[Comparative analysis of in-hospital and long-term results of patients with acute dysfunction of coronary bypass grafts depending on treatment tactics]. / Sravnitel'nyi analiz gospital'nykh i otdalennykh rezul'tatov patsientov s ostroi disfunktsiei koronarnykh shuntov v zavisimosti ot taktiki lecheniya.

OBJECTIVE: Comparative analysis of in-hospital and long-term mortality of patients in whom acute dysfunction of coronary bypass grafts was detected in the early postoperative period depending on conservative or surgical tactics. MATERIAL AND METHODS: The study is a retrospective analysis of data from 8801 patients who underwent elective coronary artery bypass grafting (CABG) between 2011 and 2022 at the Federal Center for Cardiovascular Surgery (Russia, Chelyabinsk). Among them, 196 patients underwent emergency coronary artery bypass grafting due to suspected perioperative myocardial infarction in the early postoperative period. In 119 patients, dysfunction of coronary bypass grafts was detected, in 77 patients no pathological changes were found. The criteria for inclusion in the study were patients with dysfunction of coronary bypass grafts (n=119). The 1st group included patients who underwent conservative therapy (n=33), the 2nd group (n=86) included those who underwent repeated myocardial revascularization. The primary endpoint was hospital mortality, secondary endpoints were long-term mortality and adverse cardiovascular events (myocardial infarction, stroke, repeat myocardial revascularization). Patients were surveyed via telephone. RESULTS: In-hospital mortality in the group of surgical reintervention was 8.1%, in the group of conservative treatment - 9.1% (p=0.867). According to the results of multivariate analysis, predictors of hospital mortality in patients of both groups were extracorporeal membrane oxygenation (p=0.014), time of artificial circulation (p=0.031), duration of artificial ventilation (p=0.001), number of days in intensive care (p<0.001). When analyzing long-term mortality using the Kaplan-Meier method in group 1 and group 2, no statistically significant differences were found; in the group of conservative therapy - 85±9.6 [66.2-103.7] months versus 108.2±4.8 [98.8-117.6] months in the surgery group (log-rank p=0.06). When analyzing long-term mortality from cardiovascular causes and the occurrence of adverse cardiovascular events, statistically significant differences were determined: in the group of conservative therapy - 92.5±9.3 [74.2-110.7] months versus 117.8±3.3 [111.2-124.3] months in the surgical treatment group (log-rank p=0.007) and 78.1±9.2 [60-96.3] months versus 98.9±3.9 [91.3-106.5] months (log-rank p=0.008), respectively. CONCLUSION: In-hospital mortality was comparable between groups. Long-term mortality from cardiovascular causes and the number of adverse cardiovascular events were significantly higher in the conservative therapy group. With timely detection of acute dysfunction of coronary bypass grafts, an active surgical approach has an advantage over conservative tactics and can improve the long-term prognosis of patients.

[Direct myocardial revascularization after 6, 12 and 24 hours of acute coronary syndrome]. / Pryamaya revaskulyarizatsiya miokarda cherez 6, 12, 24 chasa pri ostrom koronarnom sindrome.

OBJECTIVE: To evaluate the results of direct myocardial revascularization within 72 hours after manifestation of acute coronary syndrome. MATERIAL AND METHODS: A retrospective study included 48 (0.47%) out of 10 193 patients with coronary artery disease who underwent coronary artery bypass grafting for the period 2011-2019. Study patients underwent urgent direct myocardial revascularization. SYNTAX Score >22 points was observed in all cases. All patients were divided into 3 groups depending on timing of surgery: 26 patients - within 6 hours after admission, 15 patients - within 6 - 24 hours, 7 patients - within 24-72 hours. RESULTS: Level of myocardial damage markers was similar after 1 and 2 days (p>0.05). In the 1st group, 1 (3.84%) patient died in hospital, 5 (19.2%) patients - within 1 year after surgery. In the 2nd group, these values were 1 (6.6%) and 0, respectively. There was no mortality in the 3rd group (p>0.05). Overall 5-year survival was 100%. CONCLUSION: Early active open revascularization is advisable in patients with ACS and clear indications for surgery.

[Peculiariities of diagnostic parameters in patients with acute myocardial lesion after coronary artery bypass grafting]. / Osobennosti diagnosticheskikh pokazatelei u patsientov s ostrym povrezhdeniem miokarda posle operatsii aortokoronarnogo shuntirovaniia.

Annually, up to 850 000 coronary aortic bypass graft operations are performed worldwide. Despite modern technical equipment ensuring a high level of safety of the procedure, currently important remains a problem related to intraoperative myocardial damage in using artificial circulation. Early detection and clinical assessment of myocardial ischaemia often present a difficult task. This article deals with clinical, instrumental and laboratory methods of diagnosis, aimed at verification of an intraoperative cardiac lesion associated with graft dysfunction in coronary artery bypass grafting. Isolated electrocardiographic and echocardiographic signs of myocardial ischaemia between the comparison groups did not differ significantly. Analysing the markers of myocardial lesions, statistically significant differences were obtained only after 48 hours which, from the point of view of saving viable myocardium, is an utterly long-term interval. Studying the findings of intraoperative flowmetry showed statistically significant dependence between velocity characteristics, pulse index of shunts and their patency on angiographic examination. Thus, only combination of diagnostic parameters makes it possible to detect myocardial damage related to shunt dysfunction. This enables early determination of indications for performing bypass angiography and selection of the required therapeutic policy. Timely coronary artery angiography makes it possible to reveal defects of shunts and to timely perform surgical correction, preventing myocardial infarction.

Pulsed magnetic field generation system for laser-plasma research.

An up to 15 T pulsed magnetic field generator in a volume of a few cubic centimeters has been developed for experiments with magnetized laser plasma. The magnetic field is created by a pair of coils placed in a sealed reservoir with liquid nitrogen, installed in a vacuum chamber with a laser target. The bearing body provides the mechanical strength of the system both in the case of co-directional and oppositely connected coils. The configuration of the housing allows laser radiation to be introduced into the working area between the coils in a wide range of directions and focusing angles, places targets away from the symmetry axis of the magnetic system, and irradiates several targets simultaneously.

Episodes of Rapid Recovery of the Functional Activity of the ras85D Gene in the Evolutionary History of Phylogenetically Distant Drosophila Species.

As assemblies of genomes of new species with varying degrees of relationship appear, it becomes obvious that structural rearrangements of the genome, such as inversions, translocations, and transposon movements, are an essential and often the main source of evolutionary variation. In this regard, the following questions arise. How conserved are the regulatory regions of genes? Do they have a common evolutionary origin? And how and at what rate is the functional activity of genes restored during structural changes in the promoter region? In this article, we analyze the evolutionary history of the formation of the regulatory region of the ras85D gene in different lineages of the genus Drosophila, as well as the participation of mobile elements in structural rearrangements and in the replacement of specific areas of the promoter region with those of independent evolutionary origin. In the process, we substantiate hypotheses about the selection of promoter elements from a number of frequently repeated motifs with different degrees of degeneracy in the ancestral sequence, as well as about the restoration of the minimum required set of regulatory sequences using a conversion mechanism or similar.

[Coronary artery bypass grafting in non-ST-segment elevation acute myocardial infarction]. / Koronarnoe shuntirovanie pri ostrom infarkte miokarda bez pod''ema segmenta ST.

AIM: The study was aimed at comparatively assessing the immediate results of coronary artery bypass grafting operations without artificial circulation performed in non-ST-segment elevation acute myocardial infarction and chronic ischaemic heart disease. PATIENTS AND METHODS: The main group with non-ST-segment elevation acute myocardial infarction enrolled a total of 101 patients undergoing coronary artery bypass grafting without artificial circulation. The patients' age varied from 47 to 87 years, median 66.0 years (60.0; 71.0). The indication for the operation was persistent myocardial ischaemia on the background of carried out therapy with impossibility of performing percutaneous coronary intervention due to anatomy of coronary arteries and peculiarities of their pathology. The comparison group of chronic ischaemic heart disease was composed of 108 patients undergoing elective coronary artery bypass grafting without artificial circulation. The patients' age varied from 40 to 92 years, median - 60.0 years (58.0; 68.0). The patients with acute myocardial infarction had a significantly greater (p<0.05) number of coronary arteries measuring in diameter 2.5 mm and more, with significant occlusive and stenotic lesions, as well as a higher total SYNTAX score. The patients undergoing elective surgery were found to have an initially higher (p<0.05) left ventricular ejection fraction. RESULTS: In the group of acute myocardial infarction the waiting times for coronary artery bypass grafting varied from 2 to 8 days, median of waiting - 4.0 days (4.0; 5.0). The lethality rate (p<0.05) in the group of acute myocardial infarction amounted to 3.0% (3 cases) and in the group of chronic ischaemic heart disease to 0.9% (1 case). Twenty-one (20.8%) operations were carried out within the first 72 hours, with eighty surgical interventions (79.2%) performed after 72 hours from the onset of the disease. All 3 (3.8%) lethal outcomes were observed after coronary artery bypass grafting procedures performed later than 72 hours from the onset of acute myocardial infarction (p>0.05). The total number of complications (p>0.05) amounted to 18 (17.8%) and 10 (9.3%) in the group of acute myocardial infarction and in the group of chronic ischaemic heart disease, respectively. CONCLUSION: The immediate results of delayed coronary artery bypass grafting procedures without artificial circulation for acute myocardial infarction and chronic ischaemic heart disease were statistically comparable (p>0.05) by the lethality and complication rates. Lethality in the group of non-ST-segment elevation acute myocardial infarction din not depend on the time of operation after the onset of the disease.

[New possibilities of antithrombotic therapy improving prognosis in patients with stenosing atherosclerosis of carotid arteries]. / Novye vozmozhnosti antitromboticheskoi terapii, uluchshaiushchie prognoz u patsientov so stenoziruiushchim aterosklerozom sonnykh arterii.

The purpose of the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial was to evaluate a regimen of a two-way impact on thrombus formation in patients presenting with ischaemic heart disease and peripheral artery diseases. The study included a total of 1,919 patients with stenosis of carotid arteries and 1,032 patients with a history of stroke. Many patients with disease of peripheral arteries (including carotid arteries) enrolled into the COMPASS trial appeared to have additional risk factors for stroke such as, for instance, current or former smoking, diabetes mellitus, or ischaemic heart disease. An additionally carried out analysis for strokes revealed that supplementing rivaroxaban at a dose of 2.5 mg twice daily to acetylsalicylic acid decreased the risk for the development of ischaemic stroke by 49% (p<0.001), without increasing the risk for haemorrhagic transformation on the background of combined therapy (HR=0.35; 95% CI: 0.13-0.99; p=0.04), whereas the risk for haemorrhagic strokes remained at a low level and did not differ between the groups (HR=1.49; 95% CI: 0.67-3.31; p=0.33). The composite risk for major ischaemic and haemorrhagic events was significantly lower in the group of combined therapy. Adding rivaroxaban to acetylsalicylic acid appeared to result in a decrease in the risk of all-cause mortality in patients with ischaemic heart disease and peripheral artery disease by 18%. Thus, the addition of rivaroxaban at a dose of 2.5 mg twice daily to acetylsalicylic acid made it possible to decrease the risks of both primary and secondary strokes, and hence may be considered in patients with significant stenoses of carotid arteries for primary prevention, whereas in patients with endured ischaemic stroke - for secondary prevention, as well as after open endovascular reconstructive operations on carotid arteries.

[Possibilities of using the Colibri system for endovenous laser ablation]. / Vozmozhnosti primeneniia sistemy Colibri pri éndovenoznoi lazernoi obliteratsii.

AIM: The purpose of the study was to assess efficacy of endovenous laser ablation of major saphenous veins by means of the Mediola single-ring radial light guides with the use of the 'Optical Handpiece MHP02 (Colibri)'. PATIENTS AND METHODS: This non-comparative prospective study included 430 consecutive patients who underwent a total of 511 endovenous laser ablation procedures from January 2018 to March 2019. The great saphenous vein was subjected to obliteration in 343 (67.1%) cases, the anterior accessory saphenous vein - in 94 (18.4%) cases, and the small saphenous vein - in 74 (14.5%) cases. There were 170 (39.5%) men and 260 (60.5%) women, with a mean age of 52±12.8 years. RESULTS: The next day after the intervention the patients revisited the clinic for control examination, with the obtained findings demonstrating that occlusion of the target vein had been achieved in all 511 (100%) cases. At 2 months, we examined 411 (95.6%) people with a total of 484 (94.7%) treated veins. After 6 months, 399 (92.8%) people with 472 (92.4%) veins were examined. Recanalization with pathological reflux during the entire follow-up period was registered in 6 (1.3%) cases. Hence, the long-term rate of obliteration amounted to 98.7%. CONCLUSIONS: 1) endovenous laser ablation of major saphenous veins by means of the Mediola laser unit with wavelength of 1470 nm and single-ring radial light guides with the use of the 'Optical Handpiece MHP02 (Colibri)' made it possible to achieve obliteration of the target vein in 98.7% of cases at 6 months of follow up; 2) within the mentioned terms, the need for repeat intervention could appear in 1.1% of cases; 3) the Colibri system provides a possibility of decreasing the final cost of radial light guides for endovenous laser ablation by 30-50%.

[Possibilities of endovenous laser obliteration of subcutaneous veins with tumescence by cold saline solution]. / Vozmozhnosti éndovenoznoi lazernoi obliteratsii podkozhnykh ven s tumestsentsiei okhlazhdennym fiziologicheskim rastvorom.

AIM: The purpose of the present study was to assess the possibility of carrying out endovenous laser obliteration (EVLO) with radial light guides on a laser device operating at a wavelength of 1470 nm, using for tumescence only cold normal saline solution without additional sedation or narcosis in patients with allergy to local anaesthetics. PATIENTS AND METHODS: Our prospective non-comparative single-centre study consecutively included 37 patients who from November 2014 to June 2019 underwent a total of 41 isolated EVLO procedures without simultaneous miniphlebectomy or sclerotherapy of tributaries. Given the previous history of allergy to amide-group local anaesthetics and/or multiple allergic reactions to other agents, these patients received as anaesthesia and tumescence exclusively normal saline solution cooled to a temperature of +3-6ºC, without addition of local anaesthetics or any other therapeutic agents, with neither sedation nor narcosis. RESULTS: The great saphenous vein was subjected to coagulation in 33 (80.5%) cases, the anterior accessory saphenous vein in 5 (12.2%), and the small saphenous vein in 3 (7.3%) cases. The median of the mean diameter of the veins at 3 cm from the saphenofemoral or saphenopopliteal junction amounted to 10 mm (1st quartile 8.2; 3rd quartile 11). The median of the mean length of the coagulated vein - 45 cm (1st quartile 22; 3rd quartile 51), the median of the average amount of the administered normal saline solution - 300 ml (1st quartile 200; 3rd quartile 450), the median of the average amount of normal saline per 1 centimetre of the venous length - 8.7 ml (1st quartile 7.5; 3rd quartile 10). All patients without exception tolerated the intervention. The process of laser obliteration was not discontinued due to pronounced perioperative pain syndrome in any case. All patients after the procedure answered the question 'Would you repeat a similar intervention if the need arises?' in the affirmative. All the 41 (100 %) veins subjected to coagulation were obliterated at early terms of follow up, with no ultrasonographic evidence of recanalization. CONCLUSION: The obtained findings suggest a possibility of performing EVLO in patients with an allergy-burdened history in relation to local anaesthetics using for tumescence exclusively normal saline solution chilled to a temperature of +3-6ºC, with no additional sedation or narcosis. Such an approach makes it possible, on the one hand, not to change the organization of outpatient phlebological care and on the other hand to refuse from involving anaesthesiological support. Besides, it is absolutely safe in relation to the risk for the development of allergic reactions.

Experimental demonstration of the third cyclotron harmonic excitation in technological gyrotron with delayed selective feedback.

The excitation and effective selection of modes at high harmonics of the cyclotron frequency are experimentally demonstrated using a delayed feedback into the gyrotron. The operation at the third cyclotron harmonic at the frequency of 40.5 GHz with the output power of 3 kW and efficiency 8% is observed in a continuous wave gyrotron with an oil-cooled magnet with a field of 0.5 T in the interaction space.

Jasmonic Acid Induces Endoplasmic Reticulum Stress with Different Outcome in Cultured Normal and Tumor Epidermal Cells.

Plant hormones produce cytotoxic effect on human cells and can trigger the processes unrelated to cell death, e.g., biosynthetic system stress. The goal of this study was to investigate activation of the endoplasmic reticulum (ER) stress by jasmonic acid (JA) and to distinguish between the responses of cultured immortalized non-tumorigenic HaCaT cells and epidermoid carcinoma A431 cells to this plant hormone. JA was used in the concentration of 2 mM, as it suppressed cell proliferation in both cell lines. We analyzed expression of genes associated with the activation of ER stress (GRP78, ATF4, CHOP), the structure of the ER and Golgi complex, and synthetic processes in the HaCaT and A431 cell lines. JA induced expression of genes responsible for the activation of ER stress and caused hypertrophic changes in the Golgi complex in both cell lines. However, the patterns of gene expression in the HaCaT and A431 cells were different, and higher levels of involucrin synthesis were observed in A431 but not in HaCaT cells, suggesting that JA activated differentiation of the tumor A431 cells only. Therefore, JA induced ER stress in both cell lines, but the consequences of ER stress were different for the epidermal immortalized non-tumorigenic and tumor cells.

[Diosmin-containing phlebotropic drugs in varicose eczema]. / Diosminsoderzhashchie flebotropnye lekarstvennye preparaty pri varikoznoi ékzeme.

AIM: The purpose of the study was to examine the effect of diosmine-based phlebotropic drugs on dynamics of regress of varicose eczema in patients with chronic venous diseases, to compare their objective complaints and subjective symptoms before and after treatment, to determine the time of improvement. PATIENTS AND METHODS: The study enrolled a total of 80 patients presenting with chronic venous diseases complicated by varicose eczema (CEAP class C4A). The patients of the Study Group received combined treatment: elastic compression of lower extremities, phlebotropic agents (diosmin 450 mg + hesperidin 50 mg, 'Venarus' (manufactured by the Limited Liability Company 'Obolenskoe', Russia) and a dermatologist's prescribed topical treatment. The patients of the Comparison Group received similar treatment with the exception of phlebotropic drugs, however taking penoxiphylline at a daily dose of 1200 mg. RESULTS: The obtained findings demonstrated a decrease in pain intensity, lowered exudation, achievement of complete remission and reduced area of eczema with statistically significant differences in the groups. CONCLUSION: Modern phlebotropic drugs based on diosmin proved to be effective agents in comprehensive treatment of chronic diseases of lower-limb veins and varicose eczema.

[Analysis of risk factors for lethal outcomes of ST-segment elevation acute myocardial infarction]. / Analiz faktorov riska letal'nykh iskhodov ostrogo infarkta miokarda s pod''emom segmenta ST.

The purpose of the study was to objectively assess lethal outcomes in patients with the final diagnosis of 'ST-segment elevation acute myocardial infarction' (STEAMI) in order to reveal the circumstances and peculiarities of an unfavourable outcome. The work was performed on the basis of the medical records over 2014-2016, retrospectively analysing cases of STEAMI: a total of 131 lethal outcomes regardless of reperfusion therapy and 1,004 patients having survived after percutaneous coronary intervention (PCI). The data statistically significantly (p<0.05) distinguishing lethal outcomes were as follows: prevalence of female patients - 59.5%; transmural myocardial lesion - 90.1%; recurrent myocardial infarction - 32.1%; a history of functional class I-III angina of effort - 31.3%; a high average value of acute heart failure according to T. Killip classification - 2.4±0.2; cardiogenic shock - 30.6%; high frequency of previously endured acute cerebral circulatory impairments - 9.9%, a history of type 2 diabetes mellitus - 32.8% and degree I-III obesity - 35.1%. Amongst the deceased patients with AMI complicated by postinfarction cardiosclerosis and preexisting FC I-III angina of effort there was a low proportion of coronary angiography (CAG) (8.4%) and coronary operations (6.9%) previously performed. Also registered was a low frequency of reperfusion treatment (45.8%), which was associated with early mortality (within the first 2 hours of admission - 51.9%, within 3 to 24 hours - 16.8%). A decrease in efficacy of the interventions performed was influenced by syndromes of slow or absent blood flow (20.7% of PCI), as well as a multivessel haemodynamically significant lesion of three and more coronary arteries (56.2% of the CAGs performed). The obtained data concerning concomitant pathology and the condition are used to draw up a portrait of a patient jeopardised by a lethal outcome associated with AMI. These factors should be taken into consideration at the outpatient stage for a more active reperfusion policy aimed at preventing AMI.

[Venous thromboembolic complications in oncological patients: present-day possibilities of effective and safe anticoagulant therapy]. / Venoznye tromboémbolicheskie oslozhneniia u onkologicheskikh bol'nykh - sovremennye vozmozhnosti éffektivnoi i bezopasnoi antikoaguliantnoi terapii.

Cancer-associated thromboembolic complications in malignant neoplasms are commonly encountered. They deteriorate the course of the underlying disease and are frequent causes of death. The oncological patient is at high risk of not only thrombosis but haemorrhage during anticoagulant therapy. Recent randomized clinical trials have positively appreciated the possibilities of direct oral anticoagulants in treatment and prevention of thromboses in oncological patients. Analysing subgroups in these studies demonstrated that direct oral anticoagulants during long-term administration were at least as effective and safe as vitamin K antagonists. The most significant by the number of cases, duration of therapy, and methodology of analysis are the reports regarding rivaroxaban - an oral, direct factor Xa inhibitor. There are also findings obtained in a separate randomized study, confirming efficacy and safety of rivaroxaban in treatment of patients with cancer-associated venous thromboembolic complications as compared with therapy with low-molecular-weight heparins. Namely these results formed the basis for the guidelines of the International Society on Thrombosis and Hemostasis (SSC ISTH), according to which rivaroxaban may be regarded as an alternative to low-molecular-weight heparins in certain clinical situations.

[Stenting of calcified iliofemoral venous segment in post-thrombotic syndrome]. / Stentirovanie kal'tsinirovannogo iliofemoral'nogo venoznogo segmenta pri posttromboticheskom sindrome.

Stenting of the iliac veins in patients with post-thrombotic syndrome is an intervention associated with a low risk of complications, high primary and secondary patency rates, low incidence of restenosis, leading to a significant decrease in the severity of symptoms of chronic venous disease and a high rate of trophic ulcer healing, as compared with conservative therapy. Unlike subcutaneous veins, the formation of calcinates in deep veins after endured thrombosis is of considerably less frequent occurrence. Described in the article is a clinical case report concerning successful stenting of the iliofemoral venous segment in a female patient presenting with post-thrombotic syndrome, a trophic ulcer of the crus, and the presence of linear calcinosis in the lumen of the iliac veins and common femoral vein. This case report demonstrates the possibilities of contemporary endovenous techniques in treatment of this cohort of patients. Despite calcified segments, stenting was performed without technical obstacles and with a favourable clinical outcome. Such interventions may be regarded as justified and safe provided the operating surgeon has appropriate skill and experience.

Liquid-liquid transition in supercooled gallium alloys under nanoconfinement.

NMR studies of the thermal evolution of the Ga-In-Sn and Ga-In liquid alloys embedded into opal matrices were carried out. Temperature dependences of the gallium lineshape, shift of the resonance frequency (Knight shift), and intensity were obtained upon cooling down to the alloy freezing and subsequent warming. A second high-frequency 71Ga NMR signal emerged for both alloys upon cooling, the NMR line intensity transferring gradually into this additional signal. The Knight shifts of the signals differed noticeably. The transformations of the gallium line upon warming were continuous and not affected by changes in the alloy compositions induced by melting. 115In NMR measurements were conducted to monitor the alloy compositions at freezing and melting. The findings suggest the occurrence of the liquid-liquid phase transition in the strongly supercooled alloys under nanoconfinement.

Control of sub-terahertz gyrotron frequency by modulation-anode voltage: Comparison of theoretical and experimental results.

This paper presents a comparison of simple self-consistent theory data and experimental results aimed to study the influence of the anode voltage on the frequency of the subterahertz gyrotron with the goal of frequency stabilization. Numerical simulations of the electron beam formation and beam-wave interaction in a 0.26 THz gyrotron are performed. The experimental dependence of the gyrotron frequency tuning on mod-anode voltage is in agreement with theoretical predictions.

[Damage to subcutaneous nerves in endovenous laser coagulation of the great saphenous vein]. / Povrezhdenie podkozhnykh nervov pri éndovenoznoi lazernoi koaguliatsii bol'shoi podkozhnoi veny.

The purpose of this study was to assess the incidence of the development of symptoms of damage to subcutaneous nerves after endovenous laser coagulation (EVLC) of the great saphenous vein (GSV), as well as to determine the effect of these symptoms on quality of life (QoL) of patients. Our retrospective study enrolled a total of 119 patients (mean age 50±13.9 years) subjected to 151 isolated EVLC of the GSV. The average volume of the injected anaesthetic per 1 cm of the vein's length amounted to 8.5±1.9 ml. Puncture of the GSV at the level of the thigh was performed in 37 (24.5%) cases, at the level of the crus in 114 (75.5%) cases. The intervention was performed at the power 5-10 W and linear density of energy approximately 70 J/cm. The median of the follow up period amounted to 264 days. The patients were interrogated by phone. The questionnaire included leading, understandable for patients questions about the presence of postoperative complaints characteristic of damage to subcutaneous nerves, as well as the question about the effect of these complaints on quality of life. The complaints characteristic of damage to subcutaneous nerves were reported for 61 (40.4%) operated limbs, with these symptoms decreasing quality of life only in 7 (4.6%) cases. All respondents noted gradual regression of the symptoms with time. The median of symptom relief amounted to 2 months. The analysis of interrelationship between the level of puncture by the thirds of the femur and crus and the damage of subcutaneous nerves demonstrated no statistically significant association (p=0.108), unlike the analysis by the femur/crus level, wherein the infragenicular puncture significantly increased the risk of traumatisation of subcutaneous nerves (p=0.022). No statistically significant differences by the frequency of damage to subcutaneous nerves depending on the power of energy were revealed (p=0.662). The obtained findings make it possible to recommend EVLC, including with puncture of the GSV below the knee, for patients with varicose veins in this basin.

First experimental tests of powerful 250 GHz gyrotron for future fusion research and collective Thomson scattering diagnostics.

A 250 GHz continuous-wave (CW) gyrotron has been developed at the IAP RAS jointly with GYCOM Ltd., as a prototype of the microwave source for the envisaged prospective nuclear fusion power plants (DEMO). The main applications of such a tube are electron cyclotron resonance heating and electron cyclotron resonance current drive of magnetically confined plasma as well as its diagnostics based on collective Thomson scattering in various reactors for controlled thermonuclear fusion (e.g., tokamaks and stellarators). The results of the preliminary experimental tests in a pulsed mode of operation are presented. The microwave power of up to 330 kW with an efficiency of 30% without collector depression was obtained. At an accelerating voltage of 55 kV and an electron beam current of 12.5 A (which corresponds to the design parameters for CW operation), the measured output power was about 200 kW. The TEM00 mode content evaluated at the tube output is not less than 98.6%.

[Algorithm of treatment policy for a femoral artery false aneurysm]. / Algoritm deistvii pri lozhnoi anevrizme bedrennykh arterii.

The purpose of the study was to elaborate an algorithm of treatment policy for post-puncture false aneurysms of the femoral artery (FAFA). The study was performed on the basis of the clinical material over 2014-2017 at the Regional Vascular Centre whose specialists have since 2017 been using the femoral arterial approach (FAA) only if the radial arteries are inaccessible for puncture or for inserting the endovascular tools and appliances. The obtained findings demonstrated that the number of coronary interventions performed with the use of the femoral arterial approach in patients presenting with acute coronary syndrome decreased from a total of 758 (100.0%) in 2014 to 166 (13.8%) in 2017. The frequency of FAFAs not subjected to surgical management and those subjected to surgical suturing by 2017 increased to 3.0 and 1.2%, respectively, with the same values for 2014 amounting to 1.8 and 0.4%, respectively. Taking into account the still existing necessity of using the femoral arterial approach in the patients, as a rule, belonging to the cohort of the so-called 'problem patients', the authors worked out an algorithm of therapeutic policy for FAFAs, which would make it possible to increase both efficiency and safety of the carried out endovascular interventions, as well as to determine the risks with their minimization in the postoperative period.