[Occupational risk of cardiovascular diseases in workers engaged into underground mining].

The article presents results of evaluation of a priori and a posteriori occupational risks for workers engaged into underground mining. Evidence is that work conditions of major occupational groups of workers engaged into underground mining, according to workplace certification, correspond to 3 class 3 jeopardy degree. A priori risk of diseases development corresponds to high (unbearable). Evaluation of cause-effect relationship between health disorders and work conditions revealed a medium degree of occupational conditionality for vascular regulation disorders and metabolic disorders, that can be considered as cardiorisk indicators.

[Analysis of changes in characteristics of arterial hypertension occupational risk in workers of nonferrous metallurgy].

The article covers changes in occupational cardiovascular risk for workers of nonferrous,metallurgy. Findings are that exposure to noise up to 94 dB with length of service increases possible atherosclerosis and metabolic syndrome. With 5 years of service, risk of the predicted conditions increases by 40.5%. When occupational exposure lasts over 5 years, risk of arterial hypertension increases. A group of workers without exposure to occupational factors appeared to have no connection between length of service and metabolic syndrome and arterial hypertension. Risk evolution modelling proved that risk of functional disorders in nonferrous metallurgy workers becomes unacceptable after 5 years of service (cardiovascular disorders are critical).

[Role of opportunistic infection causative agent in etiology of obstructive bronchitis and prolonged subfebrility in children].

AIM: Determine the role of opportunistic infections causative agents in ethology of obstructive bronchitises and prolonged subfebrilities in children. MATERIALS AND METHODS: 56 children with the diagnosis of obstructive bronchitis and 46 children with the diagnosis of prolonged subfebrility were examined for the presence of herpes, mycoplasma and pneumocystic infections. EIA, IIF, rapid culture method, PCR were used. RESULTS: The highest number of cases of mixed infection was detected in children with HHV-6 infection. Mixed infection was diagnosed 6 times more frequently in children with obstructive bronchitis and 9 times in children with prolonged subfebrility. The number of children with pneumocystosis in combination with other infections was 2.4 and 2 times higher than with monoinfection; with CMV infection--4 and 2 times; with HSV infection--5 and 4 times; EBV infection--6 and 3.7 times. The only exception was mycoplasmosis detected in children with obstructive bronchitis where the difference between the number of mono and mixed infection cases was insignificant. CONCLUSION: The data obtained give evidence of wide spread of opportunistic infections.

[Ground-based speleo-climatic wards and the experience with their use in bronchial asthma]. / Nazemnye speleoklimaticheskie palaty i opyt primeneniia pri bronkhial'noi astme.

Ambient air in ground wards made to contain natural potassium-sodium salt is close in characteristics to the atmosphere of underground wards but has a number of specificities: daily fluctuations of concentrations of light aeroions and aerosol particles, elevated concentration of light aeroions concentration, low radiation background, minimal bacterial contamination. The stay in ground wards brings great benefit for patients with bronchial asthma. Ground speleo-climatic wards are perspective in nonpharmacological treatment of patients with allergic respiratory diseases.

[A cultured concentrated inactivated vaccine against tick-borne encephalitis studied during the immunization of children and adolescents]. / Izuchenie kul'tural'noi kontsentrirovannoi inaktivirovannoi vaktsiny protiv kleshchevogo éntsefalita pri immunizatsii detei i podrostkov.

The word deals with the results obtained in the study of the reactogenicity and immunological activity of concentrated and inactivated tissue-culture tick-borne encephalitis vaccine, manufactured by the Chumakov Institute of Poliomyelitis and Viral Encephalitides, in the immunization of children and adolescents. The vaccine proved to be moderately reactogenic and exhibited pronounced immunological activity. In 91.5% of the immunized children the fourfold increase of the antibody level was observed. On the basis of the data obtained in this study the tick-borne encephalitis vaccine was recommended for use in medical practice for the prophylaxis of tick-borne encephalitis among children and adolescents.

[Experience with the development of vaccinal prophylaxis in Perm Province]. / Opyt razvitiia vaktsinoprofilaktiki v Permskoi oblasti.

The results of the introduction of the system of epidemiological surveillance on vaccinal prophylaxis on the territory of Perm Province are presented. This system has permitted the realization of the principles of the regional tactics of immunization, while following the unified strategy acting on the territory of the Russian Federation. The optimization of the organizational foundations of vaccinal prophylaxis has made it possible to maintain the morbidity rates if infections, controlled by means of specific prophylaxis, on the levels below the average figures for the Federation and to preserve more stable tendencies to their decrease.

[Two cases of fibromuscular dysplasia of the aorta (intimal hyperplasia)]. / Dva nabliudeniia fibrozno-myshechnoi displazii aorty (intimal'noi giperplazii).

Two cases of this rare disease are described: in a 8-year-old girl and in a 6-year-old boy. In the former case there was a combination of a widespread damage to the aorta and coronary arteries while in the latter case intimal proliferation of the renal region of the aorta with stenosis of the renal arteries orifice were observed. Immunohistochemistry in this case showed intimal thickening in FMD to have a similar structure as in other processes. The cells of the smooth muscle type containing vimentin and some of them desmin showing a synthetic fibroplastic phenotype were found in the intimal polyps. The lack of apoprotein B in the deep layers allows to reject atherosclerotic nature of the processes. This observation confirms the opinion according to which intimal dysplasia should be recognized as a form of FMD.

[Surgical anatomy of subaortic conus of the normal heart]. / Khirurgicheskaia anatomiia podaortal'nogo konusa normal'nogo serdtsa.

One hundred and fourty-three normal hearts have been studied. The conoid septum, supraventricular crest, bulboventricular fold, area of the fibrous tissue between the aortal and mitral valves and the anterior interventricular septum make the walls (frontal view, in the direction of the hour hand) of the left ventricular cone. In the normal heart there is no real contact between the fibrous rings of the aortal and mitral valves. They are connected by means of a strip of the fibrous tissue, its size varies. The subaortal cone and deferent part of the left ventricular axes make an obtuse angle; the axes of the subpulmonary and subaortal cones have a cross direction. The geometrically definitive left ventricular cone is seen as obliquely-sectioned overturned isosceles cone, with its big base directed upward, right and back, and the small one forward and left.

[Classification of aortic and pulmonary artery origin from right ventricle]. / Klassifikatsia otkhozhdenia aorty i legochnoi arterii ot pravogo zheludochka.

An original systematics of origin of the aorta and pulmonary artery from the right ventricle (OAPA RV) is suggested on the basis of examination of 63 heart specimens with the anomaly. Two main variants of OAPA RV are distinguished: (1) with and (2) without a formed infundibular septum (IS). Types A and DA belong to the first variant, types B, C, D, and DC to the second variant. Type A is characterized by drainage of the left ventricular (LV) outflow tract (OT) into the subaortic conus. Type DA differs from type A by the existence of an auxiliary opening between the ventricles due to a deficiency of tissue of the posterior (sinus part) of the septum. Type B is characterized by the absence (or marked hypoplasia) of the septum of the conus (SC). The LV OT in this case drains under both (aortic and pulmonary) coni. In type C the LV OT opens into the subpulmonary conus. In distinction from type C, type DC has an auxiliary defect in the sinus part of the interventricular septum (IVS). Type D is characterized by complete obturation of the exit and the absence of a defect in the sinus part of the IVS (type D1: OAPA RV with an intact IVS) or with a sinus defect in the IVS-DIVS (type D2: OAPA RV with noncommitted DIVS). According to the presence or absence of stenosis of the pulmonary artery (PA) or aorta, 4 subtypes are distinguished: (1) without stenosis; (2) with stenosis of PA; (3) with aortic stenosis; (4) with combined aortic and pulmonary stenosis.

[Angiocardiographic diagnosis of the position of the interventricular septal defect in a case of double outlet of the great vessels from the right ventricle]. / Angiokardiograficheskaia diagnostika polozheniia defekta mezhzheludochkovoi peregorodki pri dvoinom otkhozhdenii magistral'nykh sosudov ot pravogo zheludochka.

The paper is devoted to analysis of the results of angiocardiographic investigation of 237 patients with a double deflection of great vessels (DDGV) from the right ventricle (RV) (the patients ranged in age from 3 months to 23.5 years) to study the potentialities of the method in the diagnosis of a defect position of the interventricular septum (DIVS). Angiographic investigation permitted a sufficiently accurate determination of a DIVS position in DDGV from the RV. Of paramount importance for determining a DIVS position is the establishment of the interrelationships of the latter with the infundibular septum and the openings of major arteries. For diagnosis of a DIVS position one should necessarily use left and right ventriculography both in standard and axial projections.

Angiocardiographic diagnosis of ventricular septal defect localization in double outlet right ventricle.

Children with double outlet right ventricle, aged 3 months to 23.5 years, were examined to assess the possibility of angiocardiographic diagnosis of defect localization. It was found angiocardiography allows satisfactory localization of the defect in question. To be able localize the defect, it is critical to determine the interaction between the defect and the conus septum, and the origin of large arteries. To establish the diagnosis of ventricular septal defect, right and left ventriculography in standard and axial projections must be performed.

[Angiocardiography in the diagnosis of interventricular septum defects in a double displacement of great vessels from the right ventricle]. / Angiokardiograficheskaia diagnostika polozheniia defekta mezhzheludochkovoi peregorodki pri dvoinom otkhozhdenii magistralnykh sosudov ot pravogo zheludochka.

The paper is devoted to analysis of the results of angiocardiographic investigation of 237 patients with a double deflection of great vessels (DDGV) from the right ventricle (RV) (the patients ranged in age from 3 months to 23.5 years) to study the potentialities of the method in the diagnosis of a defect position of the interventricular septum (DIVS). Angiographic investigation permitted a sufficiently accurate determination of a DIVS position in DDGV from the RV. Of paramount importance for determining a DIVS position is the establishment of the interrelationships of the latter with the infundibular septum and the openings of major arteries. For diagnosis of a DIVS position one should necessarily use left and right ventriculography both in standard and axial projections.

[Anomalies of atrioventricular valves in origin of the aorta and pulmonary artery from the right heart ventricle]. / Anomalii atrioventrikuliarnykh klapanov pri otkhozhdenii aorty i legochnoi arterii ot pravogo zheludochka.

Anomalies of the atrioventricular valves may influence essentially the choice of the method and volume of surgical intervention in origin of the aorta and pulmonary artery (PA) from the right ventricle (RV). The results of morphological study of 55 heart specimens with origin of the aorta and PA from the RV are analysed; structural anomalies of the atrioventricular valves were revealed in 19 of them (34.5%). The anomalies were surgically significant only in 16.4% of cases. Isolated anomalies of biventricular attachment, simultaneous biventricular attachment and displacement of one of the atrioventricular valves, and anomalous chordae and supernumerary fibrous structures connected to the atrioventricular valves, etc. were the most commonly encountered anomalies of the atrioventricular valves in origin of the aorta and PA from the RV. The frequency and complexity of anomalies of the atrioventricular valves in origin of the aorta and PA from the RV were determined by the morphology of the cardiac complex, the type of the anomaly, and the side involved in the pathology of the atrioventricular valves. The complexity of the atrioventricular valve disorders in such cases could influence noticeably the volume of the surgical intervention. Anomalies of the atrioventricular valves in origin of the aorta and PA from the RV were encountered most frequently in malposition of the heart or discordant atrioventricular connection. The frequency of anomalies of the tricuspid valve was much higher than that of mitral valve anomalies, but the last named were surgically significant in most cases as a rule.

[The anatomical criteria of the origin of the aorta and pulmonary artery from the right ventricle]. / Anatomicheskie kriterii otkhozhdeniia aorty i legochnoi arterii ot pravogo zheludka.

New anatomical criteria of the above malformation are created on the basis of the study of 63 hearts with the origin of aorta and lung artery from the right ventricle: the presence of the bulboventricular fold separating the mitral and semilunar valves; complete or partial delay of the subaortal cone movement to the left ventricle; the presence of the completely or partially formed proximal cone; underdevelopment of the left ventricle due to the complete or partial absence of its cone region; the only issue from the left ventricle is the proximal cone apertures or a part of the primary bulboventricular orifice; when the primary bulboventricular orifice is obturated the left ventricle is either deprived of the opening or has it in the form of noncommitted defect in the sinusal part of the interventricular septum; the anterior margins of the bulboventricular fold and cone septum are open and supraventricular comb is not formed; the interventricular septum defect formed due to failure of fusion between bulboventricular fold and cone septum connects the aorta with the right ventricle; aorta and lung artery start completely or partially from the right ventricle.

[What is anomalous departure of the aorta and pulmonary artery from the right ventricle?]. / Chto takoe otkhozhdenie aorty i legochnoi arterii ot pravogo zheludochka.

Available literature data on terminological and anatomical definition of congenital combined valvular disease--anomalous right ventricular origin of the aorta and pulmonary artery--are reviewed. Not a single report analysed permitted an objective precise structural outline of the disease. The causes of this situation are elicited. The review of the 8 Soviet and 55 foreign original sources shows that the question of pathognomonicity of the anomaly anatomical signs remains disputable.