Vol 9, No 3 (2016)

Relevance. To date, there is no unified approach in selection of the most physiological way to reconstruction phase of operations.
The main methods of the stomach motility and small intestine study to date are X-ray examination of the gastrointestinal tract with
barium suspension, respiratory function tests and wireless electronic systems.
Purpose of the study. Determination of the most physiological methods to the formation of anastomoses in the performance of
radical surgery in patients with neoplastic lesions of the pancreatic head based on an assessment of the functional state of the
stomach and small intestine.
Materials and methods. In a specialized department of the liver and pancreas surgery clinical hospital named after S.P. Botkin
and separation methods radionucleide diagnostics of the clinical hospital №1 named after N.I. Pirogov a prospective clinical
study of the functional state of stomach and small intestine in patients with neoplastic lesions of pancreatic head, who had medical
conditions for radical surgery, was conducted. Patients were divided into two groups. In the first subgroup of 19 patients was
performed pancreaticoduodenal resection with antrum-resection in Child modification was performed, and in second subgroup 18
patients had pelorosaurus pancreatoduodenal resection – surgery Traverso-Longmire. To study the motor-evacuation function of
the stomach, small intestine, and the functioning of the hepatobiliary system simultaneous intravenous and oral administration of
two radiopharmaceuticals – technephyte and bromezid with the subsequent registration on a two detector gamma-camera were
used. Assessment of biliary-enteric anastomoses were carried out using intravenously administered drug bromezid containing
120 megabecquerel (MBk) isotope of technetium TC-99m, and for the evaluation of the gastroenteroanastomosis 10% semolina,
labeled TC-99m by technetium, with a dose of 40 MBk TC-99m, was used. The study of the movement of labelled compounds by
biliary tract and gastrointestinal tract was recorded in the computer memory for 120 minutes.
Results and their discussion. In the group of patients after radical surgery at the preoperative stage the study of motorevacuation
function of the upper gastrointestinal tract was made for all patients. 21 patients had a slight slowing of passage of the
radiopharmaceutical from the stomach (up to 50 min.), 6 had half-life period more than 80 minutes, at a rate of T1/2 of 30 min,
which testified to the violation of food evacuation from the stomach. 10 patients had no revealed pathology.
Second study revealed slow excretion of the radiopharmaceutical from the stomach in all patients. In first subgroup the half-life of
the radiopharmaceutical from the stomach during the second study was 126.7 min±89 min, significantly exceeding the norm (T1/2
= 30 min). That slowing of evacuation was caused mainly not by a decrease of gastric motility, but by entero-gastric reflux, mostly
marked from 90 minutes of study. During the third injection of the radiopharmaceutical T1/2 of the stomach amounted to 75.3 per
min±17 min.
Patients of the second subgroup who was made PPDR had the following indicators of half-life of the radiopharmaceutical from the
stomach: during the second procedure - 118,8±44 min., during third - 46,2±8 min.
Conclusion. Application of radionucleid method in patients with neoplastic lesions of the pancreatic head allows not only
early and comprehensive diagnosis of motor-evacuation activity of the stomach, small intestine and bile ducts, but also more
physiological planning of one or another surgery way.
Practical application of presented diagnostic techniques shows objective data availability in patients undergoing PGDR "false"
gastrostasis by entero-gastric reflux, and in patients undergoing PPDR - "true" gastrostasis caused by anastomositis or violation of
innervation wall outlet of the stomach after its mobilization.
Keywords: Neoplastic lesions of the pancreas head, radical surgery, gastroenteroanastomosis, biliodigestive anastomosis,
pancreaticoduodenectomy resection.

A retrospective review of 814 Total Knee Replacements, performed in NWSMU named after I.I. Mechnikov had been conducted for the study. It had shown 20 significant criteria which can influence the occurrence of surgical site infections in postoperative period. Among these factors 15 can be identified pre-surgery, 4 -intraoperatively and 1- postoperatively. The criteria are: age, gender, host optimizations, preoperative management quality, duration of surgery and operating room (OR) conditions, intraoperative complications, amount of blood lost etc.

All these factors were estimated and included in a scaling system. A specific software was created based on this system that can forecast the complications in the area of surgical intrusion in early post-operative period. Afterwards a forecast and prevention algorithm for preventing septic complications in Total Knee Replacement had been developed and applied. In prospective study (174 clinical observations) the application of the forecast and prevention algorithm had resulted in significant decrease rate of septic site complications compared to the cases of retrospective research (decrease of 5.3% in the prospective cases and 2.3% - in retrospective).

Actuality. At the present time is an issue of earlier diagnosis and prognosis of complications related to diabetic macro- and
microangiopathy. Early detection of violations of the antioxidant system, which appear at the stage of pre-clinical manifestations,
will prevent or improve during the complications associated with diabetes mellitus.
The Aim. To assess the state of the antioxidant system in patients with various vascular complications of diabetes, such as diabetic
retinopathy (DR) and angiopathy of legs.
Materials and methods. Three groups of patients were involved in the study, only 75 people at the age of 55 ± 6,0 years. The first
group of patients (n = 25) included patients with type diabetes (non-insulin dependent) with the presence of diabetic retinopathy. In
the second group of patients (n = 25), to have of angiopathy of legs. The third group consisted of 25 healthy people. Determination
of the studied parameters was performed by HPLC methods developed in our laboratory.
Results and discussion. These data suggest that the antioxidant capacity of plasma (Cysfree / Cys-S-S-Cys) when the blood vascular
complications of diabetes decreases and the redox state of GSH / GSSG varies depending on various types of vascular complications
of diabetes.
Conclusions. With the development of vascular complications of diabetes suffers as the antioxidant capacity of plasma and cells
directly, resulting in a significant decrease in the reduced forms of defined indicators. With the progression of the disease and the
presence of diabetic angiopathy factors Cys free / Cys-S-S-Cys and GSH / GSSG was significantly different from those in the control
group. Based on this, we can confidently say that in patients with diabetes require a full assessment of the antioxidant system,
the study of the various factions, not only glutathione and cysteine for the timely pharmacological correction and prevention of
premature morbidity.
Key words: cysteine, glutathione antioxidant system, diabetes mellitus.

Purpose of the study To improve immediate and long-term results of the treatment of achalasia cardia II - III stage by
experimental development and introduction to the clinic a new method of surgical treatment of achalasia.
Materials and methods The original way of surgical treatment of an achalasia of the cardia of the II-III stage is developedby
circular removal of serous-muscular layer of the esophagus in the cardia segment of the esophagus and formation areflux
mechanism of the gastroesophageal junction. Method of forming an artificial cardiac valve tested on 20 rabbits chinchilla both
sexes weighing 5-10 kg.The study of anatomy antireflux valve was studied by the method of the isolated organ freezing according to
the canons of "Ice anatomy" for N.I. Pirogov (1851) in the modification of A.A. Sotnikov and I.B. Kazantsev.
Results and their discussion The valve is represented as a circular fold mucosal and submucosal layers.By results of the pilot
study it is shown that the created invaginatedvalve keeps the structure in all terms of supervision, without interfering with a natural
passage of food. Complications, bound to the offered technique in the early and remote postoperative period it is not revealed.
Conclusion Attempted variant surgery contributes to the formation on the border of the esophagus and stomach kind of antireflux
structures. It maintains its anatomical shape at all stages of monitoring.
Key words achalasia, experiment, surgical treatment

The paper presents an analysis of the provision of medical aid to victims of burns in the Krasnodar region, the optimal timing and
types of evacuation of patients with thermal injury, depending on the age of the victims, the area and depth of the lesion. Objects
of research were inpatients with thermal injury in the Krasnodar region in the period 2010-2015. Each year, the province recorded
3,500 victims with burns, receiving hospital treatment. 1300 of them are on the specialized treatment in the Krasnodar regional burn
center, where they performed 2,000 surgical interventions. The burn center have providing all kinds of specialized assistance to
victims, both with thermal injury and the effects of burns.
Lately, a number of trends in burn injuries and health care levels, which requires analysis and the effectiveness of victim assistance
with thermal injury. Over the past decade, progress has been made in the treatment and relief to victims with thermal injury, but the
problem of burns and remains one of the most pressing issues in modern medicine today.
Currently, combustiology remains one of the few medical specialties in Russia, which is not accepted the order to assist the victims.
In particular, the unresolved issues of early registration and early transfer of patients who received burns to specialized burn units
and centers for the provision of early surgical treatment, which is a guarantee of an optimal rehabilitation of victims and improves
the quality of life of patients with thermal injury.
In making the order to assist the victims of burns is necessary to take into account the territoriality of the Russian Federation.
Keywords: thermal trauma, sanitary aviation, medical evacuation Health Organization.

The current aspects of epidemiology, etiology, pathogenesis, clinical and laboratory picture, radiology and treatment of rare purulent-necrotic diseases of the male external genitalia, including the scrotum carbuncle, hydradenitis of the pubic region, cavernous and bulbar abscess of the penis, subcutaneous abscess median suture of the penis, scrotal abscess and fulminant gangrene of the scrotum (Fournier's gangrene) are explained in the literature review. These diseases usually occur in males to be socially active and of reproductive age with comorbid immunodeficiency background. New methods of adjuvant treatment of patients with Fournier’s gangrene, such as hyperbaric oxygen therapy and vacuum therapy are discussed. Attention is drawn that the prognosis of purulent-necrotic diseases of the external genitalia depends primarily on the timely diagnosis and timing of surgical intervention.

Key words: purulent-necrotic diseases of the male external genitalia, etiopathogenesis, diagnosis, treatment.