[Capabilities of military medical academy in the implementation of advanced scientific research].

The paper describes the main areas of current and future studies of scientific schools, scientific potential and the structure of scientific complex of Military Medical Academy. Improvement and equipping of laboratory bench and test facilities of the Academy are required to perform advanced research and further development of innovative medical technologies. It is necessary to develop and increase the scientific school of the Academy in order to prepare highly qualified scientific and pedagogical staff in the interests of military medicine in the future.

[The activation mechanisms in cytomegalovirus infection]. / O mekhanizmakh aktivatsii tsitomegalovirusnoi infektsii.

Antibodies to cytomegalovirus class IgG and IgM and level of tumor necrosis factor (TNF) in the serum were measured in 81 patients with severe surgical infections. In patients with acute lung abscess TNF level was twice higher and activation of cytomegalovirus infection (specific IgM) was three times more frequent than in patients with infectious endocarditis. The conclusion is made that severe surgical infections inducing progressive immunodeficiency create conditions for activation of latent viral infections, cytomegalovirus, in particular). Recommendations on prevention of hemotransmissible cytomegalovirus infection are presented.

[Intensive plasmapheresis: complications and their prevention]. / Intensivnyi plazmaferez: oslozhneniia i ikh profilaktika.

Upon the analysis of 246 plasmapheresis sessions performed for autoplasma provision, the correction of the blood rheology and the decrease in endogenic intoxication of 216 patients, it was stated that the frequency of various reactivity and complications comprised 12.9%. The causes of these complications and the means of their prevention were analyzed.

[Megakaryocytopoiesis in patients with acute infectious destruction of the lungs]. / Megakariotsitopoèz u bol'nykh ostrymi infektsionnymi destruktsiiami legkikh.

Partial megakaryocytograms were studied in patients with acute infectious destructions of the lungs. Acid phosphatase and glycogen megakaryocytic levels, overall number of megakaryocytes elucidated the role of the central link of the system megakaryocyte--platelet in the onset of thromboembolism and hemorrhagic complications arising in the above patients. Inefficiency of megakaryocytopoiesis in pulmonary and pleural acute pyo-destructions is under discussion.

[Disorders of the functional properties of thrombocytes causing thromboembolism in acute suppurative destructive diseases of the lungs and pleura]. / Narusheniia funktsional'nykh svoistv trombotsitov, sposobstvuiushchie formirovaniiu tromboembolii, pri ostrykh gnoino-destruktivnykh zabolevaniiakh legkikh i plevry.

An examination of 96 patients has established that the development of a pyo-destructive process in the lungs and pleura is accompanied by an increase of concentration of circulating thrombocytes as well as their adhesive-aggregating activity and degenerative-dystrophic alterations. These parameters were most pronounced in patients 1-3 days before their sudden death from thromboembolism of the pulmonary artery without a clinically detected source. Persantine, aspirin, pyrazolones and heparin in generally accepted therapeutic doses were shown not to possess evident anti-aggregative properties.

[Multiple organ failure syndrome in critically ill patients]. / Sindrom posledovatel'nykh organnykh povrezhdenii u patsientov v kriticheskikh sostoianiiakh.

A new approach to defining the notion of multiple organ failure is proposed. It is based on division of the organ humoral injuries at the stages of dysfunction, insufficiency, and failure. Criteria of these stages are defined for the central nervous and cardiovascular systems, lungs, liver, kidneys, and gastrointestinal tract.

[Endotoxinemia as a factor in the pathogenesis of thrombocytopathies in patients with acute infectious destruction of the lungs]. / Endotoksinemiia kak faktor patogeneza trombotsitopatii u bol'nykh ostrymi infektsionnymi destruktsiiami legkikh.

Laboratory studies of the influence of the staphylococcal endotoxin on functional properties of thrombocytes and clinical observations of patients with a pronounced syndrome of endotoxicosis have shown an important role of endotoxinemia in pathogenesis of the arising thrombocytopathies. Possibilities of the medicamentous protection of blood plates from the damaging action of endotoxinemia are considered.

[The functional properties of thrombocytes in patients with suppurative peritonitis]. / Funktsional'nye svoistva trombotsitov u bol'nykh gnoinym peritonitom.

An examination of 49 patients with local and diffuse purulent peritonitis at different stages of surgical treatment has shown that the pyodestructive process in the abdominal cavity develops against the background of thrombocytosis, thrombocyte destruction, their decreased energy resources and tendency to retarded and irreversible aggregation. To correct the disturbed aggregation properties of thrombocytes the HBO and intraaortal infusions of antiaggregants and vasoactive drugs may be used.

[Therapeutic plasmapheresis in suppurative-septic surgery]. / Lechebnyi plazmaferez v gnoino-septicheskoi khirurgii.

The results of the clinico-laboratory analysis conducted in 69 patients with varying forms of acute purulent surgical infections have shown that the therapeutic plasmapheresis is attended by the improvement of the disease clinical picture, and attenuation of endotoxicosis by day 3 after the perfusion. Indications and contraindications for plasmapheresis in critical patients are considered, the causes of unsuccessful plasmapheresis procedures are analyzed, the ways for the improvement of this operation are outlined.

[The detoxifying function of the pulmonary parenchyma in patients with acute infectious lung destruction]. / Detoksitsiruiushchaia funktsiia legochnoi parenkhimy u bol'nykh s ostrymi infektsionnymi destruktsiiami legkikh.

The study of arteriovenous ratio of medium-molecular oligopeptides level in 32 patients with acute infectious lung destructions has established an important detoxicating role of the lungs in endotoxemia syndrome during pulmonary-pleural suppurations. It has been found that, with the pronounced endotoxemia syndrome, during catabolic phase of the disease the lungs turn from toxin filter into their source. Detoxicating capacity of the lung parenchyma was shown to be more dependent on the severity of general metabolic disturbances than on the dissemination of suppurative lung destruction.

[New potentials for assessing the efficacy of extracorporeal blood correction methods in treating patients with acute suppurative destructive diseases of the lungs and pleura]. / Novye vozmozhnosti otsenki éffektivnosti ékstrakorporal 'nykh metodov gemokorrektsii v lechenii bol'nykh s ostrymi gnoino-destruktivnymi zabolevaniiami legkikh i plevry.

Integral mathematical analysis of changes in the peripheral blood formula was used in multiple-modality treatment of 19 patients with acute infectious destructions of the lungs and pleura. Extracorporeal methods of hemocorrection were used in the treatment. The leukocytic formula entropy, number of tension signs, degree of adaptation reaction, and leukocytic index of intoxication were assessed. Changes in the analyzed parameters were found to depend on the initial severity of patient's status, type of extracorporeal perfusion, and disease outcome. The authors came to a conclusion about the informative value of mathematical integral parameters which permit outlining the approaches to prediction of the disease outcome and plan individual treatment.

[Antiviral cellular resistance in acute sepsis]. / Protivovirusnaia kletochnaia rezistentnost' pri ostrom sepsise.

The antiviral cellular resistance was studied in 22 patients with acute sepsis of different etiology. The acute sepsis was found to develop as a rule against the background of substantially decreased antiviral cellular resistance. So, treatment of this category of patients should include not only antibacterial and antimycotic, but also antiviral methods of therapy.

[The role of the pulmonary parenchyma in regulating the functional properties of the thrombocytes in acute septic lung lesions]. / Rol' legochnoi parenkhimy v reguliatsii funktsional'nykh svoistv trombotsitov pri ostrykh septicheskikh porazheniiakh legkikh.

An examination of 110 patients with septic injuries of the lungs (acute pneumonia without purulent destruction, acute abscessing pneumonia, gangrene and lung abscess) has established that lung parenchyma plays an important role in the regulation of functional properties of thrombocytes. Growth of unfavourable thrombocytic lesions were shown to accompany an increase of sizes of purulent-destructive lesions of the lungs. The suppression of coagulolytic and barrier function of the lungs was found to be associated with the appearance of thrombotic complications.

[Clinical importance of changes in thrombocytic hemostasis in lung cancer]. / Klinicheskoe znachenie izmenenii trombotsitarnogo gemostaza pri rake legkogo.

Clinico-laboratory examinations of 86 patients have shown that lung cancer develops against the background of activation of the thrombocytic link of hemostasis which manifested itself in thrombocytosis, greater degree of destruction of the lysosomal membranes, lower energy resources of the cells, their tendency to slow and little reversible aggregation. The authors consider that the indicators of the ADP-induced aggregation of thrombocytes may be used for prognosis of postoperative pyo-inflammatory and thromboembolic complications. HBO is good for correction of alterations in the thrombocytic link of hemostasis in lung cancer and its suppurative complications.

[Therapeutic plasmapheresis and extracorporeal low-flow blood oxygenation in the combined treatment of patients with acute suppurative-septic lesions of the lungs and pleura]. / Lechebnyi plazmaferez i ékstrakorporal'naia malopotochnaia gemoksigenatsiia v kompleksnom lechenii bol'nykh s ostrymi gnoino-septicheskimi porazheniiami legkikh i plevry.

It was shown that plasmapheresis included in the complex program of intensive therapy of patients with acute pyo-septic lesions of the lungs and pleura allowed to effectively arrest manifestations of endotoxicosis and to improve results of treatment of this category of patients. Extracorporeal hemoxygenation of small volumes added to plasmapheresis at the expense of inclusion of dialyzer DIP-02-02 in the extracorporeal contour considerably reinforced the detoxicating effect of plasmapheresis at the expense of nonspecific biotransformation of toxins.

[Functional activity of precursor cells of granulo-monocytopoiesis and stromal precursor cells in acute suppurative-destructive lung diseases]. / Funktsional'naia aktivnost' kletok-predshestvennikov granulomonotsitopoéza i stromal'nykh kletok-predshestvennikov pri ostrykh gnoino-destruktivnykh zabolevaniiakh legkikh.

Under study was functional activity of stromal (fibroblast) and granulo-monocytic cells-precursors in bone marrow cultures of 32 patients with acute pyodestructive diseases of the lungs. The disturbance of functional activity of cells-precursors of granulo-monocytopoiesis and stromal cells-precursors responsible for regulation of hemopoiesis was established which makes for the development of leukemoid reactions and anemia in patients with acute pyo-destructive diseases of the lungs.

[Leukocyte transfusions in the treatment of sepsis]. / Leikotransfuzii v lechenii sepsisa.

Leukotransfusion from ordinary donors and those immunized by staphylococcal anatoxin were used in complex treatment of 55 patients in a catabolic phase of different forms of sepsis. It was found that transfusion of leukosuspensions, immune ones in particular, had pronounced immunostimulating, detoxicating, antibacterial and anti-inflammatory effects. A short course of transfusions of allogenic leukocytes can be fulfilled without a selection by the HLA system.

[The extracorporeal correction of disorders in the blood aggregate state in patients with acute infectious destructions of the lungs and pleura]. / Ekstrakorporal'naia korrektsiia narushenii agregatnogo sostoianiia krovi u bol'nykh s ostrymi infektsionnymi destruktsiiami legkikh i plevry.

Positive hemorheological effect was found in using therapeutical plasmapheresis in combination with extracorporeal blood oxygenation. Indications and contraindications for therapeutical plasmapheresis are discussed in the paper.

[The role of changes in thrombocytic hemostasis in the pathokinesis of purulent surgical infection]. / Rol' izmenenii trombotsitarnogo gemostaza v patokineze gnoinoi khirurgicheskoi infektsii.

A study of 425 patients demonstrated that a pyodestructive process, located anywhere, affects platelet functional properties, resulting in the first place, in disorders of spontaneous cell disaggregation. Impaired platelet functional properties are conducive to the development of postoperative purulent and thromboembolic complications.