2024, volume 20

Objective: to assess the informativity of the use of the rapid cytological method in the study of sentinel lymph nodes in patients with breast cancer. Material and methods. The study involved 46 patients from 30 to 85 years old with verified breast cancer. On the eve of the operation, about 150-200 MBq of the 99 mTc-Nanotope radiopharma-ceutical was peritumorally injected into the parenchyma of the affected mammary gland. After 1.5-2 hours, lymphos-cintigraphy was performed, followed by SPECT/CT, in which sentinel lymph nodes are zualized. The next day after the administration of the radiopharmaceutical, during surgery, sentinel lymph nodes were found using a g-detector. Further, the surgeon removed the node (or nodes) and sent them for express cytological examination. To check the informativity of this method, a comparison was made with the "gold standard" of morphological diagnostics — with histological examination of postoperative material. Results. An express cytological study revealed the presence of metastases in the sentinel lymph nodes in 12 patients, which significantly influenced the further tactics. It was found that the cytological method of the study is not inferior to the histological one, the sensitivity and specificity of the method is 100%. When comparing the results of rapid cytological and planned histological studies, there were no discrepancies in diagnoses by the state of the lymph nodes. Conclusion. Rapid cytological examination of sentinel limphatic nodes informative method for sentinel lymph node detection in breast cancer patients.

We have presented a clinical case of successful restoration of the frontal group of teeth by the method of aesthetic restoration using the universal nanogibrid composite. The experience of applying direct restoration allows us to ensure high quality restoration of carious teeth, aesthetics of the dentition with minimal time costs — 1 day. Compared to the manufacture of ceramic structures, the time spent on the manufacture of structures is 7 days. The applied method is economically more favorable by an average of 50% compared to the last specified method.

Objective: to determine the effect of membrane peeling on the dynamics of retinal inner layers anatomy changes after surgery for retinal detachment with macular hole. Material and methods. Patients of group 1 (20 patients, 20 eyes) underwent surgical treatment with repair of the rupture using an inverted flap of the internal limiting membrane. Patients of group 2 (20 patients, 20 eyes) did not undergo hole blocking during the first stage of surgery. All patients underwent optical coherence tomography to assess the condition of the inner layers of the retina. Results. One day after surgery, in patients of group 1, the thickness of retinal tissue in the parafoveal zone was 128.2±11.6 nm. In patients of group 2 it was 102.7±6.4 nm (p=0.041). These values remained until the silicone oil was removed. When comparing the indicator of the volume of retinal tissue in the parafoveal zone, there is a decrease in the indicator in patients who underwent membrane peeling, the indicator was 0.645±0.041 mm3, compared with the data of patients of the 1st group, where it was at the level of 0.787±0.52 mm3 (p=0.047). In the temporal quadrant, the difference in indicators persisted until one year after surgery. Conclusion. Membrane peeling leads to damage to the retinal tissue, local defects which can persist up to a year. The outer layers of the retina are damaged throughout the entire area of the macula due to the impact on the supporting plates of the Muller cells and the nerve fiber layer.

This rare clinical case demonstrates the treatment of paralytic mydriasis caused by taking a herbal drug, Atropa belladonna, which is extremely rare in the treatment of diseases today, using sequential implantation of an intraocular lens (IOL) and an artificial iris with simultaneous correction of refractive errors. The patient took Atropa belladonna extract for 5 years to prevent exacerbation of gastric ulcer according to the scheme 2 times a year (spring, autumn) for 2 weeks, 5-7 drops 3 times a day with meals. The uniqueness is explained by the fact that paralytic mydriasis arose as a result of long-term drug exposure. Analysis of the state of the iris stroma showed the impossibility of performing suture plasty of the pupil. In addition, patients with this pathology have been denied treatment in other medical institutions for decades.

Objective: to evaluate the efficacy of the stentless endoscopic technique for congenital choanal atresia in infants. Material and methods. Subjects: 51 infants younger than 1 year of age undergoing the stentless choanoplasty procedure. Main group: 27 children who underwent surgery for the first time Comparison group: 24 children who experienced relapse after traditional stent-tube choanoplasty. To assess results, endoscopic examinations and saturation levels were used. The quality of life was evaluated using the Qualite de vie du Nourisson questionnaire for children between 3 and 12 months of age. Parents of 45 children were involved: 25 from the main group and 20 from the comparison group. Results. An endoscopic examination of the nasal cavity/nasopharynx in 50 patients showed no signs of restenosis over a 1- to 2-year follow-up period. The saturation level increased from 98.4±2.4% in the main group to 99.4±1.0% (p=0.001) in the comparison group; in the latter, it increased from 93.5±4.7 to 99.0±1.0% (p<0.001). The assessment of the quality of life after surgery using the stentless approach in the main group showed an increase from 14.4±0.4 points to 15.3±1.8 (p=0.056); points, while in the comparison group the increase was from 14.0±0.4 points to 15.6±1.0 points (p<0.001). Conclusion. Based on the results of this study, we can conclude that the endoscopic, stentless, nasal approach to surgical treatment of congenital choanal atresia in infants is more effective than traditional choanoplastic techniques with stent tubes.

The article presents the history of the formation and development of the leading department of the pedi-atric faculty of Saratov State Medical University named after V. I. Razumovsky. The path of formation of the scientific school of pediatric gastroenterology is traced. The main directions of educational, scientific and medical work of the staff of the department are highlighted.

The article presents the contribution of Professor Boris I. Slovtsov to the development of Russian science during his work at the Military Medical Academy, the St. Petersburg Women's Medical Institute and the Imperial Nikolaev University (Saratov). His scientific research in the field of biochemistry, nutrition, fasting, physiology of labor, as well as in the study of the effect of chemical warfare agents on the body of animals is shown. The work highlights the issues of improving the educational process in the training of medical personnel in medical universities of the country and social activities. Professor B. I. Slovtsov made a significant contribution to the organization and formation of the Department of Pharmacology with Formulation, Toxicology and the Study of Mineral Waters at the Medical Faculty of the Imperial Nikolaev University (Saratov) in 1910-1912.

Objective: to identify the frequency of occurrence and size characteristics of various forms of the head of the lower jaw, depending on the sex and shape of the skull in people of the first period of adulthood. Material and methods. Subject: 77 women (21-35 years old) and 78 men (22-35 years old). The shape and dimensions of the man-dibular head were determined on cone-beam computed tomograms. Results. The most common was the oval shape of the mandibular head (73% in women, 51 % in men). In women, the bean-shaped form was least common (9%), in men — cone-shaped (10%). Bilateral differences in the size characteristics of the mandibular head were revealed: on the right, the frontal diameter is 5.0% larger, and the sagittal diameter and height of the head are 3.7 and 5.0% smaller (p=0.010-0.017). The height of the oval head on the right and left is 15.5 and 10.8% greaterthan that of the head of the lower jaw, which has a bean-shaped shape (p<0.001). With an increase in cranial index, the height of the mandibular head on the right decreases (r=-0.36); the height of the head on the right increases with increasing cranial vault length {r=0.33) and with decreasing cranial vault width (r=-0.27). Conclusion. The oval head of the lower jaw in women/men with brachycrania was found in 18.2/23.1%, with dolichocrania in 22.1/11.5%, with mesocrania in 32.5/16.7% of cases. The bean-shaped head in women/men of brachycranes was detected in 1.3/2.6%, mesocranes in 7.7/24.4%, dolichocranes in 0/11.5% of cases. The cone-shaped head in women/men of brachycranes was noted in 2.6/6.4%, mesocranes in 7.8/3.8%, dolichocranes in 7.8/0% of cases.

Objective: to evaluate basic metabolism and its relationship with changes in body composition in patients with liver cirrhosis. Material and methods. A retrospective study was conducted, which included an analysis of data from 110 patients with a confirmed diagnosis of liver cirrhosis from 02.2020 to 12.2022. Assessment of body composition and basic metabolic data was carried out using ABC-01 MEDASS (STC MEDASS, Russia). Results. The basic metabolism in men with cirrhosis was 1631.0 (1577.5-1760.0) kcal/day, in women — 1337.0 (1256.0-1421.5); p=0.005. At the same time, among women, the indicator was reduced by an average of 18.1 % relative to the reference values of the main exchange for their age group. According to the results of multivariate regression analysis, gender (p<0.001), active cell mass (p<0.001), proportion of skeletal muscles (p<0.001), mineral mass (p=0.0034) and phase angle (p<0.001) were significantly associated with basic metabolism in patients with liver cirrhosis. The correlation coefficient between basic metabolism and extracellular fluid was r=0.807; p<0.001; between active cell mass index r=0.877; p<0.001, respectively. Conclusion. The level of basic metabolism against the background of cirrhosis of the liver is determined by changes that affect the components of the body composition against the background of the disease. Active cell mass, skeletal muscle fraction, mineral mass, phase angle and sex are important parameters to consider when predicting changes in basal metabolism and its correction in patients with cirrhosis.

Objective: to determine the typological features of the intertragal notch (ITN) shape of the auricles (AU) in young men. Material and methods. After somatotyping and cephalotyping of 140 young men both right and left AU were photographed. 25 marks were applied on the images of AU along the margin of the ITN by digitizer tpsDig2 2.31. We performed a procedure for superposition of label configurations using the method of generalized Procrustean analysis using MorphoJ 1.06d soft. Procrustean coordinates were determined, characterizing the variability of the ITN shape of the right and left AU. A one-way AN OVA was carried out on the obtained data with the determination of Goodall's F-criterion, which was used to determine the strength of the influence of the cephalotype and somatotype of the young men on ITN shape both left and right AU. The significance level of the F-criterion is set at 0.05. To visualize the change in the shape of the ITN of AU of the corresponding side, the method of transformation grid was used. Results. As a result of ANOVA, a statistically significant influence of the somatotype of young men on ITN shape only in the left AU was established (F =1.98; p<0.0001). The significance level of the F-criterion in determining the strength of the influence of the cephalotype on ITN shape of both AU exceeded the critical value. As a result of discriminant analysis of ITN shape in groups of young men belonging to different morphotypes, models were obtained that allow for the correct classification of ITN. The classification accuracy of such models in some cases exceeds 90%. Conclusions. Variability in the form of ITN is more associated with the somatotype than with the cephalotype of young men. The shape of ITN differs in young men with different morphotypes.