[Features of an explosive lower extremities injury protected by sapper shoes]. / Osobennosti vzryvnoi travmy nizhnikh konechnostei, zashchishchennykh obuv'yu sapera.

The purpose of the work is to conduct experimental studies that reveal the characteristic features of explosive injuries of the lower extremities using various samples of sapper protective shoes of domestic and foreign production. The subjects of experiment were the amputated by medical reasons lower extremities of a person. The severity of explosive damage during contact blasting and the parameters of shock accelerations acting on the lower extremities, as well as approximate periods of disability and the forecast of possible disability, are determined. The results of the study can serve as initial data when testing safety shoes. In addition, using the proposed modeling technique, it is possible to compare the protective properties of various samples of anti-mine shoes, assess the presence (or absence) of signs of aggravation of damage during an anti-personnel mine detonation, and carry out a forensic medical assessment of an explosive injury.

Use of nitric oxide producer L-arginine during infusion therapy of experimental hemorrhagic shock.

Experiments on rats showed that infusion of NO precursor L-arginine before bleeding enhanced their tolerance to hemorrhagic shock. When infused after blood loss as a component of saline solution, L-arginine improved efficiency of infusion therapy for hemorrhagic shock and increased survival rate of the animals.

[Features of hemocomponental therapy in oncological patients].

The authors present an analysis of specific features of transfusions of erythrocyte containing media in oncological patients. Special attention was given to necessary selection of donor erythrocytes in performing operations with massive intraoperative blood loss. It considerably contributes to a decreased number of posttransfusional reactions and complications. For the recent five years transfusions of erythrocyte containing media to more than 15 thousand patients with surgical treatment were analyzed. Among them the individual selection of donor blood was fulfilled in 2047 cases. Compatible erythrocytes could not be selected in five cases only. In these patients infusions of Perftoran were used as an oxygen carrier both during operation and at the postoperative period.

[Effects of indirect electrochemical oxidation of blood on certain indices of homeostasis in surgical patients].

An analysis of certain biochemical hematological and hemostasiological indices of blood of 41 patients has shown that an intravenous injection of sodium hypochlorite with concentration 300 mg/l has a marked detoxicating and hypocoagulating effect.

[The hemostasis system state in patients with ulcerous gastrointestinal bleedings].

In patients with gastrointestinal bleedings there occurs activation of the hemostasis system directed to arrest of bleeding. Short-term hypercoagulation directed to arrest of the bleeding gives place to hypocoagulative changes. Their degree and duration depend on the severity and rate of blood loss. The excessive intravascular activation of blood is accompanied by the formation of fibrin deposits not only in the area of the bleeding source but in other regions of the blood channel. There appears disseminated intravascular coagulation of blood deteriorating the reparative processes in the ulcer, initiating and maintaining generalized plasminemia which promotes the thrombus lysis in the ulcer crater and recurrent bleeding.

[New blood substitutes of polyfunctional action]. / Novye krovezameniteli polifunktsional'nogo deistviia.

The paper deals with two categories of new oxygen-carrying blood substitute solutions (OCBSS), based on a modified hemoglobin (MG) and perfluor-organic carbon emulsion (PCE), and with crystalloid and colloid blood substitutes of the antihypoxic action containing the Crebs' substrate (sodium fumarat). Described are the results of clinical use of Russian OCBSS based on MG (Gelenpol) and on PCE (Perftoran) in 151 patients with hemorrhagic shock and intraoperative blood loss. Both drugs are allowed for medical application in Russia. Gelenpol was administered at 1 to 6 units, perftoran--at 10-15 ml/kg. An improved oxygen status as well as normalization of hemodynamics, microcirculation, rheology, and of blood acid-base balance (ABB) were registered. Gelenpol had a hematosis-stimulating action. The combined use of both drugs or one of them alone in surgery is under discussion. The OCBSS efficiency can be enhanced when they are used jointly with the first Russian infusion antihypoxants containing sodium furmarat, i.e. Mufasol and Polyoxyfumarin. Both of them were shown to normalize the oxidation in tissues, to recover the mitochondrial metabolism in the liver and myocardium and to improve the blood ABB when used in hypovolemic and hypoxic conditions of different etiologies, in substituting for intraoperative blood losses (gastrointestinal hemorrhages), in polytrauma and destructive cholecystitis as well as in preoperative preparations of patients with diffuse peritonitis. The OCBSS preparations and antihypoxants are undoubtedly drugs of choice in emergency infusion-transfusion therapy and in cases of multiple victims from accidents.

[Composition and various properties of acetylcholinesterase from human erythrocytes]. / O sostave i nekotorykh svoistvakh preparata atsetilkholinésterazy éritrotsitov cheloveka.

Composition and some properties of human erythrocyte acetylcholinesterase prepared for use in medical practice were studied. After electrophoresis 5 protein bands, two of which exhibited the enzymatic activity, were detected in the preparation. Three isoenzyme forms of acetylcholinesterase, dissimilar in their electrophoretic mobility, were detected in the preparation by ion exchange chromatography on DEAE Sephadex A-50. The preparation did not contain hemoglobin, thromboplastic substances and group isoagglutinogens A and B.

[Study of oligohemoglobin solutions in vitro and in vivo]. / Issledovanie rastvorov oligogemoglobina in vitro i in vivo.

Solutions of oligohemoglobins (OHb) with middle molecular mass 100 x 10(3) = 400 x 10(3), obtained after polycondensation of hemoglobin with glutaric aldehyde as well as oligohemoglobin modified with pyridoxal-5-phosphate, were studied in vivo and in vitro (plethoric administration, isovolemic metabolic substitution, hemorrhagic shock; at a dose of 0.5-1.8 g/kg of body mass; dogs, rabbits, rats). With increase of the OHb molecular mass period of its circulation in blood was elevated; blood plasma protected OHb from autooxidation; half-life of OHb was about 12-18 hrs in isovolemic metabolic substitution and in hemorrhagic shock and about 5 hrs--in plethoric administration. During circulation molecular mass selection of OHb occurred, where low molecular fraction decreased and high molecular fraction--accumulated; sign and value of human erythrocyte charge were similar both in OHb solutions with concentration up to 5% and in physiological solution.

[Contribution of A. N. Filatov in the solution of problems concerning the preparation of therapeutic blood and blood substitutes]. / Zaslugi A. N. Filatova v razvitie problemy sozdaniia lechebnykh preparatov krovi i krovezamenitelei.

A review of achievements of academician A. N. Filatov in the field of creation of preparations of blood and blood substitutes is presented. The contribution made by A. N. Filatov in the development of the problem is shown to cover both the search for methods of obtaining efficient therapeutic preparations of blood and the overwhelming studies of the mechanism of their effect in different pathologic conditions.

[Experimental study of hemodynamics and oxygen regimen in the body during replacement of massive blood loss with a suspension of erythrocytes in a solution of modified deionized gelatin]. / Izuchenie v éksperimente gemodinamiki i kislorodnogo rezhima organizma pri vozmeshchenii massivnoi krovopoteri vzves'iu éritrotsitov v rastvore modifitsirovannogo deionizirovannogo zhelatina.

In experiments on dogs with acute massive hemorrhage the effectiveness has been studied of red blood cell suspension in glucose-saline solution N 8 prepared in the Central Research Institute of Hematology and Blood Transfusion, and in a preservative based on gelatin developed in the Leningrad Research Institute of Hematology and Blood Transfusion. The advantage of the colloid preservative has been proved by the parameters of macro- and microdynamics of the blood, oxygen-basic state, oxygen budget and rheologic properties of the blood.

[Characteristics of the effect of various erythrocyte-containing media on central hemodynamics, microcirculation and oxygen consumption during the treatment of massive hemorrhage]. / Osobennosti deistviia razlichnykh éritrotsitsoderzhashchikh sred na tsentra'lnuiu gemodinamiku, mikrotsirkuliatsiiu i koslorodnyi rezhim organizma pri lechenii massivnoi krovopoteri.

Experiments in 30 rats have shown that transfusion of autologous erythrocytes suspended in the modified deionized gelatin exerts a more pronounced positive effect upon central hemodynamics, microcirculation and oxygen regimen as compared with transfusion of the whole autologous blood and erythrocyte mass.

[Erythrocyte-containing media in programs of infusion-transfusion therapy in massive blood loss]. / Eritrotsitsoderzhashchie sredy v programmakh infuzionno-transfuzionnoi terapii massivnoi krovopoteri.

The article presents data on medical effects of the whole glucose-citrated blood, erythrocyte mass and erythrocyte suspension in the solution of modified gelatine used in the scheme of the infusion-transfusion therapy for massive blood loss in experiment. The advantages of erythrocyte suspension in the gelatine solution was confirmed by data on systemic hemodynamics, oxygen regimen and acid-base state of the organism.

[Prophylactics of hemotransfusion complications in surgical practice]. / Profilaktika gemotransfuzionnykh oslozhnenii v khirurgicheskoi praktike.

In the paper the authors are making an analysis of the courses of hemotransfusion complications and recommend a system of measures to prevent them.

[Production of transfusion media on the base of erythrocytes and plasma substitute solutions]. / Sozdanie transfuzionnykh sred na osnove éritrotsitov i plazmo- zameshchaiushchikh rastvorov.

A review of investigations has been made conducted in the USSR and abroad on the production of combined polyfunctional hemotransfusion media--red blood cell suspensions in plasma-substituting solutions possessing preservative properties and hemodynamic action. The advantages of the hemotransfusion therapy with the use of these media have been shown associated with the diminution of the risk of posttransfusion complications and reactions (especially under extreme conditions) and depending on economic aspects. The properties of red blood cell suspension in the modified deionization gelatin solution have been considered in detail.

[Activation of the processes of lipid peroxidation in the small-intestinal mucosa and liver in peritonitis and possible ways of their correction by a complex infusion-detoxification therapy]. / Aktivatsiia protsessov perekisnogo okisleniia lipidov v slizistoi tonkoi kishki i pecheni pri peritonite i vozmozhnye puti ikh korrektsii kompleksnoi infuzionno-detoksikatsionnoi terapiei.

Possibilities of lipid peroxidation (LPO) correction by infusion-detoxication therapy in peritonitis were studied in an experiment on 160 white rats and during clinical treatment of 88 patients with general peritonitis. It was shown that peritonitis development in rats was attended by an increase of LPO products--malonic dialdehyde and diene conjugates, in the hepatic tissue and small intestine mucosa, while the activity of antioxidant defense elements--superoxide dismutase and fat-soluble antioxidants, decreased. It was noted that LPO became normal after intravenous administration of exogenous superoxide dismutase (6 mg/kg) and the blood substitute Mafusol containing Krebs cycle substrate--sodium fumarate (9 ml/kg). Inclusion of Mafusol into the combined therapy of patients with general peritonitis contributed to the reduction of malonic dialdehyde and diene conjugate levels in the blood, normalization of its acid-base state, diminution of medium mass molecule content. Similar normalization of LPO was not recorded when lactosol was used. It has been concluded that blood substitute Mafusol used in the combined therapy of patients with general peritonitis significantly raises the treatment effectiveness.

[Use of an artificial carrier of oxygen on the base of modified hemoglobin in patients with gastroduodenal hemorrhage]. / Primenenie iskusstvennogo perenoschika kisloroda na osnove modifitsirovannogo gemoglobina u bol'nykh s gastroduodenal'nymi krovotecheniiami.

Infusions of Helenpole used in 23 patients allowed for a short time to stabilize hemodynamics and to considerably improve the gas-transporting function of blood. The best curative effect in patients with hemorrhagic shock was obtained by means of intravenous jet infusions of the medicine, after stabilization of the hemodynamic indices with the help of an intravenous dropper (80-90 drops/min). The dose of the 1% solution of the medicine was 25-30 ml/kg of the patient's body weight.

[Effects of methods of freezing and thawing of blood plasma on the activity of procoagulants and antithrombin-III]. / Vliianie metodov zamorazhivaniia i razmorazhivaniia plazmy krovi na aktivnost' prokoaguliantov i antitrombina-III.

The authors investigated the activity of procoagulants and antithrombin-III after freezing and thawing of blood plasma by different methods. It was shown that quick freezing and thawing using special apparatuses best of all preserved the coagulative properties of the plasma. The medical efficiency of quick-frozen plasma was shown to depend on the method of freezing and thawing.

[An erythrocyte suspension in Modegel in the treatment of acute gastrointestinal hemorrhages]. / Vzves' éritrotsitov v "Modezhele" pri lechenii ostrykh gastroduodenal'nykh krovotechenii.

The effectiveness of a suspension of erythrocytes in the new colloid preservative "Modegel" (in 1:1 ratio) was studied in the complex treatment of 31 patients with severe gastroduodenal bleedings. It was established that the hemodynamic, antianemic action of the suspension was not inferior (and even excels) to the action of the whole preserved blood and the erythrocytic mass. The suspension transfusion has a favorable effect upon functions of the liver and kidneys, corrects the acidic-alkaline state of the recipients' blood, decreases the lipid peroxidation and has detoxicating properties. During transfusion of the suspension hypocoagulation of blood doesn't take place. The temperature reactions following the suspension transfusion are rare. The suspension of erythrocytes "Modegel" deserves wide introduction to clinical practice.

[Conservation of erythrocyte transfusion media after removal of leukocytes by filtration]. / Konservirovanie éritrotsitnykh transfuzionnykh sred posle udaleniia iz nikh leikotsitov metodom fil'tratovaniie.

Preserved whole blood and erythrocyte suspension in the colloid preservative "Modezhele" were studied after leukocyte filtration through newly designed leukofilter. Morphofunctional properties of erythrocytes from the filtered media remained much more potent than from the nonfiltered ones throughout 18 months of the follow-up. The filtered media exhibited good rheology and were free of microclots. It is suggested that a favourable effect of leukocyte elimination in conservation of erythrocytic media may result from inhibited activity of leukocytic enzymes, primarily, proteolytic.