[The comparative analysis of surgical procedures a in patients with benign prostatic hyperplasia and type 2 diabetes mellitus].

AIM: To compare the efficiency of two surgical methods, holmium laser enucleation of prostate (HoLEP) and laparoscopic retropubic simple prostatectomy with clamping of internal iliac arteries and vesicourethral anastomosis [LPA+CIIA+VUA]) for treating of patients with benign prostatic hyperplasia (BPH) and type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A total of 56 men with T2DM who underwent surgical treatment of BPH in the National Research Centre for Endocrinology of the Russian Ministry of Health (director - corresponding member of RAS Mokrysheva N.G..) in a period from 2021 until 2022 were included in the study. Patients with T2DM received two types of antidiabetic drugs: basal-bolus insulin therapy and metformin (1000 mg/day per os). Patients were divided into the group of LPA+CIIA+VUA (n=28) and HoLEP (n=28). Preoperative, intraoperative and postoperative examinations with an evaluation of intraoperative and early postoperative complications (I, II, III, IV grades according to the Clavien-Dindo scale) were performed. After 1 year of follow-up, International Prostatic Symptom Score (IPSS), "Quality of Life" score (QoL), International Index of Erectile Function-5 score (IIEF-5), maximal urine flow rate (Qmax), and postvoid residual volume (ml) were assessed. Efficiency of surgical procedures was estimated according to "trifecta": absence of postoperative complications, urine continence, maximal urine flow (Qmax) >15 ml/sec. RESULTS: In the group of HoLEP, shorter postoperative bladder catheterization time but higher risk of urinary incontinence, bladder neck contracture and urethral strictures was found. LPA+CIIA+UVA leaded to a two-fold decrease in intraoperative hemoglobin loss with no necessity of repeat procedures. CONCLUSIONS: Our preliminary results demonstrated higher efficacy of LPA+CIIA+VUA for treatment of BPH in patients with T2DM than HoLEP. Patients who underwent LPA+CIIA+VUA were more often achieved the "trifecta". In order to implement LPA+CIIA+VUA into clinical practice, multi-center, large-scale, double-blind, placebo-controlled ("scar-surgery") randomized studies are required.

Intravascular ultrasound-guided internal carotid artery stenting. / Stentirovanie vnutrennikh sonnykh arterii pod kontrolem vnutrisosudistogo ul'trazvukovogo issledovaniia.

AIM: The study was aimed at demonstrating efficacy and feasibility of intravascular ultrasound during internal carotid artery stenting for assessment of atheromatous plaque protrusion through a stent. PATIENTS AND METHODS: Over the period from October to December 2018, the specialists of our Centre performed a total of 90 internal carotid artery stenting procedures in 83 patients (of these, 7 patients underwent bilateral staged stenting of both internal carotid arteries) using intravascular ultrasound in order to assess intraoperative protrusion of an atherosclerotic plaque through the implanted stent. The patients' age varied from 42 to 87 (mean 68.6±6.9) years. Symptomatic lesions of internal carotid arteries were revealed in 14 (16.9%) operated patients and asymptomatic lesions in 69 (83.1%). The degree of stenosis varied from 60% to 90% according to the findings of preliminary duplex ultrasonography and was subsequently confirmed by the results of multislice computed tomography or selective angiography. The assessment of the patients' neurological status, as well as duplex ultrasonography of brachiocephalic arteries were performed at a scheduled follow-up visit on day 30 after discharge from hospital. RESULTS: The technical success of stenting was achieved in 100% of patients. According to the findings of intravascular ultrasound, plaque protrusion was observed in eight (8.8%) stented patients. Among them, six (6.6%) were free from angiographic signs of protrusion and only two (2.2%) had apparent angiographic signs of protrusion. During the early postoperative period, transient ischaemic attack was identified in four (4.4%) cases. One (1.1%) patient was found to develop ST-segment elevation acute myocardial infarction 24 hours after internal carotid artery stenting, followed by large hemispheric stroke on the side of stenting revealed on postoperative day 3. Nine (10%) patients according to the findings of intravascular ultrasound were diagnosed as having incomplete stent apposition after postdilatation, with the absence of such signs on angiography. CONCLUSION: Intravascular ultrasound during carotid stenting provides a more accurate assessment of such an event as atherosclerotic plaque protrusion through a stent's cells. At the same time, IVUS-guided assessment of the intraoperative outcome may prevent the risk for the development of stroke in the early postoperative period. Besides, intravascular ultrasound allows a more detailed assessment of stent apposition and the degree of stent expansion in order to optimize and improve the remote results of the operation.

[Topographic study of mandibular block landmarks]. / Sposob provedeniia mandibuliarnoi anestezii na osnovanii topografoanatomicheskikh orientirov.

The study samples included 12 anatomical specimens taken from the fixed corpses of various gender and age. Pterygomandibular space topography was assessed by macro - and micropreparation methods. The landmarks for the universal way of mandibular anesthesia were defined associated with low risk of medial pterygoid muscle, lingual nerve, inferior alveolar neurovascular bundle damage. The study results allow increasing the efficiency and safety of anesthesia of the lower jaw teeth.

Identification of a Catalytically Highly Active Surface Phase for CO Oxidation over PtRh Nanoparticles under Operando Reaction Conditions.

Pt-Rh alloy nanoparticles on oxide supports are widely employed in heterogeneous catalysis with applications ranging from automotive exhaust control to energy conversion. To improve catalyst performance, an atomic-scale correlation of the nanoparticle surface structure with its catalytic activity under industrially relevant operando conditions is essential. Here, we present x-ray diffraction data sensitive to the nanoparticle surface structure combined with in situ mass spectrometry during near ambient pressure CO oxidation. We identify the formation of ultrathin surface oxides by detecting x-ray diffraction signals from particular nanoparticle facets and correlate their evolution with the sample's enhanced catalytic activity. Our approach opens the door for an in-depth characterization of well-defined, oxide-supported nanoparticle based catalysts under operando conditions with unprecedented atomic-scale resolution.

[Chronic Heart Failure With Preserved Systolic Function and Reversible Dilatation of Cardiac Chambers].

Diagnosis of dilation (D) cardiomyopathy (CMP) requires exclusion not only of inflammatory and genetically determined forms but also of some rare diseases. This 51 year old patient with history of moderate arterial hypertension approached a cardiologist because of new onset atrial fibrillation and dyspnea. Echocardiography detected dilation of all cardiac chambers with relatively preserved ejection fraction, causing suspicion of DCMP. Among conditions excluded were coronary atherosclerosis, congenital heart defect with left to right shunt, primary pulmonary hypertension, pulmonary embolism, hypertensive heart, tachycardia induced CMP, arrhythmogenic right ventricular dysplasia, noncompaction myocardium. Further examination revealed massive pelvic arteriovenous malformation with branches of right internal iliac artery and inferior mesenteric artery as feeding vessels. This malformation was considered the leading cause of DCMP. Successful multistage embolization of feeding arteries was associated with reduction of cardiac chambers, alleviation of valvular regurgitation and pulmonary hypertension, restoration of sinus rhythm. Presentation of this case is followed by discussion of possible mechanisms of heart failure with high cardiac output and preserved systolic function in patients with arteriovenous malformations with left to right shunt. Approaches to interventional treatment of these malformations are also discussed.

[PROGNOSTIC STRATIFICATION OF CLINICALLY LOCALLY SPREAD CANCER OF PROSTATIC GLAND].

In 2002 ­ 2015 yrs in the clinic radical prostatectomy was performed in 403 patients for prostatic cancer, including those having stage cТ3 ­ in 102 (25.3%). Basing on analysis of main risk factors, a model of prognostic stratification of clinically locally spread prostatic cancer on three groups was created: with low risk ­ in the absence of data, confirming invasion into seminal vesicles (stage cТ3а), the prostate­specific antigen (PSA) content less than 20 ng/ml, degree of cellular differentiation of tumor (Glisson's index) in accordance to biopsy data ­ 6 and less; with intermediate risk ­ while presence of one of unfavorable prognostic factors (stage cТ3b), PSA 20 ng/ml and more, Glisson's index 7 and more; with high risk ­ while presence of two and more unfavorable prognostic factors. The follow­up duration was 50,6 mo at average. Biochemical recurrence in the groups while low, intermediate and high risk presence have occurred, accordingly, in 14.3, 37.1 and 62.3% patients (р<0.05), and its occurrence risk in patients while intermediate risk present is in 3,5 times, in high risk ­ in 9.9 times bigger, than in a low risk. Stratification may appear useful for practical physicians and investigators while choosing tactics of treatment in patients with prostatic cancer clinical stage ІІІ

[Interventional radiology in vascular surgery: congress "Cirse 2014" in Glasgow].

The world's largest Congress of the Cardiovascular and Interventional Radiological Society of Europe (CIRSE)was held in Glasgow (Scotland) on September 13-17, 2014. During four days the participants discussed the most important problems concerning cardiovascular interventional radiology. Separate sections were dedicated to treatment of stroke, aneurysms of the thoracic and abdominal aortic portions, lower-limb ischaemia, as well as interventional methods of treatment in oncology. Special attention was paid to the report delivered by Lars Lenne from Denmark entitled "Bifurcated iliac stent graft for treatment of aortoiliac aneurysms", attaching particular significance to the technique aimed at preserving the internal iliac artery. Also worthy of notice is the report of Gerard Goh (Melbourne, Australia) dedicated to treatment of patients with acute lower-limb ischaemia,presenting the results of studying time intervals of rendering care for patients with critical ischaemia and comparing various methods of treatment. Of interest was the section on visualization of vessels, where special attention was deserved by the lecture delivered by Professor Marco Das from the Medical University of Maastricht (The Netherlands) and dedicated to contrast-free interventions, also reporting the use of carbon dioxide (CO:;) used as an al~emative to iodine-containing contrast media routinely used in our practice.

[State of the carotid artery bifurcation after surgery involving the use of absorbable suture material].

The authors present herein a clinical case report assessing the state of the carotid artery bifurcation zone while performing secondary operation for restenosis 7 years after the primary operation (eversion carotid endarterectomy). The redo operation was carried out using absorbable suture material during anastomosis formation. This suture material used in arterial reconstructions turned out to result in good reparation of the anastomosis, not inducing coarse deformity of the vascular wall, thus in the long run making it possible to simplify the course of the redo operation.

[Endovascular treatment of traumatic arteriovenous fistulas of the vertebral artery].

The authors describe herein the use of balloon-distensible stent grafts for endovascular treatment of patients presenting with traumatic arteriovenous fistulas in the first segment of the vertebral artery, exemplified by two clinical case reports. In both cases, the arteriovenous fistula formed after a stab-and-slash wound in the neck area. In order to exclude the arteriovenous aneurysm from the blood flow in the first case we performed endoprosthetic repair of the first segment of the subclavian artery with shutting off of the ostium of the vertebral artery carrying the aneurysm. In the second case, in order to remove the arteriovenous shunt we carried out performed endoprosthetic repair of the first segment of the vertebral artery. These cases show possibilities of roentgenoendovascular methods of treatment, making it possible to successfully replace technically complicated surgical interventions in traumatic arteriovenous fistulas of vertebral arteries.

[Blood supply topographic features in maxilla and mandible].

Topographic anatomical studies provide data on the characteristics of blood supply to maxilla and mandible. It is established that maxilla is supplied by the large number of major arteries which are commonly anastomosed to each other. Mandible intraosseous blood supply is by one major lower alveolar artery and a large number of small extraosseous arteries that supply blood to the bone, masticatory and facial muscles.

[Clinical case of the sharp cholecystitis process under mask of a sharp myocardial infarction].

Presented case report of an.elderl patient having polymorbidity pathology. Clinical "mask" of the destructive cholecystitisis an acut emyocardial infarction complicated bycardia casthma. The diagnosis of myocardial infarction has not been confirmed. Onemergency indications was performed cholecystectomy.

Anti-fibrillogenic properties of phthalocyanines: effect of the out-of-plane ligands.

The axially-coordinated phthalocyanines were previously reported as agents possessing strong anti-fibrillogenic properties. In the presented study we used the atomic force microscopy to investigate the intermediates and the products of insulin aggregation reaction formed in the presence of Zr and Hf phthalocyanine complexes that contain out-of-plane ligands of different size and nature. It is shown that while phthalocyanine-free insulin generated mostly amyloid fibrils with a diameter of 2-8nm and a length of up to 5µm, the presence of phthalocyanines with spatial bulky ligands (PcZrDbm2) leads to the redirection of the fibrillization reaction to the formation of the spherical oligomer aggregates with a diameter of 4-12nm. At the same time the phthalocyanine complex PcHfCl2 having the small-volume ligands induces the formation of large size insulin aggregates with a height of about 100nm that are supposed to be amorphous species. The study of the aggregation intermediates showed the certain similarity of the reaction passing for phthalocyanine-free insulin and insulin in the presence of PcZrDbm2. The large-size amorphous species were observed at the beginning of reaction, later they dissociated, leading to the formation and growth of the smaller size particles. The amyloid-sensitive cyanine dye 7519 demonstrates the strong fluorescent response both in the presence of fibrils and spherical oligomers, while it is non-sensitive to amorphous aggregates.

[Clinical and ultrasound features of gallbladder pathology in patients with a weight deficit].

We undertook analysis of clinical and instrumental features of gallbladder pathology in patients with a weight deficit for the elucidation of peculiarities of eating behavior, blood leptin level, and cytokine content of gastric biopsies. Underweight patients with inflammatory and dysfunctional diseases of gallbladder more frequently than others presented with abdominal pain syndrome. All patients enrolled in the study showed every type of eating disorders with the predominance of the limiting behavior. Weight deficit in patients with chronic cholecystitis was associated with hyperleptinemia and increased production of proinflammatory cytokines.

[Experience of percutaneous transhepatic rheolytic thrombectomy using in treatment of postresection portal vein thrombosis].

Vessels resection in case of pancreatic head cancer may be associated with portal vein thrombosis. System AngioJet 9000 (Possis Medical Inc.) for rheolytic thrombectomy is one of endovascular device for treatment of patients with venous thrombosis. Descriptions of 3 cases with rheolytic thrombectomy using are presented in the article. Percutaneous transhepatic approach under ultrasound control was used for visualization of portal vein branches. Stent-grafts were implanted in 2 of 3 cases after thrombectomy in zone of portal vein thrombosis. Bleeding from liver puncture site was observed in 1 case in early postoperative period. There was not recurrent thrombosis in long-term postoperative period (31 months after surgery maximally). The authors consider that use of several endovascular techniques such as rheolytic thrombectomy with stenting or without it provides satisfactory clinical results in treatment of patients with postoperative portal vein thrombosis.

[TMJ morphological changes in abnormal occlusion].

TMJ dysfunction is one of the most common diseases among all disorders of the maxillofacial region. Any abnormality in synchrony or amplitude of motion of the TMJ results in the malposition of the articular disc. Researchers and clinicians were always interested in topographic anatomy of the TMJ. There is currently no consensus on matters relating to changes in anatomical features of the TMJ by occlusal disturbances.

Complexes of hydrogen peroxide molecules with DNA nucleic bases.

The analysis of complexes formation of hydrogen peroxide molecule with DNA nucleic bases is carried out using methods of quantum chemistry. Optimized geometries of complexes are determined and the interaction energies that lead to complex formation are calculated. Comparison with the same calculations for water molecule is made. It is shown that complexes with hydrogen peroxide molecule are energetically more stable than the same complexes with water molecule. Such energetic advantage is achieved particularly due to geometrical properties of hydrogen peroxide molecule, especially presence of dihedral angle. Position of hydrogen peroxide molecule in close vicinity to DNA could lead to blocking of its recognition by proteins or direct damage via hydroxyl radical formation. These results can have significant impact in understanding of mechanisms of cancer therapy.Communicated by Ramaswamy H. Sarma.

[Possibilities of surgical management of paraganglioma of the neck extending to the base of the skull].

Presented in the article is a rare clinical case report concerning successful treatment of a female patient with vaginal paraganglioma of the neck - a tumour extending from the level of the trunk of the common carotid artery in cranial direction to the base of the skull. Mentioned are difficulties of carrying out an operational intervention requiring the use of certain surgical techniques. The tumour was removed as a single block with the involvement into the process of the major vessels of the neck and nervous formations. The reconstructive operation performed was common carotid - internal carotid prosthetic repair with a 6.3-4.5 mm cone-shape prosthesis 'Gore-tex' on the right.

Freezing and melting of 3D complex plasma structures under microgravity conditions driven by neutral gas pressure manipulation.

Freezing and melting of large three-dimensional complex plasmas under microgravity conditions is investigated. The neutral gas pressure is used as a control parameter to trigger the phase changes: Complex plasma freezes (melts) by decreasing (increasing) the pressure. The evolution of complex plasma structural properties upon pressure variation is studied. Theoretical estimates allow us to identify the main factors responsible for the observed behavior.

[Topographological-anatomic changes in the structure of temporo-mandibular joint in case of fracture of the mandible condylar process at cervical level].

Pathological changes in soft tissues surrounding the fracture site as well as in the structural elements of temporo-mandibular joint always occured in condylar process fracture with shift at cervical mandibular jaw level. Other changes were also seen in the joint on the opposite normal side. Modelling of condylar process fracture at mandibular cervical level by means of three-dimensional computer model of temporo-mandibular joint contributed to proper understanding of this pathology emergence as well as to prediction and elimination of disorders arising in adjacent to the fracture site tissues.

Intensities of DNA ion-phosphate modes in the low-frequency Raman spectra.

The Raman intensities of counterion vibrations with respect to the phosphate groups of the double-helix backbone (ion-phosphate modes) in the low-frequency spectra (< 200 cm(-1)) of B -DNA with different alkali metal counterions have been calculated using the model for DNA conformational vibrations and the valence-optic approach. The results have showed that the spectra of DNA with heavy counterions (Rb(+) and Cs(+)) differ from the spectra of DNA with light counterions (Na(+) and K(+)). The calculated spectra of DNA with heavy counterions are characterized by intensive modes of ion-phosphate vibrations that form one united band near 115 cm(-1). Ion-phosphate modes in the spectra of DNA with light counterions are characterized by higher frequencies (near 180 cm(-1)) and much lower intensity. Our calculations explain why the modes of ion-phosphate vibrations are observed in Cs-DNA spectra rather than in Na-DNA. The determined sensitivity of the intensities of DNA low-frequency spectra to the counterion type proves the existence of the ion-phosphate modes.