin by blocking its dissociation, while profilin catalytically promotes nucleotide exchange. Because both proteins exchange rapidly between actin molecules, low concentrations of profilin can overcome the inhibitory effects of high concentrations of thymosin beta 4 on the nucleotide exchange. These reactions may allow variations in profilin concentration (which may be regulated by membrane polyphosphoinositide metabolism) to control the ratio of ATP-actin to ADP-actin. Because ATP-actin subunits polymerize more readily than ADP-actin subunits, this ratio may play a key regulatory role in the assembly of cellular actin structures, particularly under circumstances of rapid filament turnover.

A study was made of the manufacture of plane light guides by diffusion of cadmium in plane-parallel polished monocrystalline plates of ZnSe at different cadmium vapor pressures in the ampul and different annealing times. Profiles of the refractive index in the diffusion layer of the specimens were calculated from measurements of the resonance angles associated with mode excitation. Optical transmission from 0.4 to 0.2 μm was measured for specimens obtained under different diffusion annealing conditions. A conclusion was reached as to the optimum annealing conditions.

Adherence of platelets to endothelial cells may be a significant event in the development of vascular thrombosis. Existing models, which examine platelet-endothelial cell interactions, compromise endothelial cell integrity or use radioactivity to identify platelets that adhere to endothelial cells. We report a novel method for in vitro detection of platelet-endothelial cell adhesion that allows endothelial cells to remain as an intact monolayer and for visualization of individual platelets.Fluorescently labeled platelets were incubated with a confluent monolayer of endothelial cells. Laser scanning cytometry (LSC) identified platelets bound to endothelial cells based on their fluorescent signals.LSC detection of platelets reliably reproduced well-described findings of thrombin-induced platelet-endothelial cell adhesion. Results demonstrating reduced adhesion with a glycoprotein IIb-IIIa-specific blocking monoclonal antibody confirmed the specificity of the LSC detection of platelet-endothelial cell adhesion.LSC is a novel method for detecting platelet--endothelial cell adhesion. Its advantages over other methods are: (a) endothelial cells remain undisturbed and adherent throughout; (b) the ability to detect individual bound platelets and subpopulations; (c) the ability to store images and slides and then relocate, revisualize, and reanalyze individual cells or cell populations of interest; and (d) no radioactivity.

The only known function of the 41 amino acid cleaved peptide (TR1-41) of the seven transmembrane domain thrombin receptor (PARI) is to activate platelets (as determined by aggregation, surface P-selectin, and fibrinogen binding to activated GPIIb-IIIa). We now demonstrate that TR1-41 results in a concentration-dependent decrease in the platelet surface expression of each component of the GPIb-IX-V complex, as determined by flow cytometry with a panel of monoclonal antibodies (including 6D1, directed against the von Willebrand factor binding site on GPIbalpha, and TM60, directed against the thrombin binding site on GPIbalpha). TR1-41 also decreased ristocetin-induced platelet agglutination. Immunoblotting after incubation of platelets with TR1-41 revealed neither a loss of platelet GPIb nor increase in supernatant GPIb fragments. As demonstrated by immunoelectron microscopy, TR1-41 resulted in a redistribution of GPIb, GPIX, and GPV from the platelet surface to the surface-connected canalicular system (SCCS). In summary, the cleaved peptide (TR1-41) of PAR1 results in a redistribution of the platelet surface GPIb-IX-V complex to the SCCS, thereby negatively regulating the GPIbalpha binding sites for von Willebrand factor and thrombin.

In addition to inhibition of platelet aggregation, GPIIb-IIIa antagonists may reduce thrombotic events via other mechanisms. In a novel whole blood flow cytometric system, we investigated the effects of GPIIb-IIIa antagonists, in the presence or absence of thrombin inhibitors, on platelet surface-bound factor V/Va and platelet surface phospholipids. Diluted venous blood was incubated with either buffer or a GPIIb-IIIa antagonist (abciximab, tirofiban, or eptifibatide). Some samples were pre-incubated with clinically relevant concentrations of unfractionated heparin (UFH), a low molecular weight heparin, a direct thrombin inhibitor, or buffer only. Platelets were then activated and labeled with mAb V237 (factor V/Va-specific) or annexin V (binds phosphatidylserine), fixed, and analyzed by flow cytometry. In the absence of thrombin inhibitors, GPIIb-IIIa antagonists (especially abciximab) significantly reduced agonist-induced platelet procoagulant activity, as determined by reduced binding of V237 and annexin V. At high pharmacologic concentrations, unfractionated heparin and enoxaparin, but not hirudin, further reduced factor V/Va binding to the surface of activated platelets in the presence of GPIIb-IIa antagonists. Agonist-induced platelet procoagulant activity was reduced in a patient with Glanzmann's thrombasthenia. We conclude that GPIIb-IIIa antagonists reduce platelet procoagulant activity in whole blood and heparin and enoxaparin augment this reduction. Fibrinogen binding to GPIIb-IIIa is important in the generation of platelet procoagulant activity.

We found that rats pretreated with interleukin-1 (IL-1) intraperitoneally did not develop the acute oxidative, neutrophil-dependent lung leak that occurs after administration of IL-1 intratracheally (IL-1-induced tolerance). IL-1-pretreated rats also had increased lung catalase and glucose-6-phosphate dehydrogenase (G6PDH) activity and increased plasma catalase activity compared with sham-pretreated rats. In contrast to reducing lung leak, IL-1 pretreatment did not reduce the numbers of neutrophils that are increased in lung lavages of rats given IL-1 intratracheally. IL-1-induced tolerance to IL-1-mediated lung leak and the associated increases in lung catalase, lung G6PDH, and serum catalase activities were all prevented by treating rats with the IL-1-receptor antagonist or with N-acetyl-L-cysteine, an agent that increases intracellular glutathione levels. Our results indicate that IL-1 pretreatment confers tolerance to IL-1-mediated lung leak without decreasing IL-1-induced increases in lung neutrophils. The possible protective actions of IL-1 should be considered in experiments and clinical trials where IL-1 activity is reduced pharmacologically.

The authors discuss developmental abnormalities of the thyroid cartilage and its injuries in blunt injuries of the neck. Basing on two cases, they describe developmental abnormalities (no joining between the superior horn and the lamina or complete absence of one of the superior horns) that during autopsies were considered, to be resultant from injuries.

A multidisciplinary approach to the study of a family with autosomal dominant sensorineural hearing loss is presented. The affected family members underwent extensive clinical and laboratory evaluation. They were found to have various degrees of bilateral congenital inner ear anomalies as imaged by computed tomography. The degree of structural abnormalities in the inner ears correlated with the severity of hearing impairment. Vestibular testing revealed nonspecific abnormalities generally correlating with audiologic and radiographic findings. This report presents a unique form of sensorineural hearing loss not previously described and is the first in-depth clinical study of nonsyndromal “Mondini dysplasia” occurring in a family.

Physicians in various subspecialties routinely perform physical examinations of the back and extremities utilizing their understanding of peripheral anatomy, extremity kinesiology, and neuro- musculo-ligamentous pathologies. We are developing a HyperCard computer application which combines text, graphics, and sound to teach, review, and test functional limb anatomy and kinesiology in an independent, non-confrontational, user-friendly environment. The software incorporates principles which maximize learning, runs on hardware accessible to most people, encourages independent learning and self evaluation, and utilizes links which take advantage of the network structure inherent to anatomy.

Presented are the literature data as well as the results of our own investigations on the genotoxic and carcinogenic effects of sodium nitrite (SN). The carcinogenicity of SN detected in animal experiments appears to be related to the formation of nitroso compounds from endogenous nitrosable precursors. Sodium nitrite possesses transforming and promoting effects in cell cultures, as well as mutagenic effects in the bacterial systems, where the predominant effect of SN was compared to that of N-nitrosodimethylamine (NDMA). Prolonged pretreatment with SN amplifies the liver DNA damage in rats in case of NDMA endogenous synthesis.

Data from literature as well as the results of the author's investigations on the genotoxic and carcinogenic effects of sodium nitrite (SN) are presented. Carcinogenicity of SN detected in animal experiments proved to be connected with the formation of nitroso compounds from endogenous nitrosable precursors. Sodium nitrite possessed the transforming and promoting effects in the cell cultures as well as the mutagenic effects in the bacterial systems where predominant effect of SN as compared with N-nitrosodimethylamine (NDMA) was registered. The prolonged pretreatment with SN amplified the liver DNA damage in rats in case of NDMA endogenous synthesis.

We describe a method for growing epitaxial layers of zinc sulfide and cadmium sulfide solid solutions on the A-side of GaAs (111) by means of separated sulfide sources in an open hydrogen iodide system. The effects of substrate temperature, amount of doping from substrate elements, and source temperatures on photoluminescence from epitaxial films of ZnxCd1−xS on GaAs are determined. By varying the growth conditions it is possible to primarily obtain a single band in the emission spectrum. The presence of a larger number of photoluminescence bands indicates that the solid solution is nonhomogeneous. The composition of the solid-solution films was determined through empirical relationships based on spectra from standard solutions. X-ray analysis was used to confirm the compositions.

The damage of liver DNA formation during endogenic synthesis of N-nitrosodimethylamine (NDMA) have been studied after introduction of its precursors, dimethylamine, amidopyrine and sodium nitrite, into the rat stomach. A combined administration of various doses of dimethylamine and nitrite increased the amount of single-strand DNA from 3.0 to 11.3%. The maximum DNA damage after administration of the precursors was observed after 24 h, and after 48 h it decreased to the control level. Pretreatment of rats with dimethylamine or nitrite increased the DNA damage induced by NDMA formation (37.4% and 41.6%, respectively).

A complex of immunological cell tests with M. pneumoniae antigen (the lymphocyte blast-cell transformation test, the allergic neutrophil alteration test) was carried out in order to establish the correlation between the results of positive seroconversion and the sepcific immunological reactivity of lymphoid cells in pneumonia patients. Mycoplasmic cutireactive allergen, when used for the accelerated diagnosis of mycoplasmic pneumonia in humans, was shown to be specific and safe. Cuti-allergic tests with mycoplasmic allergen allowed to diagnose mycoplasmic pneumonia at early stages (beginning from days 5--7), which ensures the possibility of indicating etiotropic treatment to patients in due time.