[Efficacy of antibiotic prophylaxis using zinacef in postoperative period].

The results of intravenous injection of Zinacef for purulent--septic complications in patients with various acute surgical diseases of the abdominal cavity organs were presented. Main principles and rules of antibioticoprophylaxis and antibioticotherapy conduction in surgery were substantiated.

[Ways of optimization for the plan of treatment of acute appendicitis]. / Puti optimizatsii programmy lecheniia ostrogo appenditsita.

Results of surgical treatment of 318 patients with an acute appendicitis, using principles of antibioticoprophylaxis and antibacterial therapy, new medicinal preparations, were analyzed.

[Effects of thermal injury on the reactivity of the neuroendocrine system]. / Vplyv termichnoho ushkodzhennia na reactyvnist' neiroendokrynnoï systemy.

To study reactivity of hypothalamo-hypophyseal-adrenal system to stress in patients with thermal skin burns we determined the content of cortisol in blood, chemosensitivity of glucocorticoid receptors on thrombocytes and effects of dexamethasone infusions on these parameters. In patients with normal reactivity of the organism and increased initial level of cortisol its content was shown to be increased by 34.1% in 2-3 hours after infusion of dexamethasone, but it decreased in 5-6 hours and subsequently. In patients with low initial level of cortisol dexamethasone caused prolongation of the hormonal response (the level of cortisol increased by 57.9% in 2-3 hours; by 27.1% in 5-6 hours, and by 16.9% in 24 hours as compared to the initial level), which is a manifestation of its modifying effect on the reactivity of the system to stress. In these patients decrease in chemosensitivity of glucocorticoid receptors should be taken into consideration at analysis of the inflammatory reaction owing to modifying effects of steroid hormones on the cytokine production.

[Free radical oxidation and antiradical protection of the rat brain during adaptation to intense physical loading]. / Vil'noradykal'ne okyslennia ta antyradykal'nyi zakhyst mozku shchuriv pid chas adaptatsiï do intensyvnoho fizychnoho navantazhennia.

The cerebral free radical oxidation processes on 40 Wistar rats-males were studied by evaluation of thiobarbituric-active products of lipid peroxidation level, superoxide dismutase and glutathione peroxidase activity in sensomotor cortex, hypothalamus and brain stem. Was found that differential stability of rats to motor activities during single intensive physical loading is due by reactivity of free radicals oxidation, associated with decrease of cerebral antioxidant enzymes activity. Long term intensive physical loading may accompanied by reducing of reserve possibilities of antioxidant enzymes an cerebral structures, what possible play potential role in pathogenetic mechanisms of osteoarthritis.

[Prognosis and prophylaxis of postop inflammatory-purulent complications in patients with acute gastroduodenal ulcerative bleeding]. / Prognozirovanie i profelaktika posleoperatsionnykh gnoino- vospalitel'nykh oslozhnenii u bol'nykh s ostrym gastroduodenal'nym krovotecheniem iazvennogo geneza.

Basing on retrospective analysis of the cases records of 254 patients, suffering an acute gastroduodenal hemorrhage of ulcerative genesis, operated on in the clinic, the group of high degree risk was delineated for occurrence of inflammatory-purulent complications. This have permitted to prognosticate the complications occurrence and to suggest the ways of their prophylaxis. High efficacy of perftoran in the postoperative infusional-transfusional therapy complex was established.

[The central mechanisms regulating the blood circulation in hyperuricemia]. / Stan tsentral'nykh mekhanizmiv rehuliatsiï krovoobihu pry hiperurykemiï.

In experiments conducted on male Wistar rats for elucidation the role of central mechanisms in development alterations of heart electric stability was studied activity of 5(1)-nucleotidase and adenosine desaminase in sensomotor cortex, hypothalamus and hippocamp. Were shown that changes of heart function were in case increased adenosine content in neurons of sensomotor cortex, hypothalamus and hippocamp. Introduction to animals with hyperuricemia DOCA, with activate 5(1)-nucleotidase and adenosine desaminase, was accompanied by changes of cAMP and cGMP content in neurons. Developing alterations of heart electric stability suggest the responsibility of injury adenosine metabolism in different brain structures of animals with hyperuricemia in alterations of central regulatory mechanisms of systemic blood flow.

[The osmolar concentrating function of the kidneys under the influence of nonspecific transplantation factors against a background of hypercalcemia]. / Stan osmokontsentratsiinoï funktsiï nyrok za umov vplyvu nespetsyfichnykh faktoriv transplantatsiï na foni hiperkal'tsiiemiï.

In experiment on rats functional overload (36 hours of water depression) helps in establishing the fact that the kidney subjected to the actions of non-specific factors of transplantation (ischemia, denervation, delymphatization) restores its ability to keep osmotic haemostasis to the 17th day. The same alterative factors against a background of hypercalcemia is not accompanied by the restoration of osmoconcentration functions to the 30th day of the experiment. One of the causes of this phenomenon may be the increase in the velocity of filtration in the kidney.

[The immediate results of treating patients with acute early postoperative intestinal obstruction]. / Blizhaishie rezul'taty lecheniia bol'nykh s ostroi rannei posleoperatsionnoi neprokhodimost'iu kishechnika.

We performed 58,938 operations on the abdominal organs. Three hundred and six (37.8%) patients developed early postoperative acute ileus. After its operative elimination, 22 (7.2%) patients required performance of a reoperation. Ninety (29.4%) patients died. Of them in 72, death was caused by peritonitis, in 18--pneumonia, acute cardiovascular failure, impairement in cerebral circulation and pulmonary thromboembolism.

[Long-term results of the surgical treatment of stomach ulcer]. / Otdalënnye rezultaty khirurgicheskogo lecheniia iazvennoi bolezni zheludka.

The results of surgical treatment of 384 patients with gastric ulcer disease within the follow-up period of 1 to 10 and more years have been analysed. Two hundred and fifty patients underwent gastric resection, 85--organ-preserving operation with vagotomy, 49--closure of a perforative ulcer. On the basis of data of clinico-functional investigations, the advantages and disadvantages of the methods of surgical treatment used have been studied.

[The prevention of the entry of foreign bodies into the stomach and intestines]. / Profilaktika popadaniia inorodnykh tel v zheludok i kishechnik.

On the basis of the results of treatment of 320 patients, the organization and sanitary-instructive measures aimed at prevention of getting, or development of the foreign bodies in the stomach and intestine are suggested. The primary prophylaxis (prevention of penetration of the substances which are alien to the organism into its cavities and tissues) and the secondary one (removal of the foreign bodies from the organism of a patient before their penetration into the intestine) are distinguished.

[Rheologic blood disorders in ulcer diseases complicated with posthemorrhagic syndrome]. / Nerusheniia reologicheskikh svoistv krovi pri oslozhnennoi iazvennoibolezni s postgemorragicheskim sindromom.

Of the 229 patients with ulcerous bleeding operated on, 27 (11.8%) died. In 19 of them, the death was caused by hemorrhagic syndrome with severe disorders in rheologic blood properties. Considerable decrease in capability of erythrocytes for deformation is, possibly, a pathogenetic link of the posthemorrhagic syndrome development.

[The health status dynamics of schoolchildren and the importance of biomedical factors in its development]. / Dinamika sostoianiia zdorov'ia detei shkol'nogo vozrasta i znachenie mediko-biologicheskikh faktorov v ego formirovanii.

The dynamics in schoolchildren's health status varies in time, as the incidence of some chronic diseases decreases and that of the others increases. As a result, the health status of schoolchildren has deteriorated due to a reduction in the number of healthy children and an increase in the number of chronic patients in the past 30 years. Nervous, immune (allergic), and blood diseases have become frequent. Chronic ENT diseases have been encountered more infrequently due to the noticeable reduction in the incidence rates of tonsillitis and otitis. The positive trend is that schoolchildren have no rheumatism, infective allergic myocarditis, chronic pneumonia and diffuse glomerulonephritis and that the prevalence of locomotor disorders, renal and metabolic (obesity) diseases is low. During school time, the health status of children slightly improves due to the lower incidence rates of chronic diseases and the higher proportion of healthy children, but it has remained still worse than it was 30 years ago. The formation of chronic diseases has been found to occur in health group II children, who have morphological and functional changes, in 50% of cases from the first to the sixth forms and in 20% of cases from the seventh to the tenth forms. The present-day children are characterized by a combination of abnormalities and functional disturbances. This all require active and timely prophylactic measures to block chronization at the premorbid stage. Lifestyle (to keep the hygienic school regime, to do exercises and to go in for sports), sociohygienic conditions and genetic factors have profound effects on the health status.

[Crohn disease in the emergency surgery]. / Bolezn' Krona v neotlozhnoi khirurgii.

The authors discuss the results of their personal observations over patients with Crohn's disease (57 males and 88 females). Preoperative diagnosis of the disease is extremely difficult. A purposeful and carefully taken medical history, and dynamic observation may help in recognizing the disease. Appendectomy is indicated when the process occurs in the terminal ileum because the appendix is involved in the inflammatory process; resection of the stenosed segment is indicated in small intestinal obturation.

[Acute hepatorenal failure as a component of multiorgan failure syndrome in patients after surgical intervention]. / Ostraia pechenochno-pochechnaia nedostatochnost' kak komponent sindroma poliorgannoi nedostatochnosti u bol'nykh posle khirugicheskikh vmeshatel'stv.

The etiology, pathogenesis, clinical features of acute postoperative hepatorenal failure (APHRF) in 50 surgical patients were studied. APHRF was considered as a component of the multiorgan insufficiency syndrome. The general somatic factors contributing to APHRF development were established: chronic pathology of the liver and kidneys, chronic cardiogenic pathology, hypertension. The risk factors for APHRF development before, at operation and at the nearest period after it were distinguished: shock, hemorrhage, massive transfusion of blood, or its components, hypoxia, systemic arterial hypotension. The attention is attracted to the significance of combination of the systemic arterial hypotension with the contributing general somatic factors and risk factors before, at operation and at the nearest period after it in APHRF development.

[Aspects of surgical treatment of peptic ulcer complicated by hemorrhage]. / Aspekty khirurgicheskogo lecheniia iazvennoi bolezni, oslozhnennoi krovotecheniem.

The article presents materials of clinical examination of 407 patients with ulcer disease of the stomach and duodenum complicated by bleeding. The nearest and long-term results of vagotomy and resection of the stomach are shown in comparison. Totally, organ-preserving interventions give more promising results than resection of the stomach especially by the Billroth-II method. After vagotomy, however, recurrent disease was observed in 8.4% and dyspeptic symptoms took place in 17% of the patients examined. By the data of medical labour examination 3-5 years after operation, advantages of vagotomy become increasingly notable, social labour characteristics of vagotomy as a method of treatment is considerably more preferable than resection of the stomach.

[The effect of 5-fluorouracil on lipid metabolism in patients with acute pancreatitis]. / Vliianie 5-ftoruratsila na lipidnyi obmen u bol'nykh ostrym pankreatitom.

The state of lipid metabolism was investigated in 72 patients with acute pancreatitis using the method of thin-layer chromatography on "Silufol" plates. It was established that the level of general phospholipids underwent a reduction in destructive pancreatitis. The level of triglycerids reduced sharply after treatment with 5-fluoruracil. The revealed changes were the basis for instituting fatty emulsions and lipid mixtures in the treatment of these patients.