Venous Blood Outflow Research Articles

Potential Causes of Iatrogenic Intraoperative Bleeding During C1 Surgeries: A CT 3D Rendering Study

BackgroundIatrogenic intraoperative bleeding during C1 surgeries is difficult to manage. PurposeTo investigate the potential causes of iatrogenic intraoperative bleeding in atlas surgeries. Study designThis was a retrospective study, observational cohort of patients with DICOM. Patient SampleHigh-resolution head and neck computed tomography angiography (CTA) images from 551 subjects were included. Outcome MeasuresPonticulus posticus (POPO), vertebral artery (VA), venous plexus communication. MethodsThree dimension rendering was utilized in the present study. Potential arterial bleeding was evaluated based on the variation in the VA and the polymorphism of the POPO over the groove for VA (GVA). The communication of the venous plexus in the occipitoatlantal region was investigated to assess the venous hemorrhage. ResultsAmong the 551 atlases examined, POPOs were identified on 155 sides, resulting in a prevalence of 14.07% (155/1102). These POPOs (n = 155) were reclassified into four types: tiny spur (54.84%), long spur (7.10%), ossified bridge (30.32%), and ossified canal (7.74%). In 42.92% (473/1102) of cases, the VA did not directly contact the sulci of the GVA, creating space for the passage of the rich venous plexus that drained intracranial venous blood outflow to various extracranial layers. Moreover, in 12.7% of the subjects, the study revealed the presence of additional foramens in the posterior lamina of C1, which served as a conduit for the communicating vein ConclusionThe potential underestimation of polymorphism in POPOs and VAs can lead to arterial bleeding, whereas a lack of understanding of the intricate condylar emissary venous plexus can result in venous hemorrhage. To mitigate iatrogenic hemorrhage during C1 surgeries, a preoperative HEAD AND NECK CTA is recommended, and heightened caution should be exercised during dissection in the lateral half of the C1 lamina. Furthermore, unknown causes of intraoperative bleeding may arise during the posterior C1 approach; modifications should be considered based on the specific circumstances encountered.

Pathobiochemical Features of Posthepatectomy Liver Failure and Prospects for Its Metabolic Correction

We review the current understanding of pathophysiology and pathobiochemistry of conditions following extensive resections of the liver parenchyma and describe potential ways of surgical and metabolic correction, including promising molecular targets for therapy. Reduced residual tissue volume (small-for-size syndrome), parenchymal edema due to hyperperfusion and impaired venous blood outflow, septic complications, organ ischemia-reperfusion, mitochondrial dysfunction, and oxidative stress are considered key pathogenetic factors in liver failure development following extensive resections of the liver parenchyma. Given the above, promising ways of managing posthepatectomy conditions are the use of agents reducing portal pressure (octreotide [somatostatin analogue], terlipressin [vasopressin analogue], and propranolol), energotropic metabolic drugs (combined preparations of succinate and antioxidants, gasotransmitter donors), and antibiotics and synbiotics for prevention of infectious complications. The approaches currently used in clinical practice cannot always effectively manage complications following extensive hepatectomy, so fundamental research should focus on searching and creating effective strategies for prevention and therapy of posthepatectomy liver failure.

Tissue oxidative metabolism and microhemodynamics of the skin in rats exposed to stress factors of different durations and combinations

BACKGROUND: Changes in tissue oxidative metabolism under the action of stressors of different durations have not been studied. The relationship between NADH and FAD coenzymes and the microcirculatory bed remains unclear.
 AIM: This study aimed to identify the features of the reaction of skin microhemodynamics and tissue oxidative metabolism in rats exposed to acute and chronic stress factors of different durations and their combinations.
 MATERIALS AND METHODS: The experiment was performed on 100 male Wistar rats weighing 200–220 g. The animals were divided into five groups of 20 rats. The first control group and the second and third groups were exposed to acute stress (AS) and chronic hypokinetic stress (HS), respectively; the fourth group (AS-HS) was previously exposed to AS (on the first day) and then to HS (1–10 days); and the fifth group (for 10 days of the HS, then the effect of the AS on day 10). On day 10, the indicators of tissue oxidative metabolism and skin microhemodynamics were recorded.
 RESULTS: AS and HS increased the requirement of cells for ATP and contributed to the predominance of oxidative phosphorylation over other processes, as indicated by an increase in FAD. AS-HS significantly changed oxidative metabolism, separating oxidative phosphorylation and activating glycolysis. HS-AS did not cause such changes. AS increased the microcirculation index and reduced the coefficient of variation, and HS reduced the microcirculation index and increased the mean square deviation. AS–HS significantly increased the microcirculation index, and HS-AS increased the mean square deviation and coefficient of variation but reduced the microcirculation index.
 CONCLUSIONS: AS and HS increase the requirement of cells for ATP and contribute to the predominance of oxidative phosphorylation over other processes. AS-HS modifies oxidative metabolism by disconnecting oxidative phosphorylation and activating glycolysis. HS-AS depletes the metabolic reserves of the body. AS-HS rearranges metabolism along the path of glycolysis, protecting against stress factors and preventing the development of oxidative stress. AS leads to hyperemia and stasis of blood circulation in the microarray, reducing the vasomotor activity of the vessels. HS inhibits the level of tissue perfusion and reduces the inflow of arterial blood into the microcirculatory bed and the outflow of venous blood, leading to spastic, stagnant phenomena and stasis. AS-HS reduces vasoconstriction, preparing a microcirculatory bed for prolonged hypokinesia. HS-AS levels vasodilation and improves the parameters of skin microhemodynamics (mean square deviation and coefficient of variation).

The venous bed of the shoulder and forearm area of the fruits of blackand-white cows

Embryonic development and formation of the bloodstream, namely the venous outflow highways of the shoulder and forearm area in the fetuses of black-and-white cows, in our opinion, are an urgent topic for study. Unfortunately, despite active measures to prevent limb injuries in animals, modern veterinary agricultural complexes continue to face periodic non-contagious diseases associated with limb injury. The cascade of reactions occurring in the body after an injury is inextricably linked with the venous system of fluid outflow from the limbs of animals. The corpses of fetuses of black-and-white cows aborted at the fifth month of pregnancy with no signs of infectious diseases were used as the studied material. In total, five fruits were examined, delivered from private farms of the Leningrad region. The following research methods were used: fine anatomical dissection, vasorentgenography, morphometry using an electronic caliper, measuring ruler and the RadiAnt DICOM Viewer program. As a result of the study, we found that in the fetuses of black-and–white cows at the fifth month of pregnancy, the outflow of venous blood from the shoulder and forearm area is carried out through the following vessels: the superficial venous trunk in the forearm area is formed by the additional subcutaneous vein and the subcutaneous vein of the forearm; the deep venous trunk is formed by the median radial vein, as well as the initial sections of the shoulder veins and median vein of the elbow. The largest diameter in the forearm area are the veins of the superficial trunk. This is due to the fact that it takes the bulk of the blood from the brush area. Venous valves are located more often in the vessels of the deep trunk than in the superficial trunk. This is due to their location and hemodynamic functions, as they contract more strongly than the surface ones. An extensive venous bed is necessary for the passage of a large amount of blood, so the diameter of the vessels of the deep trunk of the shoulder area is larger than the surface.

Ultrasound and magnetic resonance of extrinsic stenosis and hypoplasia of internal jugular veins

Highlights. Ultrasound and MR venography of internal jugular veins in case of unilateral cerebellar hypoplasia or extrinsic stenosis enables noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.Aim. To compare the visual and hemodynamic characteristics of ultrasound and magnetic resonance venography of extrinsic stenosis and hypoplasia of internal jugular veins (IJV).Methods. Ultrasound and magnetic resonance (MR) venography were performed in 47 patients with extrinsic stenosis and 23 patients with hypoplasia of one of internal jugular veins, and in the control group (30 patients).Results. In case of obvious vein compression and deformation and local stenosis (65% on average), there is a decrease in the vein cross-sectional area by 2 times compared with the contralateral vein, the blood flow velocity in the stenotic vein in acute cases increases (on average, up to 45 cm/s), and in chronic cases it significantly (p = 0.00001) decreases (to 13 cm/s on average). The criteria for hypoplasia are the small caliber of the vein (on average 0.22 cm², within the range of 0.13–0.46 cm²) throughout its entire length - with the cross-sectional area not exceeding that of the common carotid artery, and the vein being 4 times smaller than IJV on contralateral side, as well as a significant (p = 0.0006) velocity increase on the contralateral side (on average 40.9±12.52 cm/s) with normal velocity in the hypoplastic vein. Ultrasound assessment of the arterial-venous balance (AVB) makes it possible to evaluate the contribution of each IJV to the outflow of venous blood from the brain separately. From the hypoplastic side it was only 11.01±6.72%, and from the stenotic side it was 18.22±17 42% on average, which is significantly (p = 0.000001) below the norm, but does not allow us to differentiate these conditions. The total AVB for IJVs on both sides was within normal values (65–85%), and the absence of a pronounced expansion of the vertebral veins during MR venography confirms their insignificant role in the compensatory mechanisms of ensuring adequate outflow of venous blood from the brain in cases of unilateral hypoplasia and extrinsic stenosis of IJV.Conclusion. Ultrasound and MR venography of internal jugular veins in cases of unilateral hypoplasia or extrinsic stenosis enable noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.

Відсмоктувальний (дренажний) принцип в класичному лікувальному масажі

The article analyzes scientific research on the use of suction equipment in massage practice. The anatomical structure and physiological features of the lymphatic and venous vascular systems of the human body are considered. It was determined what effect massage has on these systems, on the basis of which the optimal methods for achieving a healing therapeutic effect from massage according to the drainage principle are substantiated. The technique of suction (drainage) classical massage is described. A diagram of massage lines and a diagram of the main lymphomas of the body and the direction of massage movements are given. The physiological process that occurs during the action of suction massage is described. Characterized by therapeutic massage for injuries and diseases of the musculoskeletal system, including joints, tendons, muscles, as well as the peripheral nervous system, for vascular disorders, in the first days after surgery or injury. The features of the functioning of the venous system are outlined. Special attention is paid to the outflow of venous blood, where microcapillaries of growing caliber are formed. It has been determined that the lymphatic system is an integral part of the transport or vascular system of the human body. The general effect of massage on the lymphatic and venous systems of the body is characterized, in particular the effect of massage performed taking into account the physiological characteristics of the vessels, which is suction drainage massage, which in turn will help eliminate edema, congestion, and rapid regeneration of damaged tissues. syndrome. It has been established that the massage of each zone has a preliminary, main and final part. Ultimately, as a result of the therapeutic massage procedure, a positive therapeutic effect should be achieved.

Historical view onto the contribution of phlebodynamometry to the knowledge of venous hemodynamics in the lower extremity

Contribution of phlebodynamometry to the knowledge of the venous hemodynamics in the lower extremity is assessed from the historical point of view. Höjensgard, Stürup, and Arnoldi yielded in the 50's and 60's of the last century substantial information concerning changes of venous pressure in superficial and deep veins of the lower extremity arising during calf pump activity. They confirmed the previous finding that the venous pressure in the quiet standing position corresponds to the column of blood extending from the point of measurement to the heart. During calf pump activity, the systolic-diastolic amplitudes in lower leg veins are very marked; in contrast to that, they are only modest in the popliteal vein. The mentioned authors documented marked decrease in pressure in the posterior tibial vein as well as in the great saphenous vein arising during calf pump activity in healthy people. Contrary to that, the pressure in the popliteal vein did not decrease; it kept principally the value of the resting hydrostatic pressure. This difference of pressure between the thigh veins and the lower leg veins has been called ambulatory pressure gradient; its value in the examined patient cohort was 37.4±6.4 mm Hg. Ambulatory pressure gradient constitutes the suction force that triggers reflux in incompetent superficial and deep veins; this refluxing flow causes ambulatory venous hypertension. Simultaneous pressure recordings in the posterior tibial vein and great saphenous vein in healthy volunteers documented that the systolic and diastolic pressure amplitudes were similar in both veins. The systolic pressure in the posterior tibial vein increased on average by 75 mm Hg; this generates a strong impulse propelling the venous blood mainly into the popliteal vein, and partially into the great saphenous vein. Thus, there is a double-barreled outflow of venous blood from the lower extremity toward the heart. The steep increase in systolic pressure in the great saphenous vein gave evidence of the incompetence of the calf perforators system in healthy people. At present, plethysmography is able to yield similar information on the hemodynamic status of the lower limbs like phlebodynamometry.

Macro-microscopic examination of the valves of the deep dorsal vein of the human penis

Objective to study the valves of the deep dorsal vein of the human penis.
 Material and methods. The study of deep dorsal vein valves in 150 men was carried out using macroscopic and microscopic methods. The work was performed on autopsy material. 47 trunks of the deep dorsal vein isolated using magnifying optics х3,5 from the coronal sulcus to the prostatic venous plexus and 103 fragments of the vein in cross section directly distal to the supporting ligament were studied. We used histological painting coloring with hematoxylin-eosin, funcionam with fuchsin and Mallory. The obtained images of valves in longitudinal and cross sections were subjected to photoregistration and archiving for further detailed study and analysis.
 Results. As a rule, the studied vein has one trunk, but in 7,3% of cases it is represented by 2 trunks. Most often there is a division of the main trunk of the vein. Valves of the deep dorsal vein in the longitudinal section are detected in 89% of observations. On the cross-section, the valve in 36% of cases is detected near the supporting ligament. Valves are represented most often by 2 flaps, at the base of which there is a roller associated with the middle shell of the vein wall. The valves of the deep dorsal vein of the penis have the typical appearance of "pocket" type valves and do not prevent the outflow of venous blood from the cavernous bodies, blocking retrograde blood flow.
 Conclusions. Valves are a constant component of the deep dorsal vein of the human penis. The structure of the valves indicates that they prevent retrograde blood flow to the cavernous bodies, both at rest and during erection.

Micro-scale assessment of bone quality changes in adult cadaveric men with congestive hepatopathy.

Congestive hepatopathy (CH) is a chronic liver disease (CLD) caused by impaired hepatic venous blood outflow, most frequently resulting from congestive heart failure. Although it is known that heart failure and CLDs contribute to increased risk for age-related fractures, an assessment of CH-induced skeletal alterations has not been made to date. The aim of our study was to characterize changes in bone quality in adult malecadavers with pathohistologically confirmed CH compared with controls without liver disease. The anterior mid-transverse part of the fifth lumbar vertebral body was collected from 33 adult malecadavers(age range 43-89 years), divided into the CH group (n = 15) and the control group (n = 18). We evaluated trabecular and cortical micro-architecture and bone mineral content (using micro-computed tomography), bone mechanical competence (using Vickers micro-hardness tester), vertebral cellular indices (osteocyte lacunar network and bone marrow adiposity), and osteocytic sclerostin and connexin 43 expression levels (using immunohistochemistry staining and analysis). Deterioration in trabecular micro-architecture, reduced trabecular and cortical mineral content, and decreased Vickers microhardness were noted in the CH group (p < 0.05). Reduced total number of osteocytes and declined connexin 43 expression levels (p < 0.05) implied that harmed mechanotransduction throughout the osteocyte network might be present in CH. Moreover, elevated expression levels of sclerostin by osteocytes could indicate the role of sclerostin in mediating low bone formation in individuals with CH. Taken together, these micro-scale bone alterations suggest that vertebral strength could be compromised in men with CH, implying that vertebral fracture risk assessment and subsequent therapy may need to be considered in these patients. However, further research is required to confirm the clinical relevance of our findings.

Spontaneous Intrinsic Hepatic Vascular Oscillations

The liver is well known as a large blood reservoir that can shift both stressed and unstressed volumes passively and actively in response to changes in portal venous and hepatic arterial blood flow, inflow and outflow blood pressures, autonomic nervous stimulation, and various humoral and pathophysiological factors. Not described is the characteristic of the liver to intrinsically modulate its own vascular pressure and volume independent of extrinsic factors.METHODSMale Holtzman rats (n=5) were anesthetized (30 mg/kg sodium pentobarbital, i.p.) and heparinized (500 IU/kg, i.v.), the portal vein and inferior vena cava were isolated and cannulated, the liver was flushed with room temperature normal saline, and the liver quickly removed. Each liver was mounted on a scale in a 37°C chamber (95% O2‐5% CO2) and pump‐perfused (Masterflex) with donor rat blood at a baseline 1 ml/min/g of tissue. The hepatic venous pressure (Phv) was regulated by raising and lowering the blood reservoir. At each Time (see table), portal venous oscillations were counted over 3 to 12 min and the portal venous wavelet pulse pressures (Ppv) were measured over at least 40 wavelets.RESULTSThe portal venous pressures of 3 of the 5 livers oscillated spontaneously. One lasted only 26 min while the others went on for over 200 min. The characteristics of these oscillations varied widely from animal to animal, but there usually was an irregular cycle length and uneven wavelet magnitude that tended to degrade to a diminished size with higher frequency over time (see Figure 1). Rat Time (Min) Maneuver Mean Portal Venous Pulse Pressure (mmHg) Frequency (Wavelets/Min) Frequency (Hz) Cycle Length (Sec) 1 0 Baseline 2.1 ± 0.9 (SD) 8.08 0.135 7.42 95 Baseline 1.5 ± 0.8 16.10 0.268 3.73 107 Change Phv 2.5 ± 1.3 17.00 0.283 3.53 (0 to 10 mmHg) (P&lt;0.001 vs. 95 Min Baseline) 180 Baseline 1.3 ± 0.5 18.67 0.311 3.21 2 0 Baseline 0.8 ± 0.4 14.42 0.240 4.16 60 Baseline 0.4 ± 0.3 20.00 0.333 3.00 130 Baseline 0.4 ± 0.2 23.78 0.396 2.52 3 0 Baseline 0.6 ± 0.3 8.67 0.144 6.92 CONCLUSIONSThis is a very limited data set, providing more questions than answers, but it opens a curiosity to much more investigation to understand the function of these intrinsic hepatic vascular oscillations under normal, reflex, and pathophysiological conditions.

Anatomia chirurgiczna gruczołu piersiowego. Unaczynienie, unerwienie, drenaż limfatyczny, budowa dołu pachowego. Część druga.

Dynamically developing oncoplasty, i.e. the application of plastic surgery methods in oncological breast surgeries, requires excellent knowledge of mammary gland anatomy. This article presents the details of arterial blood supply and venous blood outflow as well as breast innervation with a special focus on the nipple-areolar complex, and the lymphatic system with lymphatic outflow routes. Additionally, it provides an extensive description of the axillary fossa anatomy.

Morphological features of the venous bed of the heart of the Baikal seal

The article describes the features of venous blood outflow from the heart in the Baikal seal. The objects for the study were corrosion preparations of 11 hearts of the Baikal seal aged from 1 month to 10 years. In our research we used the methods of preparation, filling of vessels with the use of "Kudo" mounting foam, photographing and sketching the branching of vessels. It was established that in the Baikal seal, the outflow of venous blood occurs through the prominent coronary sinus and the large, intermediate, oblique vein of the left atrium, the middle and right heart veins that flow into it. In 18.2% of hearts, a coronary valve was found at the border of the great heart vein and the coronary sinus. The great heart vein begins above the apices of the heart and is formed from the fusing of the 6-11 collateral veins of the wall of the right ventricle, the venous pericardial plexus, and 9-16 branches on the side of the left ventricle. The most variable is the intermediate (marginal) branch, which in most cases has only one branch, however, in 18.2% of cases there are two ones or in 9.1% of cases, there are intermediate branches with a common trunk. The middle vein of the heart is located in the sub-sinus sulcus and anastomoses with the branch of the great vein of the heart, in 9.1% of cases, the valve of the coronary sinus was found at the border with the coronary sinus. The right veins of the heart have 5-6 branches, among which the marginal ones are the most prominent. 27.3% of Baikal seals have a venous sinus formed from the fusion of the middle and right coronary veins, as well as a duct connecting the large cardiac vein with this sinus.

АНАТОМИЯ СОСУДОВ МОШОНКИ И ИХ ПАТОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ КАК ОСНОВА КЛИНИЧЕСКИХ ПРОЯВЛЕНИЙ ВАРИКОЦЕЛЕ

Varicocele is found in 8–40% of young men between the ages of 15 and 40. In 25.4% of cases, it is combined with a violation of rep- roductive function and in 40% of cases it causes pain syndrome in the scrotum. The etiology and pathogenesis of the disease are associated with various disorders in venous hemodynamics of the upstream vascular network. The peculiarity of venous blood outflow from the organs of the scrotum is the presence of a developed network of anastomoses and collaterals at the level of the scrotum, the inguinal region and the retroperitoneal space. The causes of varicocele are divided into three groups: primary, secondary hypertensive and secondary symptomatic. Primary causes include congenital disorders of the testicular vein vascular wall and its valve apparatus, which are detected in about 40–60% of cases. Secondary or hypertensive causes include upper- and lower- level arteriovenous conflicts, which occur in 40–50% of cases. There is also a group of secondary symptomatic causes that are related not to vascular pathology, but to the compression of the testicular vein from the outside. The basis of pathophysiological and pathomorphological changes in the scrotal veins and testicular tissues is the reflux of venous blood from the higher departments of the vascular network. Three types of varicocele are identified by the reflux type. The first type is renotesticular, occurring in 74.5–80.6% of cases. The second type is ileotes- ticular, observed in 7.2–14.6% of cases. The third type is mixed. It is a combi- nation of the first and second types and occurs in 4.8–18.1% of cases. The type of hemodynamic reflux determines the clinical symptoms developing in patients with varicocele. Diagnostic activities include: physical examination with Valsalva and Ivanissevich, laboratory examination of blood and urine, ultrasound examination of scrotum organs, Doppler mapping of renal vessels and testicular vein, retrograde or antegrade phlebography. The most sensitive to diagnosis of varicocele is Doppler-graphical mapping of the renal vessels and the testicular vein. X-ray endovascular methods are mandatory for diagnosis of varicocele relapses and have a high sensitivity. Physical research methods play an important role. Thus, diagnosis of the disease is aimed at identifying the cause and type of pathological reflux and eliminating secondary symptomatic varicocele. Clarification of the type of venous hemodynamics violation is of great practical importance for determining the type of surgical treatment.

PECULIARITIES OF HUMAN PROSTATE VENOUS BLOOD FLOW

This article reviews scientific sources on the venous bed of the human prostate. In general, venous blood outflow from the prostate gland is provided by the prostate venous plexus. This plexus anastomoses with the deep dorsal vein of the penis, posterior scrotal veins, as well as with the hemorrhoidal and urinary bladder plexuses and with the Santorini’s venous plexus (collects blood from the prostate gland, the bottom of the bladder and seminal vesicles and enters the internal iliac vein). It is the Santorini’s venous plexus, which is often associated with massive blood loss during the surgical operations on the prostate. Since the structure of the venous intraorgan bloodstream in the prostate mainly corresponds to that for the arteries, three groups of veins are respectively distinguished. These are the intergland veins, which run to the venous plexus of the prostate capsule, the veins entering the venous plexus of the submucosal base of the urethra and, finally, the veins of the venous plexus, lying next to the ejaculatory duct. Blood flows from the parenchyma of the gland into the prostatic venous plexus through intraorgan veins, which has a complex structure and surrounds the prostate from almost all the sides. Some authors consider the periprostatic venous plexus to be a part of a single urogenital plexus. In the structure of the genitourinary venous plexus, numerous adduction and abduction pathways take place that deliver blood from the external and internal genital organs, the bladder, the distal parts of the ureters and partially from the walls of the rectum and pelvic bones. Analysis of the literature has shown that there are omissions in the study of the structure of the venous channel of the human prostate gland. They are the lack of data on the links of the circulatory microvasculature and the features of its spatial organization; the connection of the venous bed with the secretion and secretion processes; systematized data on anastomoses and their exact localization.

Validation of a mathematical model for understanding intracranial pressure curve morphology

The physiology underlying the intracranial pressure (ICP) curve morphology is not fully understood. Recent research has suggested that the morphology could be dependent on arterial cerebral inflow and the physiological and pathophysiological properties of the intracranial cavity. If understood, the ICP curve could provide information about the patient’s cerebrovascular state important in individualizing treatment in neuro intensive care patients. A mathematical model based on known physiological properties of the intracranial compartment was created. Clinical measurements from ten neuro intensive care patients in whom intracranial arterial blood inflow, venous blood outflow and cerebrospinal fluid flow over the foramen magnum had been measured with phase contrast MRI, concomitant with ICP measurements were used to validate the model. In nine patients the mathematical model was able to create an ICP curve mimicking the measured by using arterial intracranial inflow and adjusting physiological parameters of the model. The venous outflow and cerebrospinal fluid (CSF) flow over the foramen magnum predicted by the model were within physiologically reasonable limits and in most cases followed the MRI measured values in close adjunct. The presented model could produce an ICP curve in close resemblance of the in vivo measured curves. This strengthens the hypothesis that the ICP curve is shaped by the arterial intracranial inflow and the physiological properties of the intracranial cavity.

Беременность - как причина возникновения варикозного расширения вен половых органов (Литературный обзор)

A review of the literature is presented in which the authors consider the problem of varicose veins (RVV) of the pelvic organs. The first cases of the disease description by domestic and foreign scientists are given. It was found that of 25% of all patients with varicose veins (WB) 2/3 are women and in 75% of cases the pathology develops during pregnancy. According to the literature in the etiology and pathogenesis of ERW of the genitals during pregnancy, there was a mechanical theory of vasodilation, which was that the increasing uterus compresses the veins of the pelvic organs, leading to increased hydrostatic pressure, lower blood flow rate. Other authors believe that this theory does not explain the complex pathogenesis of vascular wall dilation and why, in some cases, the disease appears in the early stages of gestation, when the mechanical effect of the pregnant uterus is not yet expressed? It is believed that an equally important role is played by ovarian occlusion and pelvic vein thrombosis in history. Arteriovenous dysplasia of the deep veins of the lower extremities and compression of the veins by the pelvic organs (pregnant uterus, retro and anteflexio of the uterus, which leads to an in-flection of the uterine ligaments with a further violation of the outflow of venous blood) are also important. The problem is very urgent, since a large part of women with external and internal genital organs often occurs at a young age, is latent, and the doctor does not always associate these processes with pregnancy and childbirth.

Varicose veins of the small pelvis and pelvic congestion syndrome. A differentiated approach: the choice of method of contraception, treatment, prevention

The article considers the main points that affect the quality of life of women with varicose veins of small pelvis with congestion and without it, in particular the use of hormonal methods of contraception, and also discussed the issues of diagnostics, prevention and treatment of these diseases. Algorithms of clinical tactics for conducting such patients are presented. Particular attention is focused on the features of the appointment of hormonal drugs in this category of women. You can determine the methods of treatment and avoid long-term unreasonable prescription of various medicine (especially hormones that will mask or worsen the course of the disease) if you select groups of women with varicose veins of the small pelvis without congestion and with it (reflux).Varicose veins of the small pelvis and pelvic congestion syndrome are conditions that require an interdisciplinary and differentiated approach. Symptoms of these conditions can be put on a mask of various gynecological, urological, traumatological diseases. Anatomical and physiological features of the structure of the veins and the regulation of their venous tone explain the possibility of forming a venous congestive syndrome in women. This can be due to two reasons: due to the violation of the outflow of venous blood or due to the obstruction of any vein of the ovary, any increase in intravascular pressure not controlled by the venous tone at the level of the pelvis.Varicose veins of the small pelvis and pelvic congestion syndrome remain unexplored until the end. There are no uniform standards for their diagnostics. Varicose veins of the small pelvis and pelvic congestion syndrome are different diseases which requiring an understanding of the mechanisms of their development and consequences. If a pelvic varicose veins are suspected, the first diagnostic test is usually ultrasound. Modern ultrasound technique can evaluate blood flow in various veins. To study the blood flow in the veins, laparoscopy, venography in combination with CT or MRI can also be performed.

Experience in the Treatment of Patients with Sexual Disorders and Lower Urinary Tract Symptoms After Surgical Treatment of Benign Prostatic Hyperplasia

The aim of the research: the choice of treatment for patients with sexual disorders (SD) and lower urinary tract symptoms (LUTS) after surgical treatment of benign prostatic hyperplasia (BPH).&#x0D; Materials and methods. There were examined 270 patients, who were divided into two groups: 75 patients with BPH stage I1II who received medical therapy and 160 after surgical treatment (85 and 75 patients undergoing TUPR and the different types of prostatectomy, respectively). The period between surgery and inclusion in the study was 1-2 months. In addition, the study included 35 healthy men who made up the reference group. All patients received basic therapy according to the standards of the European Association of urology, guidelines regarding healthy lifestyle, avoiding harmful habits, diet and physical therapy methods. In addition, patients received therapy with inhibitors of phosphodiesterase of 5-th type, tailor-made preparations and metabolic stimulation therapy, drugs to improve blood flow of blood to the cavernous bodies, or tools that reduce the outflow of venous blood from them.&#x0D; Results. Treatment results were assessed by the dynamics of changes in LUTS, objective information about the functional status after 3, 6 and 12 months. Dynamics of indicators of SD, psycho1emotional status was assessed at 1, 3, 6 and 12 months.&#x0D; Conclusion. Established the identity of the nature of the assessment of men from both groups’ satisfaction with the treatment was a linear relationship between time and criteria such as overall satisfaction with desire to continue it, with confidence and pleasure, sexual opportunities, quality of erections.

Особенности гемодинамики в шейке бедренной кости у детей с асептическим некрозом головки бедра

Purpose To study the characteristic features of femoral neck blood circulation in children with femoral head ischemic defects of traumatic and dysplastic genesis. Materials and methods The authors analyzed rheovasography results of 17 patients with the ischemic femoral head defects developed due to posttraumatic aseptic necrosis (Group 1, n=9) and Legg-Calve-Perthes disease (Group 2, n=8). The measurements were performed before surgery, after tunnel perforation of the neck, and after cell-and-tissue transplantation. Results More marked changes in the parameters of pulse blood filling were recorded in Group 2 and corresponded to the state of decompensation ischemia that might be associated with the disorders of venous blood outflow. Conclusion The results confirm the feasibility of re-interventions that stimulate hemodynamics and the use of a prolonged stimulation with wires in order to achieve the draining effect.

Clinical Management of Priapism: A Review.

Priapism is defined as a persistent and painful erection lasting longer than four hours without sexual stimulation. Based on episode history and pathophysiology, priapism is classified into three subtypes: ischemic (low-flow), non-ischemic (high-flow), and stuttering priapism. Ischemic priapism is characterized by a persistent, painful erection with remarkable rigidity of the corpora cavernosa caused by a disorder of venous blood outflow from this tissue mass, and is similar to penile compartment syndrome. Stuttering priapism is characterized by a self-limited, recurrent, and intermittent erection, frequently occurring in patients with sickle cell disease. Non-ischemic priapism is characterized by a painless, persistent nonsexual erection that is not fully rigid and is caused by excess arterial blood flow into the corpora cavernosa. Because ischemic and non-ischemic priapism differ based on emergency status and treatment options, appropriate discrimination of each type of priapism is required to initiate adequate clinical management. The goal of management of priapism is to achieve detumescence of the persistent penile erection and to preserve erectile function after resolution of the priapism. To achieve successful management, urologists should address this emergency clinical condition. In the present article, we review the diagnosis and clinical management of the three types of priapism.