2nd Degrees Research Articles

Optimization of surgical treatment of abdominal hernias in patients with obesity

Introduction. Among patients with primary and postoperative ventral hernias, obesity of various degrees is observed in more than 50 % of patients. A severe complication of obesity is the development of panniculus – a skin-subcutaneous apron of varying severity. The hernia surgeon often performs a panniculectomy, which requires justification, taking into account both the positive and negative consequences.The objective was to improve the results of treatment of patients with hernias who are obese by developing a mathematical algorithm of indications for removing the skin-subcutaneous apron.Methods and materials. The analysis of surgical treatment of 253 obese patients with hernia aged 20 to 90 years was performed. There were 44 males (17.4 %) and 209 females (82.6 %). There are 2 groups: the first (comparison group) included 129 patients whom the hernia excision was performed without removing the skin-subcutaneous apron; the second (main group) – 124 patients who had the excision of the skin-subcutaneous apron during surgery. Indications for panniculus removal were based on the proposed mathematical algorithm, which took into account the size, clinical manifestations, associated complications, and possible consequences after surgeries while preserving it.Results. When considering the abdomen in patients with hernias and obesity from the side surface, the hanging apron in relation to the abdominal wall forms a truncated cone, or two conjugated cones that form significantly different moments of forces acting on the abdominal wall at different stages of development of the panniculus, and, therefore, can serve as the basis for the development of classification. Based on this mathematical model, the following classification of changes in the anterior abdominal wall in hernias and obesity is proposed: saggy belly; cutaneoussubcutaneous apron I, II, III degrees, which are based on calculated mathematical indicators and clinical manifestations of the disease. When treating patients with hernias and obesity during operations, the following tactical algorithms were followed: with a saggy stomach and panniculus of the 1st degree, the removal of the skin-subcutaneous apron can be refused; with the 2nd and 3rd degrees, its preservation contributes to the recurrence of the hernia due to the action of moments of forces that shift and pull the abdominal wall down.Conclusions. Clinical observations of patients with hernias and obesity have shown that the removal of the skinsubcutaneous apron did not lead to an increase in the frequency of wound and systemic complications, and therefore it should be considered a necessary stage of surgery.

RETRACTED: Implementation of Stochastic Analysis in Corporate Decision-Making Models

The stochastic approach as a method for modeling factor systems of interrelationships of economic activity aspects allows minimizing managerial errors against the background of company growth and expansion of operating activities. The purpose of this study is to form a decision-making model to ensure the financial competitiveness of enterprises in the context of stochastic analysis. This study demonstrates stochastic analysis implementation in companies of the 2nd and 3rd degrees of internationalization based on multiple regression and factorial analysis of variance. The practical basis of the study was Chinese and Russian mining enterprises that enter highly competitive markets and therefore should avoid mistakes in decision-making as much as possible. The model of financial competitiveness proposed in the article demonstrates the best ways to introduce stochastics in companies to optimize their overall productivity, regardless of the country of origin. In a practical sense, research on reducing managerial mistakes allows enterprises to have financial success even in the turbulent conditions of today’s global market, regardless of the company’s jurisdiction.

Differential-diagnostic criteria of active ulcerative colitis and irritable bowel syndrome

The authors conducted a comparative analysis of clinical, laboratory and endoscopic data of 80 patients with ulcerative colitis (UC) of the 1st, 2nd, 3rd degrees of activity and 82 patients with irritable bowel syndrome (IBS) to determine the possible differential-diagnostic criteria of these diseases. It has been found that UC of the 1st, 2nd, 3rd degrees of activity develops with equal frequency among men and women, but IBS develops more often in women. The average age of patients with UC [the 1st degree of activity – (49.1±1.8) years, the 2nd degree of activity – (49.2±1.9) years, the 3rd degree of activity – (49.4±2.5) years] is higher compared to the average age of patients with IBS [(38.4±1.2) years]. UC of the 1st, 2nd, 3rd degrees of activity more often develops in patients after 40 years, while IBS in patients at the age of 18 till 40 years. Pain along the intestine occurs with equal frequency in patients with UC of the 2nd and 3rd degrees of activity. Stool disorders occur with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity and IBS. In a clinical blood test with the same frequency diagnose anemia and increased erythrocyte sedimentation rate in patients with UC of the 2nd and 3rd degrees of activity. Increased level of fecal calprotectin is documented with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity. Bleeding in the large intestine is a characteristic endoscopic finding for patients with UC of the 3rd degree of activity. Erosive-ulcerative changes in the large intestine on endoscopic examination are found with equal frequency in patients with UC of the 1st, 2nd, 3rd degrees of activity. The comparative analysis of clinical, laboratory and endoscopic data in most cases did not allow to identify the clear differential-diagnostic criteria for different degrees of activity of UC, UC and IBS. The data obtained by the authors update the conduct of a comprehensive morphological study, which would identify the specific and clear differential-diagnostic criteria of UC and IBS, which will certainly improve the treatment and diagnostic process among this category of patients and also diseases prognosis. Keywords: differential-diagnostic criteria, active ulcerative colitis, irritable bowel syndrome.

Оптимизация диагностики доклинической дисфункции почек при артериальной гипертензии и ее сочетании с сахарным диабетом 2 типа

In order to optimize the diagnosis of early renal dysfunction in patients with arterial hypertension and its combination with type 2 diabetes mellitus, we examined 100 patients aged 35 to 58 years (mean age 46.8 ± 0.68). The first group included 50 patients with AH of the 1st and 2nd degrees, the 2nd group consisted of 50 patients with a combination of AH and type 2 diabetes. In all patients, the concentration of creatinine, cystatin C, uric acid was determined, and the glomerular filtration rate was calculated using the formulas of KokroftGault, MDRD, CKD EPI, Hoek. Along with this, the degree of albuminuria was determined, ultrasound and the dopplerography of the renal vessels was performed to determine the biometric parameters of the kidneys. Both in patients with AH and in its combination with type 2 diabetes, an increase in the level of cystatin C and uric acid in the blood was detected. The calculation of GFR by various formulas more often revealed an insignificant decrease in renal function when using the formula based on cystatin as opposed to the calculation based on creatinine.When the degree of albuminuria was detected in 9% of patients with AH of 1st degree and in 21% of patients with AH of 2nd degree, albuminuria of A2 grading was revealed. In the 2nd group, albuminuria of A2 gradation was detected in 36%, and in 4% — gradation A3. Ultrasound revealed a significant increase in renal volume (224.6 ± 3.17 cm3, p <0.001) in patients of group 2. Doppler sonography in both groups revealed a decrease in speed indicators and an increase in resistance and pulsation indices. Thus, a set of methods, including the determination of the level of cystatin C and uric acid in the blood, the calculation of GFR for cystatin C, the identification of the degree of albuminuria and ultrasound of the kidneys is important for the diagnosis of preclinical kidney damage in patients with hypertension and hypertension with an adjacent course with type 2 diabetes.

Морфометрический анализ тканевых структур слизистой оболочки десен крыс под действием инфракрасного лазерного излучения

The aim of the study — was a comparative study of the adaptive responses of tissue structures and gelatinases of the gingival mucosa (SOD) in healthy rats to the effect of different modes of low-intensity laser radiation (NILI) in the infrared range. Materials and methods of research: the work was performed on 55 laboratory mature female rats using histological, immunohistochemical, zymographic, morphometric and statistical methods. The results of the study: the obtained data confirm the development of biological effects in response to the action of NILI: absorption of photon energy by intracellular components стим stimulation of adaptation reactions: increased activity of enzymes and TC function, activation of microcirculation. Conclusions: 1. After 1 minute and on the 1st day after exposure to NILI with a wavelength of 970 nm and a power of 0.5 W, a more significant increase in the number of TC with VEGFR1 expression, degranulated forms of TC, including with the 1st, 2nd and 3rd degrees of degranulation, the number, diameter of blood vessels and the area occupied by them, and an increase in gelatinase activity was recorded up to 5 days compared to similar indicators at the specified periods after exposure to NILI with a wavelength of 890 nm and a capacity of 25 MW. 2. The presence of a direct strong correlation between the parameters of TC, blood vessels and the activity of gelatinases indicates the development of interrelated physiological processes of adaptation in SOD tissues in response to the action of various parameters of the NILI infrared range. 3. The immunohistochemical method allows for specific detection, precise localization, and objective morphometric analysis of TC with VEGFR1 expression in SOD of control and experimental rats.

Особливості перебігу вагітності та характеристика акушерської патології у жінок з ожирінням різного ступеня та фізіологічною масою тіла

The medical and social significance of obesity in pregnant women lies in the high frequency of obstetric complications: miscarriage, preeclampsia, placental dysfunction, abnormal labor, obstetric hemorrhages, infectious and extragenital diseases in offspring that are programmed in utero. The purpose of the research was to analyze the course of pregnancy and to characterize obstetric pathology in women with obesity of various degrees and physiological body weight. Material and methods. To achieve this goal, we surveyed 369 pregnant women. Pregnant women with obesity were divided into three experimental groups: the first one consisted of 149 women with obesity of the 1st degree; the second group included 73 women with the 2nd degree obesity; the third group had 46 women with the 3rd degree obesity. The control group consisted of 101 women with physiological body weight (BMI = 18.5-25 kg/m2). Results and discussion. In the early term of pregnancy, the risk of miscarriage in women with obesity of different degrees was reliably higher by 2.1-2.9 times compared to the control group (p˂0.05). The risk of late miscarriage in groups of women with obesity of different degrees was 1.7-2.4 times higher than in the control group, although these differences were unreliable. There was also a clear tendency for the risk of preterm labor to increase by 1.4-1.7 times (p˃0.05) in obese women. There was a significant increase in the frequency of placental dysfunction in pregnant women with obesity of varying degrees, which was 1.3-1.8 times higher than the control values. An increase in the incidence of placental dysfunction in obese pregnant women manifested as an increase in the number of cases of fetal distress during pregnancy, the frequency of which increased in accordance with the severity of obesity. There was an increase in the incidence of early preeclampsia without statistical significance in women with the 2nd and 3rd degree obesity. Regarding preeclampsia, a significant increase in its frequency should be noted in obese pregnant women depending on the severity. Only women with 2nd and 3rd degree obesity had obstetric hemorrhage caused by premature detachment of the normally situated placenta. This complication was not observed in pregnant women of the control group and with the I degree obesity. Anemia of pregnancy was 1.5 times more common in women with I degree obesity and 1.4 times in women with the 2nd degree obesity, compared to the control group. In obese pregnant women, the frequency of asymptomatic bacteriuria increased in the 1st degree obesity by 1.6 times, in the 2nd and 3rd degrees by 1.2 and 1.4 times respectively compared to the control group. Conclusion. Thus, obesity is an aggravating factor of pregnancy, as evidenced by the increasing frequency of the most threatening complications for the mother and fetus such as miscarriage, placental dysfunction, preeclampsia, and obstetric hemorrhage compared to pregnant women with physiological body weight

Thread lifting and single-step facial volumization as an optimum balanced technique of aesthetic correction

BACKGROUND: Development and introduction of minimally invasive lifting techniques is considered a demanding and relevant objective of contemporary dermatocosmetology as these techniques result in nonsurgical lifting with minimal disruption of facial harmony due to the activation of a maximal number of key anatomic landmarks following the simultaneous insertion of lifting threads and hyaluronic acid fillers.
 AIMS: To study the clinical efficacy and safety of minimally invasive lifting technique and filling up of the tissue volume deficiency with the combination of thread lifting from the temporal approach and hyaluronic acid filler augmentation.
 MATERIALS AND METHODS: The study group included 193 female patients (mean age 41.3 8.5 years) with gravitational ptosis of the 1st, 2nd, and 3rd degrees. Group 1 (main) comprised 42 (21.8%) patients who underwent lifting by the method of implantation of 12 threads with shaped polydioxanone spikes DG-Lift and injection of 2 ml of hyaluronic acid biphasic filler. Group 2 (comparison) comprised 64 (33.2%) female patients who underwent lifting using only 1220 polydioxanone DG-Lift threads. Group 3 (comparison) comprised 87 (45%) female patients who received tissue volumization with 48 ml of biphasic hyaluronic acid filler in each case.
 RESULTS: A total of 82%, 59%, and 48% of patients in groups 1, 2, and 3, respectively, noted the optimal cosmetic result and full satisfaction with the result according to the Global Aesthetic Improvement Scale. The incidence of complications in group 1 (6.4%) was lower than that in group 2 (9.1%) and group 3 (17.7%). This is due to low invasive nature and lower tissue traumatization with the use of fewer fillers and threads to obtain optimal cosmetic effect.
 CONCLUSION: The proposed technique of thread lifting with biodegradable threads DG-Lift from the temporal approach combined with tissue volumization with hyaluronic acid fillers is safe and significantly effective for patients with gravitational ptosis of the 1st, 2nd, and 3rd degrees.

The structure of heredity factors and their relationship with clinical and psychopathological manifestations of patients with recurrent depression

The article presents the features of the structure of heredity factors and their influence on the clinical and psychopathological image of recurrent depression. The study involved 87 patients with recurrent depression. Based on the results of socio-demographic, clinical-genealogical, clinical-psychopathological, psychometric studies, a high level of family related depression factors were established at all stages and levels of relationship in the genealogy of patients with recurrent depressive disorders. It is shown that in the proband genealogy, there is a high percentage of observed patients mainly of the 1st degree of relationship, by a psychiatrist. Among the inherited burden of somatic pathology in the genealogy of patients with recurrent depressive disorders, hypertension, heart disease and endocrine pathology prevail. When analyzing the information obtained, it was determined that the proportion of factors such as observation by a psychiatrist for the 1st and 2nd degrees of relationship, depressive disorders mainly for 2nd degree of relationship, suicidal behavior for the 1st and 2nd degrees of relationship and the predominance of recurrent disorder in the clinical picture of hypochondriacal and apathetic syndromes, affects the course and clinical picture of recurrent depression. The information received should be considered as diagnostic and preventive measures in the provision of care for this category of patients. Key words: recurrent depressive disorders, hereditary factors, environmental factor

Mental health of chemical workers: violation risk factors

Aim. To study the structure of psychosocial maladjustment in chemical workers and assess the contribution of industrial and non-industrial risk factors in the formation of mental illness.
 Methods. It was analysed of hygienic assessment of the leading harmful production factors chemical, physical, factors of severity and intensity of labor. During the periodic medical examination, the mental health status of 1,226 people was examined, with a focus on professional experience, mental hygiene aspects of production factors, as well as individual and personal characteristics of employees. Confidence intervals and standard errors estimating, the logistic regression models fitting were performed using R Statistical Software with significance level 0.05.
 Results. The working environment hazards in organic synthesis included chemical risk factor, continuous noise exceeding the permissible exposure limit, emotional stress and life-threatening conditions (fire and explosion hazards in the work). The general assessment of working conditions was performed using clauses 5.15.11 P 2.2.2006-05-harmful working conditions of the second-third degree (3.23.3). Working conditions at all stages of the manufacturing process of pyroxylin powders were assessed as harmful to the third-fourth degree (3.33.4), including the chemical factor, the severity and intensity of work, fire and explosion hazards in the work. It was revealed the dependence of the development of psychosocial maladjustment on non-work-related factors (such as the level of education, marital status), conditional work-related factors (level of material security). Also, the dependence of the structure of pre-existing mental health condition on the work-related and developmental characteristics (work experience) of labor in chemical production was found.
 Conclusion. Working conditions in the studied industries correspond to the 3rd harmful class, 2nd and 3rd degrees in the production of organic synthesis (3.23.3), while at the production of pyroxylic powders, it is close to dangerous (3.33.4); the structure and risk of the developmental process of employee maladjustment are determined by the feature effect of workplace hazards.

명승 부안 채석강ㆍ적벽강 일원의 경관관리를 위한 관속식물상 연구

This research was conducted to provide basic information for landscape management, natural resource 􀁆􀁒􀁑􀁖􀁈􀁕􀁙􀁄􀁗􀁌􀁒􀁑􀀃􀁄􀁑􀁇􀀃􀁘􀁗􀁌􀁏􀁌􀁝􀁄􀁗􀁌􀁒􀁑􀀃􀁗􀁋􀁕􀁒􀁘􀁊􀁋􀀃􀁖􀁜􀁖􀁗􀁈􀁐􀁄􀁗􀁌􀁆􀀃􀁕􀁈􀁖􀁈􀁄􀁕􀁆􀁋􀀃􀁒􀁑􀀃􀃀􀁒􀁕􀁄􀀃􀁄􀁑􀁇􀀃􀁏􀁄􀁑􀁇􀁖􀁆􀁄􀁓􀁈􀀃􀁆􀁋􀁄􀁑􀁊􀁈􀁖􀀃􀁒􀁉􀀃􀀶􀁆􀁈􀁑􀁌􀁆􀀃􀀶􀁌􀁗􀁈􀀃 (No. 13) Chaeseokgang and Jeokbyeokgang Cliffed Coasts, Buan. A total of 183 taxa of vascular plants were identified, the detail being 65 families, 138 genus, 157 species, 1 subspecies, 23 varieties, and 2 forms. There were only two ferns and two gymnosperms, but also 175 types of angiosperms were 􀁌􀁇􀁈􀁑􀁗􀁌􀂿􀁈􀁇􀀏􀀃􀁚􀁋􀁌􀁆􀁋􀀃􀁌􀁖􀀃􀀜􀀘􀀑􀀙􀀈􀀃􀁒􀁉􀀃􀁗􀁋􀁈􀀃􀁗􀁒􀁗􀁄􀁏􀀑􀀃􀀤􀁐􀁒􀁑􀁊􀀃􀁗􀁋􀁈􀀃􀁓􀁏􀁄􀁑􀁗􀁖􀀃􀁕􀁈􀁖􀁈􀁄􀁕􀁆􀁋􀁈􀁇􀀏􀀃􀁗􀁋􀁈􀀃􀁗􀁄􀁛􀁒􀁑􀀃􀁚􀁌􀁗􀁋􀀃􀁗􀁋􀁈􀀃􀁊􀁕􀁈􀁄􀁗􀁈􀁖􀁗􀀃􀁑􀁘􀁐􀁅􀁈􀁕􀀃 􀁚􀁄􀁖􀀃􀀦􀁒􀁐􀁓􀁒􀁖􀁌􀁗􀁄􀁈􀀃􀁚􀁋􀁌􀁆􀁋􀀃􀁕􀁈􀁆􀁒􀁕􀁇􀁈􀁇􀀃􀀕􀀙􀀃􀁗􀁜􀁓􀁈􀁖􀀑􀀃􀀤􀀃􀁗􀁒􀁗􀁄􀁏􀀃􀁒􀁉􀀃􀀗􀀃􀁗􀁄􀁛􀁄􀀃􀁒􀁉􀀃􀁈􀁑􀁇􀁈􀁐􀁌􀁆􀀃􀁓􀁏􀁄􀁑􀁗􀁖􀀃􀁚􀁈􀁕􀁈􀀃􀁌􀁇􀁈􀁑􀁗􀁌􀂿􀁈􀁇􀀞􀀃􀀦􀁏􀁈􀁐􀁄􀁗􀁌􀁖􀀃 brachyura, Populus tomentiglandulosa, Broussonetia kazinoki Siebold, and Saussurea eriophylla Nakai, while two taxa of endangered plants were identified; Koelreuteria paniculata and Glehnia littoralis. There were a total of 10 taxa in case of naturalized plants, including Brassica campestris subsp. napus var. nippo-oleifera Makino, Lepidium virginicum L., Chenopodium ficifolium Sm., and Phytolacca americana L., with the naturalization rate being 5.5%. According to the analysis of naturalized degrees of the naturalized plants, there were 7 plants with 5th degree of naturalization while there were one species for each 4th, 3rd, and 2nd degrees, and there were no 1st degree plant. The vegetation in the Gyeokpo-ri area is divided into 13 plant communities. The representative plant colonies include Pinus thunbergii colony, Pinus thumbergii-Quercus variabilis colony, Pinus thunbergii-Quercus acutissima colony, Carpinus turczaninovii Hance-Pinus thunbergii colony, Carpinus turczaninovii Hance colony, and Clerodendrum trichotomum -Euonymus japonicus colony, with Pinus thunbergii colony taking up 53.55% of the total. As the vegetation in Scenic Site Chaeseokgang and Jeokbyeokgang Cliffed Coasts, Buan mainly consist of Pinus thunbergii colony and mixed pinus thunbergii forest, the vegetation landscape does not become different throughout four seasons, and one can feel partial seasonal changes because deciduous trees, such as Quercus species and Carpinus turczaninovii Hance, are spread in parts.

Accommodative ability in patients with strabismic amblyopia at concomitant strabismus

Aim. To study the state of the accommodative ability of amblyopia before and after treatment.
 Materials and methods. One hundred patients (158 eyes) with friendly alternating and monolateral strabismus were examined. The control group consisted of 10 healthy individuals (20 eyes) with emmetropia: the average age of patients under 3 years of age was 2.4 0.15 years, from 3 years to 7 years, 4.8 0.07 years, and above 7 years, 8.3 0.4 years. The vast majority of patients (84 people, 126 eyes) had hyperopic astigmatism, and 16 patients (32 eyes) had a high degree of hyperopia. Twenty-eight patients (40 eyes), 48 patients (84 eyes), and 20 patients (26 eyes) had amblyopia of the 1st, 2nd, and 3rd degrees, respectively. Along with generally accepted methods for examining eyes, the OAA volume and ZAA were determined as the absolute accommodation margin by the proximetric method (AKA-0.1) before and after hardware treatment to relax and stimulate the ciliary muscle.
 Results. The results after treatment revealed a 1.52-fold increase in OAA to 14.4 0.23 D; 13.5 0.10 D; 13.1 0.41 D; and ZAA and a significant 2-fold increase in visual acuity (P 0.001).
 Conclusion. A criterion for the effectiveness of hardware treatment for dysbinocular amblyopia is an increase in OAA and ZAA, accompanied by a 2-fold increase in distance visual acuity (P 0.001).

Computer-aided diagnosis for burnt skin images using deep convolutional neural network

Numerous patients died every year due to the leading causes of deaths all over the world and burn injuries are one of them. Burn injury cases are most viewed in low and middle-income countries (LMIC). Researchers show great interest to classify the burn into different depths through digital means. In Pakistan, at provisional level, it’s really a significant issue to categorize the burn and its depths due to the non-availability of expert doctors and surgeons; hence the decision for the correct first treatment can't be made, so this may cause a serious issue later on. The main objectives of this research work are to segment the burn wounds and classification of burn depths into 1st, 2nd and 3rd degrees respectively. A real-time dataset of burnt patients has been collected from the burn unit of Allied Hospital Faisalabad, Pakistan. The dataset used for this research task contains 450 images of all the three levels of burn depths. Segmentation of the burnt area was done by the use of Otsu's method of thresholding and feature vector was obtained through the use of statistical methods. We have used the Deep Convolutional Neural Network (DCNN) to estimate the burn depths. The network was trained by 65 percent of the images and the remaining 35 percent images were used for testing the accuracy of the classifier. The maximum average accuracy obtained by using the Deep Convolutional Neural Network (DCNN) classifier is reported round about 79.4% and these results are the best if we compare them with previous results. From the obtained results of this research work, non-expert doctors will be able to apply the correct first treatment for the quality evaluation of burn depths.

Clinical Survey on Preputial Prolapse in Gir Bulls

A clinical survey was carried out to assess the etiopathology of preputial prolapse in Gir bulls at 41 Gaushalas of the Saurashtra region in Gujarat. A total of 202 Gir bulls under the breeding program were surveyed. The mean age of Gir bulls was recorded as 5.71 years, which ranged from 2.5 to 12 years. Preputial prolapse was diagnosed in all the surveyed Gir bulls. The first degree preputial prolapse was common in all the bulls because of the breed anatomical character. Out of the 202 breeding bulls, 30 (14.85%) bulls had pathological preputial prolapse, which varied between 2nd and 4th degrees. Among the 30 affected bulls, 12 (40 %) bulls had preputial prolapse of 2nd degree, 6 (20 %) bulls had 3rd degree of preputial prolapse and 12 (40 %) bulls had 4th degree of preputial prolapse. Traumatic injury to prepuce, followed by its contamination, was the main etiology for the preputial prolapse and its aggravations in all the animals. All Gir bulls had common anatomical / structural deformities of the preputial sheath.

Оцінка ефективності чисельних методів для обробки результатів вимірювання вдосконаленим ППР-сенсором

In this work there has been investigated the effect of electron beam treatment of the glass substrates surface of sensors based on surface plasmon resonance phenomenon with active gold based layer on the accuracy of determining the angular position of the reflection characteristics in case applying numerical methods for processing direct measurement results: approximation by polynomials of the 2nd 3rd and 4th degrees and processing by midline method. Sensors with different specific powers of electron beam treatment of glass substrates were investigated: 0, 27, and 36 W/mm2. The reflection characteristics for the gold-air interface were investigated. According to the results of experiments and numerical analysis, it was found that the effect of electron beam treatment on the change in the absolute error in determining the minimum reflection characteristics substantially depends on the chosen numerical method. Thus, the improved midline method provides a 6-fold decrease in the absolute measurement error compared to the midline method for samples without processing and almost 12 times for samples with processing power of 27 W/mm2. Moreover, for this method, the smallest absolute error is observed for the power of electron beam treatment 36 W/mm2 and is 0,58 arc sec., which indicates the appropriateness of applying new method. Compared to the approximation methods by polynomials and the midline method, the improved midline method has greater accuracy in determining the minimum reflection characteristics because it depends less on not only its symmetry associated with the optical characteristics of the gold-air transition layer, but also on changes in the intensity of reflected light minimum reflection characteristics. According to the results of calculations based on predefined optical constants from the measured reflection characteristics, it was found that, with a higher irradiation power, the symmetry of the reflection characteristic, the propagation distance and the penetration depth of surface plasmons increase, which is associated with a decrease in surface roughness after electron beam treatment and, as a consequence, a decrease in attenuation fields of surface plasmons. Research can be useful in the development of sensors based on surface plasmon resonance phenomenon and methods for processing measurement results

Effect of Ankle Resisted Exercises on Venous Leg Ulcers Healing

AbstractBackground: Venous leg ulcers are open chronic wounds that occur within the gaiter region of the leg (from below the ankle, up to mid-calf) and are a consequence of venous insuffciency. They typically present as repeated cycles of ulceration, healing, and recurrence. Such ulcers can take weeks or months to heal, and 12-month recurrence rates are between 18% and 28%. They are painful, malodorous, prone to infection, and severely affect patients' mobility and quality of life, therefore resisted ankle exercises is improving calf muscle pump action by increasing ankle (plantar flexion) range of motion which improving venous system function in the lower leg and so improving 2nd and 3rd degrees of venous leg ulcers healing.Aim of Study: The aim of this was to determine the efficacy of resisted ankle exercises on healing of venous leg ulcers.Subjects and Method: Thirty patients suffering from 2nd and 3rd chronic venous leg ulcers were recruited from Vascular Surgical Outpatient Clinic of Al-Hussien University Hospital. Their ages ranged from 45 to 60 years old: They distributed into two Groups (A & B). Group (A) study group: Fifteen patients who received ankle resistance training exercise in addition to the traditional medical treatment. Group (B) control group: Fifteen patients who received only the tradi-tional medical treatment. Resistance training exercise was applied in the form 20 or 25 repetitions maximum at the end of the twelve week, three sessions per week, every other day, for three months.Results: Results showed that ankle resistance training exercise program was effective in improving healing of venous leg ulcers by decreasing ulcers' volume measured by sterilized saline solution by improving calf muscle pump function.Conclusion: Application of 12 weeks ankle resisted exer-cises in patient with 2nd and 3rd degrees of chronic venous leg ulcers resulted in decreasing volume of venous ulcers and so increasing of healing rates.

Resident Macrophages Orchestrating Heart Rate.

The electrical conduction system of the heart is essential for maintaining normal heart rhythm and function. This is due to the presence of specialized cells that generate electrical impulses that propagate throughout the heart tissue, quickly and efficiently. This electrical impulse starts at the sinoatrial node (SAN) and propagates sequentially to atrioventricular node (AVN), subsequently being transmitted to the ventricles via specialized conduction pathways. The electrical signals are conducted from cell to cell through a cardiomyocyte permeability control system formed by proteins called connexins, and connexin-43 is the type found in the heart and is associated with the formation of so-called gap junctions. By providing the single electrical connection between the atria and the ventricles, AVN plays an essential role in the dynamics of cardiac contraction. Clinically, when the PR interval is observed in the electrocardiographic recordings, we can correlate the electrical impulse conduction time from its generation in the SAN to the delay in the AVN region, which is called decremental conduction.1 When prolongation of the PR interval or an AV block occurs, which delays excessively or even eliminates the conduction of the electrical impulse from the atria to the ventricles, will result in hemodynamic deterioration, syncope and death, in case the patient is not submitted to the brand heart.2 Over the years, several studies have described the macrophages as cells of phagocytic functions that would exclusively act in the immune system protecting the organism against pathogens. However, more recently this paradigm was mainly questioned about the origin of macrophages. Several studies have provided evidence that a subpopulation of macrophages, which originated from embryonic development and do not come from the bloodstream, reside and proliferate in virtually all body tissues and apparently act specifically on each organ. For example, resident macrophages of adipose tissue contribute to the regulation of thermogenesis,3 iron recycling in the spleen and liver,4 and participate in the process of synaptic maturation in the healthy brain.5 Such non-canonical activities emphasize the functional diversity of macrophages and their ability to perform specific tasks in the various tissues, in addition to host defence.6 In cardiac tissue, macrophages are intrinsic components of the myocardium in normal functioning, where they appear as spindle cells intercalated between cardiomyocytes, fibroblasts and endothelial cells.7 Macrophages and the heartbeat Cardiac function depends on the appropriate moment of contraction in several distinct regions, as well as the heart rate.8 Hulsmans et al.9 observed that mice that had their macrophage fauna weakened, had bradycardia and irregular beats. It is known that connexin-43 is predominant in ventricles of humans and that its reduction promotes bradycardia and AV block,8 thus, in observing specialized cells in non-muscular electrical conduction, they found that macrophages are electrically coupled to cardiomyocytes and that these resident macrophages facilitate electrical conduction through the AV node. Such conducting cells interleave with macrophages expressing connexin-43 forming additional gap junctions between cardiomyocytes (Figure 1). The investigators observed that the animals that had a reduction of resident macrophages, besides having bradycardia, had AV blockade of 2nd and 3rd degrees (Figure 2),9 whose cause in humans is still unknown.10 Another intriguing point is that cardiac macrophages have a resting membrane potential of -35 mV on average and depolarize in synchrony with cardiomyocytes. This makes the membrane potential at the rest of the cardiomyocytes more positive and according to the results obtained by computational simulation, accelerate both depolarization and repolarization phases.9 The cardioprotective role of cardiac resident macrophages can go beyond the modulation of the electrophysiological properties of the coupled cardiomyocytes. The perivascular localization of cardiac macrophages makes them uniquely positioned to interpret systemic signals in the bloodstream.10 Open in a separate window Figure 1 The normal condition of macrophage-cardiomyocyte couplings. Communications between cardiomyocytes and macrophages through connexin-43 (A) promoting normal cardiac rhythm (B).

Acupuncture correction of homeostasis in boundary mental conditions of the military personnel and penal system officers in extreme conditions

Experimental data about the physiogeny at 603 military men and penal system officers are given in various climatic conditions of Russia, Transcaucasia (Abkhazia, Azerbaijan, Armenia, Georgia) and Afghanistan and at 604 young men entering the military university. Homeostatic ranges of physiogeny adjustment at physiogenic losses in the meridian functional systems of the military personnel, penal system officers in extreme conditions are determined by the electropuncture method. Protective adaptive reactions of eight degrees are revealed by the standardized method of personality research and by the «adaptability»” scale. Discriminant decisive rules on the reference of physiogenic losses to the 1-8th degrees of protective adaptive reactions in boundary mental conditions are applied. Decisive rules establish threshold levels of normal mental state without the loss (the 1st degree), of liminal with latent one (the2nd and 3 degrees) and borderline mental state with obvious (the 4-8th disadaptation degrees) losses. Patients with symptoms are sorted by simple calculation with the use of computer equipment at the reduction of time up to 5 min. for one patient according to eight degrees of protective adaptive reactions for acupuncture performing. Methods of the discriminant analysis are perspective for the solution of diagnostics and medical sorting problems. Reliability of establishment of the correct diagnosis of physiogeny considering physiogenic losses without resorting to other diagnostic methods makes 70-95%. Acupuncture correction of physiogenic losses activates reactions of homeostasis restoration. This physiological correction leads to the transition of physiogeny in limits of the normal mental state of the 1st degree and liminal condition of the 2nd and 3rd degrees of reactions of homeostasis restoration.

Assessment of the risk of osteoporotic vertebral fractures of the 2nd and 3rd degree in women in reproductive age and men under 50 with type 1 diabetes mellitus

Rationale : Patients with type 1 diabetes mellitus (DM1) have higher rates of any fractures than those without diabetes. Aim : To identify significant predictors of the osteoporotic vertebral fractures of the 2nd and 3rd degrees and to develop a statistical model for the risk assessment in DM1 patients. Materials and methods : 97 DM1 patients and 77 control aged below 50 participated in this cross-sectional study. Multiple logistic regressions were used to assess the risk of osteoporotic vertebral fractures of the 2nd and 3rd degrees in DM1 patients. Results : Patients with DM1 had a statistically significantly lower bone mineral density (BMD) (Z-criterion) in all areas of the axial skeleton, compared to that in the control group (p< 0.001). Osteoporotic vertebral fractures were significantly more frequent (p=0.0385) in DM1 patients than in the controls. The subgroup of DM1 patients with osteoporotic vertebral fractures (n=8) had higher daily insulin requirement per kg of bodyweight compared to that in the subgroup of the patients without fractures (n=89; р=0.029), as well as lower axial BMD (Z-criterion L1–L4, p=0.002; femoral neck Z-criterion, p< 0.001; proximal femoral Z-criterion, p=0.002). We developed a statistical regression equation model including two parameters: 1) presence or absence of low femoral neck BMD based on the dual X-ray absorptiometry, 2) daily insulin requirement per kg of bodyweight. Conclusion : The statistical model has the sensitivity of 87% and specificity of 75% to predict that the DM1 patients would have low or high risk of osteoporotic vertebral fractures of the 2nd and 3rd degree.

ЕФЕКТИВНІСТЬ ПАТОГЕНЕТИЧНОЇ ТЕРАПІЇ ПАЦІЄНТІВ З ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ ІЗ НОРМОБІОЦЕНОЗОМ І ДИСБІОЗОМ КИШЕЧНИКА

Ішемічна хвороба серця (ІХС) є основною причиною кардіоваскулярної смертності в Україні, показники якої не знижуються.Мета дослідження – вивчити ефективність стандартної патогенетичної терапії пацієнтів з ішемічною хворобою серця із нормобіоценозом (НБ) і дисбіозом (ДБ) кишечника.Матеріали іа методи. Обстежено 68 хворих у віці від 50 до 65 років, серед яких 20 % жінок. Пацієнти з ІХС із постінфарктним кардіосклерозом, хронічною серцевою недостатністю (ХСН) II функціонального класу (ФК) (NYHA) і дисбіозом кишечника І і ІІ ступенів (n=45) і хворі, яких зіставили за статтю, віком, ФК ХСН (n=23) із нормобіоценозом кишечника отримували стандартне лікування хронічної ІХС. Тривалість спостереження становила 8 тижнів.Результати досліджень та їх обговорення. Установлено позитивний вплив стандартної терапії на клінічний перебіг захворювання, ліпідний обмін і пероксидне окиснення ліпідів, показники імунного запалення, системної запальної відповіді й антиоксидантного захисту в обох групах пацієнтів. Виявлено, що наявність дисбіозу кишечника І і ІІ ступенів асоціюється з меншим ступенем позитивної динаміки більшості зазначених параметрів.Висновки. Стандартна терапія хворих на ІХС із нормобіоценозом і дисбіозом кишечника І і ІІ ступенів супроводжується позитивним впливом на клінічний перебіг захворювання у формі зменшення кількості нападів стенокардії на тиждень, збільшення дистанції тесту з 6-хвилинною ходьбою і поліпшення психологічного статусу.

Patogenetic value of intestine microbiota ecosystem in the escherichiosis enterocolitis development

The taxonomic composition and microbiota population level in the colon cavity content of the 95 patients with diarrheal escherichiosis and 87 healthy individuals were investigated. The acute diarrheal escherichiosis develops against the background of taxonomic composition and bacterial population disorders of autochthonous obligate anaerobic gram-positive microbiota (Bifidobacterium and Lactobacillus), with a growing number of bacterial genera Bacteroides, Peptostreptococcus, Clostridium and facultative anaerobic and aerobic bacteria of the genus Escherichia, Proteus, Staphylococcus and fungi genus Candida, contamination and colonization of colon cavity conditionally pathogenic enterobacteria (Citrobacter, Enterobacter, Proteus, etc.) Peptococcus, fungi genus Candida, and the growth and proliferation of Enteropathogenic, Enteroinvasive, Enterohemorrhagic Escherichia coli and Hemolytic (E. coli Hly +) and lactose-negative E. coli. Dysbacteriosis was diagnosed in 57,89 % patients with acute enterocolitis, dysbiosis available in 42,11 %. Among them, 63,16 % subjects had dysbiosis 3rd and 4th degrees, 36,84 % – dysbiosis 1st and 2nd degrees (c2=13,16; p<0,001). Among healthy individuals Normal flora subjects dominate over those with 1st and 2nd degree dysbiosis (89,66 % vs. 10,34 %, p<0,001).