[Difficulties in differential diagnosis of sagittal synostosis (scaphocephaly)]. / Trudnosti differentsial'noi diagnostiki sagittal'nogo sinostoza (skafotsefalii).

Craniosynostosis is characterized by congenital absence or premature closure of skull sutures. The most common form of craniosynostosis is synostosis of sagittal suture followed by scaphocephaly. There are some head deformities similar to scaphocephaly such as positional and constitutional dolichocephaly, etc. These patients have no sagittal suture synostosis. However, there are difficulties in differential diagnosis between these deformities and scaphocephaly. OBJECTIVE: To develop differential diagnostic criteria between dolichocephalic head deformities and true scaphocephaly following sagittal synostosis. MATERIAL AND METHODS: The study included 33 patients with dolichocephaly (25 (75.8%) boys and 8 (24.2%) girls) between December 2013 and August 2022. The inclusion criterion was available CT or ultrasound data confirming or excluding sagittal synostosis. Age of patients was 8.62±7.71 (1.77-36) months. We analyzed anamnestic, clinical and radiological data. Radiological data was compared with diagnostic findings in 20 patients with scaphocephaly. Both groups were comparable in age, gender and cranial index. RESULTS: We present clinical and radiological signs, as well as algorithm for differential diagnosis between scaphocephaly and dolichocephaly. CONCLUSION: There are objective difficulties in differential diagnosis between scaphocephaly following sagittal synostosis and dolichocephalic head deformities. In most cases, we cannot establish the cause of congenital forms of dolichocephaly. The most likely causes may be pre- and postnatal compressive and positional effects. Ultrasound of skull sutures is preferable for differential diagnosis between these abnormalities. Correction of dolichocephaly can be carried out according to aesthetic indications with individual cranial orthoses.

[Functional and aesthetic significance of the uvula in cleft palate repair]. / Rol' yazychka v dostizhenii funktsional'nogo i esteticheskogo rezul'tata uranoplastiki.

OBJECTIVE: To investigate functional and aesthetic role of uvula in cleft palate repair. MATERIALS AND METHODS: Forty-one patients aged from 1 year 2 months to 7 years were included in this study with congenital cleft lip and/or palate. The morphological investigation of the resected hemi- uvula was done. Palatoplasty was performed in all cases. RESULTS: According to morphological results, most of the resected hemi-uvula consisted of vascularized fibrous tissue, covered with epithelium. In three groups of patients (with unilateral, bilateral and isolated cleft palate), the duration of the surgery and intraoperative blood loss did not exceed similar values for conventional methods. The volume of infusion therapy revealed a deficit of fluid intake of no more than 30%, which indicates early restoration of swallowing function. CONCLUSION: The technique of preserving one of the «hemi-uvulas¼ lead to excellent aesthetic results and increasing functionality. Resection of one of the «hemi-uvulas¼ is safe and physiological.

[Resorbable vs nonresorbable fixation in alveolar bone grafting in unilateral cleft lip and palate patients]. / Otsenka éffektivnosti rezorbiruemoi i nerezorbiruemoi fiksatsii transplantata pri kostnoi plastike verkhnei cheliusti u detei s odnostoronnei rasshchelinoi guby i neba.

The aim of the study was to evaluate the resorbable vs nonresorbable fixation efficiency in bone grafting for unilateral cleft lip and palate (UCLP) patients. Thirty eight UCLP patients aged from 7 to 17 years (mean 11.5±3.1 years) were divided in two groups with different types of cortical graft fixation: group 1 ─ titanium screws (22 patients), group 2 ─ resorbable pins (16 patients). The Bergland and Chelsea scales were used to evaluate the outcomes 8 months after surgery. Additional authors' original scales were introduced: bone volume scale and pyriform rim restoration scale. The Bergland and Chelsea scales have shown good results in groups 1 and 2 in 91 and 81% of cases, satisfactory in 4.5 and 19% of cases, respectively. Upon the bone volume scale good results were achieved in groups 1 and 2 in 64 and in 75% of cases, satisfactory results - in 18 and 19% of cases, respectively. Upon the pyriform rim restoration scale good results achieved in 59 and 88% of cases, respectively. We also took into consideration the influence of age, diagnosis, post-op complications. No statistically significant difference between groups was found, with neither age nor diagnosis showing any influence. Only postsurgical complications and the stability of the orthodontic design seem to be important for good bone formation after alveolar bone grafting.

[Modern diagnosis and treatment in children with congenital basal encephalocele]. / Sovremennye metody diagnostiki i lecheniia detei s vrozhdennymi bazal'nymi cherepno-mozgovymi gryzhami.

Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach. Two children had no surgery due to minimal symptoms and a lack of cerebrospinal fluid leak. RESULTS: Application of the algorithms for diagnosis and treatment of encephalocele, suggested by the authors, enabled making the timely diagnose, defining the optimal surgical tactics, and achieving good treatment results. CONCLUSION: A differentiated approach to the choice of a surgical technique for basal encephalocele, the use of auto-tissues for skull base reconstruction, intraoperative and postoperative lumbar drainage, and simultaneous elimination of deformity of the fronto-naso-orbital region enable avoiding complications and achieving good functional and aesthetic results.

[Application of semi-buried curvilinear distraction devices in complex management of lower micrognathia in children].

The aim of the study was to apply an effective treatment protocol with low morbidity for children with syndromic and nonsyndromic micrognathia using curvilinear distractors, intraoral approach and early orthodontic treatment. We report 7 patients aged from 3 to 13 years with bilateral mandibular hypoplasia. These patients were characterized by severe malocclusion, esthetic facial deformation and respiratory disorders. In 3 patients mandibular hypoplasia was combined with anterior open bite. The intraoral surgical approach was used in all cases. Good functional and esthetic results were achieved during treatment. The less traumatic intraoral approach, curvilinear distractors, ultrasound callus formation control and early orthodontic treatment assure the good functional and esthetic results in severe cases facilitating the continuinty in complex rehabilitation of the growing child.

Drift-diffusion model of the fragmentation of the external ring structure in the photoluminescence pattern emitted by indirect excitons in coupled quantum wells.

Under optical excitation, coupled quantum wells are known to reveal fascinating features in the photoluminescence pattern originating from dipole orientated indirect excitons. The appearance of an external ring has been attributed to macroscopic charge separation in the quantum well plane. We present a classical model of nonlinear diffusion to account for the observed fragmentation of the external ring into a periodic array of islands. The model incorporates the Coulomb interactions between electrons, holes, and indirect excitons. At low temperatures, these interactions lead to pattern formation similar to the experimentally observed ring fragmentation. The fragmentation is found to persist to temperatures above the quantum degeneracy temperature of indirect excitons.

[Minimally invasive two-stage treatment of cholecystocholedocholithiasis].

Two groups of patients in whom two-stage treatment of cholecystocholedocholithiasis was performed with different succession of using endoscopic papillosphincterotomy (EPST) and laparoscopic cholecystectomy (LCE) were compared. In 59 patients (1st group) EPST was used as the first stage, in 67 patients (2nd group) LCE and drainage of choledochus preceded the endoscopic intervention. The effectiveness of EPST was 93.3 and 95.5% correspondingly in the first and second groups. There were no considerable differences in the frequency of complications, period of treatment at the hospital in the two groups. Lythextraction was obtained considerably more often at the first attempt in the second group of patients (79.1% versus 59.9%, p < 0.05). Due to inefficiency of EPST in three cases in the second group of patients reoperations were required. Thus, EPST should be performed before LCE for the rationally planned further treatment in case of its inefficiency.

Electrostatic conveyer for excitons.

We report on the study of indirect excitons in moving lattices-conveyers created by a set of ac voltages applied to the electrodes on the sample surface. The wavelength of this moving lattice is set by the electrode periodicity, the amplitude is controlled by the applied voltage, and the velocity is controlled by the ac frequency. We found the dynamical localization-delocalization transition for excitons in the conveyers and determined its dependence on exciton density and conveyer amplitude and velocity.

Indirect excitons in elevated traps.

We report on the study of indirect excitons in elevated traps. The transition from a normal to elevated trap results in the appearance of narrow lines in the emission spectrum. The density, temperature, and voltage dependences indicate that these lines correspond to the emission of individual states of indirect excitons in a disorder potential in the elevated trap.

[Compression-distraction osteosynthesis in management of children with craniosynostoses].

Le Fort III midfacial distraction using internal and external devices is a generally accepted procedure for midfacial retrusion in patients with craniosynostoses. Many novel techniques for correction of cranial deformities in craniosynostoses are being introduced today. The authors described 14 consecutive cases of Le Fort III midfacial distraction using internal and external distraction devices. The paper discusses advantages and limitations of these methods.

[Ultrasound study possibilities in evaluation of anatomical structures in children with congenital cleft of upper lip and palate].

Congenital cleft of upper lip and palate (CCULP) is one of the most widely spread and complicated developmental malformation of maxillofacial region, its frequency makes up for 16.4% of the total number of inherited defects. Ultrasound study (USS) let receive clinically significant information about anatomical structures peculiarities of upper lip, alveolar process and palate in patients with crest CCULP that could be important for surgical and prosthetic treatment planning and also significant for assessment of immediate and postponed treatment results. Verification of the received during surgical interventions and orthodontic manipulations data showed high diagnostic reliability of the USS results.

Anti-trapping of indirect excitons by a current filament.

In order to explain the photoluminescence (PL) of indirect excitons collected from localized spots in experiments with a defocused laser excitation of coupled quantum wells (QWs), we model the in-plane carrier transport and charge distribution with a set of drift-diffusion, Poisson and thermalization equations. The quantum statistical corrections are included in our description via a generalized Einstein relationship and quantum mass action law. The PL spots are attributed to transverse current filaments crossing the structure and injecting electrons in the coupled QWs. The accumulated electron charge forms an anti-trap for indirect excitons. Our model quantitatively reproduces the whole set of the relevant experimental data.

Daily zinc supplementation effect on zinc deficiency in rats during prolonged restriction of motor activity.

The objective of this investigation was to evaluate the effect of 47 mg zinc supplementation on deficiency of zinc in rats during 98 d of restriction of motor activity (hypokinesia), which appeared by higher plasma zinc concentration. One Hundred 13-week-old Sprague-Dawley male rats weighing 360-390 g were used to perform the studies: They were equally divided into four groups: 1. Unsupplemented control animals (UCA); 2. Unsupplemented hypokinetic animals (UHA); 3. Supplemented control animals (SCA); and 4. Supplemented hypokinetic animals (SHA). For the simulation of the effect of hypokinesia (HK), the UHA and SHA were kept in small individual cages made of wood, which restricted their movements in all directions without hindering food and water intake. The SCA and SHA received daily with their food an additional amount of zinc. Before and during the experimental period of 98 d, plasma, urinary and fecal zinc, balance of zinc, food intake, and body weight were determined at different intervals. In the SHA and UHA, the concentration of zinc in plasma, and the elimination of zinc in urine and feces increased significantly when compared with the SCA and UCA, whereas the balance of zinc was negative. The body weight and food intake decreased significantly in the SHA and UHA when compared with the SCA and UCA. The increased plasma concentration of zinc in both the SHA and UHA groups was in contrast to the observed hypozincnemia during prolonged immobilization as during prolonged hospitalization. This reaction suggests that there may be some other mechanisms that are affecting the process of control and regulation of zinc metabolism during prolonged HK. It was concluded that exposure to prolonged restriction of motor activity of rats induces significant increases in plasma concentration, fecal and urinary elimination of zinc in the presence of negative zinc balance and regardless the daily intake of large amounts of zinc with their food, leading to zinc deficiency.

[Methodological trend in the teaching of pathological anatomy]. / O metodologicheskoi napravlennosti prepodavaniia patologicheskoi anatomii.

On the basis of fundamental concepts of the materialist dialectics and principles of morphological determinism the methodological analysis of the morphofunctional relations in normal and pathological conditions is given, the key concepts of native theory of pathology are presented. The erroneous philosophical concepts (mechanistic determinism and conditionalism , empirism and positivism ) are evaluated critically. The authors, using concrete examples, give the leading principles and the most important forms of teaching at the pathology departments of medical institutes. The necessity of educating in students the habits of independent decisions in the most complex problems of pathology, the formation of the qualitatively new, populationist style of scientific thinking and proper methodological position is grounded.

[Antithrombocyte antibodies in the serum and on the surface of the thrombocytes in patients with chronic lymphoproliferative diseases]. / Issledovanie antitrombotsitarnykh antitel v syvorotke i na poverkhnosti trombotsitov bol'nykh khronicheskimi limfoproliferativnymi zabolevaniiami.

Antiplatelet antibodies were studied in patients with chronic lymphatic leukemia (CLL) using ELISA for detection of serum antibodies and RIA for determination of antibodies associated with platelet surface. Serum antibodies were identified in 1 out of 6 CLL patients with the platelet count 100,000-200,000 per microliter and in 7 out of 54 CLL patients with the platelet count lower than 100,000. Platelet-associated antibodies were not detected in patients with the normal platelet count, but were revealed in 14 out of 25 patients with the platelet count 100,000-200,000 per microliter and in 21 of 27 patients with the platelet count lower than 100,000 per microliter. The presence of a group of thrombocytopenic patients lacking serum or platelet-associated antibodies suggested that the development of thrombocytopenia in CLL could be mediated not only by antibodies but also by other pathogenic mechanisms, i.e. by the depression of megakaryocytes in bone marrow. Increase of the platelet count after steroid and cytostatic treatment in CLL patients correlated with decrease of antiplatelet antibodies. In splenectomized CLL patients, the increase of the platelet count and disappearance of hemorrhage occurred in patients with the low level as well as with the high level of antibodies after the operation.

[Rehabilitation of patients with chronic bronchitis and spine diseases]. / Vosstanovitel'naia terapiia bol'nykh khronicheskim bronkhitom s zabolevaniiami pozvonochnika.

Correction of disturbed respiratory function and inhibition of progression of pulmonary inflammatory and obstructive processes is the aim of respiration rehabilitation in patients with chronic bronchitis (CB). It is known that rehabilitation in CB patients with spinal diseases meets with difficulties as dystrophic lesions of the spine entail its functional-anatomic disorders at the corresponding level. By supporting progression of dystrophic spinal and osteovertebral junction disorders, chronic bronchopulmonary inflammation participates in formation of interrelated respiratory affections. New approaches to rehabilitation of CB patients with spinal lesions lie in use of pharmacopuncture, acupuncture, deep reflex-muscular massage and therapeutic exercise in consensual sequence.