Organization of the Nuclei in the Tegument of Some Palaeacanthocephala and Archiacanthocephala.

The giant tegument nuclei of the acanthocephalans of the classes Archiacanthocephala and Palaeacanthocephala are fragmented at the final stage of cystacanthus formation in the intermediate host, but remain connected with each other during later life. It can be assumed that the fragments of each giant tegument nucleus are united with each other to form an independent network that ensures the vital activity of the tegument, the volume of which increases many times during the period of intensive growth of the parasite in the definitive host.

Boosting photoconductive large-area THz emitter via optical light confinement behind a highly refractive sapphire-fiber lens.

We report on a sapphire-fiber-based lens that can be used to enhance the emitted THz power of a large-area photoconductive antenna (PCA). Using numerical simulations, we demonstrate that the lens provides a spatial redistribution of the photocarriers density in the PCA's gap. By optimizing the diameter of the sapphire-fiber, one could reach efficient confinement of the photocarriers in the vicinity of the PCA electrodes with a 10-µm gap size for a 220-µm-thick sapphire-fiber. This allows enhancing the coupling of the incident electromagnetic waves at the interface between the sapphire fiber and the semiconductor with the antenna terminals by ∼40 times for a single PCA element, as well as boosting the total efficiency of the large-area PCA-emitter up to ∼7-10 times. To validate our approach, we propose a step-by-step process that can be used for the precise and controllable placement of the sapphire-fiber on the surface of a single PCA.

Efficient optical-to-terahertz conversion in large-area InGaAs photo-Dember emitters with increased indium content.

In this Letter, optical-to-terahertz (THz) conversion of 800 nm femtosecond laser pulses in large-area bias-free InGaAs emitters based on photo-Dember (PD) and lateral photo-Dember (LPD) effects is experimentally investigated. We use metamorphic buffers to grow sub-micrometer thick InxGa1-xAs layers with indium mole fractions x=0.37, 0.53, and 0.70 on a GaAs substrate. A strong enhancement of THz output energy with an increase of indium content is observed. On the surface of the sample providing the strongest emission (x=0.7), we have fabricated a 1.5cm2 area of asymmetrically shaped metallic grating for LPD emission. This LPD emitter allows achieving high conversion efficiency of 0.24⋅10-3 and a broad generation bandwidth of up to 6 THz. We also demonstrate that there is no significant difference in the conversion efficiency when operating at 1 and 200 kHz repetition rates. Our results show that large-area LPD emitters give a convenient, competitive way to generate intense high-repetition-rate THz pulses.

Object-dependent spatial resolution of the reflection-mode terahertz solid immersion microscopy.

Terahertz (THz) solid immersion microscopy is a novel promising THz imaging modality that overcomes the Abbe diffraction limit. In our prior work, an original reflection-mode THz solid immersion microscope system with the resolution of 0.15λ (in free space) was demonstrated and used for imaging of soft biological tissues. In this paper, a numerical analysis, using the finite-difference time-domain technique, and an experimental study, using a set of objects with distinct refractive indexes, were performed in order to uncover, for the first time, the object-dependent spatial resolution of the THz solid immersion microscopy. Our findings revealed that the system resolution remains strongly sub-wavelength 0.15-0.4λ for the wide range of sample refractive indices n = 1.0-5.0 and absorption coefficients α = 0-400 cm-1 (by power). Considering these findings, two distinct regimes of the THz solid immersion microscopy were identified. First is the total internal reflection regime that takes place when the sample refractive index is relatively low, while the sub-wavelength resolution is enabled by both the evanescent and ordinary reflected waves at the interface between a high-refractive-index material and an imaged object. Second is the ordinary reflection regime that occurs when the sample refractive index is high enough, so that there is no more total internal reflection at the interface, while only the ordinary reflected waves inside a high-refractive-index material are responsible for the sub-wavelength resolution. The resultant conclusions are general and can be applied for analysis of solid immersion lenses operating in other spectral ranges, such as visible and infrared, given linear nature of the Maxwell's equations.

Proof of concept for continuously-tunable terahertz bandpass filter based on a gradient metal-hole array.

A continuously-tunable terahertz (THz) bandpass filter based on the resonant electromagnetic-wave transmission through a metal-hole array featuring a gradually changing period was developed and fabricated on a silicon substrate using optical lithography. A gradient geometry of the metal-hole array yields a wide tunability of the filter transmission, when operating with a focussed THz beam. The filter was studied numerically, using the finite element method, and experimentally, using the THz pulsed spectroscopy. We find that the central wavelength of the filter transmission band can be tuned in the wide range of λc = 400-800 µm with the relative bandwidth of Δλ/λc ≃ ~0.4. Finally, Kapton-based anti-reflection coating was applied to the filter flat side, in order to suppress an interference pattern in the filter transmission spectrum. We believe that the developed filter holds strong potential for multispectral THz imaging and sensing due to its conceptual simplicity and case of operation. Moreover, the presented filter concept can be translated to other spectral ranges, where appropriate technologies are available for the fabrication of gradient sub-wavelength metal-hole arrays.

[The organization of medical social care of patients with chronic cardiac insufficiency: the literature review].

The organization of medical social care of patients with chronic cardiac insufficiency is focused on improving life of these patients through comprehensive interaction of all levels of medical care support of population. The organization of Schools of Health on the level of out-patient medical care specifically for patients with chronic cardiac insufficiency allows to extend the period of high-quality compensation of pathological condition.

Recanalization of Chronic Total Occlusions Using Modern Endovascular Techniques.

PURPOSE: to assess results of percutaneous coronary intervention (PCI) with contemporary endovascular techniques of recanalization of chronic total coronary artery occlusions (CTO) in patients with ischemic heart disease (IHD). Occlusion (CTO) he procedural and in-hospital outcomes of consecutive patients undergoing chronic total occlusion percutaneous coronary intervention. MATERIALS AND METHODS: We retrospectively analyzed data from 456 consecutive patients (mean age 59.9±7.1 years, 18.2 % women) who underwent CTO PCI procedures (n=477) during 2014-2016 in the E. N. Meshalkin National Medical Research Center. CTO was localized in the right (61.2 %), left anterior descending (23.2 %) and left circumflex (15.3 %) coronary arteries. In one patient CTO was located in the left main coronary artery. According to the J-CTO score, 30 % of lesions were classified as easy, 36.4 % intermediate, 23.7 % difficult, and 18.9 % very difficult. RESULTS: Technical and procedural successes were achieved in 374 (78.4 %) and 366 patients (76.7 %), respectively. Antegrade approach was used in 378 (79.2 %), retrograde approach - in 99 (20.7 %) cases. Retrograde approach as primary strategy was used in 27 cases (5.7 %). Most frequent access for CTO PCI was radial artery, contralateral injection was used in 151 cases (31.6 %). Total number of stents per lesion was 1.6±0.98. The mean fluoroscopy time was 36.2±31 min. CONCLUSIONS: The rate of procedural adverse events in our study was low and similar to the non-CTO PCI series. However, despite the large number of CTO PCIs, the procedural success rate was still lower than in centers with dedicated programs for the management of such patients. Thus, further work is required to overcome this difference. Possible solution of this problem might be development and introduction in clinical practice of an algorithm for CTO recanalization.

[The role of integrated assessment of the indicators of external respiration function in cardiac surgical patients]. / Rol' kompleksnoi otsenki pokazatelei funktsii vneshnego dykhaniia u patsientov s kardiokhirurgicheskoi patologiei.

This literature review dedicated to the importance of an integrated assessment of external respiratory function in cardiovascular diseases (CVDs), including an analysis of up-to-date techniques, such as spirometry, body plethysmography, examination of the diffusing capacity of the lung, determination of O2 consumption with evaluation of the effectiveness of pulmonary ventilation. It considers the pathogenetic components of impairments in pulmonary ventilation and gas exchange, which develop in different CVDs, as well as during and after cardiac surgery. The authors analyze the results of international investigations and their own experience, which emphasize the prognostic value of lung function tests and suggest that there is a need for a comprehensive functional assessment of the respiratory system in cardiac surgical patients for their effective preoperative preparation, assessment and reduction of operational risks, and improvement of the prognosis of surgical treatment.

[The possibilities for the use of unusual personality traits in the examination of the skeletonized corpses with the long prescription of burying].

The objective of the present study was to develop the method for the detection and identification of the traces of the previous diseases on the skeletonized and mummified corpses with the purpose of discovery of the new specific traits making possible the personality identification and substantiation of the search of their localization at the burial places depending on the prescription of burying. It was shown that the identification of the corpses under conditions of their complete skeletonization should be based not only on the general (sex, age, height) but also the specific (congenital malformations, post-traumatic and pathological changes of the bones) traits. The biological structures making possible the personality identification are described, such as the mineralized (petrified) fibrous capsules of the hepatic echinoccocus vesicles, the primary lung tuberculosis complex, and postoperative scar ossificates of the abdominal white tine. Some data on the lifetime of bone remains in the ground and the duration of their possible skeletonization are presented together with the description of the method for the use of this information with a view to the personality identification of the unknown corpse.

[Influence of remote ischemic preconditioning on brain injury markers dynamics during cardiopulmonary bypass].

INTRODUCTION: Remote ischemic preconditioning has gained clinicians' attention as a technique to protect the heart in patients undergoing cardiac surgery under cardiopulmonary bypass. While experimental data report neuroprotective properties of remote ischemic preconditioning, we failed to find any clinical studies investigating its effects on neurologic outcome in cardiac surgery. PURPOSE OF THE STUDY: This prospective randomized placebo-controlled study was undertaken with the aim of elucidating the role of remote ischemic preconditioning for neuroprotection in cardiac surgery. PATIENTS AND METHODS: 88 patients with coronary heart disease scheduled for on-pump coronary bypass grafting surgery were randomized to receive either remote ischemic preconditioning or control. We studied S100B peptide and neuron-specific enolase to assess neurological damage. Psychophysiological tests were employed to investigate cognitive function after surgery. RESULTS: The perioperative dynamics of S100B and neuron-specific enolase followed similar patterns in both groups throughout the observation period. At the end of surgery, level of S100B was significantly higher in the preconditioning group as compared to controls--0.58 (0.33-0.65) vs. 0.34 (0.23-0.42) mcg/l, p

[Remote results of reimplantation of the aortic valve in patients with ascending aortic aneurysm accompanied by aortic insufficiency].

Valve-sparing operations on the aorta has recently been gaining ever increasing popularity due to more detailed study of physiology of the aortic root, as well as promising mid- and long-term results. The world practice uses various techniques making it possible to remove both ascending aortic aneurysm and aortic valve insufficiency. The authors herein describe and analyse their experience in performing reimplantation of the aortic valve in patients with ascending aortic aneurysm and concomitant aortic insufficiency. Specialists of the clinic of the Novosibirsk Scientific Research Institute for Circulatory Pathology during the period from 2003 to 2013 performed a total of 77 operations of reimplantation of the aortic valve in patients with ascending aortic aneurysm and pronounced aortic valve insufficiency. The majority of patients were men (57 males and 20 females), mean age 53.1±12.2 years (range 21-72). 80% of cases had NYHA functional class II-III circulatory insufficiency (degree 2.3±0.7). Preoperative examination revealed in the majority of patients (97.4%) moderate-to-severe aortic valve insufficiency and ascending aortic aneurysm. All patients underwent reimplantation of the aortic valve. The duration of artificial circulation amounted to 202.4±33 minutes, with the average time of aortic occlusion being 164±28 min. Accompanying procedures (annuloplasty of the mitral valve and/or coronary aortic bypass grafting) were performed in 12 (15.6%) cases. Additional plasty of valvular cusps was carried out in 9 (11.7%) patients, with rethoracotomy required in 5 (6.4%) cases due to haemorrhage. The average period of follow up amounted to 53.3±8.5 (3-115) months. During this time total survival amounted to 91%, with freedom from aortic valve prosthetic repair equalling 93%. The obtained findings suggest that aortic valve reimplantation into the prosthesis is a safe intervention and associated with a comparatively low level of operative lethality. Moderate aortic insufficiency at discharge is a predicting factor for repeat surgical intervention, i.e. prosthetic repair of the aortic valve. No association between the preoperative degree of aortic insufficiency, root diameter and durability of the reimplanted valve was revealed.

Remote preconditioning and major clinical complications following adult cardiovascular surgery: systematic review and meta-analysis.

BACKGROUND: A number of 'proof-of-concept' trials suggest that remote ischaemic preconditioning (RIPC) reduces surrogate markers of end-organ injury in patients undergoing major cardiovascular surgery. To date, few studies have involved hard clinical outcomes as primary end-points. METHODS: Randomised clinical trials of RIPC in major adult cardiovascular surgery were identified by a systematic review of electronic abstract databases, conference proceedings and article reference lists. Clinical end-points were extracted from trial reports. In addition, trial principal investigators provided unpublished clinical outcome data. RESULTS: In total, 23 trials of RIPC in 2200 patients undergoing major adult cardiovascular surgery were identified. RIPC did not have a significant effect on clinical end-points (death, peri-operative myocardial infarction (MI), renal failure, stroke, mesenteric ischaemia, hospital or critical care length of stay). CONCLUSION: Pooled data from pilot trials cannot confirm that RIPC has any significant effect on clinically relevant end-points. Heterogeneity in study inclusion and exclusion criteria and in the type of preconditioning stimulus limits the potential for extrapolation at present. An effort must be made to clarify the optimal preconditioning stimulus. Following this, large-scale trials in a range of patient populations are required to ascertain the role of this simple, cost-effective intervention in routine practice.

Thermal imaging diagnostics of high-current electron beams.

The thermal imaging diagnostics of measuring pulsed electron beam energy density is presented. It provides control of the electron energy spectrum and a measure of the density distribution of the electron beam cross section, the spatial distribution of electrons with energies in the selected range, and the total energy of the electron beam. The diagnostics is based on the thermal imager registration of the imaging electron beam thermal print in a material with low bulk density and low thermal conductivity. Testing of the thermal imaging diagnostics has been conducted on a pulsed electron accelerator TEU-500. The energy of the electrons was 300-500 keV, the density of the electron current was 0.1-0.4 kA/cm(2), the duration of the pulse (at half-height) was 60 ns, and the energy in the pulse was up to 100 J. To register the thermal print, a thermal imager Fluke-Ti10 was used. Testing showed that the sensitivity of a typical thermal imager provides the registration of a pulsed electron beam heat pattern within one pulse with energy density over 0.1 J/cm(2) (or with current density over 10 A/cm(2), pulse duration of 60 ns and electron energy of 400 keV) with the spatial resolution of 0.9-1 mm. In contrast to the method of using radiosensitive (dosimetric) materials, thermal imaging diagnostics does not require either expensive consumables, or plenty of processing time.

[Cardioprotective effects of glutamine in patients with ischemic heart disease operated under conditions of extracorporeal blood circulation].

It was conducted a study of glutamine cardioptotective effects during perioperative use in patients with ischemic heart disease, operated under CB. Exclusion criteria were: left ventricular ejection fraction less than 50%, diabetes melitus, myocardial infarction less than 3 months ago, Patients of the study group (n=25) had glutamine (20% solution N(2)-L-alanine-L-glutamine ("Dipeptiven" Fresenius Kabi, Germany); 0.4 g/kg/day. Patients of control group (n=25) received placebo (0.9% NaCl solution). The main indicators were the dynamics of troponin I, as well as central hemodynamics parameters. On the 1-st day after operation the concentration of troponin I was significantly lower in the glutamine-group compared placebo-group (1.280 (0.840-2.230) 2.410 (1.060-6.600) ng/ml; p=0.035). 4 hours after CB in a glutamine-group also had significantly large indicators of cardiac index (2.58 (2.34-2.91) l/min/m2 vs 2.03 (1.76-2.32)) l/min/m2; p=0,002) and stroke index (32.8 (27.8-36.0.) ml/m2 vs 26.1 (22.6-31.8) ml/m2; p=0.023). Systemic vascular resistance index was significantly lower in glutamine-group (1942 (1828-2209) dyn x s/cm(-5)/m2 vs 2456 (2400-3265) dyn x s/cm(-5)/m2; p=0.001). Conclusion. Perioperative use of N(2)-L-alanine-L-glutamine during the first 24 hours ofperioperative period gives cardioprotective effect in patients with ischemic heart disease operated under CB.

Plasmacytoma of the lung: an indolent disease resistant to conventional myeloma treatment: report of a case.

Solitary lung plasmacytoma is a rare form of plasma cell tumors. The case of a 56-yr-old man is presented, who had a massive tumor of the right pulmonary apex. Percutaneous transthoracic lung biopsy demonstrated a tumor-cell population consisting of mature plasma cells, proplasmacytes, and rare plasmablasts. Immunohistochemically, the cells were CD79a+, kappa+, cyclin D1-, p53-, MDR-. Proliferative index was low (number of Ki-67+ tumor cells was 8%). Serum and urine immunoelectrophoresis did not show the presence of paraprotein. Screening for multiple myeloma with skeletal X-ray survey and bone marrow biopsy were negative. Radiotherapy and chemotherapy with alkylating agents were ineffective. However, the course of the disease is indolent and the patient is well, alive, and with no signs of multiple myeloma >5 yr after the diagnosis was established. Some pathogenetic aspects of tumor resistance to conventional myeloma treatment in this case are discussed.

[The differences between sexes and strains in the capacity to acquire a passive avoidance conditioned reflex in KLA- and KHA-strain rats]. / Mezhpolovye i mezhlineinye razlichiia sposobnosti k vyrabotke uslovnogo refleksa passivnogo izbeganiia u krys linii KLA i KHA.

The interstrain differences in passive avoidance conditioning were studied in male and female KHA (Koltushi High Avoidance) and KLA (Koltushi Low Avoidance) rats. These strains were selected for the rate of acquisition of active avoidance in a shuttle box. It was shown that the passive avoidance was substantially better acquired in the KLA strain than in the KHA. In females KHA rats the capability for passive avoidance conditioning depended on the estrus phase: the conditioning was impossible in proestrus.

[Comparative analysis of the learning ability in Morris water test in rats with the various rate of active acquisition of the avoidance conditioned reflex]. / Sravnitel'nyi analiz sposobnosti k obucheniiu v vodnom teste Morrisa krys, razlichaiushchikhsia po skorosti vyrabotki uslovnogo refleksa aktivnogo izbeganiia.

Place learning in Morris place navigation task was studied in male rats of KHA (Koltushi High Avoidance) and KLA (Koltushi Low Avoidance) rat strains. These strains were selected for different rate of acquisition of active avoidance in a shuttle box. At the initial stages of learning and after changing the experimental conditions, the performance of KLA rats was significantly better than that of KHA. Analysis of individual escape latency showed that the latency of the platform finding in the first trial had a significant effect on successful performance in the second trial. This effect was different in KHA and KLA rats. As distinct from KLA, the KHA rats demonstrated more rigid strategy in spatial orientation, the clear-cut thigmotropism was characteristic for their behavior in water.

[Personal experience in the treatment of tuberculosis in patients in war areas]. / Nasa iskustva u lecenju tuberkuloze kod obolelih sa ratnih podrucja.

In the four-year period (1991-1995), 96 tuberculosis patients from the war areas of former Yugoslavia were treated in the Clinic for Lung Diseases of Military Medical Academy, that makes 31% of total number of sick and treated for tuberculosis-309 (100%). In group I (patients from war areas) there were 45 cases of cavernous pulmonary tuberculosis (47%), 28 bilateral (29%), 16 pleurisy (16.7%) and 6 cases of extensive pulmonary tuberculosis (5.1%). Among 213 patients (100%) from group II (patients from FR Yugoslavia), 81 patients had cavernous pulmonary tuberculosis (38%), 49 patients had bilateral (23%), 33 patients had pleurisy (15.5%) and 6 patients had extensive pulmonary tuberculosis (2.8%). In group I the diagnosis was bacteriologically and/or histopathologically proved in 94.8% cases: by finding of acid-resistant bacilli in sputum and other biological materials in 69 patients (72%), by positive Löwenstein's cultures in 73 patients (76%) and by histopathological result of tuberculosis inflammation in 34 patients (35.4%). In group II tuberculosis was bacteriologically and/or histopathologically proved in 134 patients (63%) by acid-resistant bacilli in sputum and other biological materials, in 141 patient (66%) by positive Löwenstein's culture and in 71 patient by positive histopathological results. Pulmonary tuberculosis in war areas is characterized by greater frequency of severe clinical forms (cavernous, bilateral and extensive) and by high direct bacillarity.

[Treatment of pneumonia under hospital conditions]. / Lecenje pneumonija u bolnickim uslovima.

A random sample of 24 patients affected by bacterial pneumonia has been investigated whether their illness is treated etiologically. The agents have been detected from the endoscopically obtained samples of blood or chest punctate (percutaneous needle aspirate--PNA) and their sensitivity to antibacterial drugs, used in our institution, have been investigated. The obtained results have been compared to the empirically applied drugs. In only three patients the first given drug corresponded to the later obtained finding of the agent's sensitivity and in one patient third and the fourth drug has been adequate. The rational initial therapy has been proposed on the basis of investigation of the sensitivity of the bacterial pneumonia agents.