Vibrational spectra of DNA in the confined interglobular volume of photonic crystal.

The impact of confinement of DNA molecules in a limited volume of the cavity of photonic crystals (PC) on the vibrational properties of the DNA molecule and its conformation is studied. According to our preliminary study, the aqueous shell is removed when the DNA molecules are infiltrated into the PC cavities. Raman scattering (RS) DNA marker lines showed a dramatic conformational change of DNA in the PC cavities and the appearance of new unknown conformational states. We observed the enhancement of vibrational modes of DNA in the PC in comparison with free DNA of about tenfold and the absence of vibrational modes in DNA bases in a region of 1450-1700 cm-1. The observed features in the RS spectra of DNA are explained by the impact of confined interglobular volume and strong localization of the electromagnetic field. Namely, FDTD simulations in linear regime demonstrate the localization of light in cavities of PC with an approximately ninefold enhancement of the electric field within the photonic stop-band, which is the main reason for RS amplification.

[Nonplatelet Effects of Ticagrelor].

This review summarizes current knowledge concerning "nonplatelet effects of P2Y12 receptor antagonist ticagrelor. We show the experimental and clinical evidence that ticagrelor increases plasma concentration of adenosine as a potential mechanism of additive effects of ticagrelor. In addition, we sought to compare the clinical profile of ticagrelor with pharmacological effects of adenosine and discuss from this point of view the effects of ticagrelor on vascular tone, cardiac electrophysiology, ischemia/reperfusion injury, immunity and inflammatory reactions, peripheral nerves.

[Impact of abdominal cavity open EHF irradiation on activity of adhesive process in peritonitis].

In experiment on 45 rats a purulent peritonitis was simulated. There was established, that on background of a standard therapy for peritonitis application of abdominal cavity open irradiation of extreme high frequency (EHF) have promoted rapid stabilization of the lipid metabolism indices and the blood coagulation system, the reduction of intensity of lipids peroxidal oxidation processes and severity of systemic inflammatory reaction. Under the influence of complex treatment the severity of adhesive process was reduced in 5.4 times, comparing with such in animals, to whom a standard treatment was conducted only. The revealed pathogenetic aspects of the adhesions formation witnesses the expediency to add EHF irradiation to complex therapy of peritonitis.

[Roentgen-surgical interventions in combined treatment of patients, suffering hepatic metastases of noncolorectal cancer].

Results of combined treatment, using roentgen-surgical interventions, of 58 patients, suffering noncolorectal metastatic affection of the liver, complicated in 20 (34.5%) of them by obturation jaundice, were analyzed. While resectability of the metastases, preoperatively chemotherapy (CHT) or chemoembolization of hepatic artery (CHEHA) in 1 - 2 courses were performed, and then - hepatic resection of various volume, adjuvant regional CHEHA or systemic CHT. Median survival of the patients have constituted 31.2 mo. While presence of nonresectable metastases a regional chemoinfusion via hepatic arteries or CHEHA (2 - 3 courses) were performed. Median survival of this group of patients have constituted 15.3 mo. Application of cytostatics for regional therapy have permitted in 4 (6.9%) patients, in whom partial tumor regression was achieved, to perform radical hepatic resection. Complete answer on the treatment was not achieved in any patient, partial answer was noted in 16 (33.3%), the process stabilization - in 20 (41.7%), the tumor progress - in 12 (25.0%). In total 170 endovascular and 41 transcutaneous transhepatic endobiliary interventions were performed. After operation 1 (12.5%) patient died.

[Revascularization of lower limbs in patients with critical ischaemia induced by lesions of infrainguinal arteries].

AIM: The study was aimed at comparative analysis of efficacy of endovascular and surgical revascularization in patients presenting with lower limb critical ischaemia (LLCI) due to lesions of infrainguinal arteries. MATERIAL AND METHODS: The retrospective study included a total of 236 patients with LLCI undergoing revascularization of lower extremities performed at our Institute from 2007 to 2011. The patients were subdivided into two groups. Group One consisted of 135 patients subjected to transcutaneous endovascular interventions. Group Two comprised a total of 101 patients having endured bypass grafting operations. Limb salvage and survival of patients during five years were assessed by means of the Kaplan-Meyer method. RESULTS: Technical success and clinical improvement in the both groups did not differ significantly, amounting to 90%. The complication rate and the number of major amputations turned out considerably higher in the group of surgical treatment as compared with that in the group of endovascular treatment. After 1, 3 and 5 years the indices of limb salvage and survival (LSS) in the both groups did not differ significantly amounting respectively to 94.4, 72.7, and 52.2% in the surgical group and 89.7, 67.2 and 46.3% in the endovascular group (p=0.196). The number or re-do operations in the remote period due to relapses of LLCI was considerably higher in the group of endovascular treatment. CONCLUSION: Endovascular and surgical methods demonstrate similar immediate and remote outcomes in patients with LLCI induced by lesions of infrainguinal arteries, but the choice of the method of revascularization should obligatorily take into consideration the localization and extension of arterial lesions, the presence of an appropriate autovein for the bypass graft, the level of perioperative risk, and life expectancy.

[State of specific and natural immunobiological resistance in patients with colorectal cancer in conditions of obturation of the colon].

Estimation of the immune state was performed in 57 patients, suffering colorectal cancer (CRC) with impassability of large bowel (ILB) in compensated stage (in 30) and subcompensated (in 27). In all the patients immunosuppression was revealed, in ILB in a compensation stage activation of proinflammatory and antiinflammatory citokines--mediators of immune system, while in LIL in a subcompensation stage and in progressing of CRC--inhibition of antiblastomic mediators on background of significant rising of the problastomic citokines, what may have a prognostic significance for optimization of pathogenetic therapy in such patients.

[Roentgensurgical interventions in combined treatment of patients for hepatic metastases of colorectal cancer].

The results of combined treatment in 82 patients for hepatic metastases of colorectal cancer, complicated in 14 (17.1%) of them by obturation jaundice, using roentgensurgical interventions, were analyzed. In case of resectable metastases, preoperative chemotherapy and chemoembolization of hepatic artery was conducted, using 1 - 2 courses of oxaliplatin, and further--hepatic resection in various volume (in 23 patients), adjuvant regional chemoembolization or systemic chemotherapy. Median survival of the patients in this group was 32.2 mo. While unresectable metastases presence (in 59 patients), the treatment with the help of regional chemoinfusion via hepatic artery or chemoembolization of hepatic artery (2 - 3 courses), using oxaliplatin or irinotecan, was conducted. Median survival of patients in this group was 16.7 mo. Application of oxaliplatin for treatment with the help of regional therapy have permitted in 8 (9.8%) patients, while partial efficiency of chemotherapy, to perform radical hepatic resection. Complete answer on therapy was noted in 6 (8.6%) patients, the partial--in 19 (27.1%), the state stabilization--in 37 (52.9%), the disease progress--in 8 (11.4%). In total in 82 patients there were performed 217 endovascular and 24 transcutaneous transhepatic endobiliary interventions. Postoperatively 5 (6.1%) patients died.

[Application of statistical models for prognostication of outcomes in injured persons with severe trauma].

Basing on data, concerning the injured persons state, the investigations results for elaboration and application of statistic models, prognosticating the trauma outcome, were analyzed. Selected information about 373 injured persons, who were treated in Traumatic Shock Department, is presented. There was established, that the statistical models elaborated is expedient to use together with other qualitative and quantitative methods of prognostic determination of outcome in severely injured persons.

[Tactics of "damage control" in the injured persons with severe combined trauma of abdominal organs].

In the clinic in 2000 - 2013 yrs of 42 injured persons with severe combined trauma of abdominal organs were treated, in 18 of them the method of a multi-staged treatment (damage control) with a short-term operative intervention on the first stage was applied, what permitted to lower postoperative lethality by 22.3%, and rate of purulent-septic complications--by 18.1%.

[Evaluation of intestinal viability on a simulation model of a small ileus based on determination of dielectric parameters].

Interrelationship between dielectric parameters and level of ATPH before and during ischemia, as well as with indices of survival after elimination of strangulation, was estimated on a simulation model of strangulation ileus in rats. The data obtained permit to suppose, that parameter tg δm may be used as effective noninvasive criterion of diagnosis in real time for estimation of the intestinal wall state in strangulation. Resection of the infringed intestine without elimination of strangulation is necessary in tg δm less than 2.20, in tg δm more than 2.36 the elimination of infringement is indicated, because there exist possibility to restore intestinal function after ischemic-reperfusion injury. Tactics of treatment in intermediate meanings of tg δm is not determined, but its measurement before reperfusion may help in estimation of a small intestine viability and choice of surgical tactics in its ischemia.

[Clinical and instrumental diagnosis of stratifying aneurysm of abdominal aorta].

Modern concept of aneurysm and peculiarities of clinical and instrumental diagnostics of stratifying aneurysm of abdominal aorta are adduced.

[Surgical treatment of a solitary hepatic abscess].

Retrospective analysis of the treatment results of 120 patients, suffering solitary hepatic abscess (SHA), was conducted. The sanation methods, in accordance to technology, the treatment impact intensity and aggressiveness, may be divided on three lines: aspirational, draining and resectional. The method of sanation is selected on the background of morphological peculiarities of abscess--its sizes, by presence of sequesters, divisioning septs, dense rigid capsule, grade of periprocess. Surgical access is determined by the abscess localization, the patient's state severity, instrumental equipment of the clinic. Differentiated approach, taking into account genesis, sizes, localization and stage of its formation, constitutes a background of successful treatment of SHA. In totally formatted acute SHA, as a rule, the methods of choice are aspirational and aspiration-draining methods of sanation under ultrasonographic control or laparoscopy. In the presence of chronic SHA or suppurated parasitic hepatic cyst it is mandatory to select the resectional methods.

[The choice of the revascularization method in the patients with critical ischemia of the lower extremities].

Immediate and remote results of surgical treatment of 407 patients, suffering the lower extremities tissues critical ischemia, were analyzed. In 223 patients (the first group) endovascular revascularization was performed, in 165 (the second group)--the open-access reconstructive operations, in 31 (the third group)--the combined or hybrid interventions. The immediate technical success of operations in all this groups was equal and up to 90%. The lower extremities high amputations and complications rate is trustworthy bigger after operative interventions, then after endovascular. The remote results, including the lower extremities preservation rate and survival indices, did not differ trustworthy in the groups. The reoperations rate in remote period for critical ischemia of the lower extremities recurrences is significantly bigger after endovascular interventions performance. Thus, endovascular and the open-access surgical procedures are equally effective in patients, suffering critical ischemia of the lower extremities, but, choosing the revascularization method, it is necessary to take into account the affection localization and spread, the certain venous conduit presence, as well as the risk and expected span of life.

[The role of ischemical preconditioning in the development of ischemia-reperfusion hepatic injury in experiment].

The optimal regimen of preliminary ischemic preparation, in which the vessels occlusion causes minimal pathohistological hepatic changes without inhibition of its regeneration capacities, was studied in experiment. The ischemic-reperfusional damage of liver, using hepatoduodenal ligament crossclamping in various regimens, was modeled on 40 rabbits in a randomized experimental investigation. Morphological investigations of the animals liver fragments, taken immediately after ligament crossclamping and on the third postoperative day, were performed. There was established, that severity and reversibility of the hepatic tissue affection have differed, depending on the ischemia duration and reperfusion period. The vessels occlusion regimen with preliminary ischemic preparation was the most safe for hepatic tissue, without rude structural injuries and functional disorders, permitting to recommend it for clinical application as the optimal one while performance of hepatic resection in combination with afferent vascular exclusion.

[Multidisciplinary approach to the treatment of patients with diabetic foot].

Diabetic foot (DF) is considered now the main cause of amputations of lower limbs. The analysis of the results of 266 percutaneous endovascular interventions (EV) performed during 2008-2012 in 245 patients with ischemic and neuroishemic DF was carried out. 76% of the patients underwent percutaneous balloon angioplasty (PBA), 24%--PBA + stenting. 91% of EV were technically successful. In 95% of the patients who achieved recovery of the main flow in the occluded arterial segment, clinical improvement was observed in the form of disappearance of the pain and start of the healing of ulcer-necrotic lesions of the foot. The main causes of technical failure (9%) were impossibility to pass through long calcified occlusions of infrainguinal arteries. The complication rate was 10.5%, major amputation--5.2%, mortality--0.8%. Long-term results were shown by the combined rate of amputation-free survival after 1, 3 and 5 years follow-up which made up respectively, 86%, 70% and 43%. EV is an effective treatment for patients with DF and an integrated multidisciplinary approach to achieve high limb salvage rates in the long-term period.

[Comparative estimation of the application efficacy for ceftriaxon and Hepacef combi preparations in the abdominal infection treatment].

A positive experience was described in the work, concerning application of Hepacef combi (cefoperazon/sulbactam, manufactured by "ARTERIUM" (Corporation, Ukraine) in the treatment of inflammatory-purulent diseases of abdominal organs as a method of empirical therapy. There was the preparation action efficacy estimated together with the diseases outcomes analysis, and possible recommendations for its application suggested. The preparation may be recommended for application as the empirical therapy agent in the abdominal infection treatment.

[Application of decamethoxin solution in the treatment of surgical peritonitis].

Basing on analysis of results of clinical and experimental investigations, there was established, that application of the cationic antiseptics solution (including 0.02% solution of decametoxin) for the abdominal cavity sanation permits to reduce the microbal soiling while sanation performance and as well so on--the postoperative complications rate and mortality in surgical peritonitis.

[The criteria of choice of the surgical treatment method in the injured persons with intrapleural post-traumatic hemorrhage in the closed thoracic trauma].

The role of clinic-instrumental methods of investigation for establishment of criteria in the choice in the injured persons surgical treatment with intrapleural posttraumatic hemorrhage as a consequence of the closed thoracic trauma was studied up.

[Enhancing efficacy of the primary antibacterial therapy for intraabdominal infections].

The positive experience of their own for combined application of Hepacef and Ornizol preparations (manufactured by firm ARTERI-UM, Ukraine) as an empirical antibacterial therapy for intraabdominal infections was summarized. The preparations efficacy, the disease outcome and possible recommendations for their application in the intraabdominal infection treatment were estimated.

[Antibacterial therapy of severe intra-abdominal infections].

The experience of meropenem (Mepenam, manufactured by Corporation ARTERIUM, Ukraine) application as empirical therapy in severe intraabdominal infections was presented. The diseases outcome and the preparation efficacy were estimated, recommendations concerning its application in the treatment of severe intraabdominal infections were done.