Proceeding of the Shevchenko Scientific Society. Medical Sciences Peer-reviewed journal "Proceeding of the Shevchenko Scientific Society. Medical Sciences" published by Shevchenko Scientific Society en-US (Oksana Zayachkivska) Mon, 24 Jun 2019 00:00:00 +0300 OJS 60 PERIODONTAL DISEASES AND DENTOALVEOLAR ANOMALIES AND DEFORMATIONS IN PATIENTS OF DIFFERENT AGES (STATE OF THE PROBLEM AND WAYS TO RESOLVE IT) <p>Dentoalveolar anomalies and diseases of periodontal tissues are major main dental diseases and are characterized by high prevalence among different groups of the population. According to the WHO, about 50% of adolescents experience periodontal diseases accompanied by dental anomalies. Therefore, the lack of timely orthodontic care can lead to an increase in both the intensity of the carious process and the severity of periodontal diseases (gingivitis, periodontitis). According to various sources, in Ukraine, the prevalence of dentoalveolar anomalies generally constitutes 45-87%, of which 50% are due to anomalies of dentition and position of individual teeth. According to the WHO, the prevalence of dentoalveolar anomalies is 68%, and the excessively high level of periodontal tissue diseases is determined already at the age of 15-19 (55-89%), and at the age of 35-44, it reaches 65-98%.</p> <p>The article deals with causes, significance, and role of inflammatory and dystrophic-inflammatory complications that appear in periodontal tissues among patients with dentoalveolar anomalies. The influence of functional overload of teeth groups on the development of periodontal pathology was estimated. Orthodontic treatment of teeth dentoalveolar anomalies and deformations is a long and complex process requiring proper complex treatment, which includes two interrelated periods: the period of active orthodontic treatment and the period of retaining treatment results. The first stage of orthodontic treatment involves obtaining a functional, morphological, and aesthetic optimum and the harmonic state of the facial skeleton as a whole. The purpose of the second treatment stage is to obtain myodynamic equilibrium and physiological functioning of the reconstructed dental-jaw system. In particular, its functioning excludes the probability of relapse development. Consequently, patients with periodontal disease who seek an orthodontist doctor can be divided into two main groups. The first group includes patients with hereditary or predetermined prenatal factors of bite anomalies and present periodontal diseases. The second group includes patients, in whom primary indications for orthodontic treatment revealed pathological teeth position due to one or another periodontal disease. In this review, the first group of patients was examined. The algorithm of the complex treatment of patients with dentoalveolar anomalies and deformations with periodontal diseases was traced.</p> <p><strong>Conclusion.</strong> An adequate interdisciplinary complex of orthodontic, orthopedic, therapeutic, implantology and periodontological measures at the modern level allows providing optimal conditions for maintaining a healthy periodontal complex, as well as to improve the aesthetic looks, which is necessary for a modern person who seeks to improve the quality of his/her life.</p> O. Hodovanyi, A. Martovlos, O. Hodovana Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 INVOLVEMENT OF NEUTROPHIL HYDROLYTIC ENZYMES IN THE MODIFICATION OF CIRCULATING IMMUNE COMPLEXES UNDER THE CIRCUMSTANCES OF EXPERIMENTAL SEPSIS <p><strong>Introduction</strong><strong>.</strong> Neutrophils play an important role in the innate immune response. While patrolling the body, they find pathogens and destroy them by means of phagocytosis, degranulation, or formation of neutrophil extracellular traps (NETs). The latter process is accompanied by the release of chromatin along with granular enzymes, such as neutrophil elastase. Neutrophil-released enzymes are capable of breaking not only pathogens but also components of the host organism.</p> <p><strong>Objectives.</strong> In the current work, we investigated the NETs effect on the composition of circulating IgG-IgM immune complexes at different stages of experimental sepsis-induced in laboratory mice.</p> <p><strong>Research methods.</strong> In our study, we used an animal model of induced sepsis. The levels of circulating IgG and IgM, as well as IgG-IgM-containing immune complexes in sera were evaluated by using an enzyme-linked immunosorbent assay. Sera collected before induction of sepsis served as a negative control. Neutrophil elastase activity in serum samples was measured after adding fluorogenic neutrophil elastase substrate. NET formation was studied by staining with propidium iodide and was detected using a fluorescence microscope.</p> <p><strong>Results</strong><strong>.</strong> It was demonstrated that under septic conditions, the level of circulating IgG does not change significantly. The content of total IgM increased rapidly immediately after sepsis induction and reached its maximum 7 days later, remaining at high levels till the end of the experiment (16 days). Unlike total IgG and IgM, IgG-IgM-containing immune complexes were formed 3 days after sepsis induction, their maximum was observed on 7-9<sup>th</sup> day and then dropped. The decrease in the amount of circulating IgG-IgM-containing immune complexes was accompanied by the enhanced level of neutrophil elastase activity (a marker of NETs formation).</p> <p><strong>Conclusions.</strong> Thus, the appearance of modified immunoglobulin complexes that are non-specific for the healthy organism in the process of acute inflammation can be initiated by NETs and released hydrolytic enzymes of neutrophil granules.</p> <p><strong>Disclosures.</strong> The authors declare no conflict of interests.</p> <p><strong>Author contribution.</strong> RB designed the study; RB, TD, SP: performed the experiments; RB, TD, SP: wrote the manuscript.</p> T. Dumych, S. Paryzhak, R. Bilyy Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 DENSITY AND MINERAL CONTENT DYNAMICS OF BONE TISSUE AGAINST THE BACKGROUND OF OPIOID INFLUENCE <p><strong>Introduction.</strong> The modern scientific medical literature contains numerous data on the peculiarities of structural transformation of bone tissue and the dynamics of its mineral composition in the age aspect, as well as under the influence of various exo- and endogenous factors. However, data on changes in the mineral component of bone tissue under conditions of long-term opioid exposure have not been identified in the available literature, although the widespread use of opioids in the clinic as drugs with analgesic effect makes this issue especially relevant.</p> <p><strong>The aim</strong> of our research was to study the dynamics of mineral composition of rat bone tissue with prolonged exposure to opioids.</p> <p><strong>Materials and methods.</strong> The study was carried out on 40 sexually mature outbred male rats with a body weight of 180-200 g and aged 3.5 months. Opioid addiction was modeled by the daily (once a day with identical intervals) injection of an opioid pain reliever nalbuphine. Nalbuphine was injected intramuscularly using to the following pattern: 1<sup>st</sup> week - 8 mg/kg, 2<sup>nd</sup> week - 15 mg/kg, 3<sup>rd</sup> week - 20 mg/kg, 4<sup>th</sup> week - 25 mg/kg, 5<sup>th</sup> week - 30 mg/kg, 6<sup>th</sup> week - 35 mg/kg. To determine the mineral composition of the bone tissue of rat's mandible, the method of atomic absorption spectral analysis (AASA) was used, which made it possible to detect eight mineral elements (calcium, phosphorus, magnesium, sodium, potassium, iron, strontium, zinc) in the studied samples. The concentration of &nbsp;researched elements in bone tissue samples was specified in mg/g. The research of mineral composition of the mandible was performed weekly in the span of 7 weeks of the experiment - 6 weeks of nalbuphine consumption, and then one week after its cessation (5 animals per each experiment period); 5 other animals were attributed to the control group.</p> <p><strong>Results.</strong> The results of this study allowed to determine the quantitative content of all investigated elements in the bone tissue at each stage of the experiment and indicate the presence of their expressed dynamics. Results of the atomic absorption spectral analysis of bone tissue of the rat's mandible body allowed to determine the quantitative content of four macro-elements (Ca, P, Mg, Na) and four microelements (K, Fe, Sr, Zn) and their specific shares in the mineral content of bone tissue in intact animals against the background of nalbuphine consumption and after its cessation. Against the background of nalbuphine consumption and after its cessation, specific shares of the studied macro-and microelements in the mineral component of bone tissue of the rat’s mandible have expressed dynamics - shares of calcium, iron, strontium, and zinc grow and remain higher than normal, and after nalbuphine is no longer administered, while specific shares of phosphorus, sodium, magnesium, and potassium are lower than in intact animals during seven weeks of the experiment. The dynamics of absolute indices of the researched mineral elements against the background of nalbuphine consumption and after its cessation differs from the dynamics of their specific shares. During six weeks of nalbuphine consumption, absolute levels of calcium, phosphorus, magnesium, sodium, zinc, and iron increase, remaining above the norm after its cessation; the amount of potassium decreases and remains lower than normal after nalbuphine withdrawal, while the amount of strontium decreases, though in the minimum, and after nalbuphine is no longer administered, it returns to the same value as in intact animals.</p> <p><strong>Conclus</strong><strong>ions.</strong> Results of the study allowed to determine the absolute quantitative content of all researched elements and their specific shares in the mandible bone tissue at each stage of the experiment and showed evident dynamics, which is different for each of the researched indices.</p> R. Sohujko, Z. Masna Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 MICROBIOLOGICAL PROFILE OF NOSOCOMIAL INFECTIONS <p>Nosocomial infections, also known as health care-associated infections (HAIs) are infections that appear in patients under medical care in hospitals or other health care facilities and were absent at the time of admission. From 5 to 7 thousand cases of HAIs are registered in Ukraine every year, but according to experts, the actual number is 900 thousand cases per year. Intensive care unit (ICU) represents a prominent tool in HAIs control and quality assurance in many developed countries. In this respect, the US Center for Disease Control and Prevention (CDC) recommends monitoring HAI as a leading tool for the reduction of HAIs. Therefore, the aim of this research was to investigate microbiological profile of nosocomial infections in ICU of public hospitals in Lviv, Ukraine.</p> <p><strong>Material and methods.</strong> 105 clinical materials from 50 patients in two public hospitals in Lviv (Lviv Regional clinical hospital and Military Medical Clinical Center of the Western Region) were analyzed during July-December 2018. 114 strains of pathogens were isolated. HAIs was defined as an infection that appeared in patients later than 48 hours after admission to the hospital. Urinary tract infections (UTI), blood stream infection (BI), respiratory tract infection (RTI) and surgical site infections (SSI) were diagnosed using the criteria defined by the CDC and clinical protocols. Causative bacterial strains were isolated and identified using standard methods and chromogenic media CHROMID*S.aureusElite, CHROMID*VRE, CHROMID*MRSASMART, CHROMID*CARBASMART, CHROMID* ESBL, CHROMID*OXA-48, CHROMID*Candida (Biomerieux) and biochemical identification kitsMIKRO-LA-TESTNEFERMtest24, ENTEROtest24, CANDIDAtest21, STAPHYtest24, STREPTOtest24 (ErbaLacema, Czech&nbsp; Republic). Antibiotic sensitivity test was done using Kirby-Bauer disc diffusion technique. (Ethical Committee or Institutional Animal Care and Use Committee Approval Danylo Halytsky Lviv National Medical University: 25/06/2018 № 6). HAIs structure was as follows: Staphylococcus lentus (22%), Eschrichia coli (22%), Klebsiella pneumoniae subsp.ozaenae (9.8%), Pseudomonas aeruginosa (43.9%),&nbsp; Klebsiella pneumoniae subsp.pneumonia (8.8%), Srreptococcus spp. (7.0%), Burkholderia pseudomallei (5.3%), Staphylococcus haemolyticus (3.5), Staphylococcus aureus (3.5%). There were several types of HAIs which are rarely found, such as Staphylococcus lentus, Staphylococcus simulans, Staphylococcus lugdunensis, Aerococcus viridans, Pragia fontium, Aeromonasichthiosmia, Raoultella terrigena, Macrococcus caseolyticus.</p> <p><strong>Conclusions.</strong> In the era of antibiotics, HAIs are still uncontrollable. It is assessed that over 90.0% of HAIs are not recognized as epidemics. It is important to remember this fact when attempting to design prevention or control strategy to reduce HAIs either at WHO level, or at the level of local health care unit.</p> Y. Konechnyi , Y. Skurativskyi , I. Tymchuk , Y. Pidhirnyi , O. Kornіychuk Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 INNOVATIVE APPROACH – MINIMALLY INVASIVE MULTIVESSEL CORONARY GRAFTING THROUGH A LEFT ANTERIOR THORACOTOMY <p>Personal experience with minimally invasive multivessel coronary grafting through left anterior thoracotomy is described. Currently, we use this technique routinely, regardless of the number of grafts, quality, and location of coronary targets, left ventricular ejection fraction, age, gender, body mass index.</p> <p>Our<strong> aim</strong> was to develop minimally invasive coronary artery bypass grafting technique, which would be equally effective and safe as compared to the conventional coronary grafting technique; would be reproducible and be applied for every patient with isolated coronary artery disease. 220 patients were operated and then analyzed. In all patients, complete revascularization was performed. Mean number of grafts was 3.37± 0.68 per patient (range 2-5). Left internal mammary artery was used in 206 patients, right internal mammary artery - in 4 patients, radial artery - in 37 patients, vein grafts - in 193 patients. Complete arterial revascularization was performed in 29 patients. We had no mortality. Mean aortic cross-clamp time was 70.7 ± 18.7 min (range 31 - 146 min). Mean cardiopulmonary bypass time was 137.5 ± 31.9 min (range 71 - 339 min). Postoperatively, total drainage in the first 12 hours was 376.7 ± 205.4 ml, ventilation time was 2.6 ± 1.4 hours, ICU stay was 2.3 ± 1.2 days.</p> <p><strong>Conclusion.</strong> Minimally invasive coronary bypass grafting is an effective and safe surgical method. Complete revascularization could be performed regardless of the number of grafts, left ventricle ejection fraction, quality and size of coronary vessels, or age of the patient.</p> O. Babliak, V. Demianenko, D. Babliak, E. Melnyk, K. Revenko, O. Stohov Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 LEFT VENTRICULAR NON-COMPACTION CARDIOMYOPATHY <p><strong>Introduction.</strong> Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy, congenital defect of the intrauterine process of ventricular embryogenesis. The main feature of this pathology is an existence of prominent trabeculations in the left ventricle and deep intertrabecular recesses. The pathological structure of the myocardium leads to its dilatation and dysfunction, heart failure symptoms, embolic episodes and arrhythmia.</p> <p><strong>The aim</strong> of the manuscript is to present a spectrum of clinical manifestations of left ventricular non-compaction (LVNC).</p> <p><strong>Materials and methods</strong> Patients were diagnosed and treated in The Lviv Centre of Cardiology. Two of them were admitted for heart failure symptoms, in one patient with dysrhythmia and left bundle brunch block (LBBB); and one patient had non-specific chest pain. Cardiac imaging with echocardiography and MRI were performed.</p> <p><strong>Results.</strong> Echocardiography revealed criteria of LVNC in all patient, in two of them the diagnosis was confirmed by cardiac MRI. Patients with heart failure symptoms were managed with optimal medical therapy, CRT-D has been implanted in patient with LBBB. Asymptomatic patient is under follow-up.</p> <p><strong>Conclusions</strong>. LVNC is a cardiomyopathy with distinct echocardiographic and MRI-features and wide spectrum of clinical presentations. The prognosis in case of LVNC is serious due to systolic LV dysfunction, cardiac arrhythmia and embolic events. Echocardiography is a diagnostic tool to identify LVNC, cardiac MRI confirms the diagnosis of LVNC if echocardiography data is insufficient.</p> N. Oryshchyn, Y. Ivaniv Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 MYASTHENIA – DIFFICULTIES IN DIAGNOSTICS AND TREATMENT (CLINICAL CASE ANALYSIS) <p>Myasthenia gravis is an autoimmune rapidly progressive disease characterized by a neuromuscular disorder due to the formation of autoantibodies to different epitopes of the peripheral neuromuscular device and is clinically manifested by pathological muscle fatigue and weakness. Diagnosis of myasthenia in the elderly is very problematic because doctors regard muscle weakness at this age as a symptom of other diseases. In addition, it may be combined with various pathological conditions. The article describes the presence of comorbid states in patients with myasthenia who were treated at the neurological department of Lviv regional clinical hospital in 2016-2018. 58% of patients with myasthenia, mainly older people, had comorbid diseases. Hypertensive heart disease (34%), ischemic heart disease (20%), diabetes mellitus (12%,) and small brain vessels disease (8%) were frequently observed. A case of late diagnosed generalized myasthenia in a 66-year-old woman with concomitant small vessels disease of the brain and diabetes mellitus is described. The patient was treated at the neurological department of Lviv regional clinical hospital in December 2018. For a long time, the patient had been treated of the small vessels disease, though main complaints were difficulties with speaking, swallowing, periodic double vision, ptosis, general weakness, weakness in the right leg, memory impairment, problems with walking and urination. The diagnosis of myasthenia was based on clinical manifestations, a positive reaction to acetylcholinesterase inhibitors, and detection of antibodies to acetylcholine receptors. Clinical manifestations of myasthenia, as well as apraxia of walking, disorders of urination and cognitive impairment due to vascular changes in the brain intensified the patient's disability and created the need for careful outside care and control of the drug intake. The positive influence of anticholinesterase drugs and prednisolone in the treatment of myasthenia was noted. The presence of diabetes mellitus is a relative contraindication to the administration of corticosteroids, but in the presence of comorbidity of generalized myasthenia and diabetes mellitus type II, prednisolone was used under constant monitoring of blood glucose by hypoglycemic agents. Thus, late-onset, severe comorbid diseases (small vessel disease of the brain, diabetes mellitus) complicate and delay the diagnosis of myasthenia and prescription of appropriate therapy.</p> T. Nehrych, N. Bozhenko, S. Kirilyuk Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 The experience of minimally invasive – endoscopic methods used to stop bleeding in upper sections of the digestive system <p><strong>Introduction</strong><strong>.</strong>&nbsp; Over the past decade, the number of minimally invasive surgical interventions both in the scheduled and urgent endoscopic surgery has increased significantly. With the development of modern video endoscopic systems, endoscopic surgical tools and accessories have been actively developing. A modern development is Hemosprey from Cook, which is certified and has been widely used in the countries of the European Union, Canada, and the USA since 2011. It is provided in the form of dry hemostatic glue of inorganic origin, which is endoscopically delivered with the help of aerosol. &nbsp;When the powder contacts with blood, it absorbs water and creates a gel that acts as a cohesive and adhesive by creating a stable mechanical barrier around the bleeding site. This methodology is not common in Ukraine, therefore we have made an attempt to study the efficiency of this drug in the regional hospital setting. The relevance of this issue is highlighted by the high morbidity among the population – an average number of people hospitalized with bleeding constitutes 1 per 1000 people. Depending on the etiological factor, the mortality rate is 3-50%. The general mortality rate in case of gastrointestinal bleeding constitutes 3.1% in Kyiv and 8.5% - generally in Ukraine. Among patients, the working-age population prevails.</p> <p><strong>The</strong> <strong>aim</strong>. To study the efficiency of the method used to stop bleeding using Hemospray in the settings of endoscopic intervention. To research the efficiency of using hemostatic glue both as a mono-method and in combination with other endoscopic methods for endo-hemostasis of gastrointestinal bleeding.</p> <p><strong>Materials</strong> <strong>and</strong> <strong>methods</strong><strong>. </strong>The observed cohort included 7 patients (5 men, 2 women) aged 28-79 (average age - 52±7.1), who during the first stage received treatment at Lviv Regional clinical hospital, surgery department No. 3, surgery department No. 2, and during the second stage in 2018-2019 – at the <a href=";l1=1&amp;l2=2">gastroenterological</a>&nbsp;department of Lviv Regional Clinical Hospital.&nbsp; Video endoscope Fujinone-250, clipping devices Hemoclips from Olympus, Hemosprey preparation for hemostasis, manufacturer – Cook.&nbsp; When the bleeding stopped, powder hemostasis was combined with clipping of the bleeding source upon the surgeon-endoscopist’s decision.</p> <p><strong>Results</strong><strong>. </strong>This endoscopic hemostasis using Hemospray resulted in the avoidance of urgent surgery and saved the lives of 7 patients both when used as a mono-method and when combined with endoscopic clipping with subsequent conservative therapy. None of the patients had recurrent bleeding. Patients had various etiology and causes of gastrointestinal bleeding. 100% of patients that were treated with the endoscopic hemostasis using Hemospray had a positive effect.</p> <p><strong>Conclusions. </strong>Hemospray shows a high efficiency when it comes to stopping urgent bleeding from upper sections of the digestive system with the help of Hemospray both as a mono-method or in combination with other endoscopic methods. [ 1, 10].&nbsp; Hemospray has the following key benefits over other endoscopic methods: non-thermal – there is no thermal contact with tissues, which makes it impossible for the high risk of complications to appear; non-traumatic – since no pressure is exerted to stop bleeding, the risk of tissue injury is reduced to zero; Contactless – aerosol delivery system presupposes the need for direct mechanical and contact force; safe – disposable cannulas that come as part of the kit – minimize the risk of infectious disease transmission when contacted with blood; Convenience and ease of use – the powder is used on the source of bleeding, therefore it does not require the <strong>in face</strong> approach and accurate targeting, which is especially important when working in hard-to-reach places [ 2, 4, 6].</p> Nazar Bula, Yuriy Shavarov , Yaroslav Savytskyi , Maryana Savytska Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 STRUCTURAL ORGANIZATION OF THE LINKS OF HEMOMICROCIRCULAR CHANNEL OF THE RAT`S UTERUS UNDER THE CONDITIONS OF 6-WEEK LONG ADMINISTRATION OF NALBUPHINE <p><strong>Introduction. </strong>Each year, the problem of drug abuse increases with catastrophic consequences. It is not just physical and mental dependence, drugs affect physiological parameters, while changes caused by them can continue even after drugs are no longer consumed. If we estimate types of drugs people take, we see that opioids occupy the first place - 65.5%. Since susceptibility to addiction is higher in the female body than that of a male, and female genital organs undergo significant structural-morphological and functional changes, the study of the opioid effect on the female body is necessary. Vessels are among the first in our body to react to pathogenic factors; their structural changes become the basis for the development of a pathological process and determine peculiarities of clinical manifestations.</p> <p><strong>Aim. </strong>To detect qualitative and quantitative changes of the hemomicrocirculatory channel of the uterus walls in white rats during the 6-week opioid influence.</p> <p><strong>Materials and methods</strong>. The study was performed on 24 sexually mature female white rats with an initial body weight of 160-180 g. All animals were divided into three experimental and one control group. The control group received 0.9% NaCl solution throughout the experiment. The other three groups received intramuscular injections of nalbuphine for 2, 4, and 6 weeks respectively. Colored gelatin mixture was used for injection in the bloodstream. The following morphometric indices were used to assess and analyze the depth of structural changes: vessel diameters (arterioles, venules and capillaries), arteriolar-venular ratio, the indicator of trophic activity (radius of diffusion), the density of the net of capillaries (the number of capillaries per area unit), the coefficient of convolutedness.</p> <p><strong>Results</strong>. The conducted research has shown that the administered drug causes changes in the structure of the hemomicrocirculatory channel already in the 2<sup>nd</sup> week of the experiment, which is manifested by the expansion of vessels, both arterioles, venules, and capillaries, increasing their convulsion while maintaining the clarity of vessel contours. In the 4<sup>th</sup> week, there are areas of restructuring of the uterus blood flow, the convulsion of vessels increases, in some cases, it is possible to detect areas of hemorrhage and obliteration of capillaries, unevenness of blood vessel caliber. In the 6th week, due to the destruction of the capillary component, the ordered spiral pattern of the capillary net is disrupted, artery and venular anastomosis begin expanding and significant destructive changes develop. Statistically processed morphometric indices confirm the validity of above morphological changes, which appear in the structure of the bloodstream of rat's uterus wall.</p> <p><strong>Conclusion</strong>. Study results reveal the relationship between the duration of opioid effect on the structural organization of the uterus walls, namely on their vascular component, and the depth of damage, namely, significant changes in the structure of the hemomicrocirculatory channel.</p> Y. Ivankiv Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 VARIOUS LOCATIONS OF THE THIRD MOLARS IN THE LOWER JAW <p><strong>Introduction</strong><strong>.</strong> Wisdom teeth are the most mysterious part of human anatomy because there are still no clear terms when these molars erupt. There are several basic classifications that are based on the following: the angle of inclination and the position of the tooth germ in the bone; the eruption state; location of roots. With the help of screening, which includes a clinical examination and the review of panoramic X-rays, tooth location in the jaw is identified. Today, the removal of third molars without significant reason is very common. There is a debate among foreign doctors about the necessity of these teeth for a person.</p> <p><strong>Objective.</strong> To find out the frequency of eruption, the absence of a dental germ and possible locations for rudiments of the third large angular teeth in the lower jaw of a modern person with a physiologically formed dental bite.</p> <p><strong>Research methods</strong><strong>.</strong> Four hundred individuals from the Western region of Ukraine were screened using Panorax to establish various locations of the mandibular third molars. These panoramic X-rays were classified by age, gender, the presence of third molars and the corresponding side of their location.</p> <p><strong>Results.</strong> The sum of teeth is calculated based on the total number of erupted, impacted or missing teeth (separately) on one side in all categories. The percentage ratio of the sum of teeth in a certain group on one side to the total number of teeth on the given side was determined. The percentage ratio of teeth of a certain group on one side for a given age group to the total number of teeth for the same group was determined.</p> <p><strong>Conclusion</strong><strong>.</strong> It has been calculated that patients with erupted teeth constitute 35.29% of all individuals. Moreover, 58.5% of them have both wisdom teeth on the lower jaw. This accounts for only 20.65% of all patients. It was revealed that pathological medial location of the third molar was the most frequent. The lingual positioning of the mandibular third molar was the least frequent.</p> I. Palianytsia, B. Chekh, Z. Masna Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 JULIUSZ KAROL MARISCHLER (1869-1931) – A SCIENTIST, TEACHER, AND CLINICIAN DEDICATED HIS 150TH BIRTHDAY <p>The name of Juliusz Karol Marischler (1869-1931) is rarely mentioned by historians of medicine. Yet, the scientific heritage of this talented doctor is striking: his research was relevant, analytical findings – easy to understand, recommendations – easy to apply in practice. His circle of interests included various issues of internal diseases, while a thorough approach, vision of the prospects and the ability to find non-standard decisions indicated the extraordinary intelligence of this person.</p> <p><strong>Aim</strong><strong>.&nbsp;</strong>To tell about the life of J. Marischler, his scientific and research activities, public activities, cooperation with colleagues.</p> <p><strong>Materials</strong> <strong>and</strong> <strong>methods</strong><strong>.&nbsp;</strong>Periodical medical editions for 1989-1932 were reviewed: protocols of the scientific meeting of the Lviv Medical Society, printed works, reports on the activities of medical establishments. As an additional material, selected articles on the history of medicine were, Google Scholar search, literary and historical sources on related topics were used.&nbsp; &nbsp;</p> <p><strong>Results</strong>. Juliusz Marischler was born in Lviv on November 16, 1869. In 1894, he graduated from the Medical Faculty of Jagiellonian University. His teachers were such prominent doctors as professors Edward Korczyński from Krakow and Edmund von Neusser from Vienna. In Lviv, J. Marischler occupied the position of an assistant at the clinic of internal diseases, where he worked since 1897. In 1902, he received the right to give lectures on internal medicine and the title of an Assistant Professor; in 1910, he became an Extraordinary Professor. In late 1902, J. Marischler left the post of the assistant at the clinic but continued teaching as an Associate Professor. At the same time, he began to pursue private practice.From the very beginning of his career, a young scientist was interested in problems and issues that were of purely academic interest for a practitioner. Yet it was no so for his inquisitive analytical mind: he was able to find topics that required extraordinary thinking, and later were practically applied. With a sober look at solving various scientific issues, lecturer Marischler easily and generously shared his knowledge, ideas, experience, and skills with his students and colleagues. He collaborated with many young talented doctors, including Adam Szulisławski, Wacław Moraczewski, Eugene Ozarkiewicz, Marian Punchyshyn. J. Marischler belonged to a cohort of Polish doctors who throughout their lifetime collaborated with the Ukrainians in spite of any political moments. According to the memoirs of his contemporaries, J. Marischler was an extremely modest and noble man full of life and ideas. He could surprise people with a well-aimed idea, expressed simply and clearly. His eyes always reached beyond the horizon, which he opened for everyone. Undoubtedly, prof. J. Marischler deserves recognition and dignity as an outstanding scientist of his time.</p> O. Stadnyk Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 FAMOUS PERSONALITIES IN THE HISTORY OF THE DEVELOPMENT OF BIOCHEMISTRY IN LVIV IN THE TIME OF THE WORLD WAR II <p>The development of biological studies in Lviv can be sub-divided into three large historical periods: 1) from the foundation of Lviv university in 1661 to the World War I; 2) between the WWI and WWII; 3) after the World War II. On November 16,&nbsp;<a href="">1784</a>, the Privilege of Emperor Josef II allowed to approve four Faculties in Lviv University: theological, law, philosophical, and medical. Later on, biochemical studies started at the Medical Department. In 1939, Lviv State Medical Institute was founded on the basis of the Medical Faculty of the University where a powerful Department of Biochemistry existed and was headed in 1921-1941 by a world-known biochemist Jakub Parnas. At that time, another Department of Biochemistry was functioning at Lviv Academy of Veterinary Medicine, which was headed by Waclaw Morachewsky. At the classical university (now Ivan Franko National University in Lviv), the Department of Biochemistry was founded after the establishment of the Biological Faculty in 1940; it was later restored in 1963. This review highlights scientific and biographical about the most famous scientists in the field of biochemistry who originated from the Western region of Ukraine, namely Ivan Horbachevsky, Jakub Parnas, Waclaw Morachewsky, Stepan Hzhytsky, and Bohdan Sobchuk.</p> R. Stoika Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 Historical Milestones of the Department of Neurology at the Danylo Halytski Lviv National Medical University <p>The article relates&nbsp;&nbsp;the history of the Lviv Neurological School, which is inextricably linked to the Department and Clinic of Neurology of the Danylo Halytski Lviv National Medical University. Information about theevolution of research in the field of neurology and related specialties in Lviv during the 20th and early 21st centuries framed against the historical background of that era is presented.&nbsp;&nbsp;For more than 100 years, the Lviv Clinic and Department of Neurology was an important center of activity of highly professional doctors and scientists, a cradle of training for talented researchers, educators and clinicians, and&nbsp;&nbsp;maintained the&nbsp;&nbsp;basic&nbsp; training of students and young doctors, despite geopolitical and historical hardships.&nbsp; In particular, at different historical periods, the heads of the Department of Neurology (Henryk Halban and Dmytro Panchenko) even were Rectors of the Lviv Medical University. Today, the Department and Clinic of Neurology of the Danylo Halytski Lviv National Medical University is a modern, powerful, well-functioning unit of the university with a wide international outlook.&nbsp; It is well-known outside of Ukraine, and represents an important foundation for neurological professionalism in Western Ukraine with great prospects for the future.</p> H. Ivasiuk, T. Nehrych, Y. Matviyenko, N. Bozhenko, V. Krysa Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 THE IDEA OF MAINTAINING AND IMPROVING THE HEALTH OF OUR NATION IS PROFESSOR IRYNA DATSENKO’S LIFE MOTTO <p>І. I. Datsenko <strong>&nbsp;</strong>(1925 -2006) is a full-fledged member of Taras Shevchenko Scientific Society, a famous representative of Lviv scientific hygienic school and environmentalist, a talented teacher, active figure in the public life and organizational activities in Ukraine. &nbsp;For many years – from curious student, graduate doctor and postgraduate student to the Head of the Department of General Hygiene and Ecology of Lviv Danylo Halytsky National University, academician of the Academy of Sciences of the Higher School of Ukraine, merited member of the Ukrainian Medical Society, member of New York Academy of Sciences, Doctor of Medical Sciences, Professor, author of relevant, interesting scientific works, monographs, textbooks, and manuals for students – Iryna &nbsp;Datesenko selflessly and persistently worked her way to preserving and the health of the Ukrainian nation and&nbsp; train highly professional medical specialists. At the department, she initiated the creation of the first maps of pollution in various city districts, noise maps, maps of population morbidity. She is the author of about 400 scientific works dedicated to theoretical and practical issues of general hygiene. On March 28, 2019, Lviv Scientific and Research Institute of Hygiene and Epidemiology at Lviv Danylo Halytsky National Medical University celebrated the solemn opening of a memorial room of Professor Iryna Datsenko. The newly created exposition lets us review laboratory devices, measuring equipment, mockups used to teach the students of that time, historical documents related to the scientific creative heritage of Professor Datsenko, her works. The collection of photos are a real decoration of this exhibition. All of this combined together helps us visualize the milestones of the development of preventive medicine in Lviv Region and Prykarpattia.</p> V. Fedorenko Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 SKETCHES OF MEDICAL TERMINOLOGY <p>This article appeared on the verge of several sciences: clinical anatomy, clinical physiology, and philology. Accordingly, its authors feature a clinician, a University teacher, and a philologist. The authors critically analyse some of the Ukrainian terms (of Greek and Latin origin) drawing on special literary sources and fine literature, works in philology, and their own experience. At the same time, they substantiate every nation’s right to introduce into their specialized scientific nomenclature terms that are more common in this language, national lifestyle, and ideas relatable to this nation. The authors call for correction of some Ukrainian and Latin terms indicating inflammation, as well as for distinguishing in the clinical and anatomical nomenclature of adjectives that indicate quality from those indicating relation, belonging to a particular subject, formation, or phenomenon. Terms in the Ukrainian language were often formed under the influence of other languages and sometimes sound wrong; therefore, it makes sense to replace some medical terms with new and correct ones. It seems like some, firmly rooted terms, require some correction. First, as already mentioned, this refers to terms based on subject analogies (analogue terminology). Our duty is to develop the Ukrainian language in all spheres of science, including medical scientific language. Therefore, the work on improving Ukrainian medical terminology is a permanent process, as well as social development in general.&nbsp;</p> A. Kitsera, R. Kitsera Copyright (c) 2019 Mon, 24 Jun 2019 00:00:00 +0300 Difficult Decisions in Cardiothoracic Critical Care Surgery. An Evidence-Based Approach /Editor Vassyl A. Lonchyna, 20 <p>Difficult Decisions in Cardiothoracic Critical Care Surgery. An Evidence-Based Approach /Editor Vassyl A. Lonchyna, 20</p> Orest Chevtchik Copyright (c) Mon, 24 Jun 2019 00:00:00 +0300 Bandyopadhyay N, Fass R, Yamasaki T and Hemond C. Pocket Handbook of Esophageal Disorders, 2018 <p>Bandyopadhyay N, Fass R, Yamasaki T and Hemond C. Pocket Handbook of Esophageal Disorders, 2018</p> Vassyl A. Lonchyna Copyright (c) Mon, 24 Jun 2019 00:00:00 +0300 Internal Medicine. Textbook based on the principles of evidence-based medicine, 2018/2019, 2018 <div>Internal Medicine. Textbook based on the principles of evidence-based medicine, 2018/2019, 2018</div> Alexander Zavadka Copyright (c) Mon, 24 Jun 2019 00:00:00 +0300