[Hemodynamics in the right gastroepiploic artery and its practical application]. / Formula gemodinamiki pravoi zheludochno-sal'nikovoi arterii i ee prakticheskoe primenenie.

OBJECTIVE: To study functional anatomy of the right gastroepiploic artery (RGEA), its gastric and omental branches and practical significance of these anatomical features. MATERIAL AND METHODS: We analyzed 20 cadaveric organ complexes (11 men and 9 women, aged 49-85 years) between 2018 and 2019. The organ complexes consisted of the stomach, proximal duodenum and large omentum. RGEA catheterization at the level of pylorus was followed by selective real time angiography. We assessed the following parameters of RGEA: total length, diameter at the level of pylorus, number and diameter of gastric and omental branches. To objectify the study, we visually divided RGEA into 5 equal segments between pylorus and the last branch arising from this artery. RESULTS: The RGEA looks like a gradually and evenly narrowing tube. Mean diameter of the artery at the level of pylorus was 2.2±0.68 mm, mean length - 23.6±3.7 cm. Mean number of gastric and omental branches was 16.2±4.8 and 8.6±2.6, respectively. The number of gastric branches in the distal part of the RGEA increased, while the diameters of the gastric branches did not significantly differ. The number of gastric branches in distal RGEA increased, while diameters of gastric branches were similar. The greatest number of omental branches with the largest diameter was observed in the 2nd and 3rd segments of the artery. Considering these data, we formulated the equation for RGEA hemodynamics and developed the technique for optimal blood supply to proximal part of the gastric transplant during esophagogastroplasty. CONCLUSION: Anatomical features of the right gastroepiploic artery can be used in reconstructive surgery of abdominal cavity and chest.

[Lower urinary tract syndrome in elderly and senile people with combined pathology of the prostate and lumbar spine.]

In order to determine the place and role of degenerative changes in the lumbar spine in the pathogenesis of lower urinary tract syndrome and the success of treatment measures, 106 elderly and senile male patients suffering from benign prostatic hyperplasia and spinal pathology were observed. Long-term chronic lower back pain was experienced by 48 (45,3%) patients, 93,8% of them had night urination, 75% had difficulty urinating, and 60,4% had false urge to urinate, which motivated them to contact a urologist.The differences identified using the IPSS questionnaire, respectively 21,78±4,33 and 16,33±4,61 points, indicated a negative value of chronic pain syndrome in the formation of the overall clinical picture of urological pathology. Among the senile patients, pain and urinary tract irritation symptoms were less pronounced than among the elderly patients, and obstructive symptoms, on the contrary, were more pronounced. Chronic pain syndromes in the lumbar region were significantly more frequent (p<0,001) among 67 patients with satisfactory and unsatisfactory results of treatment for urination disorders than among 39 with the best efficiency. Thus, the pathology of the lumbar spine and associated chronic pain syndromes make a significant contribution to the pathogenesis and clinical picture of the lower urinary tract syndrome and to the effectiveness of treatment of urination disorders. The identified features should be taken into account in the process of diagnosis and treatment of combined pathology.

[Current state of elective surgery for peptic ulcer]. / Analiz sovremennogo sostoianiia planovoi khirurgii iazvennoi bolezni.

AIM: To analyze the current state of elective surgery for peptic ulcer and to assess its significance for improving the results of treatment of this disease. MATERIAL AND METHODS: The analysis included elective procedures for peptic ulcer performed in the surgical department of Tula Regional Clinical Hospital in the period from 2011 to 2015. These data were compared with those for the period 1996-2000 in order to objectively identify current changes in surgery for peptic ulcer. The interval between both periods was 10 years. The main group consisted of 47 patients with peptic ulcer who underwent surgery in 2011-2015. The control group included 254 patients who underwent similar procedures in 1996-2000. RESULTS: Annual number of elective procedures for peptic ulcer decreased 5 times. There was advanced mean age in the main group, 29.8% of patients in the main group were older than 60 years, in the control group - 23%. Male/female ratio in the main group was 1:1, in the control group - 5:1. Prolonged ulcer history was observed in 10.6% of patients of the main group and 3.2% - in the control group. At the end of the last century, the greatest number of scheduled operations was performed for duodenal ulcer, now - for stomach ulcer. There was increased incidence of surgery for post-resection gastric syndrome (17 and 4.8% in both groups, respectively). We noted similar indications for elective surgical treatment of peptic ulcer in both groups. However, the negative feature of current period is significant augmentation of patients with decompensated pyloroduodenal stenosis. The structure of elective operations in 2011-2015 was characterized by significant proportion of decompensated complications of peptic ulcer as a result of prolonged medication. Prolonged postoperative hospital-stay and increased postoperative mortality were noted in the main group. CONCLUSION: Reduced number of elective procedures for peptic ulcer is associated with changed structure of patients undergoing surgery. Unreasonable prolonged medication aggravates patient state and adversely affects the results of surgical treatment. The current state of elective surgery for peptic ulcer does not correspond to the objective to improve the results of treatment of this disease.

[Features of the clinical picture, diagnosis and treatment of pain syndromes formed on the basis of combined lesions of the spine in the elderly and senile age.]

Based on the long-term observation of 105 representatives of the elderly and senile age, the features of the clinical picture of pain syndromes formed in the elderly and senile age on the basis of combined spinal lesions in osteoporosis and spondylarthrosis are presented, and methods of diagnosis and treatment of such patients are proposed. The main variants of symptoms developing in response to long-term tonic muscle tension in degenerative age-dependent injuries of vertebral bodies, intervertebral discs and facet joints at the level of thoracic and lumbosacral spine are shown. Pathogenetic connections of frequent urination disorders in the elderly and senile age with pathological processes in the spine and muscular-tonic pain syndromes were determined. In pathological muscle hyperactivity, accompanied by pain syndromes, restrictions of movements in the spine and the formation of pathological poses, it is recommended to use in the treatment of soft techniques of manual therapy and botuline toxin therapy, and with distinct structural, anatomical defects of vertebral segments - local corticosteroid therapy.

[Efficacy of serosomyotomy in esophagogastroplasty]. / Éffektivnost' serozomiotomii pri ézofagogastroplastike.

AIM: To evaluate an effectiveness of serosomyotomy in isoperistaltic esophagogastroplasty. MATERIAL AND METHODS: Our analysis shows that serosomyotomy improves the results of isoperistaltic esophagogastroplasty. RESULTS: Esophagogastrostomy by using of proximal graft with adequate blood supply reduced the risk of anastomosis failure. The incidence of this complication was 12.2% (n=6) and 3% (n=1) in control and main groups respectively.

[Age aspects of the muscular-tonic and urological syndromes in men with disorders of the pelvic functions: the features of clinic, diagnostics, treatment].

A comparative examination of 100 patients at different ages, suffering from disorders of micturition, erectile function and pelvic pain, identified age-related peculiarities of these pathological manifestations. Irritative disorders of urination was detected significantly more frequently among persons of young and middle age than the elderly, and obstructive-related disorders were more frequent in the elderly. In elderly and senile age more prevalent was reducing of the contractility of the detrusor, and at a younger age - increased tone of striated sphincter of the urethra and bladder hyperactivity. It was shown that the participation of long-existing spasm of some muscle formation of the lumbar, pelvic and femoral region in the genesis of urinary symptoms, erectile dysfunction and pelvic pain. When using manual therapy, physiotherapy and botuline-therapy high effectiveness against disorders of micturition, erectile function and pelvic pain was achieved regardless of the age of the patients. It is recommended for the diagnosis of urological pathology to involve specialists in the field of neurology and manual therapy. In cases of diagnosis of musculo-tonic disorders not etiologically associated with pathological processes in the organs of the urogenital system, in the complex of therapeutic measures it is recommended to include methods such as manual-therapy, physiotherapy, botuline-therapy.

A comparative study of LaBr3(Ce(3+)) and CeBr3 based gamma-ray spectrometers for planetary remote sensing applications.

The recent availability of large volume cerium bromide crystals raises the possibility of substantially improving gamma-ray spectrometer limiting flux sensitivities over current systems based on the lanthanum tri-halides, e.g., lanthanum bromide and lanthanum chloride, especially for remote sensing, low-level counting applications or any type of measurement characterized by poor signal to noise ratios. The Russian Space Research Institute has developed and manufactured a highly sensitive gamma-ray spectrometer for remote sensing observations of the planet Mercury from the Mercury Polar Orbiter (MPO), which forms part of ESA's BepiColombo mission. The Flight Model (FM) gamma-ray spectrometer is based on a 3-in. single crystal of LaBr3(Ce(3+)) produced in a separate crystal development programme specifically for this mission. During the spectrometers development, manufacturing, and qualification phases, large crystals of CeBr3 became available in a subsequent phase of the same crystal development programme. Consequently, the Flight Spare Model (FSM) gamma-ray spectrometer was retrofitted with a 3-in. CeBr3 crystal and qualified for space. Except for the crystals, the two systems are essentially identical. In this paper, we report on a comparative assessment of the two systems, in terms of their respective spectral properties, as well as their suitability for use in planetary mission with respect to radiation tolerance and their propensity for activation. We also contrast their performance with a Ge detector representative of that flown on MESSENGER and show that: (a) both LaBr3(Ce(3+)) and CeBr3 provide superior detection systems over HPGe in the context of minimally resourced spacecraft and (b) CeBr3 is a more attractive system than LaBr3(Ce(3+)) in terms of sensitivities at lower gamma fluxes. Based on the tests, the FM has now been replaced by the FSM on the BepiColombo spacecraft. Thus, CeBr3 now forms the central gamma-ray detection element on the MPO spacecraft.

Hydrogen mapping of the lunar south pole using the LRO neutron detector experiment LEND.

Hydrogen has been inferred to occur in enhanced concentrations within permanently shadowed regions and, hence, the coldest areas of the lunar poles. The Lunar Crater Observation and Sensing Satellite (LCROSS) mission was designed to detect hydrogen-bearing volatiles directly. Neutron flux measurements of the Moon's south polar region from the Lunar Exploration Neutron Detector (LEND) on the Lunar Reconnaissance Orbiter (LRO) spacecraft were used to select the optimal impact site for LCROSS. LEND data show several regions where the epithermal neutron flux from the surface is suppressed, which is indicative of enhanced hydrogen content. These regions are not spatially coincident with permanently shadowed regions of the Moon. The LCROSS impact site inside the Cabeus crater demonstrates the highest hydrogen concentration in the lunar south polar region, corresponding to an estimated content of 0.5 to 4.0% water ice by weight, depending on the thickness of any overlying dry regolith layer. The distribution of hydrogen across the region is consistent with buried water ice from cometary impacts, hydrogen implantation from the solar wind, and/or other as yet unknown sources.

Experiment LEND of the NASA Lunar Reconnaissance Orbiter for high-resolution mapping of neutron emission of the Moon.

The scientific objectives of neutron mapping of the Moon are presented as 3 investigation tasks of NASA's Lunar Reconnaissance Orbiter mission. Two tasks focus on mapping hydrogen content over the entire Moon and on testing the presence of water-ice deposits at the bottom of permanently shadowed craters at the lunar poles. The third task corresponds to the determination of neutron contribution to the total radiation dose at an altitude of 50 km above the Moon. We show that the Lunar Exploration Neutron Detector (LEND) will be capable of carrying out all 3 investigations. The design concept of LEND is presented together with results of numerical simulations of the instrument's sensitivity for hydrogen detection. The sensitivity of LEND is shown to be characterized by a hydrogen detection limit of about 100 ppm for a polar reference area with a radius of 5 km. If the presence of ice deposits in polar "cold traps" is confirmed, a unique record of many millions of years of lunar history would be obtained, by which the history of lunar impacts could be discerned from the layers of water ice and dust. Future applications of a LEND-type instrument for Mars orbital observations are also discussed.

The Dynamic Albedo of Neutrons (DAN) experiment for NASA's 2009 Mars Science Laboratory.

We present a summary of the physical principles and design of the Dynamic Albedo of Neutrons (DAN) instrument onboard NASA's 2009 Mars Science Laboratory (MSL) mission. The DAN instrument will use the method of neutron-neutron activation analysis in a space application to study the abundance and depth distribution of water in the martian subsurface along the path of the MSL rover.

CO2 snow depth and subsurface water-ice abundance in the northern hemisphere of Mars.

Observations of seasonal variations of neutron flux from the high-energy neutron detector (HEND) on Mars Odyssey combined with direct measurements of the thickness of condensed carbon dioxide by the Mars Orbiter Laser Altimeter (MOLA) on Mars Global Surveyor show a latitudinal dependence of northern winter deposition of carbon dioxide. The observations are also consistent with a shallow substrate consisting of a layer with water ice overlain by a layer of drier soil. The lower ice-rich layer contains between 50 and 75 weight % water, indicating that the shallow subsurface at northern polar latitudes on Mars is even more water rich than that in the south.