[The role of multispiral computed tomographic coronarography].

The aim of the study was to assess the use of multispiral computed tomographic coronarography (MSCT-CG) in comparison with conventional coronary angiography. Overall 62 patients aged 45-72 years were examined, the MSCT-CG was conducted in 38 patients. The sensitivity of MSCT-CG was 92%, the specificity - 91,2%, in comparison with the CAG. The prognostic value of negative test was 95,7%, the prognostic value of positive test was 84%, overall accuracy was counted up to 91,5%. Though, the MSCT-CG showed certain overestimation in calculating the stenosis degree and, thus, false positive results, in cases with calcined atherosclerotic plaques. Main advantages of MSCT-CG were: non-invasiveness, possibility of vessel lumen, arterial wall and structure of the plaque assessment.

[Treatment of patients with chronic pancreatitis complicated by pseudoaneurysms of the celiac trunk basin arteries].

The authors have analyzed results of treatment of 26 patients with chronic pancreatitis complicated by pseudoaneurysms. Hospitalization and treatment of such patients should be performed in specialized hospitals which can fulfill special examination in detail and carry out roentgen-endovascular operations. Intraintestinal bleeding is an absolute indication for emergent surgery for performing hemostasis. Conservative treatment is indicated for intestinal bleedings and after arrest of bleeding the patients should be transported to specialized institutions. Two types of the appearance of pseudoaneurysms were established depending on the pathological mechanism: when there was a relationship of the pseudocyst with the main pancreatic duct (I type) and when there was not (II type). For the I type roentgen-endovascular treatment (RET) followed by operation is indicated, for the II type RET is thought to be enough.

[Current conception of stress and adaptation subject to new data of tissue hypoxia genesis].

State-of-the-art conception of stress is represented as an interrelation between stress, tissue hypoxia and adaptation. Under the influence of stressors the cell metabolism changes with producing of chemical substances capable pathologically to get bound with cell receptors. These substances change in cells optimal energy transformation (biochemical stage) and disturb cell functions (pharmacological stage). Biochemical and pharmacological stages of stress in uncellulates and in human cells are homotypic. The clinical stage of stress is typical only for humans and animals. Dysfunction of plane muscles (PM) myocytes leads to local microcirculation disturbances, transitory hypoxia and partial disorder in affected organ function. Local microcirculation disturbances are accompanied by serotonin release from damaged platelets, which leads to complete functional recovery of PM myocytes, microcirculation and affected organ function, or to formation of local "mute" focuses of tissue necrosis--the adaptation is effective. Insufficient serotonin release from damaged platelets leads to extension of hypoxia focus, lesion, tissue necrosis. The stress loses its nonspecificity and turns into infarction of myocard, brain etc., with specific clinical course--the adaptation is not effective.

[Extirpation of stomach without esophagoenteroanastomosis at recurrent profuse gastric bleedings].

Five cases of extirpation of stomach stump are analyzed. These operations have been performed due to recurrent bleeding after long conservative treatment, endoscopic and surgical procedures (gastrotomy with suturing of erosions and ulcers, resection and re-resection of stomach) at the patients with severe anemia and hypoproteinemia. The operations were limited to extirpation without esophagoenteroanastomosis due to severe condition of patients and were completed by external esophageal drainage and jejunostoma. Three of five patients have been survived and undergone reconstructive operations with Roux esophageal-intestinal anastomosis in 4 - 6 months. All these patients resumed professional activity. We didn't find the similar surgical tactics in literature.

[False arterial aneurysms of celiac trunk system in patients with chronic pancreatitis].

20 patients with chronic pancreatitis complicated by development of false aneurysms of arteries in celiac trunk system were observed. Diagnostics utilities included ultrasound study, contrasted computed tomography and angiography. Two types of aneurysms are distinguished: parencchymal and pseudocysts. Radioendovascular operation is the method of choice for aneurism treatment. Surgical treatment is carried out in case of aneurism rupture with voluminous bleeding or on necessity of elimination other complications of chronic pancreatitis (pseudocyst, pancreatic hypertension, wirsungolithiasis).

New aspects of technical testing of intravascular stents.

Maximum magnetic resonance artifacts from stents are often determined by the presence of ferromagnetic compounds in the delivery system. We propose a mathematic model describing artifacts caused by nitinol stents. A method for evaluation of critical radial rigidity of the stents was developed.

[Reconstructive surgeries after extensive resections of anterior abdominal and chest walls for tumors].

Experience of reconstructive surgeries after extensive resections of anterior abdominal and chest walls performed on account of tumors is described. Recovery of integrity of anterior abdominal wall was performed by serial grafting with dura mater and polypropylene net implant. The thorax was repaired with special grafts of the ribs and sternum. The integrity of the skin was reestablished with either suturing of the separated flaps or transposition of myodermal flap on vascular pedicle.

[Radio-frequency ablation appliance in resection of the liver]. / Ispol'zovanie apparata radiochastotnoi ablatsii pri rezektsii pecheni.

Pilot experience with "Radionics Cool-Tip RF System" appliance for radio-frequency ablation (RFA) in hepatic resection in the patients with focal lesions of the liver is presented. Advantages of RFA as an alternative method for hemostasis are demonstrated. With this technique bisegmentectomy (II - III) was performed in 4 patients, right-sided hemihepatectomy - in 2 patients. RFA permitted to minimize intraoperative blood loss without increase of surgery time. There were no severe complications during surgery and in early postoperative period. The method permits to perform combined surgeries without a significant increase of surgical risk.

[Effect of the exogenous glucose on photosynthesis of the diatom Thalassiosira weissflogii depending on nitrate supply and light]. / Vliianie ékzogennoi gliukozy na fotosintez diatomovoi vodorosli Thalassiosira weissflogii v zavisimosti ot obespechennosti nitratami i urovnia osveshchennosti.

The rate of photosynthetic carbon fixation (P) in the diatom Thalassiosira weissflogii cultivated in the presence of exogenous glucose in the medium (0-10.56 micrograms C/l) at different levels of illumination (25, 50, and 100 microE/m2 s) was studied as a function of nitrate nitrogen supply. In the diatoms limited in nitrogen and assimilating exogenous glucose, P was found to decrease or increase depending on light intensity, glucose concentration, and the duration of exposure. In the diatoms assimilating both nitrate nitrogen and glucose, compared to those supplied with nitrates alone, P was higher at medium and high light intensities and lower at a low light intensity. The interrelation of the processes of carbon and nitrogen metabolism in mixotrophic algae and the ecological role of glucose consumption by phytoplankton are discussed.

[A revised classification of hypoxic conditions]. / Utochnenie klassifikatsii gipoksicheskikh sostoianii.

The precised classification of circulatory hypoxia described in the paper is principally different from those published earlier by that it discriminates between hypoxia preconditioned by impaired cardiac-muscle constriction, on the one hand, and hypoxia due to malfunctions of smooth muscles (SM), on the other hand. The genesis of SM malfunctions is predetermined by impaired interactions of serotonin with SM serotonin receptors. The clinical use of serotonin adipinat reduces the local organic and total-tissue hypoxia in different pathologies and provides for better treatment results. The mentioned precised classification can be used to gain more data on the tissue-hypoxia pathogenesis and to schedule the clinical-and-experimental research on the purpose-oriented basis.

[Subtotal leiomyomatosis of the esophagus and proximal part of the stomach]. / Subtotal'nyi leiomiomatoz pishchevoda i proksimal'noi chasti zheludka.

Generalized leiomyomatosis of the esophagus and stomach is a rare disease. According to literature data, age of the patients ranges from 9 to 84 years, in men this disease is diagnosed 2 times more often than in women. It is necessary to differentiate this disease with cancer, esophageal diverticulum, achalasia of the cardia, hiatal hernia. In our case a woman of 32 years was ill from 5 years of age. Correct diagnosis was not made before surgery. Endoscopic examination suspected leiomyoma. Only repeated urgent histological tests during surgery resulted in accurate diagnosis (subtotal leiomyomatosis of the esophagus and proximal stomach) and in adequate surgical policy--subtotal resection of the esophagus and proximal resection of the stomach with Toprover gastrostoma creation. Then, retrosternal esophagocoloplasty was performed. 2 years after the first surgery the state of the patients is satisfactory, there are no symptoms of recurrence of the disease.

[Virtual surgeries based on spiral computed tomography]. / Virtual'nye khirurgicheskie operatsii na osnove ispol'zovaniia spiral'noi komp'iuternoi tomografii.

Experience of spiral computed tomography with bolus contrast enhancement and subsequent 3D-reconstruction of picture for virtual modeling of surgeries is presented. The method was used in 204 patients with tumors and diseases of the liver, pancreas, spleen, kidneys, adrenal glands, parapapillary diverticula of the duodenum, coarctations and aneurysms of aorta, extraorganic tumors of the retroperitoneal cavity and neck. Coincidence of virtual and real types of surgeries reached 75-92.8% depending on the disease and clinical situation. Perspectives of 3D-reconstruction for evaluation of normal and pathologic anatomic features in an individual patient, choice of an optimal surgical variant, prognosis of possible complications and their prophylaxis are demonstrated. Integration of surgeon's and radiologist's thinking is very important for correct diagnosis and surgical policy.