[X-ray-surgery of diverticular disease complicated by abscess formation]. / Rentgenokhirurgiia divertikuliarnoi bolezni, oslozhnennoi abstsedirovaniem.

PURPOSE: Show the possibility of an alternative use of interventional radiology techniques in complex treatment of patients with inflammatory complications of the diverticular disease of the colon. MATERIAL AND METHODS: In 2012-2016, there were 87 patients under our supervision with complicated diverticular disease. In 57 (65.5%) cases were diagnosed infiltrate, in 24 (27.6%) cases - abscess of paracolon area (Ib-II type by Hinchey), in 6 (6.9%) cases (III-IV type according Hinchey) generalized peritonitis have been identified. RESULTS: Emergency laparotomy was performed in 13 patients. Abscesses of paracolon (Ib-II type by Hinchey) area were diagnosed sonographically during the initial examination in 17 patients. 26 percutaneous drainage of diverticulogenous abscesses of different localizations self-locking drainage #8Fr 'pig tail' was carried out under the combined ultrasonic and X-ray control in this group of patients. The technical success of percutaneous drainaging of the abscesses was achieved in all manipulations. 13 patients had a single drainaging, and for diverticular disease - disease-free during the observation period of 1 year to 5 years. Resection of the colon in a planned manner after percutaneous drainage of recurrent abscess of paracolon area was performed in 4 patients. Complications related with the technique of installing drainage were not reported, mortality in the group of drained patients was absent. CONCLUSION: Ultrasound examination of patients with suspected inflammatory complications of diverticular disease - a necessary and sufficient method for initial diagnosis of the disease. Percutaneous drainage of diverticulogenous abscesses (Hinchey Ib-II) is represented by the pragmatic 'first line' choice in patients with complicated diverticular disease, that allows to treat the pathology steadfastly in most of the cases.

[Percutaneous cholangiostomy for portal cholangiocarcinoma]. / Chreskozhnaya kholangiostomiya pri vorotnoi kholangiokartsinome.

AIM: to analyze the efficacy of interventional methods in treatment of Klatskin tumor patients. MATERIAL AND METHODS: Treatment of 133 patients with Klatskin tumor for the period 2000-2015 was analyzed. Bismuth I type was revealed in 28 (21.1%) cases, type II  - in 45 (33.8%) cases, type III - in 51 (38.3%) cases, type IV - in 9 (6.8%) cases. All patients underwent sonofluoroscopy-assisted percutaneous transhepatic cholangiostomy using self-fixing Pig tail 8Fr drains at the first stage followed by externointernal drainage or antegrade biliary stenting. We deployed 1-6 drains simultaneously or step by step depending on severity of biliary occlusion. RESULTS: Technical success was achieved in all patients. Major postoperative complication such as drain dislocation followed by advanced biliary peritonitis was observed in 1 (0.8%) case. Minor complications occurred in 22 (16.5%) patients. In-hospital mortality was 7.5% (10 patients). The cause of death was severe liver-renal failure. Liver abscesses occurred in 13 patients after transpapillary externointernal drainage on background of temporary occlusion of biliary drain. This required interventional surgery. CONCLUSION: Obstructive jaundice management should be performed using interventional techniques simultaneously or step by step if unresectable tumor or inoperable patient are present. Herewith it is advisable to restore bile flow in maximal volume of liver parenchyma. Use of uncovered self-expanding biliary stents for palliative treatment of Klatskin tumor may be realized in «hybrid¼ variant to control stent patency as well as for neoadjuvant therapy of tumor.

[Structural and thermodynamic analysis of conformational states of self-complementary deoxyhexanucleotides 5'-d(GpCpApTpGpC) and 5'-d(GpCpTpApGpC) in aqueous solution].

The conformational states of the self-complementary deoxyhexanucleotides d(GCATGC) and d(GCTAGC) capable of forming hairpin structures in aqueous solution have been studied by one- and two-dimensional 1H NMR spectroscopy and molecular dynamics simulations. The equilibrium thermodynamic parameters of the formation of duplex and hairpin forms have been determined, and the spatial structures of the d(GCATGC) and d(GCTAGC) conformers have been calculated. A comparative analysis of the thermodynamic and conformational parameters of self-association has been made. The molecular dynamics of the hexamer forms in the nanosecond time scale has been studied, and the mobility of their structural constituents has been evaluated. Possible reasons for the observed distinction in the thermodynamic stability of duplex and hairpin forms of the deoxyhexanucleotide sequences are discussed.

[Distinctive features of the self-association of deoxyhexanucleotide 5'-D(GpCpApTpGpC) in aqueous solution: 1H NMR analysis]. / Osobennosti protsessa samoassotsiatsii molecul dezoksigeksanukleotida 5'-D(GpCpApTpGpC) v vodnom rastvore: 1H-IAMR-analiz.

The self-association of self-complementary deoxyhexanucleotide d(GCATGC) was investigated in aqueous salt solution. Homonuclear 1H NMR correlation spectroscopy (2D-TOCSY and 2D-NOESY) was used for complete assignments of nonexchangeable protons of the hexamer. The equilibrium reaction constants and thermodynamical parameters of duplex d(GCATGC)2 formation were determined from experimental concentration and temperature dependences of proton chemical shifts of the deoxyhexanucleotide. Distinctive features of the concentration dependences in the range of small concentrations at relatively low temperatures of solution enable one to assume that one single-stranded hexamer sequence forms a compact structure (similar to a hairpin) in aqueous solution. A possible spatial hairpin structure of the hexamer was proposed. Comparative analysis of the experimental and theoretical (using the "nearest neighbor" model) thermodynamical parameters of duplex formation was made.

[NMR study of complex formation of aromatic ligands with heptadeoxynucleotide 5'-d(GCGAAGC) forming stable hairpin structure in aqueous solution]. / IaMR-analiz kompleksoobrazovaniia aromaticheskikh ligandov s dezoksigeptanukleotidom 5'd(GCGAAGC), obrazuiushchim stabil'nuiu shpilechnuiu strukturu v vodnom rastvore.

Complex formation of hairpin-producing heptadeoxynucleotide 5'-d(GCGAAGC) with aromatic molecules: acridine dye proflavine and anthracycline antibiotic daunomycin was studied by one-dimensional 1H NMR and two-dimensional correlation 1H-1H (2M-TOCSY, 2M-NOESY), 1H-31P (2M-HMBC) NMR spectroscopy (500 and 600 MHz) in aqueous solution. Concentration and temperature dependences for the chemical shifts of ligand protons were measured, molecular models of equilibrium in solution were developed, and equilibrium thermodynamic parameters for the formation of intercalation complexes were calculated. Spatial structures of dye and antibiotic complexes with the heptamer hairpin were constructed on the basis of 2M-NOE data and the calculated values of limiting chemical shifts of ligand protons.

[Analysis of complex formation of daunomycin with the deoxyhexanucleotide 5'-d(TpApCpGpTpA) in an aqueous solution from NMR-spectroscopy data]. / Analiz kompleksoobrazovaniia daunomitsina s dezoksigeksanukleotidom 5'-d(TpApCpGpTpA) v vodom rastvore po dannym IaMR-spektroskopii.

Self-association of hexadeoxynucleotide 5'-d(TpApCpGpTpA) and its complexation with antitumor antibiotic daunomycin were studied by one- and two-dimensional homonuclear 1H NMR spectroscopy and heteronuclear 1H-31P NMR spectroscopy in water-salt solution. The concentration and temperature dependences of proton chemical shifts of the hexadeoxynucleotide and the ligand were measured, and equilibrium constants and thermodynamic parameters of corresponding reactions were calculated on this basis using models for the formation of hexadeoxynucleotide duplex and its complex with the antibiotic. The spatial structure of daunomycin-d(TACGTA)2 complex in solution was calculated using X-PLOR software on the basis of 2D NOE spectral data and the limit values of proton chemical shifts of the ligand. Comparative analysis of different intermolecular interactions in sequence-specific binding of the antibiotic to the DNA fragment was carried out.

[Study of the complex formation of daunomycin with deoxytetranucleotides with bases of differing sequence in an aqueous solution by 1H-NMR spectroscopy]. / Issledovanie kompleksoobrazovaniia daunomitsina s dezoksitetranukleotidami razlichnoi posledovatel'nosti osnovanii v vodnom rastvore metodom 1H-IaMR-spektroskopii.

The complex formation of the antibiotic daunomycin with deoxytetranucleotides of different base sequence in the chain, 5'-d(GpCpGpC), 5'-d(CpGpCpG), and 5'-d(TpGpCpA) in aqueous salt solution was studied by 1D and 2D (2M-TOCSY and 2M-NOESY) 1H-NMR spectroscopy. Concentration and temperature dependences of proton chemical shifts of molecules were measured. Based on these dependences, reaction equilibrium constants, relative content of various complexes depending on concentration and temperature, limiting values of chemical shifts of protons of daunomycin incorporated in various complexes, and the thermodynamic parameters delta H and delta S of complex formation were calculated. The analysis of the results enables the conclusion that the sites of predominant intercalation of daunomycin are triplet nucleotide sequences, the binding sites of the antibiotic with three consecutive GC pairs in the tetranucleotide duplex being more preferential. Daunomycin exhibits no sequence specificity upon binding to the single-stranded deoxynucleotide sequence. From the calculated values of induced chemical shifts of daunomycin protons and 2M-NOE data, the most probable spatial structures of complexes (1:2) of the antibiotic with deoxytetranucleotides were constructed. The binding of the second daunomycin molecule to both the single-stranded and duplex form of tetramers is of pronounced anticooperative mode, which is explained by the presence in the antibiotic of a positively charged amino sugar residue, which poses considerable steric constraints for the insertion of the second antibiotic molecule into the short tetranucleotide sequence. The results were compared with the data obtained under identical experimental conditions for typical intercalators proflavine and ethidium bromide.

[1H-NMR analysis of heteroassociation of caffeine with antibiotic actinomycin D in the aqueous solution]. / 1H-IaMR analiz geteroassotsiatsii kofeina s antibiotikom aktinomitsinom D v vodnom rastvore.

The molecular basis of the action of caffeine as a complex forming agent, an interceptor of aromatic drugs intercalating into DNA was studied by the example of the an anticancer antibiotic actinomycin D examined. The hetero-association of caffeine and actionomycin D was studied by one- and two-dimensional 1H-NMR spectroscopy (500 MHz). Concentration and temperature dependences of the proton chemical shifts of molecules in aqueous solution were measured. The equilibrium reaction constant of hetero-association of caffeine with actinomycin D (K = 246 +/- 48 M-1), the limiting chemical shifts of caffeine protons in complexes were determined. The most favourable structure of the 1:1 caffeine-actinomycin D hetero-complex in aqueous solution was constructed using the calculated values of the induced proton chemical shifts of molecules and the quantum-mechanical iso-shielding curves for caffeine and actinomycin D. The thermo-dynamical parameters of the hetero-complex formation between caffeine and actinomycin D were also determined. The structural and thermo-dynamical analysis showed that dispersive forces and hydrophobic interactions play the major role in hetero-association of caffeine and actinomycin D in aqueous-salt solution. The relative content of different complexes in mixed solutions containing caffeine and actinomycin D was calculated and distinctive features of the dynamic equilibrium of caffeine-actinomycin D hetero-associates were revealed as a function of concentration and temperature. It is concluded that hetero-association of caffeine and actinomycin D molecules a lowers the effective concentration of the drug in solution and hence the pharmacological activity of actinomycin D.

[Study of self-association of molecules of deoxyhexanucleotides 5'-d(CpGpTpApCpG) and 5'-d(CpGpCpGpCpG) in water solutions by NMR]. / IaMR-issledovanie samoassotsiatsii molekul dezoksigeksanukleotidov 5'-d(CpGpTpApCpG) i 5'-d(CpGpCpGpCpG) v vodnom rastvore.

The self-association of deoxyribohexanucleoside pentaphosphates 5'-d(CpGpTpApCpG) and 5'-d(CpGpCpGpCpG) in aqueous salt solutions was studied by 1 D- and 2 D homonuclear PMR and heteronuclear 1H-31P-spectroscopies. Signals from nonexchangeable protons of hexamers in NMR spectra were assigned using the available 2M-TOCSY, 2M-NOESY, and 1H-31P-(HMBS) spectra. The dependences of proton chemical shifts of deoxyhexanucleotides on concentration and temperature were measured. In terms of the two-states model (monomer-duplex), constants and thermodynamic parameters of self-association of hexamer molecules in solution were obtained based on these dependences. The values obtained correlate well with theoretical values calculated using the model of the "nearest neighbor" for the formation of duplexes of sequences d(CGTACG) and d(CGCGCG).

[Decrease of incidence of chromosome aberrations after a course of hyperbaric oxygenation]. / Snizhenie chastoty khromosomnykh aberratsii posle kursa giperbaricheskoi oksigenatsii.

The influence of the course of hyperbaric oxygenation (HBO) on the peripheral blood lymphocytes chromosomes of 7 patients with different pathology and of 3 healthy volunteers was studied. It is proved that after HBO course the frequency of chromosome, aberrations of chromatid type hasn't been practically changed whereas the frequency of aberrations of chromosome type significantly decreases by three times on the whole.

[The isolation of the contribution of the parenchyma to the radionephrogram and the assessment of kidney purifying function]. / Vydelenie vklada parenkhimy v radionefrogrammu i otsenka ochistitel'noi funktsii pochek.

The authors described the principle and algorithms of the separation of a summary radionephrogram into constituents, reflecting the contribution of a radiopharmaceutical, uptaken by neutrons, and RP in the surrounding tissues. The authors proposed a correct method for estimation (using the first constituent) of the efficacy indicator of RP uptake by the kidneys (Q-parameter) and the indicator of the mean time of transit (t) in the kidneys of RP uptaken by their parenchyma. The results of testing of the proposed methods of Q and t calculation were presented. Values of these parameters were determined in health and in essential hypertension, I and II degree, pyelonephritis, chronic nephritis (latent and hypertensive types), stenosis of the renal artery, obstruction of the upper urinary tracts, and in one kidney. These results indicate the physiological adequacy of the employed mathematical models, proving the diagnostic informative value of the calculated indicators.

[Hyperbaric oxygenation in neutralizing lipid peroxidation reactions and stabilizing cell membranes]. / Giperbaricheskaia oksigenatsiia v neitralizatsii reaktsii perekisnogo okisleniia lipidov i stabilizatsii kletochnykh membran.

A study of the cardiac ejection, peripheral tissue oxygen utilization, changes of lipoprotein cholesterol concentration, radical and antioxidant activity of blood plasma under the effect of hyperbaric oxygenation revealed that hyperbaric oxygenation stabilizes the cell membranes increasing the functional capacities of cells and organs manifested in an enhancement of the oxidation-reduction processes in the tissues, increase of the cardiac ejection and initially reduced concentrations of high-density lipoprotein cholesterol.

[The choice of the individual mode of hyperbaric oxygenation in treating patients with ischemic heart disease]. / Podbor individual'nykh rezhimov giperbaricheskoi oksigenatsii pri lechenii bol'nykh ishemicheskoi bolezn'iu serdtsa.

Analysis of HBO use in 287 CHD patients has shown that individual HBO regimens can be selected both by an increase in tissue pO2 in response to a HBO session and by an initial type of patients' blood circulation.

[Increasing the effectiveness of hyperbaric oxygenation in the treatment of patients with stage IV arterial occlusive diseases of the lower limbs]. / Povyshenie èffektivnosti giperbaricheskoi oksigenatsii pri lechenii bol'nykh s IV stadiei oblteriruiushchikh zabolevanii arterii nizhnikh konechnostei.

An analysis of treatment of 122 patients has shown that the effectiveness of HBO can be enhanced by a combination with continuous intraarterial infusions and lumbar sympathectomy. An important condition for reaching the maximum effect of HBO is an increase of the initially low cardiac output in such patients.