Surgical correction of distal tibia posttraumatic deflection

Abstract Objective – to study the issues related to diagnostics and treatment of pilon fracture of the tibial epiphysis and individual approach to surgical correction of posttraumatic deformations of the distal tibia. Material and methods. The treatment results of 49 patients who had suffered pilon fractures throughout 1–2 years after treatment completion were studied in the clinic of Traumatology and Orthopedic on the basis of “ZSMKH №9”. According to the AO classification patients had the following types of fractures: 43A – 7 patients, 43B – 14 and43C – 28. The X-ray measurements characterizing the geometric shape of articular surfaces were measured. The mathematical finite element method of computer modeling was used for the study of bone and cartilaginous tissues stress distribution pattern in the ankle joint in its normal condition and in case of post-traumatic deflections. Results. The basic pathological symptom in patients with pilon fractures of distal tibia is joint function limitation, which spreads to the sector of dorsal extension, regardless of the pilon fracture type. The joint continues to function, however movement amplitude is decreased. The most unfavorable change of distal tibia shape is valgus inclination of articular surface. This configuration change of tibial articular end requires repeated surgical correction. Conclusions. The main task of the distal tibial epiphysis surgical correction is the weight-bearing function and axial relationships restoration and pain management. It can be concluded that selective approach to posttraumatic deformations of the distal tibia surgical correction is essential. The main indications for surgical correction are pseudarthrosis, deviations in the frontal plane of more than 10 degrees, severe joint arthrosis accompanied by pain syndrome for more than a year

Temporal response to harmonic driving in electroconvection

The temporal evolution of the spatially periodic electroconvection (EC) patterns has been studied within the period of the driving ac voltage by monitoring the light intensity diffracted from the pattern. Measurements have been carried out on a variety of nematic systems, including those with negative dielectric and positive conductivity anisotropy, exhibiting "standard EC" (s-EC), those with both anisotropies negative exhibiting "non-standard EC" (ns-EC), as well as those with the two anisotropies positive. Theoretical predictions have been confirmed for stationary s-EC and ns-EC patterns. Transitions with Hopf bifurcation have also been studied. While traveling had no effect on the temporal evolution of dielectric s-EC, traveling conductive s-EC and ns-EC patterns exhibited a substantially altered temporal behavior with a dependence on the Hopf frequency. It has also been shown that in nematics with both anisotropies positive, the pattern develops and decays within an interval much shorter than the period, even at relatively large driving frequencies.Comment: 19 pages, 5 figure

Public health component in building information modeling

A building information modelling (BIM) conception has established itself as an effective and practical approach to plan, design, construct, and manage buildings and infrastructure. Analysis of the governance literature has shown that the BIM-developed tools do not take fully into account the growing demands from ecology and health fields. In this connection, it is possible to offer an optimal way of adapting such tools to the necessary consideration of the sanitary and hygienic specifications of materials used in construction industry. It is proposed to do it through the introduction of assessments that meet the requirements of national sanitary standards. This approach was demonstrated in the case study of Revit® program

Оценка влияния сопутствующей глаукомы на результаты эндотелиальной кератопластики при буллезной кератопатии

PURPOSE: Evaluate the influence of concomitant glaucoma on the ultra-thin Descemet’s stripping automated endothelial keratoplasty (UTDSAEK) outcome. METHODS: 64 patients (67 eyes) with bullous keratopathy underwent UTDSAEK. The average age of the patients was 71.7±5.4 years. The average preoperative visual acuity equaled 0.04±0.04. 19 patients (19 eyes) had a history of glaucoma (stages II-III). 45 patients (48 eyes) didn’t have glaucoma. Bullous keratopathy was detected in 47 of the studied eyes, Fuchs dystrophy - in 20. Prior to the operation mean intraocular pressure (Р0) in eyes with glaucoma was 13±2.3 mmHg, in eyes without glaucoma - 14±3.1 mmHg. Intraocular pressure before and after the operation was measured by Tonopen-XL tonometer. RESULTS: In 1 year after endothelial keratoplasty mean IOP for patients with concomitant glaucoma was higher than before surgery and equaled 16±2.8 mmHg (pЦЕЛЬ. Оценить влияние сопутствующей глаукомы на результаты автоматизированной эндотелиальной кератопластики с удалением десцеметовой мембраны и использованием тонких трансплантатов (UTDSAEK). МЕТОДЫ. 64 пациентам (67 глаз) с буллезной кератопатией произвели UTDSAEK. Средний возраст пациентов составил 71,7±5,4 года. Средняя дооперационная острота зрения равнялась 0,04±0,04. Не страдали глаукомой 45 больных (48 глаз), у 19 пациентов (19 глаз) в анамнезе имелась глаукома II-III стадии. Вторичная буллезная кератопатия была выявлена на 47 глазах, дистрофия Фукса - на 20. Среднее внутриглазное давление (ВГД, Р0) на глазах с глаукомой до кератопластики составляло 13±2,3 мм рт.ст., на глазах без глаукомы - 14±3,1 мм рт.ст. ВГД до и после операции измеряли апланационным тонометром Tonopen-XL. РЕЗУЛЬТАТЫ. Через 1 год после эндотелиальной кератопластики среднее ВГД у больных с сопутствующей глаукомой было достоверно выше, чем до операции, и равнялось 16±2,8 мм рт.ст. (

Three-dimensional pattern formation, multiple homogeneous soft modes, and nonlinear dielectric electroconvection

Patterns forming spontaneously in extended, three-dimensional, dissipative systems are likely to excite several homogeneous soft modes ($\approx$ hydrodynamic modes) of the underlying physical system, much more than quasi one- and two-dimensional patterns are. The reason is the lack of damping boundaries. This paper compares two analytic techniques to derive the patten dynamics from hydrodynamics, which are usually equivalent but lead to different results when applied to multiple homogeneous soft modes. Dielectric electroconvection in nematic liquid crystals is introduced as a model for three-dimensional pattern formation. The 3D pattern dynamics including soft modes are derived. For slabs of large but finite thickness the description is reduced further to a two-dimensional one. It is argued that the range of validity of 2D descriptions is limited to a very small region above threshold. The transition from 2D to 3D pattern dynamics is discussed. Experimentally testable predictions for the stable range of ideal patterns and the electric Nusselt numbers are made. For most results analytic approximations in terms of material parameters are given.Comment: 29 pages, 2 figure

Evaluation of myocardial damage in different types of rheumatoid arthritisduring disease-modifying antirheumatic drug or biological therapy (with infliximab)

Objective. To estimate the extent and pattern of myocardial damage in different types of rheumatoid arthritis (RA) during disease-modifying antirheumatic drug (DMARD) or biological therapy. Subjects and methods. Seventy-one patients with RA were examined; some of them received biological therapy with infliximab, while the others took DMARDs. A group of patients with incipient RA was also identified. B-type brain natriuretic peptide levels were estimated and electrocardiography, echocardiography (EchoCG), and cardiac magnetic resonance imaging (MRT) using the contrast medium Dotarem were conducted in all the patients. The follow-up totaled 6 months. A control examination was made at the moment of randomization and 6 months posttreatment. Results. Tn the bulk of patients, the level of B-type brain natriuretic peptide did not differ from the reference values, however, its lower level was observed in the incipient RA group, which was associated with the absence of cardiovascular diseases and with a younger age group. There were no negative EchoCG changes in myocardial viability values. Cardiac MRT demonstrated that the majority of patients had the similar changes that failed to affect myocardial kinetics and ejection fraction. These changes were not found in incipient RA patients without cardiovascular diseases. No improvement in myocardial viability was recorded in the patients receiving the biological therapy. Conclusion. Thus, cardiac MRT showed the similar changes that failed to affect myocardial kinetics and ejection fraction in patients with RA during both methotrexate and infliximab therapy

Магнитно-резонансная томография в диагностике функциональных изменений головного мозга при нарушениях менструального цикла: обзор

INTRODUCTION: Currently, the most common variant of the reproductive system disorders, in particular menstrual cycle disorders, in adolescent girls is oligomenorrhea. In situations after a complete diagnostic screening no organic and endocrine pathology of the reproductive system is detected in this group of patients, it is possible to conduct functional MRI as a method of identifying cause-and-effect relationships and clarifying the pathogenesis of menstrual disorders.OBJECTIVE: To analyze the available foreign and domestic literature to determine the role of magnetic resonance imaging in the diagnosis of functional brain changes in menstrual disorders in adolescent girls.MATERIALS AND METHODS: A search was conducted for scientific publications in the information and analytical systems PubMed and Google Scholar for 2013–2023 by keywords: «resting-state functional MRI» («functional resting MRI»), «oligomenorrhhea» («oligomenorrhea»), «adolescent girls» («teenage girls»), «reproductive system functional disorders» («functional disorders of the reproductive system»), «magnetic resonance imaging» («magnetic resonance imaging»), «diagnostic radiology» («radiation diagnostics»). 46 publications related to the diagnosis of functional brain changes in menstrual disorders in the form of resting state fMRI were analyzed.RESULTS: Resting state fMRI allows us to assess the basic brain activity in the absence of certain sensory or cognitive stimuli and visualize working networks that include various parts of the brain demonstrating synchronous changes in the BOLD-signal at rest. There are a number of patterns of changes in the BOLD-signal that can be observed in various phases of the menstrual cycle, as well as under the influence of stress factors, which makes it possible to visualize the morphological substrate of oligomenorrhea that occurs against the background of the absence of organic and endocrine pathology of the reproductive system in adolescent girls. Currently, there is little data in the scientific literature on the use of functional resting MRI in this cohort of patients, however, this method can have a significant impact on the formation of an individual plan for the correction of reproductive disorders in adolescence, and therefore requires further study.CONCLUSION: The use of fMRI can open up new possibilities in the diagnosis of functional brain disorders in girls with «unexplained» oligomenorrhea.ВВЕДЕНИЕ: В настоящее время наиболее распространенным вариантом расстройств репродуктивной системы, в частности нарушений менструального цикла, у девочек-подростков является олигоменорея. В ситуациях, когда после проведения полного диагностического скрининга у этой группы пациенток не обнаруживается органическая и эндокринная патология репродуктивной системы, возможно проведение функциональной МРТ как метода выявления причинно-следственных связей и уточнения патогенеза нарушений менструального цикла.ЦЕЛЬ: Анализ имеющейся иностранной и отечественной литературы для определения роли магнитно-резонансной томографии в диагностике функциональных изменений головного мозга при нарушениях менструального цикла у девочек-подростков.МАТЕРИАЛЫ И МЕТОДЫ: Проведен поиск научных публикаций в информационно-аналитических системах PubMed и Google Scholar за 2013–2023 гг. по ключевым словам: «resting-state functional MRI» («функциональная МРТ покоя»), «oligomenorrhea» («олигоменорея»), «adolescent girls» («девочки-подростки»), «reproductive system functional disorders» («функциональные нарушения системы репродукции»), «magnetic resonance imaging» («магнитно-резонансная томография»), «diagnostic radiology» («лучевая диагностика»). Были проанализированы 46 публикаций, связанных с диагностикой функциональных изменений головного мозга при нарушениях менструального цикла в форме олигоменореи у девочек-подростков с помощью метода функциональной магнитно-резонансной томографии покоя.РЕЗУЛЬТАТЫ: Функциональная МРТ покоя позволяет оценить базовую активность мозга в отсутствие определенных сенсорных или когнитивных стимулов и визуализировать рабочие сети, включающие в себя различные участки головного мозга, демонстрирующие синхронные изменения BOLD-сигнала в состоянии покоя. Существует ряд закономерностей изменения BOLD-сигнала, которые можно наблюдать в различные фазы менструального цикла, а также при воздействии стрессовых факторов, что позволяет визуализировать морфологический субстрат олигоменореи, возникающей на фоне отсутствия органической и эндокринной патологии репродуктивной системы у девочек-подростков. В настоящее время в научной литературе представлено мало данных об использовании функциональной МРТ покоя в этой когорте пациентов, однако данный метод может оказать существенное влияние на формирование индивидуального плана коррекции репродуктивных нарушений в подростковом периоде, в связи с чем требует дальнейшего изучения.ЗАКЛЮЧЕНИЕ: Использование фМРТ может открыть новые возможности в диагностике функциональных нарушений головного мозга у девочек с «необъяснимой» олигоменореей

Влияние вида и объема хирургического вмешательства на течение послеоперационного периода у больных с глиальными опухолями

283 patients with gliomas were included in this study. Age, sex, neurological status and Karnovsky performance were analyzed before and after surgery, also tumor location, type and volume of surgical resection, postoperative complications were considered. Volume of tumor resection did not depend on glioma localization, excluding deep located tumors, in which case stereotactic cryotomy was performed (p < 0,01). In cases of stereotactic cryotomy postoperative neurological deficit worsening was noted in 12,5%, in patients with open biopsy and partial resection — 10,9%, and in case of total or subtotal tumor resection in 7,0% (p > 0,05). Partial gliom resection often related with postoperative complications and neurological deficit worsening then open surgery total tumour resection. Stereotactic cryotomy does not lead to bigger postoperative complications frequency in comparisons with open surgery.В исследование включены 283 пациента с глиальными новообразованиями. Были проанализированы возраст, пол, неврологический статус и статус по Карновскому до и после операции, локализация опухоли, тип и объем хирургического вмешательства, послеоперационные осложнения. Объем удаления опухоли не зависел от локализации глиом, за исключением глубинно расположенных новообразований, при которых выполнялась стереотаксическая криотомия (p < 0,01). При выполнении стереотаксической криотомии послеоперационное ухудшение неврологического статуса отмечено в 12,5%, у больных с открытой биопсией и частичным удалением - в 10,9%, а в случаях суб- и тотального удаления - в 7,0% (p > 0,05). Частичное удаление глиом связано с большим риском развития послеоперационных осложнений и ухудшения неврологических функций, чем тотальное удаление опухоли. Стереотаксическая криотомия не приводит к большей частоте послеоперационных осложнений по сравнению с открытыми вмешательствами