[Extracorporeal methods of hemocorrection in the combined treatment of patients with purulent surgical infection of soft tissues complicated by sepsis]. / Ekstrakorporal'nye metody gemokorrektsii v kompleksnom lechenii bol'nykh s gnoinoi khirurgicheskoi infektsiei miagkikh tkanei, oslozhnennoi sepsisom.

Extracorporeal methods of hemosorption and detoxication were used in treatment of 293 patients with purulent surgical infection of soft tissues complicated by sepsis. In 35 patients with the same nosology the methods in question were not employed. An analysis of the clinical observations has shown that lethality in the main group was reduced to 23.6%. The sorption technologies were shown to be most effective for normalization of leukocytosis, lekocytic index of intoxication, middle mass molecules in this group of patients.

[Effects of extracorporeal hemo-correction on lipid peroxidation in patients in critical states]. / Vliianie ékstrakorporal'noi gemokorrektsii na perekisnoe okislenie lipidov u bol'nykh v kriticheskikh sostoianiiakh.

The article presents an analysis of immediate influence of extracorporeal hemocorrection upon the indices of lipid peroxidation in resuscitation patients of a surgical profile. It was found that hemosorption, ultrafiltration and their combination exert a moderate detoxicating effect on lipid peroxidation products. The detoxicating effect of plasmapheresis is negligible. Hemosorption and ultrafiltration fail to influence the mechanisms of antioxidant defense, plasmapheresis eliminates the antioxidant enzymes from blood plasma, and the methods of quantum therapy stimulate the activity of superoxide dismutase.

[Optimization of indirect electrochemical detoxication in the treatment of different endogenous intoxications and multiple organ failure syndrome in resuscitation practice]. / Optimizatsiia nepriamoi élektrokhimicheskoi detoksikatsii pri lechenii razlichnykh éndogennykh intoksikatsii i sindroma poliorgannoi nedostatochnosti v reanimatologicheskoi praktike.

The authors have made a statistical analysis of clinical groups of patients in the units of resuscitation and intensive therapy of a general profile and of the archive materials of a laboratory of extracorporeal hemocorrection. The ultraviolet and laser photomodification of autoblood, hemosorption, plasmapheresis, ultra- and hemofiltration were used in the complex treatment of these patients. In the experimental group there were 190 patients on whom 333 operations of extracorporeal hemocorrection were made with using indirect electrochemical detoxication (IECD). In the control group there were 527 patients on whom 1048 analogous operations were made without IECD. The statistical processing of the results obtained has shown that IECD method does not have immediate detoxicating properties in relation to middle mass molecules and fails to substantially influence the processes of lipid peroxidation; sodium hypochlorite did not have a deteriorating effect on the clinical-laboratory status of patients with severe organic disorders. IECD was shown to potentiate the elimination potencies of hemosorption, plasmapheresis, ultra- and hemofiltration which resulted in 2.7 times less lethality. The mean bed-day was 2.8 days shorter, the bed-day in the resuscitation unit--1.2 days shorter.

[Extracorporeal hemocorrection in acute pancreatitis]. / Ekstrakorporal'naia gemokorrektsiia pri ostrom pankreatite.

An experience with using 340 operations of extracorporeal hemocorrection in complex intensive therapy of 160 patients with acute pancreatitis has been generalized. In 111 of these patients (69%) pancreatic necrosis complicated by the syndrome of multiple organ failure was diagnosed. Based on the mechanisms of medical efficiency the authors have developed differential indications for using different extracorporeal technologies depending on the clinico-laboratory profile of the endogenous intoxication, structure and degree of organic and systemic dysfunctions. The adoption of such technologies allowed lethality to be reduced from 37.5 to 27.6%.

[Classification of acute dysfunctions of organs and systems in multiple organ failure syndrome]. / Klassifikatsiia ostrykh narushenii funktsii organov i sistem pri sindrome poliorgannoi nedostatochnosti.

A classification of acute dysfunctions of the vital organs and systems in cases with multiple organ failure is proposed. It is suggested to assess the function as satisfactory, compensatory sufficiency, decompensated insufficiency, or failure. Clinical laboratory criteria of such rating are offered. Experience gained in the use of this classification is presented.

[Disorders of immunity in chest and abdominal injuries]. / Narusheniia immuniteta pri povrezhdeniiakh grudi i zhivota.

Under study were disturbances in the immune competent system in 245 patients with injuries of the chest and abdomen in dynamics of the early posttrauma period. Specific features of the disturbances were analyzed in the complicated and noncomplicated course of the trauma disease. The informative value and prognostic significance of certain indices are discussed as well as approaches to immune correction.

[Fibrinogen metabolism in juvenile uterine bleeding]. / Metabolizm fibrinogena pri iuvenil'nykh matochnykh krovotecheniiakh.

The levels of fibrinogen, monomeric fibrin soluble complexes (MFSC), fibrin-fibrinogen degradation products (FDP), and the status of blood coagulation and fibrinolytic systems were studied in girls suffering from juvenile uterine bleedings. Fibrinogen and MFSC levels were found lowered and FDP concentration increased in such bleedings. Fibrinogen concentration correlated with the activities of the coagulating and fibrinolytic systems, and the MFSC level only with the coagulating system activity. Mathematical analysis has revealed a relationship between blood fibrinogen metabolism and the activities of the coagulating and fibrinolytic systems, whose functions in this condition are relatively autonomous.

[Antibacterial and detoxification therapy in acute appendicitis]. / Antibakterial'naia i dezintoksikatsionnaia terapiia pri ostrom appenditsite.

An analysis of clinical effectiveness of antibacterial therapy, photomodification of autoblood, hemosorption and their combinations was made in 395 patients with acute appendicitis. It was established that no antibacterial and desintoxicating therapy is required in catarrhal appendicitis. The prophylactic application of photomodification of autoblood is thought to be most expedient for phlegmonous appendicitis at the postoperative period, a combination of antibacterial therapy and photomodified autoblood--for gangrenous appendicitis, a combination of antibacterial therapy, photomodification of autoblood and hemosorption--for appendicular diffuse suppurative peritonitis.

[The possible reasons for an increase in the concentration of middle-weight molecules in pathology]. / Vozmozhnye prichiny povysheniia kontsentratsii molekul srednei massy pri patologii.

Human plasma and blood were treated by kaolin, thromboplastin, streptokinase, phytohemagglutinin, hydrogen peroxide, and Fe2+. An increase in the amount of median-mass substances was found after incubation. The obtained data showed that activation of limited proteolysis, immunity, and peroxidation could be the cause of increase of median-mass substances in pathological conditions.

[Endogenous intoxication in chest and abdominal injuries]. / Endogennaia intoksikatsiia pri povrezhdenii grudi i zhivota.

Results of clinico-laboratory examinations of the endogenic intoxication in patients with injuries of the chest and abdomen are presented. Correlative relationships of the endogenic intoxication parameters and their association with the degree and character of injuries were established, the clinical informative value and prognostic significance of certain laboratory tests were determined. A conclusion is made on the necessity of a correction of endogenic intoxication in complex treatment of these patients.

[Crohn disease]. / Bolezn' Krona.

Among 2,443 patients who underwent operation for acute appendicitis in a period of 9 years 19 had Crohn's disease. The specific features of the clinical picture and the morphological changes are described. The diagnosis and surgical tactics in Crohn's disease are discussed. It is emphasized that alertness in relation to this disease in emergency surgery is necessary because of the danger of the development of grave complications. Recommendations with regard to the treatment of patients in the postoperative period are given.

[The effect of autotransfusion of photo-modified blood on the growth of Walker's carcinosarcoma]. / Vliianie autotransfuzii fotomodifitsirovannoi krovi na rost kartsinosarkomy Uokera.

The study deals with the influence of autotransfusion of blood treated with ultraviolet light on the growth of experimental Walker's carcinosarcoma in rats. Animals of the study group survived longer than controls. Autotransfusion of the photo-modified blood did not influence tumor growth rate. The anti-anemic action, the inhibitory effect on lipid peroxidation and retardation of immunodepression by photo-modified blood are the possible mechanisms accounting for an increase in resistance to tumor growth in rats.

[A method of studying the absorbent phase of phagocytosis]. / Sposob issledovaniia poglotitel'noi fazy fagotsitoza.

A method has been developed for examining phagocytosis, making use of the Soviet latex RFD-48. Optimal conditions of the procedure were specified, and results of measurements in normal subjects and patients and laboratory animals presented.

[Perfusion across a medium of lyophilized xenogeneic spleen in peritonitis and septic shock]. / Perfuziia cherez sredy liofilizirovannoi ksenoselezenki pri peritonite i septicheskom shoke.

The article presents results of an experimental study of hemoperfusion through slices of lyophilized xenogeneic spleen in peritonitis and septic shock in rabbits which demonstrated longer life and survival of the animals. The mechanisms of curative effect of the procedure and discussed. Two clinical observations of using the method in septic patients are presented.

[Photomodification of autologous blood in surgery]. / Fotomodifikatsiia autokrovi v khirurgii.

The use of the method of autologous blood photomodification in surgery is discussed on basis of generalized experience of the Leningrad Research-Practical Center of Blood Photomodification (3,000 procedures conducted in over 2,000 patients). The current state of the problem, the main mechanisms of the therapeutic action of the procedure, and the clinical efficacy of the method in various surgical diseases are dealt with. The possible complications and the means of their prevention are deal with. The methodological aspects of research are discussed. The authors define the main problems which must be solved in order to raise the efficacy of using photomodification of autologous blood in surgery.

[Limited proteolysis activation syndrome in surgery]. / Sindrom aktivatsii ogranichennogo proteoliza v khirurgii.

Under consideration is an original author's conception, formulated previously, of the syndrome of activation of limited proteolysis as an obligatory pathogenetic link of all pathological processes including the alteration at the tissue level as applied to surgical diseases. A universal character of the syndrome in acute and chronic surgical diseases and traumas, its role in their pathogenesis was shown in 1107 patients and 130 experimental animals. Variants of the course of the syndrome in different diseases are considered both in the postoperative and posttraumatic periods. The significance of the syndrome of activation of limited proteolysis for practical surgery is discussed.

[Endogenous toxemia in surgery]. / Endogennaia intoksikatsiia v khirurgii.

An analysis of the mechanisms of the development of endogenous intoxication was used to consider its role in pathogenesis of most serious surgical diseases and traumas and their complications. The role of endogenous intoxication is shown in the development of multiple organ insufficiency. Methods of extracorporal hemocorrection in treatment of endogenous intoxication are substantiated. Potentialities of the present-day methods of extracorporal hemocorrection and prospects of development are discussed.