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Biomedical subjects

B A Konstantinov

Publications and source records attributed to B A Konstantinov.

At least 19 recordsLinked to original sources
PubMed2006

[Preventive intraaortic balloon counterpulsation during surgical myocardial revascularization].

Fifty patients with low myocardial functional reserves (left ventricular ejection fraction less than 40%, disseminated cardiosclerosis, multiple affection of coronary arteries, NYHA class III-IV) after coronary artery bypass surgery (CABS) were examined. All the patients were divided into 2 groups. Preventive intraaortic balloon counterpulsation (IABC) was used in 24 patients (group 1). Group 2 consisted of 26 patients with similar physical state where IABC has not been used. It was revealed that preventive IABC leads to stabilization of the left ventricle function and cardiac output, a decrease in the doses and period of catecholamines administration. The rate of cardiac rhythm disorders in group 1 was 7 times, myocardial infarction -- 2.5 times, respiratory failure -- 5 times, stay at the intensive care unit -- 2 times less compared with those of group 2. Lethality was 12.5% in group 1 and 26.9% in group 2.

Arrhythmias, Cardiac↗
PubMed2006

[Surgical treatment of dilated cardiomyopathy].

The efficacy and safety of different variants of left ventricular geometrical reconstruction (LVGR) in patients with dilated cardiomyopathy (DKMP) were studied in 2-stage clinical trial during 4 years. Results of left ventricle plication, "Myosplint" surgery and implantation of extracardial net framework (ECNF) complemented with mitral insufficiency correction (in case of need) have been evaluated on the first stage of the study. Based on this study, the implantation of ECNF and correction of mitral insufficiency are recognized as the most effective and safe method of DKMP surgical treatment. Short- and long-term results of these surgical procedures have been studied on the second stage of the study. Overall 30 surgeries of LVGR have been performed (18 on stage 1 and 12 on stage 2 of the study). Hospital lethality on stage 1 was 27%, 4-year actuarial survival rate (taking into account hospital lethality)--54+/-12%. Original protocols of surgical, anesthetic and intensive care management led to decrease of hospital lethality to 8% and an increase of 2-year actuarial survival rate to 91.6+/-7.9% (that significantly higher than in the control group treated with therapeutic methods only).

Cardiac Surgical Procedures↗
PubMed2006

[The technologies of genetic engineering in treatment of chronic lower limb ischemia].

The article contains experimental data on angiogenesis stimulated by plasmid containing the angiogenin gene. After the introduction of the gene construction, the number of capillars in the chorion-allantois membrane increases 2 to 3 times; in an ischemized limb of a rat it increases by 20 to 30%. Intramuscular administration of genetic engineering construction to patients with chronic lower limb ischemia improved the patients' condition, consisting in an increase in painless walking distance and ankle-brachial index, as well as in trophic defect healing and the betterment of muscular perfusion. Positive effects were noted after 2 to 4 weeks of treatment and remained during 6 to 24 months. There were no side-effects, except low grade fever during 1 to 2 days.

Adenoviridae↗
PubMed2004

[Transplantation of the liver right lobe from a related donor].

From 1997 to 2003 transplantation of liver's right lobe from alive related donor was performed in 64 patients (28 men, 36 women) aged from 6 to 61 years (mean age was 22.6 +/- 3.2 years). Body weight of recipients ranged from 18 to 92 Kg (52.7 +/- 2.8 Kg on average). Indications for surgery were following: cirrhosis of liver due to Wilson's disease (34), primary sclerotic cholangitis (6), viral cirrhosis of liver (6), primary biliary cirrhosis (4), Bayler's disease (3), Caroly's disease (3), Budd-Chiary syndrome (3), secondary biliary cirrhosis (2), cirrhosis of liver due to deficient of alpha(1)-antitrypsin (1), hepatocellular carcinoma (1), total nodular transformation of liver (1). Intensive care before transplantation was needed for 68.75% potential recipients. Donors of liver's right lobe were relatives of patients similar to blood group. Age of donors ranged from 18 to 49 years, mean age was 37.9 +/- 1.4 years. Donors underwent right-sided hemihepatectomy, there were no complications. Lethal outcome in recipients was seen in 2 (3.1%) cases and was not associated with function of transplant. Lethal outcome in long-term period after transplantation was seen in 4 (6.5%) cases. All the others patients survived and followed from 1 to 73 months (23.8 +/- 2.4 months on average). Quality of life was good. Transplantation of liver's right lobe from related donor is the independent line in orthotopic transplantation of liver and ensure reliable results.

Adolescent↗
PubMed2004

[The CELO-ANG recombinant avian adenovirus with human angiogenine gene inducing neovascularization in the anterior tibial muscle of rat].

The CELO recombinant avian adenovirus carrying the gene coding the human angiogenine (ANG) synthesis was obtained. Expression of the angiogenine gene was shown in the LMH cell culture after infection with the CELO-ANG virus. The ability of CELO recombinant adenoviruses to carry out the delivery and expression of alien genes in muscle cells was demonstrated in experiments with laboratory animals (Wistar line rats). The induced neovascularization in rat muscles after the animals were administered the CELO-ANG viruses was shown.

Angiogenesis Inducing Agents↗
PubMed2004

Surgical management of patients with ascending aortic aneurysms.

Between 1988 and 2002, 104 patients with ascending aortic aneurysms were operated on. The patients were distributed into 2 groups: the first group presented with aortic incompetence (n=66) and the second one had no aortic incompetence (n=38). In the first group, 8 patients received valvesparing operations, 58 (88%) patients underwent replacement of the aortic valve and ascending aortic segment according to different techniques. In the second group, 20 (53%) patients underwent graded aneurysmal resection and intimasparing exoreplacement by synthetic grafts and 18 (47%) were provided supravalvular replacement of the ascending aorta. In the shortterm postoperative period, the lethality in the first group accounted for 3% (6 patients), in the second group, it was equal to 2.6% (1 patient): of note, in the group provided aortoplasty, the lethality was 0%. In ascending aortic aneurysm associated with aortic incompetence, the Bentall DeBono operation is the method of choice of surgical treatment. Valvesparing operations are to be performed according to strict indications (in the absence of anuloaortic ectasia and microscopic lesions of aortic valve cusps). The graded resection of aneurysm with intimasparing exoreplacement may be an alternative to linear replacement of the ascending aorta in ascending aortic aneurysm without aortic incompetence and in the absence of aortic wall dissection.

Adolescent↗
PubMed2003

[Genetic engineering potential and perspectives in the management of critical ischemia].

The paper presents a new approach to management of lower limb critical ischemia which implements recent advances in molecular biology and genetic engineering technologies. A new original compound incorporating angiogenin gene was developed to activate neoangiogenesis processes after injection into living tissues. Experimental data evidence a potential efficacy of new method for complex management of critical ischemia.

Animals↗
PubMed2002

[Electrical stimulation of the spinal cord in cardiovascular disease].

The early and late outcomes of electrical stimulation of the spinal cord are analyzed in chronic critical ischemia of the lower extremities and coronary heart disease with peripheral involvement of coronary arteries. The clinical capacities of this treatment that has enjoyed little use in our country due to its high cost showed atraumaticity of electrical stimulation of the spinal cord; a few cases of complications and no hospital mortality; a rapid positive clinical effect after the initiation of electric neurostimulation, and better life quality in patients in the postoperative periods.

Electric Stimulation Therapy↗
PubMed2002

[Transplantation of the right hepatic lobe from an alive relative donor].

The use of relative donors in the transplantation of the liver has shown a good performance as an alternative line in its orthotopical grafting. Shortage of donor organs actively stimulates the development of relative transplantation. The main problem of relative hepatic transplantation is the limited capacity of obtaining a required mass of a hepatic graft for obese recipients. To settle this problem, the Russian Surgery Research Center, Russian Academy of Medical Sciences, has developed an original safe procedure for obtaining the right lobe of the liver from an alive relative donor and for implanting it in a recipient. In November 1997 to October 2001, transplantation of the right hepatic lobe from an alive relative donor was made in 23 recipients (10 males and 13 females aged 9 to 55 (mean 22.3 +/- 3.1) years. Their body weight was 24 to 80 (mean 51.4 +/- 3.0) kg. Indications for surgery were as follows: hepatic cirrhosis (HC) at the end stage of the Wilson-Konovalov disease (n = 10), primary sclerotic cholangitis (n = 4), HC of viral etiology (n = 3), Bailer's disease (n = 2), primary biliary HC (n = 2), HC in the presence of alpha 1-antitrypsin deficiency (n = 1), and secondary biliary HC (n = 1). The donors of the right lobe of the liver were recipients' mothers in 9 cases, their fathers in 6 cases, sisters in 2 cases, sons in 1 cases, their daughter, brother, aunt, cousin in 1 case each. The donors' age ranged from 19 to 49 (mean 37.9 +/- 1.4) years. The donors underwent right hemihepatectomy, complications were absent in them. There were early mortality among the recipients. Two patients died in the late postoperative period. The remaining 21 recipients were survivors and followed up for 1 to 48 (mean 14.9 +/- 2.9) months. Their life quality was good. The use of the right lobe of the liver from an alive relative donor is the optimum alternative to transplantation of the cadaverous liver and partially compensates the shortage of donor organs for children, adolescents, and adults.

Adolescent↗
PubMed2001

[B. V Petrovsky's scientific school at the turn of two centuries].

The paper shows how Academician B. V. Petrovsky's scientific school has been set up and how it has developed. Three stages of its development are identified: 1) the establishment and formation of the school on the basis of the department, the development of large areas of surgery (cardiovascular, thoracic, and esophageal surgeries) in 1951 to 1963; 2) the development of the school within the research institute-department system, the setting up of its branches, specialized services in the country, organizational and methodological management of its related research institutes in 1963 to 1989; and 3) the present period marked by the design and introduction of high technologies, the development of topical research problems (transplantation of the heart and liver, including related, miniinvasive surgery, computer-aided monitoring, telemedicine, as well as staff training). Four world's priorities of the school are noted. They included as follows: diaphragmatic plasty on a vascular pedicle for various abnormalities; the world's richest experience in surgically treating gunshot wounds of the large blood vessels during military actions; discovery of the physiological mechanisms of the function and properties of the valve-aorta complex of the human aortic root; the design and successful clinical application of nitinolic memory prostheses to endoprosthesis. The paper predicts how surgery will develop in the 21st century.

Academies and Institutes↗
PubMed2000

[Surgical treatment of carotid chemodectomas].

49 patients have been examined and 38 of them operated in RRCS RAMS for carotid hemadectomas (CH). CH is a rather rare tumor developing from the carotid gland locating in bifurcation of the common carotid artery. It is slowly growing tumor which is scantily active and rarely metastasizes. In 35 of the 38 operated patients radical ablation of the tumor was carried out. In the rest 3 patients radical removal of the tumor was impossible due to its dissemination and malignancy. The classification was used according to which all the tumors were distributed in 3 groups in dependence on the character of their growth. The basic principle of their division was the relation of CH to the carotid arteries. The use of this classification allowed to define individual surgical tactics. As a result of the treatment 97.4% of the patients were discharged with improvement. During the follow-up period (94 +/- 5 months) there were no relapses detected in these patients.

Adult↗
PubMed2000

[liver portion transplantation from living donor: pilot clinical experience].

The unique in Russia experience of 35 liver transplantations since 1990 has revealed benefits of the method and quite encouraging results with 81% survival of the recipients. But the extreme shortage of cadaveric donor organs followed by more than 60 per cent mortality in waiting list and absence of any real facilities to improve the situation dictate the living related donation to become a considerable alternative. Totally 12 living related liver transplant procedures were performed with no morbidity in donors. In 7 donors the routine surgical technique of harvesting were used to get left lateral segment in five and whole left lobe in two cases. The unique twin-to-twin liver left lobe donation with no consequent immunosuppression was observed in this series. New special technique of living donor surgery was successfully developed for liver right lobe harvesting. The living related liver right lobe replacement was used in 5 cases and appeared to become a real compensation of donor organs shortage for elder children with body weight more than 20 kg and adults.

Adult↗
PubMed2000

[Surgical correction of incomplete form of open atrioventricular canal in adults].

Clinical and anatomo-hemodynamic features of adult patients with incomplete form of the open atrioventricular canal are presented, policy of surgical treatment and optimal degree of surgical intervention on mitral valve are determined. The study of variant anatomy of the defect, revealed two variants of left atrioventricular valve formation (with "functional" and with "anatomical" septal commissure). In the first anatomic variant the mitral insufficiency was hemodynamically important and required surgical correction. In the second variant, the mitral valve had good closure function, that permitted to avoid the routine suturing of anterior velum's splitting.

Adolescent↗
PubMed1999

[Diagnostic and prognostic aspects of myxoma syndrome].

The analysis is presented of clinicomorphological and laboratory characteristics of myxoma syndrome which are of prognostic value. Early diagnosis of the syndrome is essential in making decision on the intraoperative and long-term postoperative treatment policy.

Adolescent↗