OPTIMIZATION OF A RECONSTRUCTIVE PLASTIC SURGERY OF EXTENSIVE CICATRICAL BLEPHARON DEFECTS WITH MULTIPARTITE TISSUE COMPLEX

Purpose. Assessment of efficiency in the use of a multi-component tissue complex for an optimization of reconstructive plastic surgery for extensive cicatrical deformations of blepharons.Material and methods. The analysis of plastic reconstruction of extensive cicatrical defects of blepharons was carried out in 30 patients (30 eyes) aged from 27 to 68 years (average: 52.9±14 years). The reasons of cicatrical deformations of blepharons were: mechanical traumas – 9 patients, gunshot injuries and explosive traumas – 4, tumor surgeries – 12, stings of animals – 5. The area of the eyelid defect was from 69 to 105 mm2(average: 87.5±9.0 mm2).All patients were divided into 2 groups. The main group included 15 patients (15 eyes) who underwent the operation with the technique of layerby-layer reconstruction of the eyelid using a three-layer multicomponent tissue complex consisting of a mucoperiosteal flap, a muscle-fascial flap of the temporal muscle, free skin graft. The comparative group was composed of 15 patients (15 eyes) where a two-layer graft was used which consisted of a mucoperiosteal flap and a skin flap on the nourishing base to recover the penetrating extensive eyelid defect.Results and discussion. On the 5th day after the operation, signs of infection and hematoma of the eyelids were absent, and there was a moderate edema of tissues in all patients of the main and comparative groups.On the 10th day after the operation, the skin graft acquired a pink tint on its entire surface in patients of the main group. In the comparative group, the pink shade of the skin graft was noted only from the side of the nourishing pedicle, the rest part kept a pale shade and areas of epidermal necrosis.After 1 month, the reparative process culminated in the formation of a tender fine scar, and the mobility of the eyelids appeared in the patients of the main group. The size of palpebral fissure varied from 9 to 11mm (on average 10.1±0.5mm), the deviation of the palpebral fissure size was about «-»16%. In the comparative group, the reparative process was completed by the formation of a tender fine scar only in 5 patients. In 10 patients a reduction of the graft and a formation of scar tissue retraction were observed, with a deviation in the size of the palpebral fissure by 8-12mm (on average 10.9±1.0) compared with the healthy one. Visible scar deformations of the eyelids were not observed 3 months after the operation in patients of the main group. The deviation of the palpebral fissure size was «-»7-8%. In the comparative group a cicatricial shortening of the operated eyelid with the formation of coloboma and ectropion occurred in 3 patients.During 2 years of follow-up, the correct position and anatomy of the eyelids remained in the patients of the main group, the size of the palpebral fissure averaged to 11.7±0.5mm and did not differ significantly from the healthy eye (11.9±0.4mm), p>0.05.Within the same period in the comparison group 5 patients had an incorrect position of the operated eyelid (retraction, ectropion, entropion), which required repeated plastic reconstructions.Indices of hemodynamics: in the main group, the complete correspondence of parameters of blood flow to the tissues of the healthy eyelid occurred 1 month after the operation (p>0.05). In the comparative group positive changes were detected only 3 months after blepharoplasty. In the comparative group positive changes were detected only 3 months after blepharoplasty.Conclusions. The proposed combined method of blepharoplasty for extensive complicated cicatrical defects allows to reduce its multistage approach, to increase donor resources in order to receive the desired plastic material, to empower ophthalmoplasty without serious postoperative complications, to improve esthetic results of rehabilitation. Key words: blepharoplasty, extensive cicatrical defects of blepharons

Results of Reconstructive Plastic Surgery of Extensive Through Eyelid Defects

Purpose. The analysis of clinical effectiveness of a triplex transplant in recovery of extensive through eyelid defects. Patients and  methods. 18 patients were under observation (18 eyes) aged from 27 to 68 years with extensive through eyelid defects. The area ofdefects varied from 69 to 105 mm2 (average 87.5 ± 9.0 mm2). The reasons of through eyelid defects were: a mechanical trauma —5 patients, an explosive trauma — 2 patients, result of surgery of tumors a century — 11 patients. All patients were divided into2 groups. The main group consisted of 9 people (9 eyes) who had triplex transplant containing a temporal muscle for replacement ofthrough eyelid defects. The control group consisted of 9 people (9 eyes) who had a double-layer tissular transplant for replacement ofthrough eyelid defects. Besides basic ophthalmologic examination, the research of speed and intensity of recovery of local  hemodynamic of transplant was conducted to all patients. The examination was made in 3, 10 days, 1 month after operation, then once in 6 months. Results. In 1 month after operation in main group reparative process came to the end with formation of a gentle thin hem on border of skin transplant. Color of skin transplant was identical to nearby tissues. Secondary cicatricial deformations of skin transplant were absent. Only in 5 patients of control group in 1 month after operation process came to the end with formation of thin hem on border of transplant. 3–6 months later rough deformations of transplant was not observed in any patients of the main group. Cicatricial shortening of the operated eyelid with formation of partial coloboma and eversion of eyelid were in 3 patients of control group that demanded carrying out the second stage of surgical treatment. Conclusion. The offered method of blepharoplasty with use of a temporal muscle makes a practical contribution in development of the perspective direction of a reconstructive plastic surgery of extensive through eyelid defects

State Research Centre for Preventive Medicine, Federal Agency on High Medical Technologies

Aim. То analyze the quality of medical help to Vologda citizens with acute cerebral stroke (S), considering healthcare continuum at ambulatory, pre-hospital and hospital levels in the first 28 days from S development.Material and methods. In the Vologda City healthcare system, the technology for registering acute S cases (S register) has been developed, with 2001—2005 results analyzed.Results. During the whole follow-up period, early S cases (<30 years) have been registered among Vologda City citizens. In patients with arterial hypertension (AH), pharmaceutical therapy quality deteriorated after S. Most S patients (approximately 75 %) were hospitalized in the first 24 hours. Many patients applied for emergency medical help (EMH) late, and about 25 % applied to their general practitioner, via home visits or ambulatory appointments. In various years of follow-up, acute S was diagnosed by EMH doctors in 65,6—68,2 % of the cases, and by general practitioners — in 17,9—23,1 %. During the first 28 days, about 25’fi of the S patients died, during the first year — 46,6 %. AH control effectiveness was high in S individuals during their hospital treatment.Conclusion. S register demonstrated the defects of ambulatory S treatment, especially in patients with high cardiovascular risk. AH control effectiveness was high in hospitalized hypertensive patients with acute S

Arterial hypertension registry in Vologda Region

Aim. To study implementation experience of arterial hypertension (AH) diagnostics, monitoring, and control technology in Vologda Region primary healthcare system. Material and methods. AH Registry was formed in primary healthcare system by clinic visit principle - blood pressure (BP) measurement in all visitors of out-patient departments and units. The analysis included 2003-2004 data, 45344 BP measurements, and 18656 AH patients. Results. AH prevalence was 41%, with 6% of newly diagnosed AH, and 84,5% of moderate to severe AH. As many as 43,6% of AH men were smokers, comparing to 2,3% of AH women. Obesity rates were 35,9% and 53,2%, hypercholesterolemia rates - 48,3% and 47,6%, respectively. Clinical AH severity was also assessed. Conclusion. Implementing clinic visit-based AH diagnostics technology facilitates dynamic AH control on population level, timely correction of diagnostics, prevention and treatment programs, improved access to and quality of care in rural healthcare settings

Growth of nanosized MnAs/Si(111) magnetoelectronic heterostructures and their magnetooptical study

Contains fulltext : 92623.pdf (publisher's version ) (Closed access

Magnetooptical study of granular silicon oxide films with embedded CoNbTa ferromagnetic particles

Contains fulltext : 92588.pdf (publisher's version ) (Open Access

High-Energy X-ray Photoemission and Structural Study of Ultrapure LaF3Superionic Conductor Thin Films on Si

LaF3 films in the 5−40 nm thickness range were grown on Si(111) by molecular beam epitaxy. The substrates were kept at 450 °C during deposition. The films were investigated by high- energy X-ray photoemission flanked by conventional X-ray photoemission, reflection high-energy electron diffraction, and atomic force microscopy. The film growth was layer-by-layer. The surface of the films presented flat terraces, ∼100 nm wide, separated by monatomic steps, reproducing the morphology of the substrate. La 3d, F 1s, O 1s, and Si 2p core levels and valence band were measured by high-energy photoemission to investigate the reactivity of the system and the surface and bulk composition of the films, following varying sample treatments (X-ray irradiation, sputtering, heating). The fresh prepared films resulted of high purity, with no traces of reaction or intermixing at the buried interface between the substrate and the trifluoride. The X-ray beam was seen to induce F depletion at the surface and promote oxide formation. F depletion enhancement was obtained through Ar ion sputtering. An irreversible variation of the film composition was finally observed for samples heated above 300 °C, with the development of La oxides and oxofluorides. These effects were related to the high mobility of F ions in the LaF3 lattice and to the high tendency of defects formation involving F sites