COMPARATIVE ANALYSIS OF THE EFFICIENCY OF DIFFERENT METHODS OF OSTEOTOMY WHEN PERFORMING CLOSED RHINOPLASTY

The aim. Increasing the effectiveness of treatment of patients with primary deformity of the nasal skeleton with a pronounced violation of the function of nasal breathing, by improving existing and developing new methods of reconstructive surgery of the nose. Materials and methods. 38 patients participated in the study. They were divided into two groups of 19 patients each. The gender and age distribution in both groups was approximately the same. The control group had rhinoplasty performed using a traditional osteotomy. Endonasal continuous osteotomy was performed using a 4 mm chisel. The research group underwent a combination of piezoelectric surgery and combined transcutaneous access, during rhinoplasty. At the same time, a 3 mm chisel was used for lateral and transverse lateral osteotomies, and a piezotome was used to remove the hump, medial and transverse dorsal osteotomies. All patients of both groups underwent only primary rhinoplasty in a closed manner. Results. Postoperative symptoms and complications were studied in both groups: perforation of the mucous membrane, narrowing of the nasal airways, bony irregularities, eyelid swelling, periorbital ecchymoses, as well as overall patient satisfaction. Symptoms were evaluated on the first day after surgery, 3 days after surgery, and 1 week after treatment. When comparing the obtained data, a statistically significant decrease in intra- and post-operative complications was found when performing rhinoplasty using piezoelectric surgery in combination with transcutaneous access. Also, piezotome osteotomy in combination with transcutaneous access has a number of advantages over classic osteotomy, which consist in reducing traumatic complications, obtaining more stable bone structures during surgery, which gives a better predicted result of rhinoplasty, and therefore, greater patient satisfaction. Conclusions. Performing a combination of piezotome osteotomy with a transcutaneous approach improves the postoperative period for patients and contributes to a better rhinoplasty result due to fewer complications

Influence of heat treatment technologies on the structure and properties of the corrosion-resistant martensitic steel type AISI 420

One of the methods for increasing the complexity of chromium steel properties of martensitic class AISI 420 is the use of an optimal heat treatment mode. The steel of martensitic class AISI 420 has high resistance in atmospheric conditions (except for the sea atmosphere), in the river, and tap water. It is widely used in power engineering, in cracking units with a long service life at temperatures up to 500 °C, for furnace parts. Additionally, it is used in the following fields: the production of turbine blades, working in conditions of high temperatures and parts of increased plasticity, subject to shock loads, for products exposed to atmospheric precipitation, solutions of organic salts and other slightly aggressive environments; production of fasteners; production of parts for compressor machines operating with inert gas; production of parts operating at low temperatures in corrosive environments; production of parts for aviation purposes. It is shown that the optimal mode of heat treatment for a maximum hardness of 40 HRC is quenching at a temperature of 980 °C with cooling in oil and tempering at a temperature of 200 °C with air cooling. With an increase in the tempering temperature from 200 °C to 450–500°C, the impact strength does not change much. Tempering at higher temperatures leads to the intense weakening of the steel. Simultaneously, a decrease in the impact strength is observed, the minimum value is reached at a tempering temperature of 550 °C. With an increase in the tempering temperature to 700 °C, the impact toughness increases, but the steel’s hardness sharply decreases at such temperatures

АНАТОМІЧНА МІНЛИВІСТЬ НЕРВІВ ДЕЯКИХ ОРГАНІВ ЧЕРЕВНОЇ ПОРОЖНИНИ

The forms of individual anatomical variability of the nerves of the liver, stomach, pancreas, duodenum and adrenal glands have been studied by means of the methods of macromicroscopy, microscopy and a mathematical analysis. A correlation between the form of the hillus of an organ and the nature of a nerve plexus. Myelin fibres of thin and median diameter are prevalent in the nerves under study.Методами макромикроскопии, микроскопии и математического анализа изучены формы индивидуальной анатомической изменчивости нервов печени, желудка, поджелудочной железы, двенадцатиперстной кишки и надпочечников. Определена взаимосвязь между формой ворот органа и характером нервного сплетения. У нервах превалируют миелиновые волокна тонкого и среднего диаметров.Методами макромікроскопії, мікроскопії та математичного аналізу вивчені форми індивідуальної анатомічної мінливості нервів печінки, шлунка, підшлункової залози, дванадцятипалої кишки та надниркових залоз. Визначений взаємозв'язок між формою воріт органа та характером нервового сплетення. У досліджених нервах переважають мієлінові волокна тонкого та середнього діаметрів

Clinical characteristics of a large cohort of patients with positive culture of Fusobacterium necrophorum

Background: Fusobacterium necrophorum is a rare pathogen, mostly affecting young adults, causing infections of the head and neck, typically described as the Lemierre's syndrome. Today this symptom complex has become increasingly rare and has almost turned to a 'forgotten disease'. Methods: We performed a retrospective, descriptive study to identify the clinical features of patients with positive culture of F. necrophorum . Additionally, the antibiotic susceptibility profile of the pathogens was analysed.Results: During a period of 22 years 36 patients with at least one isolate of F. necrophorum were identified. Mostly tonsillar and peritonsillar abscesses were found, 10 patients were identified with bacteraemia, but only 4 patients presented with symptoms like sore throat, fever and swollen cervical lymph nodes, which may suggest Lemierre's. Most of the isolates (33/35) showed sensitivity to all tested antibiotics.Conclusion: Appropriate techniques are needed to detect F. necrophorum , especially from throat swabs, in the microbiological laboratory. Current clinical and microbiological practice may lead to under-diagnosis of infections caused by F. necrophorum . Further research is needed to define the colonization rate and to optimize methods for detection as well as identification of virulence