[Innovations in forensic medicine: accuracy, evidence and effectiveness of expertises in emergencies in case of mass fatality]. / Innovatsii v sudebnoi meditsine: dostovernost', dokazatel'nost' i effektivnost' provodimykh ekspertiz v usloviyakh chrezvychainoi situatsii pri massovoi gibeli lyudei.

The article presents the main innovative methods used in forensic expert practice at the current stage, reveals the principle and algorithms of the developed software complex for registration and identification of the deceased. The proposed program automatically generates four documents, which reduces the time required for forensic expertise in the conditions of mass admission of deceased. The article's authors substantiate prospects of further application of computer technologies in forensic practice to improve organizational and methodological activities in emergencies with a large number of deceased.

[Method of determining disease severity in women with pelvic varicose veins]. / Sposob opredeleniia tiazhesti zabolevaniia u patsientok s varikoznoi bolezn'iu taza.

BACKGROUND: Using assessment scales in clinical and research practice is one of fundamental reference methods of evaluation in human pathological states. Pelvic vein varicosity is an independent nosological entity within the framework of chronic vein diseases. Currently, the clinical methods of assessment in the aspect of a patient-oriented approach in this type of disease are largely understudied and still not duly defined. AIM: The study was aimed at analyzing clinical outcomes of surgical treatment in the form of resection of the ovarian vein in female patients with pelvic varicose veins, based on the developed specialized scale of clinical assessment of disease severity. PATIENTS AND METHODS: We carried out an open prospective study of efficacy of resection of the ovarian vein in 37 women with pelvic varicose veins. The main criterion for assessment was a clinical method of determining manifestations of the disease by means of the Pelvic Venous Clinical Severity Score. RESULTS: According to the Pelvic Venous Clinical Severity Score, improvement of the condition was observed in 36 (97.3%) operated female patients and 1 (2.7%) woman turned out to have negative dynamics. The median of the composite score of the severity scale decreased form 11.78±5.06 points to 5.22±3.19 (p<0.05). The total positive gradient of the score amounted to 6.57±3 .65 points. A significant decrease in manifestations of severity was observed for 9 of the 10 clinical descriptors of the disease. CONCLUSION: The use of the suggested scale in practical assessment of the results made it possible to prove high efficacy of resection of the ovarian vein in women with pelvic varicose veins in the form of decreased intensity of the disease's symptomatology. The VCSS is an easy-to-fill-in tool, taking up little time, ensuring no influence of the physician's personality on the answers, presenting quantitative expression of therapeutic results.

[Endovascular treatment of women with pelvic varicose veins due to post-thrombotic iliac vein lesion]. / Éndovaskuliarnoe lechenie patsientok s varikoznoi bolezn'iu taza, obuslovlennoi posttromboticheskim porazheniem podvzdoshnykh ven.

BACKGROUND: Post-thrombotic iliac vein lesion is one of the causes of secondary pelvic varicose veins (PVV) in women. Endovascular treatment of this cohort of patients requires further studies. AIM: The study was undertaken to investigate the aspects of endovascular treatment of female patients diagnosed as having PVV secondary to post-thrombotic alterations of the iliac veins. PATIENTS AND METHODS: Presented herein are the results of diagnosis and treatment of nine women suffering from PVV in obstructive lesion of the iliac veins. All patients underwent phlebography with stenting of the iliac veins, followed by clinical and instrumental assessment of efficacy of treatment. RESULTS: The technical success rate of stenting amounted to 100%. In the early postoperative period thrombotic complications developed in two women and in the remote period in one. The operation was followed by a decrease in the intensity of PVV manifestations, as well as chronic venous insufficiency of the lower limbs, which was confirmed by clinical and instrumental methods of objectification and visualization. The composite index of quality of life was noted to decrease from 47±5.3 to 27.8±3.3 points (p<0.05). The median of the composite value of the Pelvic Venous Clinical Severity Score decreased by 8.6±1.8 points (p<0.05). The average value of the composite index of the Venous Clinical Severity Score (VCSS) diminished by 6.8±1.4 points (p<0.05) and that of the Villalta score by 8.3±1.6 points (p<0.05). CONCLUSION: Pelvic varicose veins appear to develop in two of three women after endured thrombosis. The experience with stenting of the iliac veins demonstrated good efficacy and safety. Efficiency of the intervention was determined by improved quality of life of the patients and positive dynamics of the clinical course of the disease.

[Ultrasonographic examination of major veins of lower limbs and pelvic veins in pregnant women]. / Ul'trazvukovoe issledovanie magistral'nykh ven nizhnikh konechnostei i ven taza u beremennykh zhenshchin.

The problem of chronic venous insufficiency in women during pregnancy is of current concern. A total of 115 pregnant women in the first, second and third trimesters of gestation were examined in a stage-wise manner. During the first stage we conducted a comprehensive clinical study with the obligatory consultation by the obstetrician-gynaecologist. At the second stage, all women were subjected to ultrasonographic examination of the venous system of both lower extremities and the small pelvis. Studying the diameters of the deep veins of the right and left lower limbs, as well as the paired veins of the small pelvis demonstrated no statistically significant differences, which made it possible to evaluate these parameters as a whole. In all pregnant women, the lumen of the examined vessels was uniform, with the veins being patent, compliant, stained on colour Doppler mapping. Respiration-synchronized, phasic blood flow was registered. In the course of the study it was revealed that the diameter of the veins of the lower limbs and small pelvis increased as gestation proceeded. The findings of ultrasonographic angioscanning showed that by the third trimester of pregnancy the diameter of the femoral vein was 1.5-fold larger and that of the popliteal vein was 1.4-fold larger. The diameter of the veins of the pampiniform plexus of the ovaries during gestation was noted to have increased 1.13-fold. This was accompanied and followed by deterioration of tonic-and-elastic properties of the venous wall and the development by the third trimester of valvular insufficiency with the emergence of venous congestion. Seventeen (16%) women were found to have varicose syndrome. The above mentioned alterations of venous haemodynamics appeared to lead to impairment of blood flow in the affected veins and to the emergence of thrombogenic zones in the valvular sinuses. Of the 115 women examined, 77 (67%) were found to have degree 1 sludge and 36 (31.3%) had degree 2 sludge, with the D-dimer level in these women having increased to 773.3±37.5 ng/ml. Degree 3 sludge was observed in 2 (1.7%) women previously operated on for acute venous thrombosis. Their D-dimer level amounted to 954.3±43.2 ng/ml. It was demonstrated that studying the valvular sinuses for detection of sludge during examination of pregnant women allowed obstetricians-gynaecologists and physicians of ultrasonographic diagnosis to form risk groups for the development of deep vein thrombosis and to timely take appropriate measures aimed at prevention of the pathology concerned.

[The application of the 'Biometriclal Dactylography 17.0' program complex for the digital interpretation of the finger dermatoglyphic features]. / Programmnyi kompleks 'Biometrical Dactylography 17.0' dlia tsifrovoi interpretatsii priznakov dermatoglifiki pal'tsev.

The objective of the present study was the development of the computer software for the scale-free interpretation of the finger dermatoglyphic features needed for the objective comprehensive evaluation of their principal characteristics in the digital terms. We have elaborated the program complex making it possible to address the following problems: thr formulation of the database of electronic copies of the finger print and toe print images in the family groups, the display of the finger print and toe print images on the screen, marking the points and lines for automated readout of digital angular and metric information or automated calculation of relative values, the formulation of the database of digital information about the papillary patterns on the fingers and toes in the family triplets (farther + mother + child) and its import into an Excel file.

[On the orientation of palmar whorl patterns]. / Ob orientatsii zavitkovykh uzorov ladoni.

The objective of the present work was to study the palmar whorl patterns for the inclusion them in the scope of dermatoglyphic signs along with the arc and loop patterns having a well apparent structural organization. For the first time in the history of domestic dermatoglyphic studies, we described the structure of palmar whorl patterns (based on the palmar prints obtained from 555 subjects) with respect to the surrounding tri-radii. Moreover, the role of their radiants in the formation of node orientation was considered. The analysis of the variants of palmar whorl patterns encountered in the study sample provided a basis for the elaboration of the rule for determining their orientation. Specifically, the orientation of the palmar whorl patterns can be found from the direction of the embracing radiants as in the loop or complex patterns.

[The point-digital interpretation and the choice of the dermatoglyphic patterns on human fingers for diagnostics of consanguineous relationship]. / Tochechno-tsifrovaya interpretatsiya i vybor priznakov dermatoglifiki pal'tsev dlya diagnostiki krovnogo rodstva.

The objective of the present study was the development of the point-digital model for the scaless interpretation of the dermatoglyphic papillary patterns on human fingers that would allow to comprehensively describe, in digital terms, the main characteristics of the traits and perform the quantitative assessment of the frequency of their inheritance. A specially developed computer program, D.glyphic. 7-14 was used to mark the dermatoglyphic patterns on the fingerprints obtained from 30 familial triplets (father + mother + child).The values of all the studied traits for kinship diagnostics were found by calculating the ratios of the sums of differences between the traits in the parent-parent pairs to those in the respective parent-child pairs. The algorithms for the point marking of the traits and reading out the digital information about them have been developed. The traditional dermatoglyphic patterns were selected and the novel ones applied for the use in the framework of the point-digital model for the interpretation of the for diagnostics of consanguineous relationship. The present experimental study has demonstrated the high level of inheritance of the selected traits and the possibility to develop the algorithms and computation techniques for the calculation of consanguineous relationship coefficients based on these traits.

Y-box binding protein 1 (YB-1) promotes detection of DNA bulky lesions by XPC-HR23B factor.

The nucleotide excision repair system (NER) is one of the main mechanisms protecting cellular DNA from lesions caused by such significant environmental factors as UV radiation, the influence of polycyclic aromatic hydrocarbons, and medical treatment by several antitumor drugs, e.g. cisplatin. One of the major NER components is XPC-HR23B, the key factor during the damage recognition step of repair. Binding of XPC-HR23B to DNA that contains different bulky lesions impairing the structure of DNA is the basis for the wide substrate specificity of this DNA repair pathway. The multifunctional protein YB-1 among other protein factors has high affinity towards damaged DNA. Involvement of YB-1 in the cellular response to genotoxic stress and its ability to interact with damaged DNA harboring lesions of various origins pinpoint its putative involvement as a modulatory factor in DNA damage recognition and verification steps of NER. In the present work, we assayed functional interactions of protein factors XPC-HR23B and YB-1 upon binding to DNA structures mimicking damaged DNA containing single bulky lesions, as substrates of NER, and bulky lesions combined with abasic sites as an example of clustered lesions. The results indicate that YB-1 and XPC-HR23B stimulate each other in binding to DNA containing a bulky or clustered lesion, which suggests the involvement of YB-1 in the regulation of DNA repair by the NER mechanism.

[The vermillion border of the lips as the object of medico-criminalistics expertise].

The objective of the present work was to study biometric characteristics of the vermillion border of the lips and estimate the possibility of their use for personality identification. Photographs of the lips obtained from the archive of the Department of Forensic Medical Personality Identification, Russian Centre of Forensic Medical Expertise, were analysed with the use of the specially developed ALips 2.0 software. Verification of the hypothesis of normal sign distribution allowed the values of the signs to be split into intervals. Category limits of each sign were calculated for both men and women, the categories were compared in the automatic regime with the help of the ALips 2.0 software. The diagnostic value of the described system is thus far rather low. A number of calculation procedures allowing to identify the object of interest were performed at the concluding stage of the study. The results of experiments suggest the high identification significance of the signs under consideration while the number of the objects similar to the one being identified does not exceed five which confirms that the groups are fairly well distinguished.

[Diagnosis and treatment of varicose disease of small pelvic veins].

The study was based on the findings of examination and treatment of fifty-four 19-to-55- year-old female patients (mean age 35.3 ± 7.3 years) presenting with varicosity of small pelvis veins. Of these, seventeen women with stenosis of the left renal vein were subjected to the following reconstructive operations on small pelvis veins: creating proximal ovarian-iliac anastomoses - 10 procedures, establishment of sapheno-ovarian anastomoses - 5 operations, one procedure of prosthetic repair of the left renal vein and one operation of transposition of the left renal vein. All interventions were completed with resection of the distal segments of the ovarian vein. A further 19 women with idiopathic reflux along the ovarian veins underwent uni- or bilateral embolization thereof, with multi-stage embolization of the branches of the internal iliac vein performed in one patient. The remaining eighteen endured the following interventions: unilateral resection of the left ovarian vein performed in twelve cases (3 endoscopic operations), bilateral resection in four cases (3 endoscopic resections). In seven cases the operations were supplemented with microphlebectomy of the varicosely altered perineal veins. Two patients underwent operations of crossectomy and resection of the pathologically altered internal pudendal vein. Five-year follow up showed that good-to-satisfactory results were obtained in 45 (83.3%) cases, with a disease relapse revealed in seven cases.

[Ultrasonographic diagnosis of venous thromboses].

The article deals with a new method of diagnosis of venous thromboses, which is based on ultrasonographic scanning of the area of the valvular sinuses of the femoral vein. The authors examined a total of two hundred and forty-nine people; of these, 100 patients were diagnosed as having varicose disease, 99 subjects had acute venous thrombosis, and 50 people constituted the control group. All the patients were examined by means of ultrasonographic angioscanning, and also had the D-dimer level measured in them. The carried out study resulted in a description of an ultrasonographic phenomenon consisting in the presence of echo-positive inclusions within the area of the valvular sinuses, which was called the sludge phenomenon. The authors developed a classification of this phenomenon, describing three degrees of sludge. Degree 1 sludge is a physiological one and reflects the fact that the area of the valvular sinuses is the most thrombogenic zone. Degree 2 sludge is characterized as a pathological one, being indicative of the presence of a prethrombotic condition and may serve as one of the earliest prognostic factors for the development of venous thrombosis. Degree 3 sludge reflects thrombosis of the valvular sinus. The carried out studies made it possible to reveal a correlation between the presence of a sludge, its degree, the presence of a venous thrombosis, and the values of the D-dimer level.

[Method of determining human and animal plasma kallikrein inhibitors]. / Metod opredeleniia ingibitorov kallikreina plazmy krovi cheloveka i zhivotnykh.

A method for determining blood plasma kallikrein inhibitors is suggested. It is based on inhibiting the kininogenase activity of kallikrein. The donors' dry plasma devoid of kininases, of other proteolytic enzymes and their inhibitors was used as source and reference of prekallikrein, kallikrein and high-molecular kininogen. Freshly centrifuged plasma was incubated in the presence of unithiol at 37 degrees C in amounts producing a 30-50% inhibition of the kininogenase activity of kallikrein. The values obtained reflected the activity of kallikrein inhibitors and might be of great importance in the study of the physiological role and biochemical properties of kallikrein inhibitors in different animal species, in the diagnosis and prediction of various diseases, as criterion for laboratory control over administering tissue inhibitors of proteolytic enzymes of animal origin.

[Clinical evaluation of kininogenesis indices]. / K klinicheskoi otsenke pokazatelei kininogeneza.

The discrepancies between kininogenase, BAEE-esterase and BAPNA-amidase activity in plasma kallikrein were shown in experiments in vitro. The same discrepancies were detected during examination of children aged under 3 years suffering from bronchopulmonary diseases (acute and lingering pneumonia, bronchial asthma). In these children, prekallikrein, kallikrein and kallikrein inhibitor were determined at a time by the 3 methods (esterase, test-tube chromatographic and kininogenase ones). It has been shown that the kininogenesis intensity could be assessed objectively only in the measurement of the kininogenase activity of kallikrein contained by the whole plasma or its fractions. The esterase technique characterizes total factors of contact activation and does not reflect the activity of kallikrein, prekallikrein and kallikrein inhibitor. The test-tube chromatographic method might be regarded as objective only in the measurement of the kininogenase activity of the fractions that contain kallikrein or prekallikrein.