[Some indices of homeostasis in patients operated under nitrous oxide narcosis with neuroleptanalgesia for thyrotoxic goiter]. / Nekotorye pokazateli gomeostaza u bol'nykh, operirovannykh pod narkozom zakis'iu azota s neiroleptanal'geziei po povodu tireotoksicheskogo zoba.

The authors believe that an operation under endotracheal anesthesia with phentanyl, droperidol and nitrous oxide does not substantially influence the indices of the water-electrolyte metabolism. Change of the intercellular liquid level in patients with severe thyrotoxicosis might be associated with the changed functions of the cardiovascular system.

[The experience of kidney transplantation at the Donetsk transplantation center]. / Opyt peresadki pochni v Donetskom transplantatsionnom tsentre.

In Donetskiy transplantational centre during the period from 1986 to 1996 yr were conducted 305 operations of the kidney transplantation from the cadaveric and living donor. Kidney transplantation permits to achieve higher level of rehabilitation than while application of hemodialysis and must become the method of choice in treatment of terminal stage of chronic renal insufficiency. Considering large demand for the organs transplantation in Ukraine it is necessary to create an economically substantiated programme "Transplantation of organs".

[Extracorporeal use of a donor spleen in the treatment of patients with urinary tract infection]. / Ekstrakorporal'noe podkliuchenie donorskoi selezenki v lechenii bol'nykh urosepsisom.

Ten sessions of extracorporeal connection to a xenous (pig) spleen were conducted as part of combined treatment in 7 patients with urosepsis in combination with severe renal failure. The session lasted for 40 to 90 minutes. The blood volume, required to fill the spleen and the main vessels, was below 100-150 ml with 7500-10,000 units of heparin spent. There was a marked clinical effect, manifested in reduced fever, better spirits, sleep and appetite, and a greater urinary output. Encephalopathy diminished. The connection to a xenous spleen had virtually no effect on urea, creatinin, electrolytes, bilirubin, transaminases, protein and acid-base values. There is evidence of mechanical withdrawal of compounds that are markers of septic intoxication: mean molecular levels dropped by an average of 20%, total spermine, spermidine and putrescine levels dropped by 35-40%, and blood became sterile. Circulating immune complexes decreased by 30-60%. The T-RFC count increased by 30-50%, largely owing to the helper cells. Leucocyte counts increased by 25%. FHA-induced blast transformation increased by 15-20%. Four (57%) of the 7 patients died. With hemodialysis alone, the mortality rate was 85% in this category of patients. Therefore, extracorporeal connection to a xenous spleen is indicated in cases of urosepsis as an effective as well as sparing method of biosorption and immunity activation in septic intoxication.

[The use of adaptogens for preventing suppurative-septic complications following prostatic adenomectomy]. / Primenenie adaptogenov dlia profilaktiki gnoino-septicheskikh oslozhnenii posle adenoméktomii predstatel'noi zhelezy.

Adaptive antiseptic potential of patients subjected to adenomectomy was quantified by measurement of protein synthesis according to the rate of 3H-thymidine inclusion into leukocytic DNA before and 4 hours after intravenous administration of 0.2 mg/kg prednisolone. In healthy controls this rate, when stimulated by prednisolone, rose 2.18 +/- 0.3-fold whereas in patients the rise did not exceed 1.07 +/- 0.07-fold. One-week administrations of adaptogens increased the latter rate 1.27-2.61-fold leading to less frequent infectious complications. A randomized trial of 118 patients involving the comparison of three different variants of adaptogens treatment against the control revealed the most favourable regimen: 0.15 U/kg im insulin, 0.1 mg/kg prednisolone, 0.2 mg/kg dibazol, 250 mg/kg methyluracil daily for 1 week preoperatively.

[The diagnosis of urosepsis]. / Diagnostika urosepsisa.

Two hundred-five case histories of urosepsis have been analyzed for the recent 10 years in order to delineate diagnostic details. Urosepsis resulted from urolithiasis in 88 (42.9%), prostatic adenoma in 51 (24.9%), urologic cancer in 37 (18%) patients; other 29 patients had urologic diseases complicated by urosepsis. Difficulties with identification and size delineation of a septic focus were associated with the presence of bilateral renal involvement, lower urinary tract infections, urinary reflux and posttransplantation immunosuppressive therapy which reversed classic inflammatory symptoms. Extreme clinical variability of urosepsis often resulted in a delayed or premature diagnosis. Diagnostically revealing studies were sonography and computer tomography. Additional use of blood culture for bacteroides and L-bacteria, immune and biochemical tests, including total polyamine concentration, urea/creatinine ratio and leukocyte toxemic index provided an accurate diagnosis of urosepsis. These studies are essential in older patients and those with urinary disease and urologic cancers since urosepsis is diagnostically elusive in this population.