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Конституционное (уставное) судопроизводство в Российской Федерации являлось важным элементом в системе обеспечения, охраны и защиты конституционных прав и свобод человека и гражданина, а также развития правового, демократического и социального государства. Однако в 2020 г. было принято решение об их упразднении. Авторы остановили свое внимание на формировании конституционного (уставного) судопроизводства и причинах его упразднения.

Rationale : The prevalence of malformation of internal carotid arteries (ICA) in the population amounts to 46%. In 4 to 16% of the cases, it is associated with clinical manifestations of cerebrovascular insufficiency. Hemodynamic changes in the abnormal arterial vasculature and neurological symptoms are the main indications for surgical intervention. Computed tomography (CT) angiography has shown its high information value in the assessment of ICA occlusions; however, its informativity in the diagnosis of ICA malformations has not been established. Aim : To assess ICA and brain matter in the patients with abnormal tortuosities, both isolated and combined with occlusion, by CT angiography. Materials and methods : We performed a retrospective analysis of medical files of 58 inpatients, who underwent ultrasound examination and CT angiography of extra and intracranial parts of brachycephalic arteries with 256 slice multidetector computer scanner (Philips iCT). CT angiography included native imaging, and contrast-enhanced arterial and venous phases. We assessed the impact of ICA abnormalities on the degree of brain matter lesions in patients with isolated ICA malformations (n=27) and with combination of ICA malformations with its occlusion (n=31). Results : In the group of the patients with isolated ICA malformations, there were no brain focal lesions in 14, small vessel focal lesions and single liquor cysts in 9, and areas and zones of cystic and glial abnormalities in 4. The most frequent in this group were S-like and C-like malformations, together with 2 saccular aneurysms (one of them true and one false). In the group of patients with combination of abnormal ICA tortuosities and occlusions, there were areas and zones of cystic and glial abnormalities in 7, various degrees of small vessel disease and few liquor cysts in 18, and no abnormal brain matter foci in 6. No ICA malformations in combination with true or false aneurysms were found. The patients with combination of ICA malformations and stenosis, the signs of chronic brain ischemia were more advanced, compared to those in the patients with isolated ICA malformations (p=0.012). Conclusion : CT angiography is a highly informative method for the assessment of carotid arteries and brain matter in patients with ICA malformations. The combination with ICA malformations and occlusion is associated with more advanced lesions of brain matter.

Our archeoseismological investigations in the Episcopal basilica in Varna have revealed signs of seismic deformations in its walls: numerous shifts, tilts, and rotations of the wall parts around the vertical axis, as well as subvertical through-going joints cutting several stone blocks. A cluster of (at least) three seismic events occurred for a hundred years (from the early 5th to the early 6th centuries AD). Judging by kinematic indicators in the basilica structures built of high-quality stone blocks, the source of seismic motions was located north-northeast of the basilica. Strong seismic oscillations propagated apparently from the southwest. The seismic sources were along seismically active faults localized north and south of Varna. The local seismic intensity of seismic oscillations could reach Il ≤ 9 on MSK-64 scale. The intensity of the seismic oscillations increased due to unfavorable ground conditions at the location of the basilica. These data should be taken into account when assessing the seismic hazard assessment of Varna to build a new map of seismic zoning of northeastern Bulgaria.

Objective : to investigate the informative value of computed tomography (CT) angiography for the evaluation of carotid paragangliomas. Material and methods . Twelve patients with carotid paragangliomas were examined in the Department of X-ray Computed Tomography and Magnetic Resonance Imaging, Vladimirskiy Moscow Regional Research and Clinical Institute, in 2014-2019. Before surgery, we performed ultrasound imaging and CT angiography (Philips iCT 256 slices): non-contrast study, subsequent contrast enhancement (arterial and venous phases) using the intravenous bolus injection of 60 ml of non-ionic iso- or low-osmolar contrast media. The Shamblin criteria were used to evaluate paragangliomas. The extent of changes and the spread of mass tissue were estimated along the carotid artery walls. Surgery was performed in 11 out of 12 patients. Results. Unilateral and bilateral masses were identified in 10 and 2 cases, respectively. Two neoplasms that were characterized by small sizes and minimal involvement of carotid artery walls in the process were assigned to type I in accordance with the Shamblin classification. Type II masses (n = 5) were represented by a partial encasement of the internal and external carotid arteries by paraganglioma. Type III tumors (n = 7) were characterized by large sizes and encasement of all walls of the common, internal and external carotid arteries over a considerable length. No calcifications or necrotic areas were found in the structure of the neoplasms. Multiple small tortuous arterial vessels around the tumor were determined in 12 out of 14 cases. These changes did not match the overall length of the tumor and the degree of carotid artery encasement by the latter. Histological examination confirmed the diagnosis of paragangliomas in all cases. A pathologically altered lymph node was found in 1 case during the subsequent 5-month follow-up. Conclusion. CT angiography can assume the diagnosis of carotid paraganglioma based on its characteristic features and determine the type of tumor according to the Shamblin classification, which allows to plan the optimal surgical intervention.

—In 2014–2019, integrated geological and geophysical studies were carried out in the largest flexural-rupture and fold-and-fault zones of the Northwest Caucasus (the Anapa, Akhtyr, Moldavanovka, Karabetov, Fanagoria and Azov anticlinal ridges and the Pshekha–Adler, Kerch–Tuzla, and Kerch Strait faults). Microseismic sounding method (MSM) was the main geophysical approach. The MSM studies identified the deep structural features of the Earth’s crust in the study region and made it possible to correlate them with the specific tectonic structures on the surface. The correlation was established by reconciling the results of the MSM studies, the parameters of sedimentary cover section, and crustal discontinuities revealed by drilling and previous studies of the converted waves from the earthquakes. It is found out that the Anapa flexure and longitudinal tectonic zones have the distinct deep roots beneath them. The trans-Caucasian Anapa flexural-rupture zone separates the pericline of the Northwest Caucasus from the region of the Taman Peninsula, whereas longitudinal flexures and fault structures divide the meganticlinorium from the subsided West Kuban and Azov blocks of the northern slope of the folded system and from the Kerch–Taman trough of the southern framing of the Northwest Caucasus. The faults in the study region are distinguished into deep faults penetrating into the lower crust and even reaching the upper mantle and near-surface faults localized within the sedimentary cover in the Earth’s interior. The seismogenic role of these tectonic deformations in the studied seismic region is determined.

We have conducted paleo- and archaeoseismological surveys in the Durankulak Eneolithic archaeological settlement in northeastern Bulgaria, identifying many earthquake-related deformations of different ages. The ubiquitous presence of counterfort walls added to damaged original (nearly north–south) walls on the eastern side provides evidence of the first significant earthquake in Durankulak that seems to have occurred during Middle to Late Eneolithic time (4650–4100 B.C.). This seismic event made the north–south walls tilt westward, so that the ancient residents had to build counterfort walls to prevent the original walls from collapsing. However, the upper excavations in the archaeological settlement show that the next, later, seismic deformation induced a tilting and collapse of remains of the original walls eastward, producing a gap of a few tens of centimeters between the original walls and the counterfort walls. Afterwards the settlement was abandoned. It may be surmised that the later earthquake was stronger than the earlier one, which left room for reconstruction work. The local seismic intensity of the earlier earthquake seems to have been at least Il ≥ VIII, while the later event had Il ≥ IX on the МSК-64 scale. Considering that the masonry of both walls, the original and the counterfort ones, is about the same age, the time interval between the two seismic events must have been short, one or two hundred years. Nevertheless, the epicenters of both of these earthquakes were to different directions from Durankulak. The seismic motion (compressive waves and shocks) went from the west during the first earthquake and from the east during the second. The rupture zone of the first seismic event was obviously related (1) to an earthquake-generating zone in continental Bulgaria situated west of the archaeological settlement in question, or (2) to the Intramoesian active fault that was responsible for the large earthquake of 1444. The rupture zone of the second seismic event was nearby, in the coastal part of the Black Sea; the responsible feature seems to have been the Shabla–Kaliakra seismogenic zone. Considerable seismic deformations were also identified in structures on the southern slope of the island in a dwelling dating back to the First Bulgarian Kingdom (the 9th century A.D.). This seismic event produced distortions in the walls (in map view), sigmoidal patterns, as well as fractures and rotations in the walls. The local seismic intensity due to this earthquake is supposed to be at least Il ≥ VIII. The rupture zone of a third seismic event was likely to be nearby, in the coastal part of the Black Sea, and the responsible feature must have been the Shabla–Kaliakra seismogenic zone.

The ancient city of Gorgippia is surrounded by well-known (North Black Sea, Kerch, and South Azov) seismogenic zones, all of which are submarine, and only some of their branching faults reach the surface in the coastal zone. On the surface, in the vicinity of the ancient city, there are also seismically active faults and flexure rupture zones, which can generate strong earthquakes. Our investigations in the ancient city of Gorgippia have revealed a number of seismogenic deformations and destructions in its walls: systematic tilts and shifts of the upper parts of the walls, as well as their arc-shaped bends in plan view; breaks of the walls; rotations of walls and other building elements around the vertical axes; and squeezing of the mouths and shafts of water wells. Some of the mentioned deformations could be formed during the strong historical earthquakes in the 3rd and 1st centuries BC, as well as those in the 1st and 3rd centuries AD, and all these seismic events were accompanied by local destructions and fires. Summarizing all materials on historical earthquakes of the Taman Peninsula, the regional seismic potential can be determined by the possible occurrence of a crustal earthquake with M ≥ 7.0 and average recurrence interval of once in few hundred years. Seismic shaking in the source zones of such natural events can be I0 = IX or even more.

In the period from 2007 to 2017 complex geological and geophysical studies were carried out in the three largest flexural-rupture fault zones in the North-West Caucasus (Anapa, Akhtyrka and Moldavan). The micro-seismic sounding (MSM) was used as the main geophysical method. Studies with the help of MSM allowed us to identify the features of the deep structure of the earth’s crust in the study area and to associate them with specific tectonic structures on the surface.The binding was carried out by harmonizing the results of the MSM and the parameters of the section of the sedimentary cover and crustal boundaries according to the drilling data and the work previously performed by the reflected wave method (MOVZ). It was found that the Anapa flexure and longitudinal tectonic zones have clear deep roots, and also separate the pericline of the North-Western Caucasus from the Taman Peninsula and from the lowered blocks of the Northern slope of the folded system.Faults in the study area are divided into: (1) deep faults of the Caucasian stretch, penetrating into the lower crust and even to the upper mantle, and (2) near-surface faults, do not extend to the depths beyond the thickness of the sedimentary cover. The seismogenic role of these tectonic disturbances in the studied seismically active region has been determined.

Background: The main cause of mortality in patients with atherosclerosis of aorta and peripheral arteries of the lower extremities is ischemic heart disease. The presence of peripheral artery atherosclerosis suggests a high probability of simultaneous coronary involvement. To reduce the risk of cardiac complications, these patients are offered myocardial revascularization as the first step of the intervention; however, the choice of a conduit for coronary artery bypass in these patients remains challenging.Case report: A 58-year old man with combined coronary artery stenoses, high occlusion of the aorta and common iliac arteries underwent autoarterial myocardial revascularization with the right internal thoracic artery (ITA) and left radial artery ("off pump”). In the early postoperative period, significant progression of the right leg ischemia was observed, related to partitioning of the main collateral flow between the right ITA and the inferior epigastric artery, that had contributed to blood supply to the right lower extremity. Taking into account the lack of efficacy of medical treatment and progression of the leg ischemia, at day 4 postoperatively the patient underwent resection of the infrarenal aorta with aortobifemoral bypass grafting and restoration of blood supply to the lower extremities and resolution of ischemia.Conclusion: ITA has been recognized as the conduit of choice for surgical treatment of ischemic heart disease; however, its use may result in significant progression of ischemia. When choosing a conduit, ITA at the side of less ischemic lower extremity is preferred. ITA imaging by computed tomography-angiography or by selective ITA angiography can be helpful for assessment of the ITA significance at the side of less ischemic leg. Also, the appearance of retrograde flow in the inferior epigastric artery at Doppler ultrasound examination can be a conditional valuable criterion.

In the period from 2007 to 2017 complex geological and geophysical studies were carried out in the three largest flexural-rupture fault zones in the North-West Caucasus (Anapa, Akhtyrka, and Moldavansky). The microseismic sounding (MSM) was used as the main geophysical method. Studies with the help of MSM allowed us to identify the features of the deep structure of the earth's crust in the study area and to associate them with specific tectonic structures on the surface.The binding was carried out by harmonizing the results of the MSM and the parameters of the section of the sedimentary cover and crustal boundaries according to the drilling data and the work previously performed by the earthquake converted wave method (ECWM). It was found that the Anapa flexure and longitudinal tectonic zones have clear deep roots, and also separate the pericline of the North-Western Caucasus from the Taman Peninsula and from the lowered blocks of the Northern slope of the folded system.Faults in the study area are divided into: (1) deep faults of the Caucasian stretch, penetrating into the lower crust and even to the upper mantle, and (2) near-surface faults, do not extend to the depths beyond the thickness of the sedimentary cover. The seismogenic role of these tectonic disturbances in the studied seismically active region has been determined.

Rationale : Carotid endarterectomy is a surgical procedure to prevent acute ischemic cerebrovascular accidents. Neurologic complications can occur after surgery. Multidetector computed tomography (MDCT) is used for their diagnosis in severely ill patients. Aim : To evaluate the potential of MDCT in the diagnosis of neurologic complications after carotid endarterectomy. Materials and methods : We analyzed the results of radiologic assessments in 15 patients with early postoperative neurologic complications which occurred after surgery for internal carotid artery occlusion (595 patients underwent surgery). In stable patients, brain magnetic resonance imaging (MRI) was performed (T1, T2, FLAIR, DWI modes) with non-contrast MR angiography. In critically ill patients, brain computed tomography, computed tomographic angiography and perfusion computed tomography were performed. Results: Ischemic neurologic complications were found in 11 patients. One patient had no clinical manifestation of an ischemic stroke, and acute stage signs were found in his routine brain MDCT. In 9 patients with acute brain ischemia, MDCT (n = 6) and MRI (n = 3) results were specific for this diagnosis, with no diagnostic problems. There were problems with the diagnosis of the hyperacute ischemia in 1 patient. In this patient, the complication occurred against a background of abnormal carotid blood flow before surgery, therefore, differential diagnosis between the hyperperfusion syndrome on the intervention side and the hyperacute phase of ischemic insult on the opposite side was performed. Hyperperfusion syndrome and hemorrhagic strokes were observed in 4 patients. Conclusion : The most difficult for diagnosis by MDCT is the hyperacute phase of brain ischemia. Further studies are necessary in the area of diagnosis of postoperative complications, with the search for potential specific diagnostic criteria.

Objective – to optimize dedicated assessment of carotid arteries in case of occlusive disease with computed angiography (CTA). Material and methods. During 2015–2016 years 65 patients underwent ultrasound examination and computed tomography examined before carotid surgery. Results. Aortic arc branching variants were observed in 26% cases. In 51% combined steno-occlusive process in common, internal carotid arteries and subclavian arteries was confirmed. In 29% of cases atherosclerotic plagues were detected in upper parts of common carotid arteries and such data changed surgical strategy. Patients included in study has internal carotid artery (ICA) stenosis more than 50% NASCET. Detailed assessment was used for cervical ICA distal to stenosis. In 62% of patients with carotid subocclusion narrowing in upper segments were detected. In 3 cases ascending pharyngeal artery arose from affected carotid artery and these findings change surgical approach. All patients underwent carotid surgery. Degree of ICA stenosis detected with CTA was conformed. CTA data for carotid plague extension were less informative – intraoperative plague length exceeded CTA results. Conclusion. CTA is high informative study that allows detailed assessment of occlusive carotid disease for carotid surgery.

The study was aimed at assessing efficacy and safety of treatment with Aducil® (cilostazol) compared with Trental® 400 in patients with moderate-to-severe intermittent claudication due to peripheral atherosclerosis.The study included a total of one hundred and forty-five 36-to-75-year-old patients. The participants were distributed into 2 groups according to the inclusion/exclusion criteria in a 2 to 1 proportion: patients in group 1 received Aducil® 100 mg BID, in group 2 - Trental® 400 TID for 12 weeks. 142 subjects completed the protocol.Analysis of the effectiveness of treatment according to the primary criterion showed a better effectiveness of Aducil® as compared with Trental® 400. Subjects who received Aducil® had a higher increase in the absolute maximum walking distance after 12 weeks of treatment as compared with those taking Trental® 400: 126±110 m versus 45±39 m, respectively (р0.001). Subjects who received Aducil® had a statistically significant improvement in quality of life parameters such as physical and mental health components according to the SF-36 questionnaire after 12 weeks of treatment (р≤0.01). Subjects in Aducil® group had better quality of life with an increase from 34 to 40 points according to the physical component score, while patients in Trental® 400 group demonstrated minor positive changes (from 35 to 37 points); mean mental component score increased from 45 to 48 points in Aducil® group as compared with an increase from 45 to 47 points in Trental® 400 group. While self-reported physical health status was similar between the groups at baseline, subjects in Aducil® group reported better physical functioning after treatment (р=0.016). Two adverse events were registered in two subjects in Aducil® group.Analysis of the study endpoints demonstrated that Aducil® had better treatment effectiveness in patients with chronic lower limb ischemia stage IIB according to the classification of A.V. Pokrovsky-Fontaine as compared with Trental® 400, while the safety profile and drug tolerance were similar between the two.Цель исследования. Оценка эффективности и безопасности терапии препаратом Адуцил® (цилостазол) в сравнении с терапией препаратом Трентал® 400 у пациентов с обусловленной атеросклерозом умеренной и выраженной перемежающейся хромотой. Материалы и методы. В исследование было включено 145 пациентов в возрасте от 36 до 75 лет. Участники, согласно критериям включения/исключения, были распределены в 2 группы в соотношении 2:1, одна из которых в течение 12 недель получала Адуцил® 100 мг по 1 таблетке 2 раза в сутки, другая – препарат Трентал® 400 по 1 таблетке 3 раза в сутки. Полностью завершили исследование 142 человека. Результаты. Полученные результаты анализа эффективности сравниваемых препаратов по первичному критерию показали более высокую эффективность препарата Адуцил® в сравнении с препаратом Трентал® 400. Отмечен больший прирост абсолютного максимального проходимого расстояния после 12 недель терапии в группе Адуцил® по сравнению с группой Трентал® 400: 126±110 м и 45±39 м соответственно (р0,001). Показатели качества жизни, включающие в себя физический компонент здоровья и психологический компонент здоровья по опроснику SF-36, через 12 недель терапии исследуемыми препаратами имели достоверную положительную динамику (р≤0,01). На фоне проведенного курса терапии отмечено, что средний балл физического компонента здоровья в группе Адуцил® возрос с 34 до 40 баллов, в группе Трентал® 400 – с 35 до 37 баллов, средний балл психологического компонента здоровья в группе Адуцил® возрос с 45 до 48 баллов, в группе Трентал® 400 – с 45 до 47 баллов. Однако при сравнимых значениях до начала терапии средний балл субъективной оценки пациентом своего физического здоровья после завершения лечения был выше в группе Адуцил® (р=0,016). В ходе исследования было зарегистрировано 2 нежелательных явления у двух пациентов в группе Адуцил®. Заключение. Таким образом, по оцениваемым в настоящем исследовании конечным точкам, при сопоставимых уровнях безопасности и переносимости лекарственный препарат Адуцил® продемонстрировал большую эффективность в терапии хронической ишемии нижних конечностей IIb стадии по классификации Фонтейна–Покровского, чем Трентал® 400.

Chronic heart failure (CHF) significantly worsens the prognosis of surgical treatment in noncardiac surgery, doubling mortality in compared with patients with coronary artery disease. Modern anesthesiology has at least two methods that potentially can improve the results in noncardiac surgery: anesthetic cardioprotection and the prevention of CHF decompensation with levosimendan.to study the efficacy of anesthetic cardioprotection andpreoperative preparation with levosimendan for the prevention of CHF decompensation in patients with reduced left ventricular ejectionfraction in noncardiac surgery.the primary endpoint of the trial is the need and the maximum dose of inotropic drugs in the perioperative period; secondary point: the length of stay in the ICU, composite outcome, the dynamics of SI, FI, the content ofNT-proBNP and TnT Materials and methods: A randomized study was performed in three groups of patients during reconstructive operations on infrarenal part of aorta: control (traditional methodfor prevention of decompensation of CHF were used) - 31 patients; the group with the anesthetic cardioprotectivei - 31 patients; the group with a preoperative preparing with levosimendan - 30 patients.The incidence of heart failure (estimated by need to use inotropic drugs - IS) was 83% of control group patients and 75% of the patients of the group "VIMA" (p = 0,65). The number ofpatients needing the use of dobutamine in LS-group was significantly below, 50% (p = 0,02 relative to control group and p = 0,08 compared to the group VIMA). IS in the control group was 8 [6, 9] μg xkg⁻¹ - xmin⁻¹ ; group VIMA 8 [3; 9] mg xkg ⁻¹ xmin⁻¹ , whereas in the LS group only 2 [0; 7] mg ⁻¹ xkg⁻¹ xmin⁻¹ . Differences between groups credible, given the Bonferroni correction (p = 0,0015). In our study, was not identified significant differences in 30-day mortality: in the control group it was 3,4%; in the group VIMA of 3,1%; in the group of LS - 0% (p0,017); however, a composite outcome (number of adverse events (heart attack+stroke+mortality) were slightly better in the LS group - 17%, against 34% in the control group (p = 0,043).Preoperative preparation with levosimendan in patients with reduced fraction left ventricle ejection when performing reconstructive operations on the descending aorta reduces the incidence of episodes of decompensation of heart failure compared with the control group to 39,8% (p0,05). The use of this technique improves the composite outcome of operations on the infrarenal aorta. The study has not shown the influence of anesthetic cardioprotection in terms of hospitalization and composite outcome of surgical treatment.

The present study was aimed at retrospectively analysing the results of examination and open surgical treatment of patients diagnosed with extracranial aneurysms of carotid arteries.We analysed the results of examination and outcomes of surgical treatment in a total of 11 patients (6 men and 5 women) presenting with an aneurysm of the extracranial portion of the carotid artery and undergoing treatment at the Department of Vascular and CAD Surgery of the Moscow Regional Research Clinical Institute from 2005 to 2016. The mean age of the patients amounted to 56.5±13.9 years (ranging from 33 to 73 years). The diagnosis of an aneurysm was made based upon the findings of duplex scanning with colour mapping (DS+CM), four patients were additionally subjected to computed tomography (CT) and one to magnetic resonance tomography (MRT). 8 aneurysms turned out to be true aneurysms and 3 appeared to be pseudoaneurysms. 8 aneurysms were localized in the internal carotid artery (ICA) and 3 - in the common carotid artery (CCA).Eight cases were treated by resection of the aneurysm followed by prosthetic repair (5 with an autovenous graft and 3 with a synthetic graft), a further two cases were managed by resection of the aneurysm and an 'end-to-end' anastomosis made, and in one case a false aneurysm was removed, with the arterial defect sutured. The check-up examinations were carried out at 2 and 6 months of the postoperative period. Neither lethal outcomes nor acute cerebral circulation impairments (ACCIs) were registered within the time frame the follow up period. Two patients were found to suffer from cranial nerve injury having disappeared during follow-up.An open reconstructive operation is a safe and effective method of preventing complications of aneurysms of the extracranial portion of the carotid artery.

Background: At present, efficacy of carotid endarterectomy for prevention of cerebrovascular accidents has been convincingly proven. Its results in patients with a history of an ischemic stroke depend on multiple factors. Aim: To study results of reconstructive interventions on internal carotid arteries in patients with post-stroke cerebral cysts. Materials and methods: We analyzed data from 210 patients who had undergone an intervention (159 men and 51 women, aged 61 ± 2.7 years) with occluding lesions of the internal carotid artery and a history of an ischemic stroke. Depending on the size of a post-stroke lesion, patients were divided into 5 groups: patients from group 1 had a lesion of more than 5 cm in diameter, from group 2, from 2 to 5 cm, from group 3, ≤ 2 cm, patients from group 4 had a lacunar cysts and patients from group 5 had no focal lesions. Results: A clear positive correlation between the size of a post-stroke cyst and the degree of hemodynamic abnormalities in internal carotid arteries was found. The most prominent asymmetry of blood flow in the middle cerebral artery (on average, 34.1%) was seen in patients from the group 1. Patients from the group 1 more often had low and critical brain tolerance to ischemia (42.9%). In patients with large post-stroke cysts (group 1) mean Barthell index was 69 ± 8.1, and NIHSS score 8.2 ± 1.6. In patients from other groups neurological deficiency was less pronounced: 80 ± 6.8 and 7.6 ± 1.9 in the group 2, 82 ± 5.7 and 4.1 ± 1.3 in the group 3, 94 ± 4.6 and 3.2 ± 1 in the groups 4 and 5. The differences between groups in the rates of postoperative complications were not statistically significant (p > 0.5). However, signs of hyperperfusion without any clinical manifestations were more often observed in patients from the group 1 (19%). Assessment of changes in neurological status at 1 year after the intervention, depending on the size of post-stroke lesions, showed that in patients with large cysts the regression of neurological deficiency was less obvious, than in other groups (NIHSS 7.5 ± 1.7, Barthell index 76 ± 7.7). The best restoration of impaired neurological functions was seen in patients with small cysts (NIHSS 2.2 ± 0.7, Barthell index 91 ± 3.4). Conclusion: In patients with large and intermediate post-stroke cerebral cysts surgery is associated with a higher complication rate, and, first of all, of hyperperfusion syndrome. However, the risk of these complications is significantly smaller than the probability of repeated acute cerebrovascular accidents.

Background: Stenoses of the brachiocephalic arteries (BCA) are ones of the main causes of ischemic defects of cerebral circulation. From the end of the former century to the current time, the surgical cerebral revascularization in steno-occlusive BCA disturbances occupies the topical place in prevention of acute brain circulation defects. Carotid endarterectomy (CEAE) remains till now a basic method of surgical revascularization. As a result of chronic hypoperfusion, autoregulation of the cerebral circulation can be disturbed with a persistent capillary dilatation which enables development of hyperperfusion syndrome after surgical intervention. Aim: A quantitative assessment of the cerebral tissue perfusion disturbances depending on the variants of the brachiocephalic vessels lesions before and after surgical reconstructions as well as revealing possible prerequisites for hyperperfusion syndrome development during preoperative multislice computed tomography (MSCT) perfusion. Materials and methods: The results of examination and treatment of 65 patients (mean age 64.2±5.0 years) with chronic cerebrovascular IV stage insufficiency were analyzed as well as the hemodynamically significant lesion of the inner carotid arteries. CEAE was planned for all patients. All patients underwent cerebral MSCT angiography and MSCT perfusion in preoperative and early postoperative periods. Results: The majority of patients in preoperative period showed decrease of perfusion parameters at the side of the most expressed defects. The mean circulation deficiency varied from 12 to 15%. Improvement of circulation at the side of surgical intervention formed, on the average, about 12%. The best outcome was noted in patients with bilateral stenoses of the inner carotid arteries (ICA). In one case, in critical unilateral ICA stenosis in preoperative period, MSCT perfusion demonstrated persisting dilatation of the small cerebral arteries of the disturbed hemisphere which led to autoregulation defects of these arteries with a high risk of hyperperfusion syndrome development. On the second day of the postoperative period, the said hyperperfusion syndrome developed but was successfully arrested using hypotensive therapy. Conclusion: CEAE provides circulation improvement in patients with ischemic stroke. MSCT perfusion favors circulation improvement in ischemic stroke patients. MSCT perfusion allows revealing patients with high risk of hyperperfusion syndrome development in postoperative period.

Rationale: Carotid endarteractomy is a surgical intervention that is performed for prevention of cerebrovascular accidents, up to 80% of them being of ischemic origin, in the presence of a marked stenosis and occlusion of carotid arteries. A detailed description of specifics of postoperative changes in carotid arteries depending on the type of surgical intervention has not been published. Aim: To evaluate internal carotid arteries in the early postoperative period by means of multidetector computed tomography (MDCT) and to match the changes detected with the type of surgical intervention. Materials and methods: In 2014, 23 patients with atherosclerotic stenoses of internal carotid arteries were assessed in the Department of Roentgenology of MONIKI. As a part of preoperative work-up, the patients underwent ultrasound examination (USE) of the neck vasculature and MDCT with bolus contrast enhancement. Postoperative monitoring also included USE and MDCT. The data obtained were matched against the type of surgical intervention. Results: After the eversion procedure (15 patients), there were 14 cases of expected (normal) postoperative changes and 1 case of changes that required a follow-up. After an open (classic) carotid endarterectomy (3 patients) there was 1 case of expected postoperative changes and 2 cases requiring a follow-up. Among 5 patients who underwent a resection of internal carotid artery and its prosthetic replacement, 2 patients had expected changes, 2 patients had changes that required a follow-up and 1 patient had a complication after surgery. Conclusion: The postoperative use of MDCT for assessment of reconstructed arteries allows for identification of various types of postoperative changes, for detection of symptoms of severe complications and borderline conditions that require subsequent targeted diagnostics and monitoring.

The article presents a clinical case of 2 patients with heart arrhythmias of the sick sinus syndrome type, who were implanted electriccardiac pacemakers in the acute period of cerebrovascular accidents. There were no cardiac complaints in the clinical manifestation, however, a comprehensive assessment confirmed the diagnosis of sick sinus syndrome.

Background: Aortic aneurysm is characterized by high incidence, polymorphic clinical features and sudden onset of severe complications. Aim: To develop a standard multidetector computed tomography (MDCT) protocol for aortic aneurysm examination and image analysis for detection the signs of aortic wall instability. Materials and methods: The data of 279 patients with aortic aneurysm who underwent MDCT examination during 2009–2014 was analyzed to identify aortic wall instability signs. Results: Complicated course of aortic aneurysm was observed in 100 cases (36%). The most common sign of aortic wall instability was aortic dissection. According to our results, a new definition of aortic aneurysm complications was elaborated. It included signs of aortic wall instability with incomplete and/or complete disruption of aortic wall layers. A scheme of the most common patterns of aortic wall abnormalities was proposed, allowing a radiologist to reach high accuracy in characterizing this pathology. Conclusion: A dedicated MDCT protocol for aortic aneurysm detection and image analysis can increase quality of radiologic assessment of aneurysm wall allowing to approach to the level of histological accuracy.

The fundamental components of the Earth’s rotation parameters play an important role in solving the problems of navigation and control of spacecraft motion. Mathematical models of the Earth’s pole motion and dUT1 mismatch of the UT1 and UTC time scales adequate to the observation and measurement data of the International Earth Rotation and Reference Systems Service are considered. It is shown that the proposed models provide sufficient autonomy to form parameters of the Earth’s rotation onboard the spacecraft. It is necessary to account for these parameters in real time onboard the spacecraft to solve problems of navigational support. The graphs of the daily forecast errors of the GLONASS navigation satellite orbits that are caused by the pole displacement, are presented. A comparative analysis of the graphs shows that disturbances of navigation satellite orbits are comparable with the gravitational influence of the Moon and the Sun and disturbances caused by the anomalous part of the Earth’s gravitational field. It is found that a significant increase in forecast accuracy for satellite ephemerides is achieved taking into account of the Earth’s rotational and vibrational motion in equations of spacecraft motion.

A geological, geomorphic, and paleoseismological study of paleoseismodislocation systems has been carried out. Numerous indications of prehistoric strong earthquakes expressed in sediments deposited in the fault-line region due to the formation of transient barrier lakes were revealed in the active Hovd Fault Zone on the eastern slope of the Mongolian Altay during a paleoseismological study of young near-surface sediments in trenches and dug pits. The paleosoils buried by these sediments were radiocarbon-dated. It has been established that the strongest earthquakes with magnitudes of ∼8, which took place here 7200, 6600, 1500, and later than 700 years ago, substantially changed the topography in the epicentral zone. By analogy with the results of paleoseismological investigations performed in the Gorny Altay and the western Mongolian Altay, the data obtained shed light on the recurrence of the strongest seismic events in the Great Altay.

Geometry and electronic structure of magnetite minimal cluster (Fe3O4)1 have been simulated by density functional theory and semiempirical PM6 method. Data on the cluster geometry obtained by different methods have been consistent; however, the ground state electronic structures as determined by different methods have not been identical. The existence of two states of similar stability, low-spin and high-spin ones, has been predicted. The correlation of the simulated geometry, vibration spectra, and magnetic properties of the cluster with experimentally determined properties of magnetite, nanomagnetite, and magnetite thin films has been discussed.

Nowadays drug stores of military-and-field medical organizations use the method of distillation for obtaining cleaned water and water for injection and use distillators as a technical means, which does not ensure that the water obtained has stated indices of quality. It was found out that it is the most efficient to use the technology basing on the complex usage of filtering, osmotic, ionic processes for obtaining cleaned water and water for injection from surface natural springs, which ensures minimal usage of resources and energy and the unity of constructional and technological peculiarities of cleaning water methods.

On the basis of the experience of medical support of troops gained during pre-war local conflicts and the Great Patriotic war the authors make the analysis of the main stages in the development and formation of the system of treatment of minimally wounded in the tactical, Army and Front regions. The article describes a number of aspects which have scientific and practical significance for the improvement of the modern system of evacuation and treatment procedures.

Fifteen subjects with uneventful adaptation and 28 subjects with acute high mountain sickness were kept at an altitude of 3600 m. Prior to the exposure all the test subjects, aged 18-20, were essentially healthy. As compared to the controls, the subjects with acute high mountain sickness showed a greater increment in heart rate, blood pressure in the brachial artery, pulmonary hypertension and vasoconstriction. It was found that the subjects susceptible to acute high mountain sickness exhibited (at sea level) higher values of heart rate and R wave in the ECG II lead and lower systolic pressure in the brachial artery. These findings can serve as predictors of acute high mountain sickness.