[Comparison of efficacy of rivaroxaban and warfarin after open operations on the infrainguinal segment]. / Sravnenie éffektivnosti rivaroksabana i varfarina posle otkrytykh operatsii na infraingvinal'nom segmente.

The authors analysed oral anticoagulant agents prescribed in the postoperative period to patients after endured reconstructive operative intervention on arteries of the femorotibial segment. The study included a total of 104 patients subjected to femoropopliteal or femorotibial bypass grafting using an autologous vein or a prosthesis. Depending on the prescribed anticoagulation agent, the patients were subdivided into two groups. Group One patients (n=43) in the postoperative period received rivaroxaban, and Group Two patients (n=61) took warfarin. Efficacy of therapy was evaluated by the frequency of haemorrhage and thromboses in the early and remote postoperative periods. The findings of the immediate postoperative period demonstrated comparable rates of haemorrhagic complications, early thromboses and redo interventions in both Groups (p=0.7). The duration of long-term postoperative period varied from 3 months to 5 years. No statistically significant differences in patency of the performed reconstructions were revealed between the groups. The 3-year primary assisted patency rate in the rivaroxaban group and warfarin group amounted to 89 and 80%, respectively. The incidence of haemorrhagic complications in the postoperative period was insignificant in the studied groups. Hence, rivaroxaban may be prescribed in the early and remote postoperative period to patients who underwent open reconstructive operative intervention on arteries of the infrainguinal zone.

[Results of hybrid loop endarterectomy from the superficial femoral artery with the MultiTASC]. / Rezul'taty gibridnoi petlevoi éndarteréktomii iz poverkhnostnoi bedrennoi arterii petlei MultiTASC.

The purpose of this study was to analyse the results of hybrid loop endarterectomy from the superficial femoral artery (SFA) in its occlusion, preformed in a total of forty-two patients. Of these, 27 patients had prior to the intervention been diagnosed with stage II B ischaemia and 15 patients had been diagnosed as having critical ischaemia. Technical success of the operation amounted to 88%, with the frequency of early thromboses equalling 2.7%. In the early postoperative period, one patient died of acute myocardial infarction. The 1-, 2- and 3-year remote cumulative primary patency rate amounted to 81, 74 and 74%, respectively. There were no amputations performed within the timeframe of the follow-up period. The technique of hybrid loop endarterectomy with the MultiTASC loop followed by stenting of the proximal portion of the popliteal artery in occlusion of the SFA and stenoses of the common femoral artery has proved to be a highly efficient intervention yielding good immediate and remote results.

Orthogonal coding methods for increasing the number of multiplexed channels in coherent beam combining.

We introduce orthogonally coded modulations for active coherent beam combining (CBC), and show how using Walsh codes enables the increase of the number of combined channels. Analytical, numerical, and experimental results are presented and compared to the standard multifrequency dithering technique, demonstrating that at least 5 times more fibers can be combined using the same modulation frequency. The modulation format excluded, no particular changes in the system need to be introduced and the benefits of active coherent beam combing, such as atmospheric turbulence compensation capability, are kept unchanged. Finally, we point out that this approach can be applied in partially CBC.

[Outcomes of hybrid operations in multi storeyed lesions of arteries of the aortoiliac and femoropopliteal segments].

The work was aimed at analysing immediate and remote outcomes of hybrid operations in storey atherosclerotic lesions of the aortoiliac and femoropopliteal segments. Over the period from 1997 to 2012 hybrid operations were performed in a total of 224 patients presenting with multi-storeyed lesions of iliac and lower-limb arteries, classified as TASC A, B, C, and D. The operations were carried out at departments of vascular surgery of Clinical Hospital No 83 of the Federal Biomedical Agency of Russia and the Centre of Cardiovascular and Endovascular Surgery of Clinical Hospital No 119 of the Federal Biomedical Agency of Russia. All operations were simultaneous. The patients were subdivided into groups according to the character of intervention on iliac arteries: 1 - balloon angioplasty of iliac arteries, 2 - stenosing of iliac arteries, 3 - loop endarterectomy from iliac arteries followed by implantation of a covered stent into the zone of rupture of the intimal cylinder. In all cases the interventions of the arteries of the aortoiliac segment were combined with various open surgical reconstructions of the femoropopliteal segment. Technical success amounted to 99.1%. Interventional complications of the endovascular stage requiring conversion occurred in 2 cases. The immediate period complications influencing patency of the reconstructions performed were noted in 10 (4.5%) patients. Patency on the hospital stage with the deduction of cases of technical failures amounted to 98.6%. The remote results were followed up during 5 years in 76.5% of patients. Five-year primary assisted patency of the aortoiliac zone amounted to: in group 1 - 79.2%, in group 2 - 77.9%, and in group 3 - 89.4%. Five-year assisted patency of the femoropopliteal segment amounted to: for EAE of the common femoral artery - 98.2%, for profundoplasty - 100%, femoral proximal popliteal bypass grafting - 77.3%, femoral distal popliteal bypass grafting - 74.1%, femoral-tibial bypass grafting - 61.4%. There were no statistically significant differences in patency of the reconstructions of the femoropopliteal segment depending upon the type of intervention on the aortoiliac segment.

[Hybrid surgery- a promising trend in treatment of complicated cardiovascular lesions].

The article deals with a review of scientific literature concerning hybrid cardiovascular surgery, followed by analysis various points of view on the definition of the notion hybrid operation and hybrid tactics, suggesting own definition, representing advantages of hybrid therapeutic policy in managing complex cardiovascular lesions.

[Use of RT-PCR and enzyme immunoassays for the specific diagnosis of Crimean hemorrhagic fever].

The objective of the investigation was to evaluate the efficiency of the RT-PCR kit "AmplySens CHF" produced by InterlabService of the Central Research Institute of Epidemiology and that of the ELISA kits made by the D. I. Ivanovsky Research Institute of Virology for the specific diagnosis of Crimean hemorrhagic fever (CHF). Examination of sera from CHF patients from the Astrakhan Region showed that positive RT-PCR results were observed in 95.2 and 37.5% on days 4-8 and 9-13 after disease onset, respectively; but they were absent on days 13-17. Positive ELISA-IgM results were found in 93% on disease days 6 to 16. A high percentage (78.9%) of positive IgG samples was seen only on days 9-16. Thus, RT-PCR has a marked efficiency in diagnosing CHF until day 8 of illness while ELISA-IgM has it on day 8 or later. ELISA-IgG can be considered to be a confirming rather than compulsory test. The findings suggest that the RT-PCR kit "AmplySens CHF" produced by InterlabService of the Central Research Institute of Epidemiology and that of the ELISA kits made by the D. I. Ivanovsky Research Institute of Virology have a pronounced sensitivity and specificity and a high efficiency when concurrently used to verify CHF in patients.

Coherent beam combination of narrow-linewidth 1.5 µm fiber amplifiers in a long-pulse regime.

We report what we believe to be the first experimental demonstration of coherent beam combining of two fiber amplifiers in a 100 ns pulse regime using a signal leak between the pulses. Pulses of ∼100 W stimulated-Brillouin-scattering limited peak power are combined with 95% efficiency, a residual phase error of λ/27, and no significant beam quality degradation.

[A hybrid operation for chronic type III B aortic dissection].

Presented herein is a clinical care report of a successful hybrid reconstruction (i.e., an open operation and endovascular intervention) for a chronic type III B aortic aneurysm in the setting of the renal and lower-limb arteries malperfusion syndrome. Of obvious interest are the circumstances of the operation performed in a 36-year-old male patient who was subjected to a simultaneous reconstruction of the supra- and inter-renal portion of the aorta and endovascular treatment for lower-limb chronic ischaemia. A detailed description thereof is followed by a brief review of the literature related to appropriate decision-making regarding the scope of the reconstruction in the pathology involved.

[Colour duplex scanning in assessing efficacy of roentgeno-endovascular operations on lower-limb arteries].

The authors analysed efficacy of colour duplex scanning (CDS) in patients after roentgen- assisted endovascular interventions on lower-limb arteries. The study comprised 303 patients presenting with chronic obliterating diseases of lower extremities, who underwent a total of 456 endovascular interventions, including 375 stenting procedures. Efficacy of roentgen-assisted endovascular interventions was assessed l-to-3 days after surgery. We determined the main ultrasonographic criteria for successful balloon angioplasty, i. е., vessel's geometry restoration, haemodynamic alterations in the endovascular intervention site, the presence of residual stenosis less than 25%, accuracy of stent/stents' positioning, commensurability of the diameters of the stent and artery, exclusion of the aneurysm from blood flow. Also studied were ultrasonographic criteria for arterial complications following endovascular interventions, including thromboses of the zone of angioplasty the stent, the presence of less-than-25-percent stenosis, subintimal insertion of the stent, incomplete opening of the stent, incomplete capture of the stenosis area by the stent, and stent dislocation. CDS is an important method to assess evaluating efficacy of roentgen-assisted operations and the state of arteries after angioplasty.

[Results of examination of healthy residents in the southern region of Russia and patients feverish to pappataci fever virus antibodies].

Sera from patients with acute seasonal fevers and apparently healthy individuals living in the Astrakhan Region, Krasnodar Territory, or Rostov Region were examined in two modifications of enzyme immunoassay for detection of IgM and IgG antibodies to Neapolitan and Sicilian pappataci fever viruses. IgM antibodies to Sicilian pappataci fever virus were detected in a patient from the Volodarsky District, Astrakhan Region, who had been admitted for the unverified diagnosis of Q fever. A donor residing in the Novorossiysk District, Krasnodar Territory, was found to have IgA antibodies to Neapolitan pappataci fever virus. The findings show it expedient to conduct further investigations of the serodiagnosis and seroepidemiology of pappataci fevers in the southern Russian region where mosquitoes of the genus Phlebotomus inhabit.

Surface plasmon resonance of two-segmented Au-Cu nanorods.

Two-segmented gold-copper nanorods were electrodeposited inside the pores of polycarbonate track-etched membranes from two separate solutions. The PCT membranes were dissolved in dichloromethane (CH(2)Cl(2)) and the solvent was replaced by methanol solution. Optical absorption spectra of two-segmented Au-Cu nanorods dispersed in methanol showed two peaks which were related to the transverse mode of copper and the longitudinal mode of gold. By increasing the length of the gold segment, when the total length of both metals was fixed at 1 µm, the copper and gold peaks shifted to the blue and red wavelengths, respectively. We observed that the wavelengths of the extinction peaks are not in good agreement with the expected value obtained from calculations using the nominal dielectric constant of the medium. Therefore, we suggest the effective medium dielectric constant (ε(m)(eff)) for Cu and Au segments by comparing the experimental data and calculation results. The values of ε(m)(eff) decrease by increasing the gold length.

[Isolation of the West Nile Fever virus from human patients during an epidemic outbreak in the Volgograd and Astrakhan regions]. / Vydelenie virusa likhoradki Zapadnogo Nila ot bol'nykh liudei v periodépidemicheskoi vspyshki v Volgogradskoi i Astrakhanskoi oblastiakh.

Two strains of West Nile virus LEIV 27889 Vig and Ast 986 were isolated from the brain of a dead subject and from the blood of a patient, respectively, during an outbreak of serous meningitis and meningoencephalitis in July-September, 1999, in the Volgograd region, Krasnodar territory, and Astrakhan region. These strains reacted with convalescent sera in hemagglutination inhibition test, which proves their etiological role in this outbreak.

Anniversary reactions in a five-year-old boy. Unresolved conflict, guilt, and self-identifications.

This paper examines the important role of anniversary reactions in the psychological adjustment of seriously traumatized individuals. The clinical case study examines the impact of anniversary reactions on the posttraumatic symptoms and accommodation of a five-year-old boy. Unresolved conflict with the mother, an intense sense of guilt, and difficulty in self-identification were explored during subsequent sessions of psychoanalysis. The clinical significance of considering the possibility of anniversary reactions in children manifesting repetitive attempts of trauma mastering is discussed.

Baseline assessment of children traumatized by the Armenian earthquake.

Assessed at baseline for longitudinal study is the impact of the Armenian earthquake on children screened through the Children's Psychotherapy Center in Kirovakan, Armenia. The earthquake caused close to 25,000 deaths, almost two thirds of which were children and adolescents. Examined herein are memory functioning and clinical data collected on a baseline level which provides a better understanding of both diagnostic indicators and trauma processing in child survivors of the Armenian earthquake. Current theory related to processing of trauma in children is reviewed as are recommendations for further research.

[p-Nitroanilides of amino acids and peptides and fluorescence peptide with inner fluorescence quenching as substrates for cathepsins H, B, D and high molecular weight aspartic peptidase in the brain]. / p-Nitroanilidy aminokislot i peptidov i fluorestsentnyi peptid s vnutrennim tusheniem fluorestsentsii kak substraty katepsinov H, B, D i vysokomolekuliarnoi aspartil'noi peptidazy golovnogo mozga.

p-Nitroanilides of amino acids and peptides were used to study the specificity of cathepsins H and B from human and bovine brain, respectively. The specific activity of cathepsin H decreased in the following order: Arg-pNa greater than or equal to Leu-pNa greater than Ala-pNa greater than or equal to Phe-pNa greater than Pro-pNa greater than Glu-pNa; Arg-pNa was split by the enzyme 12 times as fast as Bz-Arg-pNa. Among other oligopeptide p-nitroanilides tested (Ala-Ala, Ala-Leu, Ala-Ala-Ala, Ala-Ala-Leu, Gly-Gly-Leu, Gly-Gly-Phe, Gly-Leu-Phe, pGlu-Phe-Leu, pGlu-Phe-Ala, pGlu-Phe), PGlu-Phe-Leu and pGlu-Phe-Ala appeared to be the best substrates for cathepsin B; Km for hydrolysis were 0.1 mM and 0.165 mM, respectively, kcat were 5.1 and 8.3 s-1, respectively. A comparative study of substrate specificity of cathepsin D and high molecular weight aspartic peptidase with the use of fluorescent substrate with inner fluorescence quenching, Abz-Ala-Ala-Phe-Phe-pNa, revealed that both peptidases hydrolyzed the single bond between two phenylalanine residues, resulting in the increase of fluorescence (4.5-5-fold) of anthraniloyl tripeptide. The Km values for the substrate hydrolysis by cathepsin D and high molecular weight aspartic peptidase were 6.2 microM and 11.2 microM; kcat were 7.2 s-1 and 1.3 s-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Brain cathepsin as dipeptidylcarboxypeptidase transforming provasopressor, pro-opioid and model peptides]. / Katepsin golovnogo mozga kak dipeptidilkarboksipeptidaza, prevrashchaiushchaia provazopressornye, proopioidnye imodel'nye peptidy.

Cathepsin B from brain exhibited both endopeptidase and dipeptidyl carboxypeptidase activity. Recently the factors, contributing to dipeptidyl carboxypeptidase properties of brain cathepsin B, were identified: I. occupation of the enzyme S3 subsite, 2. free C-terminal group of the substrate, 3. specific interaction between the split off dipeptide and the enzyme active site. The identification was carried out using angiotensin I, its C-end tripeptide and chromophore oligopeptides containing p-nitrophenylalanine residue. C-terminal dipeptide was split off in the proopioid peptides dynorphins 1-7 and 1-8, Met-enkephalin-Arg6-Phe7, Met-enkephalin-Arg6-Gly7-Leu8; the enzyme hydrolyzed also the C-terminal dipeptide bond in Leu- and Met-enkephalins without the subsequent hydrolysis of the remaining tripeptide. D-Ala2, D-Leu5-enkephalin were not hydrolyzed; the bond Arg9-Pro10 was resistant to proteolysis in dynorphin 1-11. Cathepsin B split off the C-terminal dipeptide in synthetic substrates Leu-Trp-Met-Arg-Phe-Ala and Trp-Met-Arg-Phe-Ala but not in Met-Arg-Phe-Ala. These results 06.08 M-15 demonstrated the essential role of branched-chain amino acid residue at the position of P2 and/or P3 of substrates for the enzyme dipeptidyl carboxypeptidase activity. The data obtained suggest that Arg residue at the position P2 (dynorphin 1-7) slowed down, D-amino acid at the position P2 (D-Ala2, D-Leu5-enkephalin) and Pro-Lys bond at the position P1-P2 (dynorphin 1-11) inhibited the cathepsin B dipeptidyl carboxypeptidase activity.

[Multiple forms of cathepsin D from the human brain]. / Mnozhestvennye formy katepsina D iz mozga cheloveka.

Six peaks of the endopeptidase activity at pH 3.2 were obtained after isoelectric focusing of soluble fractions of cortex and hypothalamus of the human brain. The molecular weight of these endopeptidases are approximately 50000. All obtained endopeptidases possess almost the same Km and I50 relative to the substrate--pyridoxal globin and specific inhibitor--pepstatin. The studies of the revealed properties show that the endopeptidases are multiple forms of cathepsin D.