IMPROVEMENT OF THE MODEL OF PREVENTION OF MALIGNANT NEOPLASM OF THE GASTRIC.

The fight against malignant neoplasms is one of the most important problems of health care in Ukraine; its relevance is due to the continuous growth of oncological morbidity in the population, the complexity of timely diagnosis and treatment, high cost, as well as quite high levels of disability and mortality of such patients. Gastric cancer, which remains one of the most common and deadly neoplasms in the world, occupies one of the leading positions among cancer. Aim - scientifically substantiate and develop a model for improving the organization of prevention of malignant neoplasms of the gastric. A study of performance indicators of oncology health care facilities and a survey of respondents was conducted: 180 respondents of patients with gastric cancer and precancerous diseases of the stomach using medical-statistical, sociological methods and questionnaires. A functional and organizational model for improving the prevention of malignant neoplasms of the stomach has been scientifically substantiated and developed. The features of the proposed model were the inclusion in it, in addition to the previously existing, innovative elements (an algorithm for early diagnosis and prevention of negative consequences of malignant neoplasms of the stomach at the level of primary medical care, reminders for primary medical care doctors regarding monitoring of risk factors and predictors of malignancy of precancerous stomach diseases, the allocation of a dynamic monitoring group due to the increased risk of precancerous gastric diseases becoming oncological), as well as previously existing, but functionally changed components (optimization of the functions of the primary care physician in relation to the information provision of the patient and his relatives; monitoring of risk factors for precancerous and cancerous stomach diseases, control and accounting for the implementation of the recommendations of specialist doctors and rehabilitation specialists), the interaction between which provided the model with a qualitatively new focus on achieving its strategic goal - preventing the occurrence and progression of the development of malignant neoplasms of the gastric. The proposed functional and organizational model will lead to a positive medical and social effect for the improvement of the organization of the prevention of gastric cancer in the main areas: systematicity, comprehensiveness and preventive direction. Its implementation will lead to an increase in early detection, coverage of dynamic monitoring of patients, as well as a projected economic effect due to a decrease in the specific weight of neglected forms of gastric cancer, improvement in survival and reduction in mortality.

FEATURES OF GRANULATION TISSUE MORPHOLOGY AROUND THE NET ALLOTRANSPLANT WHEN APPLYING POSTOPERATIVE RADIATION THERAPY.

The aim of the research was to study experimentally the morphologic peculiarities of the granular tissue around the elements of the reticular allotransplant of the muscular aponeurotic layer of the anterior abdominal wall when using postoperative distant gamma therapy. The experiment has been done on 168 laboratory rats which were implanted with a prolenic mesh allograft into the tissues of muscular aponeurotic layer of the anterior abdominal wall. From the 13th to 19th day after the implantation of the reticular allograft, animals from the main group (96 rats) received irradiation of the site of the last one. Taking of the biological material was carried out on the 20th, 30th, 40th and 50th day after surgery. For optical research at histological examination the samples of biopsy were fixed in 10% neutral formalin. Paraffin sections were stained with hemotoxylin and eosin. To identify collagen fibres the method of histological sections' coloring was applied. The results of the research indicate that the use of distant gamma therapy after reticular allotransplant implantation leads to uneven maturation of the granulation tissue, its edema, probable decrease in the percentage of fibroblasts, increase of lymphoid cells as well as the appearance of plasma cells and macrophages on the 40th and 50th days of observation. At the histologic sections coloring with aquious blue-chromotrope B2, there is a predominance of the specific volume of collagen fibers and an increase in the specific volume of blood vessels on the 50th day of observation. Thus, the use of the postoperative radiotherapy at the plasty of the anterior abdominal wall with a reticular allograft leads to the distortion of the maturation process of the granular tissue, its edema, which shows itself in the probable reduction in the percentage of fibroblasts, increase in lymphoid cells, appearance of plasma cells and macrophages as well as prevalence of specific volume of collagen fibres, increase in the specific volume of vessels.