The content of the plasminogen activation system components (plasminogen, plasminogen tissue activator, and its inhibitor PAI-1) was investigated as well as the concentration of thrombomodulin, protein C, matrix metalproteinases (MMP -1, -2, -3, -8, -9, -10) and their inhibitor TIMP, growth factors content (such as transforming growth factor-β1, insulin-like growth factor-1, fibroblasts growth factor-2) and cytokine profile (interleukines IL-1β, -4, -6, -8, -10, tumor necrosis factor, interferon-γ in patients with chronic pancreatitis (CP) and pancreatic cancer (PC) were established. Khmelnitsky Regional Clinical Hospital patients aged 28-89 were selected for this study: 20 people with chronic pancreatitis (group CP); 20 people with pancreatic cancer (group PC); 20 conditionally healthy persons (control). Blood plasma samples and pancreatic tissue homogenates were obtained from all the patients. The studied indicators’ content in the experimental materials was determined by the enzyme-linked immunosorbent assay using appropriate antibodies. At the level of systemic circulation, a statistically significant increase was found in most of the studied parameters under the CP conditions. However, PC was characterized by an increase of two blood plasma indications only (thrombomodulin and protein C). In contrast, the pancreatic sample tissue examination for both aforementioned pathologies revealed significant changes in the content of most metalloproteinases and cytokines under PC. This indicates the development of metastasis, angiogenesis, and immunomodulation-aimed local biochemical processes in the affected organ.
The aim of our study was to evaluate the trypsin-like serine proteases (TLPs) distribution between systemic circulation and pancreatic tissue and to investigate the peculiarities of their involvement in the extracellular matrix components degradation in patients with pancreatic pathologies with electrophoretic analysis methods using. Тhe Khmelnitsky Regional Clinical Hospital patients aged 28-89 were selected for this study: 20 people with chronic pancreatitis (group CP); 20 people with pancreatic cancer (group PC); 20 conditionally healthy persons (control). Blood plasma samples and pancreatic tissue homogenates were obtained from all the patients, from which the TLPs fractions were subsequently obtained by the affinity chromatography method. The study showed that TLPs content in the blood plasma of patients with pancreatic pathologies is higher, and in tissue homogenates is lower relative to the values of the corresponding indicators in the control. Disk-electrophoresis using showed that TLPs fractions obtained from the blood plasma of patients of all studied groups contain a lot of high molecular weight (HMW) proteins, while TLPs from the pancreatic tissue homogenates of patients with pancreatic pathologies mainly consists of low molecular weight (LMW) proteins. Enzyme-electrophoresis results showed that all TLPs fractions include enzymes with fibrinogenolytic, gelatinolytic and collagenolytic activity. In plasma, the first were represented by medium molecular weight (MMW) proteins, and the last two groups included a lot of HMW proteins as well as proteins with very high molecular weight. In homogenates, fibrinogenolytic activity was characteristic for LMW proteins only, whereas gelatinases and collagenases were represented by both MMW and LMW proteins. Our results indicate the differences in the TLPs fractions components obtained from blood plasma and pancreatic tissue of patients with investigated pathologies, as well as significant distinctions in the processes of extracellular matrix remodeling under СР and РС.
Annotation. Obesity is considered a risk factor for postoperative complications and postoperative mortality. The aim of the study was to assess the impact of obesity on the postoperative period and the level of postoperative mortality after left hemicolectomy. A retrospective analysis of the medical records of 217 patients who underwent left hemicolectomy for colon tumors was performed. Assessment of comorbid conditions was performed using the Charlson index. Postoperative complications were assessed according to the Clavien-Dindo classification. The calculation of postoperative survival was performed by the Kaplan-Mayer method. Database formation and statistical analysis were performed using Microsoft Excel and STATISTICA 10.0. It was determined that the mean values of the Charlson index did not differ significantly between the two groups (6,31 ± 2,07 and 6,33 ± 2,08 respectively), but there was a significantly higher level of endocrine diseases in the group of obese patients. Non-disseminated (I-II) stages of the tumor process predominated in patients of both groups (60% and 57.5%, respectively). Among non-obese patients n = 107 (51.8%) patients had an uncomplicated postoperative period and n = 59 (28.5%) patients had mild complications that were not associated with the surgical site, but were associated with concomitant chronic pathology of other organs and systems, and did not require any invasive interventions. In contrast, among obese patients n = 6 (60%) patients had severe early postoperative complications requiring surgery, and n = 2 (20%) patients underwent relaparotomy. The rate of early postoperative mortality differed significantly between the two groups and was significantly higher among obese patients (40% vs 6.8% among non-obese patients). This study showed a significantly higher percentage of postoperative mortality and severity of postoperative complications in the group of obese patients. The prospect of further research is to study and analyze the course of the postoperative period in obese patients undergoing extended, multi-visceral and multi-stage surgery for cancer of the left half of the colon.