Risk modeling of femoral neck fracture based on geometric parameters of the proximal epiphysis.

Background: Fractures of the proximal femur epiphysis are problematic for state health care because they are associated with severe medical and social problems and high morbidity and mortality rates.

Aim: To model the potential risk of hip fracture femur geometric parameters.

Methods: Seventy educational cadaveric femurs from people aged 14 to 80 years, 10 X-ray images from the records of the Human Anatomy Department and 10 X-ray images from the Department of Traumatology, Orthopedics and Disaster Surgery of Sechenov University, were evaluated.

[The alternative way of colorectal cancer developing. The histogenetic and molecular features of serrated lesions (review, continued)].

The occurrence of colorectal cancer can be traced in two ways: from conventional adenomas with the APC-gene mutation (model Fearon-Vogelstein) and the "serrated way", that has a unique genetic profile and morphological characteristics at the early stages. These neoplasms are determined from 7 to 9%. The risk of developing cancer of them is 7.

[Modern aspects of photodynamic therapy of esophageal].

This review presents the current possibilities of photodynamic therapy in the treatment of precancerous lesions and cancer of the esophagus. Mechanisms of photodynamic effects on tumor and especially the accumulation of photosensitizer in tumor tissue, results of studies on the use of photodynamic therapy in the treatment of early esophageal cancer, esophageal cancer stenosis and combinations with other treatment techniques. Results of treatment of Barrett's esophagus using photodynamic therapy were analyzed and a compared with other methods of treatment.

Three clinical methods of circulatory assistance.

Three clinical methods of circulatory assistance are described: intraaortic balloon counterpulsation, left ventricular bypass using a roller pump, and the artificial ventricle. All three methods have hemodynamic effectiveness. The first method is indicated in cases of widespread cardiosclerosis and pronounced coronary insufficiency and may be contraindicated in pathology of the valvular apparatus.

[Surgery of complicated aneurysms of the abdominal aorta].

Results of the surgical treatment of 107 patients with a complicated aneurysm of the abdominal aorta are presented. The general lethality for the period from 1966 to 1984 was 49,5%. In the recent years the postoperative lethality in patients with ruptured aneurysms has been reduced from 79,4% to 47,2%, in patients with threatening ruptures from 41,6% to 16%.

[Our experience with the surgical treatment of renovascular hypertension].

The experience with 785 operations performed for the period from 1962 to 1983 on 697 patients is presented. The advantage of direct reconstructive operations over restorative interventions with the employment of explantation materials is proved. In the remote period after operation positive results were noted in 85% of patients with fibrose-muscular dysplasia of renal arteries and in 70% of patients with non-specific aorto-arteritis.

[Surgical treatment of recurrent renovascular hypertension].

The article analyzes the results of surgery for a recurrence of vasorenal hypertension developing as a result of an impaired major blood flow in the operated on renal artery. The main causes of the blood flow impairment in the immediate postoperational period included an expansion of indications for the primary reconstructive operation or technical drawbacks during the operation itself whilst in the long-term post-operational period the progression of the underlying disease was the principal culprit. Repeated operations on the renal arteries were performed in 19 patients, and in 28 patients surgery consisted of secondary nephrectomy.

[Iatrogenic injuries of the major vessels].

Jatrogenic injuries of the major vessels during performing intravascular instrumental examinations and different operative procedures are known to be dangerous and severe complications and make 22,4% of the total number of patients with traumatic injuries of the vessels. The early reconstructive operation is considered to be a basis of the surgical tactics for this pathology facilitating the re-establishment of the major blood flow in 78,4% of patients. The total lethality made up 7,2%.

[Stellectomy in patients with ischemic heart disease and only slightly changed coronary arteries].

A group of coronary patients were identified who coronarographically showed no or only minor lesions of main coronary arteries (hemodynamically insignificant stenosis of up to 50% of vascular lumen). The results of stellectomy performed in 71 such patients are reported. To achieve good surgical results, primary focus should be on accurate diagnosis of coronary disease using specialized techniques: coronary arterial scanning to assess myocardial microcirculation, and the measurement of lactic acid arterial-venous difference under atrial electrostimulation to assess metabolic manifestations of myocardial ischemia.

[Surgery of extracranial aneurysms of the carotid and vertebral arteries].

An analysis of the literature and personal observations of 27 patients with extracranial aneurysms of the arteries enabled the authors to determine clinical symptoms, methods of diagnosis and surgical treatment of the disease. Resection of the aneurysm with suturing the artery defect is recommended as optimal techniques of the operation for posttraumatic aneurysms, resection with the end-to-end anastomosis being proposed for a true aneurysm of the aorta arch branches.