[Morphological substantiation of laparoscopic suturing of stomach ulcer with formation of a covered perforation]. / Morfologicheskoe obosnovanie laparoskopicheskogo sposoba ushivaniya probodnoi yazvy zheludka s formirovaniem prikrytoi perforatsii.

OBJECTIVE: Morphological substantiation of laparoscopic suturing of gastric ulcer with formation of a covered perforation. MATERIAL AND METHODS: To analyze morphological tissue reaction in surgical area, we used 12 Chinchilla rabbits. All animals were divided into 2 groups by 6 animals. The main group enrolled rabbits undergoing suturing of perforated gastric ulcer with formation of a covered perforation by anterior stomach wall. In the control group, gastric perforation was sutured by conventional double-row suture. For histological analysis, 2 animals in each group were withdrawn from the experiment after 7, 14 and 21 days. We excised gastric wall within the area of perforation closure. Morphological data on healing process were compared between both groups. RESULTS. S: Tomach deformation after 7 days was more severe in the main group compared to simple suturing. However, these differences were absent after 21 days. Morphological analysis revealed postoperative transmural necrosis after 7 days. Signs of early epithelialization were more obvious in the main group. After 21 postoperative days, we observed almost completely restored differentiation of stomach wall layers in both groups of animals.

[Venous thromboembolic complications in patients with intracerebral hemorrhage]. / Venoznye tromboembolicheskie oslozhneniya u patsientov s gemorragicheskim insul'tom.

OBJECTIVE: To evaluate the effectiveness and safety of various heparin therapy regimens for venous thromboembolic complications in patients with acute cerebral circulatory disorders of the hemorrhagic type. MATERIAL AND METHODS: In a prospective single-center study, treatment results of 62 patients with hypertensive brain hematoma were analyzed. All patients were divided into two comparable groups: the group of «very early¼ prophylactic heparin therapy or the first 48 hours from the moment of the disease (n=35) and the group of «early¼ prophylactic heparin therapy, or later than 48 hours from the moment of the intracerebral hematoma development (n=27). The end points of the study were: venous thrombosis, pulmonary embolism (fatal and non-fatal), recurrent intracerebral hemorrhage, other clinically significant hemorrhagic complications, and intrahospital mortality. RESULTS: In the group of «very early¼ and «early¼ prophylactic heparin therapy, the results were as follows: venous thrombosis 22.9% vs. 29.6% (p=0.36), total rate of PE 2.9% vs. 11.1% (p=0.03), nonfatal PE 0% vs. 7.4% (p=0.007), fatal PE 2.9% vs. 3.7% (p=0.76), recurrent intracerebral hemorrhage and other hemorrhagic complications 0% in both groups, intrahospital mortality was 54.3% versus 48.1% (p=0.54). CONCLUSION: The earliest administration of direct anticoagulants in prophylactic doses in patients with hemorrhagic stroke leads to the decrease in the frequency of venous thrombosis and thromboembolic complications, without being accompanied by the development of repeated intracranial and other hemorrhagic events.

[Pathomorphological characteristics and risk factors of asymptomatic cerebral infarction based on the results of a cross-sectional hospital-based study]. / Patomorfologicheskie osobennosti i faktory riska asimptomnogo infarkta golovnogo mozga po dannym sektsionnogo gospital'nogo issledovaniya.

AIM: To study the prevalence, pathomorphological characteristics and risk factors of asymptomatic cerebral infarction (CI) based on the results of post-mortem studies and clinical charts of patients. MATERIAL AND METHODS: The autopsies of 735 patients died due to different diseases were analyzed using continuous sampling method. CI lesions were found in 86 patients (47 women, 39 men, mean age 76.3±10.5 years). Morphological parameters of CI and cardiovascular risk factors were analyzed. RESULTS AND CONCLUSION: There were mean 2.7±1.5 CI lesions per patient in the main group: 47 (54.6%) patients had ≥3 lesions, 9 (10.5%) - 2 lesions and 30 (34.9%) - 1 lesion. The significantly higher frequency of cardiovascular risk factors was found in CI patients (arterial hypertension, diabetes mellitus, atrial fibrillation, tobacco smoking) while the adherence to prevention strategies was lower compared to patients without CI.

[GENUS ANELLOVIRIDAE VIRUSES IN CHRONIC LIVER DISEASE].

AIM: Viruses from genus Anelloviridae (TTV, TTMDV and TTMV) are small DNA viruses that are widespread in human popu- lation. Data on tissue tropism, cell localization and morphometry of anelloviruses are scarce. The purpose of this study was to determine the prevalence of TTV, TTMDV and TTMV in persons with liver disease and in healthy individuals, as well as electron-microscopic verification of Anelloviridae species. METHODS: Detection of anelloviral DNA was performed in serum samples from 203 patients with liver diseases of various etiology and 115 voluntary blood donors using PCR with primers allowing to differentiate TTV, TTMDV TTMV based on the length of amplified fragment. Histopathological and electron microscopic studies were performed for liver biopsy specimens from 203 patients with liver disease. RESULTS: High prevalence (70-90%) of all three anelloviruses in healthy individuals and patients with liver disease was demonstrated, with high frequency of triple TTV, TTMDV and TTMV infection (52.2-55.7%). Electron-microscopic study of liver biopsy specimens from TTMDV monoinfected patients gave a submicroscopic image of TTMDV virions with diameter 35.86 ± 2.04 nm. Electron microscopic studies confirmed the nature of liver damage in TTMDV monoinfection: accumulation of virus in the hepatocytes, significant cyropathy with enlightenment matrix of the cytoplasm and reduction of intracellula organelles involved in protein synthesis, portal and perivascular perisinusoidal fibrosis. TTV, TTMDV and TTMV virions were dentified in hepatocytes, confirming these viruses to be hepatotropic. CONCLUSION: Our results demonstrate that anelloviruses are lymphotropic viruses, individual genotypes of those might be hepatotropic and pathogenic to liver.

[The possibilities of laser Doppler flowmetry for the estimation of the intestine resection volume by the acute mesenteric ischemia].

The results of the surgical treatment of the acute mesenteric ischemia in 2 groups of patients were comparatively analyzed. The control group (n=52) experienced the traditional way and criteria of detecting the volume of intestinal resection (color and peristaltic activity, arterial pulsation). For the main group (n=57) the intraoperative estimation of the intestinal viability was performed with the help of laser Doppler flowmetry. As a result, the postoperative intestinal gangrene rate was 9.1% among patients of the main group, whereas the complication was registered among 48.6% of the control group. The main group of patients demonstrated the overall lower rate of postoperative complications in comparison with the control group: 67.6 and 40.9% (p=0.01), respectively. The same picture was for the lethality rate: 76.9 and 52.6% (p=0.03), respectively.

[Safety and efficacy of various regimens of heparin-mediated prevention of venous thromboses in patients with intracranial haemorrhage].

Analysed in the article is the incidence rate of the development of venous thromboembolic complications in a total of 79 patients presenting with various-aetiology intracranial haemorrhage in different regimens of heparin-mediated prevention. The authors have revealed that early (on day 2-4 after the onset of the disease) administration of preventive doses of heparin in patients with intracerebral and intracranial haematomas is a safe and efficient regimen, since it decreases the rate of venous thromboses in the system of the vena cava inferior and fatal thromboembolic complications as compared with a later term (on day 5 and more) of initiating heparin-mediated prevention.

[1H-NMR study of complex formation between the aromatic dye ethidium bromide and the single-stranded noncomplementary deoxytetranucleotide 5'-d(CpTpGpA) in aqueous solution]. / Issledovaniie kompleksoobrazovaniia aromaticheskogo krasitelia bromistogo etidiia s odnotsepochechnym nekomplementarnym dezoksi tetranucleotidom 5'-d(CpTpGpA) v vodnom rastvore metodom 1H IaMR -spektroskopii.

Complex formation between the aromatic dye ethidium bromide (3,8-diamino-6-phenyl-5-ethylphenanthridine) and the single-stranded noncomplementary deoxytetranucleotide 5'-d(CpTpGpA) in aqueous solution was studied by one- and two-dimensional 1H NMR spectroscopy (500 and 600 MHz). Complete assignments of proton signals from the deoxytetranucleotide 5'-d(CTGA) were made using 2D-TOCSY and 2D-NOESY spectra. The concentration dependences of proton chemical shifts of the tetranucleotide were measured at T = 298 K to determine the self-association constants of tetranucleotide molecules in solution. Due to a small probability of tetranucleotide duplex formation, the complexing of dye molecules with the monomer of the tetramer plays the main role in the equilibrium of the complex in solution, which makes it possible to analyze the specificity of interactions of the aromatic ligand with the single-stranded DNA. Different schemes of complex formation were examined, and equilibrium constants for the reactions and the limiting chemical shifts of dye protons in different complexes were determined. The relative content of different types of complexes was analyzed, and specific features of the dynamic equilibrium were revealed as a function of the dye-tetranucleotide concentration ratio. The analysis indicates a sequence-specific binding of ethidium bromide to the single-stranded oligonucleotide. The structures of 1:1 complexes of the dye with the single strand of the tetranucleotide that correspond to two most probable orientations of the dye chromophore in the pyrimidine-purine T-G-site of the tetramer base sequence were constructed using the calculated values of induced chemical shifts of ethidium bromide protons.