Relevance. The ability of patient to recover following coronary artery bypass grafting (CABG) is denoted by the term “rehabilitation potential” (RP). RP is crucial for arranging further referrals and developing of tailored rehabilitation program, which would comply with patient’s needs and capabilities to the greatest possible extent. Use of rehabilitation potential in routine medical practice is impeded by lack of commonly accepted definition and plausible set of assessment criteria. Objective. To determine parameters from those available to rehabilitation center physician at initial evaluation that are most representative of patient RP in phase II of rehabilitation following CABG. Materials and Methods. 703 discharge summaries and 450 inpatient medical charts of patients in cardiorehabilitation phase II were analyzed. Information that was present in ≥ 95 % of discharge summaries of a given patient was considered available information. Multifactor analysis was conducted to obtain impact level values for the parameters that influence the outcome of cardiorehabilitation phase II and are available at initial patient evaluation. Results. Patient RP is mainly determined by the level of daily physical activity before surgery, target level of physical activity achieved in phase I of rehabilitation, patient’s age, body mass index, severity of concomitant disorders and post-surgery complications, hemoglobin level, treatment adherence, history of myocardial infarction, diagnosed hypertensive heart disease and diagnosed chronic heart failure. Conclusion. Rehabilitation potential in patients in phase II of cardiorehabilitation following CABG can be assessed by 11 parameters with the highest levels of impact on rehabilitation outcome available to the physician at initial patient evaluation.

Objective. Phenotypic analysis of cardiac mesenchymal cells from patients with a ventricular septal defect and tetralogy of Fallot.

Methods. The study included cardiac mesenchymal cells from 8 patients with ventricular septal defect and from 18 patients with tetralogy of Fallot who underwent surgery. Using the flow cytometry method, the content of the following antigens on the cell surface was evaluated: CD31, CD34, CD90, CD117, CD146, CD166, PDGFRB.

Results. Cardiac mesenchymal cells from patients with ventricular septal defect are statistically significantly different from patients with tetralogy of Fallot in surface markers CD90 and PDGFRB. The content of a stem cell marker PDGFRB tends to decrease with age in patients with tetralogy of Fallot.

Conclusion. The cells obtained from myocardial tissue from patients with tetralogy of Fallot and from patients with ventricular septal defects have characteristics of mesenchymal stem cells. The differences found between the cells from the two groups of patients indicate that pathology can affect the phenotype of cardiac mesenchymal cells. Apparently, the stem properties of the mesenchymal heart cells tend to decrease with age.

Purpose. The possibility of painless MR-hysterosalpingography (MP-GSH) in assessing the patency of fallopian tubes as alternative to traditional x-ray hysterosalpingography and laparoscopy. Materials and methods. The study included 93 infertile women. Written informed consent had been obtained from all patients to perform both MR-HSG. MRI scan allowed to assess the shape of the uterus, the fallopian tubes and their patency, the degree of penetration of contrast into the abdominal cavity. Results. 63 women showed passable fallopian tubes, not expanded ones. 14 women had not passible fallopian tubes in intramural departments from both sides, not expanded. In 7 cases — one of the fallopian tubes was not passable, not expanded. In 3 cases the uterine tubes are deformed on the background of adhesions, not expanded and fallopian tubes are not patent. In 6 cases women showed expanded and wriggled one or two fallopian tubes and partial diffluence of radiopaque over the abdomen to the places far from the ampoule. Flask-like expanded fallopian tubes remain forming «valve» hydrosalpinx. Conclusion. MR-hysterosalpingography a less painful, radiation-safe technique of MRI, the use of which allows to reliably determine the patency of fallopian tubes.

Single intrauterine fetal demise (sIUFD) in multiple pregnancy occurs with frequency from 3.7 up to 6.8 % and is associated with an risk of premature birth, death of cotwin and high morbidity and mortality rates in newborns. The time of sIUFD and type of twin gestation would determine perinatal outcomes. The rate of prenatal death of the co-twin is different and depend on the type of multiple pregnancy, accounting 4 % for dichorionic and 12 % in monochorionic pregnancies. However, the correlation between the type of chorionicity, delivery time and the frequency of preterm delivery is not clearly established. The risk of neurological complications in newborns after sIUFD fluctuate significantly in case of the type of chorionicity and could achieve 18 % in monochorionic twins and only 1 % in dichorionic twins. The paper was discussed the main reasons for sIUFD in multiple pregnancy, rather pathophysiological aspects of perinatal morbidity and mortality for cotwin was also discussed. The management of complications, methods of their correction, optimal methods and time of delivery in case of sIUDF in multiple pregnancies was presented.

Background. Monochorionic monoamniotic twin pregnancies (MCMA) have very high rates of antenatal fetal loss (8–42 %). Objective. The aim of the study was to estimate the terms of delivery, complications and pregnancy outcomes in MCMA. Design and methods. A retrospective study of MCMA outcomes was conducted in 18 patients. Delivery was planned by cesarean section after 32 weeks of gestation. Results. The average term of delivery was 34 weeks 1 day. In 16 (88.9 %) cases was performed the elective cesarean section, in 2 (11.1 %) — the emergency. The indication for emergency delivery was in 1 case (5.6 %) the deterioration of fetoplacental hemodynamics and in 1 case (5.6 %) premature rupture of membrane. The average weight of the newborns was 2078 g with an average Apgar score of 7.4/8.3 points. There was a collision of the umbilical cord in 14 (77.8 %) cases. There were no cases of antenatal death in the study group after reaching 24 weeks of gestation. Conclusion. The study indicate a low risk of antenatal loss in MCMA after 24 weeks of gestation, despite the presence of umbilical cord collision in most of the cases, which justifies the planning of delivery after 36 weeks of gestation in uncomplicated course of pregnancy.

Twin reversed arterial perfusion (TRAP) is a specific complication of monochorionic multiple pregnancy. It has the incidence of approximately 1:9500 pregancies or 2.5 % monochorionic twins. The main one for nowadays is hemodynamic theory that suggests that severely malformed acardiac fetus lacks most organs and particularly heart and grows up because of the artery-to-artery anastomose that shunts blood from another normally developed pump fetus system. The perinatal mortality for pump twin rises to 70 %. There are different surgical approaches that aimed in acardiac twin blood cessation in order to improve the outcome for pump twin. At the same time today we can provide highly effective ultrasound monitoring for pump twin that can exclude fetal intervention and organize safe conservative option for the pump twin. The paper represents the comparative analysis for conservative and fetal intervention managements and shares our descriptive analysis of triplet pregnancies with twin reversed arterial perfusion sequence.

Background. The scientific literature contents clearly not enough data at interaction of collagen materials with a living organism and about influence of multipotent stromal cells (MSC) on this process. There are controversies about the collagen degradation and the development of foreign body reactions. However, without account these results, it is impossible to estimate the timeframes for complete lysis of such materials, to progress effective methods for the prevention and treatment of developing complications. Objective. To study the features of the collagen-based material degradation after implantation with adsorbed autologous mesenchymal MSC of bone marrow origin (AMMSCBMO) in the experiment. Design and methods. In different times the condition of tissues around the implanted collagen membrane with adsorbed AMMSCBMO was studied by method of light microscopy. Results. The number of vessels and cellular elements in the collagen material implanted without AMMSCBMO increases to 3 weeks and remains at this level until the end of the observation. A distinctive features of the use of collagen membrane with adsorbed AMMSCBMO are increased vascularization and cellular infiltration of the material in the first 2 weeks after surgery. This effect further leads to a more rapid degradation of all implanted collagen, including its more dense parts, but does not prevent the formation of multinuclear macrophages with fused cytoplasm. Conclusion. As a result of more significant vascularization and cellular infiltration caused by AMMSCBMO adsorbed on the surface of the collagen material, to the 4th week the entire implant is full destroyed and absorbed, and dense fibrous connective tissue is formed in its place. For the implantation into the body, one should choose the most homogeneous collagen materials, without areas of different density, as slowly degrading fragments can cause the development of granulomatous inflammation and the failure of the implantation procedure.