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Introduction. Fine needle aspiration biopsy (FNAB) of uveal melanoma (UM) is an invasive procedure. Many authors consider UM FNAB to be safe procedure, however extraocular extension of the tumor through the scleral tracts may occur. Current studies of scleral tracts after FNAB do not compare different biopsy techniques (cannula-assisted and without cannula) in terms of UM cells. Purpose. To assess morphology of scleral tracts for the presence of malignant cells when different biopsy techniques are approached. Material and methods. Forty-four scleral samples were analyzed after transvitreal FNAB performed in 22 enucleated eyes with UM. Cannula-assisted FNAB was performed in 22 cases. In the same eyes FNAB (n=22) was performed without cannula. Results. FNAB material was adequate for cytological examination in all cases. UM was confirmed in 22 eyes pathologically. UM cell implantation was detected in 5 scleral samples after FNAB without cannula. No signs of cell implantation were seen after cannula-assisted FNAB. The risk of scleral tract UM cell implantation was statistically lower in cannula-assisted FNAB technique (p=0.018, Pearson Chi-square test). Conclusions. UM FNAB performed directly through the sclera without cannula is associated with tumor cells implantation in scleral tract. Cannula-assisted FNAB significantly reduces the incidence of UM implantation in scleral tract. Key words: uveal melanoma, fine-needle aspiration biopsy, enucleation, morphology, ophthalmology.

Objective: to analyze the inflow cannula of an implantable axial-flow blood pump for a long-term left ventricular assist system in order to minimize thromboembolic complications. Materials and methods. Hemodynamics was considered for 4 different designs of the inflow cannula, from 0 mm to 25 mm long. Areas at the base of the cannula received the most attention. Analysis was performed using the OpenFOAM software. Results. It was revealed that sizes of stagnation and recirculation zones directly depended on the length of the cannula when placed in the left ventricle. Accordingly, longer cannula increases the risk of thrombosis. Conclusion. The design of an inflow cannula determines the likelihood of thrombosis in the cannula. Longer inflow cannula increases stagnation and recirculation zones. This provides a basis for a search for other possible modifications.

The aim of the study was to evaluate the possibility of US navigation for Radiofrequency denervation (RFD) of the lumbar facets.Material and methods. The authors performed a prospective controlled cohort study which included 50 patients with chronic pain syndrome who underwent RFD LIII-SI facets on both sides. The main group (US) included 25 patients, who underwent US guided navigation with FScontrol of the correct placement of the cannula prior to ablation. In the control group (FS) the RFD was performed only under FS control. Patients were selected after preliminary test block of medial branch with 50% pain reduction from the baseline. Patients with overweight, spinal deformity, pronounced degenerative changes, spinal stenosis and developmental anomalies were not included in the study. For the evaluation of outcomes, the numeric pain scale NRS-11 and the Oswestry index (ODI) were used, the accuracy of the cannula position was assessed and factors determining the accuracy were searched.Results. As a result of the intervention, there was a significant decrease of NRS-11 and ODI criteria in both groups (p0.001), a positive outcome was achieved in 18 (72%) of US patients and 16 (64%) of FS patients, p = 0.564. Of the 200 attempts to position the cannula under the ultrasound control, 169 (84.5%) were successful, in most cases (187 out of 200, 93.5%) at least 3 attempts were required to reposition the cannula. The average time for performing the procedure under the ultrasound control was 47.3±1.13 minutes. The facet angle and procedure level were defined as predictors of the cannula positioning accuracy, odds ratio 0.93 (95% CI 0.894–0.963) and 0.51 (95% CI 0.32–0.805), respectively.Conclusion. RFD of lumbar facet under ultrasound navigation allows to achieve a relatively high accuracy of the cannula position into the zone of passage of the articular branch. The navigation capabilities are reduced at the level of LV and SI vertebrae due to structural features of the joints, namely coronary orientation of the facets with the formation of a narrow space between the transverse and upper articular process, which create difficulties for scanning. The disadvantage of ultrasound control is the lengthy procedure and the need for repeated reinsertion of the cannulae worsening the patient’s tolerance of procedure.

Introduction. Successful liver transplantation including from donors with a sudden irreversible cardiac arrest requires the use of modern hardware and technical support to maintain, select and sustain organ viability for the period from harvesting to transplantation to the recipient.Materials and methods. Hardware-software system (HSS) developed by the Russian State Scientific Center for Robotics and Technical Cybernetics (RTC) was used for testing of normothermic perfusion of donor’s liver ex vivo. The experiment was conducted on the isolated pig liver (Duroc breed) in accordance with the ethical principles.Result. During perfusion spontaneous recovery of bile outflow through the cannula installed in the common bile duct (volume of bile released – 240 ml) was observed, and the color and uniformity of the perfused liver did not differ from the normal parameters. Biochemical indicators were stabilized at the physiological values after 40 minutes of perfusion procedure.Conclusion. Isolated liver transplant was completely restored after 30 minutes of warm ischemia and was functioning well due to ex vivo perfusion procedure on the new perfusion device. The first case of the new device usage for normothermic liver ex vivo demonstrated hopeful results to be further investigated.

Aim: of our clinical study was to present own experience of veno-venous extracorporeal membrane oxygenation (VV ECMO) for the treatment of an adult patient (female, 28 yrs, 150 cm, 35 kg) with acute respiratory distress syndrome (ARDS) in the early period after liver transplantation against satisfactory liver graft function. Materials and methods. Double-lumen cannula 22 F was placed percutaneously in the right internal jugular vein. The ext- racorporeal contour reduced in length and the polymethylpeptene oxygenator (priming volume 175 ml) were also. Results. In 1 hour after the beginning of VV ECMO, we registered the noted improvement of arterial blood gas and acid-base balance (regress of respiratory acidosis, improvement of arterial oxygenation) which allowed us to use the «protective» mode of mechanical ventilation. Improvement of gas exchange and regress of clinical and radiological manifestations of ARDS allowed for VV ECMO weaning and decannulation on day 7. The patient was discharged from ICU and then from our Centre to a homestay respectively on the 9 th and 16 th day after VV ECMO weaning with the satisfactory liver graft and lungs function. Conclusion. VV ECMO can be successfully applied to correct the life-threatening acute respiratory failure in the early period after liver transplantation.

Objective: to study the mechanisms of redistribution of toxins between biological media (blood and lymph) during enhanced lymph circulation after thoracic duct cannulation. Materials and methods. Experimental studies were performed on 12 mongrel dogs with reproduced general purulent peritonitis, which were divided into 3 groups and which differed in various times of thoracic duct cannula functioning. The redistribution of toxins was based on the study of medium-weight molecular fractions in different development periods of endotoxicosis. Results. Clinical observations have ascertained and confirmed that the potentiated draining effect of the lymphatic system in surgical endotoxicosis depends on the completeness of lymph circulation rearrangement after thoracic duct cannulation and external lymph drainage restoration. Conclusion. It is expedient to carry out thoracic duct cannulation as soon as possible if the course of surgical endotoxico-sis is supposed to be severe. This will accelerate lymph circulation rearrangement and ensure a prompter elimination of toxins, which can enhance the efficiency of extracorporeal lymph detoxification. Key words: lymph circulation, endotoxicosis, thoracic duct cannulation, medium-weight molecules.