[Atresia of the first segment of the subclavian artery in a 41-year-old woman with no other developmental abnormalities].

Presented in the article is a clinical case report concerning a 41-year-old female patient with atresia of the first segment of the subclavian artery without combination with other defects and developmental disorders. Described are the process of making the diagnosis and the course of the operative intervention performed, i.e. carotid-subclavian bypass grafting. This is followed by assessing the early postoperative period and immediate therapeutic results.

[STRUCTURAL ABNORMALITIES OF THE OBSTRUCTED URETEROVESICAL JUNCTION].

The article presents a morphological study of UVJ removed during surgery in 110 children with stage III hydronephrosis. Morphological changes in resected UVJs indicate a predominance of sclerotic transformation accompanied by different types of dysplasia.

[Evaluation of compensation abilities of kidneys using radionuclide examination].

The article presents the results of evaluation of compensation abilities of kidney based on the identification of volume of functioning renal tissue according to the single-photon emission scintigraphy (SPECT) and planar scintigraphy. The study included adult patients (65 patients with renal cell carcinoma, 32 patients with renal cysts and 20 patients without renal involvement) and pediatric patients aged 1 to 17 years (57 patients with various non-neoplastic lesions of the kidney). The following parameters were used: volume ratio of functioning tissue and the specific activities of the affected and contralateral kidneys, and the volumetric ratio of volumes estimated to the reference kidney volume depending on anthropomorphic data of patient (age and sex). It was found that the maximum compensatory renal reserve occurs in the case of reducing the volume of functioning tissue of the affected kidney and the simultaneous increase in the volume ofcontralateral kidney.

[Endoscopic treatment of vesicoureteral reflux in children].

The one of the most common defects of the ureter-vesical segment in children is the condition, leading to a disorder of obturative function of this segment. Complications of vesicoureteral reflux include continuously recurrent pyelonephritis, reflux nephropathy. In this regard, the choice of the optimal treatment strategy based on minimal invasion is considered as one of the priorities of pediatric urology. The article presents the data obtained during the treatment of VUR in children of different ages in the Clinic of Reproductive Health FSBSI SCCH. A comparative evaluation of the results of endoscopic correction of vesicoureteral reflux depending on the kind of the bulking agent was performed. It was found that the use of endocorrection of reflux is highly effective surgical procedure, with the high number of positive results against the background of use of bulking agent "vantris". The study discriminates a group of patients with vesicoureteral reflux, intractable for endoscopic correction with cystoscopically normal structure of the orifices that allows to refer this method to the initial stage of treatment of the disease.

The structure of deoxy- and oxy-leghaemoglobin from lupin.

The leghaemoglobins have oxygen affinities 11 to 24 times higher than that of sperm whale myoglobin, due mainly to higher rates of association. To find out why, we have determined the structures of deoxy- and oxy-leghaemoglobin II of the lupin at 1.7 A resolution. Results confirm the general features found in previous X-ray analyses of this protein. The unique feature that has now emerged is the rotational freedom of the proximal histidine. In deoxy-leghaemoglobin the imidazole oscillates between two alternative orientations, eclipsing either the lines N1-N3 or N2-N4 of the porphyrin; in oxy-leghaemoglobin it is fixed in a staggered orientation. The iron atom moves from a position 0.30 A from the plane of the pyrrole nitrogen atoms in deoxy- to a position in the plane in oxy-leghaemoglobin while the Fe- bond distance remains constant at 2.02 A. The Fe-O-O angle is 152 degrees, as in human haemoglobin. The oxygen is hydrogen-bonded to the distal histidine at N epsilon 2-O1 and N epsilon 2-O2 distance of 2.95 A and 2.68 A, respectively. The porphyrin is ruffled equally in deoxy- and oxy-leghaemoglobins, due to rotations of the pyrrols about the N-Fe-N bonds, causing the methine bridges to deviate by up to 0.32 A from the mean porphyrin plane. The only feature capable of accounting for the high on-rate of the reaction with oxygen are the mobilities of the proximal histidine and distal histidine residues in deoxy-leghaemoglobin. The eclipsed positions of the proximal histidine in deoxy-leghaemoglobin maximize steric hindrance with the porphyrin nitrogen atoms and minimize pi-->p electron donation, while its staggered position in oxy-leghaemoglobin reverses both these effects. Together with the oscillation of the imidazole between the two orientations, these two factors may reduce the activation energy for the reaction of leghaemoglobin with oxygen. The distal histidine is in a fixed position in the haem pocket in the crystal, but must be swinging in and out of the pocket at a high rate in solution to allow the oxygen to enter.