[First experience in using cardiocytoprotector mexicor in operations of myocardial revascularization under conditions of extracorporeal circulation].

We examined a total of forty-four patients diagnosed with coronary artery disease who were subjected to coronary artery bypass graft surgery under conditions of extracorporeal circula tion. In the examined group (15 patients) during anaesthesia and perfusion, we additionally administered the cardiocytoprotector mexicor at a total dose of 1,500 mg. It was revealed that administering mexicor in a complex of anaesthesiological-and-resuscitation support considerably increased the indices of myocardial contractility and oxygen-transporting function of blood in the postperfusion period, also decreasing both the amount and duration of inotropic stimulation, and favourably contributing to early recovery and restoration of spontaneous respiration in the immediate postoperative period.

[Use of morphine analgesia in patients with acute forms of ischemic heart disease].

The adequacy of morphine analgesia was studied in 77 patients with acute forms of coronary heart disease (CHD). The studies demonstrated that morphine analgesia was inadequate in 37.7% of the patients with acute CHD. Inadequate morphine analgesia was more frequently observed in patients with lower acute myocardial infarction, in those with severe or very severe pain requiring additional morphine administration, in those with bradycardia and hypotension or high arterial hypertension, in elderly patients after morphine readministration. The above categories of patients require more adequate analgesic methods.

[Fatty acid absorption in the heart of male mongrel dogs]. / Pogloshchenie zhirnykh kislot serdtsem besporodnykh sobak-samtsov.

Cardiac absorption of nonesterified fatty acids (NEFA) and acids making part of cholesterol and triglyceride ethers from the bloodstream of male dogs was investigated. Changes were assessed on the basis of arteriovenous difference between fatty acid content in lipid fractions of the heart's in- and outflow. The dogs on predominantly animal-fat diets showed outflow changes in the quantitative and qualitative composition of most NEFA, which provide energy substrate, and in the fatty-acid composition of potential NEFA suppliers--cholesterol and triglyceride ethers.

[Morphological changes in the lungs in the early recovery period after clinical death from acute blood loss depending on the method of its compensation]. / Morfologicheskie izmeneniia legkikh v rannem vosstanovitel'nom periode posle klinicheskoi smerti ot ostroi krovopoteri v zavisimosti ot sposoba ee vospolneniia.

Pathomorphological changes in the lungs in the period of clinical death due to acute blood loss and within 1 1/2--2 hours of resuscitation using intraarterial, intravenous, and intraosteal routes for blood loss substitution were studied in dogs. In the period of clinical death significant changes in the lung morphology were observed (capillary plethora, sludge, leukostasis, hemorrhages, fat embolism, irregular aeration of pneumonic tissue), in the early postresuscitation period the intensity of the changes varied in relation to the method of blood loss substitution. The above-mentioned methods are compared.

[The metabolic effects of the neurotropic action of actovegin during hypoxia]. / Metabolicheskie éffekty neirotropnogo deistviia aktovegina v usloviiakh gipoksii.

Recent data on the mechanisms of the effect of aktovegin on the brain in hypoxia are systematized. It is shown that the drug improves the transport and utilization of oxygen and glucose, activates the aerobic routes of energy metabolism and, as a result, improves the functional state of the central nervous system cells.

[The role of cytochrome c in preventing postresuscitation functional disorders of the central nervous system]. / Rol' tsitokhroma c v preduprezhdenii postreanimatsionnykh narushenii funktsional'nogo sostoianiia tsentral'noi nervnoi sistemy.

The effect of intracarotid injection of cytochrome c on the course of the early postresuscitation period was studied in experimental animals (albino rats) after 5-min clinical death from acute blood loss. It was shown that the drug normalizes the disturbed metabolic processes in the brain, reduces the structural changes consequent upon total ischemia, stabilizes the activity of the cardiovascular system and, as a result of this, contributes to restoration of functional activity of the central nervous system in the early postresuscitation period.

[Changes in the fatty acid composition of myocardial phospholipids after hypothermic ischemia]. / Izmeneniia zhirnokislotnogo sostava fosfolipidov miokarda posle gipotermicheskoi ishemii.

Index of phospholipids saturation was increased in myocardium within 90 min reperfusion after hypothermic (8-12 degrees) ischemia. Content of oleic, linoleic and arachidonic acids was decreased in all the phospholipid fractions studied thus suggesting that phospholipase mechanism was involved in cardiomyocyte membranes impairment. However, mechanisms of adaptation-protective reactions were maintained as synthesis of prostaglandins from these fatty acids was possible and amount of polyenic acids (eicosapentaenic, decasatetraenoic acids) was increased in some phospholipids. Data of literature corroborated this suggestion.

[Effect of using gutimine in the pre-ischemic period on myocardial phospholipids during reperfusion]. / Vliianie primeneniia gutimina v predyshemicheskom periode na fosfolipidy miokarda vo vremia reperfuzii.

Physico-chemical properties of phospholipids were studied in heart muscle at postischemic period after preventive treatment with gutimine. Two administrations of the drug, as compared with its three times treatment, during the preischemic period contributed to development of stable adaptive antiischemic and antireperfusion responses involving alterations in fatty acid composition of phospholipids as demonstrated by an increase in content of arachidonic acid in all the phospholipid fractions studied as well as in total content of monoenic acids in lysophosphatidyl choline and phosphatidyl serine and of polyenic acids in lysophosphatidyl choline, phosphatidyl serine and phosphatidyl ethanolamine.

[Metabolism of fatty acids in the healthy myocardium and in ischemia]. / Metabolizm zhirnykh kislot v miokarde v norme i pri ishemii (obzor)

Data on absorption and consumption in heart tissue of free and ester-bound fatty acids from blood lipids are discussed. Preferential utilization of individual fatty acids in heart tissue from blood lipids is considered. Dependence of fatty acid metabolism on the activity of tricarboxylic acid cycle, interrelationship between metabolism of endogenous and exogenous fatty acids in heart muscle are considered. The data are analyzed on pathways of exogenous fatty acids turnover in tissues, their conversion into endogenous fatty acids, specific for individual tissue, cells and their organelles. Development of syndrome of unsaturated fatty acids deficiency, induced by incomplete fatty diet, is discussed. Metabolism of fatty acids in heart under conditions of oxygen deficiency is considered. The data are reviewed on the effects of hypoxia on metabolism of fatty acids in myocardium. Carbohydrate and fatty acid consumption in heart muscle, typical alterations in fatty acid incorporation into heart lipids, effect of fatty acids excess on functioning of sarcoplasmic reticulum and mitochondrial membranes are discussed.

[Effect of nerobolil on higher fatty acid metabolism in the rat liver normally and in disordered protein metabolism]. / Vliianie nerobolila na metabolizm vysshikh zhirnykh kislot v pecheni u krys v norme i pri narushenii belkovogo obmena.

Metabolism of fatty acids in rat liver tissue and content of albumin in blood of control rats as well as in the animals with impaired protein metabolism as a result of thermic trauma were studied under conditions of nerobolyl treatment (5 mg per kg of body mass within a day) of different duration. After daily administration of the drug (within 13 days) into control rats and into the animals with burns, content of oleic and linoleic acids was decreased in liver tissue but the content of 5,8,11-eicosatrienic acid and total monoenic acids with uneven amount of carbon atoms was increased with simultaneous decrease in albumin concentration in blood. Metabolism of fatty acids was altered only slightly in liver tissue of healthy animals after nerobolyl administration within three weeks (with an interval for 3-4 days); under conditions of the thermic trauma nerobolyl normalized the fatty acids metabolism in liver tissue and increased the albumin content in blood.

[Metabolic effect of gutimine on the myocardial tissue in blood loss]. / Metabolicheskii éffekt gutimina v tkani miokarda pri krovopotere.

A rate of hemorrhage accounted for 31 mg/kg in 80 adult dogs premedicated with promedol and atropine. After circular-hemic hypoxia caused by the hemorrhage, single intravenous administration of gutimine (35-40 mg/kg) transformed the carbohydrate metabolism in heart muscle: activated glycolysis and accelerated the rate of its products oxidation, maintained the free amino acids concentration at the level similar to that of intact animals, reduced the rate of creatine phosphate synthesis.

[The effect of cytochrome c on the myocardium during reperfusion]. / Vliianie tsitokhroma c na miokard vo vremia reperfuzii.

Experimental and clinical trials have shown high effectiveness of cytochrome c (0.5 mg/kg) in prevention of reperfusion myocardial disorders in cardiosurgical patients. Cytochrome c inhibits development of myocardial ischemic contracture, depression of coronary circulation, activation of lipid peroxidation. It reduces myocardial consumption of oxygen and promotes earlier restoration of fatty acids metabolism under lower glucose consumption by the heart muscle. By correction of myocardial metabolism, the drug suppresses fermentemia in early reperfusion.

[Use of cytochrome C in the prevention of myocardial reperfusion injury during heart valve prosthesis implantation under conditions of extracorporeal circulation]. / Primenenie tsitokhroma C dlia profilaktiki reperfuzionnykh povrezhdenii miokarda pri protezirovanii klapanov serdtsa v usloviiakh iskusstvennogo krovoobrashcheniia.

Cytochrome C used at the postischemic period causes a rapid reestablishment of coronary circulation, hemodynamic parameters, prevents activation of lipid peroxidation in reoxygenation of the heart after prolonged total myocardial ischemia in patients with acute bacterial endocarditis in whom the prostheses of heart valves had been fulfilled. Parallel with the positive inotropic effect, Cytochrome C reduces the postloading and, as a result, transfers the cardiac muscle to a more profitable regimen. At the end of the myocardial ischemia period Cytochrome C provides rapid and effective recovery of the bioelectrical function of the heart, improves its pumping function, thus allowing the dose and duration of inotropic stimulation of the myocardium at the postischemic period to be reduced, lowers pulmonary resistance and finally leads to less postoperative intrahospital lethality from acute heart failure.

[Changes in cerebral blood flow, intracranial and cerebral perfusion pressure in neurosurgical patients during anesthesia induced with diprivan]. / Izmenenie mozgovogo kovrovotoka, vnutricherepnogo i mozgovogo perfuzionnogo davleniia u neirokhirurgicheskikh bol'nykh vo vremia vvodnogo narkoza diprivanom.

Effect of diprivan on cerebral blood flow, intracranial (ICP) and cerebral perfused pressure (CPP) was studied in neurosurgical patients during induction narcosis. The labored perfusion syndrome was observed in all patients during the initial stage. Infusion of diprivan at the initial stage of narcosis in a dose of 2 mg/kg led to a decrease in arterial pressure, mean arterial pressure, CPP, and ICP. During intubation ICP decreased by 3-7 mm Hg. At the stage of anesthesia stabilization ICP decreased by 27.3%, mean arterial pressure by 10%, CPP by 6%, linear blood flow velocity in the mid-cerebral artery of the intact hemisphere by 28.1% and in the involved hemisphere by 39.9%, with simultaneous leveling of cerebral blood flow between them.