[Surgical management of cancer patients within the COVID-19 pandemic]. / Strategiya khirurgicheskogo lecheniya onkologicheskikh bol'nykh v usloviyakh pandemii COVID-19.

OBJECTIVE: A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery. MATERIAL AND METHODS: Literature data searching included Pubmed, MedLine, Scopus, Web of Science, and RSCI databases. We enrolled literature data published for the period from March 2020 to June 2020. RESULTS: Retrospective and prospective clinical trials have been analyzed. The review ensures up-to-date data on surgical management of cancer patients under the pandemic, recommendations for resuming the elective surgery, preoperative screening and prevention of COVID-19. CONCLUSION: To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still actively developed considering the benefits of treatment and risks of SARS-CoV-2 infection. Resumption of elective surgery should be progressive and cautious, especially in pandemic areas. For safety reasons, all patients eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.

[Positioning of mesh implants in endoscopic inguinal hernia repair]. / Sposoby pozitsionirovaniya setchatykh implantov pri endovideokhirurgicheskoi pakhovoi gernioplastike.

OBJECTIVE: To improve the results of endoscopic inguinal hernia repair by determining the optimal access to inguinal region and method of positioning of the mesh implant. MATERIAL AND METHODS: There were 221 patients with inguinal hernia who underwent 278 operations. We formed 2 groups: the main group A consisted of 92 (41.6%) patients who underwent extraperitoneal interventions (TEP/e-TEP); the control group B - 129 (58.4%) patients after transabdominal surgery (TAPP). In each group, 3 subgroups were identified depending on the method of mesh implant positioning: subgroups A1 and B1 - stapler reduced fixation at 1-3 points, subgroups A2 and B2 - glue fixation, subgroups A3 and B3 - vacuum positioning without fixation. Acute, chronic pain syndrome and quality of life were evaluated using visual-analogue scale (VAS), Short-Form Inguinal Pain Questionnaire (sf-IPQ) and SF-36 questionnaire, respectively. RESULTS: All interventions were completed in minimally invasive fashion. Regression of acute pain syndrome after 3, 24, 48, 72 hours and 7 days was as follows: in group A - from 3.39±0.37 to 0.53±0.18 scores, in group B - from 4.47±0.34 to 0.94±0.24 scores. The lowest values were observed in subgroups with non-invasive positioning (p<0.05). Chronic pain syndrome was evaluated by all patients as less than 2 scores in 6 months after surgery. SF-36 values after 6 months ranged from 78±1.5 to 92±1.0 at TEP/e-TEP and from 75±1.6 to 92±1.1 at TAPP. Between-group and within-group differences were not significant (p>0.05). Control examination within 0.5-2 years was performed in 189 (85.5%) patients. No relapses were detected. CONCLUSION: E-TEP technology is a priority. Glue fixation increases the congruence of mesh implants with inguinal region due to enlarged area of immobilization. This ensures safety and reliability of hernia repair, comfort for patients.

[Staged bilateral total extraperitoneal allohernioplasty by e-TEP in a patient with recurrent oblique inguinal hernia on the left and combined strangulated femoral hernia on the right]. / Étapnaia dvustoronniaia total'naia ékstraperitoneal'naia allogernioplastika po metodike e-tep u patsienta s retsidivnoi kosoi pakhovoi gryzhei sleva i kombinirovannoi ushchemlennoi bedrennoi gryzhei sprava.

A case of two-stage minimally invasive surgical treatment of an elderly patient with bilateral inguinal hernia is presented: a recurrent oblique on the left, combined (femoral, obturator, oblique and direct inguinal) on the right with incarceration and necrosis of the small intestine in the femoral canal. Previously, the patient underwent closure of perforated ulcer of duodenum from upper-midline laparotomy, epicystostomy, transvesical adenomectomy from the lower-midline laparotomy. The first stage we performed diagnostic laparoscopy, minilaparotomy, reduction and resection of necrotic small intestine loop. The second stage was carried endovideoscopic total extraperitoneal allohernioplasty by the method of Extended-View Totally Extraperitoneal (e-TEP) on two sides. The positive results of the treatment indicate a high efficiency of video endoscopic alloplasty of occult hernias in a complex case. To diagnose and perform adequate surgical intervention with a combined femoral hernia, when the obturator and inguinal hernias are formed, but clinically do not manifest themselves, it is possible only with endoscopic examination of potential sites of hernia formation in the inguinal region, which is not possible with open plastic hernia of the inguinal region.

[The algorithm of the treatment and diagnostic strategy for the treatment the children presenting with acute mastoiditis]. / Algoritm lechebno-diagnosticheskoi taktiki lecheniia detei s ostrym mastoiditom.

This article was designed to report the results of the analysis of the cases of chronic otitis media complicated by mastoiditis in the children admitted to the Morozovskaya City Children's Clinical Hospital for the examination and treatment during the period from 2009 till 2017. The objective of the present study was to evaluate the clinical significance and the optimal time schedule of computed tomography (CT) of the temporal bones in the patients with suspicion of mastoiditis for the determination of the indications for their surgical treatment. All the patients were divided into three groups differing in the severity of clinical manifestations of the disease. A special algorithm of the treatment and diagnostic strategy was developed for the management of the patients included in each group that made possible the structured approach to the choice and performance of the treatment and diagnostic procedures.

[Endoscopic surgery and laparoscopy are new insights of evolution of inguinal hernia repair (in Russian only)]. / Éndovideokhirurgiia i laparoskopiia - novyi vitok évoliutsii operativnogo lecheniia pakhovykh gryzh.

This article is devoted to general and particular problems of inguinal hernia repair through the analysis of statistical data and comparison of advantages and disadvantages of various methods of inguinal hernia repair. Particular attention is paid to the analysis of current options of mesh implant fixing during endoscopic hernia repair: TAPP, TER, e-TER. Long-term outcomes are essential to determine surgical technique. The authors consider that careful adherence to the basic principles of minimally invasive surgery can reduce the incidence of complications, recurrences and chronic pain syndrome after inguinal hernia repair. The main advantages of current surgical technologies are accelerated rehabilitation, earlier restoration of social activity, improvement of the quality of life.

[The first experience of TAPP and TEP allohernioplasty in patients with inguinal hernias at CRH]. / TARR i TER-allogernioplastika pri pakhovykh gryzhakh v usloviiakh TsRB.

AIM: To improve the outcomes in patients with inguinal hernias by application of advanced minimally invasive procedures. MATERIAL AND METHODS: The article describes an experience of 59 laparoscopic allohernioplasties in 48 patients at the central regional hospital. There were bilateral hernias in 11 cases. Transabdominal preperitoneal (n=49) and extraperitoneal (n=10) placement of polypropylene mesh graft were used. RESULTS: Intraoperative complications such as sigmoid colon lesion occurred in 2 patients with sliding left-sided hernia. Mortality was absent. Mean hospital-stay was 5.4 days, 12-month examination after discharge did not show any recurrent hernias. CONCLUSION: Positive results of TAPP and TEP hernia repair justify their application as minimally invasive techniques in patients with various inguinal hernias at CRH if appropriate technical training and motivation of surgical team are present.

[Acute otitis media in a 5 year-old child complicated by mastoiditis and abscess of the temporomandibular joint]. / Ostryi srednii gnoinyi otit u rebenka 5 let, oslozhnivshiisia mastoiditom i abstsessom visochno-nizhnecheliustnogo sustava.

This article was designed to report a case of otogenic abscess of the temporomandibular joint in a 5 year-old child. The specific feature of this observation is a rare complication of acute otitis media (otogenic abscess of the temporomandibular joint). Of crucial importance for the establishment of the correct diagnosis was the timely evaluation of the state of the temporomandibular bones by means of CT examination.

Interaction of isoforms of S100 protein with smooth muscle caldesmon.

Interaction of S100a and S100b with duck gizzard caldesmon was investigated by means of native gel electrophoresis, fluorescent spectroscopy and disulfide crosslinking. Both isoforms of S100 interact with intact caldesmon and its C-terminal deletion mutant 606C (residues 606-756) with apparent Kd of 0.2-0.6 microM thus indicating that the S100-binding site is located in the C-terminal domain of caldesmon. The single SH group of duck gizzard caldesmon can be crosslinked to Cys-84 of the beta-chain or to Cys-85 of the alpha-chain of S100. Crosslinking of S100 reduces the inhibitory action of caldesmon on actomyosin ATPase activity. S100 reverses the inhibitory action of intact caldesmon and its deletion mutants 606C (residues 606-756) and H9 (residues 669-737) as effectively as calmodulin. S100a has higher affinity to caldesmon and is more effective than S100b in reversing caldesmon-induced inhibition of actomyosin ATPase activity. Although monomeric (calmodulin, troponin C) and dimeric (S100) Ca-binding proteins have different sizes and structures they interact with caldesmon in a very similar fashion.

Utilization of troponin C as a model calcium-binding protein for mapping of the calmodulin-binding sites of caldesmon.

Troponin C, a structural analogue of calmodulin, was used for mapping the calmodulin-binding sites of caldesmon. The apparent Kd values for the formation of the caldesmon-calcium-binding-protein complex as determined by native gel electrophoresis were 0.5, 1.2 and 3.9 microM for calmodulin, rabbit skeletal muscle troponin C and bovine cardiac troponin C respectively. Troponin C induced a 4-6 nm blue shift of the Trp fluorescence of caldesmon without affecting the amplitude of fluorescence. In the presence of Ca2+, troponin C induced partial displacement of caldesmon from actin tropomyosin complexes. Addition of 5,5'-dithiobis(nitrobenzoic) acid to an equimolar complex of caldesmon and troponin C induced disulphide cross-linking between Cys-98 of rabbit skeletal muscle troponin C and the single Cys residue of duck gizzard caldesmon, located in a position analogous to Cys-580 of the chicken gizzard protein. The cross-linked caldesmon-troponin C complex was ineffective in inhibiting actomyosin ATPase activity. It is concluded that Cys-580 of caldesmon can be located close to both the central helix of calcium-binding proteins and the C-terminal domain of actin. This may be important for the regulation of actomyosin ATPase activity by caldesmon.