Minimally Invasive Surgical Repair of Vertebral Artery Ostium Stenosis in Patients with Ischemic Stroke: A Single-Center Case Series.

Background: Ischemic stroke is the second leading cause of death in North Macedonia. Posterior circulation disease, caused by vertebral artery (VA) ostium (VAo) stenosis, is a common cause of ischemic stroke. We established a treatment approach using surgical revascularization of posterior circulation disease.

Effects of high temperatures and drought during anthesis and grain filling period on wheat processing quality and underlying gluten structural changes.

Background: Climate changes do not only affect wheat yield, but also its quality. Information on this topic gathered so far is somewhat contradictory and insufficient. Climate changes also affect wheat indirectly through their influence on the ecosystem, including insects and fungi that affect wheat technological quality.

Wheat breadmaking properties in dependance on wheat enzymes status and climate conditions.

The objective of this study was to evaluate albumins profile, proteolytic and amylolytic activity level and baking performance of wheat varieties grown in two production years with different climate conditions (2011 and 2012) in four locations. The results of ANOVA showed that variety, location, production year, and their interactions all had significant effects on all tested wheat quality parameters. The enzymatic activity and specific bread volume were mainly influenced by the variety.

Intramuscular cavernous hemangioma in the left soleus muscle: successful surgical treatment.

We describe here the case of a 16-year-old boy successfully treated at our hospital for intramuscular cavernous hemangioma in the left soleus muscle. The patient was diagnosed using magnetic resonance imaging and open biopsy after attempted/failed surgery at another institution. We performed lower leg phlebography in order to identify all the feeding and draining veins of the cavernous hemangioma.

Resuscitation after prolonged cardiac arrest: effects of cardiopulmonary bypass and sodium-hydrogen exchange inhibition on myocardial and neurological recovery.

Objective: To determine if cardiopulmonary bypass (CPB), together with inhibition of the sodium-hydrogen exchanger (NHE), limits myocardial and neurological injury and improves recovery after prolonged (unwitnessed) cardiac arrest (CA), as NHE inhibition improved recovery after deep hypothermic circulatory arrest.

Methods: Twenty-seven pigs (31-39 kg) underwent 15 min of prolonged (no-flow) CA followed by 10 min of cardiopulmonary resuscitation-advanced life support (CPR-ALS). Subjects with restoration of spontaneous circulation (ROSC) during CPR-ALS received either no drug (n=6) or an inhibitor of the NHE (HOE-642; n=5).

Resuscitation after prolonged cardiac arrest: role of cardiopulmonary bypass and systemic hyperkalemia.

Background: The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF).

Methods: Thirty-one pigs (34 +/- 2 kg) underwent 15 minutes of cardiac arrest after induced VF, followed by 10 minutes of cardiopulmonary resuscitation-advanced life support. Peripheral CPB was used if cardiopulmonary resuscitation failed to restore stable circulation.

Dual left anterior descending artery distribution.

Dual left anterior descending (LAD) coronary artery with distribution of the vessels from the left main coronary artery and the right aortic sinus of Valsalva is a rare coronary anomaly. Here, we report such a rare anomaly in a young female with anterior wall myocardial infarction and stenting of the 'short' LAD coronary artery, which was subsequently confirmed in the operating room and by multi-slice cardiac computerized tomography after surgery.

Amplatzer occlusion of paravalvular leak of mitral mechanical prosthesis following a reoperation for thrombosed mitral mechanical prosthesis.

We describe a case of a 46-year-old woman with dehiscence and paravalvular leak of a second-time replaced mitral mechanical prosthesis, successfully treated with Amplatzer occlusion of the paravalvular leak, thus avoiding a second reoperation and improving the patient's symptoms.

Suture line reinforcement using suction-assisted bioglue application during surgery for acute aortic dissection.

Bioglue has been widely and variously applied in treating acute aortic dissection according to the pathological process and surgeon's preference. This publication outlines a new hemostatic technique using suction-assisted bioglue application for aortic suture line reinforcement during surgery on acute aortic dissection. Twenty consecutive patients were treated in our center for acute aortic dissection using this technique.

Septal structure and function relationships parallel the left ventricular free wall ascending and descending segments of the helical heart.

Objective: Determine if ventricular septum structure and function relationships parallel the left ventricular free wall descending and ascending segments of the helical heart.

Methods: Forty pigs (30-38 kg) were studied physiologically by sonomicrometer to determine if septal fiber orientation resembled responses in the free wall. Following pilot studies in the non-bypassed heart, a right ventriculotomy was made to place septum crystals with fiber orientations that were either perpendicular to or reflected simultaneous free wall measurements.

Sequential deformation and physiological considerations in unipolar right or left ventricular pacing.

Objective: To determine the effects of ventricular pacing on the normal contraction sequence of the helical ventricular myocardial band, and its' impact on left ventricular function.

Methods: Ten pigs (25-68 kg) underwent analysis of percent segmental shortening (%SS) by sonomicrometry, with crystals placed along the fiber orientation of the ascending and descending segments, and posterior LV wall of the geometry of the helical heart. Unipolar pacing electrodes stimulated either the right atrium (RA), right ventricular apex (RVA) and outflow tract (RVOT), or posterior LV wall.

The effect of ventricular sequential contraction on helical heart during pacing: high septal pacing versus biventricular pacing.

Objective: To investigate the effect of biventricular and high septal pacing on the normal contraction sequence of the helical ventricular myocardial band, and its impact on left ventricular function.

Methods: Ten pigs (25-68 kg) underwent analysis of percent segmental shortening (SS%) by sonomicrometry, with crystals placed along the fiber orientation of the ascending, descending segments, and posterior LV wall within the spatial geometry of the helical heart. Unipolar pacing electrodes stimulated the right atrium (RA) and either the right ventricular apex and left ventricular posterior wall (atrio-biventricular), or the proximal high septum (atrio-high septal).