[Changes in the cellular immunity factors in suppurative complications of penetrating craniocerebral trauma]. / Izmenenie faktorov kletochnogo immuniteta pri gnoinykh oslozhneniiakh pronikaiushchei cherepno-mozgovoi travmy.

The authors examined patients with penetrating cerebrocranial trauma (CCT) and uneventful course of traumatic disease (30) and those with CCT complicated by intracranial purulent process (24 persons). A direct correlation of the marked character and severity of the clinical course of the posttraumatic period and the changes in the immune system was revealed. Increase of the level of neutrophil rosette formation, indices of the NST test, the activity and intensity of neutrophil phagocytosis in penetrating CCT allows the development of an intracranial purulent process to be predicted at an early stage before the appearance of clinical sings. Decrease of the number of spontaneous rosette-forming and formazan-positive neutrophils is an indication of an unfavourable course of an intracranial purulent complication with a fatal outcome.

[The experimental and clinical use of gelatin sponges with kanamycin and gentamycin for the prevention and treatment of suppurative complications in neurosurgery]. / Eksperimental'noe i klinicheskoe primenenie zhelatinovykh gubok s kanamitsinom i gentamitsinom dlia profilaktiki i lecheniia gnoinykh oslozhnenii v neirokhirurgii.

Antiseptic gelatin sponges with kanamycin and gentamicin, which were studied in experiments on animals and used in the clinic, are a reliable measure for the prevention of suppuration in craniocerebral surgery in planned operations and in combination with debridement in penetrating injury of the skull and brain. For therapeutic purposes, local application of the agents is effective in focal suppurative processes in the skull and brain after surgical debridement of the purulent focus (abscess of the brain, osteomyelitis of the skull, etc.).

[Local blood flow and metabolism in a focus of cerebral crushing]. / Lokal'nyi krovotok i metabolizm v oblasti ochaga razmozzheniia golovnogo mozga.

Study of ECoG, local cerebral circulation, and brain pO2 in 39 patients in the acute period of severe craniocerebral injury, as well as morphohistochemical measurements around the focus of crushing (in experiments) showed that the transitional zone is a risk zone because the "enzymatic death" of the tissue of this zone occurring at the moment of the injury predetermines extension of the areas of necrosis later on. The most effective measure is the removal not only of the detritus but also of the transitional zone of the focus within the range of tissue that had hardly suffered any changes and the inclusion of vasoactive and dehydration agents in the therapeutic complex.

[Alloplasty of dura mater defects with identical tissue prepared and transported in formalin-containing gel media]. / Alloplastika defektov tverdoi mozgovoi obolochki odnoimennoi tkan'iu, zagotovlennoi i transportirovannoi v formalinsoderzhashchikh gel'-sredakh.

The storage of dura mater transplants in formalin-containing gel media which allow the entire process of preparation of the biological material to be conducted in non-sterile conditions is substantiated experimentally and clinically. A formalinized allogenous tissue of the same name transplanted in experiments and in the clinic into a defect in the dura mater undergoes active reorganisation and is replaced within a year with a newly-formed connective tissue which does not differ in architectonics from the dura mater of the recipient. When transplants of the dura mater stored in formalin-containing gel media were used in the clinic (172 operations) no complications of the type of liquorrhea, prolapse of the cerebral tissue or coarse subdural adhesions were noted. Suppuration developed in 3 patients (1.7%). The cause of the suppuration, however, was not associated with the transplant. All this makes it possible to recommend allogenous transplants of dura mater stored in formalin-containing gel media for wide use in the practice.