[Prevention and correction of cognitive dysfunction after general anesthesia]

AIM

To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders.

MATERIAL AND METHODS

The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution). Patients underwent thyroidectomy with general inhalation anesthesia using desflurane. Cognitive testing was performed one day before operation and 6, 24 and 48 h after. Waking time after stopping desflurane administration and time prior tracheal extubation were recorded.

RESULTS AND CONCLUSION

The use of cytoflavin promoted the early post anesthesia adaptation and more rapid recovery of initial cognitive status of the patients.

[Treatment of paracolostomic hernias using polypropylene mesh]

It was analyzed the results of treatment of 23 patients with large paracolostomic hernias. Twenty patients underwent colostomy suturing and hernial ring Onlay-plasty with polypropylene mesh without tension. Onlay-plasty of hernial ring with own tissues and polypropylene mesh and colostomy reconstruction outside of implant were performed in 3 patients. Onlay-alloplasty with polypropylene mesh "PROLENE" is effective method of treatment of postoperative paracolostomic ventral hernias with colostomy closing as well as with its reconstruction outside of implant.

[Features of behavioral reactions of chronically irradiated mice in the raised crosswise labyrinth with various genetically determined radiosensitivity and possibilities of their modification by the fungal biopolymer complex]

Structural elements of the central nervous system--neurons, along with the higher neuroendocrine structures and the hypothalamus centres, show high sensitivity to a chronic action of low doses of ionizing radiation (IR) in view of their extreme enrichment by phospholipids and intensive supply by oxygen, creating favorable conditions for the development of oxidizing stress. Stressful influences cause negative emotions in the behaviour of animals manifested as fear or uneasiness. The study represents the results of comparative research into the behavioral reactions characterized by uneasiness in the Balb/c and C57bl/6 mice exposed to a chronic irradiation at low doses. The chitin-melanin-glucan complex from fungi Fomes fomentarius (ChMG) was approved as an adaptive agent. It has been shown that under identical conditions, deposition levels of radionuclides 137Cs and 90Sr are raised in mice with IR hypersensitivity--line Balb/c, in comparison with less radio sensitive mice--line C57bl/6. Simultaneously, Balb/c mice were observed to exhibit the signs of a more anxious behaviour in the new environment. Chronic external and internal radiation exposure to rare ionizing radiation at low doses promotes strengthening of anxiety and phobic reactions in mice with IR hypersensitivity. The use of ChMG in animals neutralized the increase in anxiety and phobic reactions after a prolonged irradiation, thus indicating the presence in ChMG of the anxiolitic activity along with the above mentioned powerful radiosorbent, antioxidant, gene protective and immunomodulatory properties.

[Remote signaling of radiation damage to the extracellular space in mice with various levels of genetically determined radio sensitivity]

The search results of "bystander" signals are presented at different model of influence of IR on Balb/c and C57bl/6 mice, characterized by different levels of genetically determined sensitivity to IR influence. We used the following models of IR influence: 1) external gamma-quanta influence from small samples of nuclear fuel from the CNPP 4th power unit modified in the course of the accident in 1986, which are 99% connected with 137Cs, with the total dose of irradiation of about 5.0 Gy for 16 hours and accumulated dose of 0.290 Gy for 231 day of exposure, 2) internal intake of 137Cs with water for 40 days. It is shown that cells of different types (splenocytes, hepatocytes, bone marrow and astroglia cells) irrespective of a model of IR influence produce the factors, which failed to be identified in this research, raising the SSF levels in the DNA of non-irradiated cells. Under conditions of a single exposure to gamma-field external irradiation at a dose of about 5.0 Gy, the intensity of production of "bystander" signals is higher in the mice with the raised level of genetically determined sensitivity to RI (Balb/c). Under the same conditions of gamma-field exposure, induction of additional levels of SSF in the DNA of non-irradiated cells is detected for at least one month after IR exposure. Intraperitoneal injection of melanin in the melanin-glucan complex from fungus F. fomentarius before irradiation exposure promotes an essential decrease in the production of "bystander" signals, testifying in favor of the free radical nature of their certain part.

[Effect of herpes simplex virus on spermatogenesis]

To investigate the effect of Herpes Simplex virus (HSV) on spermatogenesis, HSV in ejaculate was detected by a rapid cultural method in 268 infertile males and 47 healthy ones. The number of mobile spermatozoa in HSV infected samples was less than in non-infected samples (21 mln/mlversus 40 mln/ml, p = 0.0001). The relative number of morphologically normal gametes was 13% versus 19% (p = 0.002), respectively. The quantitative karyological test discovered that males with HSV-infected ejaculate have more degenerating sex cells while in high virus contamination (more than 10 virus particles in 1 ml) the number of spermatides and spermatocytes of the 1 order at diploten stage is low. Organic testicular culture was used for more detailed study of pathogenetic mechanisms of HSV impact on spermatogenesis. Testicular explants infection was associated with reduction in the number of spermatogones, spermatocytes and spermatides on culturing week 2. The above findings reveal some pathogenetic mechanisms underling fertility disorders in males with HSV infection: a gametotoxic effect of the virus reducing populations of spermatogones, spermatocytes and spermatide; affected mobility and morphological characteristics of spermatozoa. Detection of the mechanisms of HSV action on spermatogenesis opens a perspective of antivirus drug administration in combined treatment of male infertility.

Lidar monitoring of regions of intense backscatter with poorly defined boundaries

The upper height of a region of intense backscatter with a poorly defined boundary between this region and a region of clear air above it is found as the maximal height where aerosol heterogeneity is detectable, that is, where it can be discriminated from noise. The theoretical basis behind the retrieval technique and the corresponding lidar-data-processing procedures are discussed. We also show how such a technique can be applied to one-directional measurements. Examples of typical results obtained with a scanning lidar in smoke-polluted atmospheres and experimental data obtained in an urban atmosphere with a vertically pointing lidar are presented.

[Carotid endarterectomy and endovascular angioplasty with stenting in patients with atherosclerotic stenoses and occlusions of the internal carotid artery]

The authors made a comparative assessment of carotid endarterectomy and endovascular angioplasty with stenting in patients with atherosclerotic lesions of the carotid arteries. The authors consider that indications to stenting and carotid endarterectomy are identical in patients with stenose and occlusions of the carotid arteries. Contraindications to angioplasty of carotid arteries are determined. It was shown that angioplasty and stenting in atherosclerotic lesions of the carotid arteries was an effective method with a less number of complications as compared with carotid endarterectomy and are thought to be an adequate alternative to open surgical method of treatment of patients with stenoses and occlusions of the carotid arteries.

[Peyronie's disease: comparative results of conservative treatment]

Long-term clinical experience with conservative treatment of Peyronie's disease has demonstrated that clinical efficacy of this therapy comprises maily anesthesia while erectile problems are not solved. Introduction of the drugs into the fibrous plaque is not adequate and hard to perform. Some drugs affect only some components of pathogenesis. For stabilization of the process it is recommended to use transdermal electrophoresis or phonophoresis. The search for new effective drugs and methods continues.

Determination of smoke plume and layer heights using scanning lidar data

The methodology of using mobile scanning lidar data for investigation of smoke plume rise and high-resolution smoke dispersion is considered. The methodology is based on the lidar-signal transformation proposed recently [Appl. Opt. 48, 2559 (2009)]. In this study, similar methodology is used to create the atmospheric heterogeneity height indicator (HHI), which shows all heights at which the smoke plume heterogeneity was detected by a scanning lidar. The methodology is simple and robust. Subtraction of the initial lidar signal offset from the measured lidar signal is not required. HHI examples derived from lidar scans obtained with the U.S. Forest Service, Fire Sciences Laboratory mobile lidar in areas polluted by wildfires are presented, and the basic details of the methodology are discussed.

[New conception of surgery in Peyronie's disease]

Clinical experience of the authors on patients with Peyronie's disease shows that intraplaque therapy with verapamil and interferon and a malignant course of the disease can result in shortening of the penis (4 and 1 cases were observed, respectively). The length of the penis diminished by 30 to 50%. The patients were treated with graft corporoplasty with endoprosthesis of the penis. Basing on the experience with these cases the following conclusions were made: intraplaque injections are hard to perform and can provoke progression of the disease; long-term conservative treatment for stabilization of the active stage of Peyronie's disease can lead to shortening of the penis; in malignant course of the disease and progressive shortening of the penis surgical policy is justified despite "acute" phase of the disease.

Alternative method for determining the constant offset in lidar signal

We present an alternative method for determining the total offset in lidar signal created by a daytime background-illumination component and electrical or digital offset. Unlike existing techniques, here the signal square-range-correction procedure is initially performed using the total signal recorded by lidar, without subtraction of the offset component. While performing the square-range correction, the lidar-signal monotonic change due to the molecular component of the atmosphere is simultaneously compensated. After these corrections, the total offset is found by determining the slope of the above transformed signal versus a function that is defined as a ratio of the squared range and two molecular scattering components, the backscatter and transmittance. The slope is determined over a far end of the measurement range where aerosol loading is zero or, at least, minimum. An important aspect of this method is that the presence of a moderate aerosol loading over the far end does not increase dramatically the error in determining the lidar-signal offset. The comparison of the new technique with a conventional technique of the total-offset estimation is made using simulated and experimental data. The one-directional and multiangle measurements are analyzed and specifics in the estimate of the uncertainty limits due to remaining shifts in the inverted lidar signals are discussed. The use of the new technique allows a more accurate estimate of the signal constant offset, and accordingly, yields more accurate lidar-signal inversion results.

[Long-term results of one-stage urogenital reconstruction in total epispadia and extrophy of the urinary bladder in adults]

Surgical treatment of 34 patients with total epispadia and extrophy of the urinary bladder aged 15-33 years consists in one-stage extending corporoplasty, extending urethroplasty, granuloplasty, spongioplasty and sphincteroplasty. This novel method of one-stage urogenital reconstruction in adult males with total epispadia and extrophy of the urinary bladder provided satisfactory cosmetic results in all the patients and functional results in 68% patients, improved quality of life, social and sexual adaptation in patients with the above serious conditions. Postoperative complications and relevant prophylaxis are described.

Determination of the particulate extinction-coefficient profile and the column-integrated lidar ratios using the backscatter-coefficient and optical-depth profiles

A new method is considered that can be used for inverting data obtained from a combined elastic-inelastic lidar or a high spectral resolution lidar operating in a one-directional mode, or an elastic lidar operating in a multiangle mode. The particulate extinction coefficient is retrieved from the simultaneously measured profiles of the particulate backscatter coefficient and the particulate optical depth. The stepwise profile of the column-integrated lidar ratio is found that provides best matching of the initial (inverted) profile of the optical depth to that obtained by the inversion of the backscatter-coefficient profile. The retrieval of the extinction coefficient is made without using numerical differentiation. The method reduces the level of random noise in the retrieved extinction coefficient to the level of noise in the inverted backscatter coefficient. Examples of simulated and experimental data are presented.

Experimental method for the examination of systematic distortions in lidar data

An experimental method for determining the presence and the level of systematic distortions in lidar data is considered. The method has been developed on the basis of two years of field experiments with the Fire Sciences Laboratory elastic scanning lidar. The influence of multiplicative and additive distortion components is considered using numerical experiments and is illustrated with experimental data. The examination method is most applicable for short wavelengths at which the atmospheric molecular component in clear atmospheres is large enough to stabilize the Kano-Hamilton multiangle solution, based on the assumption of horizontal atmospheric homogeneity.

[Heterotopic urine derivation in females with urinary bladder extrophy]

Fifteen females aged from 17 to 31 years with bladder extrophy (the condition after ureterosygmostomy) have undergone heterotopic urine derivation with creation of a cutaneous urine-retention catheter mechanism. Surgery was indicated in progressive decline of renal function in the presence of renal reflux, total urine incontinence in the failure of pelvic floor muscles and rectal sphyncter apparatus. Creation of cutaneous urine-retention catheter mechanism was made by the following techniques: heterotopic plastic repair from the ileocecal angle by Mainz pouch I (11 patients, 73.4%); heterotopic W ileocystoplasty by Abol-Enein (4 patients, 26.8%). Implantation of both ureters was conducted by Wallace technique in 4 (26.7%) cases. In 7 (46.6%) patients ureteral implantation was performed with antireflux defense by the method of cross dublicate creation. Four (26.7%) patients with small intestinal derivation have undergone extramural implantation of the ureters according to Abol-Enein. The results show that conversion of ureterosygmostomy in heterotopic urine derivation with one-stage genital reconstructive interventions decreases the number of potential complications, improves surgical outcomes and provides much better medico-social rehabilitation. Heterotopic intestinal continent derivation of urine is an operation of choice in women with urinary malformations. In such patients orthotopic urine derivation is impossible.

Determination of slope in lidar data using a duplicate of the inverted function

An iterative method for determining slope in noisy lidar data is considered based on the use of a corrected ('shaped') inverted function and an assumed behavior of the unknown function of interest (an 'image function'). The method is utilized for extracting extinction- coefficient profiles from data of multiangle measurements. The sequence and specifics of the retrieval procedure, results of simulations, and essentials of the practical retrieval of particulate extinction-coefficient profiles from signals of the elastic scanning lidar are considered. The methodology may be applicable when extracting the extinction-coefficient profiles from an elastic lidar operating in a multiangle scanning mode, a combined Raman elastic-backscatter lidar, or a high spectral resolution lidar operating in a fixed angular position.

[The method of a complete one-stage urogenital reconstruction in extrophy of the urinary bladder and total epispadia in the adults]

In the context of surgical treatment of bladder extrophy/epispadia in the adults, the authors offer one-stage urogenital reconstruction, i.e. urethro-corporo-glanulo-sphyncteroplasty with penile preparation. Long-term results were analysed in adult patients with total epispadia and urine incontinence. Intact erectile function was observed in all 25 patients. An adequate function of the artificial muscular sphyncter was registered in 20 patients. The length of the penis increased from 2.5 to 5 cm. Sexual adaptation was achieved in 88% cases. Social adaptation occurred in all the cases.

[Intestinal replacement of the urinary bladder with creation of continent cutaneostomy]

Continent urine derivation with creation of cutaneous urine-retaining catheter mechanism was conducted in 28 patients. Indications for surgery were the following: contracted urinary bladder in combination with long obliteration of the urethra, urinary bladder extrophy (the condition after ureterosygmostomy), urinary bladder cancer, arteriosclerotic urinary bladder. Creation of cutaneous urine-retaining cather mechanism was performed according to the following methods: urine derivation by Minez pouch I (with creation of appendistoma) was made in 14 patients; extending intestinoplasty by Minez pouch (creation of intestinal reservoir from ileocecal angle with catheter appendicostoma) was made in 8 patients; extending ileoplasty with catheter ileostoma by Huder--2 patients; creation of a reservoir of the ileum with catheter ileocutaneostoma by extramural technique of Ald-Enein--2 patients; extending intestinoplasty with catheter ileostoma--2 patients. Implantation of the ureters was made using principles of antireflux defense.

[Choice of corporoplastic method in Peyronie's disease depending on hemodynamic status of the penis]

We studied 164 patients with Peyronie's disease, 34 of whom have clinical symptoms of erectile dysfunction. Dopplerography has detected alterations of penile hemodynamics in 71.8% cases. Vein occlusive dysfunction prevailed (54.8%). Dopplerographic signs of venoocclusive dysfunction were seen also in patients with minor erectile disorders (55.4%). The analysis of absolute values of the systolic velocity peak allowed us to consider values in the range > 25 but < 35 cm/s as borderline or suboptimal, corresponding to subclinical period of venoocclusive dysfunction. Dynamic cavernosometry results served the basis for criteria of subclinical venoocclusive dysfunction characterized by threshold intracavernous pressure 50 mm Hg, coefficient of 30-s reduction of intracavernous pressure from 1.75 +/- 0.93 to 2.1 +/- 0.8 mm Hg and supporting perfusion velocities under 29.2 +/- 15 ml/min. Characteristics of hemodynamic status and penile geometry help an optimal choice of deviation correction in patients with Peyronie's disease.

[Congenital penile deviation: an integral diagnostic approach to correction]

A comparative analysis of diagnostic examination of 130 men with isolated congenital erectile penile deviation (EPD) aged 14-22 years (mean age 17 years) has demonstrated that true EPD can be determined objectively only at adequate erection. Therefore, the diagnosis should be based not on subjective opinion of the patient but on the results of artificial pharmacological erection or viagra-test in combination with visual erotic and genital stimulation. Vacuum erection test is not justified. In patients with congenital EPD rigidity depends much on correlation between perfusion volume and functional volume of the penis (cavernous volume). The problem of congenital EPD can be formulated as the problem of "long penis". Measurements of the penis in the group of 54 patients with congenital EPD registered a low penile coefficient in 67% cases while a mean length of the penis in all the examinees was longer than a mean standard one and was about 13 cm in relaxed condition. EPD patients often suffer from asthenodepressive disorders deteriorating the copulative function. Psychotherapy and medication of the depressive syndrome result in stabilization of the psychological condition improving quality of life 1.3 times. Thus, an integrative diagnostic and therapeutic approach, due selection of the patients for operative correction of penile deviation can improve quality of the treatment aimed both at correction of erectile malformation and psychosexual adaptation of the patients.

Simple algorithm to determine the near-edge smoke boundaries with scanning lidar

We propose a modified algorithm for the gradient method to determine the near-edge smoke plume boundaries using backscatter signals of a scanning lidar. The running derivative of the ratio of the signal standard deviation (STD) to the accumulated sum of the STD is calculated, and the location of the global maximum of this function is found. No empirical criteria are required to determine smoke boundaries; thus the algorithm can be used without a priori selection of threshold values. The modified gradient method is not sensitive to the signal random noise at the far end of the lidar measurement range. Experimental data obtained with the Fire Sciences Laboratory lidar during routine prescribed fires in Montana were used to test the algorithm. Analysis results are presented that demonstrate the robustness of this algorithm.

Distortions of the extinction coefficient profile caused by systematic errors in lidar data

The influence of lidar data systematic errors on the retrieved particulate extinction coefficient profile in clear atmospheres is investigated. Particularly, two sources of the extinction coefficient profile distortions are analyzed: (1) a zero-line offset remaining after subtraction of an inaccurately determined signal background component and (2) a far-end incomplete overlap due to poor adjustment of the lidar system optics. Inversion results for simulated lidar signals, obtained with the near- and far-end solutions, are presented that show advantages of the near-end solution for clear atmospheres.

Calibration method for multiangle lidar measurements

A new method based on a two-angle approach is developed to determine the lidar solution constant from scanning elastic lidar data, hence providing a relative calibration for each lidar scan. Once the solution constant is determined, the vertical profiles of atmospheric extinction can be calculated. With this calibration method a minimization technique is used that replaces the linear regression used in a known two-angle approach that requires only local atmospheric homogeneity over a restricted altitude calibration range rather than overall horizontal homogeneity. Lidar signals from at least one pair of elevation angles are used, averaged in time when the system is operated in a permanent two-angle mode, or an arbitrary number of signal pairs is used, when a two-dimensional lidar scan is being processed. The method is tested extensively with synthetic data. The calibration method is a robust tool for determining the solution constant to the lidar equation and for obtaining vertical profiles of atmospheric extinction.

Near-end solution for lidar signals that includes a multiple-scattering component

A variant of the near-end solution is presented that allows one to consider a multiple-scattering component in lidar measurements of distant clouds or dense smoke. It is assumed that the lidar signal, contaminated by multiple scattering, obeys a single-scattering lidar equation in which an additional term, which is related to the range-dependent ratio of a multiple-to-single-scattering component, is included. For the inversion, a brink solution is proposed that does not require an a priori selection of the extinction-to-backscatter ratio in the optically dense aerosol formation under investigation. The solution requires either knowledge of the multiple-to-single-scattering ratio (e.g., determined experimentally with a multiangle lidar) or the use of the analytical dependence of the multiple-to-single-scattering ratio on the aerosol optical depth. In the latter case, an iterative technique is used.

[Complications after angioplasty and stenting of coronary arteries in ischemic heart disease patients]

The authors have made an analysis of most frequent complications of angioplasty and stenting of coronary arteries in 1900 patients with various forms of ischemic heart disease. The mechanisms, pathomorphology, angiographic and clinical manifestations of such complications as dissection of the coronary artery intima, acute occlusion of the coronary artery, "no-reflow" syndrome, perforation and rupture of the coronary artery, acute thrombosis in the stent area and other complications are considered in detail. Special medical strategy, both therapeutic and surgical, is proposed for each case. The authors propose a number of prophylactic measures allowing to avoid the complications described or to minimize them. Intraoperative lethality in this group of patients was 0.5% (10 patients), during the first week after endovascular intervention 26 patients died (1.4%).

Stable near-end solution of the lidar equation for clear atmospheres

A stable variant of the near-end solution has been developed for inversion of lidar signals measured in clear atmospheres. The inversion is based on the use of reference values of the extinction coefficient obtained with a nephelometer at the lidar measurement site. The inversion method, based on a combination of the optical depth and boundary point solutions, is illustrated by simulated and experimental data.

Analytical differentiation of the differential-absorption-lidar data distorted by noise

A method of analytical differentiation is developed for processing differential absorption lidar (DIAL) data. The method is based on simple analytical transformation of the DIAL on and off signal ratio. The derivatives consequently are found for either individual data points or local zones of the measurement range. The method makes possible the separation of local zones of interest and the separate investigation of these. The smoothing level is established by the selected value of the exponent in a transformation formula rather than by the selection of the resolution range. The method does not require the calculation of local signal increments. This reduces significantly the high-frequency noise in the measured concentration. The method is general and can be used for different experimental data, including inelastic (Raman) lidar data. The processing technique is practical and does not require a determination of the solution for a large set of algebraic equations. It is based on the simple repetition of the same type of calculations with different constants. The method can easily be implemented for practical computations.

[Use of absorbable polymers for plastic repair of postoperative ventral hernias]

In surgical clinic of Vladivostok State Medical University 48 patients were operated for postoperative ventral hernias with use of absorbable polymers. In group 1 (42 patients) the explant "Carbonicus-I" was used (period of absorption-2 years). 6 patients of group 2 underwent plastic repair with suture-glue duplication of aponeurosis of abdominal white line. The analysis of the results demonstrated that explants "Carbonicus-I" and tissue glue "MK-7M" can be used for plasty of hernial ring on anterior abdominal wall in large ventral hernias. Polymers with long period of absorption (over 2 years) form dense scar which prevents recurrence of hernia. At the same time polymers with short period of absorption (4-6 months) reduce possibility of early reaction of explant rejection.

Three-dimensional texture analysis of MRI brain datasets

A method is proposed for three-dimensional (3-D) texture analysis of magnetic resonance imaging brain datasets. It is based on extended, multisort co-occurrence matrices that employ intensity, gradient and anisotropy image features in a uniform way. Basic properties of matrices as well as their sensitivity and dependence on spatial image scaling are evaluated. The ability of the suggested 3-D texture descriptors is demonstrated on nontrivial classification tasks for pathologic findings in brain datasets.

[Pharmacotherapy of erectile dysfunction]

Among the drugs used to treat erectile dysfunction most common are prostaglandins El, viagra, iochimbin, vasodilators and desaggregants, vitamins, biogenic stimulators, etc. The comparative analysis of their efficacy was made in 360 patients with erectile dysfunction, primarily at subcompensated stage, aged 17-83 years. Organic and psychogenic erectile dysfunctions were diagnosed in 69 and 31% of the patients, respectively. Intracavernous injections of prostaglandin El (Caverject) were effective in 74%, transurethral alprostadil (MUSE) when adjusting the dose--in 38.7% of the patients. Iochimbin in patients with organic and psychogenic forms of erectile dysfunctions was effective in 25 and 40% of patients, respectively. In 26.3 and 19% of such patients the response was obtained after use of the combination including xantinol, nicotinate, trental, biogenic stimulators and adaptogens. Viagra was effective in 60 and 77.3% of patients with psychogenic and organic erectile dysfunctions, respectively.

Texture anisotropy in 3-D images

Two approaches to the characterization of three-dimensional (3-D) textures are presented: one based on gradient vectors and one on generalized co-occurrence matrices. They are investigated with the help of simulated data for their behavior in the presence of noise and for various values of the parameters they depend on. They are also applied to several medical volume images characterized by the presence of microtextures and their potential as diagnostic tools and tools for quantifying and monitoring the progress of various pathologies is discussed. No firm medical conclusions can be drawn as not enough clinical data are available. The gradient based method appears to be more appropriate for the characterization of microtextures. It also shows more consistent behavior as a descriptor of pathologies than the generalized co-occurrence matrix approach.

[A trial of the use pf prostaglandin E1 (Edex, Caverject) for the diagnosis and treatment of erectile dysfunction]

The authors have examined 48 patients aged 17-70 years with erectile disorders. In 15 cases sexual adaptation was achieved after teaching them autoinjections. Pharmacological aid with PGE1 (Edex, Caverject) proved effective for sexual adaptation of patients with erectile disorders. In case of well adjusted dose and strict compliance of the autoinjection regimen the number of complications was minimal. In 50-70-year-olds PGE1 do not cause systemic complications due to pharmacokinetics and endogenic nature of PGE1. This prostaglandin is highly effective in some forms of psychogenic erectile dysfunction especially in expecting failure. For such patients 1 or 2 autoinjections of minimal dose are enough to correct erection.

Nonlinear-approximation technique for determining vertical ozone-concentration profiles with a differential-absorption lidar

A new technique is presented for the retrieval of ozone-concentration profiles (O(3)) from backscattered signals obtained by a multiwavelength differential-absorption lidar (DIAL). The technique makes it possible to reduce erroneous local fluctuations induced in the ozone-concentration profiles by signal noise and other phenomena such as aerosol inhomogeneity. Before the O(3) profiles are derived, the dominant measurement errors are estimated and uncertainty boundaries for the measured profiles are established. The off- to on-line signal ratio is transformed into an intermediate function, and analytical approximations of the function are then determined. The separation of low- and high-frequency constituents of the measured ozone profile is made by the application of different approximation fits to appropriate intermediate functions. The low-frequency constituents are approximated with a low-order polynomial fit, whereas the high-frequency constituents are approximated with a trigonometric fit. The latter fit makes it possible to correct the measured O(3) profiles in zones of large ozone-concentration gradients where the low-order polynomial fit is found to be insufficient. Application of this technique to experimental data obtained in the lower troposphere shows that erroneous fluctuations induced in the ozone-concentration profile by signal noise and aerosol inhomogeneity undergo a significant reduction in comparison with the results from the conventional technique based on straightforward numerical differentiation.

Compensational three-wavelength differential-absorption lidar technique for reducing the influence of differential scattering on ozone-concentration measurements

A three-wavelength differential-absorption lidar (DIAL) technique for the ultraviolet spectral region is presented that reduces the influence of aerosol differential scattering on measured ozone-concentration profiles. The principal advantage of this approach is that, to a good first approximation, no correction for aerosol differential-extinction and backscattering effects are needed. Therefore, one avoids having to obtain an aerosol extinction-coefficient profile at a reference wavelength; nor does one have to invoke questionable assumptions regarding the spectral dependence of the aerosol total and backscatter coefficients.

[The surgical treatment of aneurysms of the abdominal aorta]

Based on an experience with treatment of 107 patients with aneurysms of the abdominal aorta subjected to planned or urgent operations the authors discuss the problems of the clinical course, diagnosis, indications for operative treatment, the technique of operative interventions and their results. In planned operations lethality was 4.1%, in ruptures of the aneurysm-64.2%. One year after the operations 90% of the patients were practically healthy, 5 years later they were 70%.

Sensitivity of the lidar solution to errors of the aerosol backscatter-to-extinction ratio: influence of a monotonic change in the aerosol extinction coefficient

Unlike other errors in the lidar equation solution for the two-component atmosphere, the error of the measured aerosol extinction coefficient caused by inaccuracies in the assumed aerosol backscatter-to-extinction ratios significantly depends on the aerosol spatial inhomogeneity. In a slightly nonhomogeneous atmosphere, an incorrect value in the assumed aerosol backscatter-to-extinction ratio does not significantly corrupt the measurement result, whereas in an atmosphere with a large monotonic change of the aerosol extinction [e.g., in the lower troposphere], the incorrect value yields a large distortion of the retrieved extinction-coefficient profile. In the latter case, even the far-end solution can produce a large error in the retrieved extinction coefficient. The analytical formulas for the determination of the range errors, obtained for the Klett and the optical-depth solutions, show that these errors significantly depend on the method of the boundary-condition determination. Distortions of the retrieved aerosol extinction profiles are, in general, larger if the assumed aerosol backscatter-to-extinction ratio is underestimated in relation to the real value.

Differential absorption lidar measurement of vertical ozone profiles in the troposphere that contains aerosol layers with strong backscattering gradients: a simplified version

A technique for determining approximate ozone-concentration profiles from differential absorption lidar (DIAL) data obtained in the troposphere with large gradients of aerosol backscattering is presented. The atmospheric interferences are defined as errors of the off-on DIAL signal ratio; the interferences are separated and removed before the ratio is differentiated. To facilitate the separation of the regular (subjected to differentiation) component of the signal ratio from random noise, the ratio is transformed into an intermediate function, and the measurement error is minimized by fitting of an analytical function to the transformed function. Simple criteria are used to demarcate atmospheric layering, for which a strong aerosol-backscattering gradient can result in an unacceptably large error in the measured ozone concentration.

Distortion of particulate extinction profiles measured with lidar in a two-component atmosphere

Distortions of particular extinction-coefficient profiles measured with lidar in a two-component (molecular and aerosol) scattering atmosphere are analyzed. The error of the extinction coefficient measured at range r depends on the location of the point r(b), where a boundary value is specified, and the particulate optical depth of the atmosphere between r and r(b); the particulate backscatter-to-extinction ratio; and the ratio of particulate and molecular scattering extinction. If the near-end solution is used, small measurement errors can produce a significant divergence between the actual and the retrieved extinction-coefficient profiles, even if the boundary value and the particulate backscatter-to-extinction ratio are specified accurately. This effect is exacerbated at small values of the particulate scattering coefficient and the backscatter-to-extinction ratio. When reasonable criteria are used, feasible minimum and maximum boundary values can be specified to restrict the range of lidar equation solutions from below and from above.

[Activity of free radical lipid oxidation and the state of antioxidant system in patients with ischemic heart disease during myocardial revascularization]

It has been established that aortocoronary bypass surgery is characterized by imbalance in lipid peroxidation and antioxidant defense system. These changes are more pronounced in patients with the most severe forms of ischemic heart disease. During surgery the greatest intensity of lipid peroxidation is observed at the end of assisted circulation period. To prevent these disturbances it is necessary to minimize surgical trauma, reduce the duration of operation stages, refuse pronounced normobaric hyperoxia during cardiopulmonary bypass.

[A method for revascularizing the penis]

The authors propose an original method of vasculogenic impotence surgery involving correction of arterial and arteriovenous insufficiency of the penis. This includes isolation of penile dorsal artery and deep dorsal vein in the proximal and middle third, then of the low epigastric artery along the entire length from the branching to the distal third. Upon establishing the shunt from the dorsal artery and vein, it is sutured with epigastric artery end-to-side. The procedure ends by placing the deep dorsal vein into the duplicature of the corpus cavernosum tunica albuginea. Follow-up results (within 3 years) available for 12 surgical patients demonstrate that improvement did not occur only in one case. This patient had corpus cavernosum sclerosis.

Lidar measurement of the vertical aerosol extinction profiles with range-dependent backscatter-to-extinction ratios

An iterative lidar-signal inversion method is presented that is valid for two-component (molecular andaerosol) scattering atmospheres. The iterative procedure transforms the original lidar signal, thereby making it possible to use the lidar-equation solution for a single-component atmosphere. In a manner analogous to Fernald's approach, the molecular extinction profile is used as a foundation for the boundary-condition determination, but the inversion procedure can be performed with either constant or variable (range-dependent) phase functions. A specific region in the measured range is located at which the ratio of the aerosol to molecular extinction coefficients is a minimum as determined by an examinationof the lidar-signal profile; for this region boundary conditions are specified.