An innovative universal protocol for orthognathic surgery three-dimensional virtual simulation.

The aim of this technical note is to describe a protocol for three-dimensional virtual simulation of orthognathic surgery that has been designed to be easily implemented, without the need for any special clinical apparatus, software brand, or computed tomography sequence. The protocol comprises innovative concepts and simplified steps for image segmentation, creation of a composite skull, control of the condylar position, and sequencing of bimaxillary surgery. This protocol was applied by the developers in about 2000 cases performed between 2015 and 2022, and has become quite popular among local surgeons. Previous preliminary studies have shown that it meets the accuracy standards for clinical use, although further studies with larger numbers of patients are desirable for additional validation.

[Immune disturbances in patients with postnecrotic pseudocysts of the pancreas].

The aim of the study was to investigate the role of immune disturbances in development of postnecrotic pseudocysts of the pancreas. 94 patients including 74 with postnecrotic pancreatitis and pseudocysts of the pancreas were observed. The adaptive reactions and subpopulation composition of the peripheral blood lymphocytes were assayed. The percentage of the cells in the state of apoptosis in the cyst content was estimated. The disturbances in the subpopulation composition of the lymphocytes and stress adaptive reactions of the blood system were shown to be some of the main pathogenetic factors in development of postnecrotic complications of pancreatitis. The data are useful in differential diagnosis of pseudocysts and choice of the optimal tactics in the operative treatment of such patients.

[The activity of antioxidant enzymes of erythrocytes under intensive physical activity on the background of D-ribose use].

Biochemical analysis of blood of 30 male rats with 240 +/- 20 g mass and 50 sportsmen at the age 17-20 years were done. They were subjected by intensive physical activity with D-ribose use and without it. Carbohydrate was being put into them before and after intensive physical activity during 5-7 days. The dose was 30-50 mg/kg of their body mass. Concentration of glucose, lactate and uric acids, level of malondialdehyde, activity of superoxide dismutase, glutathione peroxidase and glucose-6-phosphate dehydrogenase were defined in the male rats and sportsmen blood. It is shown that D-ribose use influences positive by to the dynamics of biochemical data in blood. It has taken place owing to the intensification of reutilization of purine mononucleotides and the activity of pentose cycle, as a result lipid peroxidation of membrane of erythrocytes reduces and state of antioxidation system improves.

Ultrasonic model of acute pancreatitis.

Acute pancreatitis was modeled in outbred albino rats by contact exposure of the pancreatic lobes to low-frequency ultrasound. This method induces focal destruction of the pancreas not accompanied by damage to the adjacent intact tissues. Morphological study showed microcirculatory disorders, parenchymatous edema, plethoric vessels with diapedetic and focal hemorrhages, and small foci of hemorrhagic impregnation and steatonecrosis in zones locally exposed to low-frequency ultrasound.

[Use of plasmapheresis for correction of metabolic disorders in patients with surgical sepsis]. / Ispol'zovanie plazmafereza dlia korrektsii metabolicheskikh narushenii u bol'nykh s khirurgicheskom sepsisom.

Twenty-four patients aged 16-67 years with surgical sepsis developing as a result of pancreonecrosis, gynecological diseases, urological sepsis. closed abdominal injury, and suppurative inflammation of soft tissues were examined. Endotoxemia caused pronounced disorders in metabolism, particularly purine metabolism, and the associated lipid peroxidation processes. Plasmapheresis exerted a positive effect in patients with high concentration of medium molecular-weight polypeptides (more than 0.32 arb. units) in the blood, decreasing the mortality by 40.5%. At lower concentrations of these polypeptides in the blood (less than 0.32 arb. units) plasmapheresis is inefficient.

[Disorders of purine metabolism in patients with peritonitis complicated by sepsis]. / Narusheniia metabolizma purinov u bol'nykh peritonitom, oslozhnivshimsia sepsisom.

Progressive hypoxia and cell destruction leading to increased production of active oxygen forms by xanthinoxidase and manifesting by an increased level of uric acid in the blood in parallel with inhibited pentose cycle reaction due to low activity of glucose-6-phosphate dehydrogenase determine the severity of peritonitis.

[Cellular factors of natural immunity in patients with acute peritonitis]. / Kletochnye faktory estestvennogo immuniteta u bol'nykh ostrym peritonitom.

A total of 233 patients with acute peritonitis who in the postoperative period were subjected only to conventional complex intensive care (Group I) have been examined. Changes in medium molecular weight polypeptide level, relative and absolute monocyte and granulocyte content, phagocyte number and index, blood phagocytosis capacity and metabolic potential of macrophages in spontaneous and activated NBT test have been established. Integral tetrazolium neutrophil activity was different in subgroups of patients with (Group I) and without (Group II) complications. The factors which play the key role in the formation of pyoseptic complications have been identified as were diagnostic-prognostic tests evaluating their critical level. Patients from Group II with a high level of medium molecular weight toxin, besides conventional therapy, were subjected to hemosorption which brought about a positive clinical and laboratory effect.

[The general biological principles of the development of complications in the postoperative period of acute peritonitis and the expediency of hemosorption]. / Obshchebiologicheskie zakonomernosti formirovaniia oslozhenii v posleoperatsionnom periode ostrogo peritonita i tselesoobraznost' gemosorbtsii.

The dynamic study of a number of clinical and laboratory findings in 107 patients with acute peritonitis have shown that with the current complex infusion therapy the onset of postoperative complications is to a great extent mediated by high toxin level--medium molecular mass polypeptide, inhibiting the processes of protein synthesis and consequently causing changes in the relationship between adaptation compensatory reactions, which demonstrates the necessity of additional active detoxicating therapy, i.e. hemosorption (HS). HS was performed to 126 patients and its efficacy in pronounced toxemia was established. The data obtained make it possible to consider HS as an effective means preventing the onset of postoperative complications in acute peritonitis.

[Immunologic effect of hemosorption in patients with acute peritonitis]. / Immunokorrigiruiushchii éffekt gemosorbtsii uu bol'nykh ostrym peritonitom.

An examination of 65 patients with acute diffuse peritonitis has shown that pronounced T-immune deficiency is observed in the postoperative period of acute peritonitis. Hemosorption was shown to be efficient in patients with high content of toxin which allows considering the method of extracorporeal detoxication as effective means of immune-correcting therapy in peritonitis patients with high level of toxinemia who make up a group of risk.

[Extracorporeal detoxification of the body and the B system of immunity in acute peritonitis]. / Ekstrakorporal'naia detoksikatsiia organizma i B-sistema immuniteta pri ostrom peritonite.

65 patients with acute peritonitis of various etiology have been examined. It has been established that marked toxemia in the early postoperative period, normal relative B-lymphocyte content, low level of EAC-RFC with moderate to high content of receptors to sheep red blood cells are prognostically unfavourable. The level of intermediate molecular mass polypeptides (IMMP) above 0.4 units and absolute absence of B lymphocytes with high receptor density during one postoperative week seem threatening and are an indication for hemosorption (HS). HS in patients with high toxin content was accompanied by a positive clinical effect related to its non-specific stimulation of qualitative and functional B-lymphocyte properties including their receptor apparatus due to IMMP removal from blood.

[Immunologic reactivity and sorption detoxication of patients with acute peritonitis]. / Immunologicheskaia reaktivnost' i sorbtsionnaia detoksikatsiia bol'nykh ostrym peritonitom.

Follow-up using immunological monitoring of 233 acute peritonitis patients revealed various immunological shifts occurring at all levels postoperatively, with the therapeutic methods being common. Depression of specific immune response mechanisms (T- and B-systems) along with disinhibited phylogenetically old forms of the common biological phenomenon non-specific immunity (phagocytosis) is believed to reflect the common adaptive mechanism activated in emergencies in patients with peritonitis. With high levels, the toxin median molecular mass polypeptide in the complicated postoperative course, the immunological impairment is more pronounced, while restoration of immunological responsiveness of the organism becomes protracted, resulting in reduction of the cellular homeostasis and metabolism reserved. Application of the extracorporeal detoxication-hemosorption promotes adaptation buildup and makes immunity functioning optimal.

[Adaptation reactions in acute peritonitis and their correction using sorption detoxification]. / Adaptatsionnye reaktsii pri ostrom peritonite i ikh korrektsiia s pomoshch'iu sorptsionnoi detoksikatsii.

Examined were 233 patients with acute peritonitis. In patients, who underwent the conventional intensive infusion therapy alone, in complicated course of the postoperative period, within 28 days, the high level of pathologic stress reactions was observed, which correlated with changes in the content of middle molecular mass peptides (MMMP). In uncomplicated course of the postoperative period, the MMMP level and adaptation reactions didn't differ from the control findings. Hemosorption in patients with high toxin level was accompanied by the decline in MMMP concentration below the diagnostic level, restoration of physiologic adaptation reactions.

[Effect of hemosorption on the level of medium molecular mass polypeptides and humoral immunity in patients with peritonitis]. / Vliianie gemosorbtsii na uroven' polipeptidov srednei molekuliarnoi massy i gumoral'nyi immunitet u bol'nykh peritonitom.

An examination of 43 patients with acute diffuse peritonitis of various etiology has revealed different direction of the dynamics of indices of humoral immunity (M, G, A immunoglobulins, general complement activity, circulating immune complexes) depending on the level of middle mass polypeptides (MMP) in the patient's blood. Hemosorption in peritonitis was established to allow rapid and effective elimination of MMP in patients with high content and thus control critical endotoxicosis.

[Comparative characteristics of methods of evaluation of plasma toxicity and severity of toxemia in acute diffuse peritonitis]. / Sravnitel'naia kharakteristika metodov otsenki toksichnosti plazmy krovi i tiazhesti intoksikatsii pri ostrom razlitom peritonite.

Experimental and clinical investigations have established the method of biological testing on mice and the leukocyte index of intoxication to be objective and reliable criteria for the estimation of the blood plasma toxicity and the degree of intoxication.