Nikolay Ivanovich Pirogov (1810-1881): Anatomical research to develop surgery.

The 19th century Russian surgeon Nikolay Ivanovich Pirogov believed passionately in the importance of anatomy for surgeons. His interest in anatomy began as a medical student in Moscow. After graduating in 1828 Pirogov entered the postgraduate German-Baltic University of Dorpat (now Tartu in the Republic of Estonia) where he studied anatomy and surgery. After completing his study, he remained to research the consequences of ligation of the aorta in a series of animal experiments, which formed the core of his doctoral thesis. He wanted to determine the feasibility of aortic ligation as a treatment for patients with an aneurysm of the aorta or iliac artery. He discovered that success was only likely when the aorta was ligated between the two mesenteric arteries and the ligature gradually tightened, an approach surgically difficult in humans. Pirogov then spent 2 years at the Charité Hospital in Berlin before returning to Russia. In 1841, he was appointed Professor of Applied Anatomy and Surgery at the Imperial Medico-Surgical Academy in Saint Petersburg. He instituted the teaching of microscopy and histology to the medical curriculum and in 1846 formed the Institute for Applied Anatomy within the academy, where in addition to teaching medical students future teachers of anatomy in Russia were trained. Pirogov published extensively on anatomy, including several anatomical atlases, the most notable his three-dimensional atlas of topographical anatomy published in four volumes between 1852 and 1859. Today Pirogov's contributions to anatomy are remembered in a number of anatomical structures named after him. Clin. Anat., 33:714-730, 2020. © 2019 Wiley Periodicals, Inc.

[Efim Anatolyevich Dyskin - the hero of the Defence of Moscow (To the 75th anniversary of the Battle of Moscow 1941-1942)].

Efim Anatolyevich Dyskin - the hero of the Defence of Moscow (To the 75th anniversary of the Battle of Moscow 1941-1942). Efim Dyskin - one of the first artilleryman, who awarded the title of Hero of the Soviet Union for a feat accomplished in the Battle of Moscow. After the war he finished the Military Medical Academy and later became a prominent domestic scientist - anatomist and morphologist, head of the general anatomy department, teacher of high school, Major General of the Medical Service. He created a scientific morphological school that developed guidelines for the features of the morphology of the different species of a gunshot wound and the impact of extreme factors of the military working on the body brow-century. Under the leadership of E.A.Dyskin conducted research on. the status of collateral circulation, functional anatomy of the digestive system, craniology, histoty of military medicine and the Military Medical Academy.

Effects of allogenic fetal pancreatic tissue transplantation on regeneration of islet cells in recipient rats with alloxan-induced diabetes mellitus.

The linear parameters and number of Langerhans islets were evaluated in rats with alloxaninduced diabetes mellitus after transplantation of fetal pancreatic tissue to the anterior chamber of the eye. The islets significantly increased in size by week 3 after surgery and a trend to an increase in their number was observed.

[The peculiarities of petrotympanic fissure topography in Costen syndrome and possible causes of its development].

A complex study of morphometric characteristics of the articular surfaces of the temporomandibular joint and the examination of the peculiarities of the petrotympanic fissure topography were performed on 138 samples of skulls of adult individuals with intact occlusion, complete anodontia and different forms of cranial skull (dolicho-, meso- and brachicranial). No distinct differences in studied parameters were found between the studied groups. However, in the hypsicranial group the petrotympanic fissure was found to pass more often through the medial third of the mandibular fossa, which may be a predisposing anatomical factor for Costen syndrome. Due to the fact that in anodontia the parameters characterizing the articular surfaces of the temporomandibular joint, are significantly changed, the immediate cause of the Costen syndrome are the changes of the articular surfaces of the temporomandibular joint, primarily the reduction in the size of mandibular condyle, which is accompanied by its pathological displacement and compression of the chorda tympani.

[Morpho-functional characteristic of the lateral vaults of the epidural space of the spinal cord and their clinical significance].

The study of the epidural space was performed on 362 samples of the vertebral column obtained from the fetuses aged from 16 weeks, newborns, children and adult persons aged up to 90 years, using anatomical and histological methods. Within the lateral parts of the epidural space, the lateral vaults were distinguished. A new anatomical interpretation of these structures is proposed, considering them as a complex of anatomical structures including the periosteum of the intervertebral foramen, the sleeve of dura mater, intervertebral veins, spinal arteries, adipose tissue, the system of the connective-tissue trabeculae, recurrent nerves controlling the blood flow in the vascular system of the vertebral channel and promoting the communication of the epidural space with the paravertebral areas.

[The anatomical basis of the formation of the pedicled bone grafts on the upper extremity].

The study of the vascular bed of the upper extremities was performed by the method of anatomical preparation of 24 formalin-fixed cadaver specimens from 5 men and 7 women and by the injection of black latex into the arterial bed of 4 male and 4 female cadavers (16 specimens). The arteries, directly feeding the bones, and the arteries that provide blood supply to the muscles, attached to the bones, were studied. M. pectoralis major, m. pronator teres, m. pronator quadratus, mm. lumbricalis and interosseus were examined. These studies were followed by the experimental surgeries during which bone grafts on vascular pedicle were formed and moved. It was found that the feeding arteries of the bone grafts on musculo-vascular pedicle were: on the clavicula--the branches of a. thoracoacromialis, on the brachium--muscular branches of a. brachialis, on the proximal parts of forearm bones--muscular branches of a. radialis and ulnaris, on the distal parts of forearm bones--the branches of a. interosseous anterior, on the metacarpal bones--the branches of aa. metacarpalis palmaris and dorsalis. The size of the bone transplants is determined by the size of the defect of recipient field and varies from 3 to 8 cm. The displacement of vascularised bone graft can be made over the distance from 4 to 8 cm.

[Morphological changes of hemomicrocirculatory bed of the organs of rat masticatory apparatus after the exposure to general vibration and during pharmacologic correction].

The effect of chronic exposure to general vibration on the state of hemomicrocirculatory bed in the organs of rat masticatory apparatus and the efficacy of antihypoxants and adaptogens for its pharmacological prophylaxis was studied. The experiments were performed in 210 albino male rats aged 8 to 30 weeks. The intact rats served as control. Transcapillary injections with 1% collargol solution, histological, electron microscopic and morphometric methods were used. It was found that chronic exposure to general vibration induced a hemodynamic disturbances at the level of hemomicrocirculatory bed vessels in the organs of masticatory apparatus with subsequent hypoxia. Electron microscopic study revealed the damage of the cellular ultrastructure in the endotheliocytes of blood vessels of the hemomicrocirculatory bed. Antihypoxants, adaptogens and their combinations demonstrated a pronounced protective effect

[Morphometric characteristics of the hemomicrocirculatory bed vessels in rat colon in large bowel obstruction and after its resolution].

The results are presented that describe the experimental study of colonic hemomicrocirculatory bed (HMCB) in intact rats, in animals 6 days after large bowel obstruction development that was modeled using the device created by the authors, and 1-15 days after its resolution. The most significant changes were observed in the capillaries and HMCB venular portion--capillary diameter was increased by 60-100%, while that of venules--by 73% as compared to those in control group. The degree of changes depended on the distance from the extraorgan bowel compression site. The dynamics of the normalization of morphometric parameters after colon obstruction resolution was demonstrated. It was found that the average arteriolar and venular diameters reached the initial level by day 5, while that of the capillaries by day 7 after colon obstruction resolution.

[Variant anatomy of penile venous vascular bed in adult man].

The methods of anatomical preparation and X-ray examination were applied after the preliminary injection of blood vessels with the setting and radio-opaque masses, to study the variant anatomy of penile vascular bed. Organ complexes of minor pelvis and perineum, obtained from 54 cadavers of adult men, were used. It was found that the architecture and the places of the confluence of the main veins of penis are very variable. The trunks of the superficial and deep dorsal vein (DDV) may be single or double. Venous trunks tare connected by a network of anastomoses, more developed in the root of the penis. Valve apparatus in the anastomotic veins is presented only in 80% of the observations. Under normal conditions, the valves of the anastomotic veins provide the outflow of blood in DDV of the penis. The data obtained are of practical importance for understanding the anatomical causes of erectile dysfunction of venous origin.

[Comparative characteristic of craniometric and computed tomography studies of the mandible structure in applied aspect of dental implantation].

The series of 60 computed tomography scans of maxillofacial area performed in frontal projection, were used to study the peculiarities of mandible structure. The values of mandible morphometric parameters obtained with craniometric method and by computed tomography, were compared. The scope of computer-aided tomography in the evaluation of mandible structure variability was examined. The method of computer-aided tomography makes it possible to receive the data on mandibular corpus height and thickness and on the inclination angle of its alveolar part in the area of prospective surgical operation, as well as on the anatomic-topographical interrelations between teeth root apical portions and mandibular canal.

[Sex- and age-related peculiarities of the morphometric characteristics of the lower part of facial skull in the adult persons].

Age-related changes and sexual differences of some of the morphometric characteristics of the lower part of facial skeleton were studied. It was shown that the height of the face lower part in the skulls with intact orthognathic occlusion remained unchanged during the age period from 22 to 70 years. In both men and women with full dentition and orthognathic occlusion aged from 22 to 35 years, the significant decrease was observed in the angle of the ramus of mandible due to the bone tissue formation in this region. The parameters of the height of the ramus of mandible, the projection height of the mandibular condylar process, and the least width of the mandibular ramus in men and women have significant age- and sex-related differences.

[Morphometric parameters of facial cranium asymmetry in adult man].

This investigation was aimed at the evaluation of the morphometric characteristics of the contralateral sides of the facial cranium in adult men and women, the evaluation of asymmetry manifestation degree and the detection of most frequent zones of its localization. The study was conducted on 180 crania (90--male, 90--female) of the adults of I and II mature age periods. To detect the asymmetry of the facial cranium, the original "fan" principle of morphometry was developed. This approach has shown the asymmetry in the area of localization of different "fans" ("superior", "inferior", "lateral"), i.e., in the different regions of the facial cranium. On the basis of the data obtained, it can be concluded that in order to identify the asymmetry of the facial 1 cranium and to estimate the asymmetry manifestation degree it is expedient to take into account the following parameters: the distance from a nasion point to a point on the lateral edge of apertura piriformis, from a nasion point to a frontomolare-temporale point, from a zygomaxillare point to a lateral point on naso-frontal suture, from a zygomaxillare point to a dacryon point, from a subspinale point to a nazomaxillare point and from a subspinale point to a lateral point on naso-frontal suture. As in the series of the male crania asymmetry of the facial cranium was significantly more expressed than in the series of female ones, it is assumed to be associated with the different tone of mimic muscles.

[Morphometric characteristics of lumbar vertebrae of adult individuals and the feasibility of their body volume prediction in percutaneous vertebroplasty].

Using the material obtained from 96 human corpses (480 skeletal vertebra), the linear parameters of vertebra were studied. The research objective was to study morphometric characteristics of lumbar vertebra of an adult person taking into consideration the individual and sexual variability, and to estimate the feasibility of calculation of a vertebra body volume with reference to percutaneous vertebroplasty. The results of research have demonstrated the general patterns of modification of linear and volumetric parameters of L(I)-L(V) vertebra; it was shown that the values of linear parameters for the male samples were bigger than those for the female samples. The length of an axis of operational action, the linear and angular sizes of pedicles of vertebral arch were independent on gender factor, but, as a rule, gradually changed from L(I) to L(V). On the basis of comparison of the calculated and measured volumes of lumbar vertebra bodies, it is concluded that the mathematical model proposed by us has sufficiently high accuracy.

[Potentialities of intravital methods of the evaluation of morphometric pelvic characteristics in adult persons].

Comparative assessment of posthumous and intravital methods of morphometric study of the pelvis in adult persons was performed in 110 embalmed anatomical specimens and in 81 patient. It was proved statistically, that magnetic resonance tomography and spiral computer tomography (SCT), performed following definite algorithm, appear to be highly informative methods for the evaluation of pelvimetric parameters. They permit to define various osseous landmarks with high precision and to perform the measurements of linear metric pelvic parameters. On the basis of the data obtained, various pelvimetric indices that characterize bony pelvis shape, could be reliably calculated. Moreover, SCT together with shade surface reconstruction in different projections permits to demonstrate visually the 3D shape of the pelvis or its separate fragments and to evaluate the symmetry, presence or absence of bone structural deformations.

[Pathogenetic features of respiratory distress syndrome in newborns with extremely low body weight].

Congenital atelectasis and ascending infection around the fetuses were of importance in the pathogenesis of respiratory disturbances in 38 newborns with extremely low body weight.

[Choice of a method of plasty of the anterior abdominal wall in patients with postoperative ventral hernias].

The individual characteristics of the structure of the anterior abdominal wall were studied for revealing the anatomical preconditions for the formation of postoperative ventral hernias in order to substantiate efficient methods of surgical treatment. It was established that patients with brachiomorphous build had anatomical features facilitating the formation of ventral hernias. The greatest strength of the fascio-aponeurotic complex of the anterior abdominal wall is characteristic of patients with a dolichomorphous constitution, while the least strength of the fascio-aponeurotic complex of the anterior abdominal wall is characteristic of patients with brachiomorphous constitution. Patients with the dolicho- and mesomorphous constitution having postoperative ventral hernias can undergo plasty of the hernial gates with the local tissues. Patients with brachiomorphous constitution after elimination of the postoperative ventral hernias need the strengthening of the anterior abdominal wall with cellular explants.

[Intramural nervous apparatus of jejunum and rectum in experimental portal hypertension]. / Intramural'nyi nervnyi apparat toshchei i priamoi kishok pri éksperimental'noi portal'noi gipertenzii.

Using histological and electron microscopical methods, the state of intramural nervous structures of jejunum and rectum was studied in 92 dogs with experimental portal hypertension. Three phases of changes of portal pressure were detected and its influence upon the intramural nervous apparatus was observed. In phase 1 (first 4-5 days after the surgery) the reactive changes of the nervous apparatus were shown that were more pronounced in jejunum. In phase 2 (day 5 to 2.5 months) the portal pressure was shown to drop; this was accompanied by some signs of regeneration in jejunum and by an aggravation of destructive processes in rectum. In phase 3 of the repeated rise of portal pressure (2.5 to 6.5 months after the surgery), destructive changes in the nervous apparatus were demonstrated that were similar to those found in phase 1. However, the differences in the reaction of nervous structures in different layers of intestinal tube and the heterogeneity of the changes of the nervous apparatus in jejunum and rectum were absent. The association of time of appearance and of severity of structural changes with the elevation of portal pressure suggests the significant role of vascular factor in the morphogenesis of alterations observed in phase 3 of hemodynamic changes.

[Local and individual features of angioarchitectonics of the stomach and their significance in manifestation of bleedings]. / Lokal'nye i individual'nye osobennosti angioarkhitektoniki zheludka i ikh znachenie v proiavlenii krovotechenii.

The investigation has shown that on the lesser curvature in the area of the body and cardial part of the stomach there is a 2.3+/-0.3 cm section where there are no large branches of the left gastric artery and tributaries of the coronary vein. In the antral portion of the stomach such a section is not determined. Here there are terminal branches of the posterior descending and right gastric arteries. However, the diameter of these arteries when introduced into the gastric wall is rarely more than 1 mm. In addition, the arterial loops of the first and second order are formed on the anterior and posterior walls of the antral portion by the arteries of less diameter than in other parts of the stomach. In cases of the bleeding complicating the gastric ulcer it can be observed from any part of blood circulation, but the severity of bleeding is mainly dependent on the erosion of the arterial vessels. Hence, the site of the ulcer in the zone of the invasion of large arterial vessels into the gastric wall and their presence in the crater in the endoscopy picture should incline the surgeon to operative intervention.

[Ileoascendoanastomosis]. / Ileoastsendoanastomoz.

A complex anatomical investigation of the extra- and intra-organic vessels of the ascending colon has shown that the formation of ileoascendoanastomosis is possible and expedient without a preliminary intraoperative assessment of the vascular bed. The indications to such operation are developed. The extirpation of the blind gut and resection of the ascending colon with applying the anastomosis in question was performed on 6 patients with carcinoma of the blind gut and ascending colon. The results of operations were good.