[The single-stage surgical treatment of the complicated colon cancer].

The results of the single-stage surgical treatment of 54 patients with the complicated forms of colon cancer were analyzed. All patients had radical operations with the formation of primary intestinal anastomosis. For the improvement of the results we have optimized the algorithm of the diagnostics and treatment of such patients, including the endoscopic colon decompression with its recanalization and colic stasis liquidation. The approach to the colon cancer, complicated with the intestinal bleeding was also optimized by the use of intensive hemostatic and substitutional therapy. The optimal use of the described above methods allowed the single-stage radical endosurgical treatment of the patients.

[Early evaluation of blood loss by the profile of blood proteins in patients with injuries]. / Ranniaia otsenka ob"ema krovopoteri po profiliu belkov plazmy krovi u bol'nykh s travmoi.

The concentrations of positive (C-reactive protein, orosomucoid, haptoglobin, ceruloplasmin) and negative (transtiretine, alpha 2-macroglobulin, transferrin) markers of acute phase response were measured in 55 victims with injuries to hollow organs on day 1 of hospitalization. By visual intraoperative evaluation of blood loss, the patients were divided in 2 groups: with blood loss under 1 liter (n = 32, group 1) and more than 1 liter (n = 23, group 2). Acute phase response was more manifest in group 1. Blood loss affected the levels of orosomucoid and haptoglobin, which is explained by functional characteristics of these blood proteins. Orosomucoid and haptoglobin tests were highly sensitive, specific, and accurate in evaluation of blood loss in patients with hollow organ wounds (87.5, 90, 89% and 80, 80, 80%, respectively). The content of these proteins equal to no more than 1 g/liter during the first day after the injury indicates blood loss higher than 1 liter with high probability.

[Postoperative treatment of retroperitoneal fat suppuration in patients with gastrointestinal injuries]. / Posleoperatsionnoe lechenie nagnoenii zabriushinnoi kletchatki u bol'nykh s travmoi zheludochno-kishechnogo trakta.

Early diagnosis of retroperitoneal festering is possible if methodologically strictly carrying out of succession of radiation methods (US, computed tomography, roentgenological examination) is applied and used in complex. Extraperitoneal approach to phlegmon of retroperitoneal cellular tissue provides good visualization and is less traumatic. Infusional and enteral therapy in postoperative period promote effective elimination of volemic disturbances, stabilization of hemodynamic indices, and provides stable curative effect.

[Use of ultravist to examine the gastrointestinal tract in patients with emergency abdominal pathology]. / Ispolzovanie ultravista dlia issledovaniia ZhKT u bolnykh s ékstrennoi abdominalnoi patologiei.

The paper deals with the results of using the nonionic water soluble contrast agents ultravist 300 and ultravist 370 (Schoring, Germany) to examine the gastrointestinal tract (GIT) in 21 patients with acute abdominal abnormality. GIT contrasting was made in 9 patients in the early postoperative period and in 12 patients on their admission to the Institute. The examinations revealed the high contrast rate of the above agent when administered into the stomach and upper small intestine, which excluded failure of gastroenteroanastomic sutures and the sutured gastric wall in 2 patients, established, in terms of gastric displacement and deformity, left-sided subdiaphragmatic abscess, and in terms of transposition of a portion of the gastric fornix into the pleural cavity, rupture of the left diaphragm, and to exclude diaphragmatic rupture with closed abdominal injury. The revealed important quality of ultravist within a short time (1-2 hours) to contrast the small intestine and enter the colon enabled differential diagnosis to be made between complete and partial small intestinal ileus and between early comissural small intestinal ileus and postoperative intestinal paresis. Ultravist contrast studies allowed the authors to avoid an emergency operative intervention and to follow up the resolution of ileus during medical therapy.

[Effect of ranitidine on the function of the gastric glucocorticoid receptors]. / Vliianie ranitidina na funktsiiu gliukokortikoidnykh retseptorov zheludka.

The authors studied ranitidine effects on the function of glucocorticoid receptors (GR) of gastric cytosol in patients with massive bleeding from gastric ulcer. Fast cytosol was obtained from the tissues taken from the great culvature of the resected stomach. GR type II and III were identified using 3H-acetonide triamcinolone and 3H-hydrocortisone with high specific activity, respectively. Ranitidine (10(-3) and 10(-2) M) effects on the function of GR type II and III were analyzed according to Scatchard. Ranitidine (10(-2) M) increased 4 times the number of sites of glucocorticoid receptor binding for acetonide triamcinolone and aroused the association constant of hormone-receptor complex. Ranitidine dose-dependently reduced the number of binding sites of GR type III for hydrocortisone. Thus, ranitidine modulates type II and III GR function.

[Use of dalargin in the intensive therapy of critical conditions]. / Vozmozhnosti ispolzovaniia dalargina v intensivnoi terapii kriticheskikh sostoianii.

The paper analyzes whether the national synthetic leukenkephalin analogue dalargin can be used in the prevention and treatment of postoperative polyorgan deficiency. Dalargin has been experimentally demonstrated to be effective in preventing impairments in transcapillary fluid exchange, by stopping the development of pulmonary edema. The use of the drug in the intra- and postoperative period in patients undergone cardiac surgery during general assisted circulation reduced the incidence substantially and decreased the severity of respiratory distress syndrome. The experimental and clinical findings suggest that dalargin has pulmono-, hepato-, and pancreatoprotective properties. Thus, dalargin should be used in the multimodality intensive care of postoperative polyorgan deficiency.