[Legal responsibilities of anesthesia-resuscitation specialists for professional malpractice]. / Problemy iuridicheskoi otvetstvennosti anesteziologov-reanimatologov za professional'nye pravonarusheniia.

An experience of consulting at large medical insurance companies is indicative of that anesthesiology and resuscitation belong to most risky professions, which involve a possibility of inflicting an illegal damage on an insured citizen. The reasons of such a situation are as follows: a surface knowledge of the legal-and-normative aspects (which regulate the provision of medical care to citizens) by anesthesiologists and experts in resuscitation; a lack of profound erudition in the main fields of medicine and a comprehensive use of sophisticated medical instruments, which is a source of an extra danger to patients. The protection of both the doctor and the patients is an important issue under such conditions. Therefore, it is necessary to define the rights and obligations of anesthesiologists and experts in resuscitation, to master the normative acts regulating the standards of medical care and to obey strictly the fixed-by-law rights of patients.

[Peculiarities of immune responses during general anesthesia in otosurgery]. / Osobennosti immunnykh reaktsii pri obshchei anestezii v otokhirurgii.

Immune responses were investigated in 118 patients suffering from chronic purulent inflammation of middle ear. All of them were operated under different methods of anesthesia. Immunotherapy preceding intravenous anesthesia with combination of phentanyl and clophelline along with supporting spontaneous breathing was found to be the most optimal from the immunologic point of view. This anesthetic approach has such advantages as IgG, IgA elevation by 50%-100% and sIgA secretory antibodies content increment by 30% in local mucosal immune system, activating the macrophageal-phagocyte system of antigen treatment.

[The features of the brain immune system in brain neoplasms]. / Osobennosti immunnoi sistemy golovnogo mozga pri ego onkologicheskoi patologii.

Examining responses of the local immune system of the brain in neurocancer patients suggests that the immune system is involved in the neuroimmune interaction of both physiological and pathological conditions in the central nervous system (CNS). The setting off the local immune system of the brain is of functional nature, similar to functional analogy with the local system of the mucosae. By functional analogy, the aggregate of immune responses in the nervous tissue and cerebrospinal fluid should be called local and the system that includes these responses should named the local immune system of the brain. Due to the fact that nervous, endocrine, and immune regulatory pathways intersect in the CNS (hypothalamus), it is expedient to call this aggregate of defensive factors and mechanisms in CNS more broadly--the neuroimmune system.

[A system of individual immunotherapy with leakadin in the combined therapy of acoustic neurinomas]. / Sistema individual'noi immunoterapii leakadinom v kompleksnoi terapii nevrinom slukhovogo nerva.

Analyzing the immunological responsiveness of patients with acoustic neurinomas on the antitumor immunomodulator leacadin has revealed some significant features. In leacadin-treated patients, postimmunotherapy promotes the formation of high sanogenetic responses: an increase in the rigidity of the brain-immune system; elevations of the levels of antitumor factors of the immune system: T helper cells and locally synthesized antibodies; a decrease in neuro-sensitization after tumor removal, which prevents tumor stimulation and recurrence; an indirect reduction in the activity of T suppressors that inhibit immunological responses in growing neoplasm. Immunotherapy with the antitumor immunomodulator leacadin in patients with acoustic neurinomas contributes to the development and optimization of the tumor carrier's immunological adaptative responses, creates conditions for the optimal postoperative course and prevents recurrence.

[A system of individual psycho- and immunotherapy in neuroanesthesiological practice]. / Sistema individual'noi psikho- i immunoterapii v neiroanesteziologicheskoi praktike.

Effects of the newly developed system of individual immunotherapy on the immune reactions of patients with disc hernias were examined in order to validate the use of immunotherapy in neuroanesthesiology. Preoperative treatment in the form of standard immunotherapy with an immunomodulating agent leakadin has been shown to lead mainly to activation of the humoral immunity. A system of individually selected immunotherapy activates both humoral and cellular immunity and, judging from the helper-suppressor coefficient, the processes regulating the immune reactions as well.

[The immunological reactions and enzymatic activity of the cerebrospinal fluid in intracranial complications following neurosurgical operations]. / Immunologicheskie reaktsii i énzimaticheskaia aktivnost' tserebrospinal'noi zhidkosti pri vnutricherepnykh oslozhnenii posle neirokhirurgicheskikh operatsii.

The specific features of immunological responses and enzymatic activity of cerebrospinal fluid in the development of intracranial infectious complications were outlined in 16 neurosurgical patients after surgical interventions. On days 1-3-5 days after surgery, the immunobiochemical spectrum of cerebrospinal fluid showed substantial changes associated with the impaired permeability of the blood-brain barrier and the stress-induced transition of biochemical functional systems on the minimum functioning during anaerobic energy supply. Increasing lipid peroxidation processes reflect the result of catabolic reactions and energy deficiency, followed by intensive cytolysis of leukocytes and nerve cells. With this, antibody synthesis and great rises in the formation of circulating immune complexes is the essence of sanogenetic mechanisms basically aimed at eliminating the released and bound antigen in the given time interval.

[The individual immunotherapy of the intracranial complications after neurosurgical operations]. / Individual'naia immunoterapiia vnutricherepnykh oslozhnenii posle neirokhirurgicheskikh operatsii.

A system of individual immunotherapy is proposed which is based on the selection of an immunomodulator maximally suitable for the patients' immune system which is the therapeutic measure directed to the stimulation of forming the functional adaptive CNS dominant adequate to the pathological focus--the main component of sanogenesis in neuroanimatologic patients representing a complex of psychoneuroimmunoendocrine connections of the organism. As a result of immunotherapy the adequate adaptive CNS dominant makes concrete effector adaptive functional systems, determines the rate and sequence of the course of the adaptive reactions.

[A system of individual immunotherapy for intracranial complications and the local immune reactions of the cerebrospinal fluid]. / Sistema individual'noi immunoterapii vnutricherepnykh oslozhnenii i mestnye immunnye reaktsii tserebrospinal'noi zhidkosti.

The influence of the individual immunotherapy with the selection of the immunomodulator upon the level of lymphocyte functional activity on sanogenetic mechanisms of local immune system of the cerebrospinal liquid was investigated. It is shown, that sanogenetic potential of the CSF local immune system is mediated by the presence of sufficient adaptive resources, maintaining protective immunobiochemical processes in the active state for the whole period of adaptation to injury. Individual immunotherapy promotes optimization of the sanogenetic mechanisms in the cerebral local immunity system on postoperative period in complicated craniocerebral injury.

[The concept of the adaptive functional dominant of the CNS in clinical neurotraumatology]. / Kontseptsiia adaptivnoi funktsional'noi dominanty TsNS v klinicheskoi neirotravmatologii.

A conception of the adaptive functional dominant of the CNS is proposed for the description of general regularities of the course of patho- and sanogenesis in neurotramatologic patients. It was shown that the forming adaptive dominant is responsible for the development of adaptive processes in the posttraumatic period. The interaction of the functional dominant and adaptive potential of sanogenesis leads to the course of the disease with the natural outcome as recovery, complication or lethal outcome.