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Background. The success of surgical treatment of urethral strictures is often assessed in terms of the quality of urination and the patency of the urethral lumen. Despite the fact that this assessment is carried out according to the above parameters, it seems important to take into account such a possible complication as erectile dysfunction, which can significantly impair the patient’s quality of life. This is the difference in the perception of the success of the surgical intervention by the clinician and the patient.Aim. To determine the relationship between urethroplasty and the likelihood of erectile dysfunction in the postoperative period according to world literature.Materials and methods. The PubMed database was analyzed using the keywords: anterior urethroplasty, posterior urethroplasty, urethroplasty, sexual dysfunction, erectile dysfunction. All articles were reviewed by two independent authors for inclusion based on predetermined criteria. Among the included scientific papers are randomized controlled trials, systematic reviews.Results. Sixteen scientific papers with a total of 1476 patients were included in the final study. The decrease in erectile function after surgery in this meta-analysis is 3 %. The main factors influencing postoperative parameters were age and erectile function at the time of surgery.Conclusion. Most studies state that urethroplasty does not imply a significant impact on erectile function, however, they acknowledge that the occurrence of this complication affects the assessment of treatment outcomes among patients and the further impact on their quality of life, regardless of postoperative urinary function.

The authors analyzed clinical and morphological correlations between the manifestations and outcome in nephritis with Henoch– Schönlein purpura and assessed the effect of morphological data on achieving remission as per ISKDC, SQC, MEST-C classification.Patients and methods. 32 patients with nephritis in Henoch–Schönlein purpura (15 girls and 17 boys) were enrolled into retrospective longitudinal single-center study, median of primary admission to the nephrological department was 9.0 y. o. [5; 12 y.]. Clinical features of the onset (age, form of onset, glomerular filtration rate, daily proteinuria, hematuria, serum IgA level) and the course of the disease were analyzed in all children. The morphological data were assessed using such morphological classifications as ISKDC, SQC, MEST-C. A search for statistically significant relationships between clinical and morphological data and a comparative analysis of the influence of each morphological classification on the achievement of remission were carried out.Results. The sum of the SQC scores had a statistically significant effect on the outcome (p=0.006): in patients with complete remission, on average, 4 points were obtained, patients who did not achieve remission had 2 points more. When assessing the likelihood of detecting remission depending on the total score of the Oxford scale using the ROC-analysis, a statistically significant model was obtained (p=0.012). If the total MEST-C score was less than or equal to 3, remission was predicted (=0.032). The sensitivity and specificity of the method were both 75%.Conclusions. The practical application of the Oxford MEST-C classification and the new semi-quantitative SQC classification in comparison with the ISKDC classification for children with nephritis in Henoch–Schönlein purpura is promising for predicting an unfavorable renal outcome.

According to modern concepts, bone remodeling disorders that are directly dependent on the imbalanceof osteo-associated trace elements play a key role in the pathogenesis of OA. Therefore, the purpose of ourstudy is to develop the program of physical rehabilitation of patients with post-traumatic gonarthrosisand to investigate its effect on the composition of osteoassociated macronutrients.To determine the metabolic function of bone tissue there were the results of the study of mineralhomeostasis by the level in the peripheral blood of phosphorus and magnesium, total calcium and itsionized form, as well as the amount of urinary calcium excretion. The processes of bone formation wereevaluated by the content of bone isoenzyme of alkaline phosphatase, bone resorption was evaluated bythe level of tartrate-resistant acid phosphatase. 42 patients with post-traumatic osteoarthritis of the kneejoints of I–II stages according to Kellgren-Lowrence were observed.The complex of physical therapy included the educational program, medical gymnastics and massage.The theoretical part of the program included 6 topics covering the main issues related to the risk factorsand prognosis for the disease, the main mechanisms of its progression, as well as the basics of differentphysical therapy use. The practical part of the program was carried out in a small-group way and includedthe gradual application of static, dynamic, active and proprioceptive neuromuscular stretching usingthe exercises with elastic bands and metered loading. As for the massage technology a combinationof segmental massage with Swedish technique was used in the program. The total duration of the complexprogram was 9 months, after which patients were advised to perform independent classes. The applicationof the developed program of physical rehabilitation had a positive effect on the processes of boneremodeling, and allowed to reduce the number of exacerbations during the year.

BACKGROUND. The course and outcomes of primary IgA nephropathy in children are variable. Early therapy for high-risk individuals can help to delay the development of end-stage renal disease.THE AIM: to analysis of risk factors for progression and outcomes in children with IgA nephropathy, taking into account clinical and morphological data at the onset and during follow-up.PATIENTS AND METHODS. A retrospective study of 75 children was carried out; the median follow-up was 28 months. The median age of onset was 9.1 years. Patients were divided into 2 groups: 1st – patients with idiopathic IgA nephropathy (n= 53), 2nd – patients with Shenlein-Henoch purpura (n = 22). The diagnosis of primary IgA nephropathy was morphologically confirmed in all patients. Nephrobiopsy data were classified according to the Oxford scale (MEST-C score). The age of onset and first-time admission, the level of proteinuria and glomerular filtration rate (GFR) at the onset, at 12 months, at the end of follow-up, mean arterial blood pressure, MEST-C score, medication before nephrobiopsy were investigated. Progression was determined as a decrease in GFR less than 60 ml/min/1.73 m2. Outcomes were assessed by absence/presence of remission. We provided a search for factors influencing GFR at the end of the follow-up. Data analysis was performed using Student's t-test, Mann-Whitney, χ2, Fisher, linear regression model, binary logistic regression.RESULTS. Unlike adults, the predictive value of the MEST-C score in children has not been proven and is not associated with a decrease in GFR 2. GFR at the end of follow-up was lower in the idiopathic IgA nephropathy group than in group 2. The use of multiple linear regression predicts GFR on average after 28 months of observation.RESULTS. Unlike adults, the predictive value of the MEST-C scale in children has not been proven and is not associated with a decrease in GFR 2. GFR at the end of follow-up was lower in the idiopathic IgA nephropathy group. The use of multiple linear regression predicts GFR on average after 28 months of observation.CONCLUSIONS. The influence of morphological factors on the outcome and course of IgA nephropathy has not been proven. The level of GFR at the onset, mean blood pressure, and the age of the first-time admission turned out to be independent variables, which made it possible to identify children with an expected decrease in GFR less than 90 ml/min /1.73 m2 to the group of specific outpatient follow-up.

Robot-assisted radical prostatectomy (RARP) is a widely used treatment method for patients with clinically localized prostate cancer. Posterior reconstruction of urethrovesical anastomosis (UVA) is one of the techniques that provides early recovery of urinary continence after surgery. Changes in the technique of performing posterior reconstruction of UVA may contribute to further improvement of functional results.To evaluate the functional results of early removal of the urethral catheter (after 3 days) after RARP using a modified surgical technique of performing posterior reconstruction of UVA compared with the standard catheterization time (7 days after surgery).Patients who underwent RARP were randomly assigned to early catheter removal (3 days after surgery, main group, n=15) and standard catheterization time (7 days after surgery, control group, n=15). RARP was performed using the Da Vinci Si system. The primary end point was the rate of spontaneous voiding after catheter removal. Secondary endpoints were the incidence of urine leakage into the paravesical tissue during retrograde cystography, as well as complications according to the Clavien-Dindo system. The frequency and severity of stress urinary incontinence after catheter removal was assessed using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF).There were no significant differences between groups in terms of baseline and perioperative parameters. After removal of the catheter, no acute urinary retention was observed in both groups. Also, there were no cases of urine leakage into the paravesical tissue during retrograde cystography. The ICIQ-UI SF questionnaire showed no significant differences between the groups at 1, 3, 6, and 12 months after surgery.The method of modified posterior reconstruction allows to remove the urethral catheter 3 days after RARP. Early removal of the urethral catheter did not adversely affect the early recovery of urinary continence, the quality of UVA, and did not increase the incidence of acute urinary retention. Further studies with longer follow-up periods are needed.

The current socio-economic situation in Russia in rural areas is characterized by accumulated problems that hinder its transition to sustainable development. Low-quality living environment, limited opportunities for work in rural areas, lower (in comparison with urban) income levels have a significant impact on the processes of labor outflow and depopulation of villages, and as a result - on the growth of socio-economic imbalances in rural areas and the emergence of depressed rural areas, where many economic, social and environmental problems are increasingly aggravated, lead to general instability of the Russian economy. In this regard, the rural development to a qualitatively new level is one of the most important state tasks, and the sustainable development of rural areas is one of the main goals of the modern state agrarian policy.

The relationship between the content of supernatant cytokines and the immune histochemical (IHC) expression of epithelial-mesenchymal transition (EMT) markers was studied in biopsy samples of invasive breast carcinoma of no special type (IBC-NST) from patients with and without lymphatic spread of metastases (group II and group I, respectively). The concentrations of TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF, MCP-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, and IL-1Ra, as well as the immunohistochemical (IHC) expression of EMT markers cadherin-E (CDH1), β-1 integrin (CD29) and type II collagen (CII) were assayed. Results have shown that the patients of these groups statistically significantly differed by spontaneous production of IL-18 and G-CSF, and by the index of the polyclonal activator influence (IPAI) on G-CSF production. The study of relationships between supernatant cytokine production and the IHC expression by biopsy samples revealed correlations between the parameter of CII expression in the tumor tissue and the cytokine production by tumor biopsy specimens; these correlation links were typical for all IBC-NST patients, while correlation links (both direct and reverse ones) between CDH1, CD29, and cytokine production varied in groups of patients with and without lymphatic spread of metastases. The study revealed the features of the correlation links between the cytokine production by the tumor, its microenvironment and the IHC expression of EMT markers in IBC-NST patients with and without lymphatic spread of metastasis.

The material of patients with invasive carcinoma of no special type (ICNT) and nonmalignant diseases (ND) of the mammary gland was studied. When comparing the concentrations of histidine-rich glycoprotein (HRG) and E-cadherin (CDH1), statistically significant differences between ICNT and ND by HRG in the supernatant of blood cells and its spontaneous production by biopsies and by CDH1 at its induced production, as well as by influence indices of polyclonal activators on the production of CDH1 were found. When comparing the expression of immunohistochemical markers, no statistically significant differences between ICNT and ND were obtained.

We studied the effect of the HLDF differentiation factor on production of cytokines by biopsy samples of nonmalignant breast diseases (ND) and invasive breast carcinoma of no special type (IBC-NST), in the absence and presence of lymphogenic metastasis: IBC-NST patients werw subdivided into groups on the prognostic protocol of the 8th edition of the AJCC committee. Group IA consisted of patients with T1-T2 tumor sizes, and predominantly with positive expression of estrogen and progesterone receptors (ER+/PR+/HER2-); it also included one patient with the HER2+ (ER-/PR-/HER2+) molecular subtype. The IB group was mainly composed of patients with T2 tumor size, with the presence of lymphogenic metastasis (in 8 out of 10) patients and with positive expression of estrogen and progesterone receptors (ER+/PR+/HER2-) and it also included three patients with the HER2+ (ER-/PR-/HER2+) molecular subtype. Group IIA consisted of patients with T1-T2 tumor sizes, mainly with no metastases in the lymph nodes (in 11 out of 12 patients) and with a triple negative molecular subtype. Group IIB included patients with T2 tumor size, the presence of nodal metastasis and the expression of markers of ER-/PR-/HER2 - and ER-/PR-/HER2+. Group IIIA consisted of patients with tumor size T1-T3, with the presence of nodal metastasis and the expression of markers of ER-/PR+/HER2+ and ER-/PR-/HER2+. Group IIIC consisted of patients with T3 tumor size, lymphogenic metastasis, and expression of ER-/PR-/HER2-markers (triple negative molecular subtype). Due to a limited number of patients in the groups IIB, IIIA and IIIC, as well as due to more severe clinical and pathological stages, according to the prognostic Protocol of the 8th edition of the AJCC Committee, they were pooled into group III. Concentrations of IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF and MCP-1 were assayed in supernatants of biopsy specimens of breast tissue. Results have shown that with IBC-NST, a statistically significantly higher level of spontaneous production (SP) by biopsy specimens of IL-17, IL-18, IFN-γ and VEGF, and a lower level of SP IL-6 as compared with ND. Patients of all clinical and pathological groups showed a high VEGF spontaneous production as compared with ND, while statistically significant differences from patients with ND were not found in IL-17 spontaneous production in group IB patients, and IL-18 spontaneous production were absent in group IA. Only in patients with IA and IB, the IL-6 spontaneous production was lower as compared to ND, and the IL-8 spontaneous production was lower in the IA group. IFN-γ spontaneous production was higher in patients with IBC-NST group IIA as compared with ND. Under the influence of the HLDF differentiation factor, it was found that the parameters of IBC-NST patients were statistically significantly higher in the production of IL-1Ra, IL-17, IL-18 and VEGF, and statistically significantly lower in the production of IL-6 as compared to ND. HLDF had a higher impact on the content of IL-18 in IBC-NST patients than in ND. After HDLF sublimation IL-6 values were lower in patients of groups IA and IB, and HLDF-induced IL-17 production was higher only in patients of group IA. Statistically significant differences in the index of influence of HLDF (IVHLDF), representing ratio of the cytokine concentration in the supernatants of a biopsy specimen stimulated by HLDF to spontaneous cytokine production, were found between ND and IBC-NST in the case of on IFN-γ production, and also in the case of IL-4 production (between patients in the absence and presence of lymphogenic metastasis). IVHLDF for production of IL-6, IL-8 and TNF-α was lower in group IIA patients compared to group IA, and IVHLDF for production of GM-CSF and MCP-1 was lower in group IIA as compared to group III, in addition IVHLDF for MCP-1 products was lower in group IIA as compared to ND. The HLDF effect on the cytokine production by the tumor and its microenvironment was different in ND patients and IBC-NST patients. HDLF suppressed IFN-γ production in the pooled group of IBC-NST patients; HLDF mainly had a suppressive effect on the production of IL-6, IL-8, TNF-α, GM-CSF and MCP-1 in IBC-NST patients of group IIA.Issledovali vliianie faktora differentsirovki HLDF na produktsiiu tsitokinov bioptatami pri nezlokachestvennykh zabolevaniiakh molochnoĭ zhelezy (NZ) i pri invazivnoĭ kartsinome molochnoĭ zhelezy nespetsificheskogo tipa (IKNT), pri otsutstvii i nalichii limfogennogo metastazirovaniia, a takzhe u patsientov s IKNT, raspredelennykh po podtipam na osnove prognosticheskogo protokola 8 izdaniia komiteta AJCC. Gruppu IA sostavili patsienty s razmerami opukholi T1-T2 i preimushchestvenno s polozhitel'noĭ ékspressieĭ retseptorov éstrogena i progesterona (ER+/PR+/HER2-) i odin patsient s HER2+ (ER-/PR-/HER2+) molekuliarnym podtipom. V gruppu IB byli vkliucheny patsienty s razmerami opukholi T2, preimushchestvenno s nalichiem limfogennogo metastazirovaniia (8 iz 10) i s polozhitel'noĭ ékspressieĭ retseptorov éstrogena i progesterona (ER+/PR+/HER2-), a takzhe tri patsienta s molekuliarnym podtipom HER2+ (ER-/PR-/HER2+). Gruppu IIA sostavili patsienty s razmerami opukholi T1-T2, preimushchestvenno s otsutstviem metastazov v limfouzlakh (11 iz 12 bol'nykh) i s troĭnym negativnym molekuliarnym podtipom. Gruppu IIB sostavili patsienty s razmerami opukholi T2, nalichiem limfogennogo metastazirovaniia i ékspressieĭ markerov: ER-/PR-/HER2- i ER-/PR-/HER2+. Gruppu IIIA sostavili patsienty s razmerami opukholi T1-T3, nalichiem limfogennogo metastazirovaniia i ékspressieĭ markerov: ER-/PR+/HER2+ i ER-/PR-/HER2+. Gruppu IIIC sostavili patsienty s razmerami opukholi T3, s nalichiem limfogennogo metastazirovaniia i s ékspressieĭ markerov ER-/PR-/HER2- (troĭnoĭ negativnyĭ molekuliarnyĭ podtip). Vvidu malogo kolichestva patsientov v gruppakh IIB, IIIA i IIIC, a takzhe v sviazi s bolee tiazhelymi kliniko-patologicheskimi stadiiami soglasno prognosticheskomu protokolu 8 izdaniia komiteta AJCC oni byli ob"edineny v odnu gruppu III. Kontsentratsii IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL- 1β, IL-1Ra TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF i MCP-1 opredeliali v supernatantakh bioptatov tkani molochnoĭ zhelezy. Issledovaniia pokazali, chto pri IKNT otmechalsia statisticheski znachimo bolee vysokiĭ uroven' spontannoĭ produktsii (SP) IL-17, IL-18, IFN-γ i VEGF i bolee nizkiĭ uroven' SP IL-6 po sravneniiu s NZ molochnoĭ zhelezy. U patsientov vsekh kliniko-patologicheskikh grupp IKNT otmechena vysokaia SP VEGF po sravneniiu s NZ, togda kak statisticheski znachimye razlichiia ot patsientov s NZ po SP IL-17 otsutstvovali u patsientov gruppy IB, a po SP IL-18 otsutstvovali u patsientov IA. Tol'ko u patsientov grupp IA i IB SP IL-6 byla nizhe po sravneniiu s NZ, a SP IL-8 byla nizhe u patsientov gruppy IA. SP IFN-γ byla vyshe u patsientov s IKNT gruppy IIA po sravneniiu s NZ. Pri vozdeĭstvii faktora differentsirovki HLDF ustanovleno, chto pokazateli patsientov s IKNT byli statisticheski znachimo bolee vysokimi po produktsii IL-1Ra, IL-17, IL-18 i VEGF i statisticheski znachimo bolee nizkimi po produktsii IL-6 po sravneniiu s NZ molochnoĭ zhelezy. Pri vozdeĭstvii HLDF na produktsiiu IL-18 ego soderzhanie okazalos' vyshe u patsientov vsekh kliniko-patologicheskikh grupp po sravneniiu s patsientami s NZ. Po sravneniiu s NZ tol'ko u patsientov grupp IA i IB pokazateli IL-6 pri vozdeĭstvii HLDF byli nizhe, a indutsirovannaia HLDF produktsiia IL-17 byla vyshe tol'ko u patsientov gruppy IA. Statisticheski znachimye razlichiia po indeksu vliianiia HLDF (IVHLDF), predstavliaiushchim soboĭ otnoshenie kontsentratsii tsitokinov v supernatante bioptata, pri vozdeĭstvii HLDF k spontannoĭ produktsii tsitokinov byli ustanovleny mezhdu NZ i IKNT po IVHLDF na produktsiiu IFN-γ, a takzhe po IVHLDF na produktsiiu IL-4 mezhdu patsientami pri otsutstvii i nalichii limfogennogo metastazirovaniia. IVHLDF na produktsiiu IL-6, IL-8 i TNF-α byl nizhe u patsientov gruppy IIA po sravneniiu s gruppoĭ IA, a IVHLDF na produktsiiu GM-CSF i MCP-1 byl nizhe u gruppy IIA po sravneniiu s pokazateliami gruppy III, krome togo, IVHLDF na produktsiiu MCP-1 byl nizhe u gruppy IIA po sravneniiu s NZ. Vliianie faktora differentsirovki HLDF na produktsiiu tsitokinov opukhol'iu i ee mikrookruzheniem razlichno dlia patsientov s NZ i IKNT. Faktor differentsirovki okazyval supressiruiushchee vliianie na produktsiiu IFN-γ u patsientov s IKNT i na produktsiiu IL-4 tol'ko u patsientov s limfogennym metastazirovaniem i na produktsiiu IL-6, IL-8, TNF-α, GM-CSF i MCP-1 u patsientov s IKNT gruppy IIA.

Breast cancer, in most cases, is a malignant neoplasm associated with infiltration of a tumor with the cells that form its microenvironment and produce various cytokines. The aim of the study was to evaluate the cytokine-producing function of tumor cells and their microenvironment in biopsy specimen of patients with invasive carcinoma of no special type and in patients with benign breast diseases. To assess the cytokine-producing activity of the tumor and its microenvironment, the index of polyclonal activators influence on cytokine production by biopsy specimens of patients with invasive carcinoma of no special type (group I) and in patients with benign breast tumors (group II) was calculated. Group II was further subdivided into group IIa, which included only patients with fibroadenoma, and group IIb, which included the patients with leaf-shaped fibroadenoma, fibroadenomatosis, fibrocystic mastopathy, intraductal papillomatosis, sclerosing adenosis and fibrocystic mastopathy with microcalcifications. The concentrations of IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF, and MCP-1 were measured in tumor biopsy supernatants. When comparing groups I and II, higher indices of the polyclonal activators influence on the production of IL-17, IL-18 and TNF-α were observed in patients with benign diseases. Higher indices of the polyclonal activators influence on the production of IL-18, TNF-α, and IL-1β and the ratio of IL1β/IL1Ra were observed in patients with fibroadenoma as compared to those with invasive carcinoma of no special type. There were no significant differences in the indices of the polyclonal activators influence between groups I and IIb. This suggests the existence of changes in the mammary gland in patients of group IIb similar to those present in patients with invasive carcinoma of no special type. Higher indices of polyclonal activators influence on the production of IL-1β, as well as the ratio of IL1β/IL1Ra were observed in the patients of group IIa compared to the patients of group IIb. The results of the study identify the features of the cytokine-producing resource of tumor biopsy specimens in patients with invasive carcinoma of no special type and with benign breast tumors.Rak molochnoĭ zhelezy v bol'shinstve sluchaev iavliaetsia primerom zlokachestvennogo novoobrazovaniia, sviazannogo s infil'tratsieĭ opukholi kletkami, obrazuiushchimi mikrookruzhenie opukholi i produtsiruiushchimi razlichnye tsitokiny. Tsel'iu issledovaniia byla otsenka tsitokinprodutsiruiushcheĭ funktsii opukholevykh kletok i ikh mikrookruzheniia v bioptatakh opukholi patsientov s invazivnoĭ kartsinomoĭ nespetsificheskogo tipa (gruppa I) i u patsientov s nezlokachestvennymi zabolevaniiami molochnoĭ zhelezy (gruppa II). Bol'nye II gruppy byli razdeleny na gruppu IIa, v kotoruiu voshli patsienty tol'ko s fibroadenomoĭ, i gruppu IIb, v kotoruiu voshli ostal'nye patsienty s listovidnoĭ fibroadenomoĭ, fibroadenomatozom, fibrozno-kistoznoĭ mastopatieĭ, vnutriprotokovym papillomatozom, skleroziruiushchim adenozom i fibrozno-kistoznoĭ mastopatieĭ s mikrokal'tsinatami. Kontsentratsiiu IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF i MCP-1 opredeliali v supernatante bioptatov opukholeĭ. Dlia otsenki tsitokinprodutsiruiushcheĭ aktivnosti bioptatov opukholi i ee mikrookruzheniia opredeliali indeks vliianiia poliklonal'nykh aktivatorov na produktsiiu tsitokinov. Pri sravnenii I i II grupp byli polucheny vysokie indeksy vliianiia poliklonal'nykh aktivatorov na produktsiiu IL-17, IL-18 i TNF-α u patsientov s nezlokachestvennymi zabolevaniiami. Bolee vysokie znacheniia indeksov vliianiia poliklonal'nykh aktivatorov na produktsiiu IL-18, TNF-α, i IL-1β i sootnosheniia IL1β/IL1Ra byli u patsientov s fibroadenomoĭ po sravneniiu s invazivnoĭ kartsinomoĭ nespetsificheskogo tipa. Statisticheski znachimykh razlichiĭ v gruppakh I i IIb po indeksam vliianiia poliklonal'nykh aktivatorov obnaruzheno ne bylo. Éto pozvoliaet predpolozhit' sushchestvovanie analogichnykh invazivnoĭ kartsinome nespetsificheskogo tipa izmeneniĭ v molochnoĭ zheleze u patsientov IIb gruppy. Pri sravnenii grupp IIa i IIb byli polucheny bolee vysokie znacheniia indeksa vliianiia poliklonal'nykh aktivatorov na produktsiiu IL-1β, a takzhe sootnosheniia IL1β/IL1Ra u patsientov s fibroadenomoĭ molochnoĭ zhelezy. Provedennoe issledovanie pozvolilo vyiavit' osobennosti tsitokinprodutsiruiushchego resursa bioptatov opukholeĭ u patsientov s invazivnoĭ kartsinomoĭ nespetsificheskogo tipa i s dobrokachestvennymi opukholiami molochnoĭ zhelezy.

The relationship between the content of supernatant cytokines and the expression of non-specific type of markers of epithelial-mesenchymal transition markers in the presence (group II) and the absence of lymphogenous metastasis (group I) were studied in biopsy specimens of mammary invasive breast carcinoma. The concentrations of TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF, MCP-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β and IL-1Ra, as well as the expression of immunohistochemical (IHC) markers of the epithelial-mesenchymal transition - cadherin-E (CDH1), β-1 integrin (CD29) and type II collagen (CII) were assayed. Results have shown that patients of these groups statistically significantly differed in spontaneous production of IL-18 and G-CSF, in terms of the index of the effect of the polyclonal activator on G-CSF production. There was a correlation between the parameter of CII expression in tumor tissue and the production of cytokines by tumor biopsy specimens; it was characteristic of all patients with invasive carcinoma of a non-specific type, and correlations, both direct and reverse between the expression indices of CDH1, CD29 and cytokine production varied depending on the presence or the absence of lymphogenous metastasis. The study revealed the features of the correlation between the production of cytokines by the tumor, its microenvironment and the expression of IHC markers of the epithelial-mesenchymal transition in patients with invasive non-specific breast carcinoma in the presence and absence of lymphogenous metastasis.Izuchena vzaimosviaz' mezhdu soderzhaniem tsitokinov supernatantov i ékspressieĭ v bioptatakh invazivnoĭ kartsinomy molochnoĭ zhelezy nespetsificheskogo tipa markerov épitelial'no-mezenkhimal'nogo perekhoda pri nalichii (II gruppa) i otsutstvii (I gruppa) limfogennogo metastazirovaniia. Opredeliali kontsentratsiiu TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF, MCP-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β i IL-1Ra, a takzhe ékspressiiu immuno-gistokhimicheskikh (IGKh) markerov épitelial'no-mezenkhimal'nogo perekhoda – kadgerina-E (CDH1), β-1-integrina (CD29) i kollagena II tipa (CII). Po rezul'tatam issledovaniia patsienty étikh grupp statisticheski znachimo otlichalis' po spontannoĭ produktsii IL-18 i G-CSF, po indeksu vliianiia poliklonal'nogo aktivatora na produktsiiu G-CSF. Pri izuchenii vzaimosviazi mezhdu produktsieĭ tsitokinov supernatantami i ékspressieĭ v nikh IGKh markerov ustanovleno, chto korreliatsionnye sviazi mezhdu pokazatelem ékspressii CII v tkani opukholi i produktsieĭ tsitokinov bioptatami opukholi kharakterny dlia vsekh patsientov s invazivnoĭ kartsinomoĭ nespetsificheskogo tipa, a korreliatsionnye sviazi, kak priamye, tak i obratnye mezhdu pokazateliami ékspressii CDH1, CD29 i produktsieĭ tsitokinov, razlichalis' v zavisimosti ot nalichiia ili otsutstviia limfogennogo metastazirovaniia. Provedennoe issledovanie pozvolilo vyiavit' osobennosti korreliatsionnykh sviazeĭ mezhdu produktsieĭ tsitokinov opukhol'iu, ee mikrookruzheniem i ékspressieĭ IGKh – markerov épitelial'no-mezenkhimal'nogo perekhoda u patsientov s invazivnoĭ kartsinomoĭ molochnoĭ zhelezy nespetsificheskogo tipa pri nalichii i otsutstvii limfogennogo metastazirovaniia.

To study the influence of the technique of posterior reconstruction of the vesicourethral anastomosis (VUA) on the prevention of urinary incontinence after robotic-assisted radical prostatectomy (RARP).A total of 67 patients (mean age 63 years) with localized prostate cancer were included in the study. All patients were divided into two groups. In the group 1 (n=32) the standard technique of the VUA was used, while in the group 2 (n=35) the two-layer posterior reconstruction was done. The impact of urinary incontinence on the quality of life was analyzed using the ICIQ-SF questionnaire 1, 3 and 6 months after operation. On postoperative days 5-7, all patients underwent cystography to assess the tightness of the VUA.One month after RARP in the group 1 the mean score of ICIQ-SF questionnaire was 6.72, compared to 4.57 in group 2 (p=0.04). After 3 and 6 months the respective values were 3.8 vs. 2.3 (p=0.09) and 1.94 vs. 1.2 (p=0.23), respectively. Cystography revealed no extravasation of the contrast.The results of a retrospective comparative study suggest that a two-layer posterior reconstruction of the VUA during RARP, being a simple method, provides better continence rate one month postoperatively compared to standard technique, although larger randomized clinical trials are needed.

The article focuses on the influence of human leukemia differentiation factor (HLDF), carcinoembryonic antigen (CEA), and polyclonal activators (PA) on cytokine production by peripheral blood cells in breast cancer and benign breast diseases. It was found that the influence of internal factors on the production of cytokines by the peripheral blood cells is associated with lymphatic metastasis (CEA: IL-10; HLDF: IL-6, IL-1β, TNF-α, and G-CSF). One special circumstance was that there were no differences between the production of cytokines by peripheral blood cells in the patients with breast cancer compared to the patients with benign breast diseases with a high risk of malignant transformation. This is evidence of the functional similarity of peripheral blood cells in patients with these conditions. Cytokine production under the influence of PA was different only in case of TNF-α in all study groups.

Rural development is also a social task for any region of Russia and the country as a whole. Assessment of the degree of rural development and development of measures to address the identified problems are the key points in this article. Based on the analysis of the problems of rural territories of one of the regions of Russia-the Nizhny Novgorod region, the crisis characteristics of the current situation and the causes of the systemic crisis of socio – economic development of these territories are revealed. The refined method of integrated assessment makes it possible to determine key parameters, specify the value of factors that take into account the peculiarities of rural development and the specifics of the market under study, make a forecast for key management parameters and, as a result, determine the main directions of sustainable development.

Sustainable rural development is linked not only to the development of agriculture and forestry, but also to infrastructure components such as fixed telecommunications services. Universal communication services provide one of the primary needs for human life safety. The penetration of universal communication services is the basis for the existence and effective functioning of rural areas, as well as the subsequent improvement of the social and economic situation in the country. The lack of social infrastructure in rural areas, in particular, telephone communication, the Internet leads to a decrease in the level of comfort of living in rural areas, and, consequently, to an increase in the rate of urbanization on the territory of the subjects of the Russian Federation. In this regard, it is necessary to create a mechanism for determining the level of telecommunications development in rural areas, which would help solve a number of problems related to the introduction of telecommunications services in rural areas. The integrated criterion for assessing the need for telecommunications services proposed by the team of authors will help determine the degree of need for providing these services and make a step forward on the path to sustainable development of rural areas.

In this work, we have compared malignant and non-malignant diseases of the mammary gland using 8 proteins: HRG, MUC1, PAI-1, HSP90αA1, CDH1, ERα, PGR and IL-12. Their concentrations in the supernatants of blood cells and breast biopsies were compared in terms of spontaneous production, induced by a polyclonal activator and after exposure to biopsy samples of the HLDF differentiation factor, as well as the indices of the effect of the polyclonal activator and HLDF on the protein production. In addition, the correlation relationships of the above indicators with the expression of markers of the epithelial-mesenchymal transition: collagen type II (CII), β-1 integrin (CD29) and cadherin-E (CDH1) were studied. The study revealed statistically significant differences in the concentration of HRG in the supernatant of blood cells, IL-12 during spontaneous production by biopsy specimens, PGR production of biopsy specimens induced by the polyclonal activator, CDH1 and IL-12 production biopsy specimens exposed to HLDF. According to the influence index of the polyclonal activator and HLDF, statistically significant differences were found for CDH1production. Comparison of non-specific invasive carcinoma biopsy specimens and non-malignant breast diseases by means of the markers of the epithelial-mesenchymal transition revealed statistically significant differences in CD29 expression and the lack of differences in the expression of CDH1 and CII. This indicates the presence of cell atypia in samples of non-malignant breast diseases; it is confirmed by the recognized correlation between the production of certain proteins and the expression of the epithelial-mesenchymal transition markers.Provedeno sravnenie pokazateleĭ zlokachestvennykh i nezlokachestvennykh zabolevaniĭ molochnoĭ zhelezy po 8 belkam: gistidinbogatyĭ glikoprotein (HRG), mutsin 1 (MUC1), ingibitor aktivatora plazminogena 1 (PAI-1), belok teplovogo shoka 90αA1 (HSP90αA1), E-kadgerin (CDH1), retseptor éstrogena α (ERα), retseptor progesterona (PGR) i interleĭkin 12 (IL-12). Ikh kontsentratsii opredeliali v supernatantakh immunnokompetentnykh kletok krovi i bioptatov molochnoĭ zhelezy pri spontannoĭ, a takzhe indutsirovannoĭ poliklonal'nym aktivatorom produktsii i posle vozdeĭstviia na bioptaty faktora differentsirovki HLDF. Pomimo étogo rasschityvali indeksy vliianiia poliklonal'nogo aktivatora i HLDF na produktsiiu étikh belkov i issledovali korreliatsionnye sviazi perechislennykh vyshe pokazateleĭ s ékspressieĭ markerov épitelial'no-mezenkhimal'nogo perekhoda: kollagena II tipa (CII), β-1-integrina (CD29) i kadgerina-E (CDH1). Obnaruzheny statisticheski znachimye razlichiia v kontsentratsii HRG v supernatante immunnokompetentnykh kletok krovi, IL-12 pri spontannoĭ produktsii bioptatami, PGR pri indutsirovannoĭ poliklonal'nym aktivatorom produktsii bioptatami, CDH1 i IL-12 pri vozdeĭstvii HLDF na bioptaty. Po indeksam vliianiia poliklonal'nogo aktivatora i HLDF statisticheski znachimye razlichiia vyiavleny na produktsiiu CDH1. Pri sravnenii markerov épitelial'no-mezenkhimal'nogo perekhoda mezhdu bioptatami invazivnoĭ kartsinomy nespetsificheskogo tipa i nezlokachestvennymi zabolevaniiami molochnoĭ zhelezy obnaruzheny statisticheski znachimye razlichiia v pokazateliakh ékspressii CD29, v to vremia kak po ékspressii CDH1 i CII razlichiĭ polucheno ne bylo. Éto svidetel'stvuet o nalichii kletochnoĭ atipii v obraztsakh nezlokachestvennykh zabolevaniĭ molochnoĭ zhelezy i podtverzhdaetsia obnaruzhennymi korreliatsionnymi sviaziami mezhdu produktsieĭ nekotorykh belkov i ékspressieĭ markerov épitelial'no-mezenkhimal'nogo perekhoda.

AIM to carry out a comparative analysis of treatment results of patients with renal tumors who were undergone to nephron-sparing surgery, depending on the type of temporary and definite hemostasis. MATERIALS AND METHODS a total of 163 laparoscopic partial nephrectomies were performed by single surgeon from January 2015 to July 2018. The comparative analysis of treatment results of patients with renal tumors based on following parameters: tumor stage, features of the tumor site, the duration of surgery, the amount of blood loss, complications rate and grade as well as functional and oncological outcomes, depending on the type of temporary and definite hemostasis, was conducted. For preoperative planning the generally accepted nephrometric scale R.E.N.A.L. was used as well as 3D-reconstruction of the tumor. RESULTS Of the 163 patients, 64 were women (39.3%). The mean age of patients was 56.7+/-11.1 (25-80 years). A clinical stage T1a, T1b, T2 and T3a was diagnosed in 77, 20, 2 and 64 cases, respectively. The average tumor size was 34.8+/-1.1 (11-78 mm). The mean operative time was 84.5+/-32.2 min (30-180). Laparoscopic transperitoneal access was used in 90 patients (55.21%), retroperitoneoscopic approach was chosen in 73 cases (44.79%). The tumor had exophytic growth in 110 cases (67.5%) and in 53 cases it was endophytic (32.5%), while in 59 cases it localized in renal sinus (36.2%). The operative time was significantly shorter in the Group of zero ischemia (72.2+/-29.02 [p

Виявлено, що, незважаючи на відсутність чіткого державного регулювання форм і напрямів діяльності громадських організацій (ГО), вони активно залучаються до діяльності установ виконання покарань (УВП) в різних сферах їх функціонування. Актуальність залучення ГО пов’язана з наступними чинниками: державні інституції не в змозі забезпечити успішну ресоціалізацію засуджених в контексті пенітенціарних закладів та створити передумови для подальшої їх реінтеграції у суспільство; працівники пенітенціарних установ та самі засуджені високо оцінюють діяльність ГО; представники ГО виступають важливим каналом зв’язку із соціумом, пропагуючи його норми та цінності тощо. Встановлено, що роль ГО в ресоціалізації засуджених до позбавлення волі полягає у втіленні заходів, що безпосередньо сприяють повторному процесу засвоєння цими особами соціальних норм, цінностей, ролей та навичок, що є адаптивними для функціонування в некримінальних соціальних середовищах, а також сприяють активізації ресоціалізаційного впливу на засуджених з боку персоналу УВП. З’ясовано, що основними функціями ГО щодо ресоціалізації засуджених до позбавлення волі є: 1) група функцій, що безпосередньо (або переважно) орієнтовані на засуджених (правова, психологічна, соціальна, матеріально-економічна, професійна, освітня, просвітницько-виховна, культурна, медична, фізкультурно-оздоровча), 2) група функцій, що не мають безпосередньої орієнтації на засуджених (інформування громадськості, налагодження співпраці, контролю, навчально-методичних заходів для працівників). Встановлено, що найширше у першій групі представлені професійна, просвітницько-виховна та культурна функції, а в другій – функція інформування громадськості. З’ясовано, що за локалізацією серед ГО переважають місцеві та всеукраїнські, а за функціями – ГО з чітко вираженою соціальною спрямованістю, правозахисні та ті, які сприяють діяльності інших ГО.

The results of research of the multidisciplinary approach to the provision of the palliative care in Ukraine have been presented in the article. It has been found that the palliative (hospice) care improves the quality of life of patients (adults and children) and their families who face problems, related to life-threatening diseases. The peculiarities in the definition of a «multidisciplinary team» in Ukrainian law (the focus on means of implementation) and international documents on the palliative care (focused on the provision of care components) have been examined. The subjects of the palliative care in Ukraine are palliative institutions, specialized departments of medical institutions, mobile groups (services) of palliative care at home, centers for prevention and combating of AIDS, psychological services, territorial centers of social service for pensioners and lonely disabled people, NGOs and volunteers. The basic medical and non-medical (social, psychological, spiritual) care components of palliative care have been described in the article. The main service users of palliative care are not only terminally ill patients, but also their family members, relatives and palliative care institution employees, who experience high rates of professional burnout. The results of our empirical research have shown that the palliative care services in the city of Lviv include the functions of social workers, though no social worker positions exists in the service providing working groups. Instead, the functions of the social worker in this area are handled either by other team members (e.g. a chief doctor or other medical personnel, psychologist, priest, etc.), or professionals who do not belong to the service team (mostly psychologist). In some cases most part of the functions of the social worker are not delivered at all. The main social worker’s functions while implementing the social component of the palliative care may include the conduction of self-help groups for the terminally ill and their relatives, management of a client’s case, drawing up an individual work plan with the client and his/her family, basic legal counseling, provision of the supervision for members of the multidisciplinary team, establishment of contacts with other specialists, conduction of measures to prevent burnout, development of educational and leisure programs for children of different ages with different illnesses, training for teachers how to work with terminally ill children, development of leisure programs for the elderly (taking into account their age and physical condition), training for practitioners to provide these services, research and development of new programs in order to improve social services in the palliative care, establishment of networks with other social organizations, search for partners, grants, and training of clergy to work in palliative care.

and Objectives: to date there have been several hypotheses on the causes of kidney stone formation. Compromised intrarenal blood flow might play one of major roles in stone formation. Advances in software and 3D technologies have unveiled the nature of contrast medium flow in the intrarenal structures. Mathematical analysis and 3D rendering of computed tomography (CT) scans was utilized for inrarenal contrast medium flow assessment in patients with stone kidney disease. This study aimed at assessing split glomerular filtration rate (sGFR) in patients at the initial stage of stone kidney disease (SKD). sGFR was measured by means of mathematical analysis of 3D rendering abdominal contrast enhanced CT scans. As well as that, possible correlations between irregular inrarenal contrast medium flow and causes of stone formation were considered.23 patients of both sexes with stone kidney disease (SKD) were recruited. They underwent US/Dopler investigation of the kidneys and the bladder, plain X-ray, histopathological evaluation of the tissues (those patients who were operated on), spectroscopic analysis of the stone(s). Mathematical analysis of 3D rendering of CT scans was utilized for sGFR assessment (sGFR reference value: 0,55% of contrast medium per second). Inclusion criteria are as follows: 1) newly diagnosed SKD; 2) stone size less than 1,5-2,0 cm 3) stones that do not block urine flow 4) non-operated young patients; 5) patients free of comorbidities. Inclusion criteria were set to mitigate the effects of other factors that might influence on intrarenal blood flow and conduct the study per se.Mathematical analysis of 3D rendering of CT scans allowed to elucidate changes in sGFR in 22 (95,6%) patients out of 23. HypErfiltration (hyperF) was detected in 10 (43,5%) patients, hypOfiltration (hypoF) was detected in 11(47,8%) patients. sGFR values were statistically significantly different in these groups both on the left (p=0,000142) and on the right (p=0,00068). No significant gender differences were observed (hypoF group aged 25-67 years with the mean age of 43,5 years; hyperF group aged 17-57 years with the mean age of 39 years (p=0,563). Ultrasound Doppler renal resistive index in renal arteries was within the normal range in both groups with no statistically significant difference between the groups. However, 1 patient demonstrated no sGFR changes. Another patient had hyporfiltration on the left (0,48%) and hyperfiltration on the right (0,62%) Conclusions: sGFR alterations (hypo- or hyperfiltration) were detected in the majority of the patients with SKD (95,6%). This in turn might be suggestive of compromised intrarenal blood flow. Further studies are needed to elucidate the optimal management of these patients.

The aim of this research was to study cytokine production by blood immune cells, tumor, and its microenvironment, and characterize extracellular matrix of patients with invasive ductal carcinoma of no special type and lymphatic metastases. Spontaneous and polyclonal activators stimulated production of cytokines by blood immune cells, tumor and its microenvironment were studied in 95 patients with invasive ductal carcinoma of no special type. The concentration of IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF and MCP-1 was determined by the solid-phase enzyme-linked immunosorbent assay. The condition of fibrous component and presence of neutral glycoproteins and sulfated glycosaminoglycans were evaluated during the research of extracellular matrix. Regional lymphatic metastases were detected in 35 of 95 patients. It was shown that in the presence or absence of lymphatic metastases index of polyclonal activators influence on the production of cytokines by blood immune cells was different for IL-6, IL-8, and IL-1β; while in the case of cytokine production by tumor and its microenvironment the index of influence was different for IL-2 and IL-17. The presence of lymphatic metastases corresponded with the rise of cytokines spontaneous production, while the absence of lymphatic metastases corresponded with the rise of cytokines production stimulated by polyclonal activators. The value of indices of polyclonal activators influence on the production of cytokines by blood immune cells pointed to the highly stimulating effect of polyclonal activators while the value of indices of polyclonal activators influence on cytokines production by tumor and its microenvironments pointed to the low and sometimes even absent effect of polyclonal activators. Basing on these data we propose a ratio of indices of polyclonal activators influence for the better evaluation of the probability of lymphatic metastases during preoperative period. After characterizing extracellular matrix we found out a point threshold, which, in 100% of cases, predicted the presence of lymphatic metastases basing on the condition of extracellular matrix. Using the data acquired, we are proposing a risk group for metastasis among women with no lymphatic metastases in the moment of check-up.Issledovali spontannuiu i stimulirovannuiu poliklonal'nymi aktivatorami produktsiiu tsitokinov immunokompetentnymi kletkami krovi, opukhol'iu i ee mikrookruzheniem, a takzhe sostoianie vnekletochnogo matriksa u 95 patsientok s invazivnoĭ kartsinomoĭ molochnoĭ zhelezy nespetsificheskogo tipa pri limfogennom metastazirovanii. S pomoshch'iu immunofermentnogo analiza opredeliali kontsentratsiiu IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α, IFN-γ, G-CSF, GM-CSF, VEGF i MCP-1. Pri izuchenii vnekletochnogo matriksa otsenivali sostoianie voloknistogo komponenta, soderzhanie neĭtral'nykh glikoproteinov i sul'fatirovannykh glikozaminoglikanov. Metastazy v regionarnye limfaticheskie uzly prisutstvovali u 35 iz 95 patsientok. Issledovanie pokazalo, chto pri nalichii ili otsutstvii limfogennogo metastazirovaniia indeks vliianiia poliklonal'nykh aktivatorov na produktsiiu tsitokinov immunokompetentnymi kletkami krovi razlichalsia po trem pokazateliam (IL-6, IL-8 i IL-1β), a indeks vliianiia poliklonal'nykh aktivatorov na produktsiiu tsitokinov kletkami opukholi i ee mikrookruzheniia po dvum (IL-2 i IL-17). Nalichiiu limfogennykh metastazov sootvetstvovalo povyshenie spontannoĭ produktsii tsitokinov, a ikh otsutstviiu – povyshenie produktsii, stimulirovannoĭ poliklonal'nymi aktivatorami. Znacheniia indeksov vliianiia poliklonal'nykh aktivatorov na produktsiiu tsitokinov immunokompetentnymi kletkami krovi svidetel'stvovali o vysokom stimuliruiushchem éffekte poliklonal'nykh aktivatorov, a znacheniia indeksov vliianiia poliklonal'nykh aktivatorov na produktsiiu tsitokinov kletkami opukholi i ee mikrookruzheniia – o nizkom i dazhe otsutstvuiushchem éffekte poliklonal'nykh aktivatorov. Na osnovanii poluchennykh dannykh bylo sostavleno sootnoshenie indeksov vliianiia poliklonal'nykh aktivatorov dlia otsenki veroiatnosti limfogennogo metastazirovaniia v dooperatsionnom periode. Pri otsenke sostoianiia vnekletochnogo matriksa byl vyiavlen porog, kotoryĭ v 100% sluchaev pokazal sootvetstvie sostoianiia vnekletochnogo matriksa nalichiiu metastazov v regionarnykh limfaticheskikh uzlakh. Na osnovanii poluchennykh rezul'tatov byla predlozhena gruppa riska po metastazirovaniiu sredi zhenshchin, ne imeiushchikh na moment issledovaniia metastazov v limfaticheskikh uzlakh.

to carry out a comparative analysis of treatment results of patients with renal tumors who were undergone to nephron-sparing surgery, depending on the type of temporary and definite hemostasis.a total of 163 laparoscopic partial nephrectomies were performed by single surgeon from January 2015 to July 2018. The comparative analysis of treatment results of patients with renal tumors based on following parameters: tumor stage, features of the tumor site, the duration of surgery, the amount of blood loss, complications rate and grade as well as functional and oncological outcomes, depending on the type of temporary and definite hemostasis, was conducted. For preoperative planning the generally accepted nephrometric scale R.E.N.A.L. was used as well as 3D-reconstruction of the tumor.Of the 163 patients, 64 were women (39.3%). The mean age of patients was 56.7+/-11.1 (25-80 years). A clinical stage T1a, T1b, T2 and T3a was diagnosed in 77, 20, 2 and 64 cases, respectively. The average tumor size was 34.8+/-1.1 (11-78 mm). The mean operative time was 84.5+/-32.2 min (30-180). Laparoscopic transperitoneal access was used in 90 patients (55.21%), retroperitoneoscopic approach was chosen in 73 cases (44.79%). The tumor had exophytic growth in 110 cases (67.5%) and in 53 cases it was endophytic (32.5%), while in 59 cases it localized in renal sinus (36.2%). The operative time was significantly shorter in the Group of zero ischemia (72.2+/-29.02 [p0.001]) and bipolar coagulation of the tumor bed (60.8+/-31.7 [p0.001]). The mean volume of blood loss was 160.8+/-142.7 ml (30-900). A GFR calculated by the MDRD equation (mean level was 75.7 ml/min/1.73 m2) on the next day and 6 months after surgery showed a slight decrease in group of zero ischemia, compared to other groups: next day and 6 months after surgery it was 72.8+/-21.6 (p0.001) and 72.01+/-16.6 (p=0.025), respectively. A simple enucleation was performed in 41 cases, while enucleoresection was done in 70 cases. A collection system was opened in 22 cases (13.5%+/-9.8). The suturing and clipping were performed in 20 and 2 patients, respectively. In 2 cases a stenting was performed. In 2 cases there was hemoglobin drop requiring blood transfusion (1.2%+/-3). An embolization due to refractory bleeding was required in 3 cases (1.8%+/-3.7). There was no conversion to open surgery or nephrectomy. Of the 163 tumors, a malignancy was diagnosed in 151 (92.6%+/-7.5) cases. There was no positive surgical margin and recurrence of the tumor.Laparoscopic partial nephrectomy can be successfully performed under zero ischemia. The intervention without clamping of renal blood vessels contributes to significant preservation of the renal function.

The present study represents spectrophotometric method of rutin determination in the dry roots of wild yams (D. caucasica Lipsky), growing in Abkhazia. Obtained results have proven the presence and quantity of flavonoid rutin in the prepared extracts of this medicinal plant. The differential spectrophotometric method was used to confirm the presence of flavonoids and determine their amount in ethanol extracts from Dioscorea caucasica roots. Rutin was applied as a standard sample. A solution of aluminum chloride with rutin had a significant maximum at a wavelength of 0.576 nm. The present data have shown that flavonoids from wild yams roots formed a complex compound with an analytical maximum of intrinsic absorption at 0.565 nm in the aluminum chloride presence. A method of differential spectrophotometry has been developed for the quantitative analysis of the flavonoid rutin, which was found with value of 0.343 mg / g.

To evaluate an effectiveness of simultaneous laparoscopic procedures in patients with synchronous multiple primary cancer (SMPC).We observed 3 patients (2 men and 1 woman) aged 61-78 years with synchronous multiple primary gastric and kidney cancer. Gastric tumors were localized in the lower third of the body (1) and the antrum (2), histological structure corresponded to adenocarcinoma G1 (1) and G2 (2). Kidney tumors were verified as light cell carcinoma and localized in the upper segment of the left kidney in 2 patient and right kidney in one patient. Mean dimension of tumor scheduled for resection was 4.65 cm, nephrectomy - 10.3 cm. Complexity of resection according to the RENAL scale was equal to 8 and 10.Three patients underwent laparoscopic Billroth-I distal gastrectomy, 2 - kidney resection and one patient - nephrectomy. Mean surgery time was 265±37 min, blood loss - 175±29 ml. There were no conversion and redo interventions within 30 days after surgery. Mean hospital-stay was 11±2 days.Minimally invasive technologies in patients with SMPC reduces blood loss, ICU- and hospital-stay. Earlier rehabilitation ensures the next stage of treatment in early postoperative period, while quality of life is better in comparison with traditional interventions.Оценить возможность и эффективность симультанных лапароскопических операций у больных первично-множественным синхронным раком (ПМСР).Мы наблюдали 3 пациентов (2 мужчин и 1 женщину) с ПМСР желудка и почки в возрасте от 61 до 78 лет. Опухоль желудка локализовывалась в нижней трети тела (1) и антральном отделе (2), гистологическое строение соответствовало аденокарциноме G1 (1) и G2 (2). Опухоль почки верифицирована как светлоклеточный рак и локализовывалась в верхнем сегменте левой почки у 2 пациентов, правой — у 1. Средний размер опухоли у пациентов, которым выполнена резекция почки, составил 4,65 см, при нефрэктомии — 10,3 см. Оценка сложности резекции по шкале RENAL — 8 и 10 баллов.Всех больных прооперировали: 3 выполнили лапароскопическую дистальную субтотальную резекцию желудка по Бильроту I; у 2 пациентов произвели резекцию почки, у 1 — нефрэктомию. Среднее время операции — 265±37 мин, кровопотеря в среднем составила 175±29 мл. Конверсии доступа, а также повторных хирургических вмешательств в течение 30 сут после операции не было. Среднее время пребывания в стационаре — 11±2 дня.Применение мини-инвазивных технологий у больных с ПМСР уменьшает кровопотерю, время пребывания в реанимации и стационаре. Более ранняя активизация и реабилитация позволяют приступить к следующему этапу лечения уже в раннем послеоперационном периоде, при этом качество жизни больных выше, чем при традиционных вмешательствах.

Biopsy material of patients with malignant and benign breast diseases was examined. HRG mRNA expression was detected in 70% of cases in biopsy material obtained from patients with nonspecific invasive carcinoma and in 66.7% of cases in biopsy material of patients with benign breast diseases. Immunohistochemical analysis revealed expression of collagen II, the beta-1 integrin, and E-cadherin – markers of epithelial–mesenchymal transition. The use of RT-qPCR combined with immunohistochemical study made it possible to identify atypical cells, which can be regarded as precancerous changes, in individual patients.

Traditionally, evaluation of the split renal function is performed using nephroscintigraphy. However, as shown in several studies, there might be quite significant inaccuracy in the interpretation of dynamic nephroscintigraphy results. But due to the lack of alternative methods for evaluation of split renal function, nephroscintigraphy remains the method of choice.To investigate the feasibility of digital analysis of contrast-enhanced MSCT imaging for evaluation of the split renal function.This is a prospective study conducted at the R.M. Fronshteyn Clinic of Urology from November 2015 to February 2017. The study comprised 31 patients with urolithiasis (n=7), hydronephrosis (n=9), kidney cancer (n=14) and urinary bladder tumor (n=1). During the preoperative period, the patients underwent contrast-enhanced MSCT, 3D-reconstruction, and digital analysis. The obtained data were compared with the results of dynamic nephroscintigraphy.Contrast-enhanced MSCT findings were not inferior to data obtained with dynamic nephroscintigraphy regarding information content (p0.004).The new method of digital processing of three-dimensional contrast-enhanced MSCT allows for concomitant assessment of both the anatomical features of the kidney and renal function that may help to improve the accuracy of surgical planning to choose the optimal extension of the intervention.

Introduction: Instrumental methods of examination may alter the course of treatment and patients' management: from minimally invasive nephron-sparing procedures to radical operations. Objective:to present preliminary data on split kidney function assessment (in a kidney volume, e.g. segment) in patients with urological diseases. Materials and methods: A prospective study was launched in aResearch Institute for Uronephrology and Reproductive Health from November, 2015 to February, 2017. 31 patients were enrolled into the study: 15 with stone kidney disease, 2 with kidney anomalies, 14 with renal tumors. Contrast-enhanced CT with 3D-models and mathematical analysis were performed in all patients. Correlation between CT-based and renal scintigraphy-based measures of split renal function was estimated. Results: CT-based methods for the calculation of split renal function with 3D-models showed correlation with renal scintigraphy (p

We present a complete analytical solution for the plane elasticity problem of a concentrated force acting on a half-space weakened by a circular hole. The solution is based on the algorithm proposed by G.B. Jeffery in 1920 for elasticity problems, using bipolar coordinates to characterize the geometry. We found the biharmonic stress function describing stresses and strains in the half-space and the associated biharmonic function that allows determining the displacement field. Both functions are given in the form of Fourier series with quite compact coefficients. Particular attention is paid to the displacements at the plane boundary of the half-space. It is discussed how these displacements can be used in an inverse procedure for the identification of a circular hole diameter and position.

Consideration of major strategic socio-economic development direction of the Zakarpatsky region and foreign economic activity peculiarities has allowed identifying priorities in their economic safety provision. Among the dominant activities the following ones have been emphasized:creation of the partner relationship management process model applied to realizing economic relations within the framework of joint projectsformation of the regional production base readiness, by means of foreign direct investment (FDI) as well, for the inclusion into TNKconducting control over the activity of operating and newly-created corporationsidentification of the controlling and coordinating authority representing regional interests.

The anatomical and functional relationship of the pelvic organs is a prerequisite to the development of complications when performing surgical procedures in this anatomical region. Prevention and timely diagnosis of intraoperative injuries of both the urinary system organs and intestine, as well as well-coordinated work of urologist and colorectal surgeon team offer the opportunity to employ optimal tactics for the patient management.

The main objective of this article is to show the role of modern computer technology in performing virtual and real surgical procedures for renal tumors. At the present time, 3D based modeling makes it possible to preoperatively identify individual strategy and tactics of treatment of a patient.

We determine the values of the stress intensity factor at the crack tip depending on the location of circular holes used to simulate pores and compare the results of theoretical calculations with the experimental data.