THE EFFECT OF PHOTODYNAMIC THERAPY AND PLATELET-ENRICHED PLASMA ON THE HEALING OF SKIN RADIATION ULCERS INFECTED BY STAPHYLOCOCCUS AUREUS. / VPLYV FOTODYNAMIChNOÏ TERAPIÏ TA ZBAGAChENOÏ TROMBOTsYTAMY PLAZMY NA PROTsESY ZAGOIeNNIa PROMENEVYKh VYRAZOK ShKIRY, INFIKOVANYKh STAPHYLOCOCCUS AUREUS.

OBJECTIVE: To determine in experiment the quality of healing of skin radiation ulcers infected with Staphylococcusaureus (S. aureus) under the photodynamic therapy (PDT) administration and the use of platelet-rich plasma (PRP). MATERIALS AND METHODS: The experiment was performed on 95 male WAG rats of 6 months of age, which were divided into three groups. Group 1 included animals in whom a skin radiation ulcers in the thigh area was simulated, followed by application of a 0.2 ml suspension of reference strain of S. aureus to its surface on the 7th day after irradiation. Group 2 included animals with S. aureus-infected skin radiation ulcers, in whom the PET was administered aday after infection contamination. Group 3 included animals with S. aureus-infected skin radiation ulcers, in whomthe PDT was administered a day after infection in the morning, and the PRP was manifold injected in periwound areain the afternoon. The skin with underlying soft tissues from the area of radiation damage were the material for morphological examination. The hematoxylin and eosin, picrofuxin according to van Gizon, Mallory staining wereapplied to micropreparations. A morphometric study was conducted. RESULTS: In animals with skin radiation ulcers, in whom the PDT was administered upon infection with S. aureus(group 2), compared with animals with simulated infected skin radiation ulcers without treatment (group 1), Theactivation (i.e. accelerating) of the healing occurred for the period from the 14th to the 52nd day of experiment dueto the active processes of wound cleansing from necrotized tissues, less pronounced inflammatory changes in thelesion, and active of appearance and maturation of granulation tissue, less pronounced hemodynamic, ischemic andalternative disorders in the dermis, hypodermis, muscle tissue surrounding the wound cavity, activation of proliferative processes in epithelial layer localized in the marginal parts of the wound. Formation of pathological (hypertrophic or keloid) scar of the skin was the result of healing of skin radiation ulcer infected with S. aureus. In animalswith radiation ulcers infected with S. aureus, in the case of PDT and PRP (group 3) the regenerative process wasdirected not only at accelerating the rate of healing, but also on restoration of original structure of the lost parts ofthe skin compared with only PDT administration (group 2). Acceleration of the healing of the infected skin radiation ulcer in animals of groups 2 and 3 was due to similar processes. CONCLUSIONS: Photodynamic therapy activates and accelerates the healing process of skin radiation ulcers infectedwith S. aureus and leads to formation of a pathological scar (hypertrophic or keloid). Healing of the infected S. aureusradiation ulcers occurs more actively upon the photodynamic therapy administration in combination with multipleperiwound injections of the platelet-enriched plasma, compared with only photodynamic therapy administration,and finishes with an organotypic regeneration and almost complete skin recovery.

TISSUE IMMUNE CELLS AND THEIR ROLE IN THE HEALING PROCESS OF INFECTED RADIATION ULCERS UNDER THE IMPACT OF PHOTODYNAMIC THERAPY (EXPERIMENTAL STUDY). / TKANYNNI IMUNNI KLITYNY TA ÏKh ROL' U PROTsESAKh ZAGOIeNNIa INFIKOVANYKh PROMENEVYKh VYRAZOK PRY VPLYVI FOTODYNAMIChNOÏ TERAPIÏ (EKSPERYMENTAL'NE DOSLIDZhENNIa).

OBJECTIVE: to study the effect of antibacterial photodynamic therapy (PDT) on the dynamics of tissue neutrophilic leukocytes CD18 and tissue macrophages ED1 in the tissues of infected radiation ulcer during the stages of sponta- neous healing and in the treatment of PDTMaterials and methods. Infected radiation ulcer was modeled by local X-ray irradiation of the rat thigh skin at a dose of 85.0 Gy, followed by applying to the surface of the ulcer bacterial suspension of S. аureus. PDT was performed using a «Barva-LED/630¼ photonic apparatus and a methylene blue photosensitizer. The effect of PDT on the state of cellular immunity was determined using an immunohistochemical method based on the quantitative indices of neutrophilic leukocytes CD18 and ED1 macrophages during the stages of healing of an infected radiation ulcer. RESULTS: In the course of spontaneous healing of the ulcer (control I), the dynamics of changes in the relative vo- lume of tissue neutrophil leukocytes CD18 and ED1 macrophages in the lesion zone, a decrease in the CD18 / ED1 index more than 2 times indicated that switching of the neutrophil response to macrophage occurred before 52nd days of observations. When infected with S. аureus X-ray (control II), the switching of the neutrophil response to the macrophage did not occur during the entire observation period. When using PDT in the case of S. аureus infected ulcer (experimental group), the decrease in the CD18 / ED1 index was determined from the 21st day of observation. CONCLUSIONS: The positive effect of the antibacterial PDT method of infected S. аureus radiation ulcers was manifes- ted by complete microbial decontamination of the wound, reduction of phases of the wound process, complete hea- ling of radiation ulcers.The use of PDT has led to the death of bacteria, a decrease in the number of neutrophilic leukocytes and an increase in macrophages in the lesion area, the switching of the neutrophilic response to the reaction of monocyte-macrophage cells in the early stages of healing.

Doppler-guided transanal hemorrhoidal dearterilization versus conventional hemorrhoidectomy for treatment of hemorrhoids - early and long-term postoperative results.

BACKGROUND: A variety of effective methods for treatment of hemorrhoids has been proposed. In recent years, there has been an increasing number of studies comparing transanal hemorrhoidal dearterilization (THD) and conventional hemorrhoidectomy (CH), but the focus of most studies has been about the early postoperative results. The data about long-term outcomes is still limited. We aimed to compare Doppler-guided THD and CH with regard to early and long-term postoperative results. METHODS: The conducted prospective research included 287 patients who underwent CH (167 cases) or Doppler-guided THD with mycopexy (120 patients) between November 2010 and December 2015. Information on hemorrhoidal stage, demographic data, presenting symptoms, complications, duration of hospital stay, postoperative pain, patients' satisfaction and follow-up were obtained. Statistical tests were performed by SPSS 19.0. RESULTS: There was no significant difference between the studied groups according to gender, mean age, preoperative prolapse, pain and pruritus, hemorrhoidal stage and postoperative complications. Preoperative bleeding was more frequent in THD group (p = 0,002). The mean visual analog scale (VAS) pain scores in CH and THD groups on days 1, 2 and 7 were 7.01 vs 5.03, 5.07 vs 2.98, 2.39 vs 0,57 (p = 0,000). Practically, there was no difference in VAS on day 30 and patients' satisfaction at the 18th month. Mean hospital stay was 5,13 (CH) and 3,38 days (THD), p = 0,000. The postoperative follow-up was between 18 and 78 months (mean 46 ± 16 months). During this stage, 5 patients (2,99%) in CH group required surgery for recurrence. In THD group, 3 patients (2,5%), all with 4th-degree hemorrhoids underwent additional procedures (p 0,802). CONCLUSIONS: Doppler-guided THD seems to be an efficient and safe option for treatment of hemorrhoids, related to lower postoperative pain and excellent, similar long-term outcomes compared to CH. For advanced grades of hemorrhoids, Doppler-guided THD could be a valuable alternative, but there is a need for patients' selection. TRIAL REGISTRATION: (retrospectively registered) researchregistry 3090 .

Photodynamic therapy effect on healing of radiation skin ulcer infected with pseudomonas aeruginosa. / VLIIaNIE FOTODINAMIChESKOI TERAPII NA ZAZhIVLENIE LUChEVOI IaZVY KOZhI, INFITsIROVANNOI PSEUDOMONAS AERUGINOSA.

OBJECTIVE: To reveal the effect of photodynamic therapy on the healing of experimental radiation skin ulcers infect ed with Pseudomonas aeruginosa. MATERIALS AND METHODS: The infected radionuclide was modeled by local X ray irradiation of the rat's hip skin at a dose of 85.0 Gy, followed by the application of Pseudomonas aeruginosa bacterial suspension to the surface of the ulcer. Photodynamic therapy (CTD) was performed with the help of a photon apparatus «Barva LED/630¼ and a photosen sitizer of methylene blue. The effect of PDT on the rate and quality of healing of an infected radionuclide was deter mined by comparing the histological and morphometric study of skin from the region of ulcer in animals from the control and treated groups of PDT. RESULTS AND CONCLUSIONS: The presence of Pseudomonas aeruginosa in the radiation sickness caused an increase in the area of the wound cavity compared with the non infected radionuclide and to a significant inhibition of its healing processes. The addition of the infection factor reduced the activity of the reparative processes in the radiation sick ness by 20 % compared with the uninfected. The effect of photodynamic therapy contributed to complete healing on average one month earlier than in control groups.

[Genetic and clinical characteristics of 22q11.2 deletion syndrome].

In a group of 140 patients with typical phenotype, the 22q11.2 microdeletion was detected in 43 patients (32%) using FISH and MLPA methods. There were no deletions of other chromosomal loci leading to phenotypes similar to the 22q11.2 deletion syndrome (22q11.2DS). Sequencing of the TBX1 gene did not detect any mutations, except for some common neutral polymorphisms. For the first time in the Russian Federation, the diagnostic efficiency of 22q11.2DS appeared to be 32%, as a result of the application of a combination of genetic approaches for a large group of patients with suspected 22q11.2DS.

Advantages of transanal hemorrhoidal dearterialization as compared to other surgical techniques for the treatment of hemorrhoidal disease.

UNLABELLED: Transanal hemorrhoidal dearterialization (THD) is a new surgical technique used for the treatment of hemorrhoidal disease. It is known for its easy performance and low perioperative risk. 44 patients have been operated by this method at the Clinic of General, Liver and Pancreatic Surgery for a period of 22 months. A comparative analysis was performed between the postoperative results with the use of transanal hemorrhoidal dearterialization, modified hemorrhoidectomy of Milligan-Morgan, and Whitehead's hemorrhoidectomy. CONCLUSIONS: When comparing transanal hemorrhoidal dearterialization with other methods, we found that it has an excellent aesthetic effect, requires shorter hospital stay and less analgesics, and causes less discomfort in the postoperative period.

Oxidative destruction of chlorinated hydrocarbons on Pt-containing fiber-glass catalysts.

Novel catalysts comprising noble metals (Pt), supported on fiber-glass woven materials demonstrated efficient oxidation of different chlorinated hydrocarbons (chlorobenzene, dichloroethane, dichloropropane,butyl chloride) and industrial mixed chlorinated organic wastes into HCl, CO2 and H2O at moderate temperatures without formation of highly toxic by-products (dioxins, phosgene, polychlorinated hydrocarbons,elemental chlorine). The highest oxidation activity and selectivity was observed for the platinum catalysts produced from fiber-glass supports with increased acidity and with additional introduction of promoting elements (such as Co, Mn and Cu). Long-term tests (more than 100 h) have shown no deactivation of the said catalysts. In combination with competitive catalyst price (due to the extra-low content of Pt--below 0.05% mass) it opens the way for development of highly efficient and feasible technology for utilization and detoxication of various chloro-organic wastes.

[The quality of life of patients with oncological gynecological pathology during period of involution].

The representative group of women older than 40 years with oncological gynecological pathology during involution period was examined. Quality of life of these patients and their attitude to their health as well was studied during various rehabilitation periods of the course of this disease. Survey was applied using questionnaire MOS-SF 36 Health Survey 2.0 with subsequent statistical data processing. The results can be applied to enhance effectiveness of preventive activities in gynecology and practical and research medicine.

[On prevention of oncological involutory complications].

Actual issues of modem medicine meeting basic directions of reformation of national public health system and enhancement of preventive services to female patients of various age groups are considered. Actual information on development of oncological gynecological diseases in women with complicated involutional period is included. Possibility in getting new data on risk factors in women with involutional period for the purpose of health promotion in women of reproductive age and of enhancement of life quality during involutional period is surmised. Prospective and effective pattern of primary prevention of oncological gynecological involutional pathology is proposed to be implemented in practice of public health cervices as standardized normative document.

[Hygienic rationale for diagnosis and correction of excessive body weight in schoolchildren with physical training]. / Gigienicheskoe obosnovanie diagnostiki i korrektsii izbytka massy tela u shkolnikov sredstvami fizicheskogo vospitaniia.

The results have shown that schoolchildren with moderate body mass (M +/- 0.3 sigma) have the highest physical capacity for work (PWC 170/kg) and schoolchildren with body mass from M + 0.3 to M + 1 sigma show a decrease by 20% and with an excessive body mass M + 1.75 sigma by more, about 40%. Bearing in mind this rough drop of capacity to work and the significant aggravation of functional state with an excessive body mass M +/- 1 sigma we consider that limitation of body mass standard by limits M +/- 0.67 sigma is advisable. The studies showed the high efficiency of exercises of cyclic nature (swimming, running, skiing, bicycle) with a view to correcting disorders due to obesity.

[Social aspects of the problem of suppurative surgical diseases]. / Sotsialnye aspekty problemy gnoinykh khirurgicheskikh zabolevanii.

The case records of 259 patients with purulent surgical diseases are analysed. The following social groups of patients were distinguished; students--10.4%, office workers--20.5%, factory and agricultural workers--35.9%, lonely pensioners, invalids, and homeless persons--33.2%. The last named group is least socially protected, and the diseases in these cases have a characteristic course and outcomes. In the groups of students and office workers the disease is predominantly marked by the formation of abscesses with rapid resolution after an operative intervention. In the socially unprotected group with somatic diseases, poor nutrition, and absence of care, the purulent process takes a phlegmanous course calling for the use of antibiotics and immunostimulators. The percentage of rehospitalization among these patients is high (up to 20%) due, in many respects, to social factors.

[The use of highly adsorbent albumin in severe endogenous intoxication]. / Primenenie al'bumina povyshennoi sorbtsionnoi emkosti pri tiazheloi éndogennoi intoksikatsii.

The efficacy of albumin pretreated on carbohydrate adsorbents as a means of sorption detoxication was assessed in experimental postresuscitation toxemia and burn-induced trauma complicated by endogenous intoxication. It has been established that the use of highly effective "Albosorb" prevented the onset of intoxication in the early period of experimental pathologies by increasing binding protein capacity, and namely that of animal plasma albumin, to various types of ligands.

[Hygienic substantiation of physical load standards in physical education of schoolchildren]. / Gigienicheskoe obosnovanie normativnykh trebovanii k nagruzkam pri fizicheskom vospitanii shko'lnikov.

The research specific to the changes in body functioning under the effect of various loads of cyclic character was carried out. The results thus obtained made it possible to analyze sex- and age-specific characteristics of body functional capacities of schoolchildren aged 6-15 (yearly characteristics). It was pointed out that by 13-14 years the schoolchildren, primarily girls, lost some of their adaptation capacity to physical load. The problem could be solved due to additional physical training activities aimed at the development of endurance, the trait being of primary importance for health promotion in schoolchildren.