Colorectal cancer liver metastases within the central and peripheral segments: Parenchymal sparing surgery adaptation.

BACKGROUND: The debate over the surgical strategy optimization in colorectal cancer patients with liver metastases (mCRC) has been ongoing in the last 20 years. However, parenchyma sparing surgery (PPS) in cases of hard to reach liver cites (HTRLC) remain to be controversial. METHODS: A prospective analysis of 185 mCRC patients performed who were devided in two groups depending by predominant liver cite localization. Peripherally localized metastases (PLM) (n = 107) (S2, S3, S6, S7, Spiegel lobe and subcapsular area 1-2 cm below the liver surface). Group 2 included those with metastases localized in HTRLC (n = 78) - metastatic lesions of the "right venous core", portal and caval hilum, paracaval part of S1, "deep" parenchyma cites of S5, S8 and S4. RESULTS: In 26 (33,3%) and 32 (29,9%) patients of HTRLC and PLM, respectively, performed one liver re-resection (0,62). In HTRLC group 2 and more re-resection were performed in 7 (8,9%) cases while in PLM in 11 (10,3%), p = 0,76. Postoperative major morbidity was 24,4%, 21,8% (p = 0,15) and mortality 8,9%, 4,6% for HTRLC and PLM groups, respectively. R1v principles were implemented in 24 (30,7%) cases with centrally located metastases and in only 6 cases (5.6%) with peripheral localized metastases (p = 0,001). Cumulative 3-year disease-free survival (DSF) for PLM and HTRLC groups was 63% and 41% (p = 0,008). DFS for R1v (n = 24) and R0 (54) cochorts in HTRLC group was 33% and 43%, respeсtively (p = 0,44). CONCLUSIONS: Principles of the PPS tactic provides an adequate removal of metastatic lesions in hard to reach liver cites allowing to maintain organ functions and increases the feasibility of the repeated liver resections in case of the initial disease progression.

MORPHOLOGICAL ASSESSMENT OF NO-SYNTHASE DISTRIBUTION IN OVERACTIVE BLADDER AND STRESS URINE INCONTINENCE IN ANIMAL MODELS ADMINISTERED WITH EXPERIMENTAL PHARMACOCORRECTION REGIMENS.

The objective of the study was immunohistochemical evaluation of distribution of various NO synthase fractions in the structural elements of the bladder wall under stress urinary incontinence and its overactivity prior and post Mirabegron, Spasmex, Quercetin therapies and their combinations with Testosterone and Estradiol. Using the immunohistochemical method, we studied the expression of the main fractions of NO synthase in experimental models of hyperactive bladder (OAB) and stress urinary incontinence (SUI). We found that OAB and SUI were characterized by emergence of expression of the inducible fraction (iNOS) predominantly in the interstitial cells of the muscular layer of the bladder and reduced expression of endothelial (eNOS) and neuronal (nNOs) NO synthase fractions. In contrast to Spasmex, Mirabegron and Quercetin in combination with Testosterone and Estradiol contributed to stabilization of eNOS and nNOs expression already at early observation phases, and reduced the level of iNOS expression with its further disappearance in the later observation period.

ENERGY PROFILE OF RATS WITH OVERACTIVE BLADDER SYNDROME PHARMACOLOGICALLY CORRECTED WITH QUERCETIN.

We studied the effect of Quercetin on energy profile of erythrocytes of rats with the overactive bladder syndrome. It was shown that animal models with the subject pathology demonstrated alteration of quantitative composition of the adenine nucleotide system in erythrocytes. Abrupt decrease of the total concentration of adenyl nucleotides and ATP compared to the intact group of animals was noted in the study. Administration of Quercetin significantly improved the energy profile of erythrocytes in rats with the overactive bladder syndrome. The data obtained provide new findings of the pathogenesis and correction regimens for the subject pathology.

FEATURES OF HISTOCHEMICAL CHANGES IN THE ACTIVITY OF SUCCINATE DEHYDROGENASE OF ARTIFICIAL BLADDER IN DYNAMICS (EXPERIMENTAL STUDY).

The gold standard for the treatment of invasive bladder cancer recognized throughout the world is radical cystectomy with orthotopic ileocystoplasty using the ileal intestinal tract. The study of the effect of urine on the adaptation of the mucosa of the artificial bladder continues for the last twenty years. According to the researchers, the results are quite contradictory, as some scientists note the hypersecretion of sulphomucins, sialomucins, progressive atrophy of microvilli, adenomatous hyperplasia and dysplasia. The aim of investigation to study the features of the histochemically revealed activity of succinate dehydrogenase in the wall of the artificial bladder and ileum in experimental animals. The material of the present study were the results obtained from the study of 18 female mini-pigs aged 4-5 months and weighing 8-10 kg. The modeling of the artificial bladder was performed in experimental animals, by cystectomy and subsequent ileo-cystoplasty. Experimental animals with a bladder model in groups of 6 animals were withdrawn from the experiment 3, 6 and 12 months after operational modeling. As for the wall of the official bladder, the changes in the activity of the studied enzymes were significant and showed not only possible changes in the activity of the Krebs cycle, but also about periodic displacements of the accents of substrate maintenance. These changes, in our view, are related to the transformation processes in the structural elements of the ileum wall, from which an unproblem has been formed to fulfill new functional duties. Signs of a violation of energy metabolism indicate the processes of hypoxia in the tissue of the artificial bladder and require further study and observation.

[Role of transcription factors in transdifferentiation of the gastric mucosa].

The analysis of intestinal differentiation transcription factor CDX2 in the gastric mucosa biopsies has been carried out. It was established that CDX2 by itself promoter activation pathway can obtain intestinal phenotype for gastric mucosa cells. The loss of CDX2 expression in the nuclei of metaplastic epithelium may serve as a predictor of gastric mucosa malignization.

[Experimental hypovitaminosis D in guinea pigs administered different amounts of vitamin C]. / Eksperimental'nyi D-gipovitaminoz u morskikh svinok pri razlichnoi obespechennosti organizma vitaminom C.

The experimental model of D-hypovitaminosis is first obtained on guinea pigs. It is established that the least degree of its manifestation is determined under conditions of the optimal supply of the organism with vitamin C. The necessity of using ascorbic acid in a complex of rachitis prophylaxis measures is substantiated.

[Effect of the supplemental administration of ascorbic acid on its content in the blood and tissues of rabbits exposed to excess amounts of ultraviolet radiation]. / Vliianie dopolnitel'nogo vvedeniia askorbinovoi kisloty na ee soderzhanie v krovi i tkaniakh krolikov pri vozdeistvii izbytochnykh kolichestv ul'trafioletovoi radiatsii.

In the blood and tissues of rabbits receiving with the food 40-50 mg of vitamin C per day and irradiated with an excess doses of ultraviolet radiation the vitamin C content decreases. Depending upon the irradiation dose it is recommended that the quantity of vitamin C in the food of rabbits be increased up to 120-220 mg/kg.