Effect of photodynamic therapy on glutathione S-transferase activity in oral liquid of children with high risk of caries

Department of Pediatric Oro-Maxilo-Facial Surgery, Pedodontics and Orthodontics, Department of Biochemistry and Clinical Biochemistry, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Pediatric dentistry is looking for new methods to influence the cariogenic microorganisms of dental biofilm without the use of antiseptics and antibiotics, which often have negative side effects. Photodynamic therapy (PDT) is a promising and effective method to influence on the cariogenic microorganisms without using antiseptics and antibiotics. Material and methods: Forty five children aged 7 to 12 years with high risk of dental caries and pathology of central nervous system were observed during three years of the complex preventive measures, including multivitamins, minerals, antioxidants and PDT of dental biofilm. The activity of glutathione S-transferase (GST), content of reduced glutathione (GSH), thiocyanate (SCN) and total protein in the oral liquid (OL) were determined by spectrophotometry (Diasys Diagnostics, DE). The results were statistically processed using the program Excel Microsoft: Microstat 2007. Results: In three years the protein content in OL of the children was below the initial content in all groups that may be the confirmation of PDT bacteriostatic effect. In all periods of the study significant changes in the content of GSH, thiocyanate and activity of GST in OL in the children were not observed. Conclusions: Our results are indicating that complex preventive measures including the non-invasive method of PDT were effective, without any negative side effects and had bacteriostatic action. These complex preventive measures may be recommended for children with high risk of caries and pathology of CNS

On the approximate solution of the exclusive case of singular integral equations with complex conjugation values on the unknown function on the closed Liapunov contour

Not available

Ruptured aneurysms of the abdominal aorta or iliac arteries – initial experience and “lessons learned”

Scopul lucrării. Ruptura anevrismelor intraabdominale se asociază cu mortalitate înaltă. Scopul studiului a fost analiza retrospectivă a managementului pacienților cu anevrism erupt de aortă abdominală (rAAA) sau de artere iliace (rIAA), spitalizați într-un singur centru vascular. Materiale și metode. Datele clinice, procedurale și rezultatele tratamentului a 14 pacienți, internați între 01/2019-05/2023 au fost extrase din baza electronică spitalicească. Rezultate. Operație deschisă urgentă a fost efectuată pentru 8 rAAA (6 infrarenale, 1 juxtarenal, 1 suprarenal) și 6 rIAA (5 iliaca comună, 1 iliaca internă): bărbați – 78,5%, vârsta 72±11 (53-90) ani. Numai un pacient a fost diagnosticat cu rAAA la prezentare, ceea ce a cauzat reținerea intervenției în mediu cu 13 (4-48) ore. Diametrul rAAA a fost 9,7±4,7 (6,5-21) cm, iar lungimea colului – 2,5±0,9 (0,5-6,8) cm. Clamparea infrarenală a fost utilizată în 5, suprarenală în 1 și supraceliacă în 2 cazuri. Proteza bifurcată a fost implantată la 4 (50%) bolnavi. Durata medie a intervenției – 192±64 (140-320) min, volumul hemoragiei – 2,1±1,3 (1,1-5) litri. Reintervenția a fost necesară la 2 pacienți din cauza ocluziei branșei protezei. Patru (50%) pacienți au decedat în spital la 5,5±3,6 (1-10) zile postoperator. Clamparea supraceliacă, transfuzia >4 unități de concentrat eritrocitar și lactatul seric elevat postoperator s-au asociat cu risc de deces. rIAA cu diametrul mediu 7±0,8 (5,8-8) cm au fost diagnosticate exclusiv la bărbați. Un anevrism s-a erupt în vena iliacă. Cazuri de deces nu s-au înregistrat. Concluzii. Pentru reducerea mortalității cauzate de anevrisme aortoiliace erupte sunt necesare acțiuni complexe: screening, centralizare, educație, implementarea tratamentului endovascular.Aim of study. Rupture of intraabdominal aneurysms is associated with a high rate of mortality. The aim was retrospective analysis of the management of patients with ruptured abdominal aortic (rAAA) or iliac artery aneurysms (rIAA) hospitalized in a single vascular center. Materials and methods. Clinical data, details of intervention and outcomes of 14 patients, admitted between 01/2019-05/2023 were retrieved from the hospital database. Results. Urgent open repair was performed for 8 rAAA (6 infrarenal, 1 juxtarenal, 1 suprarenal) and 6 rIAA (5 common iliac, 1 internal iliac): male – 78.5%, age – 72±11 (53-90) years. Only one patient was diagnosed with rAAA at the moment of presentation that caused delay in repair of 13 (4-48) hours mean. Diameter of rAAA was 9.7±4.7 (6.5-21) cm; neck length – 2.5±0.9 (0.5-6.8) cm. Infrarenal clamping was used in 5, suprarenal in 1 and supraceliac in 2 cases. Bifurcated graft was implanted in 4 (50%) cases. Mean duration of surgery was 192±64 (140-320) min with blood loss of 2.1±1.3 (1.1-5) litres. Reintervention was required in 2 cases due to occlusion of the graft limb. Four (50%) patients died during hospitalization, at 5.5±3.6 (1-10) days postoperatively. Supraceliac clamping, transfusion >4 doses of red blood cell and elevated serum lactate after surgery were associated with risk of death. The rIAA with mean diameter of 7±0.8 (5.8-8) cm were diagnosed in males only. One aneurysm ruptured in iliac vein. No mortality was registered. Conclusions. Complex actions (screening, centralization, education, endovascular repair) are required for reduction of mortality caused by ruptured aortoiliac aneurysms

Current role of tibial artery bypass in the treatment of chronic limb threatening ischemia: a prospective study

Scopul lucrării. Deși intervențiile endovasculare reprezintă o abordare efectivă în tratamentul ischemiei cronice amenințătoare a membrelor (ICAM), unii pacienți în continuare necesită efectuarea bypass-ului chirurgical pentru salvarea extremităților. Scopul studiului a fost analiza indicațiilor, particularităților tehnice și rezultatelor bypass-urilor infrainghinale cu anastomoza distală mai jos de artera poplitee. Materiale și metode. În perioada 01.2020-04.2023 bypass-uri tibiale au fost efectuate la 44 pacienți: 84% bărbați, vârsta – 65,5±10,9 (23-86) ani. ICAM stadiul IV Fontaine a fost diagnosticată în 25 (56,8%) cazuri și 14 (31,8%) pacienți au suportat revascularizări ipsilaterale în trecut (8 – endovasculare, 6 – deschise). Conform datelor angiografiei toți bolnavii au avut stadiul III GLASS. Rezultate. Ca sursă de inflow a servit artera: femurală comună – la 14 pacienți, femurală superficială – la 22, femurală profundă – la 5, și poplitee – la 3. Anastomoza distală a fost aplicată pe: trunchiul tibioperoneal în 8 cazuri, artera tibială anterioară – în 19, artera tibială posterioară – în 12 și artera peronea – în 5. Vena safena magna reversată a fost utilizată în 39 (88,6%) cazuri (8 – contralaterală), grefa sintetică – în 3, vena in situ și vena cefalică – câte un caz. Durata medie a intervenției – 190 (120-345) minute. Indicile gleznăbraț a crescut de la 0,36±0,17 la 0,94±0,14 postoperator. Pe durata spitalizării 5 (11,3%) pacienți au dezvoltat ocluzia definitivă a bypass-ului, 4 (9%) au suportat amputație majoră și 2 (4,5%) au decedat. Supraviețuirea fără amputație la termen mediu de 12 luni a constituit 75%. Concluzii. La pacienții cu ICAM și imposibilitatea sau eșecul tratamentului endovascular bypass-urile tibiale oferă șanse acceptabile pentru salvarea extremităților.Aim of study. While endovascular interventions represent an effective approach for treatment of chronic limb threatening ischemia (CLTI) some patients still require surgical bypass for limb salvage. The aim of study was analysis of the indications, technical details and results of infrainguinal bypasses with distal anastomosis below the popliteal artery. Materials and methods. During 01.2020-04.2023 tibial bypasses were performed in 44 patients: 84% male, age 65.5±10.9 (range 23-86) years. CLTI stage IV Fontaine was diagnosed in 25 (56.8%) cases and 14 (31.8%) patients had failed previous ipsilateral revascularizations (8 – endovascular, 6 – open). Based on angiography results, all patients were classified as GLASS stage III. Results. The inflow artery was: common femoral – in 14 patients, superficial femoral – in 22, deep femoral – in 5, and popliteal – in 3. Distal anastomosis was constructed with tibioperoneal trunk in 8 cases, anterior tibial artery – in 19, posterior tibial artery – in 12 and peroneal artery – in 5. Reversed great saphenous vein was used as a conduit in 39 (88.6%) cases (8 – contralateral), synthetic graft – in 3, vein in situ – in 1 and cephalic vein – in 1. Duration of surgery was 190 (120-345) min. Ankle-brachial index increased from 0.36±0.17 to 0.94±0.14 postoperatively. During hospitalisation 5 (11.3%) patients developed definitive bypass occlusion, 4 (9%) – suffered major amputation and 2 (4.5%) died. Amputation-free survival at median follow-up of 12 months was 75%. Conclusions. In patients with CLTI and impossibility or failure of endovascular treatment tibial bypasses offer acceptable chances for limb salvage

Clinical outcomes of lower limbs revascularization using extra-anatomic bypasses

Scopul studiului. Evaluarea rezultatelor revascularizării extremităților inferioare prin bypass-uri cu traseul grefei diferit de cel al segmentului arterial nativ ocolit – extra-anatomice (BEA). Materiale și metode. S-au analizat datele medicale ale bolnavilor operați în Clinică prin BEA pe parcursul a 41 luni (ianuarie 2020 – mai 2023). Rezultate. Lotul a cuprins 50 pacienți, vârsta – 70 (25%-75%IQR 63-73) ani, bărbați – 40 (80%). Printre comorbidități au prevalat: hipertensiunea arterială (47/94%), insuficiența cardiacă (35/70%), boala coronariană (19/38%), diabetul zaharat (15/30%) și fibrilația atrială (14/28%). Intervenții de revascularizare în antecedente au suportat 24 (48%) pacienți, iar în 9 (18%) cazuri anterior s-au efectuat diverse amputații. BEA s-au realizat pentru ischemie cronică amenințătoare (37/74%), ischemie acută (8/16%), ocluzie postembolică (2/4%), traumă vasculară (1/2%), pseudoanevrism infectat (1/2%) și neoplasm cu implicarea vaselor magistrale (1/2%). Structura BEA: crossover femuro-femural (13/26%), femuro-tibial (13/26%), crossover ilio-femural (12/24%), ilio-femural transobturator (3/6%), profundo-tibial (3/6%), axilo-femural (2/4%), crossover ilio-femural/tibial secvențial (1/2%), ilio-femural trans-aripă iliacă (1/2%), popliteo-tibial anterior (1/2%) și femuro-popliteu proximal lateral (1/2%). Drept conduite s-au utilizat grefe sintetice (28/56%) sau autologe (22/44%). În 4 (8%) cazuri BEA s-au asociat cu angioplastii percutanate transluminale (intervenții hibrid). Rata amputațiilor majore și decesului la 30 zile postoperator – 4% și, respectiv, 12%. Pe parcursul evaluării timp de 14 (25-75%IQR 8-22) luni intervenții arteriale adiționale au necesitat 5 (10%) bolnavi; rata cumulativă de supraviețuire fără amputații constituid 82% (41/50). Concluzii. Revascularizarea extremităților inferioare prin BEA reprezintă o opțiune curativă fiabilă, asociată cu rezultate clinice satisfăcătoare chiar și la bolnavii cu patologii asociate multiple și/sau operații arteriale anterioare eșuate.Aim of study. Assessment of outcomes of lower limbs revascularization using bypasses with a graft route different from that of the bypassed native arterial segment – extra-anatomic (EAB). Materials and methods. The medical data of patients operated on using EAB during 41 months (January 2020 – May 2023) were analyzed. Results. The studied group included 50 patients, age – 70 (25%-75%IQR 63-73) years, males – 40 (80%). Among comorbidities prevailed: arterial hypertension (47/94%), heart failure (35/70%), coronary artery disease (19/38%), diabetes (15/30%) and atrial fibrillation (14/28%). Previous revascularization of affected extremity underwent 24 (48%) patients; in 9 (18%) cases various amputations were performed in past. EAB were applied for chronic limb-threatening ischemia (37/74%), acute ischemia (8/16%), postembolic occlusion (2/4%), vascular trauma (1/2%), infected pseudoaneurysm (1/2%) and neoplasm involving magistral vessels (1/2%). Types of EAB: femoro-femoral crossover (13/26%), femoro-tibial (13/26%), ilio-femoral crossover (12/24%), transobturator ilio-femoral (3/6%), profundo-tibial (3/6%), axillo-femoral (2/4%), sequential ilio-femoral/tibial crossover (1/2%), trans-iliac wing iliofemoral (1/2%), popliteo-anterior tibial (1/2%) and lateral above-knee femoro-popliteal (1/2%). Prosthetic (28/56%) or autologous (22/44%) grafts were used as conduits. In 4 (8%) patients EAB was associated with percutaneous transluminal angioplasties (hybrid interventions). The rate of major amputations and death at 30-day after surgery – 4% and 12%, respectively. During the 14 (25- 75%IQR 8-22) months follow-up additional arterial interventions were required in 5 (10%) cases; while the cumulative amputation-free survival rate was 82% (41/50). Conclusions. Lower extremity revascularization using EAB represents a reliable curative option associated with satisfactory clinical results even in patients with multiple comorbidities and/or failed previous arterial surgery

Correlation of anatomic characteristics of occlusive-stenotic lesions of infrainguinal arteries according to „GLASS” and clinical severity of chronic ischemia

Scopul lucrării. Clasificarea GLASS (Global Limb Anatomic Scoring System) a fost implementată recent pentru a determina pronosticul intervențiilor de revascularizare. Scopul studiului a fost studierea corelațiilor între caracteristica anatomică a leziunilor ocluziv-stenotice infrainghinale, descrise conform GLASS și severitatea ischemiei cronice (IC). Materiale și metode. Studiul a inclus 125 pacienți (141 membre) cu IC. GLASS a fost determinat în baza datelor DSA (digital subtraction angiography) și a inclus descrierea segmentului femuro-popliteal (FP), infrapopliteal (IP) și arcului plantar (P); stabilirea stadiului și calcularea scorului compozit (FP+IP+P). Severitatea IC a fost evaluată prin valorile indicelui gleznă-braț (IGB), PAT (pedal acceleration time) și clasificarea WIfI. Rezultate. Stadiul GLASS I a fost determinat în 16 (11,3%) cazuri, GLASS II – în 29 (20,5%) și GLASS III – în 96 (68%). Nu au existat diferențe semnificative între stadii referitor la vârsta și genul bolnavilor. Valorile IGB au fost semnificativ mai mici la pacienții cu GLASS III – 0,44±0,18 vs 0,52±0,16 în GLASS II și 0,58±0,12 în GLASS I (p<0,05). Respectiv, valorile PAT au fost veridic mai mari în stadiul GLASS III – 206±30 ms vs 168±26 ms în GLASS II și 140±14 ms în GLASS I (p<0,05). Scorul GLASS compozit a demonstrat corelație negativă moderată cu valorile IGB: rs = -0,37 (95%CI -0,51 – -0,21), p<0,0001. Vice versa, rata cazurilor cu stadiul WIfI 3-4 și valoarea scorului mediu WIfI nu s-au deosebit între GLASS I-III. Concluzii. Caracteristicile anatomice ale leziunilor ocluziv-stenotice, cuantificate conform GLASS, corelează cu severitatea ischemiei, însă nu influențează în mod direct riscul de amputație a membrului.Aim of study. GLASS (Global Limb Anatomic Scoring System) classification was implemented recently aimed to predict the success of revascularization. The aim was evaluation of correlation between anatomic characteristics of infrainguinal occlusive-stenotic lesions, described by GLASS, and clinical severity of chronic ischemia (CI). Materials and methods. Study cohort included 125 patients (141 limbs) with CI. GLASS was determined basing on DSA (digital subtraction angiography) data and included description of femoral-popliteal (FP), infrapopliteal (IP) segments, plantar arch (P); determination of stage and calculation of composite score (FP+IP+P). Severity of CI was evaluated with ankle-brachial index (ABI), PAT (pedal acceleration time) and WIfI classification. Results. Stage GLASS I was determined in 16 (11,3%) cases, GLASS II – in 29 (20.5%) and GLASS III – in 96 (68%). There were no differences in age and gender of the patients between stages. ABI values were significantly lower in patients with GLASS III – 0.44±0.18 vs 0.52±0.16 in GLASS II and 0.58±0.12 in GLASS I (p<0.05). Similar, values of PAT were significantly higher in GLASS III – 206±30 ms vs 168±26 ms in GLASS II and 140±14 ms in GLASS I (p<0.05). GLASS composite score demonstrated moderate negative correlation with ABI values: rs = -0.37 (95%CI -0.51 – -0.21), p<0.0001. Vice versa, rate of limbs with WIfI stages 3-4 as well as values of mean WIfI score were similar in GLASS stages I-III. Conclusions. Anatomic characteristics of the occlusive-stenotic lesions, quantified according to GLASS, corelate with severity of ischemia, but not directly influence the risk of limb amputation

Treatment of acute limb ischemia (ALI) in patients with COVID-19 infection: assessment of outcomes

Scopul lucrării. Analiza rezultatelor tratamentului IAE la bolnavii cu infecție cu coronavirus de tip nou (COVID-19). Materiale și metode. În perioada iulie/2020 – aprilie/2023 au fost tratați 62 pacienți; vârsta – 70 (25%-75%IQR 65-74) ani; bărbați – 40 (64,5%). IAE a survenit la 67 extremități: superioare (19/28,3%), inferioare (48/71,6%). Timpul debut IAE–spitalizare: 48,8±58,5 ore. Repartizarea cazurilor în funcție de gradul IAE (Rutherford): I – 7 (10,4%), IIA – 10 (14,9%), IIB – 34 (50,7%), III – 16 (23,8%). Etiologia IAE: tromboză (43/64,1%), embolie (22/32,8%), anevrism periferic trombozat (2/2,9%). Pentru diagnosticarea IAE s-au utilizat selectiv: duplex scanarea (20/32,2%), CT-angiografia (16/25,8%), angiografia cu substracție digitală (1/1,6%). COVID-19 s-a confirmat prin testul polymerase chain reaction (PCR), la 45 (72,5%) pacienți fiind documentată afectarea pulmonară. Rezultate. Tratamentului chirurgical au fost supuși 50/80,6% pacienți (52 membre); 12/19,3% (15 extremități) – tratați conservator (anticoagulante). Spectrul intervențiilor: embol- (22) și tromb-ectomie (18), bypass (2), trombectomie+tromboliză intraoperatorie (1), tratament endovascular (1) și amputație primară (8). În 10 (19,2%) cazuri s-a intervenit repetat pentru retromboză: amputație (5) sau trombectomie (5), asociată în 2 observații cu tromboliză intraoperatorie. Rata amputațiilor pe durata spitalizării (9,4±9 zile) – 19,4% (n=13); rata decesului – 43,5% (n=27), fiind influențată semnificativ de prezența sau absența afectării pulmonare – 55,5% vs. 11,7% (P=0,002; testul χ²). Către follow-up-ul de 21 (25%-75%IQR 19-28) luni rata supraviețuirii per general și fără amputații: 56,4% (n=35) și 57,1% (24/42), corespunzător. Concluzii. IAE la bolnavii cu COVID-19 se asociază cu rată elevată de amputații și deces, corelată cu prezența injuriei pulmonare. Abordul curativ convențional nu asigură rezultate clinice optime, frecvența retrombozei fiind înaltă.Aim of study. Analysis of results of ALI treatment in patients with novel coronavirus infection (COVID-19). Materials and methods. Between July/2020 and April/2023, 62 patients were treated; age – 70 (25%-75%IQR 65-74) years; males – 40 (64.5%). ALI occurred in 67 extremities: upper (19/28.3%), lower (48/71.6%). ALI onset–hospital admission time: 48.8±58.5 hours. Distribution of cases (Rutherford): grade I – 7 (10.4%), IIA – 10 (14.9%), IIB – 34 (50.7%), III – 16 (23.8%). Etiology of ALI: thrombosis (43/64.1%), embolism (22/32.8%), thrombosed peripheral aneurysm (2/2.9%). Duplex scanning (20/32.2%), CTangiography (16/25.8%), digital subtraction angiography (1/1.6%) were selectively used for diagnostic purposes. COVID-19 was confirmed by polymerase chain reaction (PCR) test; acute lung injury being documented in 45 (72.5%) patients. Results. Fifty/80.6% patients (52 limbs) underwent surgery; 12/19.3% (15 extremities) – treated conservatively (anticoagulants). Spectrum of interventions: embol- (22) and thromb-ectomy (18), bypass (2), thrombectomy+intraoperative thrombolysis (1), endovascular treatment (1), primary amputation (8). In 10 (19.2%) cases repeated surgery was performed for early re-thrombosis: amputation (5) or thrombectomy (5), associated in 2 observations with intraoperative thrombolysis. Amputation rate during hospitalization (9.4±9 days) – 19.4% (n=13); while mortality rate was 43.5% (n=27), being influenced by presence or absence of lung injury – 55.5% vs. 11.7% (P=0.002; χ² test). At 21 (25%-75%IQR 19-28) months follow-up the overall and amputation-free survival rate was 56.4% (35/62) and 57.1% (24/42), respectively. Conclusions. ALI in COVID-19 patients is associated with a high rate of amputations and death, correlated with the presence of lung injury. Conventional curative approach does not ensure optimal clinical results, frequency of re-thrombosis being high

Arterial dissections after femoropopliteal angioplasty by long versus short time of balloon inflation: the ”LOVES” randomized controlled trial. Preliminary results

Scopul lucrării. Câteva studii anterioare au identificat că angioplastia cu umflare îndelungată a balonului ar preveni disecțiile pe durata tratamentului leziunilor ocluziv-stenotice femuro-popliteale. Scopul este testarea ipotezei precum că umflarea pe lungă durată a balonului de angioplastie poate diminua rata disecțiilor arteriale severe și necesității în stentare impusă la pacienții cu ischemie cronică amenințătoare de membre (ICAM). Materiale și metode. S-a realizat un studiu monocentric deschis, controlat, cu două brațe paralele (câte 50 cazuri) – trialul LOVES (LOng VErsus Short), ce a prevăzut recrutarea bolnavilor cu ICAM (categoria 4-6, Rutherford) care corespundeau criteriilor de eligibilitate (NCT04442802). Prezența stenozei ≥50% (n=18) sau ocluziei (n=82) în segmentul femuropopliteu s-a confirmat prin angiografie diagnostică. După recanalizarea leziunii pacienții s-au supus randomizării 1:1, utilizând aplicația Research Randomizer, version 4. În lotul de studiu balonul s-a umflat timp de 6 minute; în cel de control – 3 minute. Prezența și severitatea (gradele A-B sau C-F conform clasificării NHLBI) disecției s-au evaluat independent de către 3 investigatori. Decizia de a clasifica disecția drept severă (gradul C-F) și a efectua stentarea s-a luat prin consensul dintre minim 2 cercetători. Rezultate. Vârsta bolnavilor – 69 (25%-75%IQR 65-74) ani; bărbați – 62. Accesul endovascular s-a realizat prin a.brahială (17), a.femurală comună (82) sau crossover (1). Rata disecțiilor severe și a necesității în stentare în lotul de studiu vs. control: 38% vs. 42%, și 36% vs. 34%, respectiv (p–NS). Concluzii. Umflarea pe durată lungă (6 minute) a balonului de angioplastie în timpul tratamentului leziunilor ocluziv-stenotice femuropopliteale nu reduce semnificativ riscul disecțiilor severe și rata stentărilor impuse.Aim of study. To test the hypothesis that a long-time inflation of angioplasty balloon would reduce the rate of severe arterial dissections and necessity in bailout stenting in patients with chronic limb-threatening ischemia (CLTI). Materials and methods. We conducted a single-center, two parallel groups (each of 50 cases), open label, controlled trial – LOVES (LOng VErsus Short), which involved recruitment of CLTI patients (category 4-6, Rutherford) who met eligibility criteria (NCT04442802). Presence of femoropopliteal stenosis ≥50% (n=18) or occlusion (n=82) was confirmed by diagnostic angiography. After crossing of lesion patient was supposed to 1:1 randomization using application Research Randomizer, version 4. In the study group, the balloon was inflated for 6 minutes; in control one – 3 minutes. Presence and severity (grades A-B or C-F according to NHLBI classification) of dissection was assessed independently by 3 investigators. Decision to classify dissection as severe (grade C-F) and to perform stenting was done by agreement between at least 2 investigators. Results. Patients' age – 69 (25%-75%IQR 65-74) years; males – 62. Endovascular access was achieved through brachial (17), common femoral artery (82) or crossover (1). The rate of severe dissections and need for stenting in study vs. control group: 38% vs. 42%, and 36% vs. 34%, respectively (p–NS). Conclusions. Long-time (6 minutes) inflation of the angioplasty balloon during the treatment of occlusive-stenotic femoropopliteal lesions does not significantly reduce the risk of severe dissections and necessity in bailout stenting

Role of pCO2 (AV gap) of Multi Organ Dysfunction Syndrome

Recruitment of Microcirculatory-Mitochondrial (RMM) reduces Microcirculatory-Mitochondrial Distress Syndrome (MMDs), and Syndrome of Multi-Organ Dysfunction (MODs), by accelerated speed of delivery and return of blood flow which directly leads to a decrease in tissue hypoxia marker pCO2 (AV gap) and respectively with ↓ many other Endogenous Toxic Substances (ETS). In cases of pulmonary damage with ↑ pCO2 & ↓ Oxygenation Index PaO2/FiO2 ↓ 300 the development of Acute Respiratory Distress Syndrome (ARDs), MMDs are also aggravated at ↑ with pCO2 AV gap. RMM also needs additional support of Multiple Organ Therapies-Multi-Organ Supportive Therapy (MOST), Alveolar Recruitment, Extracorporeal Life Support Organization (ELSO), Modeling of the Index of Extravascular Lung Fluid, EVLWI, Th4- Th5 Thoracic Epidural Block, Active detoxification methods. The absence of decreasing of the pCO2 tissue hypoxia marker at the pCO2 AV gap ↓ 5.0 mmHg, after RMM proves the mitochondrial eu-energetic metabolic remodeling with the elimination of the hypo(an)ergic mitochondria performed by lysosomal clearance (mitophagy) makes the predominance eu-ergic mitochondria with the normalization of mitochondrial Ca++-uniporter-channel and mitochondrial permeability pore transition which productively inactivate the toxic forms of oxygen and nitrogen

Ground-based direct-sun DOAS and airborne MAX-DOAS measurements of the collision-induced oxygen complex, O₂O₂, absorption with significant pressure and temperature differences

The collision-induced O2 complex, O2O2, is a very important trace gas for understanding remote sensing measurements of aerosols, cloud properties and atmospheric trace gases. Many ground-based multi-axis differential optical absorption spectroscopy (MAX-DOAS) measurements of the O2O2 optical depth require correction factors of 0.75 ± 0.1 to reproduce radiative transfer modeling (RTM) results for a nearly pure Rayleigh atmosphere. One of the potential causes of this discrepancy is uncertainty in laboratory-measured O2O2 absorption cross section temperature and pressure dependencies due to difficulties in replicating atmospheric conditions in the laboratory environment. This paper presents ground-based direct-sun (DS) and airborne multi-axis (AMAX) DOAS measurements of O2O2 absorption optical depths under actual atmospheric conditions in two wavelength regions (335–390 and 435–490 nm). DS irradiance measurements were made by the Washington State University research-grade Multi-Function Differential Spectroscopy Instrument instrument from 2007 to 2014 at seven sites with significant pressure (778 to 1013 hPa) and O2O2 profile-weighted temperature (247 to 275 K) differences. Aircraft MAX-DOAS measurements were conducted by the University of Colorado (CU) AMAX-DOAS instrument on 29 January 2012 over the Southern Hemispheric subtropical Pacific Ocean. Scattered solar radiance spectra were collected at altitudes between 9 and 13.2 km, with O2O2 profile-weighted temperatures of 231 to 244 K and nearly pure Rayleigh scattering conditions. Due to the well-defined DS air-mass factors during ground-based measurements and extensively characterized atmospheric conditions during the aircraft AMAX-DOAS measurements, O2O2 "pseudo" absorption cross sections, σ, are derived from the observed optical depths and estimated O2O2 column densities. Vertical O2O2 columns are calculated from the atmospheric sounding temperature, pressure and specific humidity profiles. Based on the ground-based atmospheric DS observations, there is no pressure dependence of the O2O2 σ within the measurement errors (3%). Two data sets are combined to derive the peak σ temperature dependence of the 360 and 477 nm dimer absorption bands from 231 to 275 K. DS and AMAX-derived peak σ ( O2O2) as a function of T can be described by a quadratic function at 360 nm and linear function at 477 nm with about 9% ± 2.5% per 44 K rate. Recent laboratory-measured O2O2 cross sections by Thalman and Volkamer (2013) agree with these "DOAS apparent" peak σ( O2O2) at 233, 253 and 273 K within 3%. Changes in the O2O2 spectral band shape at colder temperatures are observed for the first time in field data. Temperature effects on spectral band shapes can introduce errors in the retrieved O2O2 column abundances if a single room temperature σ( O2O2) is used in the DOAS analysis. Simultaneous fitting of σ( O2O2) at temperatures that bracket the ambient temperature range can reduce such errors. Our results show that laboratory-measured σ( O2O2) (Hermans, 2011, at 296 K and Thalman and Volkamer, 2013) are applicable for observations over a wide range of atmospheric conditions. Column densities derived using Hermans (2011) σ at 296 K require very small correction factors (0.94 ± 0.02 at 231 K and 0.99 ± 0.02 at 275 K) to reproduce theoretically calculated slant column densities for DS and AMAX-DOAS measurements. Simultaneous fitting of σ( O2O2) at 203 and 293 K further improved the results at UV and visible wavelengths for AMAX-DOAS