[Modern achievements of the functional diagnostics in dentistry]. / Sovremennye dostizheniya funktsional'noi diagnostiki v stomatologii.

The article presents the development of functional research methods in the maxillofacial region, methods of their application and the results of scientific research on the study of the neuromuscular balance of the masticatory muscles with defects and deformations in the maxillofacial region. Methods of blood circulation research (laser doppler flowmetry, ultrasound dopplerography, computer capillaroscopy) have been developed and implemented in the tissues of the maxillofacial region: periodontal, tooth pulp, in the mucous membrane of the alveolar ridge, which allowed us to study the mechanisms of disease pathogenesis and monitor the effectiveness of treatment in the maxillofacial region.

[The results of treatment of newborns with postrenal anuria due to upper urinary tract obstruction, caused by fungal bezoar].

AIM: To evaluate the results of different methods of urine derivation in patients with postrenal anuria due to upper urinary tract (UUT) obstruction, caused by fungal bezoar. MATERIALS AND METHODS: The results of treatment of postrenal anuria in 8 patients without congenital obstructive anomalies of UUT in 5 clinics from 2004 to 2018 were analyzed. All patients from the birth received continuously two or more antibiotics for diseases not related to kidneys and the urinary tract. Median of gestational age was 32 weeks [31.5; 38.5]. There were 4 boys (50%), and 4 girls (50%). The duration of anuria at the time of hospitalization was 2 days [1.5; 5]. Creatinine level at admission was 218 mol/l [164.5; 392.5] and urea was 17.9 mmol/l [13.2; 24.95]. In all cases, candida albicans was revealed in urine. Postoperative complications were graded according to the Clavien-Dindo classification. RESULTS: All patients received systemic antifungal therapy; UUT drainage was performed in 7 (87.5%) cases. Ureteral catheter was placed bilaterally in 2 (28.6%) patients (4 renal units). There were 5 complications (Clavien-Dindo grade IIIb). Bilateral percutaneous nephrostomy was performed in 3 (42.8%) patients (6 renal units), and there were 2 complications (Clavien-Dindo grade IIIb and V). Open pyelostomy was performed in 2 (28.6%) patients (one bilateral, one on the right side; a total of 3 renal units). There was only one complication of Clavien-Dindo grade V. The average number of surgical procedures required to alleviate UUT obstruction per one renal unit was as following: 2.25 for ureteral catheterization; 1.17 for percutaneous nephrostomy; 1 for open pyelostomy. Regardless of the drainage method, diuresis tended to be normalized and azotemia decreased during the first postoperative day. In one case, the obstruction was eliminated by antifungal therapy without drainage of UUT. Mortality rate was 25% (n = 2). CONCLUSION: Ureteral catheterization is a minimally invasive, safe method for decompression of UUT obstruction, caused by fungal bezoar, which is non-inferior to nephrostomy tube or open pyelostomy. Ureteral catheterization can be used as a primary method of urine derivation in children with UUT obstruction caused by candida bezoar.

[Dental rehabilitation in the complex treatment of children and adolescents with maxillofacial neoplasms]. / Stomatologicheskaya reabilitatsiya v kompleksnom lechenii detei i podrostkov s novoobrazovaniyami chelyustno-litsevoi oblasti.

THE PURPOSE: Of the study was to improve algorithms and methods of complex dental rehabilitation of children and adolescents with maxillofacial neoplasms. MATERIALS AND METHODS: Sixty-seven patients aged from 2 to 17 years (average age 10.43±4.56; 30 boys, 37 girls) underwent complex rehabilitation as a part of neoplasm treatment (40 benign, 27 malignant). Patients were divided into 3 groups: group 1 aged 2 to 7 years; group 2 aged 8 to 12 years; group 3 aged 13 to 17 years. RESULTS: Structural integrity of upper and lower jaws was reconstructed using vascularized bone flaps (27 cases), non-vascularized bone flaps (5 cases), titanium reconstructive plates (11 cases) or individual titanium endoprostheses of the temporomandibular joint (2 cases). Orthodontic, orthopedic and surgical dental treatment was performed at all stages of rehabilitation of patients and had its own characteristics depending on the group affiliation. CONCLUSION: Algorithms for dental rehabilitation of children and adolescents with maxillofacial neoplasms have been improved on the base of performed treatment.

[Achievement of consensus and standardization of methods in dentistry on the example of studies of support reactions (posturography, stabilometry)]. / Dostizhenie konsensusa i standartizatsiia metodov v stomatologii na primere issledovanii opornykh reaktsii (posturografii, stabilometrii).

Comprehensive treatment of dental pathology involves a multidisciplinary integration of doctors, the use of general physiological control methods and correction of human conditions, such as study of support reactions (on the stabilometric platform). Participation of dentists in the public scientific-methodological initiative 'Moscow consensus on the use of stabilometry and biofeedback for the support reactions in public health practice and research' increases the efficiency of application of this method in dentistry and the development of relationships with other practical areas.

[Relationship between masticatory muscles activity and motor cortex activation during treatment of patients with distal malocclusion]. / Vzaimosviaz' izmeneniia aktivnosti zhevatel'nykh myshts i motornykh zon kory golovnogo mozga pri lechenii patsientov s distal'noi okkliuziei.

The processes of neuroplasticity of the motor cortex of the brain were evaluated in the treatment of 20 (12 women and 8 men) patients aged 18-35 years (22.5±1.5 years) with distal occlusion using functional magnetic resonance imaging (fMRI), as well as comparison of surface myography (EMG) data to assess the adaptive capabilities of the tooth-jaw system and the central nervous system against the background of orthodontic correction. Correction of distal occlusion was carried out using ceramic braces 'Damon' (f. 'Ormco', USA). The advancement of the lower jaw forward with bite enhancement was carried out using the Twin force device ('Ortho Orgonizers GmbH', Germany). The study was conducted in five stages: 1) before orthodontic correction; 2) before installing the Twin force device; 3) after anterior displacement of the lower jaw and bite enhancement on the Twin force device; 4) after removing the brackets; 5) 1.5 months after the treatment. FMRI proved to be a useful tool for orthodontic treatment efficacy assessment and neuromuscular adaptation of maxillofacial structures to changing functional status.

[Changes of postural statusa in patients undergoing orthodontic treatment]. / Izmenenie postural'nogo statusa pri ortodonticheskom lechenii narushenii prikusa.

The study objective was to determinate variations of stato-dynamical functional markers of postural balance system in the process of malocclusion treatment. Twenty patients aged from 14 to 30 years with class II malocclusion were recruited for this prospective study. All patients underwent electromyography of mm. temporalis and mm. maseter in rest and at maximal jaws pressure. Postural balance was evaluated by stabilometry platform and body's regions relationship was assessed by computer optical topography. Orthodontic interventions included using occlusal splint, dental straps or 'TwinForce' device. There were two diagnostic sessions: before and after one month of orthodontic treatment. The majority of patients after anterior dislocation of mandible demonstrated significant increase in unilateral masticatory muscles activity (р<0.05) which correlated with iliac crest position. According to computerized topography data superior iliac crest position was registered in opposite side with regard to muscle hypertonia. According to stabilometry data forward translation of the mandible resulted in retroversion of total pressure point projection (р<0.05). Asymmetric muscle working in the process of occlusal adjustment may provoke postural imbalance in distal body regions. It dictates postural system condition monitoring during orthodontic treatment.

[Laparoscopic heminephrureterectomy for duplex kidney in children].

INTRODUCTION: Duplication of the upper urinary tract is one of the most common congenital urological anomalies. In patients with critically decreased or lost function of one of the renal segments, heminephrureterectomy is usually the treatment of choice. Until recently, this was an open surgery; in cases of complete removal of the ureter, an additional incision in the iliac region was required. Currently, heminephrureterectomy is increasingly performed laparoscopically. We report the experience in laparoscopic heminephrureterectomy (LHNUE) in 10 clinics in Russia and Belarus. Some of them have already used this technique for 10 years. AIM: The study aimed to to improve the treatment results in children with urodynamic dysfunction due to duplicated upper urinary tract. MATERIALS AND METHODS: We retrospectively analyzed medical records of 111 children treated from 2007 to 2016. There were 26 (23.4%) boys and 85 (76.6%) girls with mean age 44.6 months (from 2 to 170) at the time of surgery. All children included in the study had complete duplex kidneys, including 51 (45.9%) right-sided and 60 (54.1%) left-sided. All the children underwent LHNUE for a critical decrease or absence of function of the upper or lower segment of the duplex kidney caused by the following pathology: obstruction of the ureterovesical junction with the development of the megaureter of the upper ureteral segment in 57 (51.4%) patients; ureterocele in 28 (25.2%); extra-vesical ectopic ureter with urinary incontinence in 10 (9.0%) girls; high-grade UVR in 16 (14.4%) patients. RESULTS: There were no conversions in this series of patients. The mean operative time was 135 minutes (60-240 min.). All children included in the study were followed for 1 to 9 years after surgery. Complications occurred in 17 (15.3%) patients, of whom 12 (10.8%) required repeat surgery. In one patient with the loss of lower pole function, the treatment result was considered unsatisfactory. CONCLUSION: LHNUE for duplex kidney is performed by a few clinics and is still at the stage of development and accumulation of experience. Nevertheless, LHNUE, though an effective treatment modality, carries the risk of reducing or losing the function of the retained segment.

Commissioning of the PRIOR proton microscope.

Recently, a new high energy proton microscopy facility PRIOR (Proton Microscope for FAIR Facility for Anti-proton and Ion Research) has been designed, constructed, and successfully commissioned at GSI Helmholtzzentrum für Schwerionenforschung (Darmstadt, Germany). As a result of the experiments with 3.5-4.5 GeV proton beams delivered by the heavy ion synchrotron SIS-18 of GSI, 30 µm spatial and 10 ns temporal resolutions of the proton microscope have been demonstrated. A new pulsed power setup for studying properties of matter under extremes has been developed for the dynamic commissioning of the PRIOR facility. This paper describes the PRIOR setup as well as the results of the first static and dynamic proton radiography experiments performed at GSI.

A weighted and directed interareal connectivity matrix for macaque cerebral cortex.

Retrograde tracer injections in 29 of the 91 areas of the macaque cerebral cortex revealed 1,615 interareal pathways, a third of which have not previously been reported. A weight index (extrinsic fraction of labeled neurons [FLNe]) was determined for each area-to-area pathway. Newly found projections were weaker on average compared with the known projections; nevertheless, the 2 sets of pathways had extensively overlapping weight distributions. Repeat injections across individuals revealed modest FLNe variability given the range of FLNe values (standard deviation <1 log unit, range 5 log units). The connectivity profile for each area conformed to a lognormal distribution, where a majority of projections are moderate or weak in strength. In the G29 × 29 interareal subgraph, two-thirds of the connections that can exist do exist. Analysis of the smallest set of areas that collects links from all 91 nodes of the G29 × 91 subgraph (dominating set analysis) confirms the dense (66%) structure of the cortical matrix. The G29 × 29 subgraph suggests an unexpectedly high incidence of unidirectional links. The directed and weighted G29 × 91 connectivity matrix for the macaque will be valuable for comparison with connectivity analyses in other species, including humans. It will also inform future modeling studies that explore the regularities of cortical networks.

[Correlation of bioelectric activity of maxillofacial muscles with postural status and chewing function in patients with disocclusion].

The aim of the study was to evaluate the correlation between the activity and the function of the maxillofacial muscles and the postural status in patients with the Class II malocclusions. The study revealed posture stabilizing function of sterno-cleido-mastoid muscles and interference of postural and maxillofacial muscles. In addition in class II patients asymmetric masticatory dysfunctions were identified.

First biological images with high-energy proton microscopy.

High-energy proton microscopy provides unique capabilities in penetrating radiography including the combination of high spatial resolution and field-of-view, dynamic range of density for measurements, and reconstructing density variations to less than 1% inside volumes and in situ environments. We have recently proposed to exploit this novel proton radiography technique for image-guided stereotactic particle radiosurgery. Results of a first test for imaging biological and tissue-equivalent targets with high-energy (800 MeV) proton microscopy are presented here. Although we used a proton microscope setup at ITEP (Moscow, Russia) optimized for fast dynamic experiments in material research, we could reach a spatial resolution of 150 µm with approximately 10(10) protons per image. The potential of obtaining high-resolution online imaging of the target using a therapeutic proton beam in the GeV energy region suggests that high-energy proton microscopy may be used for image-guided proton radiosurgery.

[Some issues of the relevant values of stabilometric study in dentistry].

New stabilometry value associated with energy consumption of the examinee is proposed and clinical case illustrating its use for complex prosthodontic treatment quality assessment. Need for national guidelines on stabilometry for dental practice is also discussed.

Weight consistency specifies regularities of macaque cortical networks.

To what extent cortical pathways show significant weight differences and whether these differences are consistent across animals (thereby comprising robust connectivity profiles) is an important and unresolved neuroanatomical issue. Here we report a quantitative retrograde tracer analysis in the cynomolgus macaque monkey of the weight consistency of the afferents of cortical areas across brains via calculation of a weight index (fraction of labeled neurons, FLN). Injection in 8 cortical areas (3 occipital plus 5 in the other lobes) revealed a consistent pattern: small subcortical input (1.3% cumulative FLN), high local intrinsic connectivity (80% FLN), high-input form neighboring areas (15% cumulative FLN), and weak long-range corticocortical connectivity (3% cumulative FLN). Corticocortical FLN values of projections to areas V1, V2, and V4 showed heavy-tailed, lognormal distributions spanning 5 orders of magnitude that were consistent, demonstrating significant connectivity profiles. These results indicate that 1) connection weight heterogeneity plays an important role in determining cortical network specificity, 2) high investment in local projections highlights the importance of local processing, and 3) transmission of information across multiple hierarchy levels mainly involves pathways having low FLN values.

[Reactive restructuring of ureteral smooth muscle tissue during development of urinary vesico-ureteral reflux in children]. / Reaktivnaia perestroika gladkoi myshechnoi tkani mochetochnika pri razvitii puzyrno-mochetochnikovogo refliuksa u detei.

By means of target cell dissociation we studied the cells of smooth muscle tissue from the wall of intact ureter in children in the course of compensatory-adaptive reactions in the vesico-ureteral reflux. Three types of ureteral myocytes differing by structural-metabolic parameters are distinguished. A comparative analysis of the intact and reactively altered ureteral smooth muscle tissue has revealed changes in the population structure manifesting with high optic density of DNA from myocytic nuclei and high activity of synthetic processes in the cytoplasm.

[Effect of fragmin, a low-molecular heparin, on hemostasis in patients with alimentary-constitutional obesity]. / Vliianie nizkomolekuliarnogo geparina fragmina na gemostaz u bol'nykh alimentarno-konstitutsional'nym ozhireniem.

The authors conducted comparative study of the hemostasis indices before and in the immediate period after operation for formation of a small stomach in 31 patients with stage III-IV alimentary-constitutional obesity, in 50 patients without obesity who underwent operation on the stomach, and in 15 volunteers. Nonspecific prevention of thrombogenesis was performed in all patients with normal weight and those with obesity. Patients with obesity were given in addition specific thrombogenesis prevention with nonfractionated heparin (group I) and fractionated low-molecular heparin-fragmin produced by KABI (groups II and III). Study of the parameters of the hemostasis system in the postoperative period showed nonspecific prevention of thrombogenesis to be sufficient to reduce the risk of pulmonary artery phlebothrombosis and embolism in most patients without obesity. In patients with obesity the probability of phlebothrombosis and thromboembolism is much higher, in view of which they must be given heparin in addition to nonspecific prevention. Fragmin, as an agent for thrombosis prevention, has certain advantages over nonfractionated heparin and should be used more frequently in clinical practice in patients of the risk group, e. g. with pathological obesity, in a dose no less than 100 U/kg. With the use of fragmin laboratory control before each injection is not needed. Administration of nonfractionated and fractionated heparins must be combined with bandaging of the lower limbs and other measures of nonspecific prevention of thrombogenesis.

[The modern aspects of the surgical treatment of the perforated gastric and duodenal ulcer with a view to the immediate results]. / Suvremenni aspekti pri khirurgichnoto lechenie na perforiralata stomashna i duodenalna iazva s ogled na neposredstvenite rezultati.

Experience is recorded with the operative treatment of 185 patients with perforated gastric and duodenal ulcer over the period 1981-1991. The period was divided in two: 1981-1985 and 1986-1991. During the first period were operated 89 patients: 58 with perforated duodenal ulcer and 31 with gastric ulcer. The method of choice during this period was suture of the perforation. During the second period were operated 96 patients: 90 with duodenal and 6 with gastric ulcer. Surgical approach was also individualized depending on the pathologic process, patient age and accompanying diseases. The following operative interventions were performed: "pure suture" of the ulcer--55 patients; gastric resection by Billroth I and II techniques--7 patients; different variants of vagotomy with drainage operation--34 patients. Analysis of the immediate results in 42 patients demonstrated that best results were obtained by vagotomy + drainage operations.

[The treatment procedure in vesicoureteral reflux in young children]. / O taktike lecheniia puzyrno-mochetochnikovogo refliuksa u detei mladshego vozrasta.

A group of 54 children with vesicoureteral reflux recognized in the first 3 years of life was analysed. All of them received adequate nonoperative treatment including prolonged antibacterial therapy and management of cystitis and urodynamic disorders of the lower urinary tract. According to the degree of vesicoureteral reflux (VUR), the children were divided into two groups. Group 1 consisted of 29 children with Degrees I-II VUR in 37 ureters. Nonoperative treatment was effective in 75% of cases. Retrospective appraisal of urograms revealed no signs of cicatricial-sclerotic changes in the parenchyma of the kidneys. In five children with Degree II VUR of long duration the kidneys were smaller than the normal size of their age. Group 2 was made up of 24 patients with Degrees III-V VUR into 34 ureters. No changes were found in the renal parenchyma on urograms made during the first examination. During follow-up, however, signs of reflux-nephropathy (RN) were detected, which according to the recommendations of the International group for reflux study were evaluated as Degree I RN--10 cases, Degree II RN--12 cases, Degree III RN--8 cases, and Degree IV RN--4 cases. The authors believe nonoperative treatment of children with Degrees I-II VUR to be justified, patients with Degrees III-V VUR call for active surgical intervention from the moment that the reflux is recognized.