[Cryohemosorption--a method of removal of lipoprotein-antibody immune complexes and other atherogenic substances in patients with atherosclerosis]. / Krioplazmosorbtsiia--metod udaleniia immunnykh kompleksov lipoproteid-antitelo i drugikh aterogennykh substantsii u bol'nykh aterosklerozom.

The efficacy of extracorporeal cryohemosorption was estimated in the treatment of atherosclerotic patients in terms of the autoimmune theory of the pathogenesis of this disease. There was a slight decrease in the plasma levels of total cholesterol and triglycerides, there was over 2-fold reduction in the plasma levels of fibrinogen and fibronectin. All major components of apo B-containing lipoproteins and immunoglobulin G were found as part of the cryoprecipitate. An extremely high concentration of lipid hydroperoxides in the precipitate suggest that cryoprecipitation removes not only autoimmune complexes, but highly-atherogenic peroxide-modified lipoproteins. The three-fold decrease in the levels of lipoprotein-antibody complexes resulted in lower atherogenicity of apo B-containing lipoproteins. It is suggested that the mechanism responsible for beneficial clinical action of cryohemosorption sessions is largely associated with the removal of autoimmune lipoprotein-antibody complexes and peroxide-modified apo B-containing lipoproteins than correction of lipid metabolism.

[Effect of hemosorption on the elimination of an amphotericin B derivative in experimental studies]. / Vliianie gemosorbtsii na vevedenie proizvodnogo amfoteritsina B v éksperimente.

Possible extracorporeal removal of a novel water soluble derivative of amphotericin B (NWSDA) from the host was studied. The bench tests demonstrated that actilen, a fibrous carbon adsorbent, was the optimal carbon sorbent for sorption of NWSDA. It was shown in the acute experiments on animals that during the hemosorption the antibiotic blood concentration on the outlet of the column was significantly lower than that on the inlet. Still, the NWSDA concentration in the blood lowered slowly which was likely due to the return of the antibiotic to the blood from the tissues.

[The clinical trial of a Russian membrane plasma filter in patients under therapy]. / Klinicheskaia aprobatsiia otechestvennogo membrannogo plazmofil'tra u terapevticheskikh bol'nykh.

35 procedures of plasmofiltration were conducted on the test series of domestic membrane plasmofilter in 25 patients suffering from atopic diseases, systemic affections of connective tissue, advanced atherosclerosis, etc. The filter proved promising in therapeutic patients. The procedure is easier to perform compared to centrifuge plasmapheresis, it can work under thin blood flow. However, centrifuge plasmapheresis has advantages over the above filtration in patients with hyperhydration, hemorrhagic syndrome, contraindications to large-dose anticoagulants.

[The effect of therapeutic plasmapheresis on changes in the rheological properties of the blood in bronchial asthma patients]. / Vliianie lechebnogo plazmafereza na izmeneniia reologicheskikh svoistv krovi u bol'nykh bronkhial'noi astmoi.

Bronchial asthma runs its course in association with marked blood viscosity which lies in a decrease of deformability of red blood cells and suspension stability of red blood cells, an increase of their aggregation capacity and of whole blood viscosity, of platelet proneness to decelerated and little noticeable aggregation, in hyperfibrinogenemia and hyperglobulinemia. Therapeutic plasmapheresis produces a favourable action on changes of the rheological blood properties in bronchial asthma patients. Plasmapheresis entails an improvement of whole blood viscosity and red blood cell aggregation, accompanied, however, by aggravation of the aggregation properties of platelets. Therapeutic plasmapheresis can be used for correction of the syndrome of high blood viscosity in bronchial asthma patients.

[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.

[A sorption microfilter for blood transfusions]. / Sorbtsionnyi mikrofil'tr dlia gemotransfuzii.

A special device is developed to purify the conserved blood from microaggregations and toxic agents. It also decreases the CO2 level and the citrate content. The device combines the properties of a microfilter and a sorption column. The specifications of the device are given.

[The prospects for using extracorporeal detoxication methods in disaster medicine]. / Perspektivy ispol'zovaniia metodov ékstrakorporal'noi detoksikatsii v meditsine katastrof.

A lot of specific injuries caused by catastrophes provoke endogenic intoxication. In this situation the application of extracorporal detoxication methods will be conditioned by pathogenetical mechanisms of their action. There are indications for ED management in mechanical injuries, prolonged squeezing effects, thermal injuries, acute poisoning, irradiation injuries, acute infectious diseases, acute reactivity state. The experience of 163 operations on 111 wounded in catastrophes proves the worth-while character of work in this sphere. 10 variants of extracorporal operations including combined methods were applied.

[The basic principles of extracorporeal detoxication in military field surgery]. / Osnovnye printsipy ékstrakorporal'noi detoksikatsii v voenno-polevoi khirurgii.

Extracorporal detoxication (ED) was used in 64 operations of 40 wounded with gunshot injuries, thermal burns and acoubarotraumata. ED was applied with plasmapheresis, plasmosorption, hemoxygenation, ultrafiltration and hemodialysis. Combinations of these methods also were used. Indications and contraindications for extracorporal management of blood were elaborated for each category of wounded. Alterations were made in the methods of operations with reference to the peculiarities of pathogenesis. Positive results were marked at 30 persons. The authors propose a scheme of indications, as well as basic principles and criteria of efficiency for ED management of surgical patients. The article makes a conclusion that these operations must be preferably realised at the stages of secondary care.

[The use of extracorporeal detoxication methods in treating infectious disease patients]. / Primenenie metodov ékstrakorporal'noi detoksikatsii pri lechenii infektsionnykh bol'nykh.

The article summarizes the results of 1090 operations of extracorporal detoxication (ED) performed on severe infectious patients. ED was realized by methods of hemosorption, plasmasorption, plasmapheresis for viral hepatitis, typhoid diseases and mixed infections. For each category of patients indications and counterindications for ED application were worked out. Positive results were marked at 54-92% of cases, depending on nosological forms, period of illness and ED type. The authors propose a scheme of indications, optimal parameters and criteria for ED efficiency estimation. ED methods adopted for Afghan conditions can be successfully used in other regions with dry and hot climate.

[Dependence of the effectiveness of massive blood transfusions on the state of cellular and humoral immunity in severe mechanical injury]. / Zavisimost' éffektivnosti massivnykh gemotransfuzii ot sostoianiia kletochnogo i gumoral'nogo immuniteta pri tiazheloi mekhanicheskoi travme.

The observation of 97 patients with severe mechanical traumas has shown massive hemotransfusions performed within the first two days subsequent to trauma against the background of maximum reduced cell immunity to be much more efficient than the massive hemotransfusion performed within the 3d--7th days after trauma (against the background of repairing cell immunity).

[Use of thymalin in trauma patients]. / Primenenie timalina pri travmaticheskoi bolezni.

A clinical study of the thymus preparation Thymalin was carried out in 23 patients with special reference to its use for prevention and treatment of infectious complications of critical traumas. The complex treatment can improve the clinical course of the trauma disease and normalize immune indices of the patients.

[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.

[Early toxemia in patients with severe mechanical injuries]. / Ranniaia intoksikatsiia u bol'nykh s tiazhelymi mekhanicheskimi povrezhdeniiami.

The examination of 2033 patients with severe mechanical injuries has shown that early intoxication takes place in 30.3% of the patients. Patients with blood loss of 35-40% and more, receiving more than 1 l of preserved blood make a group of high risk. Intoxication was more frequent in patients with one localization of injury when it is an injury of extremities or abdomen. In associated injuries the development of intoxication is determined by localization and kind of the main injury and is dependent on association with severe traumas of the extremities and abdomen.

[The storage and preparation of autologous plasma for transfusions to patients with arteriosclerosis obliterans of the vessels of the lower extremities]. / O khranenii i podgotovke autoplazmy k transfuziiam bol'nym obliteriruiushchim aterosklerozom sosudov nizhnikh konechnostei.

An investigation of the regimen of storage and sorption of plasma in patients with obliterating atherosclerosis of lower extremity vessels has shown that the optimum regimen of storage of plasma is freezing (with addition of 1 thousand of heparin units per 100 ml of plasma) at t = -20 degrees C followed by thawing at t = +6(+/- 2) degrees C in running water before sorption. The optimal sorbent for sorption of plasma of patients with obliterating atherosclerosis of lower extremity vessels is "Actilen" charcoal. The optimal method of sorption is sorption after thawing the plasma. The sufficient degree of plasma purification can be reached in the ratio sorbent/sorbate for charcoal "Actilen" equal to 1:100 and a single perfusion of plasma through the column.

[Estimation of blood loss in mechanical injuries]. / Velichina krovopoteri pri mekhanicheskikh povrezhdeniiakh.

The examination of 2033 patients with severe mechanical injuries has shown that in most patients with traumas of the head, chest and upper extremities of the same localization (isolated or multiple) the volume of blood loss was not more than 20% of the circulating blood volume. Isolated and multiple injuries of the abdomen, pelvis, spine and lower extremities in 28-54% of the patients were followed by blood loss more than 20% of the circulating blood volume. Associated traumas in most cases were followed by massive blood loss (more than 40% of the CBV).

[Feasibility of correction of blood aggregation properties in the course of extracorporeal hemosorption in atherosclerosis patients]. / Vozmozhnosti korrektsii agregatnogo sostoianiia krovi pri provedenii ékstrakorporal'noi gemokorrektsii bol'nym aterosklerozom.

Aggregation and rheological properties of blood were evaluated in 20 atherosclerotic patients after cryoplasmosorption. The change of the patients' plasma for extracorporeally modified autoplasma reduced coagulation potential, enhanced fibrinolysis and suppressed anticoagulation systems. Clinical efficacy manifested in decreased frequency and duration of anginal episodes, intensity of intermittent claudication. Biochemically, cholesterol levels and atherogenic index lowering was evident.

[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.

[Clinical testing of hemo- and plasmosorption on the Aktilen hemosorbent]. / Klinicheskaia aprobatsiia gemo- i plazmosorbtsii na gemosorbente "Aktilen".

The authors make an analysis of using hemosorption and plasmasorption in 43 patients with the help of fibrous sorbent "Actilen". The developed methods have a pronounced detoxicating immunocorrecting, rheocorrecting effect, exert mild aggressive influence on blood and can be used in treatment of surgical, therapeutic and infectious diseases. The following advantages are noted: high sorption and kinetic characteristics of the sorbent, domestic devices and materials, small volume of the filling of mass transfer devices, low cost.

[Complications of traumatic disease (their incidence, characteristics and causes]. / Oslozhneniia travmaticheskoi bolezni (chastota, osobennosti, prichiny razvitiia.

An examination of 2033 patients has established that the conditions for the development of pyo-septic and pulmonary complications of a severe trauma appear in the period of shock. Each kind of complications of trauma disease is associated with a certain set of risk factors. The localization, character of the injury and kind of early posttraumatic intoxication are responsible for the structure of complication. The blood loss value and volume of the infusion-transfusion therapy are considered to be the most common risk factors of the development of complications.

[Experimental substantiation of the sorption of reinfused blood]. / Eksperimental'noe obosnovanie sorbtsii reinfuziruemoi krovi.

An analysis of results of experiments on the assessment of morphofunctional properties of the bacterio-contaminated blood has been made. A conclusion is drawn that it is expedient to use hemosorption in order to provide safe reinfusion in patients with massive blood loss and injury of hollow organs of the abdomen.