(1) Purpose: Improving the treatment effectiveness of intraepithelial neoplasia of the cervix associated with human papillomavirus infection, based on the application of the method of photodynamic therapy with simultaneous laser excitation of fluorescence to clarify the boundaries of cervical neoplasms. (2) Methods: Examination and treatment of 52 patients aged 22 to 53 years with morphologically and cytologically confirmed mild to severe intraepithelial cervix neoplasia, preinvasive, micro-invasive, and squamous cell cervix carcinoma. All patients were carriers of human papillomavirus infection. The patients underwent photodynamic therapy with simultaneous laser excitation of fluorescence. The combined use of video and spectral fluorescence diagnostics for cervical neoplasms made it possible to control the photodynamic therapy process at all stages of the procedure. Evaluation of the photodynamic therapy of intraepithelial cervical neoplasms was carried out with colposcopic examination, cytological conclusion, and morphological verification of the biopsy material after the photodynamic therapy course. The success of human papillomavirus therapy was assessed based on the results of the polymerase chain reaction. (3) Results. The possibility of simultaneous spectral fluorescence diagnostics and photodynamic therapy using a laser source with a wavelength of 660 nm has been established, making it possible to assess the fluorescence index in real-time and control the photobleaching of photosensitizers in the irradiated area. The treatment of all 52 patients was successful after the first photodynamic therapy procedure. According to the PCR test of the discharge from the cervical canal, the previously identified HPV types were not observed in 48 patients. Previously identified HPV types were absent after repeated PDT in four patients (CIN III (n = 2), CIS (n = 2)). In 80.8% of patients, regression of the lesion was noted. (4) Conclusions. The high efficiency of photodynamic therapy with intravenous photosensitizer administration of chlorin e6 has been demonstrated both in relation to eradication therapy of human papillomavirus and in relation to the treatment of intraepithelial lesions of the cervix.

Российская ФедерацияЦель. Улучшение результатов лечения пациентов, страдающих циррозом печени, путем внутрипече-ночного введения криопреципитата, стимулирующего регенерацию органа.Материал и методы. В исследование включено 72 пациента, страдающих циррозом печени вирусной (НСV и НВV) и токсической этиологии. Цирроз печени класса А и В по Child-Pugh до введения криопреципитата был у 32 (44%) пациентов, класса С -у 40 (56%). Криопреципитат вводили чрескожно в печень пункционным методом под ультразвуковым контролем. Оценивали динамику клинико-лабораторных показателей, параметры порталь-ного кровотока у всех пациентов, изменения в морфологической картине биопсийного материала печени у 42 (58%) и показатели иммунного статуса у 38 (53%) пациентов до и после введения криопреципитата.Результаты. После стимуляции регенерации печени криопреципитатом у большинства пациентов от-мечено уменьшение выраженности клинических и лабораторных проявлений цирроза печени как через 3, так и через 6 и 12 месяцев после введения криопреципитата. Цирроз печени класса С через год регистрировался у 7 пациентов (до стимуляции -у 40). Через 12 месяцев у 65 (90%) достоверно уменьшился диаметр воротной и селезеночной вен. У 11 (15%) пациентов снизился индекс застоя, у 18 (25%) -сплено-портальный индекс. У 40 (95%) из 42 больных при морфологическом исследовании биоптата печени спустя год после проведенного лечения была выявлена положительная динамика (снижение воспалительно-клеточной инфильтрации, дистро-фических изменений, у 29 (69%) -уменьшение выраженности ступенчатого некроза гепатоцитов.Заключение. Введение криопреципитата в печень под ультразвуковым контролем является безопас-ным, так как позволяет избежать травмирования крупных внутрипеченочных сосудов. Криопреципитат оказывает стимулирующее действие на регенерацию печени, что улучшает ее функциональную активность и позволяет продлить время до трансплантации печени. Ключевые слова: цирроз печени, портальная гипертензия, хирургическое лечение, регенерация печени, малоинвазивная хирургия, криопреципитат, функциональная активностьObjectives. To improve the results of treating patients with liver cirrhosis by intrahepatic injection of cryoprecipitate, stimulating regeneration of cirrhotic liver.Methods. The study included 72 patients who suffered from hepatitis B virus (HBV) and hepatitis C virus (HCV) and toxic liver cirrhosis. 32 (44%) patients had liver cirrhosis grading Child-Pugh class B, and 40 (56%) patientsclass C. Cryoprecipitate injected percutaneously into the liver by puncture method under ultrasound guidance. Dynamics of clinical and laboratory parameters, portal blood flow in all patients, morphological changes in the liver biopsy were evaluated in 42 (58%) patients and immunological parameters › -in 38 (53%) patients before and after administration of cryoprecipitate.Results. The improvements of clinical and laboratory parameters were registered in 3, 6, and 12 months after the administration of cryoprecipitate in most patients. After a year 7 patients had Child-Pugh class C live...

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Introduction Non-parasitic spleen cyst (NSC) is a relatively rare and difficult to diagnose disease, which rapture due to a traumatic impact to the spleen, can lead to the peritonitis. Case presentation We present the case of a 30-year-old woman with a 7.5 × 7.5 × 5 cm NSC, who underwent the microwave ablation (MWA) of the splenic cyst. Results The procedure was performed under intravenous anesthesia. MWA of the cysts was performed using a probe placed in the cavity of the cyst, with the frequency of 902–928 MHz delivered during 15 minutes. The postoperative period was uneventful, and the patient was discharged after 2 days. Conclusion We demonstrated that MWA can be utilized as a novel, minimally-invasive, and cost-effective approach in NSC treatment.

Background: Portal hypertensive colonopathy is a consequence of portal hypertension that develops in hepatic cirrhosis. Pathological processes occurring in intestinal epithelium cells can be revealed by changes in the autoantibody titers to intestinal antigens. It is important both in diagnosis and in the evaluation of the treatment effectiveness. Purpose: To investigate the effect of portal hypertension in patients with liver cirrhosis on degenerative processes in the walls of the small and large intestines after stimulation of liver regeneration with cryoprecipitate. Methods: Thirty-six patients with liver cirrhosis underwent a procedure for percutaneous introduction of cryoprecipitate into the liver tissue. Before and 1 year after it, all the patients were measured for portal blood flow parameters, performed colonoscopy with biopsy, and determined autoantibodies to intestinal antigens (ItM, SCM) in the blood. Comparative analyses of changes in the large intestine mucosa before and after reducing portal hypertension by stimulating liver regeneration with cryoprecipitate were conducted. Results: Here, we show that the degenerative process in the mucosa of the intestines increases, despite the positive dynamics of portal blood flow parameters after the liver regeneration. Autoantibodies values for the intestine antigens were higher than normal in 22 of the 36 patients after 1 year of introduction of cryoprecipitate into the liver. Morphological analysis of the intestinal wall showed the presence of edema/mucosal atrophy and neutrophilic/lymphocytic-histiocytic infiltration in 28 of the 36 patients. Conclusion: Changes in autoantibodies to intestinal antigens are an informative method for diagnosing colonopathy and enteropathy at early stages, providing the possibility to administer proper timely treatment. Patients with hepatic cirrhosis are recommended to have their intestinal microflora tested and be administered drugs that improve their composition.

The stimulatory effect of cryoprecipitate on liver regeneration was studied in rabbits with cirrhosis of the liver induced by subcutaneous injection of tetrachloromethane. Cryoprecipitate stimulated the hepatocyte regeneration (appearance of binuclear and proliferating cells) in liver tissue in cirrhosis, but the initial structure of the liver was not restored. The newly formed focus of regeneration with proper girder structure of hepatocytes forced back the connective tissue. Highly concentrated solution of fibrinogen, injected by puncture method into cirrhotic hepatic tissue, stimulated its regeneration.

IntroductionAbdominal abscesses are one of the frequent and dangerous postoperative complication. They occur as a result of failure of seams esophagojejunal anastomosis after gastrectomy (17%), perforation of gastric and duodenal ulcers (26.8%), splenectomy (25.4%), failure of biliodigestive anastomoses (23.8%), inadequate drainage of the subphrenic space (22.2%), acute pancreatitis (14%). Left-sided subphrenic abscesses are the most common of them.Case presentationWe present a patient with the left-sided subphrenic abscess, formed as a result of insolvency of the esophagojejunal anastomosis after gastrectomy and splenectomy, which underwent percutaneous drainage under the control of ultrasound and X-ray. Sanitation of the abscess cavity and the introduction of fibrin glue into it made it possible to close the fistula and heal the patient.DiscussionThe described case shows that the rehabilitation of the abscess and the injection of fibrin glue into it, made it possible to avoid surgery, eliminate the abscess and close the connection with the esophagojejunal anastomosis in a short time.ConclusionPercutaneous drainage under the control of ultrasound made it possible to avoid surgery and heal the patient with the left-sided subphrenic abscess in a short time. Fistula treatment with fibrin glue is not only effective, but is also less risky than surgery.