[Experience of transnazal endoscopic surgery of juvenile angiofibroma of the skull base and nasopharynx without performing preoperative embolization]. / Opyt transnazal'noi endoskopicheskoi khirurgii yuvenil'noi angiofibromy osnovaniya cherepa i nosoglotki bez vypolneniya predoperatsionnoi embolizatsii.

Juvenile nasopharyngeal angiofibroma (JNA) is a hypervascular, blood-supplied, benign tumour affecting the sinuses, nasal cavity, nasopharynx and the base of the skull. For intraoperative hemostasis, pre-operative embolism is a common and recommended procedure, but it has serious disadvantages, such as additional radiation exposure, anesthesia, and the risk of iatrogenic complications associated with the occlusion of the central artery of the retina, orbital and middle cerebral arteries. This article presents a report on successful radical removal of the widespread SAS without resorting to preoperative embolization, but with intraoperative transnazal endoscopic clipping of the internal maxillary artery (IMA).

EVALUATION OF BURDENSOME SYMPTOMS IN PATIENTS WITH RADIATION6ASSOCIATED AND SPONTANEOUS MYELOPROILIFERATIVE NEOPLASMS WITH THE USE OF OPTIMIZED SELF-ASSESSMENT MPN-SAF TSS. / OTsINKA OBTIaZhLYVYKh SYMPTOMIV U KhVORYKh NA RADIATsIINO-ASOTsIIOVANI TA SPONTANNI MIIeLOPROLIFERATYVNI NEOPLAZIÏ Z VYKORYSTANNIaM ADAPTOVANOÏ ShKALY SAMOOTsINKY MPN-SAF TSS.

OBJECTIVE: To investigate the intensity of burdensome symptoms using self-assessment MPN-SAF TSS in patientswith radiation-associated and spontaneous myeloproiliferative neoplasms (MPNs). MATERIALS AND METHODS: The study included 89 patients with radiation-associated and spontaneous MPNs, the bur-densome symptoms of MPN were determined using MPN-SAF TSS. RESULTS: The average score for complaints in patients with radiation-associated MPNs was significantly higher thanin patients with spontaneous MPNs - 43.46 and 25.04 points, respectively (p = 0.003). MPN patients classified bysubtypes also showed differences regarding intensity of burdensome MPN symptoms, demonstrating significantlyhigher average score of complaints among primary myelofibrosis patients (35.60), compared to polycythemia vera(29.60) and essential thrombocythemia (18.05) patients, (p = 0.005). Our study did not reveal any influence of theJAK2 V617F mutation on MPN burdensome symptoms intensity in MPN patients. CONCLUSIONS: We demonstrated a higher intensity of the MPN burdensome symptoms determined by the optimizedself-assessment MPN-SAF TSS in patients with radiation-associated, and in primary myelofibrosis patients, indicat-ing increased severity of patient's general conditions at the stage of diagnosis verification. It is advisable to usethe optimized MPN-SAF TSS at the moment of molecular genetic testing during the diagnosis of MPN for selectionor modifying treatment strategies in order to achieve better quality of life for patients.

[The application of the hidrogel-based medicinal compositions for the targeted delivery of medications in rhino- and otosurgery]. / Ispol'zovanie gidrogelevykh lechebnykh kompozitsii dlia napravlennoi dostavki lekarstv v rino- i otokhirurgii.

The objective of the present study was the analysis of the application of the hydrogel-based medicinal compositions for the treatment of the patients presenting with pathological changes in the nasal cavity and paranasal sinuses during the postoperative period. A total of 25 patients at the age from 18 to 60 years with the diseases of the nasal cavity and paranasal sinuses were available for the examination including 12 ones with polypous polysinusitis and 13 patients having benign neoplasms in the nasal cavity, paranasal sinuses, and the base of the skull. All these patients underwent endoscopic endonasal polysinusotomy. After the surgical intervention was completed, the postoperative cavities were filled up with a gel containing sodium alginate, sodium hyaluronate, and dioxydin. This procedure was followed by the tamponade with the use of the silicone oil tampons in conformity with the standard method. The application of the polyfunctional depot-materials in the combination with the physiotherapeutic treatment modalities made it possible to accelerate the wound healing processes including epithelization, changes in the mucous membrane of the paranasal sinuses, and the reduction of the postoperative oedema.

Experimental and CFD flow studies in an intracranial aneurysm model with Newtonian and non-Newtonian fluids.

BACKGROUND: According to the clinical data, flow conditions play a major role in the genesis of intracranial aneurysms. The disorder of the flow structure is the cause of damage of the inner layer of the vessel wall, which leads to the development of cerebral aneurysms. Knowledge of the alteration of the flow field in the aneurysm region is important for treatment. OBJECTIVE: The aim is to study quantitatively the flow structure in an patient-specific aneurysm model of the internal carotid artery using both experimental and computational fluid dynamics (CFD) methods with Newtonian and non-Newtonian fluids. METHODS: A patient-specific geometry of aneurysm of the internal carotid artery was used. Patient data was segmented and smoothed to obtain geometrical model. An elastic true-to-scale silicone model was created with stereolithography. For initial investigation of the blood flow, the flow was visualized by adding particles into the silicone model. The precise flow velocity measurements were done using 1D Laser Doppler Anemometer with a spatial resolution of 50 µ m and a temporal resolution of 1 ms. The local velocity measurements were done at a distance of 4 mm to each other. A fluid with non-Newtonian properties was used in the experiment. The CFD simulations for unsteady-state problem were done using constructed hexahedral mesh for Newtonian and non-Newtonian fluids. RESULTS: Using 1D laser Doppler Anemometer the minimum velocity magnitude at the end of systole -0.01 m/s was obtained in the aneurysm dome while the maximum velocity 1 m/s was at the center of the outlet segment. On central cross section of the aneurysm the maximum velocity value is only 20% of the average inlet velocity. The average velocity on the cross-section is only 11% of the inlet axial velocity. Using the CFD simulation the wall shear stresses for Newtonian and non-Newtonian fluid at the end of systolic phase (t= 0.25 s) were computed. The wall shear stress varies from 3.52 mPa (minimum value) to 10.21 Pa (maximum value) for the Newtonian fluid. For the non-Newtonian fluid the wall shear stress minimum is 2.94 mPa; the maximum is 9.14 Pa. The lowest value of the wall shear stress for both fluids was obtained at the dome of the aneurysm while the highest wall shear stress was at the beginning of the outlet segment. The vortex in the aneurysm region is unstable during the cardiac cycle. The clockwise rotation of the streamlines at the inlet segment for Newtonian and non-Newtonian fluid is shown. CONCLUSION: The results of the present study are in agreement with the hemodynamics theory of aneurysm genesis. Low value of wall shear stress is observed at the aneurysm dome which can cause a rupture of an aneurysm.

Study of the Reynolds Number Effect on the Process of Instability Transition Into the Turbulent Stage.

The results of the experimental study of the Reynolds number effect on the process of the Rayleigh-Taylor (R-T) instability transition into the turbulent stage are presented. The experimental liquid layer was accelerated by compressed gas. Solid particles were scattered on the layer free surface to specify the initial perturbations in some experiments. The process was recorded with the use of a high-speed motion picture camera. The following results were obtained in experiments: (1) Long-wave perturbation is developed at the interface at the Reynolds numbers Re < 104. If such perturbation growth is limited by a hard wall, the jet directed in gas is developed. If there is no such limitation, this perturbation is resolved into the short-wave ones with time, and their growth results in gas-liquid mixing. (2) Short-wave perturbations specified at the interface significantly reduce the Reynolds number Re for instability to pass into the turbulent mixing stage.

[Comparison of various diagnostic methods of Helicobacter infection].

PURPOSE OF INVESTIGATION: There has been conducted comparison of the most wide-spread methods of diagnosis of Helicobacter pylori infection: histologic, cytologic, method of polymerase chain reaction (PMCR) and respiratory urease Xelic-test on the method of AMA firm. MATERIALS AND METHODS: 1118 patients participated in the investigation, 403 patients were investigated by urease test and 50 ones were investigated by method of PMCR. The results of investigations were compared by means of correlative and variational analysis. RESULTS: There has been shown fine comprison of histologic, cytologic methods of Helicobacter pylori revealing and PMCR method both between them (coefficients of correlation 0.79, 0.34 and 0.53 accordingly), and with indices of gastritis activity (coefficients of correlation 0.49, 0.52 and 0.37 accordingly). On the other hand the results of respiratory urease Xelic-test did not correspond to any of investigated indices (coefficients of correlation 0.02, 0.05 and 0.09). The possible causes of such discrepancy, based on features of chemical properties of ammonia have been defined. Except known reaction of neutralization with hydrochloric acid, ammonia able to show donor-acceptor interactions and form various compounds with organic substances. CONCLUSION: Urease respiratory Xelic-test on the method of AMA firm can not be used for definition of Helicobacter pylori infection.

[Biological properties of the chick infectious bronchitis virus isolated in Russia].

A field chick infectious bronchitis virus (IBV) was isolated from the pathological material on chick embryos. The nucleotide sequence of the S1 gene was determined and comparatively analyzed with some sequences of this gene of foreign and Russian vaccine strains and isolates. A cross-neutralization test using sera to various IBV seroptypes was performed. The isolate was shown to antigenically differ from the reference strains. Bioassay was carried out, by using one-day chicks and the immunogenic properties of the virus were investigated.

[Karyotype and relationships of the endemic char Salvelinus krogiusae from Dal'nee Lake (Kamchatka)].

Resident (lacustrine) chars, inhabiting many lakes of Kamchatka, Chukotka, and continental coast of the Sea of Okhotsk, are of particular interest for understanding the mechanisms of speciation and evolution of Salvelinus chars. Since one of these, the char from Dal'nee Lake (Paratunka River basin, southeastern Kamchatka), is substantially different from lacustrine-riverine and anadromous chars from the Paratunka River basin in several morphological traits, hemoglobin spectrum, ecology, and reproduction, it is considered an isolated species Salvelinus krogiusae. The karyotype of the resident char from Dal'nee Lake was shown to be variable in most individuals, containing 76 to 80 chromosomes in different cells, with NF = 98. This suggests that the variability of the chromosome number in this char form is explained by Robertsonian translocations. In females and males, cells with respectively 2n = 78 and 2n = 77 prevailed. Heteromorphic sex chromosomes were not found in the karyotype of this char species. Nucleolar-organizing regions (NORs) were mostly detected in the telomeric regions of short arms of large submetacentric chromosomes. These features of the Krogius char karyotype demonstrate that this species is isolated from other Kamchatka chars, being similar to Taranetz char S. taranetzi from Chukotka Peninsula, which is in good agreement with morphological data.

[Karyological differences of the Northern Dolly Varden Salvelinus malma malma and the white char Salvelinus albus from the Kamchatka River basin]. / Kariologicheskie razlichiia severnoi mal'my Salvelinus malma malma i belogo gol'tsa Salvelinus albus iz basseina reki Kamchatki.

The karyotypes of northern Dolly Varden and white char, sympathrically inhabiting the Kamchatka River basin, were studied. The karyotype of Dolly Varden was stable: 2n = 78 and NF = 98 + 2, while in white char, polymorphism and mosaicism for the chromosome number were revealed: 2n = 76-79, NF = 98 + 2. Using a routine chromosome staining technique, the karyotype of white char (2n = 78) was shown to be identical to that of Dolly Varden. In both karyotypes, similar sets of marker chromosomes were present: two pairs of submetacentric (SM), one pair of submeta-subtelocentric (SM-ST), one pair of large acrocentric (A), and one pair of large sub-telocentric (ST) chromosomes. However, the karyotypes of Dolly Varden and white char differed in the number and location of nucleolus organizer regions (NORs). In Dolly Varden, single NORs located in the telomeric regions of the marker SM-ST chromosomes were observed. In white char, NORs were multiple and located both in the telomeric regions of the marker SM-ST chromosomes and on the short and long arms of large ST chromosomes. The identical marker chromosomes indicate considerable phylogenetic relatedness between Dolly Varden and white char from the Kamchatka River basin. Variation in NORs provides evidence for the reproductive isolation of these chars and their species status.

[Karyotype of Chukotka char from Estikhed Lake (Eastern Chukotka)]. / Kariotip chukotskogo gol'tsa iz ozera Estikhed (Vostochnaia Chukotka).

The karyotype of chars from the Estikhed Lake (Eastern Chukotka) was examined. This karyotype comprises 78 chromosomes, NF = 98. Marker chromosomes include one pair of submetacentrics, one pair of large acrocentrics, and one pair of large subtelocentrics with very short second arms. Nucleolus organizer regions are located in telomeric regions of short arms of marker submetacentric chromosomes. Small heterochromatin blocks are observed in centromeric regions of most chromosomes. The Chukotka char karyotype is very similar to that of Taranetz char Salvelinus taranetzi from the Achchen Lake: these karyotypes differ only in stability of the chromosome number.

[Karyotype and divergence of stream Dolly Varden from the Southern Sakhalin]. / Kariotip i divergentsiia ruch'evoi mal'my iuzhnogo Sakhalina.

The karyotype of stream Dolly Varden inhabiting a tributary of the Belaya River (the basin of Naiba River, southern Sakhalin) was determined (2n = 82 and NF = 98 + 2). According to the main characteristics (chromosome number and arm number, the presence of a pair of marker submeta-subtelocentric chromosomes with nucleolus organizer regions (NORs), one pair of large acrocentric chromosomes, and one pair of subtelocentric chromosomes), this karyotype is identical to the karyotype of anadromous southern Dolly Varden from Salvelinus malma krasheninnikovi of Primorye and Japan. However, in most stream Dolly Varden individuals, additional active nucleolus organizer regions (NORs) located in telomeric and paracentric regions of two to three pairs of acrocentric chromosomes were revealed. It is suggested that the stream and anadromous southern forms of Dolly Varden are evolutionarily related NORs that are silent in the anadromous souther form are active in the stream form. Possible causes of these differences in NOR activity are discussed.

[Polymorphism and divergence of karyotypes in taimens of the Hucho genus]. / Polimorfizm i divergentsiia kariotipov taimenei roda Hucho.

Karyotypes of Siberian taimen Hugo taimen from the Manoma River (Amur basin) were investigated. The karyotypes examined differed in chromosome number from 2n = 82 to 2n = 83; chromosome arm number was NF = 112. These differences, as well as the difference in the karyotype of Siberian taimen from the lower flow of the Amur River (2n = 84) described earlier, are due to Robertsonian polymorphism of one pair of large submetacentric chromosomes. The nucleolus organizer regions are located on the short arms of one or two subtelocentric chromosomes of different pairs. The probable sequence of karyotype divergence in taimens of the Hugo genus is discussed.

[Late results of endoscopic papillosphincterotomy in patients with non-neoplastic diseases of the common bile duct]. / Otdalennye rezu'ltaty éndoskopicheskoi papillosfinkterotomii u bo'lnykh c neopukholevymi zabolevaniiami obshchego zhelchnogo protoka.

An investigation of long-term results of treatment of 226 patients has shown that endoscopic papillosphincterotomy is a highly effective method of treatment of patients with cholelithiasis and stenosis of the major duodenal papilla. The complex use of the surgical and endoscopic methods of treatment gave most favorable results.

[Acute cholecystitis and its complications]. / Ostryi kholetsistit i ego oslozhneniia.

The results of operative treatment of 4,011 patients with acute complications of cholecystitis are analysed. Problems of diagnosis and tactics and the results of treatment are discussed. It is pointed out that the management of patients with acute complicated cholecystitis is a great and urgent problem in abdominal surgery in view of the diffuse character of the process.

[Endoscopic papillosphincterotomy in the treatment of choledocholithiasis and its complications]. / Endoskopicheskaia papillosfinkterotomiia v lechenii kholedokholitiaza i ego ozlozhnenii.

Endoscopic papillosphincterotomy was performed in 306 patients with hepatocholedochal calculi. Mechanical jaundice was found in 271 patients (88.5%), 183 patients (59.8%) had acute cholangitis, 41 patients (13.4%) had acute pancreatitis. Complete sanitation of bile ducts was successfully fulfilled in 264 patients (86.3%). Three patients had bleedings from the area of incision, 7 patients had transient diastasuria, 3 patients had edematic form of acute pancreatitis, 24 patients died (7.84%).