A 16-Year-Old Ukrainian Boy Shot at Close-Range to the Back of the Neck with a Handgun Who Required Surgical Removal of a 9×18-mm Bullet Shell from the Left Posterior Maxilla and Recovered Following Physical Therapy.

BACKGROUND The conflict in Ukraine during the past year has resulted in increased deaths and injuries to soldiers and civilians from military weapons and large and small caliber firearms. Unlike clinicians in some Western countries, until recently, clinicians working in Ukraine hospitals had little experience managing patients with gunshot wounds. CASE REPORT A 16-year-old boy was admitted as an emergency following a gunshot wound to the back of the neck from a Makarov pistol. The gun was reported to have been fired at a distance of more than 15 cm. Imaging showed the 9-mm bullet hit the cervical spine, causing nerve root involvement at C4 to C7, traveled upwards, and lodged in the left posterior maxilla. On examination, the patient had facial asymmetry and paralysis of the left shoulder, arm, hand, and wrist and was in pain and shock. Intubation and emergency surgery were performed, with the removal of a 9×18-mm bullet shell from the pterygopalatine fossa, deep to the infratemporal fossa, and posterior to the maxilla. The patient underwent postoperative physical therapy and continues to improve his physical function. CONCLUSIONS This report has shown the importance of immediate evaluation of gunshot wounds so that surgery can be planned and performed rapidly, with a view to postoperative recovery and active physical therapy.

Determination of CCL2 / MCP-1 levels in the serum of children with melanocytic nevus in the postoperative period after using different methods of surgical treatment.

To date, there are many methods and ways to remove pigmented skin tumors, which have their own indications and contraindications for use, early or late complications.The aim of the study was to determine the level of CCL2 / MCP-1 in the serum of patients with melanocyte skin nevi in the postoperative period with different methods of their removal.Materials and methods of research. The study involved 60 children with melanocyte skin nevi of different localization, who were hospitalized in the pediatric surgery clinic in the period from 2018 to 2020. All patients were divided into 3 groups : I group - the excision of the formation took place with a scalpel, group II - excision of the formation was performed using a high-intensity surgical laser, group III - excision of the formation using a high-frequency electrosurgical device "BOWA-ARC 350.Results and discussion. The results of studies showed an increase in the level of CCL2 / MCP-1 in the plasma of patients of group I in 2,6 times 12 hours after surgery and 3,15 times in 24 hours after surgery. A similar dynamics of increase in the level of CCL2 / MCP-1 in plasma was observed in patients of group II, but was more pronounced. The largest increase in CCL2 / MCP-1 levels was in comparison group III.Conclusions. High levels of CCL2 / MCP-1 in the plasma of patients of groups II and III 12 and 24 hours after surgery convincingly indicate the presence of a pronounced inflammatory reaction under the influence of thermal damaging factor on skin tissues.

ASSESSMENT OF THE INFLUENCE OF UTERINE APPENDAGES TORSION ON THEIR PATHOMORPHOLOGICAL CHANGES IN THE EXPERIMENT.

OBJECTIVE: The aim: The study of pathomorphological changes in uterine appendages during torsion of different duration and after their detorsion in the experiment on rats. PATIENTS AND METHODS: Materials and methods: Experimental studies were performed on the basis of vivarium in the conditions of chronic experiment on 48 females of outbred white rats weighing 200.0 ± 20.0 grams.The essence of the experimental model is that the female rats, under the ketamine's anesthesia at the rate of 1-2 mg / kg of the drug, conduct a right-sided ovary twist at 7200 in the projection of the oviduct with fixation of the organs with an external clip of indifferent metal. RESULTS: Results: After ovarian detorsion, until 72 hours after its torsion, reliable reversible restoration of the structural components of the ovary is determined as a positive consequence of the effect of the correction factor (detorsion). CONCLUSION: Conclusions: The data obtained in the experiment showed that there was a discrepancy between the macroscopic features of the twisted uterine appendages and the microscopic changes in their morphological examination. Despite the presence of external signs of necrosis in the tissue of the uterine appendages, after the detorsion and the restoration of blood flow in them, studies have shown the possibility of performing organ-saving surgical operations in the torsion of the uterine appendages.

A case of congenital infantile fibrosarcoma in a newborn.

Infantile fibrosarcoma is a malignant tumor, which is most common in infants, preferentially localized in the lower limbs. An important prognostic factor of the disease is early diagnostics, both clinical and instrumental. The operative treatment of infantile fibrosarcoma is a leading treatment method. The article describes a clinical case of infantile fibrosarcoma in a newborn with fetal development of the disease.