The Historical Consciousness of Modern Russian Society.

What is the current assessment of the comparative significance of historical events in the mass consciousness of Russians? From what sources do our compatriots draw their knowledge about the past of the country? Can one talk about "good" and "bad" eras in the development of Russia? Based on the materials of empirical research, the author of this article undertakes an attempt to analyze the dynamics of features characteristic of the historical consciousness of Russian society. In his opinion, the transformation of people's ideas about the historical path of the country can be considered as one of the analytical tools for early diagnostics of the changes simmering in society. In addition, a conclusion is formulated that Russian society demonstrates an expressed demand for the elaboration of stable historical reference points and interpretations, a certain unified historical narrative.

Laparoscopic repair of a posttraumatic left-sided diaphragmatic hernia complicated by strangulation and colon obstruction.

BACKGROUND: Posttraumatic diaphragmatic hernias (PDH) are serious complications of blunt and penetrating abdominal or thoracic trauma. Traditional thoracic or abdominal operations are usually performed in these cases. METHODS: We present 2 cases of posttraumatic left-sided diaphragmatic hernia complicated by strangulation and colon obstruction. Both cases were successfully treated with laparoscopy. RESULTS: We found that laparoscopy is a safe, successful, and gentle procedure not only for diagnosis but also for treatment of complicated PDH. Strangulation and colon obstruction were not contraindications to performing laparoscopic procedures. The postoperative course and long-term follow-up (range, 12 to 30 months) were uneventful and short. We expect the same good long-term results after laparoscopic repair as after open conventional surgery. CONCLUSION: We recommend the use a minimally invasive approach to treat posttraumatic diaphragmatic hernia complicated by strangulation and colon obstruction in hemodynamically stable patients.

[Laparoscopic restoration of the colon continuity after Hartmann procedure].

Literature data and personal experience with laparoscopic restoration of the continuity of the colon after Hartmann's procedure in 19 patients allowed the authors to conclude that minimally traumatic procedures had a number of advantages over operations of wide laparotomy such as less blood loss, rapid restoration of the intestinal motility, early activation of the patients, shorter postoperative stay at hospital. They are also thought to be effective methods of treatment and prophylactics of peritoneal commissures and their complications.

[Persistence of Burkholderia cenocepacia bacteria in vivo in dependence of their ability to form biofilms].

AIM: To select the most susceptible line of mice which allows to conduct comparative studies of infectious process caused by different strains of B. cepacia in order to explore correlation between ability to form biofilms and persistence of bacteria in organs of infected animals. MATERIALS AND METHODS: Strain B. cenocepacia 370, which is a clinical isolate, and its mutants with modified ability to form biofilms were used. Conditional microbiologic methods and biological models of intraperitoneal and intranasal inoculation of mice belonging to 4 lines: BALB/c, BLACK, I/St, and A/Sn derived in Central Institute of Tuberculosis were employed. Criteria of persistence was duration of isolation of different strains of bacteria from lungs and spleen of inoculated animals as well as number of CFU. RESULTS: The most susceptible line of mice which enables to conduct comparative studies of infectious process caused by Burkholderia species was determined. It was shown that even after intraperitoneal inoculation the agent was better preserved in lungs than in spleen that corresponds to natural localization of this infection. At any time of observation the number of cells of mutant strain, which is a superproducer of biofilms, isolated from organs of inoculated mice was 2 - 10 times higher than number of isolated cells of mutant, which do not produce biofilms. CONCLUSION: Correlation of more prolonged persistence of B. cenocepacia in organs of inoculated animals in vivo with ability of the agent to form biofilms determined in vitro is experimentally established. The susceptible line of mice which allows to conduct comparative studies of dynamics of infectious process caused by various strains of Burkholderia species was revealed. It was shown that irrespective from method of inoculation B. cepacia are able to continuously persist in organism of susceptible animals with lungs as a predominant localization.

[Electron microscopic study of Burkholderia cepacia biofilms].

Using the methods of transmission electron microscopy, the structure of the biofilms formed by the bacterium Burkholderia cepacia (clinical isolate and mutants with an increased and decreased ability to produce biofilms) were investigated. The biofilms were obtained on a liquid nutrient medium or on an abiotic surface (polystyrene). It has been demonstrated that the cultures of the studied strains differ in some morphological and functional characteristics. In biofilms, changes in the size and submicroscopic organization of all the components of bacterial cells occur. Staining biofilms with ruthenium red revealed the presence of exopolysaccharides in the intercellular space. The differences in the ultrastructure of bacterial films formed on nutrient medium and abiotic surfaces were demonstrated.

[Endoscopic endoprosthesis in inoperable cancer of the esophagus].

The author describes technical characteristics and results of endoprosthesing in 24 patients with inoperable cancer of the esophagus or cardioesophageal zone which can be used for substantiation of indications, contraindications and risk of complications. Based on his positive experiences with endoprosthesis of the esophagus the author makes a conclusion that this operation is minimally traumatic, allows the reestablishment of enteral nutrition and avoidance of gastrostomy.

[Formation of biofilms as an example of the social behavior of bacteria].

This paper is a brief review of data on bacterial biofilms that occur inside and outside of host organisms. Such biofilms are of great ecological and clinical importance. The role of interspecies communications in the development of bacterial biofilms and infectious diseases is particularly emphasized. Considerable attention is given to the electron microscopic study of biofilms formed by Salmonella typhimurium cells incubated as a broth culture in microtubes without aeration. Bacterial samples taken from the biofilm and planktonic culture grown in the same microtube were comparatively investigated by transmission electron microscopy.

[Biofilm formation by different strains of Salmonella typhimurium in artificial systems].

The ability of 14 different strains of Salmonella typhimurium to biofilm formation depending on genotype and culture conditions was investigated in artificial systems: in 96-well plastic microtitre plates, plastic and glass tubes, plastic Petri dishes and on microscope glasses. Quantitative biofilm growth was monitored by using an assay based on crystal violet staining, while planctonic growth in the same cultures was monitored by absorbance in iEMS Reader MF, and qualitatively--by digital photo and visually. Optimal rate between growth and biofilm indications for all strains was determined at initial cell concentration 10(6-7) KOE/ml and culture incubation at t degrees 28 degrees C. The nutrient content of the medium significantly influenced the quantity of produced biofilm. The nutrient broth LB without NaCl was more effective in promoting biofilm formation, than LB itself. The least quantity of biofilm was formed in water. The genotype of the strains also critically influenced the quantity of produced biofilm. Nonmotile mutants cells had reduced ability to form biofilm. RpoS mutant cells produced significantly less biofilm as compared with cells of isogenic parent strains. The chemical content of plastic and glass also influenced biofilm formation.

High frequency hysteresis-free switching in thin layers of smectic-C* ferroelectric liquid crystals.

The insulating layers used for the alignment of ferroelectric liquid crystals (FLC) in electro-optical cells usually have non-negligible thickness and their capacitance determines the type of the director switching caused by a triangular-form external voltage U(tr) . With decreasing frequency of U(tr) , the hysteresis in a switching direction changes from the normal to the abnormal one at a characteristic hysteresis inversion frequency f(i) . In the vicinity of f(i) , the electro-optical response is thresholdless and the optical transmission manifests the V -shape field dependence. The V -shape regime is very interesting for certain applications, in particular to microdisplays due to a possibility of the gray scale realization. However, f(i) has to be enhanced from the usually observed frequency of a few Hz up to the range of hundreds of Hz. To this effect, a special FLC material has been designed and its basic properties (tilt angle, spontaneous polarization, rotational viscosity, and electric conductivity) have been measured over the entire range of the smectic-C* phase. Upon variation of cell parameters (thickness of both the FLC and alignment layers), temperature, and external voltage, the frequency of the V -shape effect as high as 150-1000 Hz (in the temperature range 30-75 degrees C) has been found experimentally. The operating voltage remains lower than 8 V. A quantitative interpretation of these results has been done using the modeling procedure developed earlier [S.P. Palto, Cryst. Rep. 48, 124 (2003)]. The modeling has been performed with the experimental values of the FLC material and the cell parameters and has shown very good agreement with experiment. The key point of this approach is consideration of the internal voltage on the FLC layer, the sign, amplitude, and form of which differ from U(tr) . The results of the modeling allow further improvement of the performance of electro-optical FLC cells for high frequency V-shape effect.

[Laparoscopic splenectomy through a lateral access]. / Laparoskopicheskaia splenéktomiia iz lateral'nogo dostupa.

The investigation included 35 patients with diseases of blood and spleen pathology (30) and wounds and traumas of the abdomen with injuries of that organ (5), treated by laparoscopic splenectomy through a lateral access. The technique and stages of the operation and advantages of the lateral access are described. The laparoscopic splenectomy was shown to be possible in 90% of cases if patients were selected with special reference to the main disease, size and degree of pathological alterations in the spleen. An adequate approach to selections of patients with injuries of the organ allowed to make operations in more than a third of the patients and casualties. When using the lateral access laparoscopic splenectomy is thought to be more convenient, gives better visualization of the anatomical structures and reduces risk of injury of adjacent organs, thus resulting in less frequency of complications and conversions.

[Physical methods of dissection and coagulation in surgery]. / Fizicheskie sposoby dissektsii i koaguliatsii v khirurgii.

The paper presents 20-year experience in using various devices for tissue dissection and coagulation of such as electrosurgical ones EN-57M, Efa-0201 (Russia), Karl Storz-endoscope (Germany), Force-300, Force-FX, LigaSure ("Valley-lab", USA), Erbotom ICC 350 ("Erbe"), Argo-3000 ("Soring", Germany), a Surgitrone radioknife ("Ellman", USA), ultrasonic Auto Sonix devices ("Auto Suture", USA), a harmonic Ultracision scalpel ("Ethicon Endo-Surgery", USA), laser Scalpel-1 and Romashka-1 devices (Russia), plasma Fakel-01 and Prometey devices (Russia). The results of 424 experimental studies and clinical application of different energies in 1683 patients are analyzed. The influence of different types of energy on tissue and reparative processes were revealed, morphological changes were studied. Advantages and shortcomings of each type of energy are demonstrated, recommendations for their optimum application are formulated.

[Diagnosis and surgical treatment of mediastinal neoplasms]. / Diagnostika i khirurgicheskoe lechenie pri novoobrazovaniiakh sredosteniia.

The authors share their experiences with examination and surgical treatment of 163 patients with various neoplasms of the mediastinum. The first place among the neoplasms is occupied by tumors of the lymphatic apparatus (33%), the second--by tumors of the thymus (21%). The video-thoracoscopic technique was used in 17 of 131 operations performed. Complications after the operations took place in 6 patients (4.5%), two patients died (1.5%). A conclusion is made that the patients of this category must be treated not only by thoracic surgeons but also by hematologists, neurologists, neurosurgeons and specialists in radiation therapy.

[Laparoscopic surgery in colorectal tumors]. / Laparoskopicheskaia khirurgiia pri opukholiakh priamoi i obodochnoi kishki.

The authors describe their first experience with using less invasive laparoscopic methods in patients with tumors of the rectum and the colon. Twelve operative interventions were performed. The method and technique of endovideosurgical operations on the colon are described. The intraoperative and postoperative complications are analyzed. The authors not rich experience with performing laparoscopic interventions on the colon shows the necessity of stepwise and thorough mastering the method and of using strictly individual indications for such operations.

[The combined endoscopic surgery of gallstones complicated by diseases of the terminal common bile duct]. / Kombinirovannaia éndoskopicheskaia khirurgiia zhelchnokamennoi bolezni, oslozhnennoi zabolevaniiami terminal'nogo otdela obshchego zhelchnogo protoka.

The article deals with combined endoscopic treatment of cholelithiasis complicated by pathological changes of the terminal part of the common bile duct in 104 patients: in 81 of them there was choledocholithiasis (5 of them had the Mirizzi syndrome). 15 patients had choledocholithiasis and papillostenosis, 8 patients had papillostenosis. Papillosphincterotomy with laparoscopic cholecystectomy was performed in 50 patients, in 4 senile patients only papillosphincterotomy was performed. Laparoscopic cholecystectomy and interventions on the common bile duct were fulfilled in 46 patients; in 27 cases the duct was drained by the method of Holsted-Pikovskii, in 13 cases--after Kehr, in 3--after Vishnevskii. In 2 cases the concrements were removed through the cystic duct, the common bile duct was not drained. The supraduodenal choledochoduodenoanastomosis was made in one patient. The open operation was performed in 4 cases (3.9%). One patient died (1%). The experience shows that the modern endoscopic technique allows the whole program of intraoperative revision and sanitation of the hepaticocholedochus and its drainage to be realized. Advantages of the combined endoscopic treatment of the cholelithic disease complicated by a lesion of the terminal part of the common bile duct as compared with traditional surgery are evident. They are: decreased postoperative pain syndrome, less amount of complications, good cosmetic affect, shorter period of reconvalescence, high economic effect.

[Endoscopic interventions in cicatricial strictures of esophageal anastomoses]. / Endoskopicheskie vmeshatel'stva pri rubtsovykh strikturakh pishchevodnykh anastomozov.

Endoscopic balloon hydrodilation was conducted in 39 patients with cicatricial stenoses of esophageal anastomoses, in 12 patients it was combined with electrodissection of the esophageal anastomosis, in 3 with bougienage, and in 10 with temporary endoprosthetics. The anastomosis was dilated adequately (to 2.0-2.5 cm) in 38 patients. In one case endoscopic treatment was ineffective; another surgical intervention was performed. In another case endoprosthetics was complicated by decubitus of the cervical esophagus (favorable outcome). In late-term period of 2 months to 4 years restenosis occurred in 6 of 38 patients; the course of dilation was repeated in 4 patients, 2 patients underwent a reconstructive operation. The authors believe that in development of cicatricial stenosis of the esophageal anastomosis modern methods of therapeutic endoscopy should be resorted to in the first place, and only if they prove ineffective should the question of repeated surgical intervention be discussed. Balloon hydrodilation is the principal method of operative endoscopy in cicatricial stenoses of esophageal anastomoses, which in some cases should be combined with other endoscopic interventions (electroincision and temporary endoprosthetics).

[Use of electron video-endoscopic system in the diagnostic and therapeutic endoscopy]. / Primenenie élektronnoi videoéndoskopicheskoi sistemy v diagnosticheskoi i lechebnoi éndoskopii.

Welch Allyn videoendoscopic system (USA) was used in 739 diagnostic and therapeutic investigations of 573 patients with various diseases of the gastrointestinal tract. Clinical experience has demonstrated the advantages of videoendoscope over common fibroscopes: it permits monitoring of the investigation by several specialists simultaneously, improves the training of specialists in endoscopy, permits recording and storage of endoscopic information, etc. At the same time videoendoscopes of this system are not devoid of shortcomings, i.e. the working part is too flexible, the image is frequently misrepresented during operation, this necessitating additional designing. On the whole videoendoscopic systems hold good promise in gastrointestinal endoscopy.

[Endoscopic study using a superthin endoscope in benign esophageal strictures]. / Endoskopicheskoe issledovanie sverkhtonkim éndoskopom pri dobrokachestvennykh strikturakh pishchevoda.

To increase the diagnostic possibilities, the authors suggested a method of endoscopic examination of patients with esophageal strictures by means of a superthin PF-28 fibroscope produced by the Olympus firm (Japan), which was introduced along a string-guide. The examination was successful in 24 of 26 patients. Clinical observations have shown that esophagogastroscopy with a superthin endoscope makes it possible to recognize the exact length of the stenosed segment, detect the second zone of stenosis, and determine the condition of the mucous membrane of the esophago-gastric junction and the proximal part of the stomach.

[Current possibilities of diagnostic and surgical endoscopy in cicatricial esophageal stenosis]. / Sovremennye vozmozhnosti diagnosticheskoi i operativnoi éndoskopii pri rubtsovykh strikturakh pishchevoda.

Endoscopic methods of examination have been employed in 153 cases of burn and peptic strictures of the esophagus. The experience has shown that the use of small-diameter (including ultrathin) fiber endoscopes provides maximum information of the status of the esophagus along its whole length as well as of the stomach and duodenum, which is of importance in the choice of therapeutic tactics in this category of patients. Eighty one patients with cicatricial stenosis of the esophagus and esophageal anastomoses were subjected to various endoscopic interventions: balloon hydrodilation, bougienage, electrocision, and endoprosthesis . Balloon hydrodilatation was the major technique and in many cases was combined with other modes of therapeutic endoscopy. The authors' experience suggest that endoscopy adds to the available treatments for cicatricial strictures of the esophagus and esophageal anastomoses.