[Surgical anatomy of liver segment iv and its importance in hepatobiliary surgery]. / Khirurgicheskaia anatomiia iv segmenta pecheni i ee znachenie v gepatobiliarnoi khirurgii.

The purpose of this article was to describe clinical anatomy of liver segment IV and determine its significance in liver resection surgery and within integrated approach in the treatment of malignancies of this area.

[UNRESOLVED PROBLEMS OF THE EVALUATION OF MYOCARDIAL BLOOD SUPPLY].

Over the past few decades, a steady rise in the incidence, morbidity and mortality from cardiovascular diseases has been observed throughout the world. The most common pathology is coronary heart disease (CHD) which, in addition, is responsible for chronic heart failure in more than one third of the cases. Patients with coronary heart disease are in need of early diagnosis and timely treatment. This article provides an overview of current scientific literature concerning anatomy of coronary vessels, their age-related changes, and modern radiological diagnostic methods of the lesions associated with coronary artery disease.

[The Importance of Perfusion Assessment for Determination of Functional Sufficiency of Myocardium].

Myocardial vascular bed is represented by a network of arterial and venous vessels as well as microcirculatory vessels including arterioles, precapillaries, capillaries, postcapillaries, venules, and arteriolo-venular anastomoses. Myocardial capillaries are an exchange link providing perfusion of the myocardium with nutrients therefore sufficiency of the capillary circulation ensures the adequacy of metabolic processes in the cells of the heart muscle. There is no consensus among physicians of various specialties on the methodology of assessing coronary blood flow and blood supply to the myocardial tissue. The lack of universality and unity on measuring units, methods, and classification results in contradictions, both in defining approach to treatment strategy and to assessment of treatment effects. Currently, it is necessary to develop a common approach to assessment of coronary perfusion, which would allow to unify the criteria of sufficiency of blood supply to the heart and activity of metabolic processes in the myocardium. It is necessary to determine parameters of studying changes of myocardial vascular bed, closely related to metabolic processes in muscle tissue of the heart.

[CRITERIA FOR THE FORMATION OF PATIENTS' AGE GROUPS FOR MEDICAL RESEARCH].

At present, a variety of methods for age group formation and classification of clinical and morphological manifestations of diseases and their complications are available for the analysis of strategies of the choice of therapy and evaluation of its efficiency. Analysis of the results of diagnostic studies and the choice of therapeutic modalities need to be based on an individual approach to patients of different age groups. Age-related morphological, functional and histochemical changes responsible for combined normal and pathological alterations in the tissues, organs and their systems are associated with mild, moderate and severe clinical symptoms or their absence; they can be regarded as reflecting peculiarities of the development of the organism and subsequent tanatogenesis. Because age-specific changes are known to be risk factors of cardiovascular pathology, it suggests the necessity of more detailed objectivization and substantiation of division of such patients into age groups taking account of specific morphological and functional changes in the heart anatomical structures.

[Radiological and anatomical approaches to the evaluation of blood circulation and functional state of a cardiopatient].

Cardiovascular diseases are ranked worldwide as the key factor of morbidity and mortality; they impair the quality of life and cause great losses to state economy. Coronary heart disease is of special significance due to the high prevalence, high risk and frequency of complications. Radiodiagnostics used to examine cardiologic patients makes possible visualization of coronary arteries and evaluation of their morphometric parameters, but it fails to provide information on the changes in hemomicrocirculation and to estimate myocardial perfusion or changes in the structural and functional changes in myocardial tissue and cardiac afferent system. It does not allow to determine severity of cardiac insuffciency resulting in hemodynamic changes at the tissue, organ, and body levels. We are unaware of publications showing correlation between morphofunctional organization ofhemocilculatory system and the functional state of cardiomyocytes. None of the anatomical or clinical-diagnostic criteria of modern radiological methods gives an answer to the question of correlation between myocardial vessel structure and structural-functional state of cardiomyocytes in subjects of different sex and age. To recall, the functional potential of the heart as a whole organ is determined by that of contractile (working, typical) and atypical (conducting) cardiomyocytes responsible for impulse conduction from the pacemaker which implies differential approach to the elucidation of correlations between angioarchitectonics of vessels in different heart regions and functional potential of typical and atypical cardiomyocytes.