[Hybrid vascular interventions on the peripheral arteries in the treatment of critical ischemia in elderly patients.]

Peripheral arterial disease has a huge contribution to the overall mortality rate of the population, especially in the group of patients of old and old age. The likelihood of an adverse outcome is increased against a background with other possible nosological forms. In particular, the combination of peripheral atherosclerosis with diabetes mellitus very often manifests itself in the form of a multilevel lesion of the lower limb arteries. The treatment of such patients is very difficult, since the use of only open or endovascular approaches has its own contraindications and limitations, and cannot be used throughout the course of the lesion. The way out of this situation is the use of a hybrid approach, which consists in the combination of an open surgical reconstruction on the upper floors of the lesion and balloon angioplasty on the arteries of the lower leg. This approach allows you to use the advantages of both methods and achieve good results of treatment. The article presents the experience of treatment using a hybrid approach in elderly and senile patients with multilevel lesion of the lower limb arteries on the background of diabetes mellitus.

[Use of human insulin analogues in young patients with type 1 diabetes mellitus: Results of the RESULT observational program on the use of insulin glargine (Lantus) in combination with insulin glulisine (Apidra) as a basal-bolus regimen]. / Primenenie analogov insulina cheloveka u patsientov molodogo vozrasta s sakharnym diabetom 1-go tipa: rezul'taty nablyudatel'noi programmy RESULT po primeneniyu insulina glargin (Lantus) v kombinatsii s insulinom glulizin (Apidra) v bazal'no-bolyusnom rezhime.

AIM: To implement in 2009-2012 the RESULT observational program on the use of insulin glargine (Lantus) in combination with insulin glulisine (Apidra) as a basal-bolus regimen in patients with type 1 diabetes mellitus (DM) to evaluate the efficiency and safety of therapy with human insulin analogues. MATERIAL AND METHODS: The program covered 100 patients aged 19 to 25 years from 7 regions of the Russian Federation, who had had DM onset at the age of 9-13 years, were using human recombinant insulins as continuous insulin therapy, and had glycated hemoglobin (HbA1c) levels of 7 to 9%. The main inclusion criterion was switching to insulin therapy with the human insulin analogues Lantus and Apidra. RESULTS: A total 41 men and 59 women were followed up. Their mean baseline HbA1c level was 8.3±0.7%. After 24 months of therapy, HbA1c was significantly decreased to 7.7±0.7%; its change compared with that at Visit 1 was -0.6±0.6% (p<0.001). There was a significant reduction in fasting and postprandial blood glucose levels at 3 months of a follow-up. The number of symptomatic and asymptomatic glycemic episodes declined. No nocturnal or severe hypoglycemic episodes were recorded at 24 months of therapy. Microvascular complications did not progress during the follow-up. CONCLUSION: The use of human insulin analogues is effective and safe in treating young diabetic patients, improves their quality of life and confers no risk of asymptomatic or nocturnal hypoglycemic states.

[Determination of nitric oxide in serum and plasma of human blood. Method of high pressure liquid chromatography]. / Opredelenie oksida azota v syvorotke i plazme krovi cheloveka. Metod vysokoéffektivnoi zhidkostnoi khromatografii.

Two methods of measurement of nitrite and nitrate determination in human serum and plasma (a colorimetric method based on Griess reaction and a HPLC method) have been compared HPLC method revealed extremely low level of nitrites blood plasma, which was roughly the same (about 3 microM or less) in healthy donors, patients with diabetes and hypertension. The level of nitrates in the group of healthy donors (29.9 +/- 2.8 microM) is lower than in patients with diabetes (58.6 +/- 6.9 microM), and in patients with hypertension (35.4 +/- 2.5 microM). Comparison of data obtained by colorimetric and HPLC methods revealed close correlation (r = 0.77, p < 0.001). Methodical requirements for preparation of samples of serum and plasma of blood for analysis and correct intepretation of results are discussed in view of biochemical properties of nitric oxide molecule.

[Anti-stress effect of nitric oxide]. / Antistressornyi éffekt oksida azota.

Rat strains feature different resistances to stress. The increased production of nitric oxide (NO) in the August strain prevents the appearance of ulcerous lesions of gastric mucosa and behavioral changes induced by restraint stress. Wistar rats feature a lower level of NO production and are more sensitive to restraint stress compared to the August rats according to both the ulcer pathology and behavioral indices. The stress-induced release of catecholamines was reproduced by experimental hyperfunction of the dopaminergic (DA) system induced by the introduction of L-DOPA. Introduction of NO synthase inhibitor N omega-nitro-L-arginine (L-NNA) enhanced the L-DOPA-induced behavioral changes. This effect was more pronounced in the August strain. The introduction of the exogenous NO donor, dinitrosyl iron complexes (DNIC), limited the behavioral disturbances induced by L-DOPA in both rat strains. The protective effect of DNIC in conditions of the DA system hyperfunction is similar to the effect of a D2 blocker sulpiride. Thus, NO has a central antistress effect, apparently, mediated by limiting the release of catecholamines.

[Nitric oxide storage in rats of various genetic strains and its role in the antistressor effect of adaptation to hypoxia]. / Deponirovanie oksida azota u krys raznykh geneticheskikh linii i ego rol' v antistressornom éffekte adaptatsii k gipoksii.

Adaptation to hypobaric hypoxia induced a gradual increase in the NO production along with a progressive NO storage in vascular wall. Unadapted August rats were more resistant against stress-induced stomach ulceration than the Wistar rats. Following a 6-day adaptation rats of both strains revealed a protective antiulcerogenic effect. A long-term adaptation potentiated the stress damage of the stomach rather than protected against it. A higher basal NO production seems to provide a more efficient antistress defence in the August rats. An intense NO storage may create a relative NO shortage and thus predispose to stress-induced vasoconstriction and ulceration.

[Focusing a spherical acoustic pulse with an elliptic reflector in a medical device for non-invasive crushing of renal calculi]. / Fokusirovanie sfericheskogo zvukovogo impul'sa éllipticheskim reflektorom v meditsinkoi ustanovke dlia beskontaktnogo drobleniia pochechnykh kamnei.

In developing medical device for transcutaneous destruction of renal stones in patients suffering from nephrolithiasis we have encountered some problems concerning the focusing of sound pulses. On the assumption of the linear diffraction theory the pressure pattern is computed that is produced when sound pulses are emitted by a source in the vicinity of the elliptic reflector focal point. Pressure pattern and wave-front shape versus radiator displacements off the focal point are studied. Radiator displacement is shown to have a marked effect on pressure amplitude and distribution within the area. Thus, a correcting acoustic lens should be mounted close to the reflector aperture.