Technology transfer: innovative solutions in medicine

Long-term effects of hysterectomy due to uterine fibroids in women of reproductive age

2021-11-10T16:53:20+02:00

The article presents an analytical assessment of long-term postoperative consequences in women of reproductive age after hysterectomy for uterine fibroids.

The aim of the study to determine the structure of long-term results of hysterectomy for uterine fibroids in women of reproductive age using different approaches to the possibility of optimizing the diagnostic algorithm in the preoperative period in the future.

Materials and methods – 160 women aged 40 to 50 years with symptomatic uterine fibroids, who underwent hysterectomy performed by vaginal, laparoscopically assisted vaginal, abdominal, were examined. Research methods are the following: physical examination of patients, assessment of pelvic floor (cough test, Valsalva maneuver, “Stop Test” with Kegel cones), diagnosis of urogenital dysfunction using a standardized POP-Q system; instrumental examination:, complete urodynamic testing, cystometry, (for assessment of the severity of urinary incontinence the classification of the International Continence Society (ICS) was used); assessment of the patient’s quality of life on the 10th day after surgery, 3, 6, 12 months and three years after surgery using the international standard questionnaire MOS SF-36; study of the local infectious status of the female body (bacteriological and bacterioscopic examination of discharge from vagina and urethra, determination of vaginal pH

Results and their discussion. The structure of distant postoperative manifestations was determined (after 36 months of postoperative monitoring): clinical manifestations of intestinal function discomfort in the same degree in patients of three subgroups, 2.4 and 2.9 times less often in group I patients indicated chronic pelvic pain, in 1.7 times less often - for genitourinary disorders, vaginal prolapse in a third of cases, especially in women with abdominal HE and classic vaginal HE (30.0±5.0 % and 37.8±5.0 %, respectively, against 17.8±4.0 % – in the group with laparotomically assisted HE).

Conclusions. Given the data on genitourinary disorders and vaginal prolapse in almost a third of observations after hysterectomy for uterine fibroids, it is advisable to consider additional examination of latent signs of genitourinary syndrome at the preoperative stage to optimize the choice of access, the volume of surgical treatment.

Peculiarities of surgical tactics of patients with thymus tumors

2021-11-10T16:53:20+02:00

The aim of the study: to study retrospective analysis results of the surgical treatment of thymus tumours for predicting long-time results.

Methods. Study included 35 patients who were treated at the Department of Thoraco-abdominal Surgery from September 2019 to May 2021. The control group included 20 patients with SVCS were treated with conventional techniques, while the experimental group included 15 patients who underwent a novel bypass surgery developed by us.

Results. The venous bypass was mandatorily complemented with cytoreduction. Complications in the post-operative period were reported from the experimental group and included auriculo-subclavian bypass thrombosis, post-operative complications were reported in the control group including haemorrhage from the sternotomy wound in 1 (3.3 %) case, superior vena cava thrombosis in 2 (6.6 %) cases, pneumonia in 2 (6.6 %). The relative risk of complications and lethal outcome was calculated for patients from both groups. It was found that the risk of complications was twice as high in the control group as in the experimental group (standard error of relative risk equals 0.64).

Conclusion. The first mandatory step of the radical surgery in patients with thymomas with SVC invasion should be the auriculo-jugular and auriculo-subclavian bypasses, which can reduce the relative risk of post-operative complications by a factor of the risk of lethal by a factor of 3.5

Analysis of surgical treatment of duodenal ulcers with multiple combined complications

2021-11-10T16:53:20+02:00

The aim of the research. Analysis of results and development of surgical tactics for the treatment of DU with multiple combined complications.

Materials and methods. The results of the analysis of surgical treatment of duodenal ulcers with multiple combined complications (3 and 4 combined complications) for 3 periods are presented: 1st (1983–1995) (group A) – 77 patients, 2nd (2000–2007) years (group B) – 30 patients and 3rd (2008–2020) (group C) – 46 patients.

Results. 153 patients (100 %) underwent surgery for complicated duodenal ulcer (DU), of which 130 patients (84.9 %) had a combination of three complications and 23 (15.1 %) had four complications. Bleeding complications were noted in 139 of 153 patients, accounting for 90.8 %, and ulcer perforation in 69 patients, accounting for 45.1 % of all other complications. Based on the obtained data of the analysis, there is a steady tendency to increase the proportion of organ-preserving operations (OPO) by 1.5 times (from 50.7 % to 76.2 %), reducing the number of gastrectomy (GR) by 3 times (from 14.5 % to 4.8 %) and palliative operations (PAL) 3.3 times (from 15.8 % to 4.8 %) with a relatively stable number of performed organ-saving operations (OSO): in group A – 17 (24.6 %) interventions, in group B – 4 (21.1 %), group C – 6 (14.3 %).

Conclusions. The use of modern measures of endoscopic hemostasis allowed to operate on patients in the delayed period, and their share from the second period to the third increased 2.8 times. The number of patients who underwent emergency surgery with perforation of the ulcer as one of the complications decreased in the third period compared to the second by 2.6 times, due to the widespread use of PPIs in the conservative treatment of DU. According to the results of the analysis it became known that the chosen active-individualized tactics and developed algorithms for choosing the type of surgery allowed to achieve a stable level of postoperative mortality at 8.3 %.

The role of tumoral stroma in determining the forecast of recurrence and fatal consequence of stage IIA-IIIB colorectal cancer

2021-11-10T16:53:20+02:00

Colorectal cancer (CRC) ranks 2nd in the structure of mortality from malignant neoplasms (MN). One of the criteria for the prognosis of CRC may be a tumor stroma, which has not been widely used in clinical practice.

The aim was to determine the main morphological features of the stroma CRC T3N0-2M0 and search for prognostic criteria for their recurrence and lethal outcome according to the operating material and autopsy.

Materials and methods. Group I included primary CRC without recurrence. The average recurrence-free period was 5 years (62.5±16.5 months). Group II – primary CRC with recurrence; IIA – with recurrences within 5 years from the date of tumor removal that did not lead to death; IIB – with the appearance of recurrence and lethal consequence of the generalization of the tumor process within 5 years from the moment of removal of the primary tumor. CRC micropreparations made according to the standard method with G + E staining were studied; immunohistochemical study was performed using monoclonal antibodies to smooth muscle actin alpha.

Results. Stromal-parenchymal ratio >50 % is a prognostic criterion for recurrence (p<0.05) and shorter recurrence-free survival (p<0.001) of patients with stage IIA-IIIB CRC. Immature stroma type CRC stage IIA-IIIB is associated with the presence of tumor budding (p<0.001), G3 differentiation (p<0.01), shorter recurrence-free survival (p<0.001); among recurrent CRCs, the immature type of stroma is associated with the lethal outcome of patients (p<0.05). Expressed levels of tumor-activated fibroblasts are one of the criteria for immature CRC stroma (p<0.003), but as an independent prognostic criterion has limited prognostic value.

Conclusions. TSR and immature type of stroma are prognostic criteria for recurrence and recurrence period of CRC pT3N0-2M0, more typical of tumors of patients with recurrence and lethal outcome with the same ratio of tumors by differentiation.

Prognosis role of epitelial-mezenchimal transformation markers and surface stem tumor cells in the reccurence of serous low grade ovarian carcinomas

2021-11-10T16:53:20+02:00

Ovarian cancer remains one of the most fatal pathologies among women around the world due to late diagnosis on the advanced stages of the tumor process. Serous ovarian carcinomas (SOC) often recur, which worsens the prognosis for patients’ recovery and survival. The identification of prognostic clinical and morphological factors that predict the appearance of recurrence remains an urgent problem.

The aim of the research was studying relationships between the phenomenon of epithelial-mesenchymal transformation (EMT) and the expression of surface cancer stem cells (CSCS) markers to identify recurrence predictors among women with low grade serous ovarian carcinomas (LGSC).

The material were paraffin blocks and slides of 43 patients with LGSC I-IV FIGO stage. The study included 30 cancers without recurrence and 13 tumors with it within 24 months. The expression of E-cadherin, Vimentin, CD44 and CD117 was studied using immunohistochemical (IHC) method.

Results. Development of recurrence is typical for women with stage III-IV (p=0,01), the expression of Vimentin at level 51–100 % (p=0,001) and E-cadherin at 10–50 % (p=0.04). CD44 was expressed in 51.16 % of tumors and level didn`t depend on age, recurrence, but depended on disease stage (p=0.001). Recurrent LGSCs are characterized by the expression of CD117> 10 % (p=0.0001), its direct correlation with the stage (p=0.0001) and the recurrence (p=0.0001). A direct relationship was found between the CD117 and Vimentin expression.

Conclusions. Prognostic markers of recurrence should be considered stage III-IV, levels of Vimentin 51–100 %, E-cadherin 10-50 % and CD117> 10 %. A correlation between CD117 and Vimentin expression indicates the commonality of EMT and CSCS in progression and recur. CD44 has no independent prognostic role.

Immunomorphological features of female patient’s skin with androgenetic alopecia in the treatment of platelet-rich plasma in combination with topical minoxidil 2 % lotion

2021-11-10T16:53:20+02:00

The aim. The research was provided to obtain immunohistochemical changes in scalp biopsies of female patients with androgenetic alopecia (AGA) I-II stages according to the Ludwig scale and to detect possible changes after usage of platelet-rich plasma (PRP) injections in combination with topical minoxidil 2 % lotion.

Materials and methods. Skin biopsies of 30 patients with AGA were examined by immunohistochemistry before and after treatment, which lasted for 3 months and included 3 PRP sessions (once per month) and topical application of minoxidil 2 % lotion twice daily.

Results. It was found that AGA is accompanied by inflammatory perifollicular infiltration by T-lymphocytes CD3 +, CD4 + and CD8 +, macrophages (CD68 +); imbalance of growth polypeptides VEGF, TGF-β1, EGFR; accumulation of oxidative stress enzymes eNOS and iNOS; accumulation of pathological fraction of Collagen IV. The use of platelet-rich plasma in combination with topical 2 % minoxidil as AGA therapy leads to the normalization of immunohistochemical parameters of the skin, which indicates the possibility of its use for long-term therapeutic effect.

Conclusions. This study supplemented the understanding of the pathogenesis of AGA and serves as the basis for improving treatment regimens for this pathology. But more research is required to further study the pathomorphology of androgenetic alopecia and to standardize the technique of using platelet-rich plasma in patients with this disease.

Comparative hygienic assessment of working conditions and potential risks for workers' health when applying pesticides in different technics

2021-11-10T16:53:20+02:00

In the structure of regional and planetary pollutants, pesticides are in the top ten, and among food contaminants along with heavy metals – they occupy first place in the world. It is known that pesticides and agrochemicals, which belong to the group of biologically active compounds, are one of the important factors affecting the human body.

The aim: comparative hygienic assessment of working conditions and occupational risk when using pesticides by different methods of application (knapsack, rod, ventilator, unmanned and aviation) on the example of the fungicide Amistar Extra 280 SC.

Materials and methods. Field studies were conducted in 2018–2021. When applying the formulation knapsack sprayer SOLO-10, trailed boom sprayer AMAZON 1201 UF combined with a tractor MTZ 82.1 Belarus, unmanned aerial vehicle (UAV) for spraying fields Agras T16, AN-2 aircraft combined with OZh-2 were used.

Results. As a result of field researches of working conditions of employees during the performance of production operations on the pesticides application, it was found that in the air treatment areas and in areas of possible drift the levels of studied active ingredients were below the limit of quantification of the method. The difference between azoxystrobin (0,04±0,003) and cyproconazole (12,4±0,5) for the tank refueler and the UAV external pilot in the field studies is significant according to Student's criterion (p >0,05). For the operator who applied the pesticide with a knapsack sprayer, the values of inhalation risks were significantly higher than for the tankers of the sprayer tank at p >0,05. The values of the combined risk when using a fan sprayer (0,46±0,02) significantly exceeded the data obtained when using a rod sprayer (0,14±0,006)

Conclusions. Analysis of the obtained results showed that the values of the combined risk are significantly higher for the operator / tractor driver, signalman than for their refuelers (at p <0,05). The values of the combined risk of the external pilot were significantly lower than those of the tanker when using a pesticide using a UAV.

Biochemical status of blood of dogs with atopic dermatitis in the conditions of private veterinary clinic “Alfa vet” m. Konotop

2021-11-10T16:53:20+02:00

Metabolic changes in the body of dogs with atopic dermatitis and the causes of its occurrence still remain poorly understood. This study confirms the need for biochemical blood tests for the differential diagnosis of skin diseases in animals.

The aim of the research. To identify metabolic changes in dogs with atopic dermatitis.

Methods. Serum samples from five ill animals and five intact animals were tested. The diagnosis of the nosological form of skin lesions was established based on the results of anamnesis and clinical manifestations of the disease. Additionally, biochemical studies of the serum of sick animals were performed. Blood of dogs (n=5) was taken from the anterior subcutaneous vein of the forearm or the lateral subcutaneous vein of the tibia into blood tubes.

Results. In the study of mineral metabolism, it was found that the concentration of inorganic phosphorus in the serum of sick animals is reduced by only 0.01 mmol/l, but the concentration of total calcium by 10.0 %. The concentration of cholesterol increases 1.3 times and exceeds the reference values by 0.16 mmol/l. In the blood of sick animals, the activity of alanine aminotransferase is significantly reduced by 21.0 % and aspartate aminotransferase – by 20.0 % compared to intact animals. The enzyme gamma-glutamyltransferase probably increases by 1.51 times (P<0.05) in sick dogs, but does not exceed the reference values.

Conclusions. It was found that in atopic dermatitis in the serum of dogs decreases the activity of alanine aminotransferase by 21.0 % and aspartate aminotransferase – by 20.0 %, while the activity of gamma-glutamyltransferase increases 1.51 times. The results show the toxic effect of an allergic agent on animals, especially on the liver, which confirms the previous diagnosis – atopic dermatitis.

Application of bacillus megaterium for subclinical mastitis in cows

2021-11-10T16:53:20+02:00

The problem of treatment of subclinical mastitis often arises after calving, especially in cows of the first lactation. The paper presents the results of the therapeutic effect of Bacillus megaterium in subclinical mastitis in cows.

The aim of the research. To determine the effect of Bacillus megaterium on the microflora of the gastrointestinal tract and colonies of microorganisms isolated from subclinical mastitis in cows.

Materials and methods. The research was conducted in a dairy farm growing Holstein. Cows with subclinical mastitis of the experimental groups were given concentrated feed with the addition of Bacillus megaterium (1 × 10⁹ CFU/g) at a dose of 15–35 g per animal. The control group of cows was given the usual diet for dairy cows. The experiment lasted 30 days.

Results. The use of Bacillus megaterium (1 × 10⁹ CFU/g) at a dose of 35 g per animal had a pronounced effect on the microflora of the gastrointestinal tract of cows. The amount of Lactobacillus sp. was 67 % higher and Bifidobacterium 58 % higher than the control. In addition, the level of opportunistic pathogens on Escherichia coli decreased by 45 %, Clostridium by 27 %, Enterobacteriaceae and Staphylococcus by 75 %, and Candida by 80 % compared to controls. The amount of microflora in milk decreased by 40.2 % and the number of somatic cells by 87.9 %.

Conclusions. The therapeutic efficacy of Bacillus megaterium (1 × 10⁹ CFU/g) at a dose of 35 g per animal for 30 days in subclinical mastitis has been proven. After treatment, the amount of microflora in cow's milk decreased by 40.2 % and the number of somatic cells by 87.9 %.

A positive effect on the microflora of the gastrointestinal tract of cows, where the number of Lactobacillus sp. increased by 67 % and Bifidobacterium by 58 %. The level of opportunistic pathogenic microflora decreased by Escherichia coli – by 45 %, Clostridium – by 27 %, Enterobacteriaceae and Staphylococcus – by 75 %, Candida – by 80 %, compared to the control.

Determination of antimicrobial and fungicidal properties of experimental disinfectant "Sukhodez"

2021-11-10T16:53:20+02:00

The results of the study of antimicrobial and fungicidal properties of the experimental preparation “Sukhodez” against microorganisms E. coli, Salmonella enteritidis, Staphylococcus aureus and fungi Candida albicans in the laboratory are presented.

The aim of the research. To study the antimicrobial and fungicidal properties of powdered disinfectant and analyze the prospects for its further use in a set of anti-epizootic measures in particular in poultry farms.

Materials and methods. The research was conducted during 2021 at the Department of Veterinary Examination, Microbiology, Zoohygiene and Safety and Quality of Animal Products of the Faculty of Veterinary Medicine of Sumy National Agrarian University. Evaluation of bactericidal properties of the experimental agent “Sukhodez” was determined on museum strains of E. coli ATCC 25922, Salmonella enteritidis ATCC 13076 and Staphylococcus aureus ATCC 6538, fungicidal properties were studied on fungi Candida albicans. All cultures were standardized to 10⁹ CFU / cm³.

Results. It is established that as a result of the conducted researches at studying preparation “Sukhodez” antimicrobic properties, it had high efficiency concerning action on strains of both gram-positive and gram-negative bacteria. It had a detrimental effect on bacteria when applied to concrete at an exposure of 1 hour with a rate of 75 mg per 1 m², and had the same effect as when applied to a wooden surface, where it expressed antimicrobial action at a rate of 50 mg/m² after 4 hours. When determining the fungicidal properties, it was found that when exposed to 5 hours, the preparation “Sukhodez” had an effect on study contaminated objects with a rate of 50 mg/m², and with a rate of 75 mg/m² inhibited the growth of fungi for 1 hour.

Conclusions. It was found that the most sensitive to the preparation “Sukhodez” were the culture of Salmonella enteritidis – at a rate of 25 g / m² and action on concrete and wooden surfaces, the disinfectant inhibited the growth of the culture when exposed to 5 hours, and at a rate of 50 g / m² – for 2 years. Staphylococcus aureus was the most stable bacterial culture, so at a rate of 50 g / m² on concrete and wood surfaces, bacterial growth was inhibited for 4 and 5 hours, respectively. At the same time, in the study of fungicidal properties, “Sukhodez” showed a fungicidal effect on Candida albicans when applied to a concrete surface at a rate of 50 mg / m² for 3 hours, when applied to a wooden surface – for 4 hours.

In general, at a rate of 75 g / m², “Sukhodez” has an instant bactericidal and fungicidal effect on bacteria and fungi applied to concrete and wooden surfaces

Extraction and reverse transcription of total rna from mouse brain-derived endothelial cells.3 infected by streptococcus Suis 2

2021-11-10T16:53:20+02:00

Streptococcus suis 2 is an important emerging zoonotic pathogen. It mainly causes meningitis in pigs. We use SS2 to infect bEnd.3 to get stable cDNA for next research on differences in gene expression and protein expression of cytokines.

The paper presents an SS2 study for bEnd.3 infection to obtain stable cDNA for subsequent study of differences in gene expression and cytokine protein expression.

Objective: The aim of this study was to extract the total RNA from mouse brain-derived Endothelial cells (bEnd.3) infected by Streptococcus suis serotype 2 (SS2) and transcript to complementary DNA (cDNA).

Materials and methods: SS2 strain were obtained from Jilin University, China. BEnd.3 was from Henan institute of Science of Technology, China. Reverse transcription kit was from Takara company, Japan. Trizol was from Bioteke company,China. Nanodrop instrument was from Thermo company, USA. Polymerase chain reaction (PCR) instrument was from Biometra company, Germany.

We used SS2 to infect bEnd.3 at a multiplicity of infection (MOI) of 100 for 12h. Cells were harvested and Trizol method was chose to extract the total RNA of bEnd.3 infected by SS2. Nanodrop instrument was used to measure the concentration of RNA and the values of OD260/280 and OD260/230. RNA were transcripted to cDNA with reverse transcription kit by PCR instrument.

Results: trizol method used in this study was reliable and high-quality RNA were obtained. Stable cDNA were obtained by reverse transcription kit.

Conclusion: in this experiment high-quality RNA was obtained and reverse transcribed to stable cDNA for subsequent detection of related cytokines. This study provides an approximate RNA extraction method and good experimental foundation for downstream research.