22 research outputs found

    Optimization of electron beam parameters of LIA-10M accelerator

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    A numerical simulation of the LIA-10M accelerator was carried out. It is shown that at the existing configuration of the diode unit and maximal for LIA-10M injection parameters (3 MeV, 50 kA) significant (up to 40%) beam losses in the accelerating channel are possible. As a result of calculations the injector cathode geometry was optimized what permitted to avoid beam electron leakage onto the walls of accelerating channel and to improve significantly output parameters of the LIA-10M accelerator.ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ числСнноС ΠΌΠΎΠ΄Π΅Π»ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ ускоритСля Π›Π˜Π£-10М. Показано, Ρ‡Ρ‚ΠΎ ΠΏΡ€ΠΈ ΡΡƒΡ‰Π΅ΡΡ‚Π²ΡƒΡŽΡ‰Π΅ΠΉ ΠΊΠΎΠ½Ρ„ΠΈΠ³ΡƒΡ€Π°Ρ†ΠΈΠΈ Π΄ΠΈΠΎΠ΄Π½ΠΎΠ³ΠΎ ΡƒΠ·Π»Π° ΠΈ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡŒΠ½Ρ‹Ρ… для Π›Π˜Π£-10М ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Π°Ρ… ΠΈΠ½ΠΆΠ΅ΠΊΡ†ΠΈΠΈ (3 ΠœΡΠ’, 50 кА) Π²ΠΎΠ·ΠΌΠΎΠΆΠ½Ρ‹ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ (Π΄ΠΎ 40%) ΠΏΠΎΡ‚Π΅Ρ€ΠΈ ΠΏΡƒΡ‡ΠΊΠ° Π² ΡƒΡΠΊΠΎΡ€ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΌ Ρ‚Ρ€Π°ΠΊΡ‚Π΅. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅ расчСтов ΠΎΠΏΡ‚ΠΈΠΌΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π° гСомСтрия ΠΊΠ°Ρ‚ΠΎΠ΄Π° ΠΈΠ½ΠΆΠ΅ΠΊΡ‚ΠΎΡ€Π°, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΠΈΠ·Π±Π΅ΠΆΠ°Ρ‚ΡŒ ΡƒΡ‚Π΅Ρ‡ΠΊΠΈ элСктронов ΠΏΡƒΡ‡ΠΊΠ° Π½Π° стСнки ΡƒΡΠΊΠΎΡ€ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠ³ΠΎ Ρ‚Ρ€Π°ΠΊΡ‚Π° ΠΈ сущСствСнно ΡƒΠ»ΡƒΡ‡ΡˆΠΈΡ‚ΡŒ Π²Ρ‹Ρ…ΠΎΠ΄Π½Ρ‹Π΅ ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Ρ‹ ускоритСля.ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Ρ‡ΠΈΡΠ΅Π»ΡŒΠ½Π΅ модСлювання ΠΏΡ€ΠΈΡΠΊΠΎΡ€ΡŽΠ²Π°Ρ‡Π° Π›Π†ΠŸ-10М. Показано, Ρ‰ΠΎ ΠΏΡ€ΠΈ Ρ–ΡΠ½ΡƒΡŽΡ‡Ρ–ΠΉ ΠΊΠΎΠ½Ρ„Ρ–Π³ΡƒΡ€Π°Ρ†Ρ–Ρ— Π΄Ρ–ΠΎΠ΄Π½ΠΎΠ³ΠΎ Π²ΡƒΠ·Π»Π° Ρ– ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡŒΠ½ΠΈΡ… для Π›Π†ΠŸ-10М ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Π°Ρ… Ρ–Π½ΠΆΠ΅ΠΊΡ†Ρ–Ρ— (3 ΠœΠ΅Π’, 50 кА) ΠΌΠΎΠΆΠ»ΠΈΠ²Ρ– Π·Π½Π°Ρ‡yΡ– (Π΄ΠΎ 40%) Π²Ρ‚Ρ€Π°Ρ‚ΠΈ ΠΏΡƒΡ‡ΠΊΠ° Π² ΠΏΡ€ΠΈΡΠΊΠΎΡ€ΡŽΡŽΡ‡ΠΎΠΌΡƒ Ρ‚Ρ€Π°ΠΊΡ‚Ρ–. Π£ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ– Ρ€ΠΎΠ·Ρ€Π°Ρ…ΡƒΠ½ΠΊΡ–Π² ΠΎΠΏΡ‚ΠΈΠΌΡ–Π·ΠΎΠ²Π°Π½Π° гСомСтрія ΠΊΠ°Ρ‚ΠΎΠ΄Π° Ρ–Π½ΠΆΠ΅ΠΊΡ‚ΠΎΡ€Π°, Ρ‰ΠΎ Π΄ΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΡƒΠ½ΠΈΠΊΠ½ΡƒΡ‚ΠΈ Π²ΠΈΡ‚ΠΎΠΊΡƒ Π΅Π»Π΅ΠΊΡ‚Ρ€ΠΎΠ½Ρ–Π² ΠΏΡƒΡ‡ΠΊΠ° Π½Π° стінки ΠΏΡ€ΠΈΡΠΊΠΎΡ€ΡŽΡŽΡ‡ΠΎΠ³ΠΎ Ρ‚Ρ€Π°ΠΊΡ‚Ρƒ Ρ– суттєво ΠΏΠΎΠ»Ρ–ΠΏΡˆΠΈΡ‚ΠΈ Π²ΠΈΡ…Ρ–Π΄Π½Ρ– ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΈ ΠΏΡ€ΠΈΡΠΊΠΎΡ€ΡŽΠ²Π°Ρ‡Π°

    Results of LIA-10M accelerator investigations

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    There are presented basic results of experiments on the LIA-10M accelerator since its putting into operation (1994) till today. There were investigated various modes of accelerator operation and its output characteristics depending on the parameters of injected electron beam, number of connected accelerator modules, time program of inductors switch-in etc. There was obtained a large scope of experimental data that are of interest for LIA-10M accelerator practical use and for the development of new facilities of this type. The investigations that have been performed recently make it possible to considerably (half as much again) increase the output dose parameters of the accelerator as compared to the level achieved before: maximal dose (Si) and dose rate on the output flange constitute 400 Gy and 2.5.1010 Gy/s, while at a 1 meter distance from the target they are equal to 7.5 Gy and 5.108 Gy/s, respectively

    Sports training in parts of the active army in the period of the Caucasian war

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    The article deals with the sports training in units of the Russian army during the Caucasian war. The attention is paid to the specifics of military operations in the coastal, flatland, foothill and mountain areas. The materials included the documents from the archival department of the Sochi city administration (Sochi, Russian Federation), scientific publications, as well as orders of the military department, which reflected the studying issues. The methodology of the article is based on the traditional principles of historicism, objectivity, analytical, probabilistic and statistical, typological and comparative methods. The method of historicism made it possible to see, on the basis of dissimilar facts, obtained in the course of practical work with the documents, the important phenomena and processes related to the organization of sports training in the Russian army and in particular among the troops in the Caucasus. In conclusion, the authors stated that the system of sports exercises covered all muscle groups and developed skills of the combatant in the Caucasus to overcome any difficulties in the implementation of combat missions. The system of sports training for all units was not the same and could be different. So, for example, the teams of the Azov barges were less trained on sports equipment, and paid more attention to the exercises on the development of the arms and shoulder girdle. The reasons for this were the impossibility of using barges in other climatic zones, except for the coastal. Copyright Β© 2017 by Academic Publishing House Researcher s.r.o. Copyright Β© 2017 by Sochi State University

    Sports training in parts of the active army in the period of the Caucasian war

    No full text
    The article deals with the sports training in units of the Russian army during the Caucasian war. The attention is paid to the specifics of military operations in the coastal, flatland, foothill and mountain areas. The materials included the documents from the archival department of the Sochi city administration (Sochi, Russian Federation), scientific publications, as well as orders of the military department, which reflected the studying issues. The methodology of the article is based on the traditional principles of historicism, objectivity, analytical, probabilistic and statistical, typological and comparative methods. The method of historicism made it possible to see, on the basis of dissimilar facts, obtained in the course of practical work with the documents, the important phenomena and processes related to the organization of sports training in the Russian army and in particular among the troops in the Caucasus. In conclusion, the authors stated that the system of sports exercises covered all muscle groups and developed skills of the combatant in the Caucasus to overcome any difficulties in the implementation of combat missions. The system of sports training for all units was not the same and could be different. So, for example, the teams of the Azov barges were less trained on sports equipment, and paid more attention to the exercises on the development of the arms and shoulder girdle. The reasons for this were the impossibility of using barges in other climatic zones, except for the coastal. Copyright Β© 2017 by Academic Publishing House Researcher s.r.o. Copyright Β© 2017 by Sochi State University

    Studying the physiological effects of a new model of septoplasty in rats

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    Physiological responses to the proposed rat septoplasty model under general anesthesia were investigated. We studied the motor activity of rats and heart rate variability before experiment, one day and two days after surgery. After surgical intervention, motor activity decreased, the time of fading and grooming increased, the value of HF decreased, and VLF increased. Surgical trauma of the nasal septum mucous membrane in rats in the early postoperative stage contributes to a powerful stress response in the form of a shift in the balance of the autonomic nervous system towards the sympathetic nervous system, causes mobilization of central regulation mechanisms, reduces research activity, and provokes an anxious, depressive-like state and anxiety in rats. Β© 2020 All-Russian Federation of the Specialists in Head and Neck Diseases. All rights reserved

    Бпособ контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠΌΠ΅ΠΆΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡ΠΊΠΎΠ²ΠΎΠΉ ΠΏΠ΅Ρ€Π΅Π³ΠΎΡ€ΠΎΠ΄ΠΊΠΈ ΠΏΡ€ΠΈ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии. Π­ΠΊΡΠΏΠ΅Ρ€ΠΈΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½ΠΎΠ΅ исслСдованиС

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    Background: At present, there are no methods for intraoperative monitoring of the interventricular septum (IVS) thickness in a stopped and empty heart. This might be an obvious reason for unsatisfactory results after a number of septal myectomies.Aim: To provide an experimental background for the method to control the IVS thickness (that we had proposed) during septal myectomy.Materials and methods: The proposed technique is based on the transillumination method. The experimental models were cadaveric porcine hearts, as well as fragments of the human myocardium removed during septal myectomies. The thickness of the translucent myocardium was estimated depending on the local illumination value at the entrance to the myocardium and the external illumination of the surgical field. We compared the results of 67 septal myectomies performed in the clinic of the Almazov National Medical Research Centre with the results of 35 similar experimental procedures with cadaveric porcine hearts using the proposed way of measurement.Results: A graph of the illumination at the entrance to the myocardium against the thickness of the translucent myocardium was constructed. After conventionally performed septal myectomies the median variation of the myocardial thickness was 4 [3; 6] mm. In the experiment using the proposed control method, the median variation was 1 [1; 2] mm, i.e. significantly less than with the conventional approach (p = 3 x 10-10).Conclusion: The method to control the IVS thickness when performing septal myectomy makes it possible to achieve the required myocardial thickness the resection area with much greater accuracy than with the conventional one.ОбоснОбоснованиС. Π’ настоящСС врСмя Π½Π΅ сущСствуСт ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ² ΠΈΠ½Ρ‚Ρ€Π°ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠΌΠ΅ΠΆΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡ΠΊΠΎΠ²ΠΎΠΉ ΠΏΠ΅Ρ€Π΅Π³ΠΎΡ€ΠΎΠ΄ΠΊΠΈ (ΠœΠ–ΠŸ) Π½Π° остановлСнном ΠΈ Ρ€Π°Π·Π³Ρ€ΡƒΠΆΠ΅Π½Π½ΠΎΠΌ сСрдцС. Π­Ρ‚ΠΈΠΌ, ΠΏΠΎ всСй видимости, обусловлСны Π½Π΅ΡƒΠ΄ΠΎΠ²Π»Π΅Ρ‚Π²ΠΎΡ€ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ряда ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии.ЦСль - ΡΠΊΡΠΏΠ΅Ρ€ΠΈΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½ΠΎ ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Ρ‚ΡŒ ΠΏΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Π½Ρ‹ΠΉ Π°Π²Ρ‚ΠΎΡ€Π°ΠΌΠΈ способ контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠœΠ–ΠŸ ΠΏΡ€ΠΈ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ основу способа ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ ΠΌΠ΅Ρ‚ΠΎΠ΄ Ρ‚Ρ€Π°Π½ΡΠΈΠ»Π»ΡŽΠΌΠΈΠ½Π°Ρ†ΠΈΠΈ. Π­ΠΊΡΠΏΠ΅Ρ€ΠΈΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½Ρ‹ΠΌΠΈ модСлями слуТили Ρ‚Ρ€ΡƒΠΏΠ½Ρ‹Π΅ свиныС сСрдца, Π° Ρ‚Π°ΠΊΠΆΠ΅ Ρ„Ρ€Π°Π³ΠΌΠ΅Π½Ρ‚Ρ‹ чСловСчСского ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π°, ΡƒΠ΄Π°Π»Π΅Π½Π½Ρ‹Π΅ ΠΏΡ€ΠΈ опСрациях ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии. ΠžΡ†Π΅Π½ΠΈΠ²Π°Π»Π°ΡΡŒ Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Π° просвСчиваСмого ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π° Π² зависимости ΠΎΡ‚ Π²Π΅Π»ΠΈΡ‡ΠΈΠ½Ρ‹ локальной освСщСнности Π½Π° Π²Ρ…ΠΎΠ΄Π΅ Π² ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄ ΠΈ внСшнСй освСщСнности ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ поля. БопоставлСны Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ 67 ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии, Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π½Ρ‹Ρ… Π² ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ΅ Π€Π“Π‘Π£ «НМИЦ ΠΈΠΌ. Π’.А. Алмазова» ΠœΠΈΠ½Π·Π΄Ρ€Π°Π²Π° России, ΠΈ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ 35 Π°Π½Π°Π»ΠΎΠ³ΠΈΡ‡Π½Ρ‹Ρ… ΡΠΊΡΠΏΠ΅Ρ€ΠΈΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½Ρ‹Ρ… ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ, ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π½Ρ‹Ρ… Π½Π° Ρ‚Ρ€ΡƒΠΏΠ½Ρ‹Ρ… свиных сСрдцах с использованиСм ΠΏΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠœΠ–ΠŸ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠŸΠΎΡΡ‚Ρ€ΠΎΠ΅Π½ Π³Ρ€Π°Ρ„ΠΈΠΊ зависимости освСщСнности Π½Π° Π²Ρ…ΠΎΠ΄Π΅ Π² ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄ ΠΈ Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ просвСчиваСмого ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π°. ПослС ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΉ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии, Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π½Ρ‹Ρ… Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΌ способом, ΠΌΠ΅Π΄ΠΈΠ°Π½Π° разброса Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΉ Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π° составила 4 [3; 6] ΠΌΠΌ, Π° Π² экспСримСнтС с использованиСм ΠΏΡ€Π΅Π΄Π»ΠΎΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠœΠ–ΠŸ - 1 [1; 2] ΠΌΠΌ (Ρ€ = 3 Ρ… 10-10).Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Бпособ контроля Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠœΠ–ΠŸ ΠΏΡ€ΠΈ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ ΡΠ΅ΠΏΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ миэктомии позволяСт Π΄ΠΎΠ±ΠΈΡ‚ΡŒΡΡ Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎΠΉ Ρ‚ΠΎΠ»Ρ‰ΠΈΠ½Ρ‹ ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π° Π² Π·ΠΎΠ½Π΅ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΠΈ со Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ большСй Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ, Ρ‡Π΅ΠΌ ΠΏΡ€ΠΈ Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½ΠΎΠΌ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π΅ исполнСния

    О возмоТности ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡ информативности диагностики Π½Π΅ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΠΉ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Π³ΠΈΠΏΠ΅Ρ€Ρ‚Π΅Π½Π·ΠΈΠΈ Ρƒ ΠΊΠ°Π½Π΄ΠΈΠ΄Π°Ρ‚ΠΎΠ² Π½Π° Ρ‚Ρ€Π°Π½ΡΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΡŽ сСрдца

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    Background: Fixed pulmonary hypertension (PH) in heart transplant candidates is a risk factor for right ventricular failure in the postoperative period and early mortality. Patients with fixed PH are not included in the waiting list. Thus, the correct assessment of the pulmonary circulation before the operation affects both clinical management and prognosis. Aim: To reduce the risk of incorrect patient non-inclusion to the waiting list by reduction of false negative test results for PH reversibility.Materials and methods: Fourteen heart transplant candidates were included in this retrospective cohort single center study. Fixed PH with pulmonary vascular resistance (PVR) exceeding 3.5 Wood's units was found in all these patients using right heart catheterization and pulmonary vasoreactivity tests. Initially, these patients had not been put into the waiting list. Pulmonary catheterization was performed in the intensive care unit with a Swan-Ganz catheterΒ and pre-pulmonary thermodilution technique. To perform pulmonary vasoreactivity tests, inhaled iloprost (n = 12) or nitric oxide (n = 2) were used. Subsequently all patients received levosimendan infusion at a dose of 12.5 (0.05–0.2) mg/kg/min, with repeated pulmonary artery catheterization and pulmonary vasoreactivity tests at 72 hours after the infusion. Pulmonary vasoreactivity tests results allowed 13 patients to be included into the waiting list. Heart transplantation was performed in 8 recipients, with postoperative assessment of their hemodynamic and clinical parameters. Data are presented as median [25th percentile; 75th percentile].Results: After the levosimendan infusion, there was a decrease in the pulmonary artery mean pressure from 45 [36; 47] to 29.5 [23; 37] mm Hg (p 0.01), and in PVR from 6.9 [4.9; 8.9] to 3.6 [2.9; 5.9] Wood's units (p 0.01). In 7 patients, PVR decreased to less than 3.5 Wood's units: the rest of the patients underwent pulmonary vasoreactivity tests. As a result, 13 of 14 patients showed reversible PH and were included into the waiting list. By the date of the manuscript submission, heart transplantation has been performed in 8 patients. Their PVR 6 hours after surgery was 2.2 [2; 3.1] Wood's units; there were no cases of fixed PH and right heart failure. There was a single death associated to a hemorrhagic stroke at day 6 after heart transplantation. The sensitivity of pre-operative pulmonary vasoreactivity tests with the use of levosimendan was 87.5%.Conclusion: Levosimendan infusion may increase the sensitivity of the pulmonary vasoreactivity tests before patients' inclusion into the waiting list for heart transplantation.ΠΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ. НСобратимая лСгочная гипСртСнзия (Π›Π“) Ρƒ ΠΊΠ°Π½Π΄ΠΈΠ΄Π°Ρ‚ΠΎΠ² Π½Π° Ρ‚Ρ€Π°Π½ΡΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΡŽΒ ΡΠ΅Ρ€Π΄Ρ†Π° – Ρ„Π°ΠΊΡ‚ΠΎΡ€ риска развития ΠΏΡ€Π°Π²ΠΎΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡ΠΊΠΎΠ²ΠΎΠΉ нСдостаточности Π² послСопСрационном ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ ΠΈ Ρ€Π°Π½Π½Π΅ΠΉ Π»Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²Β Ρ Π½Π΅ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΠΉ Π›Π“ Π½Π΅ Π²ΠΊΠ»ΡŽΡ‡Π°ΡŽΡ‚ Π² лист оТидания трансплантации сСрдца. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ‚Π½ΠΎΡΡ‚ΡŒ ΠΎΡ†Π΅Π½ΠΊΠΈ состояния ΠΌΠ°Π»ΠΎΠ³ΠΎ ΠΊΡ€ΡƒΠ³Π° кровообращСния Π΄ΠΎ ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΈ влияСт Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ Π½Π°Β Ρ‚Π°ΠΊΡ‚ΠΈΠΊΡƒ лСчСния, Π½ΠΎ ΠΈ Π½Π° ΠΏΡ€ΠΎΠ³Π½ΠΎΠ·.ЦСль – ΡΠ½ΠΈΠ·ΠΈΡ‚ΡŒ риск ΠΎΡˆΠΈΠ±ΠΎΡ‡Π½ΠΎΠ³ΠΎ Π½Π΅Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΡ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²Β Π² лист оТидания трансплантации сСрдца путСм сокращСния числа Π»ΠΎΠΆΠ½ΠΎΠΎΡ‚Ρ€ΠΈΡ†Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² тСстов Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Β ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ рСтроспСктивноС ΠΊΠΎΠ³ΠΎΡ€Ρ‚Π½ΠΎΠ΅ ΠΎΠΏΠΈΡΠ°Ρ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ ΠΎΠ΄Π½ΠΎΡ†Π΅Π½Ρ‚Ρ€ΠΎΠ²ΠΎΠ΅ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡ΠΈΠ»ΠΈ 14 ΠΊΠ°Π½Π΄ΠΈΠ΄Π°Ρ‚ΠΎΠ² Π½Π° Ρ‚Ρ€Π°Π½ΡΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΡŽ сСрдца,Β Ρƒ ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… ΠΏΡ€ΠΈ ΠΊΠ°Ρ‚Π΅Ρ‚Π΅Ρ€ΠΈΠ·Π°Ρ†ΠΈΠΈ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠΈ (ЛА) ΠΈ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ тСста Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“Β Π±Ρ‹Π»Π° ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½Π° нСобратимая Π›Π“ с лСгочным сосудистым сопротивлСниСм (Π›Π‘Π‘), ΠΏΡ€Π΅Π²Ρ‹ΡˆΠ°ΡŽΡ‰ΠΈΠΌ 3,5 Π΅Π΄. Π’ΡƒΠ΄Π°. ΠŸΠ΅Ρ€Π²ΠΎΠ½Π°Ρ‡Π°Π»ΡŒΠ½ΠΎ этим ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ Π±Ρ‹Π»ΠΎ ΠΎΡ‚ΠΊΠ°Π·Π°Π½ΠΎ Π²ΠΎ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠΈ Π² лист оТидания трансплантации сСрдца. ΠšΠ°Ρ‚Π΅Ρ‚Π΅Ρ€ΠΈΠ·Π°Ρ†ΠΈΡŽ ЛА выполняли Π² условиях отдСлСния Ρ€Π΅Π°Π½ΠΈΠΌΠ°Ρ†ΠΈΠΈΒ ΠΈ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ с ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠ°Ρ‚Π΅Ρ‚Π΅Ρ€Π° Swan-Ganz ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° ΠΏΡ€Π΅ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉΒ Ρ‚Π΅Ρ€ΠΌΠΎΠ΄ΠΈΠ»ΡŽΡ†ΠΈΠΈ. Для выполнСния тСста Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“ примСняли ΠΈΠ½Π³Π°Π»ΡΡ†ΠΈΡŽ илопроста (Ρƒ 12 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ) ΠΈΠ»ΠΈ оксида Π°Π·ΠΎΡ‚Π° (Ρƒ 2). Π’ дальнСйшСм всСм Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ Π±Ρ‹Π»Π° Π½Π°Π·Π½Π°Ρ‡Π΅Π½Π° инфузия лСвосимСндана Π² Π΄ΠΎΠ·Π΅ 12,5 ΠΌΠ³ со ΡΠΊΠΎΡ€ΠΎΡΡ‚ΡŒΡŽΒ 0,05–0,2 ΠΌΠΊΠ³/ΠΊΠ³/ΠΌΠΈΠ½, Ρ‡Π΅Ρ€Π΅Π· 72 часа послС ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠΉ ΠΏΡ€ΠΎΠ²Π΅Π»ΠΈ ΠΏΠΎΠ²Ρ‚ΠΎΡ€Π½ΡƒΡŽ ΠΊΠ°Ρ‚Π΅Ρ‚Π΅Ρ€ΠΈΠ·Π°Ρ†ΠΈΡŽ ЛА и тСсты Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“. По ΠΈΡ… Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π°ΠΌΒ 13 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π±Ρ‹Π»ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ Π² лист оТидания. Врансплантация сСрдца Π±Ρ‹Π»Π° Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° 8 Ρ€Π΅Ρ†ΠΈΠΏΠΈΠ΅Π½Ρ‚Π°ΠΌ, Π² послСопСрационном ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅Β ΠΎΡ†Π΅Π½ΠΈΠ²Π°Π»ΠΈ гСмодинамичСскиС Π΄Π°Π½Π½Ρ‹Π΅ ΠΈ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ клиничСского тСчСния. Π”Π°Π½Π½Ρ‹Π΅ прСдставлСны ΠΊΠ°ΠΊ ΠΌΠ΅Π΄ΠΈΠ°Π½Π° [25-ΠΉ; 75-ΠΉ ΠΏΡ€ΠΎΡ†Π΅Π½Ρ‚ΠΈΠ»ΠΈ].Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ПослС ΠΈΠ½Ρ„ΡƒΠ·ΠΈΠΈ лСвосимСндана отмСчСно сниТСниС срСднСго давлСния Π² ЛА с 45 [36; 47] Π΄ΠΎ 29,5 [23; 37] ΠΌΠΌ Ρ€Ρ‚. ст. (p 0,01),Β Π›Π‘Π‘ ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΠΎΡΡŒ с 6,9 [4,9; 8,9] Π΄ΠΎ 3,6 [2,9; 5,9]Β Π΅Π΄. Π’ΡƒΠ΄Π° (p 0,01). Π£ 7 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π›Π‘Π‘ снизилось до показатСля ΠΌΠ΅Π½Π΅Π΅ 3,5 Π΅Π΄. Π’ΡƒΠ΄Π°, ΠΎΡΡ‚Π°Π»ΡŒΠ½Ρ‹ΠΌΒ Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ Π±Ρ‹Π» Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ ΠΏΠΎΠ²Ρ‚ΠΎΡ€Π½Ρ‹ΠΉ тСст Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“. Π’ ΠΈΡ‚ΠΎΠ³Π΅ 13 ΠΈΠ· 14 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² продСмонстрировали ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΡ‹ΠΉ Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ Π›Π“ ΠΈ Π±Ρ‹Π»ΠΈΒ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ Π² лист оТидания трансплантации сСрдца. На ΠΌΠΎΠΌΠ΅Π½Ρ‚ ΠΏΠΎΠ΄Π³ΠΎΡ‚ΠΎΠ²ΠΊΠΈ публикации трансплантация сСрдца Π±Ρ‹Π»Π° Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½Π° 8 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°ΠΌ. Π›Π‘Π‘ Ρ‡Π΅Ρ€Π΅Π· 6 Ρ‡ послС трансплантации сСрдца составило 2,2 [2; 3,1] Π΅Π΄. Π’ΡƒΠ΄Π°, случаСв нСобратимой Π›Π“ ΠΈ ΠΏΡ€Π°Π²ΠΎΠΆΠ΅Π»ΡƒΠ΄ΠΎΡ‡ΠΊΠΎΠ²ΠΎΠΉ нСдостаточности ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ Π½Π΅ Π±Ρ‹Π»ΠΎ. Π•Π΄ΠΈΠ½ΡΡ‚Π²Π΅Π½Π½Ρ‹ΠΉΒ Π»Π΅Ρ‚Π°Π»ΡŒΠ½Ρ‹ΠΉ исход Π±Ρ‹Π» связан с Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ΠΌ гСморрагичСского ΠΈΠ½ΡΡƒΠ»ΡŒΡ‚Π° Π½Π° 6-Π΅ сутки послС опСрации. Π§ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ доопСрационной диагностики обратимости Π›Π“ ΠΏΡ€ΠΈ назначСнии лСвосимСндана составила 87,5%.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅.Β Π˜Π½Ρ„ΡƒΠ·ΠΈΡ лСвосимСндана ΠΌΠΎΠΆΠ΅Ρ‚ ΠΏΠΎΠ²Ρ‹ΡΠΈΡ‚ΡŒ Ρ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ тСста Π½Π° ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ Π›Π“ ΠΏΠ΅Ρ€Π΅Π΄Β Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² лист оТидания трансплантации сСрдца
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