[Morphologic changes in limb muscles under conditions of acute experimental ischemia and recirculation]. / Morfologicheskie izmeneniia v myshtsakh konechnosti v usloviiakh ostroi ékspeimental'noi ishemii i retsirkuliatsii.

Acute ischemia was induced in the limbs of 48 dogs by wounding femoral vessels followed by hemostasis through ligation of the vessels or application of a tourniquet for 2, 4, 6 and 9 hours with subsequent blood flow restoration in the great vessels. Morphological changes were examined in the muscular tissues using light optic and ultrastructural techniques. The results showed that the vascular ligation caused reactive reversible nonspecific changes in the limb tissues, the magnitude of the changes was found to be associated with hypoxia duration. Tourniquet application is thought to induce a more severe injury and its 4-6-hour exposure leads to derangement of the compensatory and adaptative mechanisms responsible for homeostasis. The acute ischemia-induced structural changes found in the limb tissues may serve as a basis for morphological substantiation of the clinical classification developed by V. S. Savelyev and be useful for efficient treatment of post-ischemic disturbances.

[Helicobacter pylori in patients with complicated peptic ulcer]. / Khelikobakter pilori u bol'nykh s oslozhnennoi iazvennoi bolezn'iu.

The results of examination of 167 patients suffering from gastric and duodenal ulcers complicated by bleeding and perforation in a rehabilitation period are presented. High contamination by HP bacteria was established in gastroduodenal bleeding especially in duodenal ulcer (94.45%), as well as direct correlation between the contamination range and blood loss degree. The presence of HP infection during a control check-up examination suggests that the course of anti-ulcer therapy should last not less than 4-6 weeks. In treating patients suffering from ulcer bleeding conservative therapy is preferable. Stomach resection is considered as a method of choice. Lethality makes up 0.94 and 6.25%, respectively.

[Lethality in postoperative thromboembolism of the pulmonary artery and methods of its therapy]. / Letalnost pri posleoperatsionnoi tromboémbolii lëgochnoi arterii i puti eë snizheniia.

Of the 350 patients who died in 1978-1988 from pulmonary thromboembolism (PTE) in 3 clinics of Ivano-Frankovsk, the surgical patients accounted for 36% (51.6% of them--at the age of 60 years and older). The likelihood of the PTE development is the highest during the first week after the operation performed, as a rule, for a malignant tumour of the alimentary organs, vascular diseases, and after prostatectomy.

[Morpho-functional changes in the muscles of the limbs and their microcirculatory bed in acute ischemia]. / Morfofunktsional'nye izmeneniia myshts konechnosti i ikh mikrotsirkuliatornogo rusla pod vliianiem ostroi ishemii.

On 26 mature dogs in a chronic experiment the character of compensatory-adaptive changes in muscles and their blood capillaries have been studied in dynamics of an acute ischemia of the extremity and at some stages of recirculation. After strangulation for two hours, thanks to joining in the compensatory-adaptive mechanisms, certain morphofunctional changes in the extremity tissues are revealed. As the duration of hypoxia increases (6-9 h), the destructive changes in the tissues become more severe. They are inherent in an acute hypoxia and accompanied with disaggregation and hydratation of cell membranes of endotheliocytes, with formation of vesicles and spherules, with increasing microclasmatosis, formation of myelin-like bodies, with destructive changes of organelles, with destruction of sarcoplasmic reticulum, with focal discoid necrosis, myocytolysis and sequestration of autolysis altered groups of muscle fibers. The data obtained serves as a base for elaboration of a pathogenically adequate surgical treatment of severe forms of an acute ischemia of extremities.

[Experimental substantiation of the use of regional detoxication therapy in acute ischemia of the limbs]. / Eksperimental'noe obosnovanie primeneniia regionarnoi detoksikatsionnoi terapii pri ostroi ishemii konechnostei.

In the experiment on dogs, the authors modelled acute ischemia of the extremities and studied the activity of lactate dehydrogenase in the blood serum. In circulatory ischemia for 2 and 4 h, the metabolism in muscular tissue normalized by day 30 after restoration of blood flow. Circulatory hypoxia for 7 and 9 h led to failure of the compensatory-adaptive mechanisms of homeostasis of the muscular tissue and required performance of regional detoxication therapy before restoration of circulation in the extremity.

[Oxygen exchange and acid-base status in patients with diabetic angiopathy of the lower extremities with different methods of conservative treatment]. / Kysnevyi obmin i kyslotno-osnovnyi stan u khvorykh na diabeyychnu angiopatyiu nyzhnikh kintsivok pry riznykh metodakh ïï konservatyvnogo likuvannia.

In the pathogenesis of III-IV stage diabetic angiopathy, the important place belongs to oxygen deficiency and metabolic acidosis. Introduction into the complex of treatment of the patients of hyperbaric oxygenation and endolymphatic pharmacotherapy contributes to improvement of general state of the patients, alleviation of the course of destructive processes on the extremities, rapid normalization of oxygen exchange in the organism, liquidation of the phenomena of metabolic acidosis. This results in shortening of patients' stay in a hospital and permits to avoid, or postpone performance of amputation of an extremity.

[The effect of hyperbaric oxygenation on the rheologic properties of the blood and its coagulation and anticoagulation system in patients with diabetic angiopathy of the lower extremities]. / Vplyv giperbarychnoï oksygenatsiï na reologichni vlastyvosti krovi ta ïï zcidal'nu i protizsidal'nu systemy u khvorykh na diabetychnu angiopatiiu nyzhnikh kintsivok.

In 24 patients with III degree diabetic angiopathy of the lower extremities, the changes in rheologic properties of the blood, its coagulative and anticoagulative system under the influence of hyperbaric oxygenation were studied. Hyperbaric oxygenation facilitates the rapid normalization of rheologic properties and general coagulative activity of the blood. Anticoagulative blood system is activated insufficiently, especially fibrinolysis, and that is why it is necessary to prescribe heparin to the patients, and at the necrotic stage, fibrinolysin as well.

[Treatment of purulent-necrotic diseases in patients with diabetes mellitus]. / Lechenie gnoino-nekroticheskikh zabolevanii u bol'nykh sakharnym diabetom.

The experience with treatment of 214 patients suffering from diabetic angiopathy complicated by purulent-necrotic tissue lesion, which included intraarterial administration of antibiotics, insulin, novocaine, vasodilators, antiaggregants, anticoagulants, vitamins, is summarized. In soft tissue necrosis, gangrene of the toes, or foot, the necrotized tissues were excised, exarticulation, or amputation of toes, metatarsals, in extreme cases, amputation of a leg at the thigh level, were performed.

[The effect of hyperbaric oxygenation on the microcirculation, oxygen budget and acid-base equilibrium in patients with diabetic angiopathy of the lower extremities]. / Vliianie giperbaricheskoi oksigenatsii na mikrotsirkuliatsiiu, kislorodnyi biudzhet i kislotno-shchelochnoe ravnovesie u bol'nykh s diabeticheskoi angiopatiei nizhnikh konechnostei.

These effects were studied in 52 patients with degrees III-IV diabetic angiopathies of the lower limbs. Microcirculation parameters were found changed in this patient population, this leading to disorders of the oxygen budget and development of metabolic acidosis. Development of destructive changes in the limb evidences failure of the compensatory adaptive mechanisms of microcirculation. Addition of hyperbaric oxygenation to multiple-modality treatment of patients with diabetic angiopathies was conducive to improvement of the blood rheology, of tissue saturation with oxygen, and to essential reduction of metabolic acidosis. The detected microcirculation disorders necessitate addition to the therapeutic complex of the drugs improving the biophysical characteristics of the blood.