Use of monitoring system in Ekaterinburg

The monitoring of buildings and structures condition, as well as the timely implementation of corrective actions aimed at the elimination of adverse factors, are the most important aspects that shall be addressed at the construction stage. The usage of monitoring systems makes it possible to monitor the building condition and above that to implement more efficient design solutions in the prospective projects using the results of the analysis of the acquired and design data. In this work the review of a monitoring system installed in a high-rise building located in Ekaterinburg is given. The paper describes the analysis of the natural oscillation frequency and the logarithmic decrement of fundamental tone acquired with the help of accelerometers, and compares the values with the acceptance limits. The process of converting data acquired by strain gauges for the determination of the stress-strain condition of the bearing structures is analysed. The process of comparison of data obtained by the monitoring system of a high-rise building is described. The necessity of the application of the monitoring system is analysed. © Published under licence by IOP Publishing Ltd

Совершенствование методов лечения спонтанного пневмоторакса с помощью видеоторакоскопических операций

Videothoracoscopic operations are more effective than standard open surgery. The number of recurrences of spontaneous pneumothorax after videothoracoscopic operations were 3.6%, and after open surgery – 2.6%. Method of choice for surgical treatment of spontaneous pneumothorax is videothoracoscopic operations. Videoassisted operations are more efficient and allow to perform low-impact operations using multiple-cross-linking domestic vehicles apparatuses.В статье обобщен 15-летний опыт применения видеоторакоскопических операций при лечении 616 больных со спонтанным пневмотораксом. Описаны методики различных видеоторакоскопических операций в зависимости от объема и локализации патологического процесса в легочной ткани. Рассмотрены этапы развития методик эндоскопического хирургического лечения спонтанного пневмоторакса. Проведен анализ выполненных видеоторакоскопических операций при этом заболевании. Рецидивы заболевания при использовании данного метода хирургического лечения составили 3,6 %. Летальных исходов не было

Results of surgical treatment of postinfarction left ventricular aneurysm complicated with ventricular tachycardia with use of 3D-navigation system CARTO™

The aim of the research was to study localization of wandering focus and effectiveness of extensive endocardectomy at left ventricular reconstruction in patients with ischemic heart disease (IHD) with postinfarction left ventricular aneurysm (LVA) in combination with ventricular tachycardia (VT). Examined patients besides diagnostic routines had intracardiac electrophysiological examination (EPE) with use of 3D-navigation system CARTOTX (Biosense Webster). During EPE abnormal zones of delayed navigating and zones of double potential with main localization in the area of cacuminal and middle septate segments were found. All patients were divided into two groups: patients of the first group had aortocoronary bypass (ACB) in combination with left ventricular reconstruction completed with extended resection of endocardium with pinch of all cacuminal and middle septate segments; 2 patients of the second group had isolated ACB, 2 patients had ACB with mitral annuloplasty with rim and de Vega plasty of tricuspid valve, 1 patient had percutaneous transluminal coronary angioplasty, 10 patients hadACB in combination with LVA plasty without extended endocardium resection. As the result of the treatment in the first group there were no VT episodes after resection of aneurysm with extended endocardium resection; 33 % of patients in the second group had implantable cardioverter defibrillator, 7 % of the patients had radio frequency ablation of VT nidus, 7 % of the patients had anti-arrhythmic therapy. Taking into consideration that main localization of ectopic nidus in patients with IHD with postinfarction LVA and VT is in the area of cacuminal and middle septate segments, left ventricular reconstruction in these patients needs to be conducted with extended resection of endocardium of these segments

Способ паллиативного лечения распространенных форм рака легкого

We have proposed a palliative method for common forms of lung cancer, which combines the two previously mentioned methods. Using this method allows not only to stop the lung bleeding, but restore airway passage of the bronchi and then continue with the treatment of lung cancer (chemotherapy, radiotherapy). We used this method in 16 patients with age group from 54 to 76 years, with central lung cancer III A–IV stages, who had lung hemorrhage and atelectasis of bronchus. In the first step, rentgenendovascular embolization of bronchial artery (REVEBA) and their branches approaching to the tumor is performed. In the next stage, the patients underwent laser recanalization of tumor stenosis of the segmental or main bronchi. We were able to achieve a positive hemostatic effect in 15 patients, which was seen throughout first 5 months. Recanalization and restoration of the bronchial airway was achieved in all the patients. All these factors allowed the patients undergo subsequent radiation and chemotherapy. Tumor relapse, recurrence of stenosis and pulmonary bleeding have not been observed during the first 5 months. Possibilities of using the adove mentioned methods in the treatment of common forms of lung cancer have been shown.Нами предложен способ паллиативного лечения распространенных форм рака лёгкого, который объединяет две ранее указанные методики. Применение данного способа позволяет не только остановить легочное кровотечение и восстановить проходимость бронха, но и в дальнейшем продолжить лечение рака легкого (химиотерапия, лучевая терапия). Данный способ применен нами у 16 пациентов с центральным раком легкого III A–IV ст., у которых было легочное кровотечение и ателектаз бронха. Первым этапом выполнялась рентгенэндоваскулярная эмболизация бронхиальных артерий и их ветвей, подходящих к опухоли. Следующим этапом была лазерная реканализация опухолевых стенозов бронхов. Нам удалось добиться положительного гемостатического эффекта у 15 пациентов (стойкий гемостаз отмечался на протяжении 5 мес.), а также реканализации бронхов у всех пациентов. Все это позволило нашим пациентам в последующем пройти лучевую либо химиотерапию. За 5-месячный период наблюдения рецидив опухолевого стеноза и повторные легочные кровотечения нами не наблюдались. Показана возможность использования метода в лечении осложненных форм злокачественных опухолей легкого

Interleukins 4 and 6 as factors of modulation of subpopulation composition of blood monocytes in patients with ischemic cardiomyopathy

Aim. To evaluate the ratio of the fractions of classical, intermediate, non-classical and transitional monocytes in correlation with the concentration of interleukins 4 and 6 in the blood of patients with ischemic cardiomyopathy. Methods. 18 patients with ischemic cardiomyopathy (17 men and 1 woman) aged 47-66 years with circulatory insufficiency of functional class II-III according to the classification of heart failure of the New York Heart Association, were examined. The control group included 14 healthy donors matched by gender and age to patients with ischemic cardiomyopathy without any diseases of cardiovascular system and other systems in an exacerbation stage. In blood of the patients with ischemic cardiomyopathy, the relative content of classical (CD14++CD16-), intermediate (CD14++CD16+), non-classical (CD14+CD16+) and transitional (CD14+CD16-) monocytes was assessed by flow cytometry and the concentration of interleukins 4 and 6 by enzyme-linked immunosorbent assay (ELISA). Results. It was shown that the number of non-classical monocytes in the blood of patients with ischemic cardiomyopathy was 2 times lower than normal (5.05 % [4.08; 6.58] and 10.07 % [9.34; 13.84], respectively, p < 0.01), as well as the concentration of interleukin-4 (0.02 pg/ml [0; 0.04] and 0.15 pg/ml [0.05; 0.65], respectively, p < 0.05). The number of classical monocytes in the blood of patients had a tendency to decrease, and the proportion of intermediate monocytes and the concentration of interleukin-6, on the contrary, were slightly higher than in healthy individuals, and were interdependent (r = 0.61; p < 0.05). The relative content of transitional monocytes in the blood was comparable with that of healthy donors. Conclusions. The subpopulation composition of blood monocytes in patients with ischemic cardiomyopathy is characterized by a deficiency of the fraction of non-classical monocytes with protective properties against endothelium, and interleukin-4 in the blood with a certain increase in the content of interleukin-6 and the number of intermediate cells with ability to cooperate with T-lymphocytes, which predisposes to diffuse atheromatosis of small coronary arteries and diffuse hypoxic myocardial damage in ischemic cardiomyopathy

Our experience of surgical treatment of aortic arch obstruction in children in the presence of antegrade selective cerebral perfusion

This work is about outcomes of surgical treatment aortic arch obstruction in children performed with the use of selective cerebral perfusion and moderate hypothermia. The study included 97 patients with aortic coarctation, recoarctation and hypoplastic aortic arch. The patients were divided into 3 groups. 75 patients with isolated coarctation and recoarctation or with concomitant atrial septal defects, patentforamen ovale and patent ductus arterious were assigned to the 1st group. The 2nd group included 13 patients with aortic arch obstruction and ventricular septal defects. The 3rd group consisted of 9 patients with coarctation, recoarctation and complex intracardiac anomalies. All patients underwent reconstruction of the aortic arch with selective cerebral perfusion and moderate hypothermia. Overall mortality rate was 4%. Postoperative complications took place in 7% of the cases: 1% - postoperative bleeding, 1% - paresis of the diaphragm, 2% - pneumothorax, 2% - chylothorax, and 1% of the cases - vocal cords paresis. Respiratory postoperative complications were registered in 5% of cases. In 6% of the cases patients had neurological postoperative complications. After the operation there was no gradientfound between the pressures on upper and lower extremities. We consider that antegrade selective cerebral perfusion and moderate hypothermia during aortic arch reconstruction are effective methods of brain and visceral organs protection

Cytokines and HIF-1α as dysregulation factors of migration and differentiation of monocyte progenitor cells of endotheliocytes in the pathogenesis of ischemic cardiomyopathy

Background. Angiogenic endothelial dysfunction and progenitor endothelial cells (EPCs) in ischemic cardiomyopathy (ICMP) have not been studied enough.The aim. To establish the nature of changes in the cytokine profile and HIF-1α in blood and bone marrow associated with impaired differentiation of monocytic progenitor cells of endotheliocytes (CD14+VEGFR2+) in the bone marrow and their migration into the blood in patients with coronary heart disease (CHD), suffering and not suffering from ICMP.Materials and methods. A single-stage, single-centre, observational case-control study was conducted involving 74 patients with CHD, suffering and not suffering from ICMP (30 and 44 people, respectively), and 25 healthy donors. In patients with CHD, bone marrow was obtained during coronary bypass surgery, peripheral blood – before surgery. Healthy donors were taken peripheral blood. The number of CD14+VEGFR2+ in bone marrow and blood was determined by flow cytometry; the concentration of IL-6, TNF-α, M-CSF, GM-CSF, MCP-1 and HIF-1α – by the method of enzyme immunoassay.Results. A high content of CD14+VEGFR2+ cells in the blood of patients with CHD without cardiomyopathy was established relative to patients with ICMP against the background of a comparable number of these cells in myeloid tissue. Regardless of the presence of ICMP in the blood, patients with CHD showed an excess of TNF-α, a normal concentration of IL-6, GM-CSF, HIF-1α and a deficiency of M-CSF, and in the bone marrow supernatant, the concentration of IL-6 and TNF-α exceeded that in the blood plasma (the level of GM-CSF – only in patients without cardiomyopathy). With ICMP, the normal concentration of MCP-1 was determined in the blood plasma, and with CHD without cardiomyopathy, its elevated content was determined.Conclusion. The formation of ICMP is accompanied by insufficient activation of EPCs migration with the CD14+VEGFR2+ phenotype in blood without disruption of their differentiation in the bone marrow, which associated with the absence of an increase in the concentration of MCP-1 in blood plasma and not associated with the plasma content of M-CSF, GM-CSF, HIF-1α, IL-6 and TNF-α

Outbreak of West Nile virus infection, Volgograd Region, Russia, 1999.

From July 25 to October 1, 1999, 826 patients were admitted to Volgograd Region, Russia, hospitals with acute aseptic meningoencephalitis, meningitis, or fever consistent with arboviral infection. Of 84 cases of meningoencephalitis, 40 were fatal. Fourteen brain specimens were positive in reverse transcriptase-polymerase chain reaction assays, confirming the presence of West Nile/Kunjin virus

The Use of Sutureless Electrosurgical and Ultrasound Technologies in Lung Surgeries – Literature Review

На современном уровне развития видеоторакоскопической хирургии легких методом выбора является использование эндостеплеров (ЕС), осуществляющих одновременное прошивание и рассечение легочной ткани между наложенным рядом танталовых скобок. Однако широкое применение ЭС показало, что механический шов не всегда обеспечивает надежный аэростаз, что заставляет использовать дополнительные синтетические материалы. Кроме того, недостатками использования ЭС является их высокая цена, потребность в использовании нескольких картриджей, пострезекционное выключение из дыхания неизмененных участков легочной паренхимы, возможные трудности в размещении рабочей части аппарата в плевральной полости, большой диаметр торакопорта (Т), необходимый для введения ЭС.The review presents data of the use of electric seal and ultrasonic technology in the performance of open and videothoracoscopic lung resections. The possibility of seamless resection of the lung tissue by using bipolar electric seal (LigaSure) and ultrasonic (Harmonic) scalpel with tolerable aerohemostasis shown. The advantages and possible drawbacks of these methods displayed