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Aim To study the condition of coronary vasculature by data of coronarography (CG) in patients with chronic ischemic heart disease (IHD) and arterial hypertension (AH) associated with stage 2-4 chronic kidney disease (CKD) and to evaluate the effect of a 12-week complex treatment with perindopril or with a combination of perindopril/amlodipine on changes in vascular wall stiffness, endothelial function, and structure and function parameters in this patient category after coronary stenting.Material and methodsr This study included 87 patients with chronic IHD and AH associated with stage 2-3 CKD for whom CG was performed due to ineffectiveness of the antianginal therapy. The patients were divided into three subgroups: subgroup 1 included 28 patients who received a conservative treatment with perindopril 10 mg/day; subgroup 2 consisted of 25 patients who underwent coronary stenting and were prescribed perindopril; subgroup 3 consisted of 34 patients who underwent stenting and were prescribed the perindopril/amlodipine combination. The reference group included 47 patients with IHD and AH with preserved kidney function. Anatomic and functional parameters of the heart, arterial stiffness, pulse wave velocity, cardio-ankle vascular index, augmentation index, central aortic systolic and pulse pressure, endothelium-dependent vasodilation, plasma concentration of endothelin-1 (ET-1), and plasma concentration of nitric oxide metabolites were evaluated at baseline and after 12 weeks of treatment.Results In patients with IHD, AH, and stage 2-3 CKD, arterial stiffness was more pronounced than in patients with preserved kidney function. Concentrations of ET-1 were significantly higher and levels of nitric oxide were lower in CKD. Supplementing the complex therapy with perindopril resulted in a considerable hypotensive effect in all subgroups, improvement of the kidney function, and positive dynamics of arterial stiffness and endothelial function. Changes in these parameters were more pronounced in patients after coronary stenting than in patients receiving only a conservative treatment. The use of perindopril/amlodipine following stenting exerted the most significant angioprotective and cardioprotective effect.Conclusion Patients with IHD and AH in combination with early CKD have pronounced impairment of the condition of arterial blood vessels and the heart. Addition of perindopril to the treatment not only exerted a hypotensive effect but also beneficially influenced mechanisms of progression of this combined pathology.

Ommochromes are screening and antioxidant pigments in the compound eyes of invertebrates and fulfil the functions of light filtration, light absorption, and antioxidant defense. We report here the first observation that ommochromes display antiglycation activity in vitro. Ommochromes were prepared from the eyes of insects of three different families: Strationyidae, Sphingidae, and Acrididae. All the ommochromes studied were found to inhibit the reaction forming fluorescent serum albumin modification products in the presence of high fructose concentrations (fructosylation). Ommochromes from the eyes of the black soldier fly (Hermetia illucens) were the most effective fructosylation inhibitors. Ommochromes oxidized with hydrogen peroxide produced no inhibitory action in relation to glycation. Our results are of interest both for understanding the biological role of ommochromes in invertebrates, in particular for clarifying their influence on oxidative modification of the proteins of the retinular and pigment cells of ommatidia, and for using them to create pharmacological agents for the treatment and prevention of pathology associated with the development of metabolic syndrome.

Purpose: Analysis of infectious complications incidence in different types of percutaneous externalinternal biliary drainage in patients with obstructive jaundice of tumor genesis.Material and methods: The results of using antegrade external-internal drainage of the biliary tree in transpapillary and suprapapillary variants in 110 patients were analyzed. External-internal biliary drainage was performed in stages, after percutaneous transhepatic cholangiostomy or involuntarily primary with proximal obstruction of the biliary tree with bile duct segregation if it is impossible to form a fixing element of drainage proximal to the obstruction zone.Results: In the first group, transpapillary external-internal drainage was performed in 30 patients with peripapillary tumor obstruction. Of the 26 patients with proximal obstruction, suprapapillary external-internal drainage was performed in 8 patients, transpapillary — in 18 patients. Postmanipulation cholangitis in the first group occurred in 16 cases (28.6 %), liver abscesses developed 4 cases (7.1 %). In the second group, among 30 patients with transpapillary drainage on the background of peripapillary tumor obstruction, signs of acute cholangitis developed in 4 cases. Cholangitis was stopped by timely transfer of external-internal drainage to external. Among 24 patients with proximal obstruction of the biliary tree, suprapapillary external-internal drainage without complications was performed in 18 cases, transpapillary in 6 patients with the proximal block without disconnecting of the biliary tree. Acute cholangitis developed in 2 cases. Patients of the second group had no liver cholangigenic abscesses. There were no cases of hospital mortality in both groups.Conclusion: Factors in the development of postmanipulation cholangitis and liver abscesses during external-internal drainage of the biliary tree against the background of its tumor obstruction are the transpapillary position of endobiliary drainage with duodeno-biliary reflux in persistent biliary hypertension. In the case of suprapapillary location of the working end of external-internal drainage during antegrade drainage of the proximal tumor obstruction of the biliary tree with dissociation, the risk of postmanipulation cholangitis in non-drained liver segments is minimal. In the event of post-manipulation cholangitis in the case of transpapillary drainage of the biliary tree, a temporary transformation of external-internal drainage into external cholangiostomy is necessary.

Lipofuscin granules accumulate in the retinal pigment epithelium (RPE) with age, especially in patients with visual diseases, including progressive age-related macular degeneration (AMD). Bisretinoids and their photooxidation and photodegradation products are major sources of lipofuscin granule fluorescence. The present study focused on examining the fluorescence decay characteristics of bisretinoid photooxidation and photodegradation products to evaluate the connection between fluorescence lifetime and spectral characteristics of target fluorophore groups. The primary objective of the study was to apply experimental spectral analysis results of lipofuscin granule fluorescence properties to interpretation of fluorescence lifetime imaging ophthalmoscopy data. Fluorescence analysis of the lipofuscin granule fluorophores in RPE collected from cadaver eyes was performed. The fluorescence lifetimes were measured by picosecond-resolved time correlated single photon counting technique. A global analytical method was applied to analyze data sets. The photooxidation and photodegradation products of bisretinoids exhibited a longer fluorescence lifetime (average value approximately 6 ns) and a shorter wavelength maximum (530–580 nm). Further, these products significantly contributed (more than 30%), to total fluorescence compared to the other fluorophores in lipofuscin granules. Thus, the contribution of oxidized lipofuscin bisretinoids to autofluorescence decay kinetics is an important characteristic for fluorescence lifetime imaging microscopy data analysis. The higher average fluorescence lifetime in AMD eyes was likely due to the higher abundance of oxidized bisretinoids compared with non-oxidized bisretinoids. Because higher level of oxidized bisretinoids is indicative of pathological processes in the retina and RPE, the present findings have the potential to improve fluorescence lifetime imaging approaches for early diagnosis of degenerative processes in the retina and RPE.

The objective of this study was screening of ommochromes from the compound eyes of insects and comparison of their antioxidant properties. Ommochromes were isolated in preparative quantities from insects of five different families: Stratiomyidae, Sphingidae, Blaberidae, Acrididae, and Tenebrionidae. The yield of ommochromes (dry pigment weight) was 0.9-5.4% of tissue wet weight depending on the insect species. Isolated pigments were analyzed by high-performance liquid chromatography and represented a mixture of several ommochromes of the ommatin series. The isolated ommochromes displayed a pronounced fluorescence with the emission maxima at 435-450 nm and 520-535 nm; furthermore, the emission intensity increased significantly upon ommochrome oxidation with hydrogen peroxide. The ommochromes produced a stable EPR signal consisting of a singlet line with g = 2.0045-2.0048, width of 1.20-1.27 mT, and high concentration of paramagnetic centers (> 1017 spin/g dry weight). All the investigated ommochromes demonstrated high antiradical activity measured from the degree of chemiluminescence quenching in a model system containing luminol, hemoglobin, and hydrogen peroxide. The ommochromes strongly inhibited peroxidation of the photoreceptor cell outer segments induced by visible light in the presence of lipofuscin granules from the human retinal pigment epithelium, as well as suppressed iron/ascorbate-mediated lipid peroxidation. The obtained results are important for understanding the biological functions of ommochromes in invertebrates and identifying invertebrate species that could be used as efficient sources of ommochromes for pharmacological preparations to prevent and treat pathologies associated with the oxidative stress development.

A global analysis of the fluorescence decay kinetics of a chloroform extract of lipofuscin granules from the retinal pigment epithelium cells of human cadaver eyes is performed. The analysis makes it possible to reconstruct the individual fluorescence properties of four groups of fluorophores belonging to bisretinoids and the products of their photooxidation and photodegradation. The characteristic fluorescence lifetimes are correlated with the spectral characteristics of the indicated fluorophore groups using the averaged spectral and kinetic characteristics of the chloroform extract.

Fluorescence and chromatographic analysis of bisretinoids from the retina and retinal pigment epithelium of mouse eyes was carried out before and after exposure to accelerated protons in the Bragg peak. It has been shown that ionizing radiation at doses of 1–4 Gy leads to a shift in the short-wave region of the maximum of the fluorescence spectrum in the chloroform extract obtained from both the retinal pigment epithelium and the retina. Chromatographic analysis of these extracts has shown a change in the relative content of individual bisretinoids. The obtained spectral and chromatographic data indicate that the exposure of mice to accelerated protons in the Bragg peak at doses of 1–4 Gy leads to radiation oxidation of bisretinoids in eye tissues.

The article provides an overview of the frequency of distribution of pyometra in cats. Risk factors, clinical manifestations and clinical forms of the disease are analyzed. Current methods of pyometra diagnostics and clinical and laboratory criteria for early detection of signs of sepsis (systemic inflammatory response) in cats with pyometra are considered. The methods of pyometra therapy are analyzed. It was emphasized that the most effective and safest method of treating any form of pyometra is a total ovariohisterectomy in combination with broad-spectrum antibiotics. Encouraging results in the treatment of an open uncomplicated form of pyometers in cats were obtained using, along with antibiotics, preparations based on PgF2alfa and aglepristone.

Aim.To determine the role of antegrade X-ray surgical interventions in the treatment of benign postoperative biliary strictures.Material and methods.A retrospective analysis of treatment of 36 patients with benign biliary strictures was performed. Isolated stricture of biliodigestive anastomosis was diagnosed in 25 cases, partial clipping of common hepatic duct proximal to biliodigestive anastomosis – in 3 cases, partial clipping of bile duct – in 3 patients, isolated biliary strictures – in 5 patients including 4 of them with stricture within previously deployed T-shaped drainage. At the first stage, percutaneous transhepatic cholangiostomy was performed. According to antegrade cholangiography data, structure type “+1, +2” by H. Bismuth classification in modification of E. I. Galperin was diagnosed in 16 (55.2%) patients, proximal biliary strictures (“0”–“−2”) in 13 patients. Three patients with partial clipping of common bile duct and 4 patients with benign biliary stricture in the area of previously deployed T-shaped drainage were not classified. Recanalization of strictures by “catheter-guide” system was followed by antegrade dilatation of the stricture. Final stage was frame external-internal drainage for 6–12 months with stepwise redo balloon dilatation every 3 months (35 patients). The criterion for the end of minimally invasive treatment was the absence of balloon waist in the stricture zone observed during the next procedure but not earlier than in 6 months from primary balloon dilatation. Surgical correction was indicated for recurrent stricture.Results.Direct technical success was achieved in 35 patients. There was 1 case of recurrent strictures within 1 year among 3 cases of primary repair of biliary strictures in the area of previously installed T-shaped drainage. Resection of common bile duct stricture was followed by Roux-en-Y hepaticojejunostomy. Recurrence-free period among 36 patients ranged from 1 to 10 years, median – 56 months. There were no mortality and complications after X-ray surgery.Conclusion.Antegrade recanalization and balloon dilatation of the stricture followed by long-term external-internal biliodigestive frame drainage are effective for both stricture of biliodigestive anastomosis and partial clipping of bile duct. Conventional surgical procedures should be preferred for cicatricial strictures of extrahepatic bile ducts after previous T-shaped drainage deployment.

The beginning of 2020 was characterized by the development of a new coronavirus pandemic (COVID-19). Information about the epidemiology, etiology, pathogenesis, clinical and laboratory diagnostics, as well as prevention and therapy for this disease is constantly being expanded and reviewed. The COVID-19 pandemic creates the need for the emergence of new conditions of specialized care for patients with heart rhythm and conduction disorders [1]. These recommendations are intended for general practitioners, internists, cardiologists, electrophysiologists/arrhythmologists, cardiovascular surgeons, functional diagnostics doctors, anesthesiologists-resuscitators, laboratory diagnostics specialists, health care organizers in the system of organizations and healthcare institutions that provide specialized care to patients with heart rhythm and conduction disorders.

Introduction. A number of paraproteinemic polyneuropathy is directly linked to the monoclonal gammapathy of undetermined significance (MGUS). One of the first manifestations of MGUS in addition to the secretion of monoclonal immunoglobulin, and long before the manifestation of malignancy is polyneuropathy.Materials and Methods. Were examined in 16 patients with polyneuropathy associated with MGUS in age from 53 to 78 years. Patients underwent a course of infusion therapy with human immunoglobulin in the dose of 0.4 g/kg for 5 days.Results. After treatment revealed a reduction of the manifestations of the sensory component of the neuropathy, neuropathic pain and sensitive ataxia that was confirmed by electromyographic data of stabilography, and a rating on a scale Lovett, the scale of neuropathy disability score, the questionnaire «Pain detect». The motor component of polyneuropathy had more persistent symptoms.Conclusion. Treatment with human immunoglobulin is effective in reduction of neuropathic pain and sensory ataxia and in increase of superficial and deep sensation, while the motor component of polyneuropathy had more persistent symptoms.

PURPOSE: The aim of this work is the determination of quantitative diagnostic criteria based on the spectral characteristics of fundus autofluorescence to detect early stages of degeneration in the retina and retinal pigment epithelium (RPE). METHODS: RPE cell suspension samples were obtained from the cadaver eyes with and without signs of age-related macular degeneration (AMD). Fluorescence analysis at an excitation wavelength of 488 nm was performed. The fluorescence lifetimes of lipofuscin-granule fluorophores were measured by counting time-correlated photon method. RESULTS: Comparative analysis of fluorescence spectra of RPE cell suspensions from the cadaver eyes with and without signs of AMD showed a significant difference in fluorescence intensity at 530–580 nm in response to fluorescence excitation at 488 nm. It was notably higher in eyes with visual pathology than in normal eyes regardless of the age of the eye donor. Measurements of fluorescence lifetimes of lipofuscin fluorophores showed that the contribution of photooxidation and photodegradation products of bisretinoids to the total fluorescence at 530–580 nm of RPE cell suspensions was greater in eyes with visual pathology than in normal eyes. CONCLUSION: Because photooxidation and photodegradation products of bisretinoids are markers of photodestructive processes, which can cause RPE cell death and initiate degenerative processes in the retina, quantitative determination of increases in these bisretinoid products in lipofuscin granules may be used to establish quantitative diagnostic criteria for degenerative processes in the retina and RPE.

Hydroxyapatite was synthesized in conditions of mechanoacoustic treatment of an aqueous reaction mixture consisting of ammonium hydrogen phosphate and calcium nitrate using a commercially available rotary pulsation apparatus. Mechanoacoustic treatment of the reaction mixture was found to lead to the formation of nanosized hydroxyapatite particles with a predominant mean diameter of about 20 nm. Purification of technical hydroxyapatite to remove traces of ammonium nitrate by thermal processing at 350°C is proposed. The crystalline phase of hydroxyapatite was found not to be dominant in the structure. The porosity of hydroxyapatite amounted to about 75% with a mean pore diameter of 2.8 × 103 nm. Thermal processing of hydroxyapatite in aqueous medium was found to yield a paste-like form. Hydroxyapatite paste had no cytotoxicity and did not prevent cell adhesion, though it almost completely inhibited cell spreading.

Aim. To improvethe efficiency of X-ray treatment of postoperative complications (duodenal and biliary fistulae, intraabdominal iatrogenic bile collections). Material and Methods. Percutaneous transhepatic biliary drainage was carried out in 11 patients with nondilated intrahepatic bile ducts. Failure of duodenal stump after previous stomach resections in 5 patients, presence of external biliary fistulae after surgery on gall bladder and common biliary duct in 3 patients and severe pancreonecrosis in 3 cases led to need of antegrade transhepatic cholangiostomy. Results. Antegrade transhepatic cholangiostomy gives an ability to close duodenal fistulae in 5 patients and biliary fistulae in 3 patients with iatrogenic injury of common biliary duct. Percutaneous transhepatic biliary drainage was used in treatment of 3 patients with severe pancreonecrosis. There were 2 complications of antegrade transhepatic cholangiostomy such as hepatic subcapsular hematoma and porto-biliary fistula which were cured effectively using minimally invasive methods (percutaneous drainage of hematoma and disintegration of porto-biliary fistula by filling of intrahepatic canal). Conclusion. Antegradetranshepaticcholangiostomy in case of nondilated intrahepatic bile ducts differs from traditional technique. Often it assumes contrasting of biliary tree using any available way and demands strict compliance of manipulation technology

Purpose. To determine the indications for the supra - and transpapillary externally-internal drainaging of the biliary tree in case of jaundice syndrome. Material and methods. The results of minimally invasive treatment of 246 patients with external-internal drainage of the biliary tree were analyzed. Among patients with proximal tumor block the external-internal drainage is made in 92 cases, in 42 (45,7%) out of them in suprapapillary embodiment and in 50 (54,3%) - via transpapillary approach. In 154 cases with distal tumor (obstruction peripapillary cancer) transpapillary drainage was performed. Results. The technical success of the external-internal drainaging was achieved in 242 patients (98,4%). It was failed to pass the duodenum in 4 patients with the cancer of common bile duct (3) and cancer of papilla of Vater (1). There was no complications related to the technique of external-internal drainage. In 18 patients (8,8%) out of 204 with transpapillary location of the drainage, we were forced to temporarily return to full outer bile outflow because of acute cholangitis. The syndrome of an acute blockade of the papilla of Vater arising after transpapillary external-internal drainaging required endoscopic papillosphincterotomy in 42 (84%) out of 50 patients with proximal tumor block bile outflow and in 7 (4.5%) out of 154 patients with peripapillary cancer. Conclusion. Suprapapillary and transpapillary embodiment of the drainage are equivalent in terms of the efficacy of cholestasis elimination. Syndrome of an acute blockade of papilla of Vater is the most often complication of the transpapillary external-internal drainage requiring the carrying out of endoscopic papillotomy «on drainage». This syndrome arises very frequently in a case of transpapillary external-internal drainage due to the proximal tumor obstruction of the biliary tree. The risk of acute cholangitis due to regurgitation after manipulation is absent in the suprapapillary location of the external-internal drainage, and with its transpapillary position is realized only with a concomitant violation of the outflow of bile.

The presence of carotenoids in the vitreous body, retina, lens, retinal pigment epithelium together with choroid (hereinafter RPE), and ciliary body and iris together with choroidal stroma (hereinafter CBI) was studied throughout the second trimester of prenatal development of the human eye. It has been found that the vitreous body, retina, and RPE contain lutein and its oxidized forms. Zeaxanthin was not found in the tissues studied. The presence of lutein in the vitreous body is transient and no longer detected after 28 weeks of gestation. Lutein was not detected in the lens and CBI, but its oxidized forms were found. The presence of carotenoids in different tissues of the eye in the course of normal eye development and the antioxidant role of carotenoids are discussed.

OBJECIVE. The authors would like to design an original device for aerosol laparoscopic chemotherapy and propose the most effective and safe mode. MATERIALS AND METHODS. The experimental and clinical studies were carried out and included 6 series. Male rabbits (n=71) were used for experimental part and the method was applied on 4 patients in clinical part. RESULTS. The original device and the effective mode of its application were developed for aerosol laparoscopic chemotherapy. The supposed method of chemotherapy appeared to be more effective than the standard method. There weren’t noted any complications or side effects. The method proved its safety. CONCLUSIONS. The aerosol laparoscopic intraperitoneal chemotherapy using the proposed regime is the effective and safe method of peritoneal carcinomatosis treatment.

Purpose. To discuss the possible causes of discrepancies in results of laboratory and X-ray methods of diagnostics of surgical cholestasis without a concomitant dilatation of the bile ducts, as well as features of X-ray-surgical tactics in such cases. Material and methods. In 2015-2016, 271 percutaneous transhepatic cholangiostomies were performed, including 23 cases - on unexpanded bile ducts, 7 these cancer patients with the laboratory evidence of cholestasis. The criteria for the absence of dilatation of the intrahepatic bile ducts were considered as not only an obvious non-visualized biliary tree on ultrasound, but also the diameter of the peripheral intrahepatic bile ducts less than 2 mm, which must be significantly less than similar peripheral branches of the portal vein. Results.Outside bile-outflow was effective, but only in two cases it provided the relief due to cholestasis performance. In 3 cases, blood bilirubin levels decreased by more than half of the initial ones. 5 out of 7 patients after external drainage of unexpanded bile ducts had evident signs of the liver failure. Two patients with malignant lesions of the biliary tree and baseline bilirubinemia over 450 umol/L died because of progressive liver failure. Conclusion. Mechanical jaundice corresponds to the concept of surgical cholestasis, which is associated with surgical diseases stipulating the violation of the outflow of bile and requires biliary decompression. By reducing the functional reserves of liver surgical cholestasis may not be accompanied by the significant expansion of the bile duct, which can be considered as a predictor of hepatic failure, which nevertheless requires cholangiostomy.

The fluorescence lifetimes of lipofuscin fluorophores contained in chloroform extracts from retinal pigment epithelium (RPE) of human cadaver eyes without signs of pathology were evaluated by single photon counting. The comparison of fluorescence lifetimes of N-retinylidene-N-retinylethanolamine (A2E) and its photooxidation and photodegradation products has been carried out. It was shown that the contribution of A2E to the total fluorescence of chloroform extract from lipofuscin granules is not major. The results are important for the improvement of noninvasive diagnostic method of degenerative diseases of the retina and RPE-fundus autofluorescence (FAF).

cardiovascular diseases, sudden cardiac death, risk, treatment, prevention Cardiovascular mortality in Russia is one of the highest in the world reaching 614 deaths per 100,000 annually. The main causes of death from cardiovascular diseases are the progression of congestive heart failure (about half of all cases) and sudden cardiac death (the other half). Thus, we can assume that the incidence of sudden cardiac death in 2016 was no less than 300,000. In the abbreviated version of the National Recommendations in English, the principles of decision-making algorithms in various clinical situations are used.

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.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.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.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.Цель - показать возможность альтернативного применения методик интервенционной радиологии в комплексном лечении пациентов с воспалительными осложнениями дивертикулярной болезни ободочной кишки. Материал и методы. В 2012-2016 гг. под нашим наблюдением находились 87 пациентов с осложненным течением дивертикулярной болезни. У 57 (65,5%) больных был диагностирован инфильтрат, у 24 (27,6%) - параколярный абсцесс (Ib-II тип по Hinchey), у 6 (6,9%) - распространенный перитонит (III-IV тип по Hinchey) [5, 9]. Результаты. По экстренным показаниям лапаротомия была выполнена в 13 наблюдениях. У 17 пациентов с параколярными абсцессами (Ib-II тип по Hinchey) диагноз был установлен сонографически при первичном обследовании. В этой группе больных было выполнено 26 перкутанных дренирований дивертикулогенных абсцессов разных локализаций самофиксирующимся дренажем pig tail 8Fr под сочетанным ультразвуковым и рентгенологическим контролем. У 13 пациентов дренирование было однократным, а течение дивертикулярной болезни - безрецидивным за время наблюдения от 1 года до 5 лет. Резекция толстой кишки в плановом порядке после перкутанного дренирования рецидивного параколярного абсцесса была выполнена у 4 пациентов. Осложнений, связанных с техникой установки дренажа отмечено не было, случаев летального исхода после дренирования не было. Технический успех перкутанного дренирования полости дивертикулогенного абсцесса был достигнут во всех манипуляциях. Вывод. Ультразвуковое обследование пациентов с подозрением на воспалительные осложнения дивертикулярной болезни - необходимый и достаточный метод первичной диагностики заболевания. Перкутанное дренирование дивертикулогенных абсцессов (Hinchey Ib-II) представляется прагматичным методом выбора первой линии у пациентов с осложненной дивертикулярной болезнью, позволяющим в большинстве наблюдений стойко купировать осложнение.

Zinc content in blood plasma and brain tissue of rats was studied by analytic mass-spectrometry with inductively coupled plasma. In control (saline-treated animal) zinc content in plasma was 3.6±1.4 mg/ml, in the liver - 12.5±2.5 mg/mg, in the spleen - 10.9±4.1 mg/mg, in the brain - 8.7±3.0 mg/mg. After a single intraperitoneal injection of zinc donator acizolum (24 mg/kg) zinc content decreased in all examined tissues, especially in brain. After a course of sequential acizolum injections (seven administrations during two weeks) essential elevation of zinc content in blood plasma and tissues investigated was detected. The maximal increase zinc concentration in blood plasma and liver was detected in 15 h after the last acizolum injections. Selen, calcium, copper and iron contents demonstrated a more complex behaviour. The obtained data suggest that prolonged acizolum administration has a significant impact on the bioelements content, and this should be taken into consideration when this zinc donator is used as a drug.Soderzhanie bioélementov v plazme krovi, pecheni, podzheludochnoĭ zheleze i golovnom mozge krys izuchalos' metodom analiticheskoĭ mass-spektrometrii s induktivno sviazannoĭ plazmoĭ. Soderzhanie osnovnogo ob"ekta issledovaniia – tsinka u kontrol'nykh zhivotnykh (s vvedeniem fiziologicheskogo rastvora) v plazme krovi sostavilo 3,6±1,4 mkg/ml, v pecheni – 12,5±2,5 mkg/mg syroĭ tkani, v podzheludochnoĭ zheleze – 10,9±4,1 mkg/mg, golovnom mozge – 8,7±3,0 mkg/mg. Pri odnokratnom vnutribriushinnom vvedenii donatora tsinka atsizola (24 mg/kg) obnaruzhena tendentsiia k snizheniiu soderzhaniia étogo mikroélementa v issleduemykh tkaniakh, osobenno v tkani golovnogo mozga. Pri kursovom vvedenii atsizola (7 in"ektsiĭ v techenie dvukh nedel') proiskhodilo uvelichenie soderzhaniia tsinka v plazme i tkaniakh issledovannykh organov krys. Povyshenie soderzhaniia tsinka v plazme krovi pod vliianiem atsizola korrelirovalo s ego urovnem v tkaniakh organov. Rezkoe vozrastanie soderzhaniia tsinka v plazme krovi i pecheni zaregistrirovano cherez 15 ch posle posledneĭ in"ektsii. Kolebaniia soderzhaniia selena, kal'tsiia, medi i zheleza nosili bolee slozhnyĭ korreliatsionnyĭ kharakter. Poluchennye dannye pokazyvaiut, chto pri dlitel'nom primenenii atsizola proiskhodiat sdvigi v obmene bioélementov, kotorye neobkhodimo uchityvat' pri ispol'zovanii étogo donatora tsinka kak lekarstvennogo preparata.

Objective : to improve the results of preoperative diagnosis of Mirizzi syndrome. Material and methods . Under our supervision for 2006–2015 we had 23 patients with the Mirizzi syndrome. Verification of cholecystolithiasis, condition of gallbladder’s wall and biliary tract dilatation degree was evaluated sonographically. Biliary decompression was realised by percutaneous transhepatic cholangiostomy that was implemented under the combined ultrasonic and X-ray control by the Seldinger technique for self-locking pigtail drainages 8 F. As a method for direct visualization of the bile ducts was used antegrade cholangiography. Results . Preoperative diagnosis was verified in 18 (78.3%) patients, based on the results of ultrasound and data of antegrade cholangiography. In I type of Mirizzi syndrome (prefistule form) was revealed a combination of non-standard ultrasonic symptoms: if there were signs of "high" extrahepatic block of bile ducts (area of liver gate and confluence of hepatic ducts) there was recorded actual intravesical bile hypertension. Lack of lymphadenopathy near the choledoch and focal lesions of liver parenchyma in the goal area confirmed the benign character of the "high" bile ducts block. II type of Mirizzi syndrome (fistula form) was characterized by the presence of megacholelitiasis combined with a lack of intravesical bile hypertension. Antegrade cholangiography in combination with intra-ductal diagnostic catheters and manipulation wires and in some cases with cholecystography allowed to differentiate types of Mirizzi syndrome. In 5 cases Mirizzi syndrome was an intraoperative finding. Antegrade minimal-invasive access to the biliary tree was used in patients with high risk of surgery for subsequent X-ray interventions (lithotripsy, balloon dilatation of major duodenal papilla, dislocation of stones to the duodenum). Conclusions . Effective preoperative diagnosis of Mirizzi syndrome can be successful more than in half cases of the combined use of ultrasonography of the biliary tract and the results of antegrade dynamic cholangiography. That was carried out through percutaneous transhepatic cholangiostomy in conjunction with additional diagnostic intraluminal manipulations (wires and catheter inspection and palpation).

Nowadays, treatment of paraproteinemic polyneuropathy is a fairly complex interdisciplinary process. The main method of therapy is still the use of chemotherapeutic drugs as means of pathogenetic treatment of the underlying disease. However, the use of chemotherapy with neurotoxicity can cause development of toxic polyneuropathy which increases neurological deficit. Any comprehensive neurorehabilitation program for patients with these forms of polyneuropathies have not been developed to date. The article presents data of clinical observations of 26 patients with paraproteinemic polyneuropathy which had undergone a course of neurorehabilitation treatment, both medical and nondrug technologies, including the methods of kinesiotherapy and physiotherapy.

Endobiliary antegrade stenting by self-expanding stents was performed in 32 patients with unresectable tumors of pancreatobiliary area. Uncoated stents were used in 15 patients with the proximal obstruction of the biliary tree. Uncoated stents prevent the blockade of lobar, segmental and cystic duct. Covered self-expanding stents were used in 17 cases of distal occlusion and obstruction of the peripapillary area. Antegrade stenting drainages of 8Fr were performed in a stepwise manner, consistently performing outside, then outward-internal drainage of the biliary tree, which was transformed into endobiliary stenting. Hybrid endobiliary antegrade stenting, which involves maintaining outward-internal drainage in lumen installed endobiliary stent, was performed in 14 patients. Hybrid antegrade stenting endobiliary allowed to keep endobiliary access to palliative care for all the time, monitor and correct the patency of the stent, by releasing from intraluminal sludge, to carry out a successful reparative stenting “stent to stent” in case of the invasion of tumor or scar tissue in to the lumen of the stent or around of its proximal end.

A comparative analysis of fluorescence lifetime of lipofuscin granule fluorophores contained in the retinal pigment epithelium cells from human cadaver eyes in normal state and in the case of visualized pathology was carried out. Measurements of fluorescence lifetimes of bis-retinoids and their photooxidation and photodegradation products were carried out using the method of counting time-correlated photons. Comparative analysis showed that, in the case of visualized pathology, the contribution of photooxidation and photodegradation products of bis-retinoids to the total fluorescence of the retinal pigment epithelium cell suspension increases in comparison with the norm.

Risk stratification of ventricular tachyarrhythmia in patients without structural heart disease is still one of the most important question that requires the answer. We now demonstrate our attempt of risk stratification for this group of patients, taking into account their anamnestic and history data and instrumental research results.

Fundus autofluorescence mostly originates from bisretinoid fluorophores in lipofuscin granules, which accumulate in retinal-pigment-epithelium cells with age. The dynamics of accumulation, photo-oxidation, and photodegradation of bisretinoids during aging or in the presence of pathology have been insufficiently investigated. Changes in spectral properties and composition of human lipofuscin-granule fluorophores with age and pathology have now been investigated by a high-performance liquid chromatography method using spectrophotometric and fluorescent detectors connected in series. It was found that: (i) N-retinylidene-N-retinylethanolamine (A2E) fluorescence intensity is not predominant in the chloroform extract of human-cadaver-eye retinal pigment epithelium studied; bisretinoid photo-oxidation and photodegradation products have much higher fluorescent properties; (ii) the relative emission maximum in the fluorescence spectrum of suspended retinal-pigment-epithelium cells obtained from an individual human-cadaver eye without pathology is irrespective of donor age and falls within the range 575 ± 15 nm; in two cadaver eyes with signs of age-related macular degeneration, emission maxima were shifted by 23-36 nm towards the shortwave region; and (iii) the ratio of bisretinoid photo-oxidation and photodegradation products to unoxidized bisretinoids in the chloroform extract of cadaver-eye retinal pigment epithelium increases with donor age, from 0.69 ± 0.03 to 1.32 ± 0.04. The differences in fluorescence properties between chloroform extracts obtained from cadaver eyes with and without signs of age-related macular degeneration could be used to increase the potential of fundus autofluorescence imaging as a noninvasive diagnostic method.

to analyze the efficacy of interventional methods in treatment of Klatskin tumor patients.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.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.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 «hybrid» variant to control stent patency as well as for neoadjuvant therapy of tumor.Материал и методы. Проведен анализ эффективности методов интервенционной радиологии с использованием антеградного чреспеченочного доступа в лечении 133 пациентов с опухолью Клацкина за период с 2000-2015 гг. Тип опухоли Bismuth I был выявлен в 28 (21,1%) наблюдениях, II - в 45 (33,8%), III - в 51 (38,3%) и IV - в 9 (6,8%) наблюдениях. Всем больным выполняли чрескожную чреспеченочную холангиостомию под сочетанным соно-флуороскопическим контролем с использованием на первом этапе самофиксирующихся дренажей Pig tail 8Fr с последующим наружновнутренним дренированием или антеградным эндобилиарным стентированием. Одномоментно и этапно в зависимости от распространенности билиарной окклюзии мы устанавливали от 1 до 6 дренажей. Результаты. Технический успех достигнут у всех пациентов. 'Большое' постманипуляционное осложнение - миграция холангиостомического дренажа с распространенным желчным перитонитом - встретилось в 1 (0,8%) наблюдении. 'Малые' осложнения развились у 22 (16,5%) пациентов. В стационаре умерли 10 (7,5%) пациентов. Причинами смерти стало прогрессирование печеночно-почечной недостаточности. У 13 пациентов, которым выполнено транспапиллярное наружновнутреннее дренирование, на фоне транзиторной блокады билиарного дренажа развились абсцессы печени, что потребовало дополнительных рентгенохирургических вмешательств для их санации. Выводы. При наличии очевидных признаков нерезектабельности опухоли и (или) неоперабельности пациента ликвидацию синдрома механической желтухи при опухолевом билиарном разобщении половин печени следует проводить чрескожно чреспеченочно одномоментно либо последовательно с двух сторон, стараясь восстановить желчединамику в максимально возможном объеме печеночной паренхимы. Использование непокрытых саморасширяющихся эндобилиарных стентов в паллиативном лечении опухоли Клацкина при билиарном разобщении половин печени может быть реализовано в 'гибридном' варианте как для текущего контроля за проходимостью стента, так и для проведения неоадъювантной терапии опухоли.Материал и методы. Проведен анализ эффективности методов интервенционной радиологии с использованием антеградного чреспеченочного доступа в лечении 133 пациентов с опухолью Клацкина за период с 2000—2015 гг. Тип опухоли Bismuth I был выявлен в 28 (21,1%) наблюдениях, II — в 45 (33,8%), III — в 51 (38,3%) и IV — в 9 (6,8%) наблюдениях. Всем больным выполняли чрескожную чреспеченочную холангиостомию под сочетанным соно-флуороскопическим контролем с использованием на первом этапе самофиксирующихся дренажей Pig tail 8Fr с последующим наружновнутренним дренированием или антеградным эндобилиарным стентированием. Одномоментно и этапно в зависимости от распространенности билиарной окклюзии мы устанавливали от 1 до 6 дренажей. Результаты. Технический успех достигнут у всех пациентов. «Большое» постманипуляционное осложнение — миграция холангиостомического дренажа с распространенным желчным перитонитом — встретилось в 1 (0,8%) наблюдении. «Малые» осложнения развились у 22 (16,5%) пациентов. В стационаре умерли 10 (7,5%) пациентов. Причинами смерти стало прогрессирование печеночно-почечной недостаточности. У 13 пациентов, которым выполнено транспапиллярное наружновнутреннее дренирование, на фоне транзиторной блокады билиарного дренажа развились абсцессы печени, что потребовало дополнительных рентгенохирургических вмешательств для их санации. Выводы. При наличии очевидных признаков нерезектабельности опухоли и (или) неоперабельности пациента ликвидацию синдрома механической желтухи при опухолевом билиарном разобщении половин печени следует проводить чрескожно чреспеченочно одномоментно либо последовательно с двух сторон, стараясь восстановить желчединамику в максимально возможном объеме печеночной паренхимы. Использование непокрытых саморасширяющихся эндобилиарных стентов в паллиативном лечении опухоли Клацкина при билиарном разобщении половин печени может быть реализовано в «гибридном» варианте как для текущего контроля за проходимостью стента, так и для проведения неоадъювантной терапии опухоли.

To analyze efficacy of interventional methods via antegrade transhepatic approach in treatment of patients with strictures of biliodigestive anastomoses.24 patients aged 47.2 years were treated for the period 2002-2015. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. One- and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture.Restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. Recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrade extraction of blocked uncovered stent in 1 patient. There were no major postoperative complications and deaths. Maximal recurrence-free follow-up after stent installation was 11 years.Цель исследования. Анализ эффективности методов интервенционной радиологии с использованием антеградного чреспеченочного доступа в лечении пациентов со стриктурами билиодигестивных анастомозов (БДА). Материал и методы. За период 2002-2015 гг. на лечении находились 24 пациента. Средний возраст больных 47,2 года. Срок образования стриктур после реконструктивных операций на внепеченочном желчном дереве с использованием транспеченочных каркасных дренажей составил от 9 мес до 12 лет. С целью купирования билиарной гипертензии выполняли одно- или двустороннюю чрескожную чреспеченочную холангиостомию. Реканализацию стриктуры осуществляли с помощью системы катетер-проводник. Антеградную дилатацию стриктуры выполняли баллонным катетером диаметром 8 мм при рабочем давлении в баллоне до 6 атм и этапной экспозиции до 10 мин. Баллонную пластику анастомоза завершали каркасным наружновнутренним дренированием зоны стриктуры. Результаты. Восстановление проходимости зоны стриктуры БДА антеградными рентгенохирургическими методами было эффективно у 22 пациентов. В 2 наблюдениях в сроки до 1,5 года возник рецидив стриктуры, потребовавший повторной эндобилиарной реконструкции, в том числе c антеградным извлечением блокированного непокрытого стента у одного пациента. 'Больших' постманипуляционных осложнений и летальных исходов не было. Максимальный срок безрецидивного наблюдения пациента после установки непокрытого баллонорасширяемого стента в зоне гепатикоеюноанастомоза составил 11 лет.

Lipofuscin granules accumulate in the cells of retinal pigment epithelium with age, particularly in patients with hereditary diseases. These granules are heterogeneous, being composed of mixtures of proteins and lipids, including more than 21 different fluorescent compounds. Bisretinoids and their photo-oxidation and photodegradation products represent the main source of lipofuscin fluorescence and exhibit phototoxic properties. This study used time-of-flight secondary ion mass spectrometry (ToF–SIMS) with in-depth probing to assess the depth distribution of N-retinylidene-N-retinylethanolamine (A2E) and its singly and doubly oxidized forms (A2E-ox and A2E-2ox, respectively) within lipofuscin granules and in their surface layer (lipid membrane). ToF–SIMS showed that A2E and its oxidized forms were uniformly distributed throughout lipofuscin granules but were not present at the membrane surface layer. This finding is important for understanding the process involved in the formation of lipofuscin granules and in their toxicity.

Zinc level in the blood plasma and brain of rats was studied by inductively coupled plasma mass spectrometry. Maximum amount of zinc was observed in the cerebellum (15.0±5.5 μg/mg wet tissue). Single intraperitoneal administration of a zinc donor acyzol (24 mg/kg) did not change the content of this element in the tissues. Repeated injections of acyzol (7 injections over 14 days) significantly increased zinc level in rat plasma and brain. This elevation was most pronounced in the forebrain (cortex and subcortical structures). The rise in zinc concentration in blood plasma correlated with its level in the brain.

Integral parameters of bacterial lipopolysaccharide concentration and antiendotoxin immunity activity were determined in the blood serum of subjects with two extreme variants of eating disorders: obesity and anorexia nervosa (in its clinical model, long-term starvation). The results of the study showed that obese patients had initially higher endotoxin concentrations (2.41 ± 0.11 vs 1.13 ± 0.05 EU/mL in the control), which significantly decreased as a result taking a course of orlistat or after starvation (for no longer than 20 days) (to 1.34 ± 0.04 and 1.01 ± 0.09 EU/mL, respectively). The decrease in the endotoxin serum level was associated with an increase in the concentration of high-density lipoproteins (HDLs) and a decrease in the concentration of low-density lipoproteins (LDLs). This allowed us to assume that the complex of the latter with the endotoxin is the LDL fraction that may function as a depot of the hydrophobic form of the lipopolysaccharide molecule in the bloodstream. Long-term starvation (starting from day 20) led to the appearance of symptoms characteristic of septic states, which was preceded by a twofold increase in the concentration of the endotoxin and antibodies against the enterobacterial common antigen and subsequent increase in the level of anti-glycolipid antibodies (from 133.2 ± 2.6 to 355.6 ± 15.0 optical density arbitrary units) starting from day 25–27 of starvation, which is characteristic for the initial phase of the systemic inflammatory response syndrome.

This study was carried out to investigate the effect of a new microbiological preparation Vetom 21.77 containing spore-mycelial biomass of Duddingtonia flagrans on hematological and biochemical parameters of broilers. The drug was administered for 3 months. A total number of 105 five-day-old broilers (Hubbard F15) were allocated to four test groups, where birds received the preparation in doses of 2, 5, 50 and 300 µl/kg bodyweight, and a control group with no treatment. Blood samples were collected 1.5 and 3 months after the beginning of the experiment for biochemical and hematological analysis. According to the results obtained, administration of the microbiological drug was followed by positive changes in the immunity of treated broilers. The preparation seems to have stimulating effect on their metabolic processes. There was no negative effect of the drug on the physiological state of the birds. In the course of the experiment, neither disease indications, nor mortality were detected in the birds, excluding deaths caused by the required slaughter. There were no treatment-related allergic reactions, even at the highest daily dose, as exemplified by almost borderline low eosinophil levels observed in treated broilers over the study period. No clinically relevant results were detected in serum biochemical profile.

Visible light-induced changes in fluorescence characteristics of lipofuscin granules (LG) isolated from retinal pigment epithelium of human cadaver eyes are compared with the analogous age-related changes and correlated with the content and photooxidation of LG main fluorophore, A2E. We used HPLC to examine changes of LG fluorophore composition with donor age, as well as before and after visible-light irradiation (the latter HPLC tests were also done with synthetic A2E). Visible light induces oxidation of LG fluorophores. As a result, their fluorescence characteristics change: the emission spectrum is blue-shifted by 25–40 nm. The observed age-dependent changes in the relative content of LG fluorophores and their oxidized derivatives were qualitatively similar with those caused by irradiation. To improve the accuracy of a new noninvasive diagnostic method, fundus autofluorescence imaging, it is important to know the ratio of nonoxidized and oxidized fluorophore derivatives depending on age and eye pathology.

We discovered that reactions of [Pd(OOCMe)2] n and Pd3(μ-OOCMe) with 3,5-dimethylpyrazole (Hdmpz) yield mononuclear complex [Pd(Hdmpz)4](OOCMe)2, in which acetate anions can exchange for pivalate or benzoate anions in reactions with proper acids. The specifics of intramolecular hydrogen bonding in the complexes prepared are discussed as dependent on the nature of the carboxylate anion using X-ray crystallography data.

Effective, safe and convenient inhalation therapy of asthma is of particular importance in pediatric practice. We performed open randomized comparative trial to evaluate efficacy of ultra-fine Beclazone ECO Ease Breathe (BEEB) vs fluticasone in equal doses in children with asthma. The study involved 40 children (26 males, 14 females) of 6-17 years of age with moderate asthma. They were treated with fluticasone followed by BEEB 250 μg b.i.d. We analyzed clinical findings, frequency and severity of asthma symptoms, peak expiratory flow rate (PEFR), medications used for asthma, lung function parameters. After 2 months of treatment with BEEB, the full control of asthma has been achieved in 11 patients (27.5 %) vs 9 patients treated with fluticasone (22.5 %). The good control was achieved in 27 (67.5 %) and 28 (70 %) patients, respectively. The asthma control was poor in 2 patients with BEEB (5 %) and 3 patients with fluticasone (7.5 %). Moderate improvement in mean FEV 1 and PEFR and reduction of their postbronchodilator growth were noted. All the children easily acquired the proper inhalation technique for BEEB. After 2 months of treatment, 39 of 40 patients have wished to continue therapy with this inhaler. There were no adverse events of the drug. There were no additional expenses for asthma and need of hospitalization or other medical care during the study. Therefore, BEEB as the basic therapy of childhood moderate asthma improves asthma control and compliance of the patient and the physician, and significantly decreases the cost of treatment.

Carotenoids were found for the first time in the vitreous body of human eye during the fetal period from week 15 until week 28. Their maximum content was timed to week 16–22. No carotenoids were found the vitreous body of 31-week fetuses, as well as adult humans, which corresponds to the published data. It was shown using HPLC that chromatographic characteristics of these carotenoids correspond to those of lutein and zeaxanthin, characteristic pigments of the retinal yellow macula.

Supramolecular organization of rhodopsin in the photoreceptor membrane was investigated by small-angle neutron scattering method. The experiments, which were performed with mixtures of heavy/light water as solvent (contrast variation method), were aimed at obtaining information about the lipid and protein components of the photoreceptor disc membrane separately. It was shown that the packaging density of the rhodopsin molecules in the photoreceptor membrane was unusually high: the distance between the centers of the molecules was approximately 56 A. The probability of the monomeric state of rhodopsin molecules in the photoreceptor membrane, according to the data obtained, is rather high.

The role of the kidneys in endotoxin aggression (EA) and the involvement of EA in disturbance of hemostasis were shown in 33 children with congenital urological pathology. With a progressive decrease in the accumulative-excretory function of the kidneys, compensated chronic EA became subcompensated or noncompensated with a pronounced clinical manifestation: fever, exacerbation of chronic pyelonephritis, an expanded form of the disseminated intravascular coagulation (DIC) III syndrome, and macrohematuria. Preoperative correction of antiendotoxin immunity and hemostasis and improvement of urine passage prevented bleeding and other postoperative complications.

The authors examined students of specialized secondary education institutions of Syktyvkar during a three-year-long period. Some morphofunctional indices are worse in them than in similar cohorts in Central Russia. The unfavorable environmental situation impaired tolerance to hypoxemia, cardiac rhythm regulation, central hemodynamics, and balance of autonomic processes and affected dynamics of the physiological status of the body during social adaptation to learning.