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Objectives/Hypothesis. During septoplasty, an L-shaped septal strut is often preserved or created. The main goal here is to straighten the nasal septum and to provide the required stiffness of the same. Insufficient stiffness of the septum leads to exceeding the maximum permissible value of its deformation and or its excessive deviation, that could result in functional or aesthetic complications. The aim of this work is to study the influence of the geometrical shape of an L-shaped strut on its stiffness. Designed and testing tools. With the use of means of computer simulation, we developed L-strut cartilage models featuring an improved stiffness and resistance to deformation. On this basis, we developed L-strut models of various shapes from a material simulating the mechanical properties of cartilage tissue. All the models were tested under the same conditions using a multipurpose instrument ZWICK Z100 and a special device simulating the septum loading conditions. Methods. At the first stage of the study, a five-sided septum model was created based on computed tomography scans of human subjects. Then, based on this model, we developed a series of models with various combinations of L-struts, with or without the use of arcs of cartilage. It was assumed that the edges of the septum, connected with the bone support, are fixed, whereas the nasal tip is relatively freesupported. L-strut models were tested under the same loading conditions using a multipurpose instrument ZWICK Z100 and a special device simulating the septum loading conditions. The loading of the models was effected by applying a distributed load along the outer contour, that is the same for all the studied models. On the basis of an experimental data analysis, we assessed the stiffness of the modeled septa. Results. We obtained experimental "Force -- Travel" dependence for nasal septum models with different geometry. Is shown that a septum with a wider dorsal strut is characterized by the greatest stiffness. Conclusions. It is found that a septum with a wider dorsal strut is characterized by the greatest stiffness and a higher resistance to deformation. The preservation of an arc of cartilage and a wider dorsal strut increase the overall stability of the structure. [ABSTRACT FROM AUTHOR]

The article considers causes of insufficient quality of medical care. The low motivation of paramedical personnel during medical services rendering is examined. The sociological survey data made it possible to analyze opinion of students of medical college as future paramedical personnel concerning attractiveness of this profession. Their social and material status was established. The notions concerning possibility of carrier and professional progress were established too. The factors hampering involvement of this category of professionals into public health system and negatively impacting medical care quality were analyzed.

Available are the results of the treatment of 93 patients with multiple traumatic amputations of the fingers, in whom the heterotopic digital replantation was carried out. A total of 367 fingers were amputated, 187 of them have been replanted, which made up 51% of replantability. 148 fingers (79.1%) were replanted heterotopically and 39 (20.9%)--orthotopically. The viability was restored in 167 fingers, which made up 89.3%. Of 148 fingers, which have been replanted heterotopically, 88.6% have survived, and of 39 fingers, being replanted orthotopically, 92.4% survived. The analysis of functional results of the digital replantations in hand comprised the study of the hand biomechanics, blood supply and innervation. A total of 31 patients was followed up and examined in long term period from 8 months to 6 years after replantation. The biomechanics of the hand was assessed according to its capacities for seize and pinch as well as to the extent of movements in the joints of the restoration of digital innervation was assessed by the study of temperature and discrimination sensitivity. For evaluation of blood supply the US dopplerography and scintigraphy were used. The authors came to the conclusion that there was no substantial difference in the function of operated fingers both in orthotopic and heterotopic replantations. Taking into account that heterotopic replantation of the fingers resulted in more active digital function, it is safe to speak about more pronounced increase in the function of the hand in cases of heterotopic replantations of fingers in their multiple traumatic amputation.