Surgical treatment of the patients with posttraumatic aneurysms of subclavian arteries

Posttraumatic aneurysm of clavicular artery is the rare pathology (less 1% of all peripheral aneurysms). Experience of surgical treatment of 5 patients with this disease is analyzed. All the patients underwent different surgical procedures depending on aneurysm size and localization. There were no lethal outcomes. Preoperative diagnostic methods, surgical techniques and postoperative complications are described. Review of literature is also available.     

Quality of patients life after surgical treatment of dissecting aortic aneurysm type B and aneurysms of descending aorta

Quality of life at the patients with dissecting aortic aneurysm type B and aneurysms of descending aorta were studied with SF-36 questionnaire before and after surgical treatment. Quality of patients life before and after surgical treatment is lower compared with health population. Reconstructive operation takes beneficial effect on life quality at long-term postoperative period.     

Preoperative neurophysiological study of patients with epilepsy caused by damage to the temporal lobe

The paper deals with the development and substantiation of various neurophysiological procedures during preoperative examination of patients with symptomatic epilepsy. The neurophysiological findings of 133 patients with drug-resistant temporal lobe epilepsy were applied. Unprogressive damage to the medial portions of the temporal lobe was verified in 18 patients. Low- and higher-grade malignancy of the temporal lobe was confirmed in 91 and 24 patients, respectively. This yielded an algorithm of the optimum neurophysiological preoperative examination. Emphasis is laid on the differences in applied procedures depending on the side of organic lesion location. Thus, the use of the developed algorithm makes it possible to lighten the selection of candidates for surgical treatment of drug-resistant symptomatic epilepsy and to optimize the examination of epileptic patients with different types of brain damage.     

Intima-preserving exoprosthetics of ascending aortic aneurism: 15 years of experience

Short- and long-term follow-up results of intima-preserving exoprosthetics of ascending aortic aneurism in 50 patients were studied. The group of control consisted of 54 patients, whom traditional linear prosthetics of ascending aortic aneurism had been performed. Time of artificial circulation and myocardial ischemia was significantly shorter in first group: 60,3±2,6 min and 21±1,7min, respectively. Patients of both groups showed no significant aortic distension postoperatively (34,5±0,7 - 36,6±0,8 mm). Thus, a dosed resection of the ascending aortic aneurism with intima-preserving exoprosthetics proved to be relatively simple and promising technique.     

Bilateral reconstruction of the renal arteries by laparotomy approach]

Bilateral disease of renal arteries due to renovascular hypertension is encountered, according to the authors' data, in 23% of cases. The standard method of surgical treatment, generally accepted in Russia, consists in staged reconstruction of renal arteries through the thoracophrenolumbotomy approach. For the first time, one stage reconstruction of both renal arteries by type of patch "Gore-Tex" isthmoplasty through laparotomy approach was performed in RRCS RAMS. Technical aspects of the procedures performed in 2 patients are described in details. The authors suggest that one stage reconstruction of both renal arteries through the laparotomy approach is the method of choice in bilateral stenosis of renal arteries and allows to perform not only isthmoplasty but also prosthetic reconstruction of renal arteries up to their bifurcation without intersection of the right renal vein and its branches.     

Comparison of retrospective luminescence dosimetry with computational modeling in two highly contaminated settlements downwind of the Chernobyl NPP

The cumulative absorbed dose in bricks collected from six buildings in two heavily contaminated settlements (137Cs > 2,000 kBq m(-2)) located downwind of the Chernobyl Nuclear Power Plant was determined using luminescence techniques by six laboratories. The settlements, Vesnianoje in Ukraine and Zaborie in Russia, are located in, respectively, proximal and distal locations relative to the Chernobyl Nuclear Power Plant. The luminescence determinations of cumulative dose in brick, after subtraction of the natural background dose, were translated to absorbed dose in air at a Reference Location using conversion factors derived from Monte Carlo simulations of photon transport. The simulations employed source distributions inferred from contemporary soil contamination data and also took into account heterogeneity of fallout deposition. This translation enables the luminescence determinations to be compared directly with values of cumulative absorbed dose obtained by computational modeling and also other dose reconstruction methods. For each sampled location the cumulative dose was calculated using three deterministic models, two of which are based on the attenuation of dose-rate with migration of radionuclides in soil and the third on historic instrumental gamma dose-rate data. The results of the comparison of the two methods indicate overall agreement within margins of +/-25%. The methodology developed is generally applicable and adaptable to areas contaminated by much lower levels of radioactive fallout in which brick buildings are found.     

Long-term results of surgical treatment of patients with asymptomatic carotid artery stenosis

Results of treatment of 148 patients with asymptomatic carotid stenosis were analyzed in terms from 5 to 180 months. 75 (51%) patients were operated, 73 (49%)--were not operated. Non-operated asymptomatic patients with more than 90% stenosis and patients with prolonged (more than 18 mm) stenosis have the highest risk of cerebral events (4% annually and more). In long-term period (from the 70th month of follow-up) patients with the 70-90% stenosis are the group of high risk of cerebro-vascular symptoms.