[Ankle distraction hinged motion arthroplasty in the Ilizarov frame]. / Distraktsionnaya artikuliruyushchaya artroplastika golenostopnogo sustava v apparate Ilizarova.

OBJECTIVE: To study distraction hinged motion arthroplasty of the ankle joint in combined treatment of osteoarthritis in terminal stages. MATERIAL AND METHODS: Ankle distraction hinged motion arthroplasty in the Ilizarov frame was performed in 10 patients with terminal post-traumatic osteoarthritis (mean age 54±6.2 years). Surgical technique and design of the Ilizarov frame, as well as additional reconstructive interventions are described. RESULTS: Preoperative VAS score of pain syndrome was 7±2.3 cm, after 2 postoperative weeks - 1±0.5 cm, 4 weeks - 0.5±0.5 cm, 9 weeks or before dismantling - 0±0.5 cm. Arthroscopic debridement of anterior part of the ankle joint was carried out in 6 cases, posterior part - 1 case, anchor reconstruction of lateral ligamentous complex (InternalBrace technique) - 1 case, anchor reconstruction of medial ligamentous complex - 2 cases. Restoration of anterior portion of syndesmosis was performed in 1 case. Pin site infections occurred in 2 cases. In one case, there was a breakdown of the wire fixator holding the pin passed through the talus in 5 weeks after surgery. CONCLUSION: Preliminary results allow us to characterize the proposed design of the Ilizarov frame layout and surgical technique as relatively simple and promising for postponing radical surgery on the ankle joint.

[Results of surgical treatment of oral cavity cancer T1-2N0M0].

The article shows the results of treatment of 20 patients (aged from 46 to 85 years old) with early oral cavity squamous cell carcinoma at the period from April 2009 to January 2011. The surgery included the resection of primary tumor and neck dissection in all the patients. The primary tumor was removed by mouth access in 10 patients and combined method was used in 10 cases. The selective neck dissection was carried out in 22 cases. The oral cavity wounds were closed primarily by local flaps in 10 patients, some small residual defects were left open in 3 cases. The reconstructions with remote skin-muscular infrahyoid flap were performed in 7 patients. The free revascularized radial skin-fascia flap was used in 3 cases. A follow-up period was from 24 to 44 months. The primary local regional control consisted of 85% in given group of patients. The rate of recurrence of the second primary metachronous tumor was 15%. Tumors were located in the oral cavity. Overall 3-year survival was 90% (18 out of 20 patients).

[Microsurgical autografting for reconstruction of head and neck oncological defects. An analysis of 60 cases].

The authors analyzed results of the free flap transfer in surgery of head and neck. 60 operations were performed since October 2006 till May 2012. Indications for using them were reconstruction of the mucosa of the oral cavity and the pharynx in 48 cases, the extensive defects of skin and soft tissues of the head and neck in 12 cases. All cases except 2 had the initial reconstruction. First 18 operations were performed with the binocular loupes, followed by using operating microscope. During the operations 42 radial skin-fascia flaps, 10 anterolateral femoral flaps, 5 thoracodorsal flaps, 1 anteromedial femoral flap, 1 scapular skin bone flap and 1 jejunal flap were used. During the early postoperative period one of the patients died (postoperative lethality 1.7%). Necrosis of flaps took place in 6 cases (5 radial skin-fascia flaps, 1 thoracodorsal flap). The causes of failures were assessed as arterial thrombosis (1 case), venous thrombosis (2 cases), postoperative infection (1 case). The exact cause in 2 cases couldn't be determined. Thus, the total success in the given series of surgery was 88.9%.

[Method of plasty of defects of a hairy part of the head skin after tumor excision].

Results of operative treatment of 8 patients with cellular basal cancer of the hairy part of the head are presented. The patients were operated by an original worked out method of plastic reconstruction of skin defects of the head hairy part after tumor excision. The mathematical substantiation of the surgical method was stated. The technique of operative intervention is described. The clinical course and illustration of the long-term results are given.

[Use of vascularized free flaps for reconstruction of oncological defects in the head and neck].

The aim of the study is to assess our results with free flap transfer. Since October, 2005 till December, 2011 51 operations were performed. Mucosa of upper digestive tract was reconstructed in 40 cases, soft tissues and skin of the head and neck region-in 11 cases. Reconstruction was primary in all but 2 cases. 18 first cases were performed with 2,5x and 4x binocular loupes magnification. Operating microscope was used in another 33 cases. 37 radial forearm fasciocutaneous flaps, 5 latissimus dorsi musculocutaneous flaps, 7 anterolateral thigh flaps, 1 scapular osteocutaneous were used with the single case of visceral flap--jejunal free flap. Death in early postoperative period occurred once. Complete flap loss occurred six times. Five radial and one latissimus dorsi free flaps were lost. Arterial thrombosis is considered as a primary cause of failure in one case, venous thrombosis-in two cases. Severe postoperative infection was considered as a primary cause of failure in one case. In remaining 2 cases the cause of flap loss could not be determined exactly. There were three cases of revision surgery with attempts to reperform venous anastomosis, one of them was successful. Overall success rate in this series is 86,3 %. The main cause of such a low rate of success is a lack of experience.

[The use of myocutaneous flap for reconstruction of surgical defects in the oropharyngeal area].

Oncological Dispensary of Leningrad Region, St.Petersburg Our paper deals with evaluation of the results of using distal pectoralis major myocutaneous flap (38) in 37 patients; bilateral dissection of tissue--1. Plastic reconstruction of surgical effects of the oral cavity and pharynx was performed in 27 (skin cancer--8, parotid salivary gland tumor--1). Flap was used to both shield the parotid artery and prevent erosive bleeding following radical cervical dissection, urgent plastic surgery--30, postponed--8. Complication, chiefly slight was reported in 60.5% and treated conservatively. Total necrosis was identified in 2 (5.3%), partial--4 (10.8%), salivary fistula--10 out of 27 reconstructions of the upper intestinal tract (18.4%), cervical suture failure--7 (18.4%), flap avulsion from wound edges--6 (15.8%), wound edge avulsion--2 (5.3%). Nasogastric probe for feeding was used for approx. 23.7 days. Feeding per os after the first operation was restored in 23 (85.2%). Repeat reconstruction using pectoralis major myocutaneous flap has proved effective in patients with surgical effects of head and neck.

[The antioxidant activity of S-(4-quinazolyl)mercaptoacetic acid benzylidene hydrazides in vitro in the "nitrosation stress" model]. / Izuchenie antioksidantnoi aktivnosti benzilidengidrazidov S-(4-khinazolil)merkaptouksusnoi kisloty na modeli "nitroziruiushchego stressa" in vitro.

The "nitrozation stress" causes modification of the antioxidant enzymes leading to a decrease in their activity. A decrease in this activity and the resulting increase in the production of OH* and NO2* radicals via ONOO* decomposition leads to a significant increase in the extent of free-radical peroxidation during the "nitrozation stress". These factors are unfavorable from the standpoint of oxidative phosphorylation, which is manifested by inhibited activity of the oxidative enzymes. S-(4-Quinazolyl)mercaptoacetic acid benzylidene hydrazides exhibit a high antiradical activity related to the presence of a mercapto group in the quinazoline fragment. The activity depends on the position of this group on and the number of substituents in the benzylidene fragment. The compounds studied reduce the extent of damage in the brain homogenates of rats under conditions of nitrozation stress. This is manifested by inhibition of the free-radical peroxidation and an increase in the activity of antioxidant and prooxidant enzymes.

Effect of Buerger's thromboangiitis activity on the outcomes of vascular reconstructions.

Altogether 39 patients suffering from thromboangiitis obliterans were under observation. The vasculitis activity score (VAS) developed by R.A. Luqmain et al. (1994) was used as a criterion for thromboangitis activity. The patients were distributed into 2 groups: the first group included patients in the period of remission and the second, group comprised patients in the period of exacerbation. The patients underwent different types of vascular reconstructions. On examination of hemostasis and hemorheology the second group patients demonstrated potentiation of platelet function, inhibition of antiaggregation activity of the arterial wall, the rise of aggregation activity of red blood cells, and inhibition of blood fibrinolytic activity. The tendency toward hypercoagulation and hyperaggregation revealed in the second group patients led to deterioration of the immediate outcomes of reconstructive operations. Thrombosis of the reconstructed area was recorded in 5 (26.31%) first group patients and in 7 (35%) second group patients. In the first group, the high limb amputation was accomplished in one (5.26%) patient whereas in the second group, amputation was performed in 6 (30%) cases. So, the VAS according to R. A. Luqmain et al. (1994) is a reliable predictor which allows to carry out the screening of patients with Buerger's thromboangiitis for vascular reconstructions. The presence of the clinical signs of vasculitis activity in Buerger's thromboangitis requires preliminary preliminary preparation aimed at the removal of inflammation and correction of hemorheologic and hemostatic disorders.

[Effects of the anticoagulation therapy regimen on frequency of early thrombohemorrhagic complications after operations on major arteries of lower extremities]. / Vliianie rezhima antikoaguliantnoi terapii na chastotu rannikh trombogemorragicheskikh oslozhnenii posle operatsii na magistral'nykh arteriiakh nizhnikh konechnostei.

The results of 295 reconstructive operations on the major vessels of lower extremities were analyzed. The patients were divided into 4 groups depending on the scheme of anticoagulation therapy in the postoperative period. Under investigation was the state of hemostasis and hemorheology. The frequency of thrombohemorrhagic complications was assessed. It was found that the regimen based on the administration of low molecular weight heparins during the nearest 5 days after the intervention was the most rational regimen of anticoagulation therapy after reconstructive operations on the major arteries of lower extremities.

[Aneurysms of the aorta and its visceral branches as a cause of gastrointestinal hemorrhage]. / Anevrizma aorty i ee vistseral'nykh vetvei kak prichina zheludochno-kishechnykh krovotechenii.

From 1993 till 1999 6 patients with aneurysmointestinal fistulas complicated by bleedings were operated. In 4 cases the aneurysmointestinal fistulas were primary, in 2 cases--secondary. Gastroduodenoscopy, ultrasonic examination of abdominal organs, retroperitoneal space and duplex scanning of main vessels were used. Correct diagnosis before operation was made in 5 patients. The following operations on the vessels were performed: suturing of defect of central anastomosis (1), aortobifemoral grafting (1), abdominal aorta grafting (2), suturing of aortal defect (1), resection of peripheral aneurysm (1). Thrombosis of prosthesis branch (1) and suppuration of prosthesis bed with arrhosive bleeding (2) were early postoperative complications. Immediate postoperative lethality was 33.3%. Long-term results are followed in 3 patients. There were no repeated signs of graft infection in remote period. Basic methods of clinical and instrumental examination including ultrasound permit to make correct diagnosis before operation. Active surgical policy saves the life in the majority of patients, but it is necessary to use carefully the synthetic grafts for arterial vessels repair.

[Prevention of early thrombotic complications after reconstructive operations in occlusions of the aorto-iliac segment]. / Profilaktika rannikh tromboticheskikh oslozhnenii posle rekonstruktivnykh operatsii pri okkliuziiakh aortopodvzdoshnogo segmenta.

108 patients with atherosclerosis of aorto-iliac segment have undergone various reconstructive operations on this segment. Depending on the treatment all the patients were divided in 2 groups (test group--54 patients, control group--54 patients). The patients of the control group received aspirin, rheopolyglucin and trental for correction of hemorheology and hemocoagulation disorders. In patients of the test group at the same time as this treatment, the indirect electrochemical blood oxidation by intravenous infusion of 0.03% sodium hypochlorite was applied. Regional hemodynamics, hemorheology and hemostasis indices were studied in all the patients. It was established that indirect electrochemical blood oxidation permits to significantly improve the hemorheology indices, to diminish thrombophilia phenomenon during the treatment and early postoperative period. It was noted that early thrombotic reocclusion and amputations rates were reduced in the test group.

[The complexity of the information load, the functional status and the efficiency of operator activities]. / Skladnist' informatsiinoho navantazhennia, funktsional'nyi stan i efektyvnist' operators'koï diial'nosti.

Experimental data permit stating that in a wide range of functional state modelled pharmacologically with the use of aminazine, caffeine under conditions of a thrusting tempo of the work an increase in the volume of information presented has induced a decrease in speed, quality and productivity of operator's labour; an increase in tempo of information supply has led to a rise of speed and fall of information processing quality, changes in the labour productivity are subjects to the low of the optimum. It is shown that significance of the functional state for efficient operator's activity grows with complexity of the information load.

[Problem of controlling current mental capacity in operators]. / Problema kontrolia tekushchei umstvennoi rabotosposobnosti operatorov.

The industrial means to control and forecast the current mental capacity of operators are absent nowadays in spite of its level connected with about 2/3 of accidents through the personnel's fault. Results of 10 year-experience show how the computerized self-educating adaptable systems of current individual mental capacity monitoring in power engineering operators were created. The systems to control the mental capacity in operators before and over the course of the shift let also improve the reliability and economy in exploitation of huge technological enterprises and preserve the operator's health.