The role of intraoperative angiography in treating acute lower limb artery occlusion.

Objective: Aim: To compare the results of surgical treatment of patients with acute lower limb artery occlusion with and without intraoperative angiography..

Patients And Methods: Materials and Methods: Comparative analysis was conducted on the surgical treatment outcomes of 119 patients with acute lower limb artery occlusion treated at the Vascular Surgery Center of the Clinical Hospital ≪Feofaniya≫ State Administrative Department from 2017 to 2022.

The rejection that defies antirejection drugs-chronic vascular rejection (allograft vasculopathy): The role of terminology and linguistic relativity.

While allograft loss due to acute rejection has been dramatically reduced due to the introduction of immunophilins, this therapy has little effect on allografts lost due to chronic vascular rejection. This situation may be due to a misnomer of the pathology. Specifically, its designation as 'chronic rejection' has given the wrong impression that the cause of the disease has been identified.

The impact of inhalation versus total intravenous anesthesia on the immune status in patients undergoing breast cancer surgery: a double-blind randomized clinical trial (TeMP).

Background: Breast cancer (BC) mortality primarily stems from metastases rather than the primary tumor itself. Perioperative stress, encompassing both surgical and anesthetic factors, profoundly impacts the immune system, leading to alterations in neuroendocrine pathways and immune functions, potentially facilitating tumor progression and metastasis. Understanding the immunomodulatory effects of different anesthesia techniques is crucial for optimizing perioperative care in patients with BC.

Sevoflurane multiple Wash In/Wash Out at the end of anesthesia to reduce agitation: A multicenter double-blind randomized controlled trial.

Background: Postoperative agitation is common after non-cardiac surgery. It is associated with postoperative delirium and cognitive dysfunction, leading to prolonged hospital stay and delayed social readjustment. Prevention and treatment strategies are lacking.

STUDY OF THE HEMOMICROCIRCULATORY CHANNEL IN PATIENTS WITH DIABETES AND THREATENING ISCHEMIA OF THE LOWER LIMB.

Purpose of work - to investigate the hem microcirculatory channel (HCMC) in chronic critical lower extremity ischemia (CHLIC) in patients with diabetes mellitus (DM). To develop a method for calculating the indicator of the degree of diabetic microangiopathy (PSDMAP). Skin and muscle samples of 63 patients with type 2 diabetes mellitus with CKD and skin and muscle samples of 30 patients without systemic diseases.

Aquatic Ferrous Solutions of Prebiotic Mineral Salts as Strong UV Protectants and Possible Loci of Life Origin.

Liposomes are lipid-bilayer vesicles that spontaneously self-assemble from fatty acids (or other amphiphiles) in water by encapsulating surrounding aqueous media. After British scientist Alec Bangham described this phenomenon in the early 1960s, they became a prominent participant in the hypotheses on life origin, particularly in the Lipid World model. A novel scenario of self-sustained Darwinian liposome evolution is based on ever-present natural phenomena of cyclic day/night solar UV radiation and gravitational submersion of liposomes in the Archean aqueous media.

Exploring the Lipid World Hypothesis: A Novel Scenario of Self-Sustained Darwinian Evolution of the Liposomes.

According to the Lipid World hypothesis, life on Earth originated with the emergence of amphiphilic assemblies in the form of lipid micelles and vesicles (liposomes). However, the mechanism of appearance of the information molecules (ribozymes/RNA) accompanying that process, considered obligatory for Darwinian evolution, is unclear. We propose a novel scenario of self-sustained Darwinian evolution of the liposomes driven by ever-present natural phenomena: solar UV radiation, day/night cycle, gravity, and the formation of liposomes in an aqueous media.

Short-course neoadjuvant in situ vaccination for murine melanoma.

Background: Surgical resection remains an important component of multimodality treatment for most solid tumors. Neoadjuvant immunotherapy has several potential advantages, including in-situ tumor vaccination and pathologic assessment of response in the surgical specimen. We previously described an in-situ tumor vaccination strategy in melanoma using local radiation (RT) and an intratumoral injection of tumor-specific anti-GD2 immunocytokine (IT-IC).

[VALUE OF INTRAOPERATIVE DEBITOMETRY IN SELECTING OF SURGICAL TREATMENT TACTICS FOR PATIENTS WITH DIABETES MELLITUS WITH CHRONIC CRITICAL ISCHEMIA OF THE LOWER LIMB].

Aim - analyze the results of surgical treatment of patients with diabetes mellitus (DM) with chronic critical lower limb ischemia (CCLLI) against the background of the combined stenotic-occlusive lesions (SOL) of the femoral arterial segment (FAS) and popliteo-tibial arterial segment (PTAS), considering the data of the intraoperative debitometry (ID). The results of surgical treatment of 97 patients with diabetes mellitus with CCLLI caused by combined SOL of FAS and PTAS arteries after 1 month and 12 months of treatment were analyzed. All patients were treated at the Vascular Surgery Center of the Clinical Hospital "Feofania" of State Directorate for Affairs, Kiev, Ukraine during 2014 - 2018yrs.

[Chronic intestinal pseudoobstruction: difficulties in diagnosis and treatment. Case report].

The article presents a clinical case of a 23-year-old patient with an extremely severe congenital form of chronic intestinal pseudoobstruction coupled with a neuromyopathy,colon malrotation, malabsorption, bacterial overgrowth syndrome, cholelithiasis and gastrostasis, which excluded bowel transplantation. Long-term treatment in the intensive care unit with combined, mainly parenteral nutrition for 6 months, using antibiotics, prokinetics, intestinal decompression allowed to achieve partial stabilization of the patients condition and transfer to home treatment with the continuation of adequate complex therapy.

Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key event.

Adolescent idiopathic scoliosis (AIS) affects 2-3% of children. Numerous hypotheses on etiologic/causal factors of AIS were investigated, but all failed to identify therapeutic targets and hence failed to offer a cure. Therefore, currently there are only two options to minimize morbidity of the patients suffering AIS: bracing and spinal surgery.

Depth of tumor implantation affects response to in situ vaccination in a syngeneic murine melanoma model.

An important component of research using animal models is ensuring rigor and reproducibility. This study was prompted after two experimenters performing virtually identical studies obtained different results when syngeneic B78 murine melanoma cells were implanted into the skin overlying the flank and treated with an in situ vaccine (ISV) immunotherapy. Although both experimenters thought they were using identical technique, we determined that one was implanting the tumors intradermally (ID) and the other was implanting them subcutaneously (SC).

[Treatment of severe post-resection liver failure. Analysis of the specialized center].

Unlabelled: Posthepatectomy liver failure is one of the most serious complications of large liver resections.

Objective: The analyzes the management and results of treatment of patients with severe posthepatectomy liver failure (Grade C ISGLS) in a specialized hepatosurgical department.

Material And Methods: In the period from January to December 2019, 175 liver resections were performed in the Department of liver and pancreatic surgery at the A.

Pattern of organ remodeling in chronic non-communicable diseases is due to endogenous regulations and falls under the category of Kauffman's self-organization: A case of arterial neointimal pathology.

Clinical diagnosis is based on analysis of pathologic findings that may result in perceived patterns. The same is true for diagnostic pathology: Pattern analysis is a foundation of the histopathology-based diagnostic system and, in conjunction with clinical and laboratory findings, forms a basis for the classification of diseases. Any histopathology diagnosis is based on the explicit assumption that the same diseased condition should result in formation of the same (or highly similar) morphologic patterns in different individuals; it is a standard approach in microscopic pathology, including that of non-communicable chronic diseases with organ remodeling.

[Russian consensus on current issues in the diagnosis and treatment of obstructive jaundice syndrome].

The Russian consensus document on topical issues of the diagnosis and treatment of obstructive jaundice syndrome was prepared by a group of experts in various fields of surgery, endoscopy, interventional radiology, radiological diagnosis and intensive care. The goal of this document is to clarify and consolidate the opinions of national experts on the following issues: timing of diagnosis of obstructive jaundice, features of diagnostic measures, the need and possibility of conservative measures for obstructive jaundice, and strategy of biliary decompression depending on the cause and level of biliary block.

Development of an RNAi therapeutic for alpha-1-antitrypsin liver disease.

The autosomal codominant genetic disorder alpha-1 antitrypsin (AAT) deficiency (AATD) causes pulmonary and liver disease. Individuals homozygous for the mutant Z allele accumulate polymers of Z-AAT protein in hepatocytes, where AAT is primarily produced. This accumulation causes endoplasmic reticulum (ER) stress, oxidative stress, damage to mitochondria, and inflammation, leading to fibrosis, cirrhosis, and hepatocellular carcinoma.

Modeling multi-needle injection into solid tumor.

The discovery of mechanisms by which the cancer cells avoid the host immune attack (immune checkpoints) as well the capability of the monoclonal antibodies (mAbs) to blockade the checkpoint proteins on cancer and tumor-infiltrating cells (CTLA-4, PD-1, and PD-L1) promised new breakthroughs in the cure of cancer. After these mechanisms of cancer escaping the host immunity were undoubtedly confirmed in numerous experimental and clinical studies, the FDA approval of CTLA-4 and PD-1/PD-L1 mAbs for systemic treatment thought to revolutionize the outcome of cancer treatment. However, as of today, the anticipated curative effect of anti-CTLA-4 and PD-1/PD-L1 mAb treatments has been observed only in a small population of patients.

A hypothesis on paradoxical privileged portal vein metastasis of hepatocellular carcinoma. Can organ evolution shed light on patterns of human pathology, and vice versa?

Unlike other carcinomas, hepatocellular carcinoma (HCC) metastasizes to distant organs relatively rarely. In contrast, it routinely metastasizes to liver vasculature/liver, affecting portal veins 3-10 times more often than hepatic veins. This portal metastatic predominance is traditionally rationalized within the model of a reverse portal flow, due to accompanying liver cirrhosis.

A New Look at Causal Factors of Idiopathic Scoliosis: Altered Expression of Genes Controlling Chondroitin Sulfate Sulfation and Corresponding Changes in Protein Synthesis in Vertebral Body Growth Plates.

In a previous report, we demonstrated the presence of cells with a neural/glial phenotype on the concave side of the vertebral body growth plate in Idiopathic Scoliosis (IS) and proposed this phenotype alteration as the main etiological factor of IS. In the present study, we utilized the same specimens of vertebral body growth plates removed during surgery for Grade III-IV IS to analyse gene expression. We suggested that phenotype changes observed on the concave side of the vertebral body growth plate can be associated with altered expression of particular genes, which in turn compromise mechanical properties of the concave side.

A New Look at Etiological Factors of Idiopathic Scoliosis: Neural Crest Cells.

Idiopathic scoliosis is one of the most common disabling pathologies of children and adolescents. Etiology and pathogenesis of idiopathic scoliosis remain unknown. To study the etiology of this disease we identified the cells' phenotypes in the vertebral body growth plates in patients with idiopathic scoliosis.

Privileged portal metastasis of hepatocellular carcinoma in light of the coevolution of a visceral portal system and liver in the chordate lineage: a search for therapeutic targets.

Hepatocellular carcinoma (HCC) disseminates systemically, but metastases occur in distant organs only in minority of patients, whereas HCC routinely metastasizes to liver and its vessels. HCC cells disseminate via hepatic veins, but portal veins are affected by metastasis more frequently than are hepatic veins, and correlates with poor prognosis. In this review, I suggest that privileged HCC portal metastasis occurs because of high levels of pancreatic family hormones and growth factors (PHGFs) in the portal blood.

[Intraoperative fluid therapy during esophagectomy followed by repair].

Aim: To optimize fluid therapy in transhiatal eshophagectomy by using of goal-oriented infusion therapy based on stroke volume variation.

Material And Methods: Our trial enrolled 30 patients who underwent transhiatal esophagectomy followed by repair for the period 2011-2014. Patients were divided into 2 groups.

HIF2α-Targeted RNAi Therapeutic Inhibits Clear Cell Renal Cell Carcinoma.

Targeted therapy against VEGF and mTOR pathways has been established as the standard-of-care for metastatic clear cell renal cell carcinoma (ccRCC); however, these treatments frequently fail and most patients become refractory requiring subsequent alternative therapeutic options. Therefore, development of innovative and effective treatments is imperative. About 80%-90% of ccRCC tumors express an inactive mutant form of the von Hippel-Lindau protein (pVHL), an E3 ubiquitin ligase that promotes target protein degradation.