InnovativeMedicineofKuban #3 (2018)

InnovativeMedicineofKuban #3 (2018)

CONTENTS

Original articles

application of Percutaneous endoscopically assisted gastrostomy in multifunction hospital

A.N. Petrovsky 1, I.V. Vagin 1, S.L. Gobaeva 1*, A.Y. Popov 1,

A.G. Barishev 1,2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Corresponding author: *S.L. Gobaeva, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Background

Optimization of the process and improved efficiency of the prolonged compulsory enteroalimentation in the patients who require it for more than 4 weeks.

Materials and methods

We analyzed the first experience of percutaneous endoscopically assisted gastrostomy in 32 patients. Patients were treated in the neurosurgical and neurologic department of "Research Scientific Institute – Ochapovsky Regional Clinical Hospital No. 1 " Krasnodar.

Results

Application efficiency of percutaneous endoscopically assisted gastrostomy for prolonged enteral feeding in patients with combined trauma and neurological deficiency was shown. is shown to a gastrostomiya for carrying out a long enteroalimentation at patients with the combined trauma and neurologic deficiency. The greatest number of complications 3 (33,3%) was observed in the group of patients with cranio-cereberal traumas.

Key words: enteral feeding, percutaneous endoscopic gastrostomy, enteral feeding complications.

Author credentials

Petrovsky A.N., CMS, surgeon, surgical department #1, Scientific Research Institution- Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Vagin I.V., surgeon, surgical department #1, Scientific Research Institution- Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Gobaeva S.L.,еndoscopy department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Popov A.Y., head of surgical department #1, Scientific Research Institution- Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Baryshev A.G., PhD, assistant professor, head of the surgical department #1 FAT and PPS, Kuban State Medical University, deputy chief physician for surgery, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

HEREDITARY TROMBOPHILIA AND ISCHEMIC STROKE IN YOUNG PEOPLE

P.V. Kataev *, L.V. Timchenko, O.N. Zhadan, D.K. Sichinava

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Сorresponding author:* P.V. Kataev, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May street, 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In this article the most widespread hereditary trombophilia in the setting of ischemic stroke etiology in young patients is considered. Own data on prevalence of various options of hereditary trombophilia in 188 patients who were treated in neurologic department for patients with acute disorders of cerebral blood circulation in Scientific Research Institute — Ochapovsky Regional Clinic Hospital #1 are provided.

Key words: trombophilia, ischemic stroke, young age.

Author credentials

Kataev P.V., neurologist, neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Timchenko L.V., neurologist, head of the neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zhadan O.N., neurologist, head of the neurorehabilitation department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Sichinava D.K., CMS, neurologist,consulting and diagnostic clinic, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia).

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Case reports

Cell Therapy Application in Skin Grafting Surgery

S.B. Bogdanov *, I.V. Gilevich, T.V. Fedorenko, E.A. Kolomiytseva,

A.V. Polyakov

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: * S.B. Bogdanov, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 140 Rossiyskaya str, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

The clinical case of treatment in a patient with extensive defects of hairy part skin of the head and face is presented. The autoplasty with split skin with one-stage closing of wound defects with a big auto-omentum was performed. For the best adaptation of biological transplants the autologous platelet enriched plasma, and the allogenic frozen dermal fibroblasts were applied. The good esthetic and functional result was received.

Key words: skin grafting, greater omentum, cell therapy, allogenic fibroblasts, platelet enriched plasma.

Author Credentials:

Bogdanov S.B., PhD, head of the burns center, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Gilevich I.V., CMS, head of the laboratory for development and study of new treatment technologies, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Fedorenko T.V., biologist of the laboratory for development and study of new treatment technologies, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Kolomiytceva E.A., biologist of the laboratory for development and study of new treatment technologies, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Polyakov A.V., surgeon head of the burns center, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Clinical case of a successfully treated patient with open severe penetrating craniofacial injury

A.A. Kalinin 1,2*, B.B. Sazhin 1, V.Y. Goloborodko 2, G.Y. Levina 2

Corresponding author: A.A. Kalinin, Irkutsky State Medical University, 664005, Irkutsk, 10 Botkina str., e-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

1 Irkutsky State Medical University, Irkutsk, Russia

2 Dorozhnaya Clinical Hospital Irkutsk-PAssazhirsky Station OAO «RZhD», Irkutsk, Russia

In 80% cases, craniofacial injury is followed by the cerebrospinal liquid leak from natural ways. The leading life-threatening states at the same time are infectious complications. Approaches for treating such patients are ambiguous and first of all depend on severity of a patient condition. Results of mini-invasive surgical interventions for penetrating craniocereberal trauma are studied insufficiently. In this article we discuss a clinical example of successful staged surgical treatment in a patient with the open severe craniofascial injury.

This clinical case includes two hospital stays: the first has been connected to the severity of craniofascial injury itself, the second – with its complication (rhinoliquorrhea). Following the offered algorithm of managing patients with this pathology, at primary admission we performed a dynamic assessment of the patient and then conservative treatment was carried out, at the repeated admission surgical treatment was performed: lumboperitoneal shunting.

Primary severity of this injury and staged approach to treatment have allowed to achieve positive clinical dynamics at the stage of mini-invasive surgery and also considerably reduce risks for the patient’s life and carry out full rehabilitation at the shortest possible time.

Key words: open penetrating craniofascial injury, rhinoliquorrhea, lumboperitoneal shunting, minimally invasive surgery.

Author Credentials:

Sazhin B.B., resident of neurosurgery and innovative medicine department, Irkutsky State Medical University (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Goloborodko V.Y., head of anesthesiology and resuscitation department #1, Dorozhnaya Clinical Hospital Irkutsk-Passazhirsky Station OAO «RZhD» (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Levina G.Y., neurologist of Neurosurgery center, Dorozhnaya Clinical Hospital Irkutsk-Pаssazhirsky Station OAO «RZhD» (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

complicated diagnosis: retroperitoneal alveococcosis in the guise of ormond’s disease

V.L. Medvedev ¹,2, O.A. Vorobieva ², T.M. Morenets ³, O.N. Ponkina ¹*,

E.A. Terman ¹, V.V. Polegenkiy ¹, N.S. Elistratova ², A.V. Barsuk ¹, L.A. Medvedeva ¹

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 Krasnodar, Russia

2 OOO ‘National Center of Clinical Morphological Diagnosis’, Saint Petersburg, Russia

3          Kuban State Medical University, Krasnodar, Russia

Corresponding author: *O.N. Ponkina, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May str., e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.


Diagnosis of parasitic diseases, in a type of their rarity and diversity, always presents considerable difficulties. Clinical observation of an alveococcosis with invasion in the retroperitoneal space with distribution on mediastinal fat proceeding with progressing retroperitoneal fibrosis with ureteral obstruction and hydronephrosis development, with an aorta lumen stenosis, with formation of SVC syndrome in the absence of changes in other parts of the body, first of all in the liver, in the absence of eosinophilia in the peripheral blood throughout all disease and lack of antibodies to echinococci in the blood serum, twice during observation determined by an immunofermental method is presented in this article.

Key words: alveococcosis, retroperitoneal space, retroperitoneal fibrosis.

Author Credentials

Medvedev V.L., PhD, professor, deputy chief doctor on urology, head of urology and nephrology center, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, chief nontenured urologist and transplantologist of Health Care Ministry Krasnodar Region, head of urology department, Kuban State Мedical University (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Vorobieva O.A., CMS, morbid anatomist, department of morbid anatomy, OOO ‘National Center of Clinical Morphological Diagnosis’ (Saint Petersburg, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Morenets T.M., CMS, associated professor, department of infectious diseases and epidemiology ATF, Kuban State Мedical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Ponkina O.N., CMS, head of pathological anatomy department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Terman E.A., forensic surgeon, department of morbid anatomy, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Polegenkiy V.V., urologist, oncological urology department,Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Elistratova N.S., radiologist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Barsuk A.V., forensic surgeon, department of morbid anatomy, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Medvedeva L.A., head of pathological laboratory, department of morbid anatomy, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Clinical Case of Two-Stage Treatment of a Newborn with Coarctation and Aortic Arch Hypoplasy

M.V. Boriskov, A.N. Fedorchenko, G.A. Efimochkin, I.A.Tkachenko *,

P.J. Petshakovsky, O.A. Vanin

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author:* I.A. Tkachenko, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In the present article we report a clinical case of successful two-stage treatment for juvenile aortic coarctation with aortic arch dysplasia in a newborn. We demonstrated possible application of balloon angioplasty, as a palliative procedure in children with severe health condition.

Key words: juvenile aortic coarctation, aortic arch hypoplasy, balloon angioplasty.

Author credentials

Tkachenko I.A., surgeon, cardiac surgery department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1(Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Boriskov M.V., CMS, head of cardiac surgery department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Fedorchenko A.N., PhD, head of x-ray diagnosis and treatment department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Efimochkin G.A., surgeon, cardiac surgery department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Petshakovsky P.Y., surgeon, cardiac surgery department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Vanin O.A., surgeon, cardiac surgery department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

clinical case of surgery for false aneurysm of the internal carotid artery after carotid endarterectomy and carotid angioplasty

R.A. Vinogradov 1,2, V.V. Matusevich 2*, A.B. Zakeryaev 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Corresponding author: * V.V. Matusevich, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May str., e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In this article a clinical case of surgical treatment for false aneurysm of extracranial department of an internal carotid artery in a 69-year-old patient after numerous surgical treatment for stenosis atherosclerosis of an internal carotid is described. The diagnostic algorithm consisted of triplex scanning of brachiocephalic arteries, a cerebral angiography and a multispiral computer tomography with intravenous contrast enhancement. This patient underwent carotid endarterectomy in combination with reconstruction of an internal carotid and removal of earlier implanted stent and a synthetic patch were performed. The postoperative period was uneventful. Histological assessment proved that extension of an internal carotid was caused by a false aneurysm. Previous surgery and atherosclerosis were the reasons of aneurysm formation.

Key words: false aneurysm of carotid artery, aneurysms of peripheral arteries, carotid endarterectomy, internal carotid artery reconstruction, carotid angioplasty.

Author credentials

Vinogradov R.А., CMS, head of the vascular surgery department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, assistant of surgery department №1 ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Matusevich V.V., resident of cardiac surgery and cardiology department ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zakeryaev A.B., cardiovascular surgeon, department of vascular surgery, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Coronary artery anomaly. coronary-pulmonary fistula

S.V. Topilina *, E.I. Zyablova, A.M. Namitokov, E.D. Kosmacheva

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: *S.V. Topilina, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May str., e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

True coronary and pulmonary fistulas occur quite seldom. Most often this defect is a casual finding at diagnosis of other cardiac diseases. Hemodynamics of this defect is caused by the affected coronary artery shunt into the cardiac chamber or the great vessel. Before introduction in modern diagnosis methods of high-precision ultrasonic devices and cardiac treatment to verify such anomaly as a coronary artery fistula, it was impossible. In our study we present a clinical case with right and left coronary artery fistulas into a pulmonary artery and a left atrium.

Key words: coronary artery anomaly, coronary-pulmonary fistula.

Author Credentials

Topilina S.V., radiologist, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zyablova E.I., head of radiology department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Namitokov A.M., head of cardiology department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Kosmachеva E.D., PhD, professor, chief medical officer Scientific Research Institute – Ochapovsky RCH #1, head of therapy department #1, Kuban State Medical University, chief cardiologist of Krasnodar region (Krasnodar, Russia). E-mail: //e.mail.ru/compose?To= Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. "> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Technological Achievements in Medicine

E.V. Vyskubova 1*, N.V. Soroka 1, O.Y. Solodilova 1, I.A. Shelestova 1,2

Echocardiography features for Bland-White-garland syndrome diagnosis in adults

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Corresponding author: * E.V. Vyskubova, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May str., e-mail: usdhelen Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Bland-White-Garland syndrome (BWFS) is an abnormal arising of the left coronary artery (LCA) from the pulmonary artery trunk (PA), (in English-speaking literature ALCAPA – anomalous left coronary artery arising from the pulmonary artery) and it is rather rare pathology, 0,24-0,45% of cases of all congenital heart diseases. There are infantile and adult types described. In most cases, this anatomic anomaly is found at children or teenage age. We present the observations of patients with the BWGS adult type in this article and analyze possibilities of ECG while diagnosing this rare condition.

Key words: Bland-White-Garland syndrome, adult type, echocardiography, coronarography.

Author Credentials

Vyskubova E.V., ultrasound physician, department of ultrasound diagnosis, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Soroka N.V., ultrasound physician, department of ultrasound diagnosis,Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Solodilova O.Y., ultrasound physician, department of ultrasound diagnosis, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Shelestova I.A., CMS, associate professor, deputy chief physician for polyclinic work, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, assistant professor, department of cardiac surgery and cardiology ATF,Kuban State Medical University (Krasnodar, Russia). Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Endoscopic Ultrasound Investigation for Neuroendocrine Panreatic Neoplasms Diagnosis

N.S. Ryabin 1*, M.I. Bykov 1,2, A.N. Katrych 1, V.V. Schava 1,2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, department of surgery #1 for advanced training, Krasnodar, Russia

Контакт* N.S. Ryabin, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Endoscopic ultrasound diagnosis occupies an important role in neuroendocrine tumor diagnosis. Key indicators for diagnostic efficiency of this method regarding a tumor nosology are presented in the present article. We described results of the authors; investigations on ultrasonography for neuroendocrine tumor differentiated diagnosis. Possible mistakes in diagnosis of existing neuroendocrine tumors and a study algorithm are analyzed during endoscopic ultrasound investigation.

Key words: neuroendocrine tumors, endoscopic ultrasound, fine needle aspiration biopsy.

Author credentials

Ryabin N.S., CMS, endoscopist, Endoscopy department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Bykov M.I., PhD, professor of surgery department #1 ATF, Kuban State Medical University (Krasnodar, Russia), head of Endoscopy department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Katrich A.N., CMS, head of Ultrasound Diagnostics department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Shchava V.V., post-graduate student of surgery department #1 ATF, Kuban State Medical University (Krasnodar, Russia), Endoscopy department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Reviews

stromal cells of fat tissue for regenerative surgery

V.B. Karpuk 1*, V.A. Porhanov 1,2, M.D. Perova 2, I.V. Gilevich 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Corresponding author:* V.B. Karpiuk, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May street, 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background Generalize modern data on the current opportunities and the perspective application directions of stem / stromal cells of fat tissue in regenerative surgery.

Results Preclinical and clinical developments of cellular transplantology techniques and tissue engineering with use of the cultivated multipotent mesenchymal stromal cells of fat tissue and freshly isolated stromal vascular fraction of fat tissue in plastic surgery, maxillofacial surgery, orthopedics, neurosurgery, coloproctology, urology, thoracic surgery, cardiac surgery are presented.

Conclusion Transplantation of stromal vascular fraction of fat tissue for which releasing we do not perform cultivation of cells out of a human body is a safe and effective regenerative technology with an application potential in the wide range of surgical areas.

Key words: regenerative surgery, fat tissue, mesenchymal stromal cells, stromal vascular fraction.



Author Credentials:

Karpiuk V. B., CMS, scientific worker of the laboratory for development and study of new treatment technologies, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Porhanov V.A., PhD, professor, academician of the RAS, head doctor of Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia), head of oncology department with thoracic surgery course ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Perova M.D., PhD, professor, head doctor of dental clinic of KSMU (Krasnodar, Russia), professor of department of surgical dentistry and maxillofacial surgery, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Gilevich I.V., CMS, head of the laboratory for development and study of new treatment technologies, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

45-yers jubilee to burn service of Kuban region

Manuscript requirements

InnovativeMedicineofKuban #2 (2018)

InnovativeMedicineofKuban #2 (2018)

CONTENTS

Original articles

Postoperative Wound Infection Impact on Long Term Oncological Outcomes in Rectal Cancer Patients

V.V. Polovinkin*, S.O. Ivanovsky, S.V. Khmelik, S.N. Scherba

V.V. Polovinkin*, S.O. Ivanovsky, S.V. Khmelik, S.N. Scherba

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: *V.V. Polovinkin, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background Now there are heteropolar opinions on influence of postoperative purulent septic complications on rectal cancer patients on the long term oncological results.

Aim Assess influence of these complications following laparotomy and perineal wounds after operations for rectal cancer on the long term oncological results.

Methods We performed retrospective cohort research of 338 patients undergone scheduled radical operations for middle ampullar and lower ampullar rectal cancer T1-4N0-2M0 from January, 2003 to December, 2011. Patients were distributed in two groups: with suppuration of postoperative wounds and/or abscess of the abdominal cavity (n=44 - 13%) and without purulent septic complications (n = 294).

Results The logit regression analysis has shown that suppuration of laparotomy wounds and/or abscess of the abdominal cavity is one of the independent risk factors of a systemic recurrence. For development of a local recurrence purulent septic complications were not risk factors. The five-year overall and cancer specific survival in compared groups demonstrated statistically significant distinction. The overall survival in the main group - 47%, in the control one- 67,2% (Wilcoxon's criterion р = 0,10, Cox-Mentela's criterion р = 0,02, log rank criterion р = 0,03). Cancer specific survival was 43,5% and 70,1% respectively (Wilcoxon's criterion р = 0,01, Cox-Mentela's criterion р = 0,005, log rank criterion р = 0,009). The five-year recurrence free survival in the compared groups was similar 50,6 and 69% respectively (Wilcoxon’s criterion р = 0,25, Cox-Mentela's criterion р= 0,12, log rank criterion р = 0,12).

Conclusions Purulent septic complications of postoperative wounds in patients with rectal cancer have impact on long term results: they are independent risk factor for systemic recurrence development and decrease total and cancer specific survival rate.

Key words: rectal cancer, wound infection, local recurrence, survival rate.

Author Credentials

Polovinkin V.V., PhD, head of coloproctological department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Ivanovsky S.O., coloproctologist of coloproctological department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Khmelik S.V., coloproctologist of coloproctological department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. Е-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Scherba S.N., coloproctologist of coloproctological department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

impact of Preoperative Staging of Prostatic Cancer on positive surgical margin incidence following radical prostatectomy

V.L. Medvedev ¹,2,*, Lysenko V.V. 3, L.G. Rosha 3, A.V. Medvedev 1,2,

I.V. Mikhailov ¹,2, A.I. Strelyaev ¹, O.N. Ponkina 1

V.L. Medvedev ¹,2,*, Lysenko V.V. 3, L.G. Rosha 3, A.V. Medvedev 1,2,

I.V. Mikhailov ¹,2, A.I. Strelyaev ¹, O.N. Ponkina 1

1Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State medical University, Krasnodar, Russia

3 Center of Reconstructive and Rehabilitation Medicine (University Clinic), Odessky National Medical University, Odessa, Ukraine

Сorresponding author:*V.L. Medvedev, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May street, 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background Despite improvement of the equipment for polyfocal biopsy of the prostate gland (PBPG), a sufficient percent of data divergence in morphological characteristics of the prostate cancer (PC) at preoperative and postoperative stages is noted. Besides data of PBPG and clinical stage are quite important part of nomograms applied for indication detections for lymphadenectomy and neuro-sparing technique during radical prostatectomy (RPE). Regarding this fact error limits in clinical assessment of the primary tumor could influence surgical outcomes.

Aim The aim of the present study was assessment of coincidence frequency of morphological characteristics of PC according to transrectal PBPG and clinical examination with morphological assessment of operational material after radical prostatectomy (RPE). Evaluation of errors influence on frequency of positive surgical margin (PSM) at clinical staging of PC was performed.

Materials and methods Data of transrectal PBPG and operational material after RPE in 276 patients with PC were studied. Both biopsy and operative materials were exposed to preservation in 10% buffering solution of formalin, and after automatic conducting was painted by hematoxylin-eozinom. Each histologic conclusion was formed by at least two pathologists who estimated PBPG and samples after RPE in the same structure. The interrelation between staging errors and frequency of PSM was studied.

Outcomes Analysis For patients with locally-advanced PC the adequate staging according to TPFB was noted only in 18,7% cases. Errors for clinical staging of the localized PC had no significant influence on PSM frequency: 3.7% in patients with correct staging and 6,5% in patients with poor staging with stage migration within pT2b – pT2c (р = 0,07). With down-staging of locally-advanced PC which was observed in 81,3% patients, significant increase in PSM frequency reached 23,1% in comparison with proper staging – 6.6% patients (р<0,01).

Conclusions Down-staging of locally advanced prostate cancer at the preoperative stage is a frequent phenomenon which leads to essential increase in PSM after RPE.

Key words: locally advanced cancer of prostatic gland, radical prostatectomy, positive surgical margin.

Author Credentials

V.L. Medvedev, PhD, professor, deputy chief doctor on urology, head of urology and nephrology center, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, chief nontenured urologist and transplantologist of Health Care Ministry, Krasnodar Region (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Lysenko V.V., CMS, urologist, assistant professor of the department for robotic and endoscopic surgery, head of urology unit in the surgery department with invasive diagnosis and treatment, Clinic of Medical University and Rehabilitation Medicine, Odessky National Medical University (Odessa, Ukraine). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Rosha L.G., CMS, assistant professor of pathological anatomy department, Odessky National Medical University, head of pathological anatomy department of University Clinic, Odessky National Medical University (Odessa, Ukraine). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Medvedev A.V., CMS, assistant professor of urology department, Kuban State Мedical University, urologist of oncological urology department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Mikhailov I.V., PhD, professor of urology department, Kuban State Medical University, urologist of oncological urology department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Strelyaev A.I., head of oncological urology department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. . E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Ponkina O.N., CMS, head of pathological anatomy department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Possibilities of Multispiral CT to Assess Postoperative Spinal Condition following Transpedicular Osteosynthesis Technique

E.G. Shevchenko*, N.V. Agurina, E.I. Zyablova, I.V. Basankin,

E.P. Yasakova, S.V. Topilina

E.G. Shevchenko*, N.V. Agurina, E.I. Zyablova, I.V. Basankin,

E.P. Yasakova, S.V. Topilina

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: * E.G. Shevchenko, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 140 Rossiyskaya str, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In this article we describe possibilities of computer tomography in detailed assessment of surgical outcomes in patients following placement of metallic fixating systems for degenerative processes, traumatic injuries and other disturbances in the thoracic and lumbar spinal areas.

Key words: multispiral CT, spine, complications, transpedicle screw system.

Author Credentials

Shevchenko E.G., radiologist, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Agurina N.V., radiologist, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zyablova E.I., head of x-ray department, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Basankin I.V., CMS, head of neurosurgery department #3, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Yasakova E.P., radiologist, Scientific Research Institutе – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Topilina S.V., radiologist, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Clinical reserches

D.A. Valyakis 1,2, A.G. Baryshev 1,3*, N.V. Khachaturyan 1,2, M.V. Bodnya 3,

V.A. Porhanov 1,2

Surgical Outcomes following New Technique Application of Duodenal Stump Formation in Gastric Cancer Patients

D.A. Valyakis 1,2, A.G. Baryshev 1,3*, N.V. Khachaturyan 1,2, M.V. Bodnya 3,

V.A. Porhanov 1,2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, oncology department with a course of thoracic surgery for advanced training, Krasnodar, Russia

3 Kuban State Medical University, department of surgery #1 for advanced training, Krasnodar, Russia

Corresponding author: *A.G. Baryshev, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.



In 21,6-70,4% cases surgeons meet technical issues while forming duodenal stump when pathological process is closely located. We know about 200 kinds of duodenal stump closure, but with such a great variety of suturing methods there is no guarantee of safe suturing. 

Aim Improve outcomes in patients with pylorus and gastric outlet cancer.

Materials and methods: authors worked out a technique for duodenal stump formation (licence № 2613940, dated 19.01.2016) that was evaluated in 315 patients in 2014-2017. Patients with gastric cancer diagnosis underwent extended (D2-3) gastrectomy 190 (60,5%) and subtotal distal gastric resection according to Balfour 125 (39,5%).

Results while manipulating with duodenal stump in 45 (57,7%) patients we respected duodenal bulb to ensure radical surgical intervention. In 63 (80,8%) patients to adjust functional surgical results we performed cholecystectomy.

Analysing immediate results we observed no suture insufficiency in duodenal stump, in 4 (5,2%) cases we noticed increased levels of alpha-amylase and mild enlargement of pancreas head while performing abdominal ultrasound examination. 

Postoperative complications were found in 5 (6,4%) cases: thromboembolism of small pulmonary artery branches - 2 (2,6%), lower lobe pneumonia - 3 (6,4%), postoperative pancreatitis - 1 (1,3%).

Conclusions: application of monofilament for mechanic closure facilitated usage of this technique during laparoscopy with performing extra corporal knots; it secures anatomical, atraumatic adaptation of suturing tissues.

This method for duodenal stump hermetic closure is characterised as a simple and reliable technique. Its usage allowed to achieve radical reduction of suture insufficiency and improve total outcomes in gastric cancer patients.

Key words: gastric cancer, gastrectomy, duodenal stump.

Author Credentials

Valyakis D.A., oncologist, coloproctology department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia), assistant of oncology department with thoracic surgery course ATF, Kuban State Medical University (Krasnodar, Russia). E-mail://e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Khachaturyan N.V., oncologist, coloproctology department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia), post-graduate student oncology department with thoracic surgery course ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: procto_kkb1@ mail.ru.

Bodnya M.V., post-graduate student of surgery department #1 ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: //e.mail.ru/compose?To= Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. "> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Porhanov V.A., PhD, professor, RAS academician, head doctor of Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia), head of oncology department with thoracic surgery course ATF, Kuban State Medical University (Krasnodar, Russia). E-mail: vladimirporhanov@ mail.ru.

Endoprosthesis and Arthrodesis of the Ankle Joint. Comparison of Treatment Outcomes

D.L. Miroshnikov 1*, O.V. Sabodashevskiy 1, A.A. Afaunov 1,2,

I.I. Zamyatin 1, H.H. Matar 1, Y.V. Napakh 1

D.L. Miroshnikov 1*, O.V. Sabodashevskiy 1, A.A. Afaunov 1,2,

I.I. Zamyatin 1, H.H. Matar 1, Y.V. Napakh 1

1 Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2Kuban State Medical University, Krasnodar, Russia

Corresponding author: * D.L. Miroshnikov, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May street, 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.


Background Study long-term results following endoprosthesis and arthrodesis of an ankle joint.

Materials and Methods During the period from 2006 to 2018, we arthrodesed 102 ankle joint and endoprosthesing with DePyu Mobility implants in patients with arthroses of various etiology.Of operated on patients,there were 16 female patients (61,5%) and 10 (38,5%) male patients, age range was from 19 to 78 years (mean age 50,6 years). The average operative time was 1,6 hours. Average blood loss was 200 ml. Of patients with arthrodesis procedures: 76 (75,5%) – female patients and 26 (25,5%) – male patients, age range varied from 32 to 68 years (mean age was 49 years). The average operative time was 2 hours, and average blood lost was 300 ml.

Results To compare surgical results we applied AOFAS score defining treatment results according to functional criteria. Of 31 cases with endoprosthesing in 29 (93,5%) we observed sufficient long term results, and in 2 cases(6,5%) - satisfactory. Twenty-five patients (80,6%) were pleased with outcomes of surgery. In 20 patients (64,5%) volume of movement is less than usual, but more comparing to preoperative value. In 3 cases (9,3%) the pain syndrome was also stopped and volume of movements was unchanged and in 3 patients movements were normal (they had no significant ristrictions prior to the operation). In 1 case (3,2%) after endoprosthesing of ankle joint we observed varus deformity at the level of subtalar joint, so we performed correcting subtalar arthrodesis. In 2 patients (6,4%) achieved results were assessed as insufficient due to forming femoroacetabular impingement and pain syndrome. Cases of unstable endoprostheses were not seen. Following ankle joint arthrodesis we observed sufficient long-term results in 78 patients (76,4%), satisfactory results were in 24 (23,5%) patients. And in 24 cases (23,9%) patients required reoperation due to poor results of arthrodesis.

Conclusions Ankle joint replacement with modern implants allows to achieve sufficient clinical results and it is a hi-tech alternative to arthrodesis procedures.

Key words: endoprosthesis replacement of ankle joint, arthrodesed ankle joint, coxarthrosis.

Author Credentials

Miroshnikov D.L., orthopedic surgeon, traumatology and orthopaedics department #3, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Sabodashevsky O.V., candidate of medical science, orthopedic surgeon of the highest category, the head of orthopedic surgeon #3, Scientific Research

Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Afaunov A.A., PhD, head of the traumatology and orthopaedics department and BFS, Kuban State Medical University (Krasnodar, Russia). E-mail: afaunovkr@

mail.ru.

Zamyatin I.I., orthopedic surgeon, traumatology and orthopaedics department #3, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1(Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Matar K.K., orthopedic surgeon, traumatology and orthopaedics department #3, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1

(Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Napakh Y.V., orthopedic surgeon, traumatology and orthopaedics department #3, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1

(Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Anomalies of coronary arteries. «Artery – collar»

E.A. Ulbasheva*, A.M. Namitokov, E.D. Kosmacheva

E.A. Ulbasheva*, A.M. Namitokov, E.D. Kosmacheva

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: * E.A. Ulbasheva, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. @mail.ru

Anomalies of coronary arteries are very diverse. Due to angiography evolution, possibilities for their detection became more frequent, and it always attract attention of experts. In the present article, we describe a clinical case with a rare and insufficiently explored anomaly – presence of the single coronary artery.

Key words: аnomalies of coronary arteries, singe coronary artery, «artery-collar ».

Corresponding author: * E.A. Ulbasheva, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Author Credentials

Ulbasheva E.A., cardiologist of intensive care ward, cardiology department #2 for patients with myocardial infarction, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Namitokov А.М., CMS, head of cardiology department #2 for patients with myocardial infarction, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Kosmacheva E.D., PhD, chief medical officer, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Case of a successfully surgically treated patient after a сatatrauma with uncomplicated unstable compression and splintered fracture of ThVII vertebral body (AIII) and kyphotic deformation by mini - invasive stabilization by u-Centum system

A.А. Kalinin 1,2*, M.V. Lazukov 1, M.A. Belova 2

A.А. Kalinin 1,2*, M.V. Lazukov 1, M.A. Belova 2

1 Irkutsky State Medical University, Irkutsk, Russia

2 Dorozhnaya Clinical Hospital Irkutsk-PAssazhirsky Station OAO «RZD», Irkutsk, Russia

Corresponding author: *А.А. Klainin, Irkutsky State Medical University, 664005, Irkutsk, 10 Botkina str., e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Correction for post-traumatic kyphotic deformation and stabilization of the damaged segment has a defining value in surgical treatment and prevention of complications after traumatic compression and splintered fractures of the thoracic vertebral bodies. Possibilities for restoration of the sagittal balance of the spine and correction of kyphotic deformation while using mini - invasive fixation are studied insufficiently.

In the present article we describe a clinical example of successful surgical treatment of a patient following сatatrauma with an uncomplicated unstable compression and splintered fracture of the vertebral body ThVII (AIII) and kyphotic deformation by a method of percutaneous transpedicular fixation by the u-Centum system. Percutaneous transpedicular fixation allows to considerably reduce vertebrogenic pain syndrome, effectively eliminate kyphotic deformation in an acute period of a vertebral trauma, carry out significant correction of kyphotic angle, early activization and can be an operation of choice in patients with uncomplicated AIII compression and splintered fractures of thoracic spine.

Key words: compression fracture, kyphotic deformation, transpedicular fixation, mini-invasive stabilization.

Author Credentials

Kalinin A.A., CMS, associated professor of neurosurgery course, Irkutsky State Medical University, physician of neurosurgeon department NUZ «Dorozhnaya Clinical Hospital», Irkutsks-Passazhirsky station, OAO «RZhD» (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Lazukov M.V., resident of neurosurgery course, Irkutsky State Medical University (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Belova M.A., neurologist, policlinics #2, NUZ «Dorozhnaya Clinical Hospital», OAO «RZD» (Irkutsk, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

N.V. Agurina*, E.I. Zyablova, E.G. Shevchencko, E.P. Yasakova

possibilities of multispiral computer tomographyforpulmonary sequestration diagnosis

N.V. Agurina*, E.I. Zyablova, E.G. Shevchencko, E.P. Yasakova

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: * N.V. Agurina, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Pulmonary sequestration is a rare abnormality among all congenital defects of pulmonary development. We presented three clinical observations with various clinical manifestations. Possibilities of multispiral CT for the present pathology are described.

Key words: pulmonary sequestration, multispiral computer tomography.

Authors Credentials

Agurina N.V., radiologist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). Е-mail: agurinan@ rambler.ru.

Zyablova E.I., head of radiology department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Shevchenko E.G., radiologist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). Е-mail: shev- Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Yasakova E.P., radiologist, Scientific Research Institution - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). Е-email: eliz2007@list.ru.

Rare case of ultrasound diagnosis and successful surgery for mitral valve cyst treatment

V.V. Abramyan 1 *, N.V. Soroka 1, S.Y. Boldyrev 1,2, I.A. Shelestova 1,2, I.P. Pavlenko 1 , М.V. Likhobitskaya 1

V.V. Abramyan 1 *, N.V. Soroka 1, S.Y. Boldyrev 1,2, I.A. Shelestova 1,2, I.P. Pavlenko 1 , М.V. Likhobitskaya 1

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: O.A. Medoeva, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Intracardiac cysts are quite rare cardiac pathology in the adults. In this paper we describe a clinical observation for a mitral valve cyst in a ale patient, 31 year. This patient had complaints on complicated swallowing, dizziness, nausea, episodes of consciousness loss and was indicated to have transthoracic echocardiography. During the echocardiographic research on a anterior leaf of the mitral valve we found a cavitary lesion with the size 27x38 mm which did not interfere with the blood supply in an output path of the left ventricle. The patient was successfully operated. Histologic research showed a true cyst of the mitral valve.

Key words: true intracardiac cyst, mitral valve pathology, echocardiography.

Author Credentials

Abramyan V.V.,ultrasound specialist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia). Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Soroka N.V., ultrasound specialist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia). Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Boldyrev S.Y., CMS, сardiac surgeon, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia).Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Shelestova I.A., CMS, associate professor, deputy chief physician for polyclinic work, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia).Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Pavlenko I.P., ultrasound specialist,Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia).Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Likhobitskaya М.V.,ultrasound specialist, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, (Krasnodar, Russia).Е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Clinical case of initial hyperparathyroidism with multiple adenomas A.V. Romash *, E.A. Terman

A.V. Romash *, E.A. Terman

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: * A.V. Romash, Scientific Research Institution - Ochapovsky Regional Clinical hospital #1, 350086, Krasnodar, 1st May street, 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In the present article we described an interesting clinical case with multiple adenomas of parathyroid gland. We demonstrated proper combined application of visualising methods.Scintigraphy as a method of preoperative visualisation is defined as improving surgical results and reducing operative time.

Key words: initial hyperparathyroidism, parathyroid gland adenoma, hypovitaminosis D, comorbide pathology.

Author credentials

Romash A.V, endocrinologist, KKDP #1, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia).E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Тherman E.A., forensic surgeon, department of morbid anatomy, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Technological Achievements in Medicine

remote holter longitudinal monitoring – promising direction in telehealth development

Y.N. Gorozhantsev*, S.G. Sergienko, E.A. Vorotynsteva, Y.V. Emelyanenko

Y.N. Gorozhantsev*, S.G. Sergienko, E.A. Vorotynsteva, Y.V. Emelyanenko

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Correspondng author: *Y.N. Gorozhanstev, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May str., е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Experience of organization and performance of remote Holter monitoring is presented. We studied diagnostic advantages of its remote fulfillment.

We used portable recorders and proprietary software. Clinical cases demonstrating advantages of remote Holter monitoring are described. We discussed perspective of this direction of telehealth.

Key words: telehealth, remote, 7- day, prolonged, longitudinal monitoring, ECG, Holter monitoring.

Author Credentials

Gotozhanstev Y.N., head of functional diagnostics department #1, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, assistant of cardiac surgery and cardiology advanced training, Kuban Medical State University department (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Sergienko S.G., physician of functional diagnostics department #1, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Vorotynsteva E.A., physician of functional diagnostics department #1, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Emelyanenko Y.V., physician of functional diagnostics department #1, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1(Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .



Reviews

Modern Classification of diabetic foot SVS WIfi

R.S. Tupikin 1*, S.K. Chibirov 1, A.A. Zebelyan 2, A.N. Fedorchenko 1,

V.A. Porhanov 1

R.S. Tupikin 1*, S.K. Chibirov 1, A.A. Zebelyan 2, A.N. Fedorchenko 1,

V.A. Porhanov 1

1Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State medical University, Krasnodar, Russia

Corresponding author: * R.S. Tupikin, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 1st May str., 167, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Today we observe increasing rates in diabetes prevalence of diabetes, especially in industrialized countries where about 5-6% of the population have this disease. Trophic ulcer changes of tissues for diabetic foot in 70% of cases lead to high amputations, despite all ongoing efforts on decreasing percent of high amputations, progress in this field remains rather low. For high economic and social importance of diabetic foot syndrome, approach to treatment of this pathology has to be multidisciplinary and unite experts of various areas. Timely diagnosis and then effective and predicted treatment in patients with the ischemia threatening to a limb with a diabetic foot syndrome, depend on more exact stratification of patients.

Now there are a number of classifications for a diabetic foot syndrome which include basic ideas of the main pathogenetic mechanisms on development of this serious complication, and consider serious affection of the peripheral nervous system, the peripheral arterial bed, assessment of the wound defect extent and evidence of infectious process. The detailed description of SVS WlFI classification offered in 2014 by Society of vascular surgeons is presented in this article.

Key words: diabetes mellitus, diabetic foot, ischemia threatening to limb, SVS WIfI classification.

Author credentials

Tupikin R.S., surgeon, x-ray diagnosis and treatment department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Chibirov S.K., surgeon, x-ray diagnosis and treatment department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zebelyan A.A., surgeon, x-ray diagnosis and treatment department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Fedorchenko A.N., PhD, head of the x-ray endovascular diagnostics and treatment department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Porhanov V.A., PhD, professor, academician of the RAS, chief doctor of Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1, head of the Department of Oncology with the course of thoracic surgery FPK and PPS, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Manuscript requirements

Innovative Medicine of Kuban #1 (2018)

InnovativeMedicineofKuban #1 (2018)

CONTENTS

Original articles

STAGING AND CONTINUITY IN REHABILITATION OF PATIENTS WITH NEUROSURGICAL ISSUES

I.Y. Galyaev 1*, M.A. Barabanova 1,2, L.V. Timchenkо 1, O.N. Zhadan 1

I.Y. Galyaev 1*, M.A. Barabanova 1,2, L.V. Timchenkо 1, O.N. Zhadan 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Russia, Krasnodar, Russia

Corresponding author:* I.Y. Galyaev, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 , 350086, Krasnodar, 167, 1st May strееt, е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background: show efficiency of multitask team approach and continuity in recovery treatment for patients with neurosurgical issue at rehabilitation stages.

Materials and methods: we performed analysis of 58 patients after neurological interventions on brain or spine cord for post stroke complications, severe cerebral or spinal cord traumas and had two-staged rehabilitation in State Health Care Budget Institution ‘Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, in 2017, in neurorehabilitation department. The efficiency of multidisciplinary assessment of a patient condition according to scales at 1, 2 stages of rehabilitation with development of the individual program of rehabilitation is shown.

Conclusions. Exteriorisation of a patient condition at rehabilitation stages while using specialized scales, multidisciplinary approach, the early beginning of rehabilitation actions, assessment of rehabilitation potential taking into account point on the modified scale Renkin at the end of each stage of rehabilitation allow to estimate correctly the need for the following rehabilitation stage, increase efficiency of rehabilitation actions, quality of life in patients who have had neurosurgical treatment.

Key words: rehabilitation, stroke, neurosurgical, multitask team, stage, scales, rehabilitation prognosis.

Author credentials

Galyaev I.Y., physical therapist for patients with ACVE, neururehabilitation department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Barabanova M.A. PhD, professor, department of neurological disorders and a course of neurological diseases and neurosurgery of ATD, Kuban State Medical University, neurologist, head of the neurological department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Timchenkо L.V., neurologist, head of the neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zhadan O.N., neurologist, head of the neurorehabilitation department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Application OF artificial neural networks OPPORTUNITIES IN THE ANALYSIS OFholter monitoring findings

Y.N. Gorozhantsev, S.G. Sergienko, E.A. Vorotynsteva, Y.V. Emelyanenko,

A.V. Gorozhansteva

Y.N. Gorozhantsev, S.G. Sergienko, E.A. Vorotynsteva, Y.V. Emelyanenko,

A.V. Gorozhansteva

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author Y.N. Gorozhantsev, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 , 350086, Krasnodar, 167, 1st May strееt, е-mail:

Development of a Holter monitoring technique in the direction to increase research duration, imposes increased requirements to the software.

In this regard use of artificial intellect technologies are of interest. We designed and realized artificial neural networks on the basis of a self-training layer of Kokhonen. The efficiency of ANN functioning in case of execution the tasks of the QRS complexes clustering which are contained in the findings of the ROHMINE test database is studied and confirmed.

Author credentials

Gotozhanstev Y.N., head of functional diagnosticsdepartment #1, Scientific Research Institute Ochapovsky Regional Clinic Hospital #1 , assistant of cardiac surgery and cardiology advanced training, Kuban Medical State University (Krasnodar, Russia). E-mail: ygsoft2002@

rambler.ru.

Sergienko S.G., physician of functional diagnostics department #1, Scientific Research Institute Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Vorotynsteva E.A., physician of functional diagnostics department #1, Scientific Research Institute Ochapovsky Regional Clinic Hospital #1 (Krasnodar,

Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Emelyanenko Y.V., physician of functional diagnostics department #1, Scientific Research Institute Ochapovsky Regional Clinic Hospital #1(Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Gorozhantseva A.V., ultrasound diagnostics physician, Medical Technologies clinic (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Surgery impact on life quality data I  children with detached retina

A.N. Sergienko2, V. V. Dashing ¹, A.V. Malishev ¹, O. I. Lisenko ¹,S.V. Yanchenko ¹

A.N. Sergienko2, V. V. Dashing ¹, A.V. Malishev ¹, O. I. Lisenko ¹,S.V. Yanchenko ¹

1Scientific Research Institution – Ochapovsky Regional Clinical hospital #1, Krasnodar, Russian Federation

2Paediatric Regional Hospital, Krasnodar, Russia

Corresponding author:*A.N. Sergienko, Paediatric Regional Hospital, 350063, Krasnodar,1 Victory square, е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background Assessment of life quality while carrying out a vitrectomy in children with detached retina

Materials and methods Twenty three patients (23 eyes) aged from 10 up to 17 years from with detached retina were examined. Surgery included carrying out a standard three-port vitrectomy and laser endocoagulation of retina vessels. All patients have been divided by method of casual selection into 3 groups. In the I group (n=8) during the surgery the balanced salt solutions (Balansed Salt Solution - BSS) without antioxidants were used and additional purpose of the antioxidant medicines per os was not carried out; in the II group (n=8) at performing surgery BSS with antioxidants (glutathione) – BSS plus were used; in the III group (n=7) in the postoperative period in addition per os antioxidant medicines were administered for 3 months. In all patients the research of life quality on the basis of the reduced Russified version of the questionnaire VFQ-25 was conducted. The control group consisted of 10 children of the corresponding age and sex, the welfare and national identity, without contraindications to surgery in the area of a vitrealny cavity. Statistical processing of the received findings has been executed by means of a package of application programs of the statistical analysis AnalystSoft, BioStat 2007.

Results: In a week after surgery increase in visual acuity was not observed. Six months later reliable increase in visual acuity was noted. The highest final rates of a vasometry were observed in the II group, patients of the I group had minimum values. The minimal progressing of a cataract was observed in patients of the II group.

Conclusion: Surgery for detached retina positively influenced rates of life quality in children in the early and long term postoperative period.

Key words: detached retina, life quality, children.

Author credentials

Sergienko A.N., ophthalmologist, Рaediatric regional hospital (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Dashina V.V., ophthalmologist, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Malishev A.V., PhD , head of ophthalmology department, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Lisenko O.I. , CMS, ophthalmologist, Ophthalmology department, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Yanchenko S.V., PhD, ophthalmologist, Ophthalmology department, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia).E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Case reports

A rare case of successful staged surgery in the patient with joined stenosis of the vertebral canal at the cervical, thoracic and lumbar levels

V.A. Bivaltsev 1,2, A.A. Kalinin 1,2, V.V.Shepelev 1, I.A. Stepanov 1

V.A. Bivaltsev 1,2, A.A. Kalinin 1,2, V.V.Shepelev 1, I.A. Stepanov 1

1 Irkutsky State Medical University, Irkutsk, Russia

2 Dorozhnaya Clinical Hospital, Irkutsk-Passazhirsky Station, Irkutsk, Russia

Corresponding author: V.A. Bivaltsev, Irkutsky State Medical University, 664082, Irkutsk, Botkina street, 10, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

In the present article we describe a clinical example of a successful staged surgical treatment in the patient with rare joined stenosis of the vertebral canal at the cervical, thoracic and lumbar levels, surgical rehabilitation was 24 weeks.

In connection with clinical data the first stage included ventral decompression of the cervical department of the spinal cord and spondylodesis by a telescopic prosthesis of a vertebral body, during the second stage through a minithoracotomy with an endovideo-assistance we performed anterolateral decompression of the spinal cord and spondylodesis by a telescopic prosthesis of a vertebral body with a lateral plate, and the third stage consisted of dorsal decompression of a dural bag and roots of the spinal cord, transpedicular fixation with an interbody spondylodesis in a lumbar department of the spine. Applying low-traumatic techniques for decompression and spondylodesis with specialized devices we could decrease level of pain syndrome, degree of neurologic deficiency, improve life quality and carry out effective fixation of three operated on vertebral aspects. Mini-invasive staged microsurgical decompressive stabilizing techniques can be used for successful treatment in patients with joined stenoses in the vertebral canal and also allow to reduce considerable risks for life and to cause full rehabilitation in the shortest possible time.

Key words: joined stenosis of the spinal canal, low-trauma decompression of spinal canal, mini-invasive stabilization.

Author Credentials

Bivaltsev V.A., PhD, head of the neurosurgery course of Irkutsky State Mefical University, chief neurosurgeon, department of health care POJSC ‘RRW’,

head of the neurosurgery center NGHCI «Dorozhnaya Clinical Hospital, Irkutsk-Passazhirsky Station», head of the scientific clinical department of neurosurgery, Irkutsky scientific center of surgery and traumatology, professor of traumatology, orthopaedics and neurosurgery department, Irkutsky State Medical Academy of postgraduate education (Irkutsk, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Kalinin A.A., CMS, associate professor, course of neurosurgery, Irkutsky State Medical University, neurosurgeon, Neurosurgery centre, NGHCI «Dorozhnaya Clinical Hospital, Irkutsk-Passazhirsky Station»(Irkutsk, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Shepelev V.V. advanced student, course of neurosurgery, Irkutsky State Medical University (Irkutsk, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Stepanov I.A., advanced student, course of neurosurgery, Irkutsky State Medical University. E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

TRANSPORTATION OF THE PATIENT WITH REFRACTORY CARDIOGENIC SHOCK IN THE SETTING OF VENO-ARTERIAL EXTRACORPORAL MEMBRANE OXYGENATION

D.V. Kozlov*, A.A. Skopets, E.S. Dumanyan

D.V. Kozlov*, A.A. Skopets, E.S. Dumanyan

Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Corresponding author: D.V. Kozlov, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.


In the present article we describe a clinical case with onsite placing of veno-arterial extracorporeal membranous oxygenation in a patient with the acute myocardial infarction complicated by refractory cardiogenic shock. It allowed to stabilize his status and transport in a specialized medical institution to carry out a coronary angiography and myocardial revascularization to arrest cardiogenic shock and to achieve restoration of myocardial function and switch off ECMO. The course of disease was complicated by combined stroke with cerebral failure development and fatal outcome.

Key words: extracorporeal membrane oxygenation, acute myocardial infarction, refractory cardiogenic shock.

Authors Credentials

Kozlov D.V., anesthesiologist, anesthesiology and resuscitation department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Skopets A.A., CMS, head of anesthesiology and resuscitation department #2, Scientific Research Institute –Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Dumanyan E.S., anesthesiologist, anesthesiology and resuscitation department #2, Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Clinical case of chylopericardium in a patient after VATS lobectomy

A.M. Bostanova *, S.D. Sitnik, V.A. Zhikharev

Corresponding author: *A.M. Bostanova, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

A.M. Bostanova *, S.D. Sitnik, V.A. Zhikharev

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Chylopericardium is a rare medical condition when in the pericardial cavity chylous fluid is found. It contains high concentrations of triglycerids, with development of progressive cardiac insufficiency.

In the present article we report about a clinical case of chylopericardium development in a patient, 66, following thoracic intervention.  We observed clinical manifestation, etiology, diagnostics and treatment.

Key words: chylopericardium, conservative treatment, surgical treatment.

Author credentials

Bostanova A.M., anaesthesiology and reanimation department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Sitnik S.D., head of anaesthesiology and reanimation department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto%3asitnik% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Zhikharev V.A., senior registrar of anaesthesiology and reanimation department #1, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

clinical case presenting combined treatment with mechanical thrombectony with angioplasty and stenting for acute occlusion of the basilar artery

V.V. Efimov *, A.N. Fedorchenko, V.A. Porhanov, A. I. Beliy, O.S. Volkolup

V.V. Efimov *, A.N. Fedorchenko, V.A. Porhanov, A. I. Beliy, O.S. Volkolup Scientific Research Institution – Ochapovsky Regional Clinic hospital #1, Cardiac surgery department #2, Krasnodar, Russia

Corresponding author: *V. V. Efimov, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Mortality without treatment shows the highest rate among all ischemic stroke subtypes. In most cases acute thrombosis coexists with an atherosclerotic stenosis therefore treatment of both pathologies during one intravascular intervention is required quite often. Patients who underwent successful recanalization of the basilar artery have lower mortality rate. Considering all published reports, mortality for not restored blood flow in this artery is 87% vs 39% for successful recanalization.

The clinical case of a successfully treated patient with an acute occlusion of a basilar artery using of a mechanical thrombectomy with angioplasty and stenosis stenting which was a reason for arterial occlusion development is presented in this article.

Key words: basilar artery, thrombosis, mechanic thrombectomy, stenting.

Author credentials

Efimov V.V, surgeon, x-ray endovascular diagnosis and treatment, department of x-ray diagnosis and treatment, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: //e.mail.ru/compose/?mailto=mailto% Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. " target="_blank"> Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Fedorchenko A.N., PhD, head of the x-ray endovascular diagnostics and treatment department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Porhanov V.A., PhD, professor, academician of the RAS, chief doctor of Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1, head of the Department of Oncology with the course of thoracic surgery FPK and PPS, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Beliy A.I., surgeon, x-ray diagnosis and treatment department, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Volkolup O.S., surgeon, x-ray diagnosis and treatment department, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .



CASE OF COMBINED STAGED TREATMENT FOR GIANT CELL TUMOUR OF DISTAL EPIPHYSIAL CARTILAGE OF RADIAL BONE

O.V. Sabodashevsky 1*, D.A. Solodky2, E.V. Seumyan 1



O.V. Sabodashevsky 1*, D.A. Solodky2, E.V. Seumyan 1

1 Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia



Corresponding author: * O.V. Sabodashevsky, Scientific Research Institute - Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, е-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.



We present the case of successful surgical treatment in the patient with a giant cell tumor of distal epithysial cartilage of radial bone. Important feature of this case is a multi-stage combined treatment for the tumor of the radial bone with bone autotransplant in the proximal area of the peroneal bone. We discuss issues of epidemiology and choice of surgical techniques for giant cell tumor treatment.

Key words: giant cell tumor, staged surgery, autotransplant proximal peroneal bone.

Author credentials

Sabodashevsky O.V., CMS, Head of traumatology and orthopaedics department, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Solodky D.A., traumatologist, traumatology and orthopaedics department,

Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Seumyan E.V., traumatologist, traumatology and orthopaedics department,

Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Cardiac myxoma as a rare cause of ischemic stroke

O.A. Medoeva*, P.V. Kataev, L.V. Timchenko

O.A. Medoeva*, P.V. Kataev, L.V. Timchenko

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia



Corresponding author: O.A. Medoeva, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

One of the most rare reasons for ischemic stroke (according to literature sources – less 1% of all ischemic strokes) is myxoma. Myxoma represents a benign tumor of heart which is found mainly in patients from 30 up to 60 years. In 75% of cases it invades the left atrium. Sometimes the only clinical finding is cardiac embolic symptoms which are most frequently noticed like cerebral vessel embolism. Clinical cases with ischemic stroke caused by the left atrium myxoma are presented in this article.

Key words: myxoma, ischemic stroke, systemic thrombolytic therapy.

Author credentials

Medoeva O.A., neurologist, neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Kataev P.V., neurologist, neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Porhanov V.A., PhD, professor, academician of the RAS, chief doctor of Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1, head of the Department of Oncology with the course of thoracic surgery FPK and PPS, Kuban State Medical University (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Timchenko L.V., neurologist, head of the neurological department for patients with ACVE, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Reviews

Colorectal Cancer Screening. Current Techniques and Recommendations Review

D.P. Puzanov 1, V.V. Polovinkin 1,2, I.A. Puzanova 1

D.P. Puzanov 1, V.V. Polovinkin 1,2, I.A. Puzanova 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Corresponding author: D.P. Puzanov, Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, 350086, Krasnodar, 167, 1st May street, e-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.

Background The review of the main screening methods for identification of cases with colorectal cancer, and analyze differences and likeliness.

Materials and methods Review of the screening methods was performed by means of international bases MEDLINE, EMBASE, Scopus, Central, ISI Web, Google and Goggle Scholar and considering published recommendations of World Wide Organization of Gastroenterology. In most guidelines screening in patients, with mean age 50-75 years, is discussed, and performance of fibrocolonoscopy every 10 years or flexible sigmoidoscopy every 5 years and annual FOB test are recommended. Differences in guidelines may be referred to intervals between tests and consistency of performed tests.

Conclusions mean recommended age indicated for screening performance is 50-75 years; two-staged screening with FIT at first stage and FCS at second stage represent the most optimal screening pattern.

Key words: colorectal cancer, screening, FIT, colonoscopy, hemoccult test, guaiac test.

Author credentials

Puzanov D.P., CMS, surgeon, department of coloproctology, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Polovinkin V.V., PhD, head of department of coloproctology, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .

Puzanova I.A., gastroenterologist, department of gastroenterology, Scientific Research Institutе - Ochapovsky Regional Clinic Hospital #1 (Krasnodar, Russia). E-mail: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. .



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