First results of distal gastric shunting with one anastomosis in patients, suffering morbid obesity

Objective. To study a metabolic effect of distal gastric shunting with one anastomosis in patients, suffering morbid obesity (MO). Materials and methods. The results of surgical treatment of 53 patients, suffering MO, in whom in the clinic a distal gastric shunting with one anastomosis, were analyzed. The patients age range have varied from 27 to 66 yrs old. A median body mass index have constituted 53 kg/m2 (38 - 80 kg/m2). Metabolic syndrome have had all 53 (100%) patients, hypertensive disease, atherosclerotic cardiosclerosis, dyslipidemia - 30 (56.6%) patients, Pickwick syndrome - 4 (7.5%), diabetes mellitus Type II - 11 (20.8%). There were estimated the excessive body mass, laboratory indices - a НOMA index, the levels of insulin, C-peptide, lipids, general protein. Results. In a one year postoperatively a median index of the excessive body mass loss have constituted 67.1%, in 2 yrs - 76.4%. Preoperatively a НOMA index have constituted 8.02 conventional units, level of insulin - 21 mcU/ml, C-peptide - 4.2 ng/ml. Already in 3 mo after distal gastric shunting a НOMA index, the levels of insulin and C-peptide have normalized. Conclusion. Distal gastric shunting constitutes an effective method of surgical correction of MO, metabolic syndrome and in accordance to results is completely comparable with other bariatric operations, and they are technically easier to perform in patients, suffering morbid superobesity, using surgical access with 3 trocars

Модифіковане біліопанкреатичне шунтування в лікуванні метаболічного синдрому та цукрового діабету 2-го типу у пацієнтів з морбідним ожирінням

Мета. Вивчення впливу операції біліопанкреатичного шунтування (БПШ) на перебіг метаболічного синдрому (МС) у хворих з морбідним ожирінням (МО). Матеріали і методи. Проаналізовано результати хірургічного лікування 76 хворих з МО, яким виконали операцію БПШ в Інституті. Вік хворих коливався від 23 до 65 років, середній індекс маси тіла (ІМТ) становив 57 (44 - 87) кг/м2. Артеріальну гіпертензію мали 49 (64%), дисліпідемію - 53 (70%), сонне апное - 13 (17%), астму - 14 (18%), цукровий діабет (ЦД) 2-го типу - 30 (39%) пацієнтів. Середній строк спостереження становив 36 міс. Визначали антропометричні та клінічні параметри, індекс НОМА (Нomeostasis Model Assessment - індекс інсулінорезистентності), рівні інсуліну, глюкози, С-пептиду та холестерину (ХС) через 1, 3, 6 та 12 міс після операції. Результати. Через 3 міс після БПШ середній ІМТ становив 45,3 (34 - 59), через 6 міс - 36,1 (39 - 55), через 9 міс - 34,2 (33 - 42) кг/м2. До операції індекс НОМА становив (7,6 ± 0,4) ум. од., середній рівень глікемії натще - (7,8 ± 0,4) ммоль/л, інсуліну натще - (21,2 ± 2,5) мкМО/мл, глікованого гемоглобіну (HbA1с) - (6,8 ± 0,3)%. Через 36 міс після операції індекс НОМА, рівні глікемії натще, інсуліну натще, С-пептиду та HbA1с нормалізувалися. Рівні загального ХС та атерогенних ліпідів поступово знижувалися до нормальних величин. Висновки. БПШ забезпечує тривале та ефективне зменшення маси тіла (МТ) з корекцією компонентів МС

The short bowel syndrome in children: peculiarities of etiopathogenesis, clinical signs and treatment (analysis of literature and own observations)

The short bowel syndrome in children: peculiarities of etiopathogenesis, clinical signs and treatment (analysis of literature and own observations

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

Mathematical Model for Adaptive Technology in E-learning Systems

The emergence of a large number of e-learning platforms and courses does not solve the problem of improving the quality of education. This is primarily due to insufficient implementation or lack of mechanisms for adaptation to the individual parameters of the student. The level of adaptation in modern e-learning systems to the individual characteristics of the student makes the organization of human-computer interaction relevant. As the solution of the problem, a mathematical model of the organization of human-computer interaction was proposed in this work. It is based on the principle of two-level adaptation that determines the choice of the most comfortable module for studying at the first level. The formation of an individual learning path is performed at the second level. The problem of choosing an e-module is solved using a fuzzy logic. The problem of forming a learning path is reduced to the problem of linear programming. The input data are the characteristics of the quality of student activity in the education system. Based on the proposed model the computer technology to support student activities in modular e-learning systems is developed. This technology allows increasing the level of student’s cognitive comfort and optimizing the learning time. The most important benefit of the proposed approach is to increase the average score and increase student satisfaction with learning

SIMULTANEOUS DEBULKING OF GREAT OMENTUM LIKE A PALLIATIVE STAGE OF METABOLIC SYNDROM AND OBESITY TREATMENT = СИМУЛЬТАННИЙ ДЕБАЛКІНГ ЧЕПЦЯ ЯК ПАЛІАТИВНИЙ ЕТАП ЛІКУВАННЯ МЕТАБОЛІЧНОГО СИНДРОМУ І ОЖИРІННЯ

Mylytsya К. M., Lavryk А. S., Lavryk О. А. SIMULTANEOUS DEBULKING OF GREAT OMENTUM LIKE A PALLIATIVE STAGE OF METABOLIC SYNDROM AND OBESITY TREATMENT = СИМУЛЬТАННИЙ ДЕБАЛКІНГ ЧЕПЦЯ ЯК ПАЛІАТИВНИЙ ЕТАП ЛІКУВАННЯ МЕТАБОЛІЧНОГО СИНДРОМУ І ОЖИРІННЯ. Journal of Education, Health and Sport. 2016;6(9):691-698. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.159095 http://ojs.ukw.edu.pl/index.php/johs/article/view/3896       The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.09.2016. Revised 24.09.2016. Accepted: 24.09.2016.       SIMULTANEOUS DEBULKING OF GREAT OMENTUM LIKE A PALLIATIVE STAGE OF METABOLIC SYNDROM AND OBESITY TREATMENT   К. M. Mylytsya1, А. S. Lavryk2, О. А. Lavryk2   1State Institution “Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine” 2Shalimov National Institute of Surgery and Transplantology of NAMS of Ukraine   Summary The article discusses the possibility and expediency of simultaneous visceral fat debulking (omentectomy) in patients with metabolic syndrome and obesity. The investigation of the level index HOMA in the pre- and postoperative period in 50 patients with metabolic syndrome and obesity. Of these various 25 performed abdominal surgery, the rest of the 25 performed similar operations with simultaneous omentectomy. Results indicate that the greater omentum debulking affect carbohydrate metabolism by reducing the severity of insulin resistance and hyperinsulinemia. Key words: debulking, greater omentum, metabolic syndrome, obesity, simultaneous surgery.                 СИМУЛЬТАННЫЙ ДЕБАЛКИНГ БОЛЬШОГО САЛЬНИКА КАК ПАЛЛИАТИВНЫЙ ЭТАП ЛЕЧЕНИЯ МЕТАБОЛИЧЕСКОГО СИНДРОМА И ОЖИРЕНИЯ   К. Н. Милица1, А. С. Лаврик2, О. А. Лаврик2   1 ГУ «Запорожская медицинская академия последипломного образования МЗ Украины», 2Национальный институт хирургии и трансплантологии имени А.А. Шалимова НАМН Украины, Киев     Резюме В статье обсуждаются вопросы возможности и целесообразности применения симультанного дебалкинга висцеральной жировой ткани в виде оментэктомии у пациентов с метаболическим синдромом и ожирением. Проведено исследование уровня индекса HOMA в до- и послеоперационном периоде у 50 пациентов с метаболическим синдромом и ожирением. У 25 пациентов выполнены различные абдоминальные операции, у остальных − подобные операции с симультанной оментэктомией. Результаты указывают на то, что дебалкинг большого сальника влияет на углеводный обмен за счет снижения выраженности гиперинсулинемии и инсулинорезистентности. Ключевые слова: дебалкинг, большой сальник, метаболический синдром, ожирение, симультанная хирургия.                       СИМУЛЬТАННИЙ ДЕБАЛКІНГ ЧЕПЦЯ ЯК ПАЛІАТИВНИЙ ЕТАП ЛІКУВАННЯ МЕТАБОЛІЧНОГО СИНДРОМУ І ОЖИРІННЯ   К. М. Милиця1, А. С. Лаврик2, О. А. Лаврик2   1 ДЗ «Запорізька медична академія післядипломної освіти МОЗ України», 2 Національний інститут хірургії та трансплантологiї імені О. О. Шалімова НАМН України, Київ   Резюме У статті обговорюються питання можливості і доцільності застосування симультанного дебалкінга вісцеральної жирової тканини у вигляді оментектомії у пацієнтів з метаболічним синдромом та ожирінням. Проведено дослідження рівня індексу HOMA в до- і післяопераційному періоді у 50 пацієнтів з метаболічним синдромом та ожирінням. У 25 пацієнтів виконані різні абдомінальні операції, у інших – подібні операції з симультанною оментектомією. Результати вказують на те, що дебалкінг великого чепця впливає на вуглеводний обмін за рахунок зниження вираженості гіперінсулінемії і інсулінорезистентності. Ключові слова: дебалкінг, великий чепець, метаболічний синдром, ожиріння, симультанна хірургія

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