Year 2019 Vol. 27 No 1




Institute of Chemical Biology and Fundamental Medicine1,
Medical Center Avicenna 2,
Institute of Molecular Pathology and Pathomorphology, Federal Research Center for Fundamental and Translational Medicine3,
The Russian Federation

Objective. To study the possibility of complications development after the injection of the autologous multipotent mesenchymal stromal cells of the bone marrow origin (MMSC) directly in the intact liver of rats.
Methods. The changes of the rat liver after the direct injection of MMSC with a transfected GFP-gene and additionally stained cellular membranes by Vybrant CM-Dil were investigated by the methods of light microscopy with luminescence application.
Results. After the MMSC injections, the extensive congestions, depot of the injected cells in the liver were absent in all animals even after a week. In some cases, up to 1/3 observations, the aseptic inflammation manifested by the dilation and hyperemia of sinusoids, an increase of neutrophil number in the sinusoids, necroses of parenchyma and lympho-histiocytic infiltrates were developed in the organ. Long thin layers of the connective tissue extending in the vessel region and containing a large number of siderophages appeared in the liver during the 3rd week. By the 4th week the specified liver morphological changes have normalized. Throughout the experiment there was no any differentiation of injected MMSC to the liver cells.
Conclusions. The main causes of the revealed changes are the damage of the liver parenchyma at the cell suspension injection under pressure and also direct presence of MMSC and their detritus. At the syringe under pressure the MMSC suspension moves apart and lacerates the liver parenchyma along the vessels. Injected MMSC, some of which quickly perishes due to a dramatic change in living conditions, and also the detritus which is present together with them, immediately cause migration of macrophages to the site of injection and actually are the reason of aseptic inflammatory process. MMSC are quickly eliminated from the injection site in the liver by macrophages and also by means of vascular and lymphatic beds whereas the proceeding inflammatory reaction damages the liver cells and serves as the cause of the revealed changes.

Keywords: multipotent mesenchymal stromal cells, liver, inflammation, necrosis, animals, experiment
p. 5-15 of the original issue
  1. Qu M, Yuan X, Liu D, Ma Y, Zhu J, Cui J, Yu M, Li C, Guo D. Bone marrow-derived mesenchymal stem cells attenuate immune-mediated liver injury and compromise virus control during acute hepatitis b virus infection in mice. Stem Cells Dev. 2017 Jun 1;26(11):818-27. doi: 10.1089/scd.2016.0348
  2. Haga H, Yan IK, Borrelli DA, Matsuda A, Parasramka M, Shukla N, Lee DD, Patel T. Extracellular vesicles from bone marrow-derived mesenchymal stem cells protect against murine hepatic ischemia/reperfusion injury. Liver Transpl. 2017 Jun;23(6):791-803. doi: 10.1002/lt.24770
  3. Maiborodin IV, Morozov VV, Anikeev AA, Figurenko NF, Maslov RV, Chastikin GA, Matveeva VA, Maiborodina VI. Macrophage reaction to multipotent mesenchymal stromal cells introduction into surgical trauma site in rats. Novosti Khirurgii. 2017;25(3):233-41. doi: 10.18484/2305-0047.2017.3.23 (in Russ.)
  4. Li F, Yang M, Wang L, Williamson I, Tian F, Qin M, Shah PK, Sharifi BG. Autofluorescence contributes to false-positive intracellular Foxp3 staining in macrophages: a lesson learned from flow cytometry. J Immunol Methods. 2012 Dec 14;386(1-2):101-7. doi: 10.1016/j.jim.2012.08.014
  5. Mendes-Jorge L, Ramos D, Luppo M, Llombart C, Alexandre-Pires G, Nacher V, Melgarejo V, Correia M, Navarro M, Carretero A, Tafuro S, Rodriguez-Baeza A, EsperanÇa-Pina JA, Bosch F, Ruberte J. Scavenger function of resident autofluorescent perivascular macrophages and their contribution to the maintenance of the blood-retinal barrier. Invest Ophthalmol Vis Sci. 2009 Dec;50(12):5997-6005. doi: 10.1167/iovs.09-3515
  6. Lei L, Tzekov R, Tang S, Kaushal S. Accumulation and autofluorescence of phagocytized rod outer segment material in macrophages and microglial cells. Mol Vis. 2012;18:103-13.
  7. Luhmann UF, Robbie S, Munro PM, Barker SE, Duran Y, Luong V, Fitzke FW, Bainbridge JW, Ali RR, MacLaren RE. The drusenlike phenotype in aging Ccl2-knockout mice is caused by an accelerated accumulation of swollen autofluorescent subretinal macrophages. Invest Ophthalmol Vis Sci. 2009 Dec;50(12):5934-43. doi: 10.1167/iovs.09-3462
  8. Mitchell AJ, Pradel LC, Chasson L, Van Rooijen N, Grau GE, Hunt NH, Chimini G. Technical advance: autofluorescence as a tool for myeloid cell analysis. J Leukoc Biol. 2010 Sep;88(3):597-603. doi: 10.1189/jlb.0310184
  9. Liu S, Jiang L, Li H, Shi H, Luo H, Zhang Y, Yu C, Jin Y. Mesenchymal stem cells prevent hypertrophic scar formation via inflammatory regulation when undergoing apoptosis. J Invest Dermatol. 2014 Oct;134(10):2648-57. doi: 10.1038/jid.2014.169
  10. Yates CC, Nuschke A, Rodrigues M, Whaley D, Dechant JJ, Taylor DP, Wells A. Improved transplanted stem cell survival in a polymer gel supplemented with tenascin c accelerates healing and reduces scarring of murine skin wounds. Cell Transplant. 2017 Jan 24;26(1):103-13. doi: 10.3727/096368916X692249
  11. Babaei A, Katoonizadeh A, Ranjbar A, Naderi M, Ahmadbeigi N. Directly injected native bone-marrow stem cells cannot incorporate into acetaminophen-induced liver injury. Biologicals. 2018 Mar;52:55-58. doi: 10.1016/j.biologicals.2017.12.006
  12. Abdelhamid L, Hussein H, Ghanem M, Eissa N. Retinoic acid-mediated anti-inflammatory responses in equine immune cells stimulated by LPS and allogeneic mesenchymal stem cells. Res Vet Sci. 2017 Oct;114:225-232. doi: 10.1016/j.rvsc.2017.05.006
  13. Gavrilin VN, Shkurupii VA. Vliianie nakopleniia polivinilpirrolidona v sinusoidal’nykh kletkakh pecheni na kharakter toksicheskogo povrezhdeniia organa. Biul SO RAMN. 1995;15(2):24-28.(in Russ.)
Address for correspondence:
630090, The Russian Federation,
Novosibirsk, Ac. Lavrentyev Ave., 8,
Institute of Chemical Biology
and Fundamental Medicine,
Center of Innovative Medical Technologies.
Tel.: 8-913-753-0767,
Igor V. Maiborodin
Information about the authors:
Maiborodin Igor V., MD, Professor, Chief Researcher of the Stem Cell Laboratory, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russian Federation.
Figurenko Nikolay F., PhD, Applicant for Doctors Degree of the Stem Cell Laboratory, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russian Federation.
Elovskiy Aleksandr A., Anesthesiologist-Resuscitator-Transfusiologist of the Anesthesiology and Resuscitation Unit, Medical Center Avicenna, Novosibirsk, Russian Federation.
Mikheeva Tatiana V., PhD, Applicant for Doctors Degree of the Stem Cell Laboratory, Institute of Chemical Bio logy and Fundamental Medicine, Novosibirsk, Russian Federation.
Maslov Roman V., PhD, Applicant for Doctors Degree of the Stem Cell Laboratory, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russian Federation.
Maiborodina Vitalina I., MD, Leading Researcher of the Laboratory of Ultrastructural Basis of Pathology, Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russian Federation.
Shevela Andrey I., MD, Professor, Head of the Unit Center of innovative medical technologies, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russian Federation.



Ivano-Frankivsk National Medical University1,
Ivano-Frankivsk National Technical University of Oil and Gas2,

Objective. To investigate the influence of component composition and technological parameters of the formation of nano-containing biopolymer films on their therapeutic and physico-mechanical properties.
Methods. The authors studied nano-containing biopolymer films for wound treatment, which had contained gelatin, polyvinyl alcohol, glycerol, lactic acid, distilled water and zinc nano oxide with various technological mode manufactured. The studied options were as follows: elasticity, degradation time, vapor permeability of biopolymer films. Therapeutic properties of biopolymer films were evaluated based on the results of measuring the protective action diameter.
Results. The biopolymer film treatment properties are directly related to the diameter of the protective action. It has been defined that protective effect diameter of films containing zinc nanooxide increases both with an increase in the ratio of the concentrations of the components of the mixture and with an increase in the content of zinc nanooxide, reaching a maximum protective action diameter of 20.5 mm with its content of 197 mg.
Thermostat exposition period increasing leads to protective action diameter decreasing reaching a minimum, and in the future slightly increases. The increase in the heating temperature adversely affects the therapeutic properties of the film, which is due to the compaction of its structure. The film degradation time increases with increase of component concentration ratio, the zinc nanooxide concentration and the mixture heating temperature. Component composition and biopolymer film obtaining regimes and their influence on elasticity, degradation time and vapor permeability were studied. Introduction of zinc nanooxide into the composition of the film increases firstly its vapor permeability, which, after reaching the maximum, decreases. Biopolymer film is environmentally safe, water and carbon dioxide are released in its destruction. Nano-oxide of zinc is a weakly toxic, non-aggressive component, present in the products of destruction of the film in the bound state and insignificant amount.
Conclusions. Carried out studies have shown that the treatment properties of biodegradable polymeric materials depend on zinc nanooxide concentration, and their degradation properties provide metered delivery of the medicament to the lesion area.

Keywords: wound treatment, nano-containing biopolymer films, therapeutic effect, physical and mechanical properties, environmentally safe polymers, biopolymer utilization
p. 16-25 of the original issue
  1. Boateng SJ, Matthews HK, Stevens HN, Eccleston MG. Wound healing dressings and drug delivery systems: a review. J Pharm Sci. 2008 Aug, 8(97):2892-23. doi: 10.1002/jps.21210
  2. Karakurkchi A, Sakhnenko M, Ved M. Study of the influence of oxidizing parameters on the composition and morphology of Al2O3•CoOx coatings on AL25 alloy. EEJET. 2018;2:11-19. doi: 10.15587/1729-4061.2018.128457
  3. Gnedenkov SV, Sharkeev YP, Sinebryukhov SL, Sinebryukhov SL, Khrisanfova OA, Legostaeva EV, Zavidnaya AG, Puz’ AV, Khlusov IA, Opra DP. Functional coatings formed on the titanium and magnesium alloys as implant materials by plasma electrolytic oxidation technology: Fundamental principles and synthesis conditions (Review). Corros Rev. 2016 Mar; 34(1-2):65-83. doi: 10.1515/corrrev-2015-0069
  4. Buketov AV, Dolgov NA, Sapronov AA, Nigalatiin VD, Babich V. Mechanical characteristics of epoxy nanocomposite coatings with ultradisperse diamond particles. Strength Mater. 2017 May;49(3):464-71. doi: 10.1007/s11223-017-9888-y
  5. Ropyak LYa, Shatskyi IP, Makoviichuk MV. Influence of the oxide-layer thickness on the ceramic-aluminium coating resistance to indentation. Metallofiz Nov Tekh. 2017;39(4):517-24. doi: 10.15407/mfint.39.04.0517
  6. Shatskyi IP. Ropyak LY, Makoviichuk MV. Strength optimization of a two-layer coating for the particular local loading conditions. Strength Mater. 2016 Sep;48(5):726-30. doi: 10.1007/s11223-016-9817-5
  7. Yasniy O, Vuherer T, Yasniy V, Sobchak A, Sorochak A. Mechanical behaviour of material of thermal power plant steam superheater collector after exploitation.. Eng Fail Anal. 2013;27(1):262-71. doi: 10.1016/j.engfailanal.2012.06.010
  8. Yasniy V, Maruschak P, Yasniy O, Lapusta Y. On thermally induced multiple cracking of a surface: an experimental study. Int J Fracture. 2013;181(2): 293-300. doi: 10.1007/s10704-013-9826-3
  9. Shats’kyi IP, Makoviichuk MV. Contact interaction of the crack edges in the case of bending of a plate with elastic support. Mater Sci. 2003;39(3):371-76. doi: 10.1023/B:MASC.0000010742.15838.44
  10. Shats’kyi IP. Limiting equilibrium of a plate with partially healed crack. Mater Sci. 2015 Nov;51(3):322-30. doi: 10.1007/s11003-015-9845-5
  11. Chowdhary K, Rathore SPS. Biopolymers for wound healing. Res Reinf. 2015 May-Oct; 2015;3(1):1-8.
  12. Torchilin V. Multifunctional and stimuli-sensitive pharmaceutical nanocarriers. Eur J Pharm Biopharm. 2009 Mar;71(3):431-44. doi: 10.1016/j.ejpb.2008.09.026
  13. Vicentini DS, Smania JrA, Laranjeira MCM. Chitosan polyvinyl alcohol films containing ZnO nanoparticles and plasticizers. Mater Sci Eng. 2010;30(1):503-508. doi: 10.1016/j.msec.2009.01.026
  14. Volova TG. Degradable polyhydroxyalkanoates of microbial origin as a technical analog of non-degradable polyolefines. SibFU Journal. 2015;8(2):131-51. doi: 10.17516/1997-1389-2015-8-2-131-151
  15. Popadyuk O.Y. Assessment of degradable and mechanical properties of nano-containing wound healing polymer materials. Novosti Khirurgii. 2017;25(5):454-58. doi: 10.18484/2305-0047.2017.5.454 (Russ.)
Address for correspondence:
76018, Ukraine,
Ivano-Frankivsk, Galickaya Str., 2,
Ivano-Frankivsk National Medical University,
Department of General Surgery.
Tel.: +380 34 252-82-32,
Oleg Y. Popadyuk
Information about the authors:
Popadyuk Oleg Y., PhD., Associate Professor, Associate Professor of the Department of General Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Malyshevska Olga S., PhD., Associate Professor of the Department of Hygiene and Ecology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.
Ropyak Lubomyr Y., PhD., Associate Professor, Associate Professor of the Department of Computer Engineering, Ivano-Frankivsk National Technical University of Oil and Gas, Ivano-Frankivsk, Ukraine.
Vytvytskyi Vasyl S., Postgraduate Student of the Department of Machine Mechanics, Ivano-Frankivsk National Technical University of Oil and Gas, Ivano-Frankivsk, Ukraine.
Droniak Mykola M., PhD, Associate Professor, Associate Professor of the Department of Surgery and Cardiac Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.




Omsk State Medical University 1,
A.N. Kabanov Omsk City Clinical Hospital 1 2, Omsk,
The Russian Federation

Objective. To determine the prognostic value of the fluctuations of the intrapleural pressure associated with the act of breathing during thoracocentesis and draining of fluid from the pleural cavity.
Methods. The study included 36 patients who suffered from pleural effusion and underwent thoracentesis. The continuous intrapleural manometry during the procedure was performed. Then control examinations included repeated examination, chest X-ray and ultrasound examination of the pleural cavities. According to their results, patients were divided into 3 groups: group 1 patients with straightened lungs and without complications (n=18), group 2 patients with unexpandable lung (n=18), subgroup 2-1 patients, which thoracocentesis, complicated by pneumothorax (n=6). The comparison criteria were the volume of the removed liquid (ml), the mean intrapleural pressure (cm H2O), the amplitude of the pressure fluctuations associated with the act of breathing, between the inspiration and expiration peaks in quiet breathing before and after the removal of the liquid (cm H2O), the pleural elasticity and change of amplitude of the pressure fluctuations after the draining.
Results. It was found that association among the pleural elasticity and the amplitude change and unexpandable lung were statistically significant (p=0.00283). It was also found out that, with the development of pneumothorax, an increase in pleural elasticity is associated with a decrease in intrapleural pressure fluctuations (p=0.00199). There were no significant associations of development of unwanted outcomes with other comparison criteria.
Conclusions. Association with outcomes is confirmed for pleural elasticity and change of the amplitude of the fluctuations of intrapleural pressure associated with the act of breathing. An objective predictor of unexpandable lung, as well as the occurrence of pneumothorax after thoracocentesis, along with an elevation of pleural elasticity, is a decrease in the amplitude of oscillations of pleural pressure associated with the act of breathing.

Keywords: pleural effusion, intrapleural pressure, thoracentesis, pneumothorax, unexpandable lung, pleural manometry
p. 26-34 of the original issue
  1. Zielinska-Krawczyk M, Krenke R, Grabczak EM, Light RW. Pleural manometry-historical background, rationale for use and methods of measurement. Respir Med. 2018 Mar;136:21-28. doi: 10.1016/j.rmed.2018.01.013
  2. Gordon CE, Feller-Kopman D, Balk EM, Smetana GW. Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med. 2010 Feb 22;170(4):332-39. doi: 10.1001/archinternmed.2009.548
  3. Genofre EH, Vargas FS, Teixeira LR, Vaz MAC, MarchiI E. Reexpansion pulmonary edema. J Pneumologia. 2003;29(2):101-106. doi: 10.1590/S0102-35862003000200010
  4. Sohara Y. Reexpansion pulmonary edema. Ann Thorac Cardiovasc Surg. 2008 Aug;14(4):205-9.
  5. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013 Nov 27;310(20):2191-94. doi: 10.1001/jama.2013.281053
  6. Lan RS, Lo SK, Chuang ML, Yang CT, Tsao TC, Lee CH. Elastance of the pleural space: a predictor for the outcome of pleurodesis in patients with malignant pleural effusion. Ann Intern Med. 1997 May 15;126(10):768-74. doi: 10.7326/0003-4819-126-10-199705150-00003
  7. Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol. 1953 May;39(5):368-76. doi: 10.3109/00016925309136722
  8. Moon Jun Na. Diagnostic tools of pleural effusion. Tuberc Respir Dis (Seoul). 2014 May;76(5):199-10. Published online 2014 May 29. doi: 10.4046/trd.2014.76.5.199
  9. Montes JF, García-Valero J, Ferrer J. Evidence of innervation in talc-induced pleural adhesions. Chest. 2006 Sep;130(3):702-9. doi: 10.1378/chest.130.3.702
  10. Boshuizen RC, Sinaasappel M, Vincent AD, Goldfinger V, Farag S, van den Heuvel MM. Pleural pressure swing and lung expansion after malignant pleural effusion drainage: the benefits of high-temporal resolution pleural manometry. J Bronchology Interv Pulmonol. 2013 Jul;20(3):200-5. doi: 10.1097/LBR.0b013e31829af168
  11. Staes W, Funaki B. “Ex vacuo” pneumothorax. Semin Intervent Radiol. 2009 Mar;26(1):82-85. doi: 10.1055/s-0029-1208386
  12. Corcoran JP, Psallidas I, Wrightson JM, Hallifax RJ, Rahman NM. Pleural procedural complications: prevention and management. J Thorac Dis. 2015 Jun;7(6):1058-67. doi: 10.3978/j.issn.2072-1439.2015.04.42
Address for correspondence:
644112, The Russian Federation,
Omsk, Perelet Str., 7,
Omsk State Medical University,
General Surgery Department.
Tel. +7 913 621 48 03,
Algis R. Khasanov
Information about the authors:
Khasanov Algis R., Post-Graduate Student, General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Korzhuk Mikhail S., MD, Professor, Head of General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Bezmozgin, Kirill G., Thoracic Surgeon, A.N. Kabanov Omsk City Clinical Hospital 1, Omsk, Russian Federation.
Zhukova Olga O., Intern of General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.
Kinzerskiy, Alexander A., Post-Graduate Student, General Surgery Department, Omsk State Medical University, Omsk, Russian Federation.



Brest Regional Hospital, Brest,
The Republic of Belarus

Objective. To compare the immediate and long-term surgical treatment results of the superficial femoral artery occlusion by the retrograde loop endarterectomy and femoral-popliteal bypass grafting above the knee joint space with a synthetic prosthesis.
Methods. From 2011 to 2015, 192 revascularizations of the limb were performed in the atherosclerotic superficial femoral artery occlusion. Patients were divided into groups two depending on the revascularization technique: the 1st group (n=133) patients who underwent the retrograde loop endarterectomy, the 2nd group (n=59) patients who underwent femoral-popliteal bypass grafting above the knee joint space.
Results. Technical success was obtained in 100% of observations. After revascularization, the increase in the mean value of the ankle-brachial index was 0.430.03 in the group I, 0.410.04 in the group II (Mσ). Thrombosis of the desublimated segment developed in 6 patients (4.5%) of the Group I, thrombosis of the shunt in 3 patients (5.1%) of the Group II. Long-term results were studied in the terms of 1-3 years. Survival rate after 1 year and 3 years in the group I was 97.7% 92.5% respectively, in the group II 98.3% 91.5%.
Primary patency in the group I after 1 and 3 years made up 89.5% and 64.7% respectively, in the group II 74.6% and 49.2%.
The primary level of limb preservation in the group I after 1 and 3 years was 94.0% and 85.0%, respectively. And in the group II, the same indicator was noticeably lower, and in 1 and 3 years was 84.7% and 62.7%, respectively.
Conclusions. The retrograde loop endarterectomy shows better results in the postoperative and distant periods compared to femoral-popliteal bypass grafting above the knee joint with a synthetic prosthesis. Retrograde looped endarterectomy can be the operation of choice in case of primary surgical intervention on isolated atherosclerotic occlusion of superficial femoral artery.

Keywords: atherosclerosis, femoral artery occlusion, retrograde loop endarterectomy, femoral-popliteal bypass grafting, revascularization
p. 35-41 of the original issue
  1. Abramov IS, Maitesyan DA, Lazaryan TA. Semi-closed endarterectomy from the superficial femoral artery. Angiologiia i Sosud Khirurgiia. 2014;20(3):165-69. (in Russ.)
  2. Nolan B, Finlayson S, Tosteson A, Powell R, Cronenwett J. The treatment of disabling intermittent claudication in patients with superficial femoral artery occlusive disease–decision analysis. J. Vasc. Surg. 2007 Jun;45(6):1179-84. doi: 10.1016/j.jvs.2007.02.044
  3. Nguyen BN, Amdur RL, Abugideirim M, Rahbar R, Neville RF, Sidawy AN. Postoperative complications after common femoral endarterectomy. J Vasc Surg. 2015 Jun;61(6):1489-94. doi: 10.1016/j.jvs.2015.01.024
  4. Abramov IS, Maitesyan DA, Lazaryan TA, Baldin VL, Verigo AV, Eremenko AG, Papoyan SA. Otdalennye rezul’taty poluzakrytoi endaterektomii petlei iz poverkhnostnoi bedrennoi arterii i bedrenno-podkolennogo shuntirovaniia. Angiologiia i Sosud Khirurgiia. 2014;20(4):147-51. (in Russ.)
  5. Norgen L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FGR. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007 Jan;45(Suppl S):S5-67. doi: 10.1016/ j.jvs.2006.12.037
  6. Kim JH, So BJ, Byun SJ, Kim KY. The advantage of common femoral endarterectomy alone or combined with endovascular treatment. Vasc Specialist Int. 2018 Sep;34(3):65-71. doi: 10.5758/vsi.2018.34.3.65
  7. Husainy MA, Slim H, Rashid H, Huang DY. Recanalisation of chronically occluded remote superficial femoral artery endarterectomy through angioplasty for limb salvage. Cardiovasc Intervent Radiol. 2017 Feb;40(2):302-305. doi: 10.1007/s00270-016-1499-7
  8. Kostova-Lefterova DD, Nikolov NN, Stanev SS, Stoyanova BB. Patient doses in endovascular and hybrid revascularization of the lover extremites. Br J Radiol. 2018 Nov;91(1091):20180176. doi: 10.1259/bjr.20180176
  9. Soden PA, Zettervall SL, Shean KE, Deery SE, Kalish JA, Healey CT, Kansal N, Schermerhorn ML. Effect of adjunct femoral endarterectomy in lower extremity bypass on perioperative and 1-year outcomes. J Vasc Surg. 2017 Mar;65(3):711-19. doi: 10.1016/j.jvs.2016.06.118
  10. Kuma S, Tanaka K, Ohmine T, Morisaki K, Kodama A, Guntani A, Ishida M, Okazaki J, Mii S. Clinical outcome of surgical endarterectomy for common femoral artery occlusive disease. Circ J. 2016;80(4):964-69 doi: 10.1253/circj.CJ-15-1177
  11. Gisbertz SS, Ramzan M, Tutein Nolthenius RP, van der Laan L, Overtoom TT, Moll FL, de Vries JP. Short-term results of a randomized trial comparing remote endarterectomy and supragenicular bypass surgery for long occlusions of the superficial femoral artery [the REVAS trial]. Eur J Vasc Endovasc Surg. 2009 Jan;37(1):68-76. doi: 10.1016/j.ejvs.2008.09.014
  12. Perou S, Pirvu A, Morel J, Magne JL, Elie A, Spear R. Femoral bifurcation endarterectomy with transection-eversion of the superficial femoral artery: technique and results. Ann Vasc Surg. 2018 Nov;53:177-83. doi: 10.1016/j.avsg.2018.04.031
Address for correspondence:
224027, The Republic of Belarus,
Brest, Meditsinskaya Str., 7,
Brest Regional Hospital,
Unit of Vascular Surgery.
Tel.: +375 162 27-23-64,
Vladimir N. Zasimovich
Information about the authors:
Zasimovich Vladimir N., Head of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
Karpitski Aliaksandr S., MD, Professor, Chief Physician, Brest Regional Hospital, Brest, Republic of Belarus.
Nazaruk Aleksandr M., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
Malashchytski Yauheni A., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
Barysenka Maryia N., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
Zhymaila Aliaksei S., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.
Arlavets Andrei I., Angiosurgeon of the Unit of Vascular Surgery, Brest Regional Hospital, Brest, Republic of Belarus.



I.M. Sechenov First Moscow State Medical University,
The Russian Federation

Objective. Comprehensive analysis of opportunities, technical features and disadvantages of wound plasty with distant pedicled flap closing wound defects of the limbs was performed.
Methods. The study included 14 patients with limb wounds of different origin, who were treated using distant pedicled flaps grafting. Wounds were of different origin (deep frostbites, chronic osteomyelitis, neurotrophic disorders), diverse localization and perimeter. The indication for this type of full-layer plastics was the need to treat the wound in a functionally significant zone and the impossibility of using other, less complex methods of skin grafting.
Results. A positive immediate result of treatment was obtained in all 14 cases of distant flaps grafting. The development of complications (critical bend of the pedicle of the flap, sub-flap hematoma, the flaps edge necrosis) was registered in 3 cases in the early postoperative period, those complications did not significantly affect the immediate outcome of the operation. Long-term outcomes of treatment were evaluated in 8 patients in terms from 1 to 22 years after the operation. The key point determining the long-term treatment outcome was the patients compliance in the conditions of denervation of the flap and closure of wounds in functionally important areas. A flap necrosis in the plantar area occurred in two cases in patients, who did not follow the recommendations. In the remaining observations a stable positive result was obtained.
Conclusions. The distant pedicled flaps grafting is an effective method of reconstruction in functionally important areas under the conditions of limited plastic reserves of the surrounding skin. Denervation of such flaps exposes additional requirements to patients in terms of compliance with recommendations. The success of the operation in the long term period is largely determined by the patients compliance.

Keywords: extensive wounds, skin transplantation, surgical flaps, distant flaps plasty, "Italian plasty"
p. 42-48 of the original issue
  1. Kichemasov SKh, Skvortsov IuR. Kozhnaia plastika loskutami s osevym krovosnabzheniem pri ozhogakh i otmorozheniiakh IV stepeni. S-Petersburg: Gippokrat; 2012. 288 p.(in Russ.)
  2. Shapovalov VM, Gubochkin NG, Gaidukov VM, Lukicheva NP, Miasnikov NI. Reconstructive-and-plastic surgeries in treatment of patients with defects of integumentary tissues. Genii Ortopedii. 2014;(4):58-62. (in Russ.)
  3. Bezoyan, VS, Filimonov KA, Dorozhko YuA, Kirillov VI. Treatment of shin iatrogenic electric burn and its complications using the cross-leg flap (case report). Travmatologiia i Ortopediia Rossii. 2015;(2):83-89. (in Russ.)
  4. Kochish AIu, Rodomanova LA, Kozlov IV. Anatomo-klinicheskie obosnovaniia vozmozhnostei plasticheskogo zameshcheniia osteomieliticheskikh defektov nizhnikh konechnostei osevymi polikompleksami tkanei. Travmatologiia i Ortopediia Rossii. 2005;(3):75-76. (in Russ.)
  5. Bhattacharya V, Raveerandra G. Distal perforator based cross leg flaps for leg and foot defects. Indian J Plast Surg. 2005;38(1):18-21. doi: 10.4103/0970-0358.16490
  6. Lu L, Liu A, Zhu L, Zhang J, Zhu X, Jiang H. Cross-leg flaps: our preferred alternative to free flaps in the treatment of complex traumatic lower extremity wounds. J Am Coll Surg. 2013;217(3):461-71. doi: 10.1016/j.jamcollsurg.2013.03.029
  7. Kang MJ, Chung CH, Chang YJ, Kim KH. Reconstruction of the lower extremity using free flaps. Arch Plast Surg. 2013 Sep;40(5):575-83. doi: 10.5999/aps.2013.40.5.575
  8. Shoeib MA. Cross-leg flap: its reliability and outcome. Mod Plast Surg. 2013;(3):9-14. doi: 10.4236/mps.2013.31003
  9. Reisler T, Buziashvili D, Liu FC, Datiashvili RO. Revisiting the fasciocutaneous perforator cross-leg flap. Eplasty. 2016 Apr 28;16:ic16. eCollection 2016.
  10. Oleynik GA, Grigoryeva TG, Kim VM, Tsogoyev AA, Suprun AS. Case of severe thermomechanical hand injury. Meditsina Neotlozhnykh Sostoianii. 2012;(6):45. (in Russ.)
  11. Zavrazhnov AA, Shelamov IV, Argunov AV. The results of treatment of children with wound injury in different localization. Wounds and wound infections. The prof. BM Kostyuchenok journal. 2016;3(2):31-36. doi: 10.17650/2408-9613-2016-3-2-31-36 (in Russ.)
  12. Tikhilov RM, Kochish AYu, Rodomanova LA, Kutyanov DI, Afanas’ev AO. Possibilities of modern techniques of plastic and reconstructive surgery in the treatment of patients with major posttraumatic defects of extremities (review). Travmatologiia i Ortopediia Rossii. 2011;(2):164-70. doi: 10.21823/2311-2905-2011-0-2-164-170 (in Russ.)
Address for correspondence:
119991, The Russian Federation,
Moscow, Bolshaya Pirogovskaya Str., 2-4,
I.M. Sechenov First Moscow
State Medical University,
General Surgery Department.
Tel. office: +7495 915-39-21,
Tel. mobile: 89031478876,
Elena A. Komarova
Information about the authors:
Lipatov Konstantin V., MD, Professor of General Surgery Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Komarova Elena A., PhD, Assistant of General Surgery Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Khrupkin Valery I., MD, Professor of General Surgery Department, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Kiryupina Maria A., the 4th-Year Student, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.




Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden,
St. Petersburg,
The Russian Federation

Objective. To assess the quality of medical care and patient satisfaction in a specialized hospital.
Methods. Prospective study of the group consisting of 210 patients hospitalized with different orthopedic pathologies during the period from October to December 2017 was carried out. Before discharge from the hospital, patients were asked to complete the PPE-15 questionnaire (Picker Patient Experience Questionnaire). Beforehand, the PPE-15 questionnaire was translated and adapted for use in Russian-speaking medical practice.
Results. The average age of patients was 49.4 years (CI 95% 46.2-52.6), Male patients were 87 (42%), female patients 120 (58%). The average value of pain by the visual analogue scale was 27.4 points (CI 95% 24.2-30.5), satisfaction with medical support averaged 93 points (CI 95% 90.8-95.2). 91% of patients were ready to recommend treatment at our clinic to their relatives and friends, 6% abstained and left the question unanswered, 3% answered negatively. The connection between patients satisfaction and the 1, 3, 4 and 7 domains of the PPE-15, p<0.001 questionnaire was the strongest. There was no correlation between satisfaction and other factors.
Conclusions. The presented assessment results of patients satisfaction and their readiness to recommend the hospital to their relatives or acquaintances allow us making optimistic forecasts. However, a detailed study of certain aspects of patients experiences on the PPE-15 questionnaire will be useful for monitoring the work of different hospitals or hospital departments and may indicate ways of improving health care. Satisfaction with the process of medical care is indeed one of the goals of the Ministry of Health, and since the patient is the most interested party in assessing its quality, taking into account his opinion on the assistance provided is key to achieving maximum satisfaction with the treatment process.

Keywords: patient satisfaction, medical care quality, scoring systems, surveys and questionnaires, patients experience, traumatology, orthopedics
p. 49-58 of the original issue
  1. Donabedian A. Explorations in Quality Assessment and Monitoring. Vol I: The Definition of Quality and Approaches to Its Assessment. Health Administration Press; 1980. 163 .
  2. Crossing the Quality Chasm: A New Health System for the 21st Century. Institute of Medicine (US) Committee on Quality of Health Care in America. Washington (DC): National Academies Press (US); 2001. doi: 10.17226/10027
  3. Beattie M, Shepherd A, Howieson B. Do the Institute of Medicines’ (IOM) dimensions of quality capture the current meaning of quality in health care? An integrative review. J Res Nurs. 2013;18(4):288-304. doi: 10.1177/1744987112440568
  4. Patients first and foremost. The initial government response to the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: Stationary Office; 2013. 84 .
  5. Fitzpatrick R, Hopkins A. Problems in the conceptual framework of patient satisfaction research: an empirical exploration. Sociol Health Illn. 1983 Nov;5(3):297-11. doi: 10.1111/1467-9566.ep10491836
  6. Mazurenko AV, Tikhilov RM, Shubnyakov II, Pliey AS, Bliznyukov VV, Nikolaev DG. Evaluation of the possibilityof restoration of leg length in patients with severe hip dysplasia in different variants of surgical technique of hip replacement. Traumatology and Orthopedics of Russia. 2010;(3):16-20. doi: 10.21823/2311-2905-2010-0-3-16-20 (in Russ.)
  7. Locock L, Robert G, Boaz A, Vougioukalou S, Shuldham C, Fielden J, Ziebland S, Gager M, Tollyfield R, Pearcey J. Using a national archive of patient experience narratives to promote local patient-centered quality improvement: an ethnographic process evaluation of ‘accelerated’ experience-based co-design. J Health Serv Res Policy. 2014 Oct;19(4):200-7. doi: 10.1177/1355819614531565
  8. Hardy GE, West MA, Hill F. Components and predictors of patient satisfaction. Br J Health Psychol. 1996 Feb;1(1):65-85. doi: 10.1111/j.2044-8287.1996.tb00492.x
  9. Greengross P, Grant K, Collini E. Helpdesk Report: The History and Development of the UK National Health Service 1948–1999. Health Systems Resource Centre, UK; 1999. 39 p.
  10. The NHS Plan: a plan for investment, a plan for reform. London, UK; 2000. 144 .
  11. Jenkinson C, Coulter A, Bruster S. The Picker Patient Experience Questionnaire: development and validation using data from in-patient surveys in five countries. Int J Qual Health Care. 2002 Oct 1;14(5):353-58, doi: 10.1093/intqhc/14.5.353
  12. Shishliannikova LM. Primenenie korreliatsionnogo analiza v psikhologii. Psikhol Nauka i Obrazovanie. 2009;(1):98-107. (in Russ.)
  13. Kobyakova OS, Deev IA, Tyufilin DS, Kulikov ES, Tabakaev NA, Vorobyeva OO. Satisfaction with health care: how to measure and compare? Elektron Nauch Zhurn Sotsial’nye Aspekty Zdorov’ia Naseleniia. 2016;49(3). doi: 10.21045/2071-5021-2016-49-3-5
  14. Drinkwater BL. A comparison of the direction-of-perception technique with the Likert method in the measurement of attitudes. J Soc Psychol. 1965 Dec;67(2):189-96. doi: 10.1080/00224545.1965.9922270
  15. Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T. Patients’ experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care. Qual Saf Health Care. 2002 Dec;11(4):335-39. doi: 10.1136/qhc.11.4.335
Address for correspondence:
195427, The Russian Federation,
Saint-Petersburg, Ac. Baykov Str., 8,
Russian Scientific Research Institute
Of Traumatology and Orthopedics
Named after R.R. Vreden,
Scientific Department of Knee Joint Pathology.
Tel.: +7 905 276-48-48,
Arseni A. Irzhanski
Information about the authors:
Cherkasov Magomed A., Post-Graduate Student, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.
Cherny Andrey G., PhD, Associate Professor, Deputy Director for Medical Work, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.
Shubnyakov Igor I., MD, Chief Researcher, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.
Irzhanski Arseni A., Post-Graduate Student, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.
Idrisov Khasan K., Clinical Intern, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.
Dzamihov Ruslan K., Clinical Intern, Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden, Saint-Petersburg, Russian Federation.




Vitebsk State Medical University, Vitebsk,
The Republic of Belarus

Objective. To improve the surgical treatment results in patients with spinal epidural abscesses.
Methods. Surgical removal of spinal epidural abscesses, including interlaminectomy using a vacuum-draining system, was performed in 5 patients. The median age of patients was 58 [52; 64] years, 3 patients were males, 2 -females. On admission, the neurological status was studied, laboratory, bacteriological and instrumental methods of examination (computed and magnetic resonance imaging, bone scintigraphy) were carried out. The intensity of the pain syndrome was determined by the visual analogue scale (VAS). Sepsis was confirmed in 3 patients.
Results. A positive clinical outcome was achieved in 5 patients. The severity of pain before treatment and 2-3 days after surgery significantly decreased from 8.0 [8.0; 9.0] points to 5.0 [4.0; 5.0] on the VAS scale. On discharge, pain in 4 patients had almost completely regressed, but 1 patient still had a mild pain (4 points on the VAS scale) in the postoperative wound area. All patients had a regression of neurological deficit an increase in the strength and volume of active movements in the lower limbs up to 4 points, the normalization of the functions of the pelvic organs. There was no postoperative kyphotic spinal deformity in any patient. Recurrence of inflammatory process, requiring re-operations was not observed. Despite the positive neurological symptoms, regression of pain and an increase in the volume of active movements in the analyzed group, there was one death due to the extremely severe septic condition of the patient which had been already on admission.
Conclusions. The developed method of the spinal epidural abscesses surgical treatment, including interlaminectomy throughout the purulent focus and the installation of a vacuum-draining system, provides adequate sanitizing effect, rapid elimination of edema of the adjacent soft tissues, neural structures and high-quality tissue repair.

Keywords: spinal epidural abscess, vacuum therapy, drainage, interlaminectomy, lumbar pain, postoperative period
p. 59-65 of the original issue
  1. Dekonenko EP, Kupriianova LV, Tropikhin IM, Golovatenko-Abramov KV. Spinal’nyi epidural’nyi abstsess – klinicheskie osobennosti i slozhnosti differentsial’noi diagnostiki. Al’m Klin Meditsiny. 2001;(4):55-57. (in Russ.)
  2. Fadeev BP, Karabaev ISh. Diagnostika i lechenie gnoinykh spinal‘nykh epiduritov. Sankt-Petersburg, RF: VMedA, 2004. 25 p. (in Russ.)
  3. Moritani T, Kim J, Capizzano AA, Kirby P, Kademian J, Sato Y. Pyogenic and non-pyogenic spinal infections: emphasis on diffusion-weighted imaging for the detection of abscesses and pus collections. Br J Radiol. 2014 Sep;87(1041):20140011. doi: 10.1259/bjr.20140011
  4. Firsov SA, Snopko SV, Kornilova IV, Tumorin LS. Purulent spinal epiduritis: a latent threat. Tikhookean Med Zhurn. 2015;(4):92-94. (in Russ.)
  5. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev. 2000 Dec;23(4):175-204; discussion 205. doi: 10.1007/PL00011955
  6. Manoso MW, Cizik AM, Bransford RJ, Bellabarba C, Chapman J, Lee MJ. Medicaid status is associated with higher surgical site infection rates after spine surgery. Spine (Phila Pa 1976). 2014 Sep 15;39(20):1707-13. doi: 10.1097/BRS.0000000000000496
  7. Rigamonti D, Liem L, Sampath P, Knoller N, Namaguchi Y, Schreibman DL, Sloan MA, Wolf A, Zeidman S. Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol. 1999 Aug;52(2):189-97. doi: 10.1016/S0090-3019(99)00055-5
  8. Dandy WE. Abscesses and inflammatory tumors in spinal epidural space (so-called pachymeningitis externa). Arch Surg. 1926;13(4):477-94. doi: 10.1001/archsurg.1926.01130100021002
  9. Nuttall J, Evaniew N, Thornley P, Griffin A, Deheshi B, O’Shea T, Wunder J, Ferguson P, Randall RL, Turcotte R, Schneider P, McKay P, Bhandari M, Ghert M. The inter-rater reliability of the diagnosis of surgical site infection in the context of a clinical trial. Bone Joint Res. 2016 Aug;5(8):347-52. doi: 10.1302/2046-3758.58.BJR-2016-0036.R1
  10. Kolesov SV. Surgery for severe postlaminectomy spinal deformities. Khirurgiia Pozvonochnika. 2006;(2):029-032. doi: 10.14531/ss2006.2.29-32 (in Russ.)
  11. Goncharov MY, Sacovich VP, Danilov EP, Cherepanov AV, Volkov IV, Levchik EY. Immediate results of treatment for pyogenic nonspecific spine desease. Khirurgiia Pozvonochnika. 2005;(2):070-072. (in Russ.)
  12. Gain JuM, Bordakov PV, Bordakov VN, Shakhrai SV, Gain MJu, Elin IA. Vacuum-therapy at the surgical infection of soft tissues. Voen Meditsina. 2016;(4)):64-72. (in Russ.)
  13. Obolenskii VN, Nikitin VG, Semenistyi AIu, i dr. Ispol‘zovanie printsipa lokal‘nogo otritsatel‘nogo davleniia v lechenii ran i ranevoi infektsii. Novye tekhnologii i standartizatsiia v lechenii oslozhnennykh ran. S-Petersburg-M, RF; 2011. p. 58-65. (in Russ.)
  14. Anagnostakos K, Mosser P. Bacteria identification on NPWT foams: clinical relevance or contamination? J Wound Care. 2012 Jul;21(7):333-4, 336-39. doi: 10.12968/jowc.2012.21.7.333
  15. Orgill DP, Bayer LR. Negative pressure wound therapy: past, present and future. Int Wound J. 2013 Dec;10 Suppl 1:15-9. doi: 10.1111/iwj.12170
Address for correspondence:
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Neurology and Neurosurgery.
Tel. mobile +375 29 7349336,
Konstantsin M. Kubrakov
Information about the authors:
Kubrakov Konstantsin M., PhD, Associate Professor of the Department of Neurology and Neurosurgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Petukhov Uladzimir I., MD, Associate Professor, Head of the Surgery Department of the Faculty of Retraining and Advanced Training of Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Kornilov Artyom V., Post-Graduate Student of the Surgery Department of the Faculty of Retraining and Advanced Training of Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.




Perm State Medical University named after E.A. Wagner 1,
Perm Regional Clinical Hospital 2, Perm,
The Russian Federation

Objective. To investigate the endothelial dysfunction in patients with adrenal tumors during skin thermometry before and after surgery.
Methods. Microtest, a device for skin thermometry, was used to detect endothelial dysfunction in 19 patients with the adrenal tumors. The index of thermal vasodilation K was calculated for the endothelial, neurogenic and myogenic ranges. The patients were divided into two groups: patients with pheochromocytoma (n=8) and with hormonal inactive adrenal tumors and arterial hypertension (n=11). The comparison group consisted of 27 healthy adults.
Results. The patients with pheochromocytoma had lower thermal vasodilatation indices in all ranges in comparison to healthy adults; this difference was significant only in the myogenic and neurogenic ranges. A significant decrease of all indices of thermal vasodilation for patients of the second group was observed. A significant increase in indices of thermal vasodilatation in the endothelial and myogenic ranges was registered in patients with pheochromocytoma as well as the trend to rise in the neurogenic range during the early postoperative period. There was a strong positive association between the normalization of blood pressure in the postoperative period, the preoperative treatment with doxazosin, and the value of the index of thermal vasodilation in the endothelial range after the surgery.
Conclusions. All patients with pheochromocytomas, hormone-inactive adrenal tumors and arterial hypertension had the signs of impaired microvascular bed endothelial function. Preoperative treatment and adrenalectomy significantly improve the reaction of the microvascular endothelium in response to external heat stimuli in patients with pheochromocytoma.

Keywords: endothelial dysfunction, skin thermometry with local heating, adrenal tumors, pheochromocytoma, preoperative treatment
p. 66-71 of the original issue
  1. Smirnova EN, Guliaeva IL, Sobol’ AA, Turuntseva ON, Stepanova TA. Osobennosti funktsional’nogo sostoianiia endoteliia i endokrinno-metabolicheskogo profilia u zhenshchin s izbytochnym vesom i ozhireniem v sochetanii s gipotireozom v period menopauzy [Elektronnyi resurs]. Available from: (in Russ.)
  2. Podtaev S, Stepanov R, Smirnova E, Loran E. Wavelet-analysis of skin temperature oscillations during local heating for revealing endothelial dysfunction. Microvasc Res. 2015 Jan;97:109-14. doi: 10.1016/j.mvr.2014.10.003
  3. Popov AV, Podtaev SYu, Frick PG, Ershova AI, Jhukova EA. The study of low-amplitude oscillations of skin temperature during indirect cold pressure test. Regionarnoe Krovoobrashchenie i Mikrotsirkuliatsiia. 2011;10(1):89-94. (in Russ.)
  4. Smirnova E, Podtaev S, Mizeva I, Loran E. Assessment of endothelial dysfunction in patients with impaired glucose tolerance during a cold pressor test. Diab Vasc Dis Res. 2013 Nov;10(6):489-97. doi: 10.1177/1479164113494881
  5. Vasilev V, Matrozova J, Elenkova A, Vandeva S, Kirilov G, Zacharieva S. Asymmetric dimethylarginine (ADMA) and soluble vascular cell adhesion molecule 1(sVCAM-1) as circulating markers for endothelial dysfunction in patients with pheochromocytoma. Exp Clin Endocrinol Diabetes. 2013 Oct;121(9):551-5. doi: 10.1055/s-0033-1353183
  6. Yener S, Baris M, Secil M, Akinci B, Comlekci A, Yesil S. Is there an association between non-functioning adrenal adenoma and endothelial dysfunction? J Endocrinol Invest. 2011 Apr;34(4):265-70. doi: 10.3275/7101
  7. Petrák O, Widimský J Jr, Zelinka T, Kvasnicka J, Strauch B, Holaj R, Stulc T, Kvasnicka T, Bílková J, Skrha J. Biochemical markers of endothelial dysfunction in patients with endocrine and essential hypertension. Physiol Res. 2006;55(6):597-602.
  8. Thompson LD. Pheochromocytoma of the Adrenal gland Scaled Score (PASS) to separate benign from malignant neoplasms: a clinicopathologic and immunophenotypic study of 100 cases. Am J Surg Pathol. 2002; May;26(5):551-66.
Address for correspondence:
614000, The Russian Federation,
Perm, Pushkin Str., 85,
Perm Regional Clinical Hospital,
1st Surgical Unit.
Tel. +79024747460,
Alexey N. Fedachuk
Information about the authors:
Kotelnikova Liudmila P., MD, Professor, Head of the Surgery Department of the Postgraduate Additional Education, Perm State Medical University named after E.A. Wagner, Russian Federation.
Fedachuk Alexey N., Clinical Intern of the 1st Surgical Unit, Perm Regional Clinical Hospital, Perm, Russian Federation.




Vitebsk State Medical University 1
Vitebsk Regional Clinical Oncology Center 2, Vitebsk,
The Republic of Belarus

All over the world, colorectal cancer occupies the third place in terms of incidence and is the leading cause of death from malignant neoplasms. The incidence of colon cancer is expected to have 60 % increased by 2030 and will make up 2.2 million new cases per year. But despite modern diagnostics, the disease is mainly detected in the 3-4 stages. Even with the treatment of early tumor forms, progression occurs in 40-50% of patients. Tumor markers are used to monitor the development of the tumor process, but not all of them are highly sensitive and specific. In recent years, there has been an active search for new diagnostic markers that could not only predict the development of the disease but would also be the markers of a response to chemo-radiotherapy. The expression of inhibitor of apoptosis proteins (IAP) is known to increase the viability of tumor cells, and their overexpression leads to chemo-radio-resistance and is always associated with poor clinical prognosis of the disease. Due to this, inhibitor of apoptosis proteins are considered as a promising target in gene therapy for cancer. One of the most studied members of the IAP protein family is the survivin protein. In this literature review, the issue of clinical use of inhibitor of apoptosis protein survivin in colorectal cancer will be considered.

Keywords: colorectal cancer, rectal cancer, survivin, inhibitor of apoptosis proteins, prognostic tumor marker
p. 72-80 of the original issue
  1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F, eds. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from:, accessed on day/month/year
  2. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017 Apr;66(4):683-91. doi: 10.1136/gutjnl-2015-310912
  3. Tiuliandin SA, Nosov DA, Perevodchikova NI, red. Minimal’nye klinicheskie rekomendatsii Evropeiskogo Obshchestva Meditsinskoi Onkologii (ESMO). Moscow, RF; 2010. 436 p. (in Russ.)
  4. Kokhnyuk VT. Rectal cancer in the Republic of Belarus: prevalence, diagnosis and treatment outcomes. . 2013;(2):33-36. doi: 10.17650/2220-3478-2013-0-2-33-36 (in Russ.)
  5. Ries LAG, Melbert D; Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK (eds). SEER cancer statistics review, 1975-2005. U.S. National Institutes of Health, National Cancer Institute; 2008. 907 . URL
  6. Field K, Lipton L. Metastatic colorectal cancer-past, progress and future. World J Gastroenterol. 2007 Jul 28;13(28):3806-15. Published online 2007 Jul 28. doi: 10.3748/wjg.v13.i28.3806
  7. Meehan K, Vella LJ. The contribution of tumour-derived exosomes to the hallmarks of cancer. Crit Rev Clin Lab Sci. 2016;53(2):121-31. Epub 2015 Oct 19. doi: 10.3109/10408363.2015.1092496
  8. de Almagro MC, Vucic D. The inhibitor of apoptosis (IAP) proteins are critical regulators of signaling pathways and targets for anti-cancer therapy. Exp Oncol. 2012 Oct;34(3):200-11.
  9. Jaiswal PK, Goel A, Mittal RD. Survivin: A molecular biomarker in cancer. Indian J Med Res. 2015 Apr;141(4):389-97. doi: 10.4103/0971-5916.159250
  10. Yeh TC, Bratton SB. Caspase-dependent regulation of the ubiquitin-proteasome system through direct substrate targeting. Proc Natl Acad Sci U S A. 2013 Aug 27;110(35):14284-89. doi: 10.1073/pnas.1306179110
  11. Eckelman BP, Salvesen GS, Scott FL. Human inhibitor of apoptosis proteins: why XIAP is the black sheep of the family. EMBO Rep. 2006 Oct;7(10):988-94. doi: 10.1038/sj.embor.7400795
  12. Suzuki Y, Nakabayashi Y, Takahashi R. Ubiquitin-protein ligase activity of X-linked inhibitor of apoptosis protein promotes proteasomal degradation of caspase-3 and enhances its anti-apoptotic effect in Fas-induced cell death. Proc Natl Acad Sci U S A. 2001 Jul 17;98(15):8662-67. doi: 10.1073/pnas.161506698
  13. Chantalat L, Skoufias DA, Kleman JP, Jung B, Dideberg O, Margolis RL. Crystal structure of human survivin reveals a bow tie-shaped dimer with two unusual alpha-helical extensions. Mol Cell. 2000 Jul;6(1):183-89. doi: 10.1016/S1097-2765(05)00020-1
  14. Dohi T, Okada K, Xia F, Wilford CE, Samuel T, Welsh K, Marusawa H, Zou H, Armstrong R, Matsuzawa S, Salvesen GS, Reed JC, Altieri DC. An IAP-IAP complex inhibits apoptosis. J Biol Chem. 2004 Aug 13;279(33):34087-90. doi: 10.1074/jbc.C400236200
  15. Caldas H, Fangusaro JR, Boué DR, Holloway MP, Altura RA. Dissecting the role of endothelial SURVIVIN DeltaEx3 in angiogenesis. Blood. 2007 Feb 15;109(4):1479-89. doi: 10.1182/blood-2006-02-003749
  16. Altieri DC. Targeting survivin in cancer. Cancer Lett. 2013 May 28;332(2):225-28. doi: 10.1016/j.canlet.2012.03.005
  17. Jeyaprakash AA, Klein UR, Lindner D, Ebert J, Nigg EA, Conti E. Structure of a Survivin-Borealin-INCENP core complex reveals how chromosomal passengers travel together. Cell. 2007 Oct 19;131(2):271-85. doi: 10.1016/j.cell.2007.07.045
  18. Ghosh JC, Dohi T, Raskett CM, Kowalik TF, Altieri DC. Activated checkpoint kinase 2 provides a survival signal for tumor cells. Cancer Res. 2006 Dec 15;66(24):11576-79. doi: 10.1158/0008-5472.CAN-06-3095
  19. Hoffman WH, Biade S, Zilfou JT, Chen J, Murphy M. Transcriptional repression of the anti-apoptotic survivin gene by wild type p53. J Biol Chem. 2002 Feb 1;277(5):3247-57. doi: 10.1074/jbc.M106643200
  20. Sam MR, Tavakoli-Mehr M, Safaralizadeh R. Omega-3 fatty acid DHA modulates p53, survivin, and microRNA-16-1 expression in KRAS-mutant colorectal cancer stem-like cells. Genes Nutr. 2018 Apr 2;13:8. doi: 10.1186/s12263-018-0596-4. eCollection 2018
  21. Grossman D, Kim PJ, Blanc-Brude OP, Brash DE, Tognin S, Marchisio PC, Altieri DC. Transgenic expression of survivin in keratinocytes counteracts UVB-induced apoptosis and cooperates with loss of p53. J Clin Invest. 2001 Oct;108(7):991-99. doi: 10.1172/JCI13345
  22. Yamamoto T, Manome Y, Nakamura M, Tanigawa N. Downregulation of survivin expression by induction of the effector cell protease receptor-1 reduces tumor growth potential and results in an increased sensitivity to anticancer agents in human colon cancer. Eur J Cancer. 2002 Nov;38(17):2316-24. doi: 10.1016/S0959-8049(02)00247-2
  23. Sommer KW, Schamberger CJ, Schmidt GE, Sasgary S, Cerni C. Inhibitor of apoptosis protein (IAP) survivin is upregulated by oncogenic c-H-Ras. Oncogene. 2003 Jul 3;22(27):4266-80. doi: 10.1038/sj.onc.1206509
  24. You L, He B, Xu Z, Uematsu K, Mazieres J, Mikami I, Reguart N, Moody TW, Kitajewski J, McCormick F, Jablons DM. Inhibition of Wnt-2-mediated signaling induces programmed cell death in non-small-cell lung cancer cells. Oncogene. 2004 Aug 12;23(36):6170-74. doi: 10.1038/sj.onc.1207844
  25. Mobahat M, Narendran A, Riabowol K. Survivin as a preferential target for cancer therapy. Int J Mol Sci. 2014 Feb 13;15(2):2494-16. doi: 10.3390/ijms15022494
  26. Babaei E, Mowla SJ, Shariat Torbaghan S, Emadi Baygi M. Detection of surviving gene expression in formalinfixed paraffin-embedded tissue of human osteosarcoma: its potential usefulness in diagnosis and prognosis of bone tumors. IBJ. 2006;10(1):39-45.
  27. Adida C, Berrebi D, Peuchmaur M, Reyes-Mugica M, Altieri DC. Anti-apoptosis gene, survivin, and prognosis of neuroblastoma. Lancet. 1998 Mar 21;351(9106):882-83. doi: 10.1016/S0140-6736(05)70294-4
  28. Kawasaki H, Altieri DC, Lu CD, Toyoda M, Tenjo T, Tanigawa N. Inhibition of apoptosis by survivin predicts shorter survival rates in colorectal cancer. Cancer Res. 1998 Nov 15;58(22):5071-74.
  29. Ambrosini G, Adida C, Altieri DC. A novelanti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med. 1997;(3):917-21. doi: 10.1038/nm0897-917
  30. Lu CD, Altieri DC, Tanigawa N. Expression of a novel antiapoptosis gene, survivin, correlated with tumor cell apoptosis and p53 accumulation in gastric carcinomas. Cancer Res. 1998 May 1;58(9):1808-12.
  31. Altieri DC. Validating survivin as a cancer therapeutic target. Nat Rev Cancer. 2003;3:46-54. doi: 10.1038/nrc968
  32. Poomsawat S, Punyasingh J, Vejchapipat P. Overexpression of survivin and caspase 3 in oral carcinogenesis. Appl Immunohistochem Mol Morphol. 2014 Jan;22(1):65-71. doi: 10.1097/PAI.0b013e31828a0d0c
  33. Yong-Gang Lv, Fang Yu, Qing Yao, Jiang-Hao Chen, Ling Wang. The role of survivin in diagnosis, prognosis and treatment of breast cancer. J Thorac Dis. 2010 Jun;2(2):100-10.
  34. Vandghanooni S, Eskandani M, Montazeri V, Halimi M, Babaei E, Feizi MA. Survivin-deltaEx3: a novel biomarker for diagnosis of papillary thyroid carcinoma. J Cancer Res Ther. 2011 Jul-Sep;7(3):325-30. doi: 10.4103/0973-1482.87038
  35. Mohamed S, Yasufuku K, Nakajima T, Hiroshima K, Chiyo M, Yoshida S, Suzuki M, Sekine Y, Shibuya K, Agamy G, El-Shahhat H, Fujisawa T, Yoshino I. Nuclear survivin in pN2 nonsmall cell lung cancer: prognostic and clinical implications. Eur Respir J. 2009 Jan;33(1):127-33. doi: 10.1183/09031936.00068708
  36. Kawasaki H, Altieri DC, Lu CD, Toyoda M, Tenjo T, Tanigawa N. Inhibition of apoptosis by survivin predicts shorter survival rates in colorectal cancer. Cancer Res. 1998 Nov 15;58(22):5071-74.
  37. Kawasaki H, Toyoda M, Shinohara H, Okuda J, Watanabe I, Yamamoto T, Tanaka K, Tenjo T, Tanigawa N. Expression of survivin correlates with apoptosis, proliferation, and angiogenesis during human colorectal tumorigenesis. Cancer. 2001 Jun 1;91(11):2026-32. doi: 10.1002/1097-0142(20010601)91:11<2026::AID-CNCR1228>3.0.CO;2-E
  38. Lin LJ, Zheng CQ, Jin Y, Ma Y, Jiang WG, Ma T. Expression of survivin protein in human colorectal carcinogenesis. World J Gastroenterol. 2003 May;9(5):974-77. doi: 10.3748/wjg.v9.i5.974
  39. Kim PJ, Plescia J, Clevers H, Fearon ER, Altieri DC. Survivin and molecular pathogenesis of colorectal cancer. Lancet. 2003 Jul 19;362(9379):205-9. doi: 10.1016/S0140-6736(03)13910-4
  40. Jakubowska K, Pryczynicz A, Dymicka-Piekarska V, Famulski W, Guzinska-Ustymowicz K. Immunohistochemical expression and serum level of survivin protein in colorectal cancer patients. Oncology Letters. 2016;12(5):3591-97. doi: 10.3892/ol.2016.5075
  41. Kalliakmanis JG, Kouvidou Ch, Latoufis C, Kouvatseas G, Anagnostakis D, Papatheodoridis G, Koskinas J, Archimandritis A. Survivin expression in colorectal carcinomas: correlations with clinicopathological parameters and survival. Dig Dis Sci. 2010 Oct;55(10):2958-64. doi: 10.1007/s10620-009-1088-6
  42. Choi J, Chang H. The expression of MAGE and SSX, and correlation of COX2, VEGF, and survivin in colorectal cancer. Anticancer Res. 2012 Feb;32(2):559-64.
  43. Hernandez JM, Farma JM, Coppola D, Hakam A, Fulp WJ, Chen DT, Siegel EM, Yeatman TJ, Shibata D. Expression of the antiapoptotic protein survivin in colon cancer. Clin Colorectal Cancer. 2011 Sep;10(3):188-93. doi: 10.1016/j.clcc.2011.03.014
  44. Krieg A, Werner TA, Verde PE, Stoecklein NH, Knoefel WT. Prognostic and clinicopathological significance of survivin in colorectal cancer: a meta-analysis. PLoS One. 2013 Jun 3;8(6):e65338. doi: 10.1371/journal.pone.0065338. Print 2013.
  45. Shen C, Hu L, Xia L, Li Y. Quantitative real-time RT-PCR detection for survivin, CK20 and CEA in peripheral blood of colorectal cancer patients. Jpn J Clin Oncol. 2008 Nov;38(11):770-76. doi: 10.1093/jjco/hyn105
  46. Rödel F, Hoffmann J, Distel L, Herrmann M, Noisternig T, Papadopoulos T, Sauer R, Rödel C. Survivin as a radioresistance factor, and prognostic and therapeutic target for radiotherapy in rectal cancer. Cancer Res. 2005 Jun 1;65(11):4881-87. doi: 10.1158/0008-5472.CAN-04-3028
  47. Sprenger T, Rödel F, Beissbarth T, Conradi LC, Rothe H, Homayounfar K, Wolff HA, Ghadimi BM, Yildirim M, Becker H, Rödel C, Liersch T. Failure of down-regulation of survivin following neoadjuvant radiochemotherapy in rectal cancer is associated with distant metastases and shortened survival. Clin Cancer Res. 2011 Mar 15;17(6):1623-31. doi: 10.1158/1078-0432.CCR-10-2592
  48. Grossman D, McNiff JM, Li F, Altieri DC. Expression and targeting of the apoptosis inhibitor, survivin, in human melanoma. J Invest Dermatol. 1999 Dec;113(6):1076-81. doi: 10.1046/j.1523-1747.1999.00776.x
  49. Blanc-Brude OP, Mesri M, Wall NR, Plescia J, Dohi T, Altieri DC. Therapeutic targeting of the survivin pathway in cancer: initiation of mitochondrial apoptosis and suppression of tumor-associated angiogenesis. Clin Cancer Res. 2003 Jul;9(7):2683-92. http://clincancerres.aacr
  50. Gaj T, Gersbach CA, Barbas CF 3rd. ZFN, TALEN, and CRISPR/Cas-based methods for genome engineering. Trends Biotechnol. 2013 Jul;31(7):397-405. doi: 10.1016/j.tibtech.2013.04.004
Address for correspondence:
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Oncology with
The Courses of Radiology, Radiation Therapy,
Faculty of Training and Retraining
Of the Medical Specialists.
Tel.: +375-33-900-44-00,
Andrey V. Orehva
Information about the authors:
Orehva Andrey V., Surgeon-Oncologist of the Oncological Abdominal Unit, Vitebsk Regional Clinical Oncology Center, Applicant of the Department of Oncology with the Courses of Radiology, Radiation Therapy, the Faculty of Training and Retraining of the Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Shliakhtunou Yauheni A., Associate Professor of the Department of Oncology with the Courses of Radiology, Radiation Therapy, the Faculty of Training and Retraining of the Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Semenov Valeri M., MD, Professor, Head of the Infectious Diseases Department, Vitebsk State Medical University, Vitebsk, Republic of Belarus.



Belarusian Medical Academy of Post-Graduate Education 1,
Republican Scientific and Practical Center for Pediatric Surgery 2,
Belarusian Medical State University 3, Minsk
The Republic of Belarus

Vascular lesions constitute a considerable part (about 25%) of pediatric benign tumors and tumor-like masses. According to up-to-date understanding of vascular lesions (anomalies) they are divided into two main groups: vascular tumors (characterized by growth through cell proliferation) and vascular malformations (structural abnormalities of vessels development).
The mechanism of action of drugs for vascular lesions systemic medication aims at proliferation and angiogenesis, therefore that kind of management has implement mostly to vascular tumors.
The most significant pediatric benign vascular tumor is infantile hemangioma (IH). The distinctive features of IH, as a separate nosology, are its typical clinical course with phases of proliferation and subsequent involution, GLUT1 expression at immune-histochemical staining, and also positive response to beta-blockers treatment, in particular, to non-selective beta-blocker propranolol that, at present, has got a main place in the management of this kind of vascular tumors.
In certain vascular malformations molecular-genetic researches of recent years have demonstrated alterations relating to cell cycle regulation and vasculature development. For clinical course improvement of some vascular malformations, a medical treatment can be also applied.
The article presents an up-to-date vascular lesions classification and terminology, describes options of medical management for vascular tumors and tumor-like masses, provides some of their pathogenetic aspects that determine the prospects of new pharmaco-therapeutic approaches to vascular anomalies management.

Keywords: hemangioma, vascular malformations, vascular neoplasms, infantile hemangioma, propranolol, beta blockers, targeted treatment
p. 81-90 of the original issue
  1. North PE, Waner M, Buckmiller L, James CA, Mihm MC Jr. Vascular tumors of infancy and childhood: beyond capillary hemangioma. Cardiovasc Pathol. 2006 Nov-Dec;15(6):303-17. doi: 10.1016/j.carpath.2006.03.001
  2. Mulliken JB, Glowacki J. Hemangiomas and Vascular Malformations in Infants and Children: A Classification Based on Endothelial Characteristics. Plast Reconstr Surg. 1982 Mar;69(3):412-22.
  3. ISSVA Classification of vascular anomalies [Electronic resource]. International Society for the Study of Vascular Anomalies; 2014. [cited 2018 Jan 18]. Available from:
  4. Dargeon HW, Adiao AC, Pack GT. Hemangioma with thrombocytopenia. J Pediatr. 1959 Mar;54(3):285-95. doi: 10.1016/S0022-3476(59)80002-0
  5. Edgerton MT. The treatment of hemangiomas with special reference to the role of steroid therapy. Ann Surg. 1976 May;183(5):517-32.
  6. George ME, Sharma V, Jacobson J, Simon S, Nopper AJ. Adverse Effects of systemic glucocorticosteroid therapy in infants with hemangiomas. Arch Dermatol. 2004 Aug;140(8):963-69. doi: 10.1001/archderm.140.8.963
  7. Kelly ME, Juern AM, Grossman WJ, Schauer DW, Drolet BA. Immunosuppressive effects in infants treated with corticosteroids for infantile hemangiomas. Arch Dermatol. 2010 Jul;146(7):767-74. doi: 10.1001/archdermatol.2010.90
  8. Aviles R, Boyce TG, Thompson DM. Pneumocystis carinii pneumonia in a 3-month-old infant receiving high-dose corticosteroid therapy for airway hemangiomas. Mayo Clin Proc. 2004 Feb;79(2):243-45. doi: 10.4065/79.2.243
  9. Bennett ML, Fleischer AB Jr, Chamlin SL, Frieden IJ. Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation. Arch Dermatol. 2001;137(9):1208-13. doi: 10.1001/archderm.137.9.1208
  10. Chantharatanapiboon W. Intralesional corticosteroid therapy in hemangiomas: clinical outcome in 160 cases. J Med Assoc Thai. 2008 Oct;91 (Suppl 3):S90-96.
  11. Garzon MC, Lucky AW, Hawrot A, Frieden IJ. Ultrapotent topical corticosteroid treatment of hemangiomas of infancy. J Am Acad Dermatol. 2005 Feb;52(2):281-86. doi: 10.1016/j.jaad.2004.09.004
  12. Maguiness SM, Frieden IJ. Current management of infantile hemangiomas. Semin Cutan Med Surg. 2010 Jun;29(2):106-14. doi: 10.1016/j.sder.2010.03.009
  13. Egbert JE, Schwartz GS, Walsh AW. Diagnosis and treatment of an ophthalmic artery occlusion during an intralesional injection of corticosteroid into an eyelid capillary hemangioma. Am J Ophthalmol. 1996 Jun;121(6):638-42. doi: 10.1016/S0002-9394(14)70629-4
  14. Groopman JE, Gottlieb MS, Goodman J, Mitsuyasu RT, Conant MA, Prince H, Fahey JL, Derezin M, Weinstein WM, Casavante C, Rothman J, Rudnick SA, Voldberding PA. Recombinant Alpha-2 Interferon therapy for Kaposi’s sarcoma associated with the acquired immunodeficiency syndrome. Ann Intern Med. 1984 May;100(5):671-76. doi: 10.7326/0003-4819-100-5-671
  15. Sidky YA, Borden EC. Inhibition of angiogenesis by interferons: effects on tumor- and lymphocyte-induced vascular responses. Cancer Res. 1987 Oct 1;47(19):5155-61.
  16. Ezekowitz RA, Mulliken JB, Folkman J. Interferon alfa-2a therapy for life-threatening hemangiomas of infancy. N Engl J Med. 1992 May 28;326(22):1456-63. doi: 10.1056/NEJM199205283262203
  17. Greinwald JH Jr, Burke DK, Bonthius DJ, Bauman NM, Smith RJ. An update on the treatment of hemangiomas in children with interferon alfa-2a. Arch Otolaryngol Head Neck Surg. 1999 Jan;125(1):21-27. doi: 10.1001/archotol.125.1.21
  18. Dubois J, Hershon L, Carmant L, Bélanger S, Leclerc JM, David M. Toxicity profile of interferon alfa-2b in children: A prospective evaluation. J Pediatr. 1999 Dec;135(6):782-85. doi: 10.1016/S0022-3476(99)70104-6
  19. Michaud AP, Bauman NM, Burke DK, Manaligod JM, Smith RJ. Spastic diplegia and other motor disturbances in infants receiving interferon-alpha. Laryngoscope. 2004 Jul;114(7):1231-36. doi: 10.1097/00005537-200407000-00017
  20. Kaselas C, Tsikopoulos G, Papouis G, Kaselas V. Intralesional administration of interferon A for the management of severe haemangiomas. Pediatr Surg Int. 2007 Mar;23(3):215-18. doi: 10.1007/s00383-006-1840-3
  21. Rush BF Jr. Treatment of a giant cutaneous hemangioma by intra-arterial injection of nitrogen mustard: case report. Ann Surg. 1966 Nov;164(5):921-23.
  22. Hurvitz CH, Alkalay AL, Sloninsky L, Kallus M, Pomerance JJ. Cyclophosphamide therapy in life-threatening vascular tumors. J Pediatr. 1986 Aug;109(2):360-63. doi: 10.1016/S0022-3476(86)80405-X
  23. Enjolras O, Brevière GM, Roger G, Tovi M, Pellegrino B, Varotti E, Soupre V, Picard A, Leverger G. Vincristine treatment for function and life-threatening hemangiomas of infancy. Arch Pediatr. 2004 Feb;11(2):99-107. doi: 10.1016/j.arcped.2003.10.014
  24. Fawcett SL, Grant I, Hall PN, Kelsall AW, Nicholson JC. Vincristine as a treatment for a large haemangioma threatening vital functions. Br J Plast Surg. 2004 Mar;57(2):168-71. doi: 10.1016/j.bjps.2003.11.003
  25. Wang Z, Li K, Yao W, Dong K, Xiao X, Zheng S. Steroid-resistant kaposiform hemangioendothelioma: a retrospective study of 37 patients treated with vincristine and long-term follow-up. Pediatr Blood Cancer. 2015 Apr;62(4):577-80. doi: 10.1002/pbc.25296
  26. Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taïeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med. 2008 Jun 12;358(24):2649-51. doi: 10.1056/NEJMc0708819
  27. Drolet BA, Frommelt PC, Chamlin SL, Haggstrom A, Bauman NM, Chiu YE, Chun RH, Garzon MC, Holland KE, Liberman L, MacLellan-Tobert S, Mancini AJ, Metry D, Puttgen KB, Seefeldt M, Sidbury R, Ward KM, Blei F, Baselga E, Cassidy L, Darrow DH, Joachim S, Kwon EK, Martin K, Perkins J, Siegel DH, Boucek RJ, Frieden IJ. Initiation and use of propranolol for infantile hemangioma: report of a Consensus Conference Pediatrics. Pediatrics. 2013 Jan;131(1):128-40. doi: 10.1542/peds.2012-1691
  28. Caussé S, Aubert H, Saint-Jean M, Puzenat E, Bursztejn AC, Eschard C, Mahé E, Maruani A, Mazereeuw-Hautier J, Dreyfus I, Miquel J, Chiaverini C, Boccara O, Hadj-Rabia S, Stalder JF, Barbarot S; Groupe de Recherche Clinique en Dermatologie Pédiatrique. Propranolol-resistant infantile haemangiomas. Br J Dermatol. 2013 Jul;169(1):125-29. doi: 10.1111/bjd.12417
  29. Lamy S, Lachambre MP, Lord-Dufour S, Beliveau R. Propranolol suppresses angiogenesis in vitro: inhibition of proliferation, migration, and differentiation of endothelial cells. Vascul Pharmacol. 2010 Nov-Dec;53(5-6):200-8. doi: 10.1016/j.vph.2010.08.002
  30. Tu JB, Ma RZ, Dong Q, Jiang F, Hu XY, Li QY, Pattar P, Zhang H. Induction of apoptosis in infantile hemangioma endothelial cells by propranolol. Exp Ther Med. 2013 Aug;6(2):574-78. doi: 10.3892/etm.2013.1159
  31. Bernabeu-Wittel J, Narváez-Moreno B, de la Torre-García JM, Fernández-Pineda I, Domínguez-Cruz JJ, Coserría-Sánchez F, Álvarez-del-Vayo C, Conejo-Mir J. Oral nadolol for children with infantile hemangiomas and sleep disturbances with oral propranolol. Pediatr Dermatol. 2015 Nov-Dec;32(6):853-57. doi: 10.1111/pde.12686
  32. Langley A, Pope E. Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas. Br J Dermatol. 2015 Jan;172(1):13-23. doi: 10.1111/bjd.13379
  33. Ábarzúa-Araya A, Navarrete-Dechent CP, Heusser F, Retamal J, Zegpi-Trueba MS. Atenolol versus propranolol for the treatment of infantile hemangiomas: a randomized controlled study. J Am Acad Dermatol. 2014 Jun;70(6):1045-49. doi: 10.1016/j.jaad.2014.01.905
  34. Moehrle M, Leaute-Labreze C, Schmidt V, Rocken M, Poets CF, Goelz R. Topical timolol for small hemangiomas of infancy. Pediatr Dermatol. 2013 Mar-Apr;30(2):245-49. doi: 10.1111/j.1525-1470.2012.01723.x
  35. Mashiah J, Kutz A, Rabia SH, Ilan EB, Goldberg I, Sprecher E, Harel A. Assessment of the effectiveness of topical propranolol 4% gel for infantile hemangiomas. Int J Dermatol. 2017 Feb;56(2):148-53. doi: 10.1111/ijd.13517
  36. Torres-Pradilla M, Baselga E. Failure of Intralesional Propranolol in Infantile Hemangiomas. Pediatr Dermatol. 2014 Mar-Apr;31(2):156-58. doi: 10.1111/pde.12175
  37. Swetman GL, Berk DR, Vasanawala SS, Feinstein JA, Lane AT, Bruckner AL. Sildenafil for severe lymphatic malformations. N Engl J Med. 2012 Jan 26;366(4):384-86. doi: 10.1056/NEJMc1112482
  38. Rankin H, Zwicker K, Trenor CC. Caution is recommended prior to sildenafil use in vascular anomalies. Pediatr Blood Cancer. 2015 Nov;62(11):2015-17. doi: 10.1002/pbc.25600
  39. Horbach SE, Jolink F, van der Horst CM. Oral sildenafil as a treatment option for lymphatic malformations in PIK3CA-related tissue overgrowth syndromes. Dermatol Ther. 2016 Nov;29(6):466-69. doi: 10.1111/dth.12398
  40. Marsh DJ, Trahair TN, Martin JL, Chee WY, Walker J, Kirk EP, Baxter RC, Marshall GM. Rapamycin treatment for a child with germline PTEN mutation. Nat Clin Pract Oncol. 2008 Jun;5(6):357-61. doi: 10.1038/ncponc1112
  41. Fresno Vara JA, Casado E, de Castro J, Cejas P, Belda-Iniesta C, González-Barón M. PI3K/Akt signalling pathway and cancer. Cancer Treat Rev. 2004 Apr;30(2):193-204. doi: 10.1016/j.ctrv.2003.07.007
  42. Perry B, Banyard J, McLaughlin ER, Watnick R, Sohn A, Brindley DN, Obata T, Cantley LC, Cohen C, Arbiser JL. AKT1 overexpression in endothelial cells leads to the development of cutaneous vascular malformations in vivo. Arch Dermatol. 2007 Apr;143(4):504-6. doi: 10.1001/archderm.143.4.504
  43. Shirazi F, Cohen C, Fried L, Arbiser JL. Mammalian target of rapamycin (mTOR) is activated in cutaneous vascular malformations in vivo. Lymphat Res Biol. 2007;5(4):233-36. doi: 10.1089/lrb.2007.1012
  44. Hammill AM, Wentzel M, Gupta A, Nelson S, Lucky A, Elluru R, Dasgupta R, Azizkhan RG, Adams DM. Sirolimus for the treatment of complicated vascular anomalies in children. Pediatr Blood Cancer. 2011 Dec 1;57(6):1018-24. doi: 10.1002/pbc.23124
  45. Strychowsky JE, Rahbar R, O’Hare MJ, Irace AL, Padua H, Trenor CC Sirolimus as treatment for 19 patients with refractory cervicofacial lymphatic malformation. Laryngoscope. 2018 Jan;128(1):269-76. doi: 10.1002/lary.26780
  46. Uno T, Ito S, Nakazawa A, Miyazaki O, Mori T, Terashima K. Successful treatment of Kaposiform hemangioendothelioma with everolimus. Pediatr Blood Cancer. 2015 Mar;62(3):536-38. doi: 10.1002/pbc.25241
  47. Uebelhoer M, Boon LM, Vikkula M. Vascular anomalies: from genetics toward models for therapeutic trials. Cold Spring Harb Perspect Med. 2012 Aug 1;2(8). pii: a009688. doi: 10.1101/cshperspect.a009688
Address for correspondence:
220013, The Republic of Belarus,
Minsk, P. Brovko Str., 3-3,
Belarusian Medical Academy
Of Post-Graduate Education,
Department of Pediatric Oncology and Hematology.
Tel. mob.: +375 29 684-34-04,
Elena M. Sharafanovich
Information about the authors:
Sharafanovich Elena M., Applicant of the Department of Pediatric Oncology and Hematology, Belarusian Medical Academy of Post-Graduate Education, Pediatric Surgeon of the Surgical Unit 2, Republican Scientific and Practical Center for Pediatric Surgery, Minsk, Republic of Belarus.
Konoplya Natalya E., MD, Associate Professor, Professor of the Department of Pediatric Oncology and Hematology, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
Averin Vasily I., MD, Professor, Head of the Department of Pediatric Surgery, Belarusian Medical State University, Minsk, Republic of Belarus.



Ryazan State Medical University, Ryazan,
The Russian Federation

Revascularization of the occluded arterial segments is currently the main treatment method in patients with critical limb ischemia. Discussions regarding the choice of the best conduit for the reconstructive procedures on the femoro-popliteal-tibial segments have been continuing over the last five decades. Autovenous conduits using the great saphenous vein remain the golden standard in vascular reconstructive surgery. However, up to 50% of autovenous transplants lose patency within 5 years. Reaction of venous conduit to arterial circulation and its morphofunctional changes are not fully described in present-day medical literature. Markers of embryonic arteriovenous differentiation of endothelial cells determining the faith of both arteries and veins have gained popularity within past years. Ephrin-B2 is specifically expressed in arterial endothelium while Eph-B4 is expressed in venous endothelial cells. Arterialization of the autovenous conduit is characterized by the loss of the venous marker Eph-B4 without obtaining the arterial marker Ephrin-B2, which is accompanied by the negative morphological remodeling of the venous wall, i.e. its thickening. Eph-B4 in venous endothelium interacts with a number of molecules including eNOS, caveolin and others, thus regulating the process of adaptation. Further studies of the adaptation of venous conduits to arterial circulation may help improve our understanding of this process and results of the autovenous reconstructive procedures.

Keywords: endothelium, autovenous bypass, arterialization of the venous conduit, adaptation of the autovenous conduit, atherosclerosis, endothelial dysfunction, eph-B4, ephrin-B2
p. 91-100 of the original issue
  1. Gavrilenko AV, Kotov AE, Kalinin VD, Krotovskiy MA. Modern techniques of vascular surgery in the treatment of the chronic lower limbs ischemia. Annaly Khirurgiia. 2016;21(1-2):26-31. doi: 10.18821/1560-9502-2016-21-1-26-31 (in Russ.)
  2. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007 Jan;45(Suppl S):S5-67. doi: 10.1016/j.jvs.2006.12.037
  3. Natsional’nye rekomendatsii po vedeniiu patsientov s zabolevaniiami arterii nizhnikh konechnostei. Moscow, RF; 2013. 68 p. (in Russ.)
  4. Belov YuV, Vinokurov IA. The concept of surgical treatment of critical limb ischemia. Kardiologia i Serguch-Sosud Khirurgiia. 2015;8(5):9-13. doi: 10.17116/kardio2015859-13 (in Russ.)
  5. Isaji T, Hashimoto T, Yamamoto K, Santana JM, Yatsula B, Hu H, Bai H, Jianming G, Kudze T, Nishibe T, Dardik A. Improving the outcome of vein grafts: should vascular surgeons turn veins into arteries? Ann Vasc Dis. 2017 Mar 24;10(1):8-16. doi: 10.3400/avd.ra.17-00008
  6. Muto A, Model L, Ziegler K, Eghbalieh, Dardik A. Mechanisms of vein graft adaptation to the arterial circulation – insights into the neointimal algorithm and management strategies. Circ J. 2010;74(8):1501-12. doi: 10.1253/circj.cj-10-0495
  7. Kalinin RE, Suchkov IA, Mnikhovich MV, Kaktursky LV, Levitin AV, Isakov SA. Peculiarities of morphological imaging at the sites of vascular anastomosis at different periods of time fol-lowing lower extremity arterial reconstructive surgery. Morfol Vedomosti. 2013;(1):21-27. (in Russ.)
  8. Owens CD. Adaptive changes in autogenous vein grafts for arterial reconstruction: clinical implications. J Vasc Surg. 2010 Mar;51(3):736-46. doi: 10.1016/j.jvs.2009.07.102
  9. Ambler GK, Twine CP. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2018 Feb;11(2):CD001487. doi: 10.1002/14651858.CD001487.pub3
  10. Ziegler KR, Muto A, Eghbalieh SD, Dardik A. Basic data related to surgical infrainguinal revascularization procedures: a twenty year update. Ann Vasc Surg. 2011 Apr;25(3):413-22. doi: 10.1016/j.avsg.2010.10.010
  11. Park C, Kim TM, Malik AB. Transcriptional regulation of endothelial cell and vascular development. Circ Res. 2013 May 10;112(10):1380-400. doi: 10.1161/CIRCRESAHA.113.301078
  12. Wang HU, Chen ZF, Anderson DJ. Molecular distinction and angiogenic interaction between embryonic arteries and veins revealed by ephrin-B2 and its receptor Eph-B4. Cell. 1998 May 29;93(5):741-53. doi: 10.1016/s0092-8674(00)81436-1
  13. Simons M, Eichmann A. Molecular controls of arterial morphogenesis. Circ Res. 2015 May 8;116(10):1712-24. doi: 10.1161/CIRCRESAHA.116.302953
  14. Fancher TT, Muto A, Fitzgerald TN, Magri D, Gortler D, Nishibe T, Dardik A. Control of blood vessel identity: from embryo to adult. Ann Vasc Dis. 2008;1(1):28-34. Published online 2008 Feb 15.doi: 10.3400/avd.AVDrev0701
  15. dela Paz NG, D’Amore PA.. Arterial versus venous endothelial cells. Cell Tissue Res. 2009 Jan;335(1):5-16. doi: 10.1007/s00441-008-0706-5.
  16. Kanaya K, Ii M, Okazaki T, Nakamura T, Horii-Komatsu M, Alev C, Akimaru H, Kawamoto A, Akashi H,Tanaka H, Asahi M, Asahara T. Sonic Hedgehog signaling regulates vascular differentiation and function in human CD34 positive cells: vasculogenic CD34(+) cells with Sonic Hedgehog. Stem Cell Res. 2015 Mar;14(2):165-76. doi: 10.1016/j.scr.2015.01.003
  17. Eichmann A, Simons M. VEGF signaling inside vascular endothelial cells and beyond. Curr Opin Cell Biol. 2012 Apr;24(2):188-93. doi: 10.1016/
  18. Simons M, Gordon E, Claesson-Welsh L. Mechanisms and regulation of endothelial VEGF receptor signalling. Nat Rev Mol Cell Biol. 2016;17(10):611-25. doi: 10.1038/nrm.2016.87
  19. Yang C, Guo Y, Jadlowiec CC, Li X, Lv W, Model LS, Collins MJ, Kondo Y, Muto A, Shu C, Dardik A. Vascular endothelial growth factor-A Inhibits Ephb4 and stimulates delta-like ligand 4 expression in adult endothelial cells. J Surg Res. 2013 Jul;183(1):478-86. doi: 10.1016/j.jss.2013.01.009
  20. Benedito R, Hellström M. Notch as a hub for signaling in angiogenesis. Exp Cell Res. 2013 May 15;319(9):1281-88. doi: 10.1016/j.yexcr.2013.01.010
  21. Kondo Y, Muto A, Kudo FA, Model L, Eghbalieh S, Chowdhary P, Dardik A. Age-related Notch-4 quiescence is associated with altered wall remodeling during vein graft adaptation. J Surg Res. 2011 Nov;171(1):e149-60. doi: 10.1016/j.jss.2011.06.036
  22. You LR, Lin FJ, Lee CT, DeMayo FJ, Tsai MJ, Tsai SY. Suppression of Notch signalling by the COUP-TFII transcription factor regulates vein identity. Nature. 2005;435(7038):98-104. doi: 10.1038/nature03511
  23. Qin J, Tsai SY, Tsai MJ. The critical roles of COUP-TFII in tumor progression and metastasis. Cell Biosci. 2014;4(1):58. doi: 10.1186/2045-3701-4-58
  24. Salvucci O, Tosato G. Essential roles of EphB receptors and EphrinB ligands in endothelial cell function and angiogenesis. Adv Cancer Res. 2012;114:21-57. doi: 10.1016/B978-0-12-386503-8.00002-8
  25. Park I, Lee HS. EphB/ephrinB signaling in cell adhesion and migration. Mol Cells. 2015 Jan 31;38(1):14-19. doi: 10.14348/molcells.2015.2116
  26. Klein R. Eph/ephrin signalling during development. Development. 2012 Nov;139(22):4105-9. doi: 10.1242/dev.074997
  27. Yamanashi Y, Tezuka T, Yokoyama K. Activation of receptor protein-tyrosine kinases from the cytoplasmic compartment. J Biochem. 2012 Apr;151(4):353-9. doi: 10.1093/jb/mvs013
  28. Pitulescu ME, Adams RH. Regulation of signaling interactions and receptor endocytosis in growing blood vessels. Cell Adh Migr. 2014;8(4):366-77. doi: 10.4161/19336918.2014.970010
  29. Xiao Z, Carrasco R, Kinneer K, Sabol D, Jallal B, Coats S, Tice DA. EphB4 promotes or suppresses Ras/MEK/ERK pathway in a context-dependent manner: implications for EphB4 as a cancer target. Cancer Biol Ther. 2012 Jun;13(8):630-37. doi: 10.4161/cbt.20080
  30. Salgia R, Kulkarni P, Gill PS. EphB4: A promising target for upper aerodigestive malignancies. Biochim Biophys Acta. 2018 Apr;1869(2):128-37. doi: 10.1016/j.bbcan.2018.01.003
  31. Hashimoto T, Tsuneki M, Foster TR, Santana JM, Bai H, Wang M, Hu H, Hanisch JJ, Dardik A, Membrane-mediated regulation of vascular identity. Birth Defects Res C Embryo Today. 2016 Mar;108(1):65-84. doi: 10.1002/bdrc.21123
  32. Kudo FA, Muto A, Maloney SP, Pimiento JM, Bergaya S, Fitzgerald TN, Westvik TS, Frattini JC, Breuer CK, Cha CH, Nishibe T, Tellides G, Sessa WC, Dardik A. Venous identity is lost but arterial identity is not gained during vein graft adaptation. Arterioscler Thromb Vasc Biol. 2007;27(7):1562-71. doi: 10.1161/ATVBAHA.107.143032
  33. Muto A, Yi T, Harrison KD, Dávalos A, Fancher TT, Ziegler KR, Feigel A, Kondo Y, Nishibe T, Sessa WC, Dardik A. Eph-B4 prevents venous adaptive remodeling in the adult arterial environment. J Exp Med. 2011 Mar 14;208(3):561-75. doi: 10.1084/jem.20101854
  34. Model LS, Hall MR, Wong DJ, Muto A, Kondo Y, Ziegler KR, Feigel A, Quint C, Niklason L, Dardik A. Arterial shear stress reduces eph-b4 expression in adult human veins. Yale J Biol Med. 2014 Sep;87(3):359-71.
  35. Berard X, Déglise S, Alonso F, Saucy F, Meda P, Bordenave L, Corpataux JM, Haefliger JA. Role of hemodynamic forces in the ex vivo arterialization of human saphenous veins. J Vasc Surg. 2013 May;57(5):1371-82. doi: 10.1016/j.jvs.2012.09.041
  36. Wong DJ, Lu DY, Protack CD, Kuwahara G, Bai H, Sadaghianloo N, Tellides G, Dardik A. Ephrin type-B receptor 4 activation reduces neointimal hyperplasia in human saphenous vein in vitro. J Vasc Surg. 2016 Mar;63(3):795-804. doi: 10.1016/j.jvs.2014.09.036
  37. Ivanov AN, Bugaeva IO, Kurtukova MO. Structural characteristics of human and other mammalian endothelial cells. Tsitologiia. 2016;58(9):657-65. (in Russ.)
  38. Rivera M, Muto A, Feigel A, Kondo Y, Dardik A. Venous and arterial identity: a role for caveolae? Vascular. 2009 Jun;17(1):S10-14. doi: 10.2310/6670.2008.00088
  39. Yu J, Bergaya S, Murata T, Alp IF, Bauer MP, Lin MI, Drab M, Kurzchalia TV, Stan RV, Sessa WC. Direct evidence for the role of caveolin-1 and caveolae in mechanotransduction and remodeling of blood vessels. J Clin Invest. 2006 May 1;116(5):1284-91. doi: 10.1172/jci27100
  40. Jadlowiec CC, Feigel A, Yang C, Feinstein AJ, Kim ST, Collins MJ, Kondo Y, Muto A, Dardik A. Reduced adult endothelial cell EphB4 function promotes venous remodeling. Am J Physiol Cell Physiol. 2013 Apr 1;304(7):C627-35. doi: 10.1152/ajpcell.00333.2012
  41. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012 Apr;33(7):829-37, 837a-837d. doi: 10.1093/eurheartj/ehr304
  42. Onan B, Erkanli K, Onan IS, Ersoy B, Canillioglu YE, Senturk GE, Hurdag C, Yeniterzi M. The impact of vessel clamps on endothelial integrity and function of saphenous vein grafts. Ann Vasc Surg. 2014 Jul;28(5):1113-22. doi: 10.1016/j.avsg.2014.01.020
  43. Kalinin RE, Suchkov IA, Pshennikov AS. Correction of endothelial dysfunction as a component in treatment for atherosclerosis obliterans of lower-limb arteries. Angiologiia i Sosud Khirurgiia. 2014;20(3):17-22. (in Russ.)
  44. Sugimoto M, Yamanouchi D, Komori K. Therapeutic approach against intimal hyperplasia of vein grafts through endothelial nitric oxide synthase/nitric oxide (eNOS/NO) and the Rho/Rho-kinase pathway. Surg Today. 2009;39(6):459-65. doi: 10.1007/s00595-008-3912-6
  45. Chen Z, Bakhshi FR, Shajahan AN, Sharma T, Mao M, Trane A, Bernatchez P, van Nieuw Amerongen GP, Bonini MG, Skidgel RA, Malik AB, Minshall RD. Nitric oxide-dependent Src activation and resultant caveolin-1 phosphorylation promote eNOS/caveolin-1 binding and eNOS inhibition. Mol Biol Cell. 2012 Apr;23(7):1388-98. doi: 10.1091/mbc.E11-09-0811
    46 Bernatchez P, Sharma A, Bauer PM, Marin E, Sessa WC. A noninhibitory mutant of the caveolin-1 scaffolding domain enhances eNOS-derived NO synthesis and vasodilation in mice. J Clin Invest. 2011 Sep;121(9):3747-55. doi: 10.1172/JCI44778
  46. Wang M, Collins MJ, Foster TR, Bai H, Hashimoto T, Santana JM, Shu C, Dardik A. Eph-B4 mediates vein graft adaptation by regulation of endothelial nitric oxide synthase. J Vasc Surg. 2017 Jan;65(1):179-89. doi: 10.1016/j.jvs.2015.11.041
  47. Kalinin RE, Pshennikov AS, Suchkov IA. Reperfusion injury of tissues in lower limb arterial reconstructive surgery. Novosti Khirurgiia. 2015;23(3):348-52. doi: 10.18484/2305-0047.2015.3.348 (in Russ.)
Address for correspondence:
390026, The Russian Federation,
Ryazan, Vysokovoltnaya Str.,9,
Ryazan State Medical University,
Department of Cardiovascular, Endovascular,
Operative Surgery and Topographic Anatomy.
Tel. +7 910 900-95-23,
Alexander S. Pshennikov
Information about the authors:
Kalinin Roman E., MD, Professor, Rector, Head of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
Suchkov Igor A., MD, Associate Professor, Vice-Rector for Research and Innovative Development, Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
Pshennikov Alexander S., PhD, Associate Professor, Dean of the Medical Faculty, Associate Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
Vinogradov Sergey A., Clinical Intern of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.




A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow,
The Russian Federation

Frequency of primary heart tumors in children is relatively rare and according to the literature data does not exceed 0.32%, while heart fibroma is registered in 13-18%. Cardiac fibroma is a benign tumor that occurs mainly in childhood. It can be manifested by heart rhythm disturbances, heart failure, sudden death, while large number of patients remain asymptomatic and tumor is revealed accidentally. Electrocardiography and echocardiography help to diagnose this heart neoplasm, but an accurate diagnosis can be made using additional methods such as computer or magnetic resonance imaging and histological examination. Nevertheless, in some situations, nature of tumor can be established only after its resection. This case report describes the stages of diagnosis and subsequent successful resection of a large fibroma of the interventricular septum, which has created the obstruction of right ventricular outflow tract, in a baby patient. It should be noticed that the course of the disease was almost asymptomatic. The tumor was first detected at the age of 1 month when performing routine echocardiography and subsequently the child was observed for several months by cardiologist; there was a tendency to the tumor increase, but there were no specific complaints from the child.

Keywords: child, heart neoplasms, fibroma, interventricular septum, resection
p. 101-107 of the original issue
  1. Smythe JF, Dyck JD, Smallhorn JF, Freedom RM. Natural history of cardiac rhabdomyoma in infancy and childhood. Am J Cardiol. 1990 Nov 15;66(17):1247-49. doi: 10.1016/0002-9149(90)91109-J
  2. Isaacs H Jr. Fetal and neonatal cardiac tumors. Pediatr Cardiol. 2004 May-Jun;25(3):252-73. doi: 10.1007/s00246-003-0590-4
  3. Nathan M, Fabozzo A, Geva T, Walsh E, del Nido PJ. Successful surgical management of ventricular fibromas in children. J Thorac Cardiovasc Surg. 2014 Dec;148(6):2602-8. doi: 10.1016/j.jtcvs.2013.11.052
  4. Jain D, Maleszewski JJ, Halushka MK. Benign cardiac tumors and tumorlike conditions. Ann Diagn Pathol. 2010 Jun;14(3):215-30. doi: 10.1016/j.anndiagpath.2009.12.010
  5. Miyake CY, Del Nido PJ, Alexander ME, Cecchin F, Berul CI, Triedman JK, Geva T, Walsh EP. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J Am Coll Cardiol. 2011 Oct 25;58(18):1903-9. doi: 10.1016/j.jacc.2011.08.005
  6. Careddu L, Oppido G, Petridis FD, Liberi R, Ragni L, Pacini D, Pace Napoleone C, Angeli E, Gargiulo G. Primary cardiac tumours in the paediatric population. Multimed Man Cardiothorac Surg. 2013;2013:mmt013. doi: 10.1093/mmcts/mmt013
  7. Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald’s heart disease: a text book of cardiovascular medicine. 9th ed. Philadelphia: Elsevier Saunders; 2012. 2048 .
  8. Shi L, Wu L, Fang H, Han B, Yang J, Ma X, Liu F, Zhang Y, Xiao T, Huang M, Huang M. Identification and clinical course of 166 pediatric cardiac tumors. Eur J Pediatr. 2017 Feb;176(2):253-60. doi: 10.1007/s00431-016-2833-4
  9. Horovitz A, van Geldorp IE, Roubertie F, Thambo JB. Large right ventricular fibroma in a 6-month-old infant. Pediatr Cardiol. 2012 Dec;33(8):1458-60. doi: 10.1007/s00246-012-0390-9
  10. Kimura N, Matsubara M, Atsumi N, Terada M. Successful surgical removal of a giant interventricular fibroma: surgical approach without ventriculotomy. Ann Thorac Surg. 2013 Mar;95(3):1072-74. doi: 10.1016/j.athoracsur.2012.08.028
  11. Bockeria LA, Svobodov AA, Yurpol’skaya LA, Doktorova VP. The case of successful resection fibroma of right ventricle in a seven-month age child. Grudnaia i Serdech-Sosud Khirurgiia. 2014;(6):43-46. (in Russ.)
  12. Braggion-Santos MF, Koenigkam-Santos M, Teixeira SR, Volpe GJ, Trad HS, Schmidt A. Magnetic resonance imaging evaluation of cardiac masses. Arq Bras Cardiol. 2013 Sep;101(3):263-72. doi: 10.5935/abc.20130150 [Article in English, Portuguese]
  13. Ivanovskaia TE, Tsinzerling AV. Patologicheskaia anatomiia (bolezni detskogo vozrasta). Moscow, SSSR: Meditsina; 1976. 432 p. (in Russ.)
  14. Cho JM, Danielson GK, Puga FJ, Dearani JA, McGregor CG, Tazelaar HD, Hagler DJ. Surgical resection of ventricular cardiac fibromas: early and late results. Ann Thorac Surg. 2003 Dec;76(6):1929-34. doi: 10.1016/S0003-4975(03)01196-2
Address for correspondence:
121552, The Russian Federation,
Moscow, Rublevskoe Highway, 135,
A.N. Bakoulev National Medical
Research Center for Cardiovascular Surgery,
Surgery Department of Young Children
With Congenital Heart Diseases.
Tel. mobile: +79260310316,
Dmitry K. Guschin
Information about the authors:
Bockeria Leo A., Academician of RAS, MD, Professor, Director, A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation.
Guschin Dmitry K., Researcher, Cardiovascular Surgeon of the Surgery Department of Young Children with Congenital Heart Diseases, A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation.
Zelenikin Mikhail M., MD, Professor, Head of the Surgery Department of Young Children with Congenital Heart Diseases, A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation.
Yurpolskaya Lyudmila A., MD, Leading Researcher of the Department of Computer and Magnetic Resonance Imaging, A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation.



I.M. Sechenov First Moscow State Medical University, Moscow,
The Russian Federation

Nowadays the mortality rate due to the liver cirrhosis has been steadily increasing. Conservative methods of treatment have a positive effect at an early stage of the disease in some patients. The amount of five-year survival rate is 62% in the compensation stage of cirrhosis whereas it decreases to 19% at the decompensation stage. At the present time, the most effective treatment of cirrhosis is liver transplantation because a five-year survival rate is 70-75%. However, this method is followed by the number of limitations. In this aspect, we give preference to minimally invasive techniques with the use of agents influencing an inflammation process and liver regeneration. This case report describes the clinical experience of seven-year observation of the patient with viral liver cirrhosis (HbsAg+, DNA HBV+, HDV+) in the decompensation stage (C-class by Child-Pugh) treated by the minimally invasive method: intrahepatic injection of cryoprecipitate. This contributed to the improvement of the general state and clinical and laboratory parameters for a long time. The cryoprecipitate is a highly concentrated solution of fibrinogen derived from donor plasma by cryoprecipitation, containing growth factors to decrease macrophage activity and cirrhosis progress. On admission, the patient had the unfavorable prognosis for the disease. However, the usage of cryoprecipitate showed significant improvement of the laboratory and hemodynamic tests. The effectiveness and availability of this method make it perspective for the treatment of the patients with liver cirrhosis in the stage of decompensation.

Keywords: liver cirrhosis, portal hypertension, surgical treatment, liver regeneration, minimally invasive surgery, cryoprecipitate, functional activity
p. 108-113 of the original issue
  1. Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, Murray JL, Naghavi M. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Medicine 2014 12:145. doi: 10.1186/s12916-014-0145-y
  2. Marcellin P, Gane E, Buti M, Afdhal N, Sievert W, Jacobson IM, Washington MK, Germanidis G, Flaherty JF, Aguilar Schall R, Bornstein JD, Kitrinos KM, Subramanian GM, McHutchison JG, Heathcote EJ. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013 Feb 9;381(9865):468-75. doi: 10.1016/S0140-6736(12)61425-1
  3. Fleming KM, Aithal GP, Card TR, West J. All-cause mortality in people with cirrhosis compared with the general population: a population-based cohort study. Liver Int. 2012 Jan;32(1):79-84. doi: 10.1111/j.1478-3231.2011.02517.x
  4. Tovikkai C, Charman SC, Praseedom RK, Gimson AE, van der Meulen J. Time-varying impact of comorbidities on mortality after liver transplantation: a national cohort study using linked clinical and administrative data. BMJ Open. 2015 May 14;5(5):e006971. doi: 10.1136/bmjopen-2014-006971
  5. Forbes SJ, Newsome PN. Liver regeneration - mechanisms and models to clinical application. Nat Rev Gastroenterol Hepatol. 2016 Aug;13(8):473-85. doi: 10.1038/nrgastro.2016.97
  6. Fausto N, Campbell JS, Riehle KJ. Liver regeneration. Hepatology. 2006 Feb;43(2 Suppl 1):S45-53. doi: 10.1002/hep.20969
  7. Chernousov AF, Khorobrykh TV, Karpova RV, Zenkova KI. Effect of cryoprecipitate on liver regeneration in cirrhosis. Novosti Khirurgii. 2017;25(4):350-58. doi: 10.18484/2305-0047.2017.4.350 (in Russ.)
Address for correspondence:
119435, The Russian Federation,
Moscow, B. Pirogovskaya Str., 6-1,
I.M. Sechenov First Moscow
State Medical University,
Department of Faculty Surgery 1.
Tel.: +7 916 407-75-70,
Yuri M. Poluektov
Information about the authors:
Karpova Radmila V., MD, Professor of the Department of Faculty Surgery 1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Chernousov Alexander F., Academician of RAS, MD, Professor, Head of the Department of Faculty Surgery 1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Khorobryh Tatiana V., MD, Professor of the Department of Faculty Surgery 1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Kazakova Daria A., 5-Year Student of the Faculty Medicine of Future, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Poluektov Yuri M., 5-Year Student of the Faculty Medicine of Future, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.




The article is devoted to an outstanding traumatologist-orthopedist, talented scientist, remarkable teacher, public figure, MD, professor, academician of the Russian Academy of Sciences, Rector of Samara State Medical University G.P. Kotelnikov. Adhering to a strictly scientific direction in traumatology and orthopedics, high moral values, he educated a whole pleiad of students, created a scientific and pedagogical school and made a great contribution to the development of Russian Health Care.
The main scientific directions of the research and pedagogical school of Academician G.P. Kotelnikov are the following: development of the problem of tendon-muscular plastics in traumatology and orthopedics, improvement of methods in diagnosis and treatment of destructive-dystrophic and oncological diseases of the musculoskeletal system, optimization of diagnostic and therapeutic measures for post-traumatic instability of the joints, studies on the use of gravitational therapy, the study of osteoporosis, development of the concept of traumatic disease, cellular technologies in orthopedics, development of systemic analysis, mathematics modeling and evidence in medicine. The field of his activity also includes transplantology, clinical biomechanics, phlebology, urology, maxillofacial surgery and military field surgery, gerontology. He is interested in nutrition, balneology, history of medicine. In the field of healthcare organization, the main scientific direction is the improvement of methodological approaches in the training of medical personnel.

Keywords: Kotelnikov Gennady Petrovich, Samara State Medical University, history of traumatology and orthopedics, scientific and pedagogical schools
p. 114-121 of the original issue
  1. Katorkin SE. A heart of surgeon. Professor A.M. Aminev (1904-1984 yrs.) Novosti Khirurgii. 2014;22(3):269-79. doi: 10.18484/2305-0047.2014.3.269 (in Russ.)
  2. Kotelnicov GP, Suslin SA, Sirotko ML, Brulykova LI. Krasnov – organizator, uchenyi, pedagog vysshei meditsinskoi shkoly. Biul Nats nauch-issled in-ta obshchestv zdorov’ia im NA. Semashko. 2016;(2):222-23 (in Russ.)
  3. Iashkov AV. Metodologicheskie aspekty gravitatsionnoi terapii. Fizioterapiia Bal‘neologiia i Reabilitatsiia. 2013;(2):3-6. (in Russ.)
  4. Bulgakova SV. Klinicheskoe napravlenie deiatel’nosti “samarskogo oblastnogo mezhvedomstvennogo tsentra profilaktiki osteoporoza”: opyt raboty. Izv Vysshikh Uchebnykh Zavedenii. Povolzhskii Region. Med Nauki. 2011;(1):123-30. (in Russ.)
  5. Trukhanova IG. Differences in changes in the functioning of the immune system in patients with wound dystrophy at the conservative and surgical treatment of fractures. Immunologiia. 2004;25(2):103. (in Russ.)
  6. Kolsanov AV, Nikolaenko AN, Ivanov VV, Prikhodko SA, Platonov PV. Personified approach in surgical treatment of benign bone tumors with the use of pre-operative computer planning and navigation. Nauka i Innovatsii v Meditsine. 2017;(3):23-27.
  7. Volova LT, Pugachev EI, Timchenko PE, Timchenko EV. A biological model for the purposes of studying the effects of space flight factors on the human supportive and connective tissue cells. Izv Samar nauch tsentra Ros akad nauk. Sots Gumanitar Med-Biol Nauki. 2015;17(2):263-67. (in Russ.)
  8. Kotelnikov GP, Losev II, Sizonenko YV, Katorkin SE. Peculiarities of diagnostics and treatment tactics of patients with combined lesion of the musculoskeletal and venous systems of the lower limbs. Novosti Khirurgii. 2013;21(3):42-53. doi: 10.18484/2305-0047.2013.3.42 (in Russ.)
  9. Shpigel AS, Seredavina NYu. Management of patients with injuries and surgical interventions on the upper respiratory tract in the postoperative period: approaches from a perspective of evidence-based medicine. Farmateka. 2016;(6):57-63. (in Russ.)
  10. Gridasov G N, Zakharova NO, Baluyeva E S. Comparative analysis of the migration increase dynamics of the elderly population living in the Samara region. Uspekhi Gerontologii. 2011;24(4):707-12. (in Russ.)
  11. Nikolaenko AN, Kolsanov AV, Popov NV, Ivanov VV, Shcherbovskih AE, Nikolaev PYu, Prihodko SA. Development of 3d-models of digital personalized metacarpophalangeal joint on the basis of computer tomography brush. Med Fizika. 2017;(1):64-70. (in Russ.)
  12. Kolsanov AV. Innovatsionnaia deiatel’nost’ SamGMU: Sovremennoe sostoianie i perspektivy razvitiia. V: sb materialov III Mezhdunar konf. Neirokomp’iuternyi interfeis: nauka i praktik. Samara, RF; 2017. p. 14-16. (in Russ.)
Address for correspondence:
443099, The Russian Federation,
Samara, Chapaevskaya Str., 89,
Samara State Medical University,
Department of Traumatology,
Orthopedics and Extreme Surgery
Named after Acad. of RAS A.F. Krasnov,
Yuri V. Lartsev
Information about the authors:
Lartsev Yuri V., MD, Head of the Traumatology and Orthopedics Unit 2 of Clinic of Samara State Medical University, Professor of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
Katorkin Sergey E., PhD, Associate Professor, Head of the Department and Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Contacts | ©Vitebsk State Medical University, 2007-2023