[The alternative way of colorectal cancer developing. The histogenetic and molecular features of serrated lesions (review, continued)].

The occurrence of colorectal cancer can be traced in two ways: from conventional adenomas with the APC-gene mutation (model Fearon-Vogelstein) and the "serrated way", that has a unique genetic profile and morphological characteristics at the early stages. These neoplasms are determined from 7 to 9%. The risk of developing cancer of them is 7.5-15%. Precursors of epithelial neoplasia are aberrant crypts foci. About 20% of colorectal cancer demonstrated the common defects in DNA methylation (CIMP-positive profile), mutations BRAF (KRAS)--oncogenes, microsatellite instability (MSI). The serrated lesions may have these mutations. Serrated polyposis syndrome has specific genetic changes associated with biallelic mutation MUTYH also. Risk of colorectal cancer is very high in this syndrome and is more than 50%. Often the synchronous or metachronous cancers presence. They are usually accompanied by MSI-H and represented serrated morphology too. Understanding epigenetic ways and molecular features of serrated lesions gives an knowledge of their clinical significance and provides the evidence for the treatment and monitoring of patients with this disease. This review is devoted to these issues.

[Blood microcirculation disorder in patients with bronchopulmonary diseases and methods of microcirculation study].

AIM: To investigate microhemocirculation in patients with bronchopulmonary pathology with application of Doppler flowmetry (DFM). MATERIAL AND METHODS: Videobronchoscopy (Olimpas or Pentax devices) was performed in 203 patients with bronchitis of different inflammation intensity: Functional activity of microhemocirculation in bronchial mucosa was studied with endobronchial laser Doppler flowmetry (LDF) which was also made in 20 healthy controls. RESULTS: LDF-grams demonstrated that patients with chronic bronchitis and pneumonia have congestive regional microcirculation with low activity of components of microcirculatory bed, venous blood congestion, weak blood flow and tissue ischemia. High informative value of the method and its availability was shown by comparison of LDF-grams on treatment day 7 and 14. CONCLUSION: High informative value of LDF procedure is found in diagnosis of vascular and intravascular microcirculatory disorders in patients with bronchopulmonary pathology.

[Modern aspects of photodynamic therapy of esophageal].

This review presents the current possibilities of photodynamic therapy in the treatment of precancerous lesions and cancer of the esophagus. Mechanisms of photodynamic effects on tumor and especially the accumulation of photosensitizer in tumor tissue, results of studies on the use of photodynamic therapy in the treatment of early esophageal cancer, esophageal cancer stenosis and combinations with other treatment techniques. Results of treatment of Barrett's esophagus using photodynamic therapy were analyzed and a compared with other methods of treatment.

[Application of air-plasma flow for the correction of microcirculation disorders during the treatment of diabetic foot syndrome].

Analysis of data on the treatment of 100 patients with purulent-necrotic forms of diabetic foot syndrome is presented. Patients were divided into two groups. In the first group (45 patients) treatment was conducted using traditional methods and techniques. In the second group (55 patients) during operation air-plasma cutting-coagulation device "Plazon" was used in NO-therapy mode. Nitric monoxide is known as multifunctional antioxidant substance, having great value in oxidative stress reactions. In the current study it was transported to the wound surface by air-flow of "Plazon" device. The condition of microcirculation in tissues was studied by computerized laser capillary flow analyzer "LAKK-01". It was shown that after removing inflammation in the healed wound, condition corresponding to characteristics of undamaged skin takes place in contrast to the patients from the group 1, where some asymmetry in the foot tissues microcirculation was shown as an evidence of functional and structural insufficiency of microcirculation system.

[Photodynamic therapy and exogenous nitric oxide in combined treatment of purulent wounds of the soft tissues]. / Fotodinamicheskaia terapiia i ékzogennyi oksid azota v kompleksnom lechenii gnoinykh ran miagkikh tkanei.

Results of treatment of 160 patients with purulent wounds of the soft tissues treated with photodynamic therapy and exogenous nitric oxide were analyzed. High efficacy of this method is demonstrated: clinical course of the disease improves, period of wounds healing and hospitalization reduces. Photodynamic therapy in combination with exogenous nitric oxide results in rapid repair of microcirculation, stimulation of phagocytosis, accelerates cleaning of wounds, activates macrophagal reaction, fibroblast proliferation and epithelium regeneration that is in stimulation of reparation.

[Experimental study of photodynamic effect on bacterial wound microflora]. / Fotodinamicheskoe vozdeistvie na bakterial'nuiu mikrofloru v éksperimente.

The in vitro study of the influence of photodynamic action (with the use of photosensitizer "Photosens", laser and non-laser irradiation) on the strains of the main representatives purulent wound microflora was carried out. Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis cultures have been isolated from wound secretions and identified. The photosensitizer was shown to produce no bactericidal effect by itself. Irradiation with laser and non-laser light sources induced a sharp decrease in the number of viable cells in the cultures under study. The irradiation of the photosensitizer led to its activation, manifested in bactericidal action. The results thus obtained confirm good prospect of using photodynamic therapy for the treatment of purulent wounds.

[Clinical features, diagnosis and treatment for trophic, late radiation ulcers and ulcers undergone malignant transformation]. / Klinika, diagnostika i lechenie ozlokachestvlennykh, troficheskikh i pozdnikh luchevykh iazv.

Clinical and histological examinations of 1562 patients with trophic and advanced radiation ulcers were carried out during 30 years. Malignant transformation of the ulcers has been revealed in 14 of them: sarcoma--in 1, and cancer--in 13. From all the patients with advanced radiation ulcers, malignant transformation was detected in 7.07%, and in cases of ulcers of the other genesis--in 0.81% of cases. Malignant transformation of ulcers of non-radiation genesis occurs on the average after 19 years, and of radiation one--after 3.8 years. Early diagnosis of skin cancer, at the site of the ulceris rather difficult and depends thoroughly on oncological alert and timely morphological examination of various skin areas. A new, rather perspective and relatively simple method of treatment for ulcerative forms of cancer of the skin is photodynamic therapy (PhDT). This method showed to be effective even in those patients who failed conventional methods of treatment (relapses), or had contraindications. PhDT has broaden the armory of the oncologists and oncodermatologists for treatment of complicated forms of cancer of the skin.