ABSTRACT
Presented in the article are the results of surgical management of a patient with an extremely rare pathology - a saccular arterial aneurysm of the cavernous-ophthalmic segment of the left internal carotid artery. We performed multistage open surgical intervention in the following scope: osteoplastic pterional craniotomy on the left, creation of a wide-lumen anastomosis between the left external carotid artery and M2 segment of the left middle cerebral artery with the use of the radial artery, ligation of the cervical portion of the left internal carotid artery and clipping of its supraclinoid portion. The chosen surgical policy made it possible to create sufficient volumetric blood flow through the shunt, comparable to the blood flow through the internal carotid artery, which helped avoid ischaemic stroke after exclusion of the aneurysm from circulation. A conclusion was drawn on efficacy of this method of treatment.
Subject(s)
Carotid Artery, External/surgery , Carotid Artery, Internal/surgery , Intracranial Aneurysm/surgery , Middle Cerebral Artery/surgery , Anastomosis, Surgical , Brain Ischemia/etiology , Brain Ischemia/prevention & control , Humans , Intracranial Aneurysm/complications , Ligation , Radial Artery/transplantation , Stroke/etiology , Stroke/prevention & control , Vascular Surgical Procedures/methodsABSTRACT
Computer-aided simulation appropriately using the method of computational fluid dynamics (CFD) makes it possible to determine the elevated-risk zones of most probable formation of restenosis. The main idea of the method described in our article consists in a possibility of creating by the model of the geometrical shape of the vessel and characteristics of the flow at inlets and outlets the parameters of flow in each point of a vessel. The curves of velocity are used to create the curves of pressure at inlets and outlets, which are used in a CFD model. The resulting from CFD simulation of blood flow are nonstationary three-dimensional fields of pressure and velocity in the area under study. Visual examination of the dynamics of these fields makes it possible to judge about possible problem zones inside the area of flow and on the internal wall of the vessel. This article also presents a clinical case report illustrating the use of this technique.
Subject(s)
Carotid Arteries , Endarterectomy, Carotid , Blood Flow Velocity , Carotid Arteries/physiopathology , Hemodynamics , Humans , Models, CardiovascularABSTRACT
It is presented case report of extremely rare pathology - protoplasmic astrocytoma of sylvian aqueduct involving posterior section of the third ventricle. The main principles of treatment were considered. Dynamics of neurological status was demonstrated. An effectiveness of treatment strategy was assessed.
Subject(s)
Astrocytoma/surgery , Brain Neoplasms/surgery , Cerebral Aqueduct/surgery , Third Ventricle/surgery , Astrocytoma/diagnosis , Brain Neoplasms/diagnosis , Humans , Treatment OutcomeABSTRACT
Presented herein is a clinical case report concerning surgical treatment of a patient with a rare combination of two pathologies, i. e., a haemodynamically significant stenosis of the extracranial portion and a sacciform aneurysm of the communicative portion of the right internal carotid artery on the background of multifocal atherosclerosis. The patient underwent a simultaneous operation consisting in clipping of the sacciform arterial aneurysm of the communicative portion of the right internal carotid artery and carotid endarterectomy on the right. The chosen surgical policy ensured effective prevention of the development of ischaemic stroke and rupture of the arterial aneurysm, whose risks would have been high in staged treatment and sequentially performing two operations.
Subject(s)
Carotid Artery, External , Carotid Artery, Internal , Carotid Stenosis , Endarterectomy, Carotid/methods , Intracranial Aneurysm , Vascular Surgical Procedures/methods , Carotid Artery, External/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, External/surgery , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/surgery , Carotid Stenosis/diagnosis , Carotid Stenosis/physiopathology , Carotid Stenosis/surgery , Computed Tomography Angiography/methods , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/surgery , Male , Middle Aged , Risk Adjustment , Tomography, Spiral Computed/methods , Treatment OutcomeABSTRACT
OBJECTIVE: The article presents the results of assessing the impact of pre-emptive analgesia with lidocaine and paracetamol compared withfentanyl for postoperative pain in children undergoing surgery for nasal cavity and nasopharynx. METHODS: We evaluated the incidence and severity ofpostoperative pain in 150 patients aged 3 to 17 years (ASA I-II), following operations in the nasal cavity and nasopharynx. RESULTS: In pre-emptive analgesia group, patients (n = 75) experienced postoperative pain at 28% less in comparison with the control group. The severity ofpain was observed at 50% less in the intervention group which was accompanied by lower levels of cortisol. Additional analgesia during the first 2 hours after surgery there was within 15% less in a pre-emptive analgesia group when compared to the control group. Patients with multi-component of general anesthesia and local anesthetic lidocaine via a nebulizer and paracetamol i. v. were ready for extubation/removal of the laryngeal mask at 40% earlier; andfor transfer to the general department 50% sooner than patient with combined anesthesia with sevoflurane, nitrous oxide and fentanyl.
Subject(s)
Analgesia/methods , Anesthesia, General , Anesthesia, Local , Nasal Cavity/surgery , Nasopharynx/surgery , Preoperative Care/methods , Acetaminophen/administration & dosage , Acetaminophen/therapeutic use , Adolescent , Child , Child, Preschool , Drug Therapy, Combination , Fentanyl/administration & dosage , Fentanyl/therapeutic use , Humans , Lidocaine/administration & dosage , Lidocaine/therapeutic use , Pain, Postoperative/prevention & control , Treatment OutcomeABSTRACT
We investigate synchronization between the low-frequency oscillations of heart rate and blood pressure having in humans a basic frequency close to 0.1 Hz. A method is proposed for quantitative estimation of synchronization between these oscillating processes based on calculation of relative time of phase synchronization of oscillations. It is shown that healthy subjects exhibit on average substantially longer epochs of internal synchronization between the low-frequency oscillations in heart rate and blood pressure than patients after acute myocardial infarction.
Subject(s)
Algorithms , Biological Clocks/physiology , Blood Pressure/physiology , Heart Rate/physiology , Models, Cardiovascular , Nonlinear Dynamics , Oscillometry/methods , Computer Simulation , HumansABSTRACT
We report a 2-year-old boy with a plaque on the upper arm composed of multiple 2- to 3-mm leiomyomata which developed at the age of 3 months and have been unchanged since. Immunohistologically there was positive staining for the muscle intermediate filament desmin. We discuss the unusual clinical presentation and possible prognosis.
Subject(s)
Leiomyoma/pathology , Skin Neoplasms/pathology , Skin/pathology , Arm , Child, Preschool , Humans , MaleABSTRACT
1. The role of allopurinol in the protection of kidney function following ischaemia-reperfusion injury has been investigated using the novel technique of near-infrared spectroscopy. 2. An in vivo model of rat kidney ischaemia was used, with the expected falls in blood and tissue oxygenation seen and confirmed by near-infrared spectroscopy. 3. Allopurinol infusion increased the rate of reperfusion of oxygenated blood seen in control rats (P < 0.05). 4. Allopurinol enhanced the rate of tissue oxygenation during early reperfusion (P < 0.01). 5. This study provides further evidence for the proposed benefits of allopurinol in ischaemia-reperfusion injury. Furthermore, the potential of near-infrared spectroscopy as a technique of value in interventional studies of this nature is confirmed.
Subject(s)
Allopurinol/therapeutic use , Kidney/blood supply , Reperfusion Injury/prevention & control , Animals , Hemoglobins/metabolism , Ischemia/blood , Ischemia/pathology , Ischemia/therapy , Kidney/pathology , Male , Oxyhemoglobins/metabolism , Random Allocation , Rats , Rats, Sprague-Dawley , Reperfusion Injury/blood , Reperfusion Injury/pathologySubject(s)
Breast Neoplasms/pathology , Tissue Fixation/methods , Biopsy , Breast/pathology , Humans , MaleABSTRACT
Repellent effect of the Mannich bases (methoxyphenol derivatives) on Aedes aegypti mosquitoes and Xenopsylla cheopis fleas was revealed under laboratory and field conditions. The Mannich base L-methoxy-2-hydroxy-3-(dibutylaminomethyl) benzene turned to the most effective among the substances tested.
Subject(s)
Aedes , Amines , Insect Repellents , Mannich Bases , Phenols , Siphonaptera , Animals , Structure-Activity RelationshipSubject(s)
Amines/pharmacology , Insect Repellents , Mannich Bases/pharmacology , Ticks/drug effects , AnimalsSubject(s)
Aedes , Amines/pharmacology , Insect Repellents , Lactates/pharmacology , Mannich Bases/pharmacology , Siphonaptera , AnimalsSubject(s)
Amines , Aminobenzoates , Hydroxybenzoates , Insect Repellents , Mannich Bases , Aedes , Animals , SiphonapteraSubject(s)
Aedes , Amines , Cresols , Insect Repellents , Mannich Bases , Phenols , Siphonaptera , Animals , Structure-Activity RelationshipABSTRACT
By gel chromatography on Sephadex G-75 it has been demonstrated that the culture fluid of Geotrichum asteroides VKM F-144 contains two lipolytic components, one of which, lipase 1, eluates in the free volume of the column, whereas the second component, lipase 2, eluates in the volume close to that of the egg albumin yield. The paper describes a method for lipase 2 preparation consisting of precipitation of accompanying compounds at pH 4.2, depigmentation of the supernatant on the resin PAP in the Cl-form, selective sorption of lipase on the cation exchange resin CMC and further purification of the eluate gel chromatography and Sephadex G-100 rechromatography. The molecular weight of the lipase is estimated to be 45,000 and the isoelectric point to correspond to pH 4.3. pH optimum of action of the purified enzyme, areas of its pH- and thermostability have been determined.
Subject(s)
Geotrichum/enzymology , Lipase/isolation & purification , Mitosporic Fungi/enzymology , Hydrogen-Ion Concentration , Lipase/metabolismABSTRACT
The review presents current concepts of the synthesis and hydrolysis of phospholipids and triglycerides of microorganisms. The paper discusses differences in the synthesis of phospholipids in micro- and macroorganisms as well as properties an reversal of action of lipases (triglyceride hydrolases) in microorganisms.
Subject(s)
Bacteria/metabolism , Fungi/metabolism , Lipid Metabolism , Lipase/metabolism , Lipids/biosynthesis , Phospholipids/metabolism , Species Specificity , Triglycerides/metabolismABSTRACT
The localization of lipase in the cells of Candida paralipolytica was studied for the first time by the techniques of electron cytochemistry and immunocytochemistry. Lipase is formed at the outer surface of the cytoplasmic membrane and often is confined to its invaginations. The reaction products were detected in individual parts of the periplasmic space, in the cell wall, and in its exofibrillar components. Apparently, lipase is formed on the ribosomal-membrane complex. The above pattern is observed only in the cells with a high lipase activity, but not in the control. The two techniques gave similar results. A series of electronograms are presented.