[Combined treatment of arteriovenous malformations of the head and neck].

An arteriovenous malformation (AVM) is a vascular developmental abnormality conditioned by impaired embryonic morphogenesis and characterized by the development of an abnormal connection between arteries and veins. More than 50% of the total number of patients suffering from this pathology are those having the pathological foci localizing in the area of the head and neck. At present, a combined method is both a generally accepted and the most radical one used for treatment for AVM. However, in the majority of cases, excision of the malformation leaves an extensive and complicated defect of tissues, whose direct closure leads to coarse cicatricious deformities. Over the period from 2004 to 2012, we followed up a total of 37 patients presenting with arteriovenous malformations of the head and neck. At admission the patients underwent preoperative examination including clinical tests, ultrasound duplex scanning, arteriography, MRT, and computed tomography. 24-72 hours prior to the operative intervention the patients were subjected to embolisation of the main vessels supplying the vascular malformation. Excision of the AVM was in 8 cases followed by primary closure of the postoperative wound, in 17 patients the defect was closed by transposition of the axial flaps, and 12 subjects underwent free transplantation of composite complexes of tissues. Relapse of the disease was revealed in 17 patients. In the majority of cases, relapses developed during the first year after the operative intervention (10 cases). The control of the disease's course was obtained in 20 patients. In 8 of the 12 patients with free transplantation of flaps we managed to obtain long-term control over the disease's course (more than 5 years). Hence, free microsurgical transplantation of compound complexes of tissues may be considered as a method of choice for closing the defect after excising an AVM in the area of the head and neck. Replacement of the defect with a well-vascularized tissue complex considerably improves regional haemodynamics, decreases tissue ischaemia, and is capable of providing longterm control over the disease's course.

[Adaptation of surface of implants towards a recipient tissues].

The investigation was devoted to application of the adaptation method of the polymeric implants surface towards a recipient tissues, basing on application of proteins from the blood autoserum. There was conducted a comparative analysis, basing on results of histological investigations of tissues around implants after processing with adapting composition (AC) and without such. There was established in experiment and clinic, that application of AC for the prosthesis processing guarantees practically complete adaptation of their surface to the patient tissues.

[Physical methods to determine compatibility of implants].

The effect of the living organism on the polymer materials used for the manufacture of grids for implants. It is shown that the recipient's body is actively working to exogenous material , destroying its surface layer and forms around the implant insulating fibro-connective tissue capsule, the thickness of which depends on the severity of the organism's reaction to a foreign body. Proposed instrumental method of determining compatibility before surgery implant material with the recipient using an atomic force microscope (AFM).

[The biocompatibility testing of various types of nonorganic implants].

Impact of living organism on nonorganic materials, which are applied for the implants manufacturing, was studied. There was established, that organism of a recipient patient actively effects on exogenic material, destroying its superficial layer and forming the connective tissue capsule around the implant. The implant surface may start to dissolve selectively as a result of aseptic inflammation, keeping around, in such a situation it become necessary to remove the prostheses, which have lost their function. Impact of organism on surface of different implants of nonorganic origin and the ways of it prophylaxis were investigated. Instrumental method of the preoperative compatibility testing between a recipient organism and the implant material, using the atomic-power microscope, was proposed.

[Morphological substantiation for the surgical treatment of chronic hepatic abscess].

The results of histological investigation, conducted in 27 patients, operated on for chronic hepatic abscess, are presented. Macroscopic and microscopic characteristic of all zones of hepatic affection is adduced, the mechanisms of formation of pyogenic membrane, zones of infiltration and fibrosis in chronic hepatic abscess formation are delineated.

[An acute necrotic pancreatitis as a complication of cystic pancreatic tumor].

The peculiarities of the cystic pancreatic tumor morphogenesis were studied up. Possibility and probability of the anastomosis existence between mucinous cystic tumor and pancreatic duct with its secondary mucinous dilatation were confirmed, causing the complications occurrence, an acute pancreatitis in particular. Selecting the surgical tactic in mucinous cystic tumor it is necessary to take into account the probability of the intraductal malignization foci formation, what precludes application of extended pancreatic resection using adjuvant chemotherapy and the postoperative serological control conduction.

[The experience of diagnostic and surgical treatment of Barrett's oesophagus]. / Opyt diagnostiki i khirurgicheskogo lecheniia pishchevoda Barreta.

There were analyzed five-year late results of prospective investigation on surgical treatment of 23 patients, suffering long-segment Barrett's esophagus (BE). Esophagoplasty and esophagocardioplasty was performed in 7 (30.4%) patients and total fundoplication in combination with endoscopic ablation of metaplastic epithelium--in 16 (69.6%). Excellent and good results marks in 19 (827%) of patients, including those with antireflux operation, and satisfactory--in 4 (17.3%), witnessing high efficacy of surgical treatment in the BE correction.

[Morphological characteristics of cystic pancreatic tumors]. / Morfologicheskaia kharakteristika kistoznykh opukholei podzheludochnoi zhelezy.

The results of 86 clinical observations of cystic pancreatic tumor are adduced. The expediency of the postoperative pathomorphological investigation conduction was substantiated because of high degree of the cystic pancreatic tumors polymorphism presence and low informativity of preoperative and intraoperative investigations.

[Venous thromboembolic complications in abdominal and vascular surgery. The risk factors and measures of prophylaxis]. / Venoznye tromboémbolicheskie oslozhneniia v abdominal'noi i sosudistoi khirurgii. Faktory riska i mery profilaktiki.

There were analyzed 4675 histories of cases of patients, who were operated on for disease of the digestion organs (3349) and for obliterating atherosclerosis of abdominal aorta and peripheral arteries (1326). The risk factors of occurrence were established, the prophylaxis methods for venous thromboembolic complications (TEC) in postoperative period were elaborated. High efficacy of application of fraxiparine in the venous TEC prophylaxis in abdominal and vascular surgery was noted.

[Ultrastructural and morphometric characteristics of neutrophilic granulocytes of blood]. / Ul'trastrukturna ta morfometrychna kharakterystyka neitrofil'nykh granulotsytiv krovi.

Ultrastructural and morphometric characteristics of neutrophilic granulocytes (NG) of blood were investigated. It was found that every cell size fraction distinguished by its own morphologic type of NG and its specified quantitative and qualitative characteristic of primary granules. There is a close interrelation between morphometric and ultrastructural characteristics, and such parameters as perimeter, area of NG, and area of primary granules can be considered as criteria of the NG functional state.

[Diagnostic and surgical treatment of chronic abdominal aneurysm rupture]. / Diagnostika i khirurgicheskoe lechenie khronicheskogo razryva anevrizmy briushnoi chasti aorty.

Examination and treatment of 8 patients with the abdominal aorta aneurysm (AAA) chronic rupture (CHR) was done. The interval between the aneurysm rupture occurrence and of the operation performance had constituted 3.6 months. The disease was diagnosed basing on the anamnesis data, on the results of clinical, invasive and noninvasive methods of investigation. The authors suggest necessary to operate all the patients with the AAA CHR.

[Compression biliodigestive anastomosis: the morphological characteristics of its dynamics of formation]. / Kompressionnyi biliodigestovnyi anastomoz: morfologicheskaia kharakteristika dinamiki formirovaniia.

The method of the compressive biliodigestive anastomosis formation, using implant and the apparatus for its performance, was elaborated. An experimental investigation on 30 rabbits was done. An optimal strength of compression while doing the tissues connection was 0.002-0.004 N/m2. Minimal traumaticity, preservation of sufficient blood flow of the tissues connected, delineation of the healing zone from the intestinal contents and bile, the absence of chronic inflammation in anastomotic tissues are the advantages of compressive biliodigestive anastomosis, promoting early restoration of the intestinal and gallbladder wall, the formation of functionally full value anastomosis, which is not stenotizes cicatricially.