Saratov JOURNAL of Medical and Scientific Research

Saratov National Research University n.a. N. G. Chernyshevsky

The deformation-strength properties of suture line of aponeurosis of anterior abdominal wall after laparotomy

Year: 2020, volume 16 Issue: №2 Pages: 506-510
Heading: Surgery Article type: Original article
Authors: Vertyankin S.V., Vanzha Ya.E., Mayorov R.V., Turlykova I.A., Golyadkina A.A., Polienko A.V., Inozemtsev E.S.
Organization: Saratov State Medical University, Saratov National Research University n.a. N. G. Chernyshevsky, Plekhanov Russian University of Economics
Summary:

Objective: development of a method for the prevention of postoperative ventral hernias based on an experimental assessment of the deformation-strength properties of aponeurosis in various types of median laparotomy. Material and Methods. 42 fascial-muscular-aponeurotic complexes of the anterior abdominal wall were evaluated. In accordance with a variant of the method for dissecting the aponeurosis and its suturing, the complexes are divided into two groups (21 samples each): group 1 —with a bypass of the umbilical ring on the left, group 2 — with the dissection of the umbilical ring. Results. Fascial aponeurotic complexes dissected and sutured through the umbilical ring, belonging to group 2, have higher mechanical characteristics. So, the average level of tensile stress (S), the average stress at maximum load (Load), Young's modulus (E), the average values of tensile strain, aponeurosis (D) and deformation at maximum load (Dmax) average level of maximum load (Smax) prevails in group 2 by 35.4; 39.8; 14.9; 34.6; 30.2 and 40.2%, respectively. Conclusion. The development, experimental application and evaluation of a new method for the prevention of postoperative ventral hernias after median laparotomy was performed based on the assessment of the deformation-strength properties of aponeurosis.

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Surgical management of thoracolumbar fracture-dislocation (clinical case)

Year: 2020, volume 16 Issue: №2 Pages: 488-494
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Likhachev S.V., Zaretskov V.V., Ivanov D.V., Shulga A.E., Arsenievich V.B., Stepukhovich S.V., Mizyurov S.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University
Summary:

The article presents a clinical case history of successful two-stage surgical reconstruction of a rare injury — a simple thoracolumbar fracture-dislocation (Type С AOSpine classification). The optimal arrangement of the stabilizing system at the stage of surgical intervention planning was designed using computer biomechanical simulation. The functional outcome was optimal ensuring complete reconstruction of the lost anatomy with no complication in post-operative period observed.

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Decision making support system in spine-and-pel-vic surgery as an instrument of branch control automation

Year: 2019, volume 15 Issue: №3 Pages: 677-682
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Kolesnikova A.S., Rozhkova Yu.Yu., Kossovich L.Yu.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University
Summary:

Aim: to prove the use of decision making support system (DMSS) in spine-and-pelvic surgery as an instrument of control automation in health branch. Material and Methods. Development of DMSS presented in current work made at the base of methodology «planning-modeling-forecasting». For graphical analysis and description of DMSS performance applied the logic diagram method. Materials of DMSS performance evaluation were the data extracted from 22 protocols of its beta-testing processing. Results. Description of the development and beta-testing of organization tech- nology allowed to implement DMSS in healthcare at the base of Regional center (fulfilling medical and expert activity) and Technological center (fulfilling computational functions) interaction. Conclusion. Development and implementation of DMSS as an instrument of branch control automation allow influence the heath quality increasing by means of raising accuracy, specificity and personalizing of diagnostics, decreasing of complications and terms of rehabilitation. Besides this kind of systems allow reduce workload for medical personnel with rising of its labor efficiency that meets the needs of innovative development of medicine and healthcare.

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Surgical correction of the first ray deformity using osteotomy biomechanical modeling

Summary:

Objective: to enhance the outcomes of the first ray surgical correction using osteotomy biomechanical modeling of the first metatarsal bone. It allows obtaining quantitative data for the «bone — fixator» system stability as additional criteria for selecting surgery methods and surgery therapeutic approaches. Material and Methods. 97 female patients underwent surgical corrections of static deformities in the anterior parts of the feet. Biomechanical modeling of osteotomies for the first metatarsal bone was used for the main group (50 patients) at the stage of pre-surgery planning. Results. Radiological results showed no significant differences between the groups of patients. The integrated ACFAS index in post- surgery period was statistically significant inpatients of the main group. The detection rate of the restriction of movements, pain syndrome and edema around the first metatarsal bone was higher in the control group. Conclusion. The identified differences in the dynamics of functional and restorative processes proved the efficiency of objective estimation and obtaining stability in «bone — fixator» system. Biomechanical modeling is an efficient tool of the decision making support system for surgical correction of the first ray deformities.

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Optimization of the process of creating models of human blood vessels

Year: 2019, volume 15 Issue: №2 Pages: 353-357
Heading: Human anatomy Article type: Original article
Authors: Dol A.V., Ivanov D.V., Fomkina O.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University
Summary:

Objective: to optimize the process of biomechanical modeling of blood vessels on the example of creating models of the arterial circle of the brain. Material and Methods. Biomechanical modeling requires the creation of a patient-oriented three-dimensional solid-state geometric model of the object under study. This problem can be solved by computer data processing (CT) or magnetic resonance (MRI) tomography. A program that implements the construction of blood vessel contours on individual sections of MRI in semi-automatic mode. These contours are exported as saved curves in a specifc format to SolidWorks, where they are used to create three-dimensional models of blood vessels. The models obtained in this way take into account the personal characteristics of the structure of the vascular bed of a particular patient and can be used in the process of biomechanical modeling. Results. The results of the program implementation of the recursive frontal growth method for processing two- dimensional slices of tomograms are presented. Conclusion. The developed software allows semi- automatic loading of DICOM images and obtaining fat sections of vessels on their basis, as well as transferring them for further processing into computer-aided design systems.

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Transformation of the personal identifcation system in the context of severe somatic disease

Year: 2019, volume 15 Issue: №2 Pages: 347-352
Heading: Sociology of Medicine Article type: Original article
Authors: Orlova M.M.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Resocialization of persons in a situation of illness determines one of the most important tasks of a health care system, namely, restoration of social opportunities of a patient. Objective: psychological analysis of identity system transformation of identifcations in a situation of a severe physical disease. Material and Methods. The study included a random sample of men and women aged 18–65: patients with ischemic heart disease (IHD) (n=116), and the control group (n=181). The following methods have been used: questionnaire, personal self-conception survey by S. R. Panteleev; R. Lazarus» study coping strategies; «Life style index»; family environment scale (FES) adapted by S. Y. Kupriyanov; WHO Quality of Life Questionnaire (WHOQOL); M. Kuhn»s test «Who am I?»; J. Rotter»s subjective control level test questionnaire; V. N. Dovlatova»s questionnaire for identifying cognitive inclination to dependency. Results. Signifcant diferences (p=0.01) in expression of identity indicators were obtained, which allowed to identify features of identifcation system characteristic of patients with ischemic heart disease without disability and with disability. Diferences in identifcation predictors with social roles, physical characteristics, negative self-identifcation and total number of self-descriptions were identifed using the regression analysis data. Conclusion. Change of personality of a patient with ischemic heart disease can be interpreted as othering and leads to difculties in social interactions and loss of opportunity to rely on their own personality, which requires psychotherapy. Socialization as a basic characteristic of modern society defnes one of the most important tasks of medical and social assistance to the population, namely, the restoration of the social capabilities of the patient. An analysis of the internal picture of the disease in patients with chronic somatic diseases in a social context makes it possible to determine the tasks of re-socialization in a situation of disability.

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Optimization of transpedicular spondylosynthesis application for type A3 lesions of the thoracolumbar transition: clinical experimental study

Year: 2019, volume 15 Issue: №2 Pages: 275-283
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Zaretskov V.V., Arsenievich V.B., Shchanitsyn I.N., Shulga A.E., Zaretskov A.V., Ivanov D.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Objective: the optimization of transpedicular systems application for type A3 lesions of the thoracolumbar transition using computer simulation based on the fnite elements method. Material and Methods. The examination data (post-traumatic kyphotic deformation, intensity of pain syndrome, length of operation and extent of blood loss) of 81 prospec-tively enrolled male patients who in 2017–2018 had been operated for Th11-L2 vertebrae simple fractures of А3N0M1 type (AOSpine classifcation). The patients were divided into 3 groups in accordance with the type of intervention performed on them: short-segment (n=42), 8-screws polysegment (n=25) and 6-screws polysegment (n=14). Biome-chanical simulation based on the computer tomography data was performed for each variant of the metal construction arrangement. Results. In the process of biomechanical simulation with all the variants of the instrumented spine 3D- models loading 8-screws construction proved to be the most consistent one, at that the stability of polysegmental constructions exceeds that of bisegmental one by an order. The results of surgical management were evaluated in terms of up to a year following the intervention. The loss was less and the correction worked better with polysegmental fxation despite more complicated initial conditions for the correction compared to those of group 1 Conclusion. Biomechanical simulation shows prerequisites for the development of bisegmental systems instability as the equivalent stresses and peak displacements are higher compared to those of polysegmental fxation. The efciency analysis of application of various transpedicular fxations for type A3 thoracolumbar transition lesions attests to the advantage of polysegmental arrangements of transpedicular systems, at that the implantation of the 6- screws polysegmental system should be considered the frst choice on the number of indices.

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The estimation of biocompatibility of polycaprolactone matrices mineralized by vat-erite in subcutaneous implantation tests in white rats

Year: 2018, volume 14 Issue: №3 Pages: 451-456
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Kozadaev M.N., Tyapkina D.A., Kustodov S.V., Saveleva M.S., Bugaeva I.O., Parakhonsky B.V., Galashina E.A., Gladkova E.V., Norkin I.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
Summary:

Aim: to estimate biocompatibility of matrices produced from polycaprolactone (PCL) and mineralized by vaterite (CaC03) by studying local and systemic manifestations of inflammatory reaction in subcutaneous implantation tests in white rats. Material and Methods. The experiment was conducted on 40 rats divided into four equal groups: control, comparison (rats with imitation of implantation), negative control (rats with implanted non-biocompatible matrices) and experimental group, comprised of animals with implanted PCL/CaC03-matrices. Local inflammatory manifestations were analyzed by morphological assay of implantation area tissues. Systemic inflammatory manifestations were estimated by TNF-a concentration and interleukin-lp (IL-1) in blood serum by ELISA. Results. The changes in cellular population content demonstrate that a PCL/CaC03-matriceonthe21 day after the implantation to rats is evenly colonizing by fibroblast cells and vascularizing. This type of matrices does not provoke intense inflammatory reaction seen in negative control animals and accompanied by systemic manifestations such as statistically significant rise in TNF-a and IL-1 concentrations. Conclusion. The data obtained in the study proving the biocompatibility of PLC/CaC03-scaffolds experimentally substantiate the potential for their use in tissue engineering.

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Fundamental Basis of Medical Aid Organization and Management in the Region

Year: 2012, volume 8 Issue: №2 Pages: 255-258
Heading: Internal Diseases Article type: Author's opinion
Authors: Denisova Т.Р., Danilov A.N., Malinova L.I., Shuldyakov V.A., Malinov I.A., Shuvalov S.S., Gorjainov V.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University, Saratov Regional Clinical Hospital
Summary:

The article presents computations on informational and analytical basis of public health database, that help to perform accurate monitoring, and detection of public health system state, as well as prognosis of further dynamics of public health system parameters for scientifically proved health care organization and decisions in management.

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Application of laser autodyne for vibration assessment of tympanic membrane

Year: 2011, volume 7 Issue: №4 Pages: 894-897
Heading: Otolaryngology Article type: Short message
Authors: Daykhes N.A., Mareev O.V., Mareev G.O., Usanov D.A., Skripal A.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University, Moscow Clinical Center of Otolaryngology
Summary:

Research is devoted to assessing the state of the middle ear structures by usage of modern nanotechnology methods. The history of the problem, various ancient and modern methods for studying the mobility of the middle ear structures have been described. The results of the research of eardrum movements by laser autodyne and their value in differential diagnosis of ear diseases have been presented. The research goal is to assess vibrations of middle ear structures by modern nanotechnological techniques. Materials: The study included 207 persons, divided into groups of healthy individuals and patients with sensorineural deafness, otosclerosis, adhesive otitis and tubootitis. Results: Exact frequency response vibration patterns of the middle ear and tympanic membrane have been obtained. Measurements have been made in open sound field in normal ears and ears with various pathology of middle and inner ear. The value of this method in differential diagnosis of ear diseases has been investigated. Conclusion: The use of laser autodyne for measuring middle ear structures vibration is a perspective and objective method of assessing auditory function. It is very necessary in modern otolaryngology for differential diagnosis of hearing pathology

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