On the use of aged wood terminology

The paper presents an analysis of regulatory documents on the use of the terms «aged wood» and «aged wood».В работе представлен анализ нормативных документов на применение терминов «состаренная древесина» и «выдержанная древесина»

Role of portocaval shunts in development of complications after liver transplantation

Rationale. Portal blood flow is a key component in the viability of the liver transplant. Portocaval shunts formed on the background of the liver cirrhosis before transplantation can cause portal vein steal syndrome, with subsequent development of ischemic necrosis of the graft. To date, the tactics of treating patients with portal vein steal syndrome during liver transplantation has not been sufficiently developed. This paper presents a literature review and our own experience on this important, but little-studied issue. Purpose. The purpose of this research is to study the role of portocaval shunts in the development of complications after liver transplantation, based on a retrospective analysis of clinical cases. Conclusions. In liver transplantation, portocaval shunts can cause the development of portal vein steal syndrome with subsequent development of liver failure. For the diagnosis of portal vein steal syndrome, it is important to use the data obtained at all stages of liver transplantation. Surgical correction of portal vein steal syndrome can be performed during liver transplantation and in the early postoperative period. © 2022 by the authors

Методы определения проектной холодопроизводительности систем кондиционирования наружного воздуха в климатических условиях Украины и Казахстана

Методы определения проектной холодопроизводительности систем кондиционирования наружного воздуха в климатических условиях Украины и Казахстана = Methods to determine a design cooling capacity of ambient air conditioning systems in climatic conditions of Ukraine and Kazakhstan / Н. И. Радченко, Е. И. Трушляков, А. Н. Радченко, А. П. Цой, А. В. Щесюк // Матеріали XI міжнар. наук.-техн. конф. "Інновації в суднобудуванні та океанотехніці". В 2 т. – Миколаїв : НУК, 2020. – Т. 1. – С. 462–468.In general, the entire range of current heat loads of any air conditioning system (ACS) includes a range of unstable heat loads and a relatively stable range when the air is cooled from a certain threshold temperature to the required one. It is proposed to provide a stable part of the ACS operation with a conventional compressor in a close nominal mode, while pre-cooling – by regulating the cooling capacity.Аннотация. В общем случае весь диапазон текущих тепловых нагрузок любой системы кондиционирования воздуха (СКВ) включает диапазон нестабильных тепловых нагрузок и сравнительно стабильный диапазон при охлаждении воздуха от определенной пороговой температуры до требуемой. Предложено обеспечивать стабильную часть работы СКВ обычным компрессором в близком номинальному режиме, тогда как предварительное охлаждение – регулированием холодопроизводительности

КЛИНИКО-МОРФОЛОГИЧЕСКОЕ ИССЛЕДОВАНИЕ РОЛИ ФАКТОРА ТРАНСКРИПЦИИ NEUROD1 В РАЗЛИЧНЫХ ТИПАХ АДЕНОМ ГИПОФИЗА

The role of transcription factors in the pathogenesis of pituitary adenomas is extremely controversial.The aim of the study was to investigate the role of the transcription factor Neuro D1 in various types of pituitary adenomas.Materials and methods. A comparative clinico-morphological study was carried out with immunohistochemical analysis and confocal microscopy of the expression of the transcription factor NeuroD1, six adenohypophysis hormones and Ki-67 in 40 pituitary adenomas and 9 normal pituitary glands.Results. NeuroD1 was expressed in all cases and types of adenomas. The expression level of the transcription factor in adenomas was significantly different from that in the normal pituitary gland (p = 0.006). The average number of cells with expression of NeuroD1 in all tumors was higher than in the normal pituitary gland.Conclusion. NeuroD1 plays one of the key roles in the pathogenesis of pituitary adenomas, regardless of their hormonal status.Сведения о роли факторов транскрипции в патогенезе аденом гипофиза крайне противоречивы.Целью исследования явилось изучение роли фактора транскрипции NeuroD1 в различных типах аденом гипофиза.Материал и методы. Выполнено сравнительное клинико-морфологическое исследование с иммуногистохимическим анализом и конфокальной микроскопией экспрессии фактора транскрипции NeuroD1 6 гормонов аденогипофиза и Ki-67 в 40 различных аденомах гипофиза и 9 нормальных аденогипофизах.Результаты исследования. NeuroD1 экспрессировался во всех случаях и типах аденом, уровень его экспрессии в 40 аденомах достоверно отличался от такового в нормальном гипофизе (р=0,006), при этом NeuroD1 во всех опухолях был выше, чем в норме.Заключение. NeuroD1 играет одну из ключевых ролей в патогенезе аденом гипофиза вне зависимости от их гормонального статуса

ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ ТРАНСПЛАНТАЦИИ ТРУПНОЙ ПЕЧЕНИ

Aim of the study was to evaluate patient and graft survival after liver transplantation (LT) and to determine if primary disease diagnosis, early graft dysfunction or other factors affect it. Furthermore, we analyzed the reasonsof short-term and long-term deaths or retransplantations.Materials and methods. 192 LTs from donors with brain death were performed from December 2004 until June 2014. Recipient age varied from 5 to 71 years. Most frequent diagnosis was liver cirrhosis (mainly due to hepatitis C), then hepatocellular carcinoma (HCC), liver graft dysfunction, etc.Results and discussion. 1-year patient survival is 89.5%, graft survival is 87.7%, 3-year –87% and 84.6%, respectively, and 5-year – 83.5% and 83.0%, respectively. Early mortality (in fi rst 30 days after transplantation) was 8%, long-term mortality – 5.9%. Primary non-function graft (PNF) was the reason of 66.7% early deaths. In the long term, infections and oncology were the reasons of death with the same frequency – 36.4%. Early graft dysfunction including primary non-function signifi cantly decreases short term survival (p = 0.0002). Nevertheless, in the majority of cases graft function improves and doesn’t affect survival. Donor factors play role in outcomes: early dysfunction is higher (40.6%) in extended criteria donor group than in standard donor group (р = 0.0431). PNF has the same trend – 8.5% and 0.0%, respectively, but without signifi cance (р =0.0835). 5-year survival is remarkably lower in HCC group 40.8% (p = 0.003) than in other groups.Conclusion: survival after liver transplantation in our Center is comparable with the results of the world’s centers.Цель данного исследования – изучить выживаемость больных и трансплантатов в зависимости от диагно-за первичного заболевания, наличия ранней дисфункции трансплантата, причины летальности на разныхсроках, проанализировать результаты ретрансплантаций.Материалы и методы. С декабря 2004 года по июнь 2014 года в ФНЦТИО было выполнено 192 трансплантации печени от доноров с диагнозом «смерть мозга» 186 реципиентам в возрасте от 5 лет до 71 года. В структуре показаний к трансплантации на первом месте по частоте находился цирроз печени, чаще всего в исходе гепатита С, затем гепатоцеллюлярная карцинома, дисфункция трансплантата печени и другие заболевания.Результаты и обсуждение. Однолетняя выживаемость реципиентов составляет 89,5%, трансплантатов – 87,7%, трехлетняя – 87 и 84,6%, пятилетняя – 83,5 и 83,0% соответственно. Периоперационная летальность составила 8%, отдаленная – 5,9%. Основной причиной смерти в раннем послеоперационном периоде являлись первично не функционирующие трансплантаты (ПНФТ) – 66,7% потерь, в отдаленном – одинаково часто (36,4% потерь) злокачественные новообразования и инфекции. Ранняя дисфункция трансплантата (РДТ), включая ПНФТ, статистически значимо снижает выживаемость в раннем послеоперационном периоде (p = 0,0002). Однако у большинства больных РДТ обратима и в этом случае в дальнейшем не влияет на выживаемость. При использовании трансплантата от стандартного донора частота РДТ была статистически значимо меньше – 21,2%, чем при расширении критериев – 40,6% (р = 0,0431), а частота ПНФТ составила 0,0 и 8,5%, соответственно (р = 0,0835). Пятилетняя выживаемость при трансплантации по поводу ГЦК значимо ниже, чем при наличии других показаний – 40,8% (p = 0,003).Заключение: выживаемость реципиентов после трансплантации печени в нашем центре на сроке до 10 лет сопоставима с результатами мировых регистров

Comparison of Pheochromocytoma-Specific Morbidity and Mortality among Adults with Bilateral Pheochromocytomas Undergoing Total Adrenalectomy vs Cortical-Sparing Adrenalectomy

Importance: Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. Objective: To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. Design, Setting, and Participants: This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018. Data were analyzed from September 1, 2018, to June 1, 2019. Exposures: Total or cortical-sparing adrenalectomy. Main Outcomes and Measures: Primary adrenal insufficiency, recurrent pheochromocytoma, and mortality. Results: Of 625 patients (300 [48%] female) with a median (interquartile range [IQR]) age of 30 (22-40) years at diagnosis, 401 (64%) were diagnosed with synchronous bilateral pheochromocytomas and 224 (36%) were diagnosed with metachronous pheochromocytomas (median [IQR] interval to second adrenalectomy, 6 [1-13] years). In 505 of 526 tested patients (96%), germline mutations were detected in the genes RET (282 patients [54%]), VHL (184 patients [35%]), and other genes (39 patients [7%]). Of 849 adrenalectomies performed in 625 patients, 324 (52%) were planned as cortical sparing and were successful in 248 of 324 patients (76.5%). Primary adrenal insufficiency occurred in all patients treated with total adrenalectomy but only in 23.5% of patients treated with attempted cortical-sparing adrenalectomy. A third of patients with adrenal insufficiency developed complications, such as adrenal crisis or iatrogenic Cushing syndrome. Of 377 patients who became steroid dependent, 67 (18%) developed at least 1 adrenal crisis and 50 (13%) developed iatrogenic Cushing syndrome during median (IQR) follow-up of 8 (3-25) years. Two patients developed recurrent pheochromocytoma in the adrenal bed despite total adrenalectomy. In contrast, 33 patients (13%) treated with successful cortical-sparing adrenalectomy developed another pheochromocytoma within the remnant adrenal after a median (IQR) of 8 (4-13) years, all of which were successfully treated with another surgery. Cortical-sparing surgery was not associated with survival. Overall survival was associated with comorbidities unrelated to pheochromocytoma: of 63 patients who died, only 3 (5%) died of metastatic pheochromocytoma. Conclusions and Relevance: Patients undergoing cortical-sparing adrenalectomy did not demonstrate decreased survival, despite development of recurrent pheochromocytoma in 13%. Cortical-sparing adrenalectomy should be considered in all patients with hereditary pheochromocytoma

Коморбидность туберкулеза, алкоголизма и наркомании

One of the reasons of growing incidence of tuberculosis (TB) is spread of AIDS, drug dependence, and alcoholism. To investigate their mutual influence the authors examined 185 lung TB patients (of them, 124 males) admitted to TB hospitals of St-Petersburg in 2003-2005. Inclusive criteria were age of 18 to 79 yrs, recent admission to the hospital, the patient's consent to participate the study. Patients were excluded if they were severely ill or had psychiatric disorders. The lung TB was evaluated using medical history, physical, clinic, laboratory, radiologic, and bacteriologic data. Alcohol and drug abuse was assessed with Addiction Severity Index (ASI), retrospective analysis of alcohol and substance use for previous 90 days, Michigan Alcohol Screening Test (MAST), measurement of alcohol in exhaled air and detection of substances in urine. Somatic and psychic health was evaluated using ASI, Beck Depression Inventory, and Spielberger Trait Anxiety Inventory. Risk of HIV-infection was determined in a test of HIV risk assessment and with HIV risk questionnaire developed at Johns Hopkins University. The average age of the participants was 40.5 yrs. More than 60 % of them had abuse-related disorders: alcohol abuse in 51.9 %, alcoholism plus drug dependence in 8.6 %, and drug dependence in 3.8 %. Alcohol dependence facilitated development of TB multiple drug resistance (21 % vs 7.6 % in patients without alcohol dependence, p < 0.05), extensive (73.9 % and 40.9 %, respectively, p < 0.001) and chronic (28.6 % and 16.7 %, respectively) forms of TB. Most of TB patients with abuse-related disorders tended to have psychiatric disorders (depression, anxiety). The risk of HIV-infection was significantly higher in TB patients with drug abuse (3.51 vs 0.07). Thus, it is necessary to consider co-morbidity in TB patients for more effective treatment of lung tuberculosis.Одной из причин роста заболеваемости туберкулезом является распространение СПИДа, наркомании и алкоголизма. С целью изучения взаимного влияния этих заболеваний обследованы 185 больных туберкулезом органов дыхания (124 мужчины), находившихся в стационарах г. Санкт-Петербурга в 2003–2005 гг. Критериями включения в исследование были возраст от 18 до 79 лет, недавнее поступление в стационар и согласие больного на участие в исследовании. Из исследования исключались больные в тяжелом состоянии и больные с выраженными психическими расстройствами. Для оценки туберкулезного процесса анализировали анамнез, данные физикального, клинико-лабораторного, рентгенологического и бактериологического обследований. Для определения употребления алкоголя и наркотиков оценивали индекс тяжести зависимости (ИТЗ), ретроспективно анализировали употребление алкоголя и наркотиков за 90 дней, проводили Мичиганский алкогольный скрининг-тест (МАSТ), определяли алкоголь в выдыхаемом воздухе и наркотики в моче. Для оценки соматического и психического здоровья использовали ИТЗ, вопросник депрессии Бека, шкалу тревоги Спилбергера. Риск ВИЧ-инфекции устанавливали в тесте оценки степени риска ВИЧ-инфекции (ТОСР) и по вопроснику риска ВИЧ-инфекции, разработанному университетом Дж. Хопкинса. Средний возраст обследованных больных составил 40,5 лет. Более 60 % больных имели наркологическую патологию (злоупотребление алкоголем в 51,9%, алкоголизм в сочетании с наркоманией в 8,6 %, наркомания в 3,8 %). Алкогольная зависимость способствовала развитию множественной лекарственной устойчивости (21 против 7,6 % у больных туберкулезом без наркологической патологии, p < 0,05), развитию распространенных (73,9 и 40,9 % соответственно, p < 0,001) и хронических (28,6 и 16,7 % соответственно) форм заболевания. Большинство туберкулезных больных с наркологическим диагнозом склонны к психическим расстройствам (депрессии, тревожные состояния). Риск ВИЧ-инфекции у больных туберкулезом, употреблявшим наркотики, был существенно выше (3,51 против 0,07). Таким образом, для улучшения эффективности лечения туберкулеза у наркологических больных необходимо учитывать все стороны коморбидности указанных патологий

Experience of using vascularized bone grafts to treat nonunion fractures and limb bone defects

Background. Vascular bone graft transposition is the one of most effective method of nonunion fracture and bone defect treatment. However, the use of this technique is associated with some difficulties. One is the adjustment of recipient bed size and the graft. The other is the difficulty to reconstruct the alignment and length of bone. A promising method of preparing for the vascular bone graft transposition is virtual three-dimensional planning based on computed tomography data and three-dimensional printing templates.The aim was to summarize our experience in the treatment of bone nonunion and defects with vascular bone autografts using tree-dimensional virtual planning and printing.Material and methods. We analyzed the treatment process and outcomes of 4 patients with limb bone nonunion and 6 patients with bone defects. In all cases, we used vascular bone grafts. Internal fixation of grafts was used in 7 cases, external fixation was used in 3 cases. At preparation stage in 4 cases, we used tree-dimensional virtual surgery planning and printing templates.Results. One case was diagnosed with bone graft necrosis caused by venous thrombosis. Consolidation was achieved in all patients; a late consolidation was observed in 2 cases. Hematoma in donor area was seen in 2 patients. When using three-dimensional virtual planning and tree-dimensional printing templates, the operation time was decreased by 1 hour 5 minutes. We identified two cases of poor reposition in the group without virtual planning. No poor reposition was observed in the cases where tree-dimensional planning was used.Conclusion. Vascularized bone grafts provide an effective method to treat bone defects and nonunion. But the planning of graft and recipient site sizes is associated with certain difficulties. Our preliminary results have shown that virtual three-dimensional planning and printing allow improving the precision of the surgical procedure and decreasing operative time

PREVALENCE OF SLEEP DISORDERED BREATHING IN PATIENTS WITH NEWLY DIAGNOSED ACROMEGALY

Background: Obstructive sleep disordered breathing or obstructive sleep apnea (OSA) is the most common respiratory impairment in acromegaly. OSA is bound up with heightened cardiovascular mortality. Aim: Тo study frequency, features, and structure of sleep disordered breathing in patients with newly diagnosed acromegaly and to elucidate the factors influencing their development. Materials and methods: 38 patients (10 men, 28 women, median age 53 (28-76) years, median body mass index (BMI) 29 (19.9-44.3) kg/m²) with newly diagnosed acromegaly were recruited into the study. All subjects underwent full polysomnography (Embla N7000, Natus, USA) and Remlogica software (USA). Results: Sleep disordered breathing was found in 28 (73.7%) patients. OSA was revealed in all cases, in 11 (39.3%) subjects it was mixed. In 10 (35.7%) patients OSA was mild, in 8 (28.6%) moderate, and in 10 (35.7%) severe. BMI (р<0.01), disease duration (р=0.003), and insulin-like growth factor-1 (IGF-1) level (р=0.04) were different in patients without OSA and patients with moderate-to-severe OSA. No difference was found in sex (р=0.4), age (р=0.064), and growth hormone level (р=0.6). Frequency of arterial hypertension, diabetes mellitus, and other glucose metabolism impairments was the same in subjects without OSA and with severe-to-moderate OSA. Conclusion: All patients with newly diagnosed acromegaly should undergo polysomnography. BMI, disease duration, and IGF-1 level are significant risk factors for OSA development. Correlation OSA with arterial hypertension and glucose metabolism impairments needs to be further investigated