Mechanical differences between aortic and pulmonary valve are minimal. Ultrastructural studies show that the aortic and pulmonary valves have similar structural elements and architecture. This investigation suggests that the pulmonary valve can be considered mechanically and structurally suitable for use as an aortic valve replacement.

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Clinical, Radiographic and Pathohistological Outcomes of Hydroxyapatite (HAp) Ceramics and Dental Implants in Atrophic Posterior Maxilla Introduction. Implant based prosthodontic rehabilitation of patients with atrophic edentulous posterior maxilla has necessity in reinforcement of alveolar bone using different bone substitutes. It is important to evaluate late outcomes in integration of synthetic HAp as biomaterial in chemical composition close to main natural bone mineral component in elevated maxillary sinus floor and osseointegration of dental implants. Aim of the study. To evaluate clinical and radiological outcomes of one stage maxillary sinus floor augmentation with synthetic HAp granules and dental implant insertion, mineralization degree of residual bone and augmented sinus part, morphological analysis of biopsies from HAp/host tissue hybrid and residual alveolar bone was performed. Materials and methods. One stage maxillary sinus floor elevation with synthetic HAp granules and 147 SEMADOS (BEGO) dental implant insertions in 70 patients were included in this study. Clinical and radiograph analyzes by dental X-rays, digital orthopantomogramms, quantitative radiodensitometry after 3 and 5 years was done. Trephine biopsies of residual alveolar bone and elevated part of maxillary sinus 6 months after implantation was done in 30 cases. Results. During this period 6 implants (4.2%) were lost. We found the decrease of radiodensity in HAp augmentated maxillary sinus area and increase of radiodensity in the area of residual alveolar bone. In biopsies after 6 months biomaterial/host tissue hybrid consisted of small bone trabecules, fibrous tissue and granules of irregular shape without inflammatory cells. Slow degradation of HAp granules by activity of osteoclast like macrophages was observed. Conclusions. Osseointegration was lost in 4.2% of inserted in augmented maxillary sinus implants. Radiodensitometry showed decrease of optical density in augmented sinus part and increase in residual alveolar bone. In biopsies of host tissue/biomaterial hybrid was bone newformation, connective tissue and biodegradation of HAp granules by osteoclast like cells.

Introduction. Congenital heart diseases (CHD) affect 8-12 per 1000 live-born infants and it is one of the most common and serious congenital anomalies, aortic coarctation (AoCo) accounts for 6-10% of all the congenital heart diseases, and if not diagnosed early in life it can result in severe morbidity and mortality (3,9,13,11). Aim of the study. The aim of the study was to analyze the epidemiology of AoCo in newborn in Latvia, to evaluate a single centre 11 year experience with children who underwent AoCo repair in our institution within the first year of life, to define morbidity, mortality, risk factors, short and long term results. Materials and methods. The study was approved by the committee of ethics of the university hospital for children. Retrospective and prospective study/follow-up of all (74) patients younger than 12 months undergone native coarctation repair in our institution between January1, 2000 and December 31, 2010.Results. The prevalence of the coarctation of the aorta in Latvia was 3.43+/-1.2 per 10 000 life born infants. Seventy-four neonates and infants were analyzed: 44 boys (59%) and 30 girls (41%). Median age at the time of primary surgical correction was 47.3+/-58 days, medium weight 4.2+/-1.6kg. Prostoglandin E1 was used in 62%, inotropic stimulation in 20% of cases, assisted ventilation in 18%. According to the anatomy of the congenital heart disease patients constituted group I-the patients with simple coarctation with and without atrial septal defect (ASD) in 57%, group II -patients with coarctation and ventricular septal defect (VSD) 23%, group III-complex coarctation 20%. The infantile juxtaductal AoCo with isthmus hypoplasia was detected in 83%(n=62), postductal AoCo in 4%(n=3) and juxtaductal membrane in 12%(n=9), hypoplasia of the aortic arch in 16%(n=12). The techniques for primary repair included the resection with simple anastomosis end-to-end (ETE) in 26% (n=19), subclvian flap aortoplasty(SFA) in 65%(n=48) and extended anastomosis end-to-end (eETE) in 8%(n=6), primary balloon angioplasty in 1 case. There were 5 cases (6,8%) of early postoperative death and 9 cases of later death. Recoarctation occurred in 14 patients (23%), all underwent balloon angioplasty with no significant residual gradient, and there was no mortality or complications after reinterventions. Conclusions. The surgical correction of the AoCo remains gold standard for neonates and small infants. There were no statistically significant differences between the incidences of recoarctation dependent on the method of primary surgical correction. The incidence of recoarctation in cases of primary surgical correction early in life remains comparatively high. Baloon angioplasty is a method of choice in cases of recoarctation, it is safe and effective with low incidence of persistent coarctation. Mortality is most importantly influenced by preoperative status, the severity of associated anomalies, surgical outcomes, perioperative intensive treatment.

Aim of th,. study w:u to identi~" the effectiveness of laparoscopy f~ detection 1he inflammatory changes of the appendix durh~g diaguostk hpawscopy in c~c of suspect appendicitis. Methods. The laparmcopic findings and results of hystolu~cal examination where compared in 52 eases after urgent laparoscopic appendectomies in time period from 1997. 10. 01 till 1998. 08. 01. Laparoscoplt where pgfforraed hy 5.5 mm 35 ~ optical de~ico and one additional. 5.5 mm instrummt. When appendidtis was ascertained, Ihe 12ram troac.'tr for endoscopic stapler iu the hfpogsstrium was introduced. Laparoscopic appcndectom 7 where done on I9 male patients and 33 female patients under 50 with suspect appendicitis. 1.aparoscopie diagnoses, morphological diagnoses and variance bet,,con hpatosc~pie .-tad morphological diagnoses where anaIyzed &Jfing prospective comparative rest:etch.Results. in fi~de gro~ (n-33, 100%) 28 (90%) different acute appcndidti~ forms (1.4(43%) -phlegmtmose, 10(30%) -chronic with e:,:acerbadtm, 3 (9%) -gangrenose)) and 6 (18%) nonacute inflamatioo forms (5 (15%) -chronic, l(3%)-secondary) where escort:dried. In fllis group ms ~ptndettom 3 due to variance ~vas made in 6(18%) cases. In ~ak gmtp (a-Ig) following acute appendicitis forms where ascertained: iti(85%) -phlcgmonosq 2 (10%) -gangrcnosc, in 1 (5%) c~e d~:onic appendidds was identifi=L Variance between lap.xoscopic and ,norphologieaI diagnoses in male group where ~eertain~ in I(5%) c~ses, when rtgalhr aflptr~b#oray was mad,"Conclusions. Due to Iaparoscopic mist~e negative appendectomy rate nn female padcnts under 50 is 1deer (18%) than on male padents grtmp under 50 t' s' /o).The aim of this study is to evaluate the advantages of laparoseopic appcndicectomy compared to the open technique. We studied retrospectively 301 appendlcectomles performed at the Patologia Chlrurgiea of the University of Ancona: 193 laparoscopic (83 females and 110 ma]es) and 108 by open technique (37 females and 71 males). Tile conversions (I5 cases) (7.7%) were due to abdominal abscess or to difficult mobilisation of appendix. We pcrformed associated laparoscopic operations (ovariectomy, choleeistectomy, hemi.', repair) in 10 cases (5.2%). The difli'rence of men= postoperative lime was not significant. The postoperative pair was minimal in the laparoscopic appendicectmny. The meat postoperative stay was 2.5 days for the laparoscu,lic appmact' and 5 days for the open surgery. The bowel movement startec in the first day and in the third day respectively "die die era intake began in the second day for the laparoscopk appendicectomy and in third day for the open surgery. Mine. complications were 3.6% in laparoscopic approach and 5.2% in open.. Major complications, which required reoperation where: 3 (1.5%) postoperative abdominal abscess, hcmopcritoneum (0.5%) in laparoscopic access and 3 (2.8 ~ in open. At the follow up there were 2 (1%) hernia at the pot sldo and 4 (3.7%) incislonal hernia in open technique whicl required reoperation. Laparoscopic appcndicectomy is a saf technique whi...