Анестезиологические аспекты удаления гормонально-активных каротидных хемодектом: клиническое наблюдение и обзор литературы

The article describes a clinical case - the resection of the hormone- active tumor of the carotid glomus. The hormonal activity of the tumor was suspected based on data of the patient's history, (malignant arterial hypertension with sharp rises in arterial tension, episodes of the increased arterial tension during mechanical impact on the tumor) and hemodynamic parameters during surgery (heart rhythm disturbances after induction of anesthesia and pronounced hypertensive reactions when manipulating the tumor tissue). The article reviews publications on anesthetic support during the resection of hormone-active chemodectomas.Detection of typical clinical signs such as hypertension, tachycardia, fever, headaches, etc. in the history of patients with chemodectoma may suggest hormonal activity of the tumor. Biochemical tests that determine the level of catecholamines and their breakdown products can confirm the diagnosis. When planning surgery, the anesthesiologist should be prepared for the development of the relevant complications. Hypertension, as the most frequent complication, should be prevented by preoperative adrenergic blockers and treated intraoperatively with short-acting antihypertensive drugs. After exclusion of the tumor from the bloodstream, it is necessary to prepare for the development of hypotension.Приведено описание клинического наблюдения ‒ удаления гормонально-активной опухоли каротидного гломуса. Предположение о гормональной активности опухоли сделано на основании данных анамнеза (злокачественная артериальная гипертензия с кризовым течением, эпизоды подъема артериального давления при механическом воздействии на опухоль) и особенностей гемодинамики во время операции (нарушения ритма сердца после индукции анестезии и выраженные гипертензивные реакции при манипуляции на ткани опухоли). В обсуждении представлен обзор литературы, посвященный анестезиологическому обеспечению удаления гормонально-активных хемодектом.Выявление характерных клинических симптомов в виде гипертензии, тахикардии, лихорадки, головных болей и др. в анамнезе пациентов с хемодектомами могут натолкнуть на мысль о гормональной активности опухоли. Биохимические тесты, определяющие уровень катехоламинов и продуктов их распада, позволяют подтвердить диагноз. При планировании операции анестезиолог должен быть готов к развитию характерных осложнений. Гипертензия, как самое частое осложнение, должна быть профилактирована назначением адреноблокаторов перед операцией и купирована короткодействующими гипотензивными препаратами интраоперационно. После выключения опухоли из кровотока следует быть готовым к развитию гипотонии

Anesthetic aspects of the resection of hormone-active carotid chemodectomas: a clinical case and literature review

The article describes a clinical case - the resection of the hormone- active tumor of the carotid glomus. The hormonal activity of the tumor was suspected based on data of the patient's history, (malignant arterial hypertension with sharp rises in arterial tension, episodes of the increased arterial tension during mechanical impact on the tumor) and hemodynamic parameters during surgery (heart rhythm disturbances after induction of anesthesia and pronounced hypertensive reactions when manipulating the tumor tissue). The article reviews publications on anesthetic support during the resection of hormone-active chemodectomas.Detection of typical clinical signs such as hypertension, tachycardia, fever, headaches, etc. in the history of patients with chemodectoma may suggest hormonal activity of the tumor. Biochemical tests that determine the level of catecholamines and their breakdown products can confirm the diagnosis. When planning surgery, the anesthesiologist should be prepared for the development of the relevant complications. Hypertension, as the most frequent complication, should be prevented by preoperative adrenergic blockers and treated intraoperatively with short-acting antihypertensive drugs. After exclusion of the tumor from the bloodstream, it is necessary to prepare for the development of hypotension

A High Precision Fabry-Perot Cavity Polarimeter at HERA

A Fabry-Perot cavity polarimeter, installed in 2003 at HERA for the second phase of its operation, is described. The cavity polarimeter was designed to measure the longitudinal polarisation of the HERA electron beam with high precision for each electron bunch spaced with a time interval of 96ns. Within the cavity the laser intensity was routinely enhanced up to a few kW from its original value of 0.7W in a stable and controllable way. By interacting such a high intensity laser beam with the HERA electron beam it is possible to measure its polarisation with a relative statistical precision of 2% per bunch per minute. Detailed systematic studies have also been performed resulting in a systematic uncertainty of 1%.Comment: 28 pages, 16 figure