[Conditionally pathogenic microorganisms in patients with bisphosphonate jaw osteonecrosis].

The objective of the study was to define treatment strategy in cases of facial bones bisphosphonate induced osteonecrosis based on the study of the role of conditionally pathogenic oral microorganisms. Three typical clinical cases of bisphosphonate osteonecrosis of the facial bones were analyzed and 15 conditionally pathogenic oral microorganisms were identified in these patients using real-time PCR in saliva, wound and bone samples. A comparative analysis was carried out with purulent-inflammatory diseases of maxillofacial area. The study results proved an important role of conditionally pathogenic microorganisms of the oral cavity in the development of osteonecrosis of the facial bones. Wide range of bacterial species was identified in osteonecrosis of the facial bones patients. While bone tissue is most exposed to microbial communities, surgical treatment results in effective rehabilitation for a long period.

[Nickelid titanium mesh for orbital floor reconstruction].

The treatment plan for patients with mid-face fractures was presented in this article. In maxillofacial department of the I.M. Sechenov First Moscow State Medical University we used nickelid titanium mesh for reconstruction of the orbital floor. The clinical case with good result of treatment was presented here.

[Surgical treatment of patients with drug abuse and mandible necrosis].

The article describes clinical and radiological classification of osteonecrosis of the mandible in patients with drug dependence, surgical options presented on the basis of classification proposed. Clinical case of simultaneous application of individual plate of nikelid titanium in patient with osteonecrosis of the mandible is presented.

[Methods of tissue engineering of bone tissue in maxillofacial surgery].

For the last decade many experimental and clinical data about the study and application of regenerative medicine methods in the maxillofacial surgery were accumulated. For better bone regeneration mesenchymal stem cells are often used. Considering the general wariness of researchers in some aspects of cell therapy, methods of study of mesenchymal stem cells and the technologies of its clinical application are constantly being upgraded. This review will consider methods of tissue engineering used to regenerate bone tissue defects in maxillofacial surgery.

[The clinical and X-ray classification of osteonecrosis of the low jaw].

OBJECTIVE: To elaborate a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction. MATERIAL AND METHODS: Ninety-two patients with drug addiction who had undergone orthopantomography, direct frontal X-ray of the skull, and multislice computed tomography, followed by multiplanar and three-dimensional imaging reconstruction were examined. One hundred thirty four X-ray films and 74 computed tomographic images were analyzed. RESULTS: The authors proposed a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction and elaborated recommendations for surgical interventions on the basis of the developed classification. CONCLUSION: The developed clinical and X-ray classification and recommendations for surgical interventions may be used to treat osteonecroses of various etiology.

[Treatment tactics by mandibular fractures in teeth-bearing area].

The aim of this study was to develop treatment plan for mandibular fractures in tееth bearing area in order to decrease complication rate. We have developed indication and contraindication for endonontic procedures and the extraction of the tooth in the fracture line. It was concluded that the overall complication rate was low and can further be reduced.

[Bifurcational diverticulum ("aneurisms") of brain arterial junctions].

The results of clinico-morfological investigation of 220 arteries of the brain base from dead patients with aneurisms are in the article. The new facts and terms such as bifurcational hemodynamic aneurisms, segmental arterial ring of the brain and aneurysmal disease of the brain have been introduced. We have showed that aneurisms forms in the area of bifurcation, but not in linear segments of vessels. A junction of arteries in the bifurcation of vessels, formed by connective tissue, units muscle segments and takes place in development of aneurisms. The term of "aneurism" as a saccular evagination of all layers of arterial wall was prejudiced. A term as "diverticulum" could be use for denomination of evagination. Two types of aneurysmal disease of the brain clinical course have been separated out. The fist one is dysembryoplastic type with connective tissue deficiency and the second one--involutional hypertensive type at patients with long-term arterial hypertension.

[Superelastic constructions in surgical treatment of mandible condylar process fractures with full medial head of mandible dislocation].

Between 2007 and 2009 15 patients with medially dislocated head fractures of condylar process were surgically treated in Sechenov Moscow Medical Academy. All patients were surgically treated with open reduction--mandibular rami osteotomy, replantation of condylar head and osteosynthesis with nikelide titanium gages. Modern surgical technologies implementing nikelide titanium gages for osteosynthesis simplifies operation technique, decreased surgical trauma and increased overall treatment quality of such patients.

[Use of constructions from porous titanium nikelide for treatment of fractures of lower wall of eye-socket].

Surgical reconstructive treatment was done in 45 patients with fractures of lower wall of eye-socket in the clinic of maxillofacial surgery of MMA (named after I.M. Sechenov) during the period from July 2007 to July 2008. All fractures were cured with constructions from titanium nikelide. Use of implants from porous titanium nikelide let to shorten the operation time, to decrease the risk of infection joining, to prevent fibrous capsule formation along implant periphery that was essential in prevention of scarring and enophthalmia.

[Constitutional types of the structure of the cerebral arterial ring and their role in the development of aneurysmal disease].

One hundred and twenty patients who died in 2003 to 2008 were examined; of them 27 patients died from ruptured aneurysm of the cerebral arterial ring (CAR). Vascular anthropometry and morphometry were made. Correlation analysis revealed a close direct correlation between the perimeters of elastic vessels (the aorta) and those of vessels of muscular type (the major arteries of the basis cerebri) and a close inverse correlation between the perimeters of the above arteries and human height. On the basis of these data, the authors identified three constitutional types of CAR: hypoplastic, normoplastic, and hyperplastic. The distribution by age and height (somatotype) in the variational series made up of those who had died from ruptured aneurysm was found to be bimodal. The clinical and morphological comparisons of the course of aneurysmal disease in these subgroups can identify two constitutional risk groups for development of aneurysmal disease: dysplastic and involutionally hypertensive.

[Use of postmortem brain magnetic resonance imaging at autopsy].

The study was undertaken to define the possibilities of using postmortem MRI for examining the brain. A complex study was made to explore 21 neutral formalin-fixed gross brain specimens from patients with neurosurgical pathology. Macroscopic and target histological studies of the changed signal areas detected by MRI were performed using histochemical stains. The significance of the results obtained by MRI in vitro has been defined, which furnish considerable opportunities to use the technique for the postmortem diagnosis of various diseases, to detect macroscopically undetectable changes (perifocal changes, metastases), to make a complex of intractable diagnostic problems, and to study the histological substrate of changed MR signal areas.

[Conditionalism and formulation of cause of death].

Methodological principles of death cause formulation on the basis of conditionalism (its propagandists were G.V. Shor and many well known Russian pathologists) are outlined. Conclusion on the cause of death is worked out by WHO and approved by Russian Ministry of Health.

[Results of treatment of chronic generalized periodontitis with a dispersed biomaterial Alloplant]. / Rezul'taty lecheniia khronicheskogo generalizovannogo parodontita s ispol'zovaniem dispergirovannogo biomateriala Alloplant.

There is a method of treatment of generalized chronic periodontitis with using dispersing biomaterial Alloplant and immunological, histomorphological criteria of this estimation.

[Results of 25-years study of bifurcational aneurysms of the cerebral arteries in the cranial base]. / Itogi 25-letnego izucheniia bifurkatsionnykh anevrism arterii osnovaniia golovnogo mozga.

This publication is based on the materials of 3 officially registered discoveries, 4 monographs, 3 dissertations and a great deal of publications in the periodicals. Data on the segmental (metameric) structure of Willis' circle, articulations that connecting metameres, and on the previously unknown disease Distentio juncturarum circuli arterialis cerebri (DJCAC) involving the articulations, on the development of aneurysm-like diverticula in them. The authors are in favor of the hypothesis on the acquired (rather than congenital) origin of aneurysms (diverticula) that are an optional manifestation of DJCAC.

[Corrective effects of tocopherol on changes in indices of the protective activity of phagocytes under the action of the herbicide 2,4-DA]. / Korrektiruiushchee vliianie tokoferola na izmeneniia pokazatelei zashchitnoi aktivnosti fagotsitov pri vozdeistvii gerbitsida 2,4-DA.

An experimental study on non-inbred rats indicated the toxic effect of a single dose of the herbicide 2,4-dichlorophenoxyacetic acid amine salt in a dose of 240 mg/kg on phagocytic defense processes appeared as phasic changes in the concentration of peripheral leukocytes, in the microbicidal, absorptive, and oxidative activity of polymorphonuclear leukocytes and peritoneal macrophages till day 60 of the follow-up. The course administration of vitamin E produced a beneficial effect on most study indices under aftereffect of a toxicant, which was mostly manifested in the blood levels of leukocytes and in the microbicidal capacity of phagocytes.

[Hypophysis compression syndrome in the sella turcica: mechanisms of development, pathology]. / Sindrom sdavleniia gipofiza v turetskom sedle--mekhanizmy razvitiia, patologicheskaia anatomiia.

Intrasellar hypertension--a phenomenon of the hypophysis compression in the sella turcica-was described 13 years ago. It develops under stressor conditions and is probably one of the causes of frequent in critical situations (shock, collapse, coma, etc.) episodes of acute hypophyseo-adrenal failure. Intrasellar hypertension morphologically manifests by the volume unbalance between a suddenly increasing, 1.5-2 times, hypophysis (due to adenocyte hypertrophy, hyperemia, colloid retention) on the one hand, and its rigid capsule and sella turcica, on the other. Extrahypophyseal factors (high liquid and venous pressure) may take part in developing of this phenomenon due to hypophysis squeezing from outside.

[Compression of the appendix cerebri in the sella turcica in critical states as a possible cause of acute adrenocortical insufficiency]. / Sdavlenie pridatka mozga v turetskom sedle pri kriticheskikh sostoianiiakh kak vozmozhnaia prichina ostroi adrenokortikal'noi nedostatochnosti.

The paper first describes the phenomenon of pituitary compression in the Turkish saddle--intracellular hypertension--which develops during stresses and morphologically appears as a volumetric conflict between abruptly (acutely) 1.5-2-fold enlargement of the brain appendage (at the expense of adenocytic hypertrophy, hyperemia, colloidal retention) on the one hand, and the poor pliable capsule and Turkish saddle), on the other. Extrapituitary factors (elevated liquor and venous pressure) that compress the pituitary outside may be involved in the formation of the phenomenon. Intracellular hypertension seems to be one of the causes that are encountered in critical conditions (shock, collapse, coma, etc.), of acute pituitary-adrenal failure episodes.