[Pneumatosis cystoides intestinalis: a case report and literature review]. / Kistoznyi pnevmatoz tonkoi kishki: klinicheskii sluchai i obzor literatury.

Pneumatosis cystoides was first described by Du Vernay in 1783. This is a fairly rare disease with nonspecific symptoms and CT data on pneumoperitoneum. The authors present pneumatosis intestinalis in a patient with systemic connective tissue disorder. Free gas in abdominal cavity and dilated intestinal loops were an indication for emergency surgery with subsequent resection of intestine due to signs of ischemic damage. A review of clinical cases allows us to conclude that pneumoperitoneum requires careful differential diagnosis. Free gas in abdominal cavity in patients with cystic pneumatosis is an indication for emergency surgery only in case of complicated course of disease.

[Strictureplasty or resection? Optimal approach for fibrostenotic Crohn's disease]. / Strikturoplastika ili rezektsiya? Optimal'naya taktika pri fibrostenoticheskoi forme bolezni Krona.

The indications for surgical intervention in patients with Crohn's disease (CD) are ineffective therapy and complications of this disease. In case of fibrostenotic CD, strictureplasty or bowel resection are indicated. The indications for organ-sparing surgeries are multiple small bowel lesions, previous surgery for CD and short bowel syndrome. Strictureplasty is not advisable in patients with fistulas, abscesses, bowel perforation and severe hypoalbuminemia due to extremely high risk of anastomotic leakage. Therefore, bowel resection is recommended if strict indications for various types of strictureplasty are absent. This approach is associated with effective maintenance of remission and longer recurrence-free period.

[Limberg Flap reconstruction for pilonidal sinus]. / Rezul'taty khirurgicheskogo lecheniya epitelial'nogo kopchikovogo khoda s ispol'zovaniem plastiki po Limbergu.

OBJECTIVE: To compare the effectiveness of two surgical techniques in patients with pilonidal sinus. MATERIAL AND METHODS: There were 117 patients with pilonidal sinus divided into 2 groups depending on surgical approach: main group - Limberg Flap reconstruction (n=62), control group - conventional suturing of sinus (n=55). Patient data were analyzed using SPSS software. RESULTS: Mean length of hospital-stay in the main group was 8.2 days, in the control group - 5.4 days. Pain syndrome was more significant after 1 postoperative day in the main group. Three days later, severity of pain was similar in both groups. In the main group, sutures were removed after 13 days, in the control group - after 8 days. Incidence of postoperative wound infection was 3.2% in the main group and 14.5% in the control group. Long-term postoperative recurrence occurred in 1 patient of the main group and 6 patients of the control group. CONCLUSION: Limberg flap reconstruction is followed by fewer postoperative complications and recurrences. However, period of rehabilitation and wound healing is longer compared to traditional technique.

[Iron deficiency syndromes and their correction with nutritional support in elderly patients with colo-rectal cancer.]

51 patients with operated colorectal cancer T1N0M0, T3N1M0 and T4N0M1 at the age of 67±2,3 years receiving adjuvant chemotherapy and nutritional support (NS) were examined. Nutritional status was assessed using alimentazione-volume diagnosis to the points on L.N.Kostyuchenko, nutritional risk - with NRI, body composition - with bioimpedance method, the iron metabolism - with basic markers (serum ferritin, transferrin saturation with iron, erythrocyte indices: erythrocyte saturation of iron, the average concentration of hemoglobin in the erythrocyte, mean corpuscular volume, hemoglobin, etc.), traditional settings, the staging of tumors - according to TNM. Iron deficiency before the development of anemia can be corrected with NS. Upon the occurrence of anemia requires additional pharmacological treatment iron supplementation, preferable with iron III hydroxide olygoisomaltazat 1000 + NS) for the prevention of toxic-metabolic complications.

[Successful anaesthesia for abdominal reconstructive surgery in a myasthenia gravis patient].

This article presents a clinical case of colon disease surgical treatment in a 34-year old patient with. generalized myasthenia. Perioperative management peculiarities in these patients are clarified. Different approaches to anaesthesia choice were discussed on a case study. The importance of tactics individualization, rational drugs selection, including neuromuscular block reversal agents as well as intraoperative neuromuscular transmission monitoring.

[The combined abdomenotranssacral access for the extralevator rectum extirpation].

Technique of the extralevator abdomenoperineal rectum extirpation with the use of the combined abdomenotranssacral access is thoroughly described in the article. The radicality of the procedure and the immediate results has been evaluated in 27 patients with the lower ampullary rectum and anal canal cancer. The average blood loss was 625±288 (300-3500) ml. The soft tissue defect was replaced with the use of unilateral rotated gluteus maximus muscle (n=21), bilateral rotated gluteus maximus muscle (n=6). Tumor-free resection line was registered by the morphological investigation of the resected tissues in 25 cases. Long-term results (13.2±3.1) (2-22 months)) were obtained in 24 patients. The obtained results of the postoperative morbidity and survival rates allow to consider the described method as a safe and appropriate surgical procedure.

[The enhancement of treatment efficacy in chronic liver failure by using hemoperfusion across donor hepatocytes and spleen fragments]. / Povyshenie éffektivnosti lecheniia khronicheskoi pechenochnoi nedostatochnosti s pomoshch'iu gemoperfuzii cherez donorskie gepatotsity i fragmenty selezenki.

Hemoperfusion via donor hepatocytes and splenic fragments is an effective adjuvant method of treatment of hepatic insufficiency, especially in patients with autoimmune disease. Hemoperfusion effect occurs due to normalization of mesenchymoinflammatory and immunological indices as a result of positive action of hepatotropic and immunotropic factors of the spleen. The highest effectiveness of the above hemoperfusion is reached in its early use, that is before the disease becoming chronic.

[Experience in using preserved xenogeneic hepatocytes in the combined treatment of jaundice patients]. / Opyt primeneniia konservirovannykh ksenogepatotsitov v kompleksnom lechenii bol'nykh zheltukhami.

The authors give brief characteristics of the apparatus "subsidiary liver" and describe the mechanism of its work. The method of taking the liver of piglets and isolation of hepatocytes are described. The characteristics of patients are given in who the apparatus "subsidiary liver" was used. Certain parameters of blood were shown to be reduced after using the apparatus "subsidiary liver".

[Treatment of severe hepatic insufficiency by perfusion of patients' blood through a suspension of cryopreserved hepatocytes]. / Lechenie tiazheloi pechenochnoi nedostatochnosti perfuziei krovi bol'nogo cherez vzves' kriokonservirovannykh gepatotsitov.

The results of hemoperfusion through a suspension of cryoconserved hepatocytes in 21 patients with severe hepatic insufficiency are analysed. It is shown that the manipulation had a beneficial effect on the clinical and biochemical indices, which was manifested by diminished jaundice and skin pruritus, increased physical activity, improved appetite; reduced levels of bilirubin, transaminase, alkaline phosphatase, bile acids, and cholesterol. The information gained is evidence that the method can be included in the complex treatment of patients with severe hepatic insufficiency.

[Preparation of a suspension of isolated hepatocytes using the Soviet drug collalitin]. / Poluchenie suspenzii izolirovannykh gepatotsitov s pomoshch'iu otechestvennogo preparata kollalitina.

Isolation of individual hepatocytes suspension from rats was carried out using trypsin, collagenase and collalytine; maximal yield of the viable hepatocytes was obtained when 0.05% solution of collagenase was used. Trypsin was ineffective in production of viable cells, while collalytine from pig pancreas exhibited the satisfactory results at concentration of 0.15-0.20%.

[Dynamic activity of the splenic lymphocytes during the modelling of chronic denervation-delymphatization of the kidneys in mice]. / Dinamika aktivnosti limfotsitov selezenki pri modelirovanii khronicheskoi denervatsii--delimfatizatsii pochek u myshei.

In experiments on mice CBA the activity of spleen lymphocytes was investigated in sham-operated mice and in mice with denervation-delymphatization of the both kidneys. The activity of lymphocytes was determined by registration of amounts of colony-formed elements by the method of Till and McCulloch. Periodic increase of the lymphocytes activity has been observed in mice with denervation-delymphatization kidneys. It is supposed that the periodic activation of lymphoid system, induced by denervation-delymphatization, may be one of triggering mechanisms of transplant rejection.

[Effect of vitamin E on the energy allowance of functional and plastic processes in the myocardium during ischemia and reoxygenation]. / Vliianie vitamina E na énergeticheskoe obespechenie funktsional'nykh i plasticheskikh protsessov v miokarde pri ishemii i reoksigenatsii.

It was found that preliminary (before ischemia) administration of vitamin E in a dose of 200 mg/kg to albino rats causes the changes in energy support of the ischemic myocardium leading to prolonged maintenance of synthesis processes: energy production, cGMP concentration, unsaturation of cell membrane lipids increase. The combination of all these factors probably determines the anti-ischemic effect of vitamin E providing adequate restoration of the myocardial function in the postischemic period.

[Action of vitamin E on the normal myocardial energy balance and in ischemia and reoxygenation]. / Deistvie vitamina E na énergobalans miokarda v norme, pri ishemii i reoksigenatsii.

The energy mechanisms of formation of anti-ischemic myocardial resistance have been studied by means of vitamin E, administered to rats 24 hours before modelling ischemia in a dose of 200 mg/kg, in which the antioxidant activity of the preparation is pronounced. At the stage of ischemia, myocardial energy was studied by the differential calorimetry method, in the pre- and postischemic periods on a functioning heart in a stand according to Neely. It is shown, that vitamin E in ischemic and postischemic periods enhances the power and efficiency of myocardial energy consumptions: decreases irrational energy consumptions in the initial period of ischemia (the first 15 minutes) and supports a higher level of energy production further on, increasing thus the admissible periods of myocardial ischemia from 20-25 to 30-35 minutes, maintains in the postischemic period a higher level of total useful energy consumptions and coefficients of the oxygen utilization efficiency as compared with the experiments without preliminary administration of vitamin E. It is shown, that the anti-ischemic defence of the myocardium by vitamin E is formed already in the preischemic period and conditioned by redistribution of energy consumptions and growth of the share of energy consumptions aimed at the maintenance of the initial structural-functional homeostasis of myocardial cells.

[Intrasplenic xenotransplantation of human fetal pancreatic islet cell cultures in rats with experimental diabetes mellitus]. / Vnutriselezenochnaia ksenotransplantatsiia kul'tur ostrovkovykh kletok podzheludochnoi zhelezy plodov cheloveka krysam s éksperimental'nym sakharnym diabetom.

Islet cell cultures obtained from the pancreas of human embryos were transplanted to the spleen pulp of rats with alloxan diabetes mellitus. During 1-2 weeks after transplantation, 6 of the 8 recipients manifested a decrease in glycemia to normal or almost normal. The antidiabetic effect of xenotransplantation of islet cell cultures was well preserved throughout the entire observation period (up to 4 months). Two recipient rats with stable normoglycemia were subjected to splenectomy. One week after operation the animals manifested the recurrent grave diabetic status. Histological study of the removed spleen has shown the red pulp to contain the accumulations of implanted islet cells.

[Excretion of catecholamines and their precursors after heterotopic heart allotransplantation in rats]. / Ekskretsiia katekholaminov i ikh predshestvennikov pri geterotopicheskoi allotransplantatsii serdtsa u krys

The urine content of catecholamines and their precursors was studied in lineal rats subjected to heterotopic heart allotransplantation, the dynamics being traced from 3 days preoperatively and throughout the period of transplant function (6.8 +/- 0.8 days, on the average). Heterotopic heart allotransplantation was shown to activate the sympathetic link of the sympathoadrenal system.