Anatomy of coronary sinus ostium

Background: The coronary sinus is the main cardiac vein and it has become a clinically important structure especially through its role in providing access for different cardiac procedures. Materials and methods: The study was carried out on 100 randomly selected adult human cadaver hearts fixed in 10% formalin. The transverse and craniocaudal diameters of the coronary sinus ostium (CSO) were directly measured. The presence of the Thebesian valve was noted and the anatomical details of the valve were documented in each case in terms of the shape and extent of coverage of the CSO. Results: Considerable variations in the diameter of the CSO were observed. The mean craniocaudal diameter of the CSO was 8.1 ± 1.51 mm, and the mean transverse diameter was 7.67 ± 1.72 mm. Heart specimens without Thebesian valve tended to have larger ostia. The mean craniocaudal diameter and the mean transverse diameter of the CSO were statistically larger in the specimens without Thebesian valves (p = 0.000 and p = 0.001, respectively). Conclusions: The Thebesian valves were observed in 86 hearts, and a wide variety of their morphology was seen. The majority of the Thebesian valves were semilunar in shape (74.42%). The extent to which the valve covered the ostium was variable, including remnant valves that covered < 15% of the CSO (35%), and valves that were large and covered at least 75% of the CSO (22.09%). In 3 specimens the valve completely occluded the ostium.

Morphologic characteristics of sacra associated with assimilation of the last lumbar vertebra

Background: The impact of lumbosacral transitional states on biomechanics of load transmission between the spine and the legs has been sporadically reported. The aims of the study were to identify morphostructural alterations of sacra associated with assimilation of the last lumbar vertebra and to analyse them in the light of their biomechanical impact. Materials and methods: Linear dimensions of sacrum, its body and base and articular surfaces were measured in 31 normal and 41 transitory sacra. Nineteen sacra presented articular and 22 osseous fusion of the last lumbar vertebra. Measured parameters were compared between normal sacra and the two variations of transitory sacra. Results: Sacra with articular fusion of the last lumbar vertebra showed more pronounced concavity of the sacral curvature and wider than long sacral bodies. The first sacral segment was modified, broaden, ventrally wider and elevated. Almost the whole segment bore at its sides auricular surfaces. Very small portion of the segment was non-articular with less pronounced wedging. Sacra with osseous fusion of the last lumbar vertebra showed similar concavity of the sacral curvature as normal sacra, but longer than wide sacral bodies. The ventral sloping half of the newly formed first segment bore auricular surfaces. The non-articular part was enlarged with pronounced wedging. Conclusions: The term “sacralisation“ includes both types of transitory sacra with mutually different morphostructural characteristics in contrast to the normal sacra. Analysis of these morphologic variations may help in understanding the different biomechanical properties and patterns of load transmissio

Regulation of immune cell function and differentiation by the NKG2D receptor

NKG2D is one of the most intensively studied immune receptors of the past decade. Its unique binding and signaling properties, expression pattern, and functions have been attracting much interest within the field due to its potent antiviral and anti-tumor properties. As an activating receptor, NKG2D is expressed on cells of the innate and adaptive immune system. It recognizes stress-induced MHC class I-like ligands and acts as a molecular sensor for cells jeopardized by viral infections or DNA damage. Although the activating functions of NKG2D have been well documented, recent analysis of NKG2D-deficient mice suggests that this receptor may have a regulatory role during NK cell development. In this review, we will revisit known aspects of NKG2D functions and present new insights in the proposed influence of this molecule on hematopoietic differentiation

NK cell receptor NKG2D sets activation threshold for the NCR1 receptor early in NK cell development

The activation of natural killer (NK) cells depends on a change in the balance of signals from inhibitory and activating receptors. The activation threshold values of NK cells are thought to be set by engagement of inhibitory receptors during development. Here, we found that the activating receptor NKG2D specifically set the activation threshold for the activating receptor NCR1 through a process that required the adaptor DAP12. As a result, NKGD2-deficient (Klrk1-/-) mice controlled tumors and cytomegalovirus infection better than wild-type controls through the NCR1-induced production of the cytokine IFN-γ. Expression of NKG2D before the immature NK cell stage increased expression of the adaptor CD3ζ. Reduced expression of CD3ζ in Klrk1-/- mice was associated with enhanced signal transduction through NCR1, and CD3ζ deficiency resulted in hyper-responsiveness to stimulation via NCR1. Thus, an activating receptor developmentally set the activity of another activating receptor on NK cells and determined NK cell reactivity to cellular threats

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Session 17 Ecophysiology

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Analysis of the incidence of chd and resource care of cardiac patients in the North Сaucasus federal district and Karachay-dierkessia

The article presents the results of the analysis incidence of ischemic health diseases in Russia, North Caucasus federal district and Karachay-Cherkessia republic by federal statistical observation forms. The differences were found in the incidence of cardiovascular disease outcomes between regions. The significance of the availability of cardiology and cardiac care to improve the health of residents of the region was shown

СHEALTH EDUCATION AND ADHERENCE FORMATION IN SOCIALLY VULNERABLE GROUPS OF TUBERCULOSIS PATIENTS

The paper considers the incidence of tuberculosis in a pediatric population and mentally ill patients and describes the key problems of disease management in these patients. It gives data on patients’ awareness of their disease and factors forming their treatment adherence