[Analysis of learning curves for mini-gastric bypass in 341 patients with obesity]. / Izuchenie opyta osvoeniya mini-gastroshuntirovaniya metodom postroeniya krivykh obucheniya u 341 patsienta s ozhireniem.

OBJECTIVE: To analyze learning curves and appropriate experience on the features of mini-bypass surgery in 341 obese patients. MATERIAL AND METHODS: A total of 341 laparoscopic mini-gastric bypass surgeries performed by one surgeon were studied. The median age of patients was 40.5 [34; 48.3] years. There were 284 (83.2%) women and 57 (16.8%) men. The median BMI was 45 [40;52] kg/m2. RESULTS: The period of MGB development consisted of 138 interventions. Surgery time was 120 [100; 130] min and 90 [82.5; 100] mins after development of this technique (p=0.001). Complications occurred in 5 (1.5%) patients (1 patient with Clavien Dindo grade IIIA and 4 ones with grade IIIB). Of these, there were 3 patients with stapler suture defects. There were no complications only in the 4th quartile of surgeries. Surgical experience significantly affects postoperative outcomes. Surgery time was more influenced by surgical skill rather technique of anastomosis imposing. CONCLUSION: Polynomial regression objectively characterizes development of surgical skills lasting 138 interventions. MGB is safe for morbid obesity with a complication rate of 1.5% and no mortality.

[Bile duct repair after complete intersection]. / Opyt vosstanovleniya nepreryvnosti zhelchnykh protokov pri polnom ikh peresechenii.

OBJECTIVE: To determine the training period for imposing hepaticojejunostomy for bile duct repair. MATERIAL AND METHODS: Reconstructive surgery on the bile ducts was performed in 53 patients. We analyzed the learning curves based on the incidence of anastomotic leakage after hepaticojejunostomy. RESULTS: The learning curve has a downward nature. The number of anastomotic failures decreases by 2 times after 42 procedures. Surgeon had to perform 39-42 operations to reduce the incidence of this complication. CONCLUSION: Treatment of patients with iatrogenic intersections of the bile ducts should be provided in appropriate hospitals.

Lactic acid fermentation of human urine to improve its fertilizing value and reduce odour emissions.

During storage of urine, urea is biologically decomposed to ammonia, which can be lost through volatilization and in turn causes significant unpleasant smell. In response, lactic acid fermentation of urine is a cost-effective technique to decrease nitrogen volatilization and reduce odour emissions. Fresh urine (pH = 5.2-5.3 and NH4+-N = 1.2-1.3 g L-1) was lacto-fermented for 36 days in closed glass jars with a lactic acid bacterial inoculum from sauerkraut juice and compared to untreated, stored urine. In the lacto-fermented urine, the pH was reduced to 3.8-4.7 and the ammonium content by 22-30%, while the pH of the untreated urine rose to 6.1 and its ammonium content increased by 32% due to urea hydrolysis. The concentration of lactic acid bacteria in lacto-fermented urine was 7.3 CFU ml-1, suggesting that urine is a suitable growth medium for lactic acid bacteria. The odour of the stored urine was subjectively perceived by four people to be twice as strong as that of lacto-fermented samples. Lacto-fermented urine induced increased radish germination compared to stored urine (74-86% versus 2-31%). Adding a lactic acid bacterial inoculum to one week old urine in the storage tanks in a urine-diverting dry toilet reduced the pH from 8.9 to 7.7 after one month, while the ammonium content increased by 35%, probably due to the high initial pH of the urine. Given that the hydrolyzed stale urine has a high buffering capacity, the lactic acid bacterial inoculum should be added to the urine storage tank of a UDDT before urine starts to accumulate there to increase the efficiency of the lactic acid fermentation.

[Predictors of Electrical Myocardial Instability in Men With Arterial Hypertension and Obstructive Sleep Apnea-Hypopnea Syndrome].

OBJECTIVE: To access the detectability of corrected QT interval (QTc) prolongation ( more or equal 450 ms) and increased QT dispersion (QTd more or equal 60 ms) in men with obstructive sleep apnea-hypopnea syndrome (OSAS) and newly diagnosed arterial hypertension (AH). MATERIAL AND METHODS: We included in this study 138 men (mean age 40.5+/-6.9 years, body mass index 34.5+/-4.7 kg/m2, all with more or equal 3 risk factors of AH development, 34% with subclinical target organs damage). According to office systolic and diastolic blood pressure level (SBP and DBP), AH of 1st degree was diagnosed in 103 (74.6%), 2nd - in 26 (18.9%) and 3rd - in 9 (6.5%) patients. All patients underwent 24-h multifunctional monitoring. According to the apnea-hypopnea index (AHI) patients were divided into 4 groups: I (control, n=34) with AHI less than 5/h, II (n=36) with AHI 5-14/h, III (n=32) with AHI 15-29/h, IV (n=36) with AHI more or equal 30/h. RESULTS: There were no significant intergroup differences in age, body mass index, sleep duration, mean daytime SBP, QT and JT dispersion in the diurnal, daytime and nighttime periods. However, in group IV values of mean heart rate (in normal range), daytime DBP, nighttime SBP and DBP, QTc and JTc intervals were higher than in other groups. Portions of patients with prolonged QTc and increased QTd were 38.2 and 35.3%, 44.4 and 33.3%, 34.4 and 40.6%; 50.0 and 38.9% in groups I, II, III, IV, respectively. Multiple regression analysis revealed associations between mean diurnal QTc interval prolongation and reduction of mean oxygen saturation (SpO2) during sleep, and between mean diurnal JTc interval prolongation and increase of AHI. CONCLUSIONS: Rates of detection of QTc interval prolongation and QTd increase in men with newly diagnosed AH and OSAS of different severity were almost similar. However, there was a trend to higher detectability of QTc interval prolongation (50.0%) among patients with AHI more or equal 30/h. Reduction of mean SpO2 and AHI increase during sleep were found to be predictors of diurnal QTc and JTc intervals prolongation, respectively.

[Adhesive process in the abdominal cavity in patients with end colostomies and its influence on the reestablishment of the large intestine continuity].

Under analyses there were reparative operations on 79 patients with end colostomies performed using medial access in 42 patients and parastomal access in 37 patients. The investigation of prevalence of the adhesive process in 61 patients has shown that marked adhesions were formed in the area of the medial scar in 41 (67.2%) patients, the stump of the suppressed gut--in 31 (50.9%) patients and colostomy--in 27 (44.3%) Reestablishment of intestine continuity from the parastomal access allowed avoidance of adhesions in the zone of the medial postoperative scar which shortened the time of operation and decreased the level of intra- and postoperative complications.

[Enteral zond feeding in patients with insolvensy of duodenum stump].

The most effective method of insolvency duodenum stump treatment is an active drenage of stump--zone within enteral zond feeding. Using of Y-shaped enterostomia with compressive intestine anastomosis avows to fulfill feeding during a long period of time. It is not followed with new complication even in peritonitis case. The method allows to lower the death level in two times.

[Chromosomal localization of nine genes in common shrew (Sorex araneus)]. / Khromosomnaia lokalizatsiia deviati genov zemleroiki obyknovennoi (Sorex araneus).

Syntheny and localization of the following genes in common shrew Sorex araneus were determined: isocitrate dehydrogenase 2 (IDH2), acid phosphatase 2 (ACP2), glutamine--pyruvate--oxo-acid transaminase (GPT), and inorganic pyrophosphatase (PP) on chromosome ik; adenylate kinases 1 and 3 (AK1 and AK3) on chromosome af; and enolase 1 (ENO1) on chromosome jl. Two genes were assigned to definite arms: aminoacylase 1 (ACY1) to arm p of chromosome mp and glutamic-oxaloacetic transaminase 1 (GOT1) to arm q of chromosome qr. Thus, 26 genes marking eight out of ten chromosomes are present now on the cytogenetic map of common shrew. These include previously described localizations.

[Surgical treatment of median postoperative ventral hernia]. / Operativnoe lechenie sredinnykh posleoperatsionnykh gryzh zhivota.

The authors propose a new variant of operation of plasty with local tissues for great postoperative hernias, the dissection of aponeurosis of external oblique muscles on both sides resulting in increased volume of the abdominal cavity and reduced intraperitoneal pressure. Operations were fulfilled in 144 patients. Late results were studied in 126 patients in the terms from 6 months to 6 years. Recurrent hernias were found in 6,3% of cases.