[ZINAIDA KAZIMIROVNA ZABEGALSKAIA--THE FOUNDER OF SURGERY SCHOOL IN ORENBURG].

In 2014, the year of the seventieth anniversary of the Orenburg medical academy, will be ninetieth birthday of prominent surgeon, scientist, public figure, excellent pedagogue Zinaida Kazimirovna Zabegalskaia.

[Minimally invasive surgery of pancreonecrosis--progress and problems].

An analysis of treatment of 133 patients with acute pancreatitis using minimally invasive surgical interventions (laparoscopic and puncture-draining operations) has shown that in cases of total pancreonecrosis these methods were little effective in most cases as a definitive method of surgical treatment and may be considered as the first stage of complex process of treatment. However, for certain forms of pancreonecrosis the minimally invasive surgery plays one of the leading roles in the improvement of results of treatment in the general population of patients with destructive pancreatitis.

[Use of perftoran in complex treatment of acute pancreatitis].

Efficiency of using perftoran in acute pancreatitis was determined by studying the dynamics of the level of lactic acid, ascorbic acid, one of the terminal metabolites of lipid peroxidation--TBA-active products in blood serum. Using perftoran was shown to considerably reduce manifestations of hypoxia and the degree of free radical processes that is evidence of antiischemic effect of perftoran in treatment of acute pancreatitis.

[Specific changes of the thrombocyte aggregation function in acute pancreatitis].

On the basis of investigations of thrombocyte aggregation in 126 patients with acute pancreatitis it was shown that independent of the severity of the pancreatitis the aggregation function of thrombocytes decreased. The effective treatment resulted in its normalization not earlier than within 15 days.

[Changes of immune indices in pancreonecrosis and their correction]. / Izmeneniia nekotorykh immunologicheskikh pokazatelei pri pankreonekroze i ikh korrektsiia.

Indices of immune status, lipid peroxidation and intoxication syndrome were assessed in 54 patients with acute destructive pancreatitis after surgery. Immunodeficiency developed in pyoseptic complications. Polyoxidonium was used in 22 patients for correction of secondary immunodeficiency. This drug reduces number of septic complications, lethality and hospital day.

[Prognostic value of the content of lipid peroxidation products in tissues at pancreatic necrosis]. / Prognosticheskoe znachenie soderzhaniia produktov lipoperoksidatsii v tkaniakh pri pankreonekroze.

The exact role of lipid peroxidation in pathogenesis of pancreatonecrosis was established by means of studying the level of dienic conjugates and malonic dialdehyde in the intraoperative bioptates of the pancreas, liver, lymph nodes of the lesser omentum in 40 patients as well as in the autopsy material (similar tissues, spleen and bone marrow) in 18 patients dead of destructive pancreatitis. The control group included 10 patients dead of sudden death (normal), group of comparison (those who died of acute myocardium infarction--10 subjects) and of acute surgical abdominal pathology not associated with pancreatitis (10 subjects). Demonstrable activation (6-10 times) of processes of lipid peroxidation in all the bioptates under study took place at pancreatonecrosis as compared to the normal that suggests generalization of lipid peroxidation at this pathology. The level of lipid peroxidation can show the degree of destruction in the pancreas that can be considered as a criterion of the outcome of the disease. In the groups of comparison the level of lipid peroxidation was much lower than at pancreatonecrosis that suggests the pathogenetic role of activation of lipid peroxidation in the development of this disease.

[Experimental-clinical basis for using sporobacterin in the combined treatment of pancreonecrosis]. / Eksperimental'no-klinicheskoe obosnovanie primeneniia sporobakterina v kompleksnom lechenii pankreonekroza.

Experimental investigations on translocation of the intestinal microflora on the model of acute pancreatitis were performed in 54 animals (albino rats) and showed an increased bacterial dissemination of parenchymatous organs of the abdominal cavity as the inflammatory and destructive alterations increased in the pancreas. E. coli aggravated the inflammatory alterations in the pancreas while B. subtilis promoted reparative processes. Experimental substantiation is given to using sporobacterin in the complex postoperative treatment of patients with pancreatonecrosis.

[Characteristics of immunologic disorders in patients with acute destructive pancreatitis]. / Kharakteristika immunnykh narushenii u bol'nykh ostrym destruktivnym pankreatitom.

Examination of immunological status in patients with acute destructive pancreatitis with uncomplicated (14 patients) and complicated (infectious-inflammatory processes--18 patients) postoperative period illustrated depression of T- and B-links of immunity, reduction of absolute and relative number of TFU- and TFC-lymphocytes. All the patients demonstrated reliable elevation of phagocytic rate, phagocytic index and number of circulating immune complexes. These changes were more significant in patients with complicated postoperative period. Level of lactoferrin in patients with complicated period was by 10% higher than in patients without complications. Significant elevation of tumor necrosis factor Ia in blood was registered in patients of both groups. During all the periods of examination the level of interleukin-8 was higher in patients with complicated postoperative period than in the patients with favorable postoperative period. This interleukin-8 is a reliable marker of postoperative complications in acute destructive pancreatitis.

[Lipid peroxidation in acute surgical diseases of abdominal cavity organs]. / Perekisnoe okislenie lipidov pri ostrykh khirurgicheskikh zabolevaniiakh organov briushnoi polosti.

The study of lipid peroxidation (LPO) characteristics in patients with acute mesenterial circulatory disturbances (64), acute pancreatitis (44) and acute bowel obstruction (46) allowed the conclusion on informative value of determination of malonic dialdehyde and diene conjugates in the blood for staging these diseases and the degree of severity of endotoxicosis. On the basis of the state of LPO it became possible to evaluate the extent of bowel failure. According to LPO in postoperative period the process of development of vascular rethrombosis in the bowels could be assessed. The varieties of lipid peroxidation products in peripheral venous blood can be used for differential diagnosis of such diseases, similar in their clinical symptoms, as acute pancreatitis and acute bowel obstruction.

[The use of biosporin in treating an experimental suppurative wound]. / Primenenie biosporina v lechenii éksperimental'noi gnoinoi rany.

The effect of biosporin biopreparation on the agents of suppurative wound infection in the experiment on rabbits was studied. A positive effect of the preparation on healing of a suppurative wound was noted.

[Volemic indicators in patients with acute cholecystitis]. / Pokazateli volemii u bol'nykh ostrym kholetsistitom

The work is concerned with changes in extracellular fluid and its ingradient--interstitial volume, in particular, as well as TCB and its components influenced by an operative intervention, performed in patients over 50 years of age for acute cholecystitis. Based on the data obtained, it is concluded that in the early postoperative period along with parenteral injection of fluids also it is essential to correct the deficiency of TCB and its components by administration of high-molecular compounds, protein substances, plasma.