Intraoperative ultrasonography in pancreatic surgery: staging and resection guidance

Background: Intraoperative ultrasound examination (IOUS) is indispensable part of modern surgical interventions in tumors of hepatopancreatobiliary zone. In this study retrospective analysis of IOUS efficiency in surgical treatment of pancreatic tumors was provided. Materials and Methods: In the period from January 2013 till November 2015 in the National Cancer Institute IOUS was applied during 76 surgical interventions: for pancreatic head tumors — in 46 (60.5%) patients, for body/tail pancreatic tumors — in 20 (26.3%) patients, in 10 (13.2%) patients — for periampullary zone neoplasms. In IOUS we performed primary tumor assessment (localization, degree of tumor spreading to superior mesenteric vessels, hepatoduodenal ligament vessels, additional foci occurrence in pancreas), and liver metastases detection. Surgical interventions were performed: pancreatoduodenectomy in 52 (68.4%) patients, radical antegrade modal pancreatosplenectomy — in 14 (18.4%) patients. Results: IOUS allowed determining additional tumor foci in pancreas in 2 (2.6%) patients, in 8 (10.5%) observations tumor invasion into portal or superior mesenteric vein was determined. In 21 (27.6%) patient additional hepatic neoplasms were detected (in half of cases — 11.8%, metastases). These findings resulted in change of surgical intervention extent in 23 (30.3%) patients: expansion to combined resections in 14 (18.4%) patients, reduction to symptomatic operations in 5 (6.6%) cases, organ-preserving operations were performed in 4 (5.3%) patients. Variant anatomy of hepatic arterial blood supply was determined in 41 (53.9%) patients that necessitated performance correction of resection stages for preservation of adequate hepatic blood supply. Conclusions: IOUS is a highly-precise diagnostic method substantively influencing operation course in pancreatic tumors, enabling surgeon to provide adequate staging and permanent correction of operation course. Key Words: intraoperative ultrasound examination, pancreatic tumors surgery

Isolation and characterization of peptides from blood serum of patients with multiple sclerosis

In order to find novel molecular markers of multiple sclerosis we developed a scheme of oligopeptides’ isolation including their extraction from blood serum with 10 % trichloroacetic acid, followed by precipitation of soluble substances with acetone in ratio 6:1. Oligopeptides were dissolved in water and their characteristics was determined by gel filtration under HPLC conditions and thin layer chromatography. Obtained data have shown that blood serum of MS patients contains two oligopolypeptides with average molecular masses of 300–500 Da. We also studied biological activity of TCA-soluble peptides toward some eukaryotic and prokaryotic cells in comparison with phosphopeptides isolated from casein hydrolysates. It was found that TCA-soluble peptides are capable of effective inhibiting HeLa cells’ proliferation, while their inhibitory effect was expressed toward Jurkat T-cells and was not detectable toward U373 cells. The casein’s phosphopeptides were capable to stimulate proliferation of Jurkat cells and effectively inhibited growth of cells. Neither antibacterial, nor antifungal activities of these oligopeptides were detected

Biofilm forms in mono- and mixed staphylococci species culture in combination with lactobacilli

Insufficient effectiveness of antimicrobial treatment of many infectious inflammation processes are often associated with the formation of the microbial Biofilms forms. The ability to a biofilm formation was investigated in clinical S. aureus and S. epidermidis strains isolated from patients with acne vulgaris and reference L. рlantarum 8P-A3 strain. For evaluation of the film formation the spectrophotometric measuring of the optical density of structures at the bottom of plastic Petri dishes was used. Item condition of the film structures was also controlled by using microscopic method. It was established that the optical densities of monospecific biofilms formed by S. aureus and S. epidermidis were 1.69±0.77 and 0.60±1.50 OD, respectively, and the planktonic forms of the reference strain was 0.09±0.06 OD. Biofilm structure of L. plantarum 8P-A3 has optical density of 1.79±1.07 OD. Fluorescent microscopy allowed to estimate the proportion of the viable cells in the biofilm. The viable cells were absent after 48 h of mixed-species formation of L. рlantarum 8P-A3 and S. aureus biofilm. Local application of the preparations from lactobacilli contributes to the effectiveness of treatment of the inflammation caused by staphylococcus biofilm forms

Ultrastructural changes in biofilm forms of staphylococci cultivated in a mixed culture with lactobacilli

The capacity of opportunistic bacteria for biofilm formation plays an important role in the development of chronic inflammatory processes, which are difficult to treat. To improve antimicrobial therapy methods, the influence of lactobacilli on the ultrastructure of biofilm-forming clinical strains of staphylococci when co-cultured was investigated. 5 biofilm-forming clinical strains of S. aureus from the skin of acne vulgaris patients (n = 24) were isolated. Using transmission electron microscopy (TEM) the morphological changes of S. aureus cells in the mixed culture with standard strains of Lactobacillus plantarum 8P-A3 and clinical strains of L. fermentum (n = 4) were studied. It was found that in 48 hours after the inoculation on the medium of samples of mixed cultures of L. plantarum 8P-A3 and S. aureus growth of staphylococci was not revealed. Only in some cases of mixed cultures of L. fermentum and biofilm-forming staphylococci was growth of S. aureus obtained. In electron diffraction patterns of control samples of 24-hour staphylococcal monocultures and 48-hour lactobacilli monocultures, natural development of the population at the cellular level was observed. Destructive changes under the influence of lactobacilli (probiotic and clinical strains) were detected in all ultrathin sections of the cells of biofilm-forming and planktonic staphylococci. Significant destructive changes in the cell wall of the staphylococci were observed: thickening, obtaining of irregular form, detachment of the cytoplasmic membrane, the complete destruction of the peptidoglycan layer and the emergence of "shadow cells". On all electron diffraction patterns fibrillar-threadlike structures of DNA could not be observed, but in some cases mesosome-like formations were poorly contrasted. It was established that the surface S-layer of lactobacilli was expressed on a significantly larger scale in the mixed culture with staphylococci. In mixed culture of clinical strains of lactobacilli with biofilm form of S. aureus, staphylococcal cells could be found in a dormant state. Thanks to an experimental model of biofilm in a mixed culture, the development of destructive changes of staphylococci under the influence of the lactobacilli both on the morphological and at the population levels has been assessed. The results obtained can be used in improving the schemes of complex antimicrobial therapy of pyoinflammatory processes with the use of biological preparations, which are composed of lactobacilli, including those in the form of local application

INTRAOPERATIVE ULTRASONOGRAPHY IN PANCREATIC SURGERY: STAGING AND RESECTION GUIDANCE

Background: Intraoperative ultrasound examination (IOUS) is indispensable part of modern surgical interventions in tumors of hepatopancreatobiliary zone. In this study retrospective analysis of IOUS efficiency in surgical treatment of pancreatic tumors was provided. Materials and Methods: In the period from January 2013 till November 2015 in the National Cancer Institute IOUS was applied during 76 surgical interventions: for pancreatic head tumors — in 46 (60.5%) patients, for body/tail pancreatic tumors — in 20 (26.3%) patients, in 10 (13.2%) patients — for periampullary zone neoplasms. In IOUS we performed primary tumor assessment (localization, degree of tumor spreading to superior mesenteric vessels, hepatoduodenal ligament vessels, additional foci occurrence in pancreas), and liver metastases detection. Surgical interventions were performed: pancreatoduodenectomy in 52 (68.4%) patients, radical antegrade modal pancreatosplenectomy — in 14 (18.4%) patients. Results: IOUS allowed determining additional tumor foci in pancreas in 2 (2.6%) patients, in 8 (10.5%) observations tumor invasion into portal or superior mesenteric vein was determined. In 21 (27.6%) patient additional hepatic neoplasms were detected (in half of cases — 11.8%, metastases). These findings resulted in change of surgical intervention extent in 23 (30.3%) patients: expansion to combined resections in 14 (18.4%) patients, reduction to symptomatic operations in 5 (6.6%) cases, organ-preserving operations were performed in 4 (5.3%) patients. Variant anatomy of hepatic arterial blood supply was determined in 41 (53.9%) patients that necessitated performance correction of resection stages for preservation of adequate hepatic blood supply. Conclusions: IOUS is a highly-precise diagnostic method substantively influencing operation course in pancreatic tumors, enabling surgeon to provide adequate staging and permanent correction of operation course. Key Words: intraoperative ultrasound examination, pancreatic tumors surgery

EFFECT OF AMYLOID FIBRILS ON ELECTROKINETIC PROPERTIES OF LIPID VESICLES

The influence of the lysozyme and serum albumin in their native and amyloid forms on the electrokinetic behavior of the negatively charged uni- and multilamellar liposomes from the zwitterionic lipid phosphatidylcholine and anionic lipid cardiolipin has been investigated using the microelectrophoresis technique. The zeta - potential, the surface electrostatic potential and surface charge density of the lipid vesicles have been determined upon varying the lipid-to-protein molar ratio. The complex dependencies of the electrophoretic mobility on the protein concentration and reversal of the surface charge observed for the multilamellar vesicles have been explained by the multilayer protein adsorption on the liposomal surface. It has been found that the native and fibrillar proteins differ in their ability to modify the charge state of the model membranes