[Anatomical peculiarities of transcranial approach to the orbital cavity].

The purpose of this work was to study the anatomical features of transcranial approach to the cranioorbital area and the orbital cavity. The preparation of 32 orbits obtained from 16 human cadavers fixed in formalin, was performed. In the anatomical study, typical fronto-temporal extradural approach to the anterior cranial fossa was used, together with the micropreparation of the orbital structures from 3 intermuscular approaches. It was demonstrated that at different stages of transcranial approach, its parameters were mainly influenced by either craniometric indices, or anatomical peculiarities of orbital nerves and vessels position. The data obtained allow to plan the surgical intervention on the basis of results of radiological study and the data on frequency of various anatomical variants of an arrangement of ophthalmic artery branches.

[Transcranial approach to the cranio-orbital area and orbital cavity].

Almost 90 years has passed from the moment of the development of transcranial approach to the cranio-orbital area and orbital cavity. But the application of the method was limited due to using mainly extracranial approaches. The authors have analyzed results of studying the parameters of transcranial approach to 32 orbits of 16 corpses of adult subjects, and results of treatment of 24 patients with neoplasms of the cranio-orbital area and orbit, operated by transcranial approach. The indications to different modifications of the approach and to each of the intermuscular approaches to the orbital nerve were established.

[Analysis of morphological changes in the spinal cord and ganglia of dogs after epidural administration of prosidol, clopheline and prosidol-clopheline combination]. / Analiz morfologicheskikh izmenenii spinnogo mozga i spinno-mozgovogo gangliia sobak posle épidural'nogo vvedeniia prosidola, klofelina i kombinatsii proosidola s klofelinom.

Experiments were carried out on 22 mongrel dogs (12-20 kg). Group 1 consisted of 5 dogs to which prosidol in a dose of 0.65 mg/kg was injected epidurally; group 2, 5 dogs, clofelin (6.5 micrograms/kg) epidurally; group 3, 5 dogs, prosidol (0.65 mg/kg) + clofelin (6.5 micrograms/kg) epidurally. Control groups were as follows: 1) 5 intact dogs; 2) 2 dogs epidurally injected with 0.9% normal saline. Analysis of the spinal cord and ganglia in control groups showed no dystrophic changes in neurons. After epidural injections of prosidol, clofelin, or both only solitary cells with degenerative changes were detected or none at all. Nissle granules were evenly distributed in the cytoplasm of anterior and posterior spinal horn neurons in all control and experimental animals. The majority of ganglious cells in control and experiment had the nucleus and nucleolus. Hence, morphological analysis showed that epidural injection of prosidol, clofelin, and a combination of both caused no degenerative or necrobiotic changes in the anterior and posterior spinal horn neurons and in ganglious cells of spinal ganglia.

[Some regularities of morphological changes in liver tissue exposed to electricity]. / Nekotorye zakonomernosti morfologicheskikh izmenenii tkani pecheni pri élektrovozdeistvii.

An experimental investigation of the character and spread of morphological and histological alterations in the liver was performed in order to follow their dependence on the regimen of using an electrosurgical apparatus for resection and coagulation of the liver tissue.

[Significance of features of the projection of the cervical part of the thoracic duct onto the left sternocleidomastoid muscle for performing operations involving video support]. / Znachenie osobennostei proektsii sheinoi chasti grudnogo protoka na levuiu grudinokliuchichno-sostsevidnuiu myshtsu dlia vypolneniia operativnykh vmeshatel'stv s videopodderzhkoi.

To work out practical recommendations for using videosupport projection of cervical part of the thoracic duct on sternoclaidomastoid muscle was determined in 158 corpses of adults. Surgical access to the thoracic duct is available using common macrosurgical equipment until the moment of visualization of major lymphatic corrector, although it is reasonable to involve videosupport at following stage with the camera of videoendosurgical kit adjusted in inferior margin of the wound. This allows to perform all the necessary actions to expose cervical part of the thoracic duct and to correct them according to video information on the monitor.

[Individual variability in the topography of the thoracic duct and its significance for the treatment of chylothorax by a video endosurgical method]. / Individual'naia izmenchivost' topografii grudnogo protoka i ee znachenie dlia lecheniia khilotoraksa videoéndokhirurgicheskim metodom.

A possibility for clipping the ends of the damaged thoracic duct in chylothorax treatment by video endosurgical method was supported by the experiment performed in 10 dogs and topographoanatomical study carried out in 158 corpses of adults. The correlation found allows to forecast the possible position of thoracic region of the thoracic duct both by the thoracic cage shape and topography of the adjacent large anatomic elements.

[Anatomic characteristics of relatively inaccessible zones of thoracic duct and principles for improving surgical approaches]. / Anatomicheskie kharakteristiki zon otnositel'noi nedostupnosti grudnogo protoka i printsipy ulucheniia operativnykh podkhodov.

The analysis of data obtained from investigation of 158 cadavers of adults with the use of complex of anatomic methods and from experiments on video-endosurgical installation revealed that the following ways should be combined to expose thoracic duct relatively inaccessible zones: a method of opened access to thoracic duct using high traumatism elements (clavicotomy and pericardium dissection), video-endosurgical method of access to thoracic duct regions located on the bottom of infundibular recess and use of mechanical clipping for faster block of thoracic duct lumen.

[The variability in the interrelations of the terminal portions of the thoracic duct and the left vertebral vein and its importance in applying a lymphovenous anastomosis]. / Izmenchivost' vzaimootnoshenii terminal'nykh otdelov grudnogo protoka i levoi pozvonochnoi veny i ee znachenie dlia nalozheniia limfovenoznogo anastomoza.

Peculiarities of interrelations between the thoracic duct terminal regions and left vertebral vein were studied in 158 human cadavers. In case of long and thin neck trunks of the thoracic duct and vertebral vein ere established not to adjoin. Here a lympho-venous end-to-side anastomosis may be applied in vertebral vein mobilization. In short and thick neck intercrossing of the trunks was observed. In this case any type of lympho-venous anastomosis may be applied.

[Surgical anatomy of the abdominal part of the thoracic duct]. / Khirurgicheskaia anatomiia briushnoi chasti grudnogo protoka.

With the aim to determine local orienting points, that facilitate in searching the abdominal part of the thoracic duct, 43 corpses of mature persons have been investigated by means of a complex of anatomical techniques. The distance between the levels, where the superior mesenteric artery and renal arteries get off, can be used for preventing possible complications at certain surgical manipulations. In particular, when the distance from the beginning of the superior mesenteric artery is 37-64 mm, the thoracic duct is mainly situated behind the inferior vena cava; when this distance is 16-34 mm, the duct is situated between the inferior vena cava and the aorta, and when the distance between the superior mesenteric and renal arteries is 6-15 mm, the abdominal part of the thoracic duct should be searched for behind the inferior vena cava.

[Individual variability of the projection line of the common carotid artery]. / Individual'naia izmenchivost' proektsionnoi linii obshchei sonnoi arterii.

The investigation has been performed on 87 corpses of persons of both sex, that died after 60 years of age from the pathology not connected with any diseases in the neck organs. Individual variability in the common carotid artery projection line has been revealed; it conforms, to a certain extent, with the value of the neck index. When the neck is short and thick, the artery position corresponds to the line that runs across the following points: the superior--0.5 cm forward from the mandibular angle, the inferior--0.5 cm medially from the sternoclavicular joint. When the neck index is within the limits 1.71-1.88, it is expedient to draw the classical projection line. When the neck index is within the limits 1.57-1.69, it is possible to determine the projection zone as an elongated rectangle. At the bottom of every side the border of this zone is a straight line drawn between the sternoclavicular joint and the point situating 0.6 cm laterally from the joint, and at the top--the line connecting the top of the mastoid process with the point 1.0 cm behind the mandibular angle.

[Topographo-anatomical substantiation of the choice of a rational approach to the terminal region of the thoracic duct]. / Topografoanatomicheskoe obosnovanie vybora ratsional'nogo dostupa k terminal'nomu otdelu grudnogo protoka.

With the aim to state the dependence between the projection of the place where the thoracic duct flows into and the superior part of its arc with the position of its external reference marks in order to choose a rational approach to the terminal part of the thoracic duct, an investigation on 50 embalmed human corpses has been performed by the method of graphic reconstruction and quantitative estimation of the planimetric images obtained. Certain regularities have been revealed in the interconnection of the terminal part of the thoracic duct with the elements of the cervical vascular-neural fasciculi, the sternocleidomastoid muscle, the clavicle, etc. There is a correlative dependence between the position of the external reference points and topographic peculiarities of the cervical part of the thoracic duct. A technique is suggested to calculate the projection zone of the cervical part of the thoracic duct in every case with the aim to choose a rational approach for the external drainage.

[Method of determining the quality of irrigation of the vessels of parenchymatous organs before injection]. / Sposob opredeleniia kachestva promyvaniia sosudov parenkhimatoznykh organov pered in''ektsiei.

The method suggested for qualitative estimation of the renal and hepatic vessels perfusion before an injection is based on measuring oscillations of the light beam diffused by the organ's surface (the source--a gas laser of continuous action of red spectrum). An absolute photometer protected by a red filter from external effects of light is used as a registrator. Successive injection of the renal and hepatic vessels with different masses and their investigation by means of roentgenography, preparation, carrosion demonstrate a satisfactory effectiveness of the method presented.