SURGICAL TREATMENT RESULTS IN PATIENTS WITH PELVIC BONE TUMORS IN CASES OF PREOPERATIVE 3D MODELING USE. / REZUL'TATY KhIRURGIChNOGO LIKUVANNIa U KhVORYKh Z PUKhLYNAMY TAZOVOÏ KISTKY ZA VYKORYSTANNIa PEREDOPERATsIY̆NOGO 3D-MODELIuVANNIa.

The use of computer and magnetic-resonance therapy permits high accuracy visualization of tumor lesion zone in patients with pelvic bone tumors. More precise results concerning lesion zones before surgical intervention have been obtained in cases of 3D modeling use. OBJECTIVE: improvement of surgical treatment results due to determination of the optimal level for pelvic bone resection. MATERIALS AND METHODS: Cohort study was realized using 3D modeling based on computer tomography data applying the software packet RadiAnt DICOM Viewer with 3D Volume Rendering and the software packet «SolidWorks¼. Two patient groups were investigated: 1) 13 patients without preliminary preoperative 3D modeling (control group) and 2) 14 patients with modeling (main group). In both groups relapse-free survival and age-dependent survival were evaluated. RESULTS AND DISCUSSION: Tumor relapses were found in 6 patients (46.15 %) of control group and in 5 patients (33.33 %) of the main group. No statistically significant difference between groups concerning relapse-free survival results was detected. In both groups, medians of relapse-free survival were not obtained, two-year long relapse-free survival reaching (53.8 ± 13.8) % and (66.7 ± 12.2) % in control and main groups, respectively. Analyzing the cor- relation between patients age and results obtained the authors demonstrated the two-year relapse-free survival to reach (47.4 ± 11.5) % and (88.9 ± 10.5) % in patients aged above 40 and below 40, respectively (p = 0,06). CONCLUSION: Because of small sample sizes in both groups, the use of 3D modeling does not demonstrate any signif- icant difference regarding two-year relapse-free survival. However, there is a tendency for further progress. The search of approaches for improvement of the treatment results for pelvic bone tumor patients remains among the most important study problem in current orthopedics for tumor patients.

[Biomechanical aspects of efficiency of Latarjet's surgery for habitual dislocation of the shoulder in the bones fractures].

Biomechanical substantiation of efficiency of the Latarjet's operation in patients, suffering habitual dislocation of the shoulder while osteal tissue affection, was done, basing on retrospective analysis of clinico-roentgenological indices and the magnet resonance tomography (MRI) data. The data were compared among patients, to whom for habitual dislocation of the shoulder a stabilization of the shoulder joint was performed in accordance to Latarjet's method, and the results of biomechanical experiment--determination of the stress-strain state (SSS) of the shoulder joint structures in conditions of defect of the joint depression of scapula (JDS) and the Hill-Sax damage, using the method of a definitely-elemental (DE) imitational computeric modelling. In the upper extremity abduction by 90 degrees the maximal indices of SSS on surface of JDS, while presence of the defect, measuring 30% of common area, before the Latarjet's operation have exceeded their postoperative values by 198.7%; while abduction of upper extremity by 90 degrees and its external rotation by 45 degrees--by 286.8%; while abduction of the upper extremity by 90 degrees and its external rotation by 90 degrees--by 346.5%.

[Risk factors of development of left ventricular hypertrophy in patients with hypertensive disease with high compliance to treatment].

Aim of the study was to assess rate of development of left ventricular hypertrophy (LVH) and its risk factors in patients with hypertensive disease (HD) without target organs damage with high compliance to treatment. We included in this prospective cohort study 428 patients with HD without target organs damage. Duration of follow-up was 8.8+/-2.6 years. Rate of LVH development was 36.9%. It was more frequent in men (41.3%) than in women (32.7%). Intensity of antihypertensive therapy was higher in a group of patients with with left ventricular remodeling. Risk of development of LVH was associated with age especially in men older than 55 years, duration of hypertension, body mass, initial level of diastolic blood pressure, pulse blood pressure, level of low density lipoprotein cholesterol, and fasting level of glucose in blood plasma. Thus in patients with HD rate of LVH development at the background of high compliance to treatment is lower than in total population and has definite specific patterns.

[Efficacy and safety of enoxaparin use during drug-eluting stents implantation].

We assessed possibility of the use of low molecular heparin enoxaparin during percutaneous coronary interventions (PCI) with implantation of drug eluting stents. Enoxaparin was administered to 225 (0.3 mg/kg intraarterially via catheter) and 215 (0.5 mg/kg intravenously) patients. In comparison group (n=207) we used unfractionated heparin (UFG) intravenously according to standard scheme under control of activated clotting time. Stents implanted (n=797) were Cypher, Taxus, and Endeavor. Immediate angiographic success was 100%. During 48 hours after PCI pronounced bleeding (4.3%) and blood transfusions predominated in UFG treated patients. Number of bleedings was minimal after the intra-arterial use of enoxaparin (0.3 mg/kg). However total rate of all adverse events after PCI turned out to be minimal (7.0%) in the group of patients receiving enoxaparin intravenously (0.5 mg/kg). Thus the use of low molecular heparin enoxaparin is justified during implantation of drug eluting stents. Its optimal dose according to data obtained is 0.5 mg/kg intravenously.

[Effect of support removal on pre-saccadic EEG potentials in test-subjects with various asymmetry profiles].

Saccades and slow pre-saccadic potentials were investigated in 12 volunteered test-subjects (7 subjects with the leading right eye (RE-group) and 5 subjects with the leading left eye (LE-group) before and after 6-d DI experiment. Visual stimulation was provided with 3 LEDs one of which was located centrally in the field of vision and the other two - 10 degrees left and right along the horizontal axis. The subjects performed the test for antisaccades requiring to produce saccades toward a point symmetrical to displayed stimulus. EEG (monopolar in 19 standard leads) and electrooculogram were registered. Peripheral stimulus activation served as a trigger for backward averaging as a method to obtain slow pre-saccadic potentials (PSPs). Testing before immersion did not reveal any noteworthy differences in saccades produced by the members of both groups. At the same time, amplitude of pre-saccadic negativity (PSN) in LE-group was lower, especially in the frontal region of head, and distinguished by apparent asymmetry throughout the period of analysis. In immersion, latent saccades and percentage of erroneous reactions did not change in the RE-group but increased in the LE-group. Both groups reduced the PSN amplitudes shifting PSN to the right cerebral hemisphere; differences between the groups were masked by immersion. The RE-group was marked by a reliable decline of the PSN amplitude in the frontal leads due to, probably, sensory disintegration and reduced tonic afferentation in immersion. In the LE-group, maximum PSN amplitude was registered in the central region of head equally before and during immersion.

[Restenosis after bare-metal stents implantation in small coronary arteries.].

Potential of bare uncoated metal stents in prevention of restenosis in coronary arteries with diameter of 2.2-3.0 mm in comparison with balloon angioplasty (BA) was studied in 426 patients with ischemic heart disease (mean age 58+/-11 years, 16% women, 8% with diabetes, total cholesterol 211+/-44 mg/dl, all received aspirin and clopidogrel). BA was carried out in 214 patients (mean artery diameter 2.45+/-0.25 mm) and coronary stenting (CS) - in 212 patients (mean artery diameter 2.43+/-0.27 mm). Immediate success rate was 85.5 and 96.2% in BA and CS groups, respectively (p<0.001). When complementary methods of revascularization were taken into account success rate of the whole intervention was 100% in both groups. Inhospital cardiovascular complications developed in 3.7 and 2.8% of patients in BA and CS groups, respectively (p=ns). During 6 months of follow-up rates of target vessel restenosis and repeat percutaneous interventions were 24.3 and 15.6% (p=0.034) while total rate of complications related to target vessel was 36.9 and 26.9% in BA and CS groups, respectively (p=0.035). Thus CS compared with BA in patients with low risk of restenosis development in small coronary arteria provides better immediate, inhospital and remote results.

[The use of intraaortic balloon counterpulsation in patients with acute myocardial infarction]. / Primenenie vnutriaortal'noi ballonnoi kontrpul'satsii u bol'nykh ostrym infarktom miokarda.

Intraaortic balloon counterpulsation was implemented in 11 patients with acute myocardial infarction and 1 patient with unstable angina. All patients had severe multivessel coronary artery disease. In 9 patients counterpulsation was used in conjunction with percutaneous transluminal coronary angioplasty, in 3 - with thrombolytic therapy. During hospitalization 2 patients died of progressing heart failure, while significant improvement of hemodynamic parameters occurred in other patients. Thus intraaortic balloon counterpulsation used in combination with angioplasty and thrombolytic therapy is an easily accessible highly effective method of treatment of cardiogenic shock in patients with acute myocardial infarction

[Heart failure in acute myocardial infarction: comparing infusions of nifedipine and nitroglycerin]. / Serdechnaia nedostatochnost' v ostroi faze infarkta miokarda: sravnitel'naia otsenka infuzii nifedipina i nitroglitserina.

The impact of intravenous infusion of nifedipine and nitroglycerin on invasive central hemodynamic parameters and microcirculation was compared in 94 patients with acute myocardial infarction complicated by heart failure. The artery dilating effects of nifedipine were associated with baseline peripheral vascular tone, so the comparison was made separately in the groups with and without vasoconstriction. Nifedipine seems to be beneficial in the management of heart failure due to acute myocardial infarction in patients with systemic vasoconstriction. In patients with severe pulmonary congestion and normal left ventricular afterload, the intravenous vasodilators are preferable.

[Constant-frequency trans-esophageal electric atrial stimulation for evaluation of the severity of illness in patients with stenocardia and the anti-angina effect of erinit]. / Chrespishchevodnaia élektrostimuliatsiia predserdii s postoiannoi chastotoi v otsenke tiazhesti sostoianiia bol'nykh so stenokardiei i antianginal'nogo éffekta érinita.

Constant-frequency transesophageal atrial pacing was used in 87 patients with coronary heart disease concurrent with stable angina pectoris of various functional classes (I-IV). This technique, as a bicycle ergometric test, allows one to assess the functional class of patients with angina and to ascertain the antianginal effect of agents, which was exemplified by erinit given in doses of 80 and 120 mg.

[Ceruloplasmin activity in blood serum in stomach and duodenal ulcers]. / Aktivnost' tseruloplazmina syvorotki krovi pri iazvennoi bolezni zheludka i dvenadtsatiperstnoi kiski.

An examination of 100 patients with ulcer disease of the stomach duodenum and 20 practically healthy people has shown that the level of extracellular antioxidant enzyme defense (ceruloplasmin) is higher than those in practically healthy people. This dependence was most pronounced in the group of patients requiring surgical interventions. In the process of treatment the level of ceruloplasmin activity gradually decreased, without reaching normal values. The level of ceruloplasmin activity in patients with ulcer disease of the stomach and duodenum are thought to characterize the state of compensatory reactions in these patients.

[Various aspects of diagnosis and treatment of functional intestinal obstruction]. / Nekotorye aspekty diagnostiki i lechenie funktsional'noi neprokhodimosti kishechnike.

Functional activity of the mediation cholinergic system (MChS) was studied in experiment in animals as well as in patients after appendectomy, gastric resection for ulcer disease of the stomach and duodenum, cholecystectomy. Clear changes of biochemical characteristics were established in the system of neurohumoral regulation during the first day of the development of functional intestinal obstruction. In later terms of development of the disease the progressing disturbance of balance in the MChS was responsible for the decompensated state of the organism and suppression of the motor function of the intestine. Drugs such as Desoxypeganin hydrochloride and Primperan must be included in curative measures.

[Treatment of acute, experimental intestinal obstruction]. / O lechenii éksperimental'noi ostroi neprokhodimosti kishechnika.

The effect of antienzyme drug hordox in the complex with antioxidant tocopherol acetate (vitamin E) upon the duration of life in rats with experimental strangulating ileus was studied. Animals given this drug were found to survive approximately 27 hours longer than those of the control group.