[The multidisciplinary approach to the diagnostics and surgical treatment of the lacrimal passages]. / Mul'tidistsiplinarnyi podkhod v diagnostike i khirurgii sleznykh putei.

The primary objective of the present study was to highlight the current state of research on the pathology of the lacrimal organs based on the results of the analysis of the relevant publications in the domestic and foreign scientific literature. Special attention in this review is given to the problems of diagnostics, indications for the probing, the treatment and stenting strategies. The authors report their original observations contributing to the better understanding of the anatomical features of the nasolacrimal passages. In addition, the data on the principal pathogenic agents are presented together with certain peculiarities of the surgical treatment of the pathology under consideration.

[Comparative experimental morphological study of the impact of various drainages for cyclodialysis to the adjacent tissues].

The investigation was made on 8 eyes (4 rabbits) undergone cyclodialysis with the hydrogen or collagenic drainage being introduced into the supraciliary cleft. Comparative pathohistological study indicated the evident advantages of a hydrogel implant ensuring the drainage function of the formed cyclodialysis cleft throughout the experiment (5 weeks). By contrast, subject to resolution, the collagenic drainage spurred the early development of young connective tissue in the cyclodialysis cleft just on day 14 after implantation. Complete atresia of the cyclodialysis cleft and cessation of its drainage function might be suggested by week 3. Moreover, hydrogel material has, in our opinion, a less noticeable irritating effect on the adjacent tissues and causes minimum inflammatory and fibroplastic reactions.

[Role of multispiral CT angiography in diagnosis and treatment of patients with chronic cerebral circulatory insufficiency].

Implementing in our clinical practice multispiral CT angiography (MSCTA) of the brachiocephalic arteries into the diagnostic algorithm has made it possible to somewhat deviate from the "golden standard", i.e., the conventional contrast-enhanced angiography, in determining the indications for surgical interventions in a total of 328 patients presenting with chronic cerebral circulatory insufficiency (CCCI). All the patients diagnosed as having multifocal atherosclerosis are subjected to duplex scanning of the brachiocephalic arteries Detecting haemodynamically significant stenoses of the carotid arteries is immediately followed by MSCTA with bolus-mediated intravenous contrasting, which makes it possible to specify the degree of the stenosis and anatomical variants of the major arteries of the neck and brain at all levels, to reveal complicated atherosclerotic plaques and to carry out an objective densimetric analysis of their morphological structure, as well as to diagnose extravasal compression, diffuse and focal cerebral lesions, to also determine the presence of venous dysfunction and to detect concomitant pathology of the cervical and mediastinal organs. Presented herein is a comparative analysis of multispiral CT angiography and MRT angiography in diagnosis of brachiocephalic arteries pathology in the patients involved. The use of the algorithm referred to above makes it possible to determine the indications for surgical correction of CCCls at a qualitatively novel level.

[Radical removal of carotid chemodectoma followed by prosthetic repair of the internal carotid artery].

Presented herein is a case report of successful surgical management of a 34-year-old female patient diagnosed with carotid chemodectoma, a relatively rare pathology vascular surgeons come across and have to deal with. A comprehensive examination (including duplex scanning of cervical arteries, multispiral CT angiography) revealed a 7 x 8 cm cervical tumour completely invading the walls of both the external and internal carotid arteries, thus requiring their resection, followed by prosthetic replacement of the internal carotid artery with a synthetic graft. The postoperative period turned out uneventful. On the 7th postoperative day, the patient was discharged home from hospital in a satisfactory condition with good laboratory and haemodynamic values.

[Results of modified one-stage operation for cataract and glaucoma].

The paper analyzed the immediate and late results (the state of intraocular pressure and visual functions) of combined surgery for cataract and glaucoma, by using the developed instrument. Eighteen patients (19 eyes) aged 54 to 92 years who had open-angle glaucoma or phacotopic glaucoma (dislocation of the lens to the vitreous body) and cataract underwent combined surgery involving extraction of cataract, its phacoemulsification with intraocular lens (IOL) implantation through the scleral tunnel, and sinus trabeculectomy (STE) performed with a perforator, the instrument developed by the authors. The findings confirm the efficiency of the combined surgery (STE) with cataract extraction through variously extended scleral tunnels in patients with open-angle glaucoma, normalizing intraocular pressure and improving visual functions by one-stage surgery. Combined surgery for cataract extraction with IOL implantation through the scleral tunnel and STE, which is performed with the instrument proposed by the authors, has been put into practice.

[A case of surgical treatment of post-traumatic false arteriovenous aneurysm of the right kidney vessels]. / Sluchai khirurgicheskogo lecheniia posttravmaticheskoi lozhnoi arteriovenoznoi anevrizmy sosudov pravoi pochki.

This paper describes an experience gained with successful surgical correction of post-traumatic false aneurysm of the right kidney vessels in a 36-year-old patient operated on previously for knife wound and intrahepatic abscess. All-round examination (duplex scanning of the renal arteries, multispiral computed tomography, abdominal aortography, and ultrasonography of the kidneys) revealed a false aneurysm of the medium segment of the right kidney artery measuring 31x21x33 mm. The aneurysm was located downwards, to the rear and inwards from the artery, with marginal posteroinferior calcification drained to the venous collector (the right kidney vein) expanded to 36-40 mm. The preoperative diagnosis: a post- traumatic false arteriovenous aneurysm of the right kidney vessels; vasorenal hypertension; IIa stage circulatory insufficiency; chronic pyelonephritis, remission; hydronephrosis on the right; 0-I stage chronic renal insufficiency. In view of the failure of the attempts to accomplish endovascular intervention, progression of right ventricular heart insufficiency, the presence of vasorenal hypertension, and right kidney malfunction we performed operation which consisted in evacuation of the false arteriovenous aneurysm of the right kidney artery, plasty of the defect of the right kidney vein and of the defect of the right kidney artery by the aneurysmal wall. The postoperative period was uneventful. Control ultrasonography failed to discover arteriovenous shunting at the level of the right kidney arteries. Also, auscultation did not reveal any murmur in the projection of the renal vessels on the right and above the abdominal aorta. On the 14th postoperative day the patient was discharged from the clinic in a satisfactory condition. His laboratory and hemodynamic parameters were good.

[Structural changes in the brain according to computed tomographic data in patients undergoing combination therapy for hemispheric gliomas]. / Strukturnye izmeneniia mozga po dannym komp'iuternoi tomografii u bol'nykh, perenesshikh kombinirovannoe lechenie po povodu polusharnykh gliom.

Basing on CT data, the authors analyze the qualitative changes in the brain of patients with a history of multiple-modality treatment for immature neuroectodermal tumors. Plani- and volumetric parameters of the total brain, the involved and the contralateral hemispheres are compared with the same parameters in the reference group. The pattern and degree of structural changes were found related to the site of the tumor and surgery. The brain matter in both hemispheres was lost mostly in the interstitial and end portions predominantly on the side of the tumor and surgery. Changes of the brain were individual in the patients.