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The purpose of the study. To clarify the possibilities of using radiation research methods in the framework of complex diagnostics of local peritonitis for timely recognition and treatment of intra-abdominal abscesses and infiltrates.Materials and methods. The analysis of the results of a complex radiation examination in 61 patients with local peritonitis of various etiologies who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine was carried out. The complex of radiation diagnostics included ultrasound and X-ray examinations, computed tomography (CT). The studies were performed both initially at admission and in dynamics.Results. The diagnostic algorithm for local peritonitis is analyzed, three stages are identified with the determination of the method of choice on each of them. Ultrasound and X-ray examination methods are mainly used at the stage of primary diagnostics and for dynamic control. CT allows you to clarify the type, localization and volume of inflammatory changes, their relationship with the surrounding organs and structures. When analyzing the results of radiation diagnostics, it was determined the need to identify and evaluate the main signs of local peritonitis, both direct: the presence of voluminous formation of inflammatory genesis (infiltrate and/or abscess); and indirect: changes in the source organ of peritonitis; changes in structures adjacent to the infiltrate /abscess; the presence of reactive effusion into the thoracic and abdominal cavities.Conclusion. Comprehensive radiation diagnostics for local peritonitis makes it possible to obtain complete information about the nature of both inflammatory changes in local peritonitis and the causes of them. The obtained data of complex diagnostics help the surgeon to choose a rational treatment strategy for these patients, including minimally invasive. Diagnostic monitoring allows you to evaluate the effectiveness of treatment and carry out timely correction of tactics.

Study objective. To determine the role of transcranial duplex sonography measurements in prognosing the risk of adverse outcome in patients with nontraumatic subarachnoid haemorrhage.Materials and Methods. In 2010–2020 413 patients admitted to N. V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department with aneurysmatic subarachnoid haemorrhage were enrolled into the study, including 201 males (48.7 %) and 212 females (51.3 %). Mean age was 51 ± 12 years. All patients were treated surgically (aneurysm clipping). Patients’ status on admission and before surgery was evaluated according to Hunt and Hess scoring system. Transcranial duplex sonography was conducted in all patients on admission, before surgical treatment and on a daily basis after aneurysm clipping (up to the 10th day after aneurysm rupture, 2,612 examinations in total). The degree of angiospasm in middle cerebral artery, Lindegaard ratio and the presence of diffuse angiospasm in all arteries of Willis circle were assessed according to a previously described classification system. Brain computed tomography scans were used to determine the extent of subarachnoid haemorrhage according to C. M. Fisher scale and volume of ischemic lesions in areas supplied by middle cerebral artery. Outcomes were rated according to Glasgow Outcome Scale. Study sample was divided into two groups according to outcome. Group 1: adverse outcome (Glasgow Outcome Scale 1–3). Group 2: favorable outcome (Glasgow Outcome Scale 4–5). Binary logistic regression was applied to reveal risk factors for adverse outcome. To define long-term treatment outcome 104 patients (68 females, 36 males) were examined using neurologic scoring systems: Modified Rankin Scale, Barthel Index, Mini-Mental State Exam, Hospital Anxiety and Depression Scale.Results. Favorable outcome (group 2) was ascertained in 221 (53.5 %), unfavorable outcome (group 1) – in 192 (46.5 %) patients. The following independent risk factors for unfavorable outcome were detected: angiospasm in middle cerebral artery before surgery, severe angiospasm in middle cerebral artery and diffuse angiospasm. According to univariate analysis, daily increase in middle cerebral artery peak systolic velocity by 51.6 cm / s was associated with adverse outcome either. Binary logistic regression model was able to predict unfavorable outcome with sensitivity 88.5 %, specificity 76.0 %. Daily increase in middle cerebral artery peak systolic velocity by 58.7 cm / s was associated with Modified Rankin Scale increase by 1 point. Angiospasm proved to be strongly connected with cognitive and self-care ability impairment on follow-up.Conclusion. Ultrasonic signs of angiospasm in patients with aneurysmatic subarachnoid haemorrhage are independent predictors of adverse outcome and long-term results worsening.

Introduction. In the early hours and days after traumatic or surgical event it is essential to determine type of peripheral nerve injury accurately.Objective. To assess performance of diagnostic ultrasound (US) in patients with traumatic and intraoperative nerve injuries during the early hours and days after trauma or surgery.Materials and methods. 106 patients with clinical signs of extremity nerve injuries were included into the study. A total of 113 limb nerves were investigated with US.Results. US sensitivity in the detection of complete nerve rupture was 100% (95% CI: 39,8-100%), specificity — 99,0% (94,7100,0%); for nerve compression with the bone sensitivity was 100% (66,4-100%), specificity — 100% (96,3-100%); for nerve compression with fixation devices sensitivity was 100% (66,4-100%), specificity — 100% (15,8-100%) и 100% (88,4-100%).Conclusion. Nerve US is a reliable method for the evaluation of extremity nerve injury, the method can be recommended for use in the early hours and days after trauma or surgery.

AIM. To establish cut-off point of strain ratio for rectal adenocarciomas. PATIENTS AND METHODS. Forty-five patients (29 female) at mean age ± SD of 61 ± 9.5 (range, 38-80) years with histologically confirmed rectal neoplasia were included into study. Endorectal Ultrasonography accomplished by strain elastography was performed by Hitachi Hi Vision Preirus (Japan). All patients were treated by Transanal Endoscopic Microsurgery. RESULTS. Pathologic examination of operative specimen revealed 31 adenomas (5 intraepithelial carcinomas) and 14 invasive carcinomas. Cut-off point of Strain Ratio was 5,7 with sensitivity of 0.94 (95 °%CI 0,68-0,99), specificity of 0.92 (95 %oCI 0,74-0,98), positive predictive value of 0,90 (95 % CI 0,84-0,96) and negative predictive value of 0,96 (95 %CI 0,85-0,99). CONCLUSION. Obtained results testified high diagnostic value of strain elastography and made one perspective method for detection of occult malignancy in large rectal adenomas.

In this paper we describe the operation and performance of the HERA-B Outer Tracker, a 112674 channel system of planar drift tube layers. The performance of the HERA-B Outer Tracker system fullfilled all requirements for stable and efficient operation in a hadronic environment, thus confirming the adequacy of the honeycomb drift tube technology and of the front-end readout system. The detector was stably operated with a gas gain of 30000 in an Ar/CF4/CO2 (65:30:5) gas mixture, yielding a good efficiency for triggering and track reconstruction, larger than 95 % for tracks with momenta above 5 GeV/c. The hit resolution of the drift cells was 300 to 320 micrometers and the relative momentum resolution can be described as: sigma(p)/p (in %) = (1.61 +- 0.02) + (0.0051 +- 0.0006) p. At the end of the HERA-B running no aging effects in the Outer Tracker cells were observed., Comment: 38 pages, 20 figures. v2: Added clarifications about trigger efficiency, momentum resolution and alignment precision. Corrected typos. Improved figure quality

The HERA-B Outer Tracker is a large detector with 112,674 drift chamber channels. It is exposed to a particle flux of up to 2 × 10 5 cm - 2 s - 1 thus coping with conditions similar to those expected for the LHC experiments. The front-end readout system, based on the ASD-8 chip and a customized TDC chip, is designed to fulfil the requirements on low noise, high sensitivity, rate tolerance, and high integration density. The TDC system is based on an ASIC which digitizes the time in bins of about 0.5 ns within a total of 256 bins. The chip also comprises a pipeline to store data from 128 events which is required for a deadtime-free trigger and data acquisition system. We report on the development, installation, and commissioning of the front-end electronics, including the grounding and noise suppression schemes, and discuss its performance in the HERA-B experiment.

An analysis is given of possible ways of achieving extremely high coordinate accuracy and two-track resolution in a drift chamber. A coordinate accuracy of 30 μm, and a two-track resolution of 100 μm have been obtained for a 10 mm drift distance with the drift precision imager prototype. A large solid angle vertex detector is also discussed.

Methods are described which are used for the synthesis of dimethylnitrosamine and diethylnitrosamine with a view to employing these substances for induction of tumors. The preparations were fed in drinking water to male albino rats of common breed. Eight months after the beginning of application of these preparations the experimental animals developed malignant tumors of the liver metastasizing to the lungs. The tumors are variable for their histological structure.