[The development of posttraumatic maxillary sinusitis due to transconjunctival penetration of a foreign body with a fracture of the lower wall of the orbit]. / Razvitie posttravmaticheskogo verkhnechelyustnogo sinusita vsledstvie transkon"yunktival'nogo proniknoveniya inorodnogo tela s perelomom nizhnei stenki orbity.

The article presents a clinical example of the course of posttraumatic acute purulent sinusitis with reactive soft tissue phenomena due to the previous injury of the orbit by a foreign body, the introduction of the latter into orbit and the maxillary sinus result in a fracture of the lower wall of the orbit. A feature of the injury is the penetration of a foreign body through the conjunctiva of the lower eyelid and lower conjunctival fornix, without damaging the skin. This case is professionally interesting for both young doctors and experienced specialists in otolaryngology, ophthalmology, maxillofacial surgery and neurosurgery. Experts, analyzing this clinical example, will be able to correctly diagnose, effectively eliminate the inflammatory process in the maxillary sinus.

[Experience of the interdisciplinary approach to diagnostics and treatment of patients with bisphosphonate osteonecrosis of the upper jaw]. / Opyt mezhdistsiplinarnogo podkhoda k diagnostike i lecheniiu patsientov s bisfosfonatnym osteonekrozom verkhnei cheliusti.

The article discusses the issues of diagnosis, the clinical course of osteonecrosis of the upper jaw in patients with oncological diseases. The assessment of radiological indicators of bone pathology of the upper jaw, signs of the development of the inflammatory process of the maxillary sinus and other sinuses of the nose. The experience of conservative tactics and surgical treatment of patients in this group is analyzed with the participation of specialists from otorhinolaryngologists and maxillofacial surgeons.

[Renal replacement therapy after elective surgical procedures]. / Zamestitel'naia pochechnaia terapiia u patsientov obshchekhirurgicheskogo profilia posle planovykh operativnykh vmeshatel'stv.

Acute kidney injury (AKI) is not a rare postoperative complication in surgical patients. AKI dramatically affects patient's condition, increases hospital-stay and risk of lethal outcome. Moreover, AKI may be followed by deterioration of basic renal function in short- and long-term period. It seemed interesting to us to generalize the clinical data of general surgical patients treatment, which were need to use renal replacement therapy for acute renal failure in postoperative period. The analysis made us possible to draw conclusions that can broaden our understanding of the causes, course and outcomes of acute renal failure in such a patients.

[Advisability of biliary drainage in liver fragments reconstruction]. / Tselesoobraznost' karkasnogo drenirovaniya pri rekonstruktsii zhelcheotvedeniya fragmentarnykh transplantatov pecheni.

AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients. Reconstruction without drainage was applied in 266 (90.5%) cases. In the group of biliobiliary reconstruction drainage was used in 18 out of 89 cases (20.2%), in the group of biliodigestive reconstruction - in 10 out of 202 cases (4.9%). Incidence of specific biliary complications was assessed. RESULTS: There was significant direct correlation of stented drainage of biliodigestive anastomosis with various biliary complications including bile leakage (r= -0,1253; p=0.06), obturation of anastomosis (r=0.045; p=0.501), stricture of anastomosis (r= -0.0665; p=0.320), other strictures of intrahepatic bile ducts (r= -0.0291; p=0.664), hepatolithiasis (r=0.0857; p=0.199). However significant direct correation was observed between stented drainage and incidence of intrahepatic bile ducts strictures (r=0.2117; p=0.046) and anastomosis obturation (r=0.2330; p=0.028) in case of biliobiliary reconstruction. Significant correation with other biliary complications was absent (p>0.05). CONCLUSION: Unconstrained stented drainage during primary biliary reconstruction is associated with increased incidence of biliary complications and should not be indicated routinely. Clear need for drainage should be determined in further investigations.

BONE REGULATORY MECHANISMS DESTRUCTION IN EXPERIMENTAL CHRONIC KIDNEY DISEASE.

The aim of our study was to investigate the role of intercellular mediators ­ interleukin-1 receptor antagonist (IL-1 RA), interleukin-17 (IL-17), receptor activator of nuclear factor kB ligand (RANKL) and osteoprotegerin in the mechanisms of metabolic regulation of renal and bone tissue on model of violations of bone remodeling in chronic kidney disease (CKD). It was found a significant increase in the content of cytokines IL-1 RA (4,207 ± 0,546 pg/ml), IL-17 (33,944 ± 0,938 pg/ ml), osteoprotegerin (28,338 ± 1,223 pg/ml) and RANKL (0,184 ± 0,018 pmol/l) in the serum of animals in violation of bone remodeling in CKD compared with the contents of the studied cytokines in animals in the control group (2,529 ± 0,132 pg/ml, 28,166 ± 0,526 pg/ml, 21,588 ± 0,763 pg/ml and 0,131 ± 0,006 pmol/l, respectively) (P<0.05). The obtained correlations reflect the relationship between regulation of bone remodeling and the development of inflammation in CKD. The imbalance between pro- and anti-inflammatory cytokine plays an important role both in the development of CKD and in processes of bone remodeling.

[The results of biliary reconstructions after liver fragments transplantation].

AIM: To analyze the results of repeated reconstructions of choleresis after living related liver fragments transplantation. MATERIAL AND METHODS: The study included 268 recipients (145 women and 123 men) aged 5 months - 61 years (mean age 16,11 ± 14,62 years) who underwent liver fragments transplantation in the department of liver transplantation of cad. B.V. Petrovskiy Russian Research Surgery Center from 1997 to 2012. Biliary reconstructions were performed at different terms after transplantation in 37 patients (13.81%). Complications followed repeated reconstructions, the initial conditions for biliary anastomosis formation during transplantation, the results of biliary reconstructions after transplantation were analyzed. RESULTS: In most cases despite the prevailing complications there is a combination of various biliary complications requiring biliary reconstruction. It was found that live rfragment used for transplantation, type of primary reconstruction of choler sis, number of bile ducts orifices of graft and biliary anastomoses do not demonstrate statistically significant effect on the incidence of post-transplant biliary reconstructions (p>0.05). Poor prognosis in patients with biliary complications required biliary reconstructionsis determined by the development of graft dysfunction. Early reconstruction before development of liver transplant dysfunction is necessary condition of successful treatment. In the case of graft dysfunction liver retransplantation is unique method of treatment.

[The modern strategy for the treatment of the patients presenting with odontogenic maxillary sinusitis and the oroantral fistula].

The objective of the present study was the comparative analysis of various methods for the plastic correction of the oroantral fistula with the use of the mucosal flap and the osteoplastic materials based on the data from the literature and on-line publkations. The characteristics of an ideal material for the plastic correction ot the oroantral fistula and the conditions for carrying out this surgery are discussed.

[Haemorheological impairments following aortic surgery and methods of correction thereof].

The article deals with the findings concerning alterations in rheological properties of the blood in patients who endured aortic surgery with and without artificial circulation. Also shown herein is the contribution of the plasmatic and erythrocytic components to the development of haemorheological disorders in the postoperative period. To this was added the assessment of the role plasmapheresis plays in correction of impaired blood rheological properties, depending upon the terms of its carrying out and the type of a surgical intervention performed.

[Changes in hemostasis at aortic surgery under conditions of extracorporeal circulation].

This paper describes hemostatic changes in patients who had undergone aortic surgery under conditions of extracorporeal circulation. The changes in the hemostatic system are marked by the thrombophilic condition made up for activation ox blood fibrinolytic activity in the preoperative period. The basic amount of blood loss falls within the first 6 hours after operation. Prolonged hypothermic extracorporeal circulation and the high intraoperative blood loss (over 35 ml/kg bw) lead to an appreciable decrease in antithrombin III and protein C activity which results in activation of disseminated intravascular blood coagulation in the early postoperative period and ineffectiveness of heparin therapy. Secondary hyperfibrinolysis together with combined thrombocytopenia and platelet dysfunction are the basic causes of higher than usual bleeding in patients after aortic surgery under conditions of extracorporeal circulation.

[The evolutionary changes in the amino acid sequences and properties of the ATP-synthase in chloroplasts, mitochondria and bacteria]. / Evoliutsionnye izmeneniia aminokislotnykh posledovatel'nostei i svoistv ATF-sintazy khloroplastov, mitokhondrii i bakterii.

Studies have been made on ATPase from chloroplasts, cyanobacteria and mitochondria of higher plants and animals. No intraspecies and interspecies variability of chloroplast and mitochondrial ATPase was found with respect to pH optimum of the activity, to specificity to cations as substrate components, to sensitivity to stimulating and inhibiting anions and ethanol, to optimal stimulating ethanol concentration. Intergenus variation of these properties of ATPase from chloroplasts, plant mitochondria, and cyanobacteria was revealed. Analysis of homology of the amino acid sequence in ATP-synthase subunits showed that ATP-synthase genes in chloroplast DNA originate from cyanobacterial genome, whereas ATP-synthase genes in plant and animal mitochondria-from genome of Rhodospirillum rubrum or closely related species. It was established that no recombination between the genetic material of chloroplasts and mitochondria took place during evolution.