[The surgical risk factors in patients with nonmalignant space-occupying lesions of the liver and the importance of immunological studies in assessing their extent]. / Faktory khirurgicheskogo riska u bol'nykh s nezlokachestvennymi ob''emnymi obrazovaniiami pecheni i znachenie immunologicheskikh issledovanii v otsenke ego stepeni.

Results of surgical treatment of benign new growths of the liver (BVML) depend not only on timely diagnosis of local growth but on precise analysis of surgical risk factors (SR) as well as accurate definition of its significance. The proposed classification helps to evaluate factors of SR in these patients. Results of the investigation showed that in majority of patients (94.7%) with BVML without complications immune system was were not suppressed. The fact may be considered as a favourable sign, demonstrating potential immunologic safety of patients in definite period of BVML development. Patients with lowered parameters of immunologic status made up a group of a high risk to develop inflammatory and septic complications in postoperative period. Definite correlation between the extent of immunodeficiency and frequency of postoperative complications has established the necessity of action to prevent the provocation of immunological status disturbances.

[Enteral tube feeding of patients after esophagoplasty]. / Enteral'noe zondovoe pitanie u bol'nykh posle plastiki pishchevoda.

A method for enteral catheter feeding is suggested. It was applied in 60 patients after esophagoplasty. The main group consisted of 23 females and 37 males aged from 18 to 68 years. Esophageal carcinoma was observed in 31, burn stricture of the esophagus 18, and other benign diseases of the esophagus in 11 cases. All patients were subjected to extirpation of the esophagus with one-stage posteromedial esophagoplasty in 57 patients with an isoperistaltic gastric tube and in 3 patients with the colon. The control group was formed of 20 patients who underwent the same operations. Inpitan, ovolact, and hypernutril were used for enteral catheter feeding. The catheter was introduced via the nasal passage and transplant into the proximal segment of the jejunum. The mixtures were administered in drops of 5 to 7 days after the operation. Only parenteral feeding was conducted in the control group. The disorders of the alimentary status were removed quicker in patients of the main group than in the control and the incidence of postoperative complications was less. Body weight and the nitrogen balance were restored within a shorter time in the main group patients and incompetence of the esophageal anastomoses developed in a lesser number of cases.

[Immunological indices of "drainage" blood used for compensation of blood loss]. / Immunologicheskie pokazateli "drenazhnoi" krovi, ispolzuemoi dlia vospolneniia krovopoteri.

The authors discuss experience in compensation for blood loss in patients with ischemic heart disease after aortocoronary shunting using drainage blood without or with donor blood (80 persons) and donor blood alone (60 persons). Mild changes of immunity cell factors were revealed and no differences in the concentration of class A, M, and G immunoglobulins and phagocytosis as compared to the indices recorded before the operation and 24 hours after it. Analysis of postoperative infectious-inflammatory complications showed their incidence to be less in patients who received drainage blood without or donor blood (23%) than in those given transfusion of only donor blood (55%). The results of the study allow drainage blood to be recommended for reinfusion.

[Microsurgical allotransplantation of fetal bone on a vascular peduncle: immunological aspects]. / Mikrokhirurgicheskaia allotransplantatsiia plodnoi kosti na sosudistoi nozhke: immunologicheskie aspekty.

The authors studied the immunological profile of three patients after transplantation of bone allobrephotransplants with their microsurgical revascularization in the recipient zone. A reaction of rejection of the transplanted brephobone did not occur in any of the three cases. In transplantation of a complex brephobone the soft tissues overlying it, rejection of the soft tissues was encountered but there were no signs of bone rejection. The data of immunological monitoring correlate with the results of the clinicolaboratory and histological studies.

[The immunological indices of patients with echinococcosis undergoing preoperative hemoexfusions]. / Immunologicheskie pokazateli u bol'nykh s ékhinokokkozom pri provedenii predoperatsionnykh gemoéksfuzii.

The immunologic parameters were studied in 38 patients with hydatid disease of the liver and abdomen before and after a single hemoexfusion (HE) in a volume of 400 ml. Among the patients who were examined there were those with uncomplicated hydatid disease of the liver (group I, second clinical stage, 25 persons), patients with suppuration of hydatid cysts (group 11, 10 persons), and two patients with multiple hydatid cysts complicated by their suppuration and calcification with involvement of large areas of the liver. Comparative analysis of immunological parameters in patients before and in the first 24 hours after HE showed a difference between the groups of patients and the controls. The parameters were restored to their initial values in patients of both groups 3-5 days after HE. The results of the study allow the conclusion that in screening patients with hydatid disease of the liver and abdominal cavity for preoperative HE a strict individual approach is necessary with the patient's general condition, the clinical form of the disease, and complications on the part of the cysts being taken into account.

[Early postoperative rejection crises after transplantation of the kidney from the living related donors]. / Rannie posleoperatsionnye krizy ottorzheniia pri peresadke pochki ot zhivogo rodstvennogo donora.

The frequency of the development of rejection crises in the early postoperative period in 32 recipients of allogeneic kidneys from alive related donors was analysed depending on the histocompatibility according to the antigens of the HLA-AB system and the nature of the immunosuppressant therapy. The results of the analysis showed that the frequency of rejection crises was 100% when the donor and recipient were compatible in 1-2 antigens, and 40% in compatibility according to 3-4 antigens. The incidence of rejection crises was 71.4% among patients who received the standard immunosuppressant therapy (corticosteroids + azathioprine) and 36% among those given also sandimmune. Analysis of the frequency of rejection crises according to the ABO blood group system to which the donor-recipient pair occurred, showed that rejection crises occurred most frequently among patients with A (II) blood group.

[Characteristics of immunologic homeostasis in the late period after reconstructive operations on the heart valves]. / Osobennosti immunnogo gomeostaza v otdalennom periode posle rekonstruktivnykh operatsii na klapanakh serdtsa.

The immune status, i.e. T and B lymphocytes and their populations, was assessed after heart valve replacement or reconstruction in 70 patients with acquired heart defects. In 30%, the immune status was found to be normal which corresponded to inactive rheumatic process in these patients; 40% showed activated immunity manifested by increased T-active, T-total, T-helper, and T-suppressor numbers compared to the first group, which corresponded to activation of a rheumatic process in these patients. The rest 30% patients showed suppressed immunity, i.e. diminished subpopulations of T lymphocytes and B lymphocytes. These changes were detected in patients with circulatory insufficiency and progressive septic endocarditis. This allows for a conclusion that determination of the status of immunity and its correction are essential for cardiac surgery patients.

[Immunological indicators as the criteria of prognosis and treatment of infectious complications in patients operated on for chronic nonspecific diseases of the lungs and pleura]. / Immunologicheskie pokazateli kak kriterii prognoza i lecheniia infektsionnykh oslozhnenii u bol'nykh, operirovannykh po povodu khronicheskikh nespetsificheskikh zabolevanii legkikh i plevry.

A correlation of clinical specific features of the postoperative period and dynamics of immunological indices in patients operated upon for chronic nonspecific diseases of lungs and pleura was established. Pyo-inflammatory complications were three times more often in decreased amount of T-lymphocytes after operation. HBO-therapy has an immunostimulating effect in the form of increased total and active T rosette-forming lymphocytes, causes more rapid elimination of purulent intoxication, purification of the pleural cavity from the purulent discharge and makes the period of treatment at the hospital shorter.

[Regulation of glutamine metabolism in Chlorella pyrenoidosa. Regulation of glutamine synthetase activity by adenylic system components]. / Reguliatsiia metabolizma glutamina u Chlorella pyrenoidosa. Reguliatsiia aktivnosti glutaminsintetazy komponentami adenilovoi sistemy.

A decrease of glutamine synthetase (E. C. 6.3.1.2.) activity was observed under the assimilation of ammonium nitrogen in Chlorella. At the same time a decrease of ATP content in Chlorella cells took place. The ATP content was 7-fold decreased, while ADP and AMP contents were 4-fold and 3-fold increased respectively, after 15 min. of Chlorella incubation on "ammonium" medium. Further incubation for 45 min, resulted in gradual increase of ATP content and in decrease of ADP and AMP contents. The value of energy charge in ammonium assimilating Chlorella cells sharply decreased for first 15 min. of incubation and then it normalized gradually. The experiments with glutamine synthetase preparation, isolated from ammonium assimilating cells, have shown that ADP and AMP are strong inhibitors of the enzyme in the presence of Mg2+, and only ADP produces the inhibitory effect in the presence of Mn2+. No enzyme reactivation was observed after the transfer of ammonium assimilating cells into nitrogen-free medium or nitrate medium, the enzyme activity increasing at the expense of enzyme protein synthesis denovo.

[Glutamine metabolism regulation in Chlorella pyrenoidosa. Regulation of Chlorella glutamine synthetase activity by amino acids]. / Reguliatsiia metqbolizma glutamina u Chlorella pyernoidosa. Reguliatsiia aktivnosti glutaminsinettazy khlorelly aminokeslotami

Effect of glutamine and its metabolites (amino acids) on Chlorella glutamine synthetase (GS) (E.C.6.3.1.2) in the presence of Mg or Mn was studied. Purified GS preparation was used, isolated from Chlorella grown in the presence of NH as a sole nitrogen source. Glutamate, aspartate, alanine and glycine inhibit GS activity in the presence of both Mg and Mn. Tryptophane and valine (up to 15 mM) activate GS in the presence of Mn. Tryptophane inhibits GS in the system with Mg. Sinergistic inhibition was observed under the combined effect of amino acids on GS in the presence of Mn and aspartate or alanine. The change of GS activity observed is supposed to be due to the inhibitory effect of glutamine and amino acids studied, since the glutamine content is increased (in 2.5 times for 5 min) and that of alanine and dicarbonic amino acids (for the following 15 min) under NH assimilation in Chlorella cells.

[Regulation of glutamine metabolism in Chlorella pyrenoidosa. Mechanisms of regulating the activity of glutamine synthetase during ammonia assimilation]. / Reguliatsiia metabolizma glutamina u Chlorella pyrenoidosa. Issledovanie mekhanizmov reguliatsii aktivnosti glutaminsintetazy v protsesse assimiliatsii ammoniia

Glutamine synthetase (GS) (E.C.6.3.1.2) activity in Chlorella cells decreased when NH4+ was added to nitrogen-free growth medium. This GS inactivation had such a rate, that it could not be due to the repression of enzyme synthesis: the GS activity decreased by 20% within 5 minutes of NH4+ assimilation. Glutamine content in cell increased in 2.5 times for this period. In vitro experiments have shown that glutamine is a strong inhibitor of GS from Chlorella grown in the presence of NO3-, and in a less degree--an inhibitor of GS from cells grown in ammonium-containing medium. The data obtained are negative with respect to possible mechanisms of GS activity regulation via adenylation and ATP-dependent destruction of glutamine synthetase.