[Experience in treatment of combined osteovascular limb injuries in children].

The article is dedicated to one of the currently important problems of present-day traumatology and angiosurgery, i. e. possibility of performing primary reconstructive operations in children with complete and incomplete amputations, open and closed bone fractures in the conditions of circulatory impairment. The authors share their experience in treatment of 92 patients presenting with such injuries, describing the main indications for carrying out repair operations, and drawing appropriate conclusions. The main stages of reconstructions are demonstrated by a series of clinical examples.

[Intraocular lens implantation into anterior capsule in the cases of posterior capsule rapture during phacoemulsification].

Rationale and safety of IOL implantation into anterior capsule in the cases of posterior capsule rapture during phacoemulsification and secondary IOL implantation into capsule duplication of aphakic eye. Degree of postoperative refractive changes is estimated.

[Experience with the treatment of combined open injuries to the upper extremities with affected main arteries].

The paper deals with the principles of management of combined mechanical injuries to the upper extremities with special reference to amputation of their segments based on the 3-year experience with the treatment of 1488 patients including 405 ones with traumatic amputations. Replantation of large and small segments was undertaken in 24 and 76% of the cases respectively. 43% of the patients underwent one-step traumatic amputation of two and more segments. Skin and soft tissue defects occurred in 111 patients including 27 with extensive lesions. 82.4% of the surgical interventions had the desired outcome. An example of successful replantation is described. The results are compared with the literature data.

[State of water and its diffusion across lipid bilayers: effect of hydration degree].

The state of adsorbed water (estimated from the dependence of the shape of the 1H NMR spectrum on the angle between the normal to the bilayers and the direction of the magnetic field) and the diffusion of water molecules in the direction of the normal to the bilayers (estimated by 1H NMR spectroscopy with the impulse gradient of magnetic field) in microscopically oriented dioleoylphosphatidylcholine bilayers have been studied depending on hydration. The dependences of the shape of the NMR spectrum on angle differ qualitatively only at concentrations of water greater and less than the concentration that is achieved upon hydration from saturated vapors chi(eq) (about 23 weight %). At concentrations below chi(eq), all water present in samples enters the hydrate shells of polar "heads" of lipids or is in the state of "rapid exchange" with the water of hydrate shells, with the result that the signal of spin echo for water is observed only in a narrow range of angles close to the "magic angle", 54 degrees C. At concentrations above xhi(eq), the signal of spin echo for water is retained at all orientations, indicating probably that part of water between the bilayers ("quasi-free water") is in the state of a "slow exchange" with water "bound" to polar "heads". It was found that the coefficient of self-diffusion of water across the system of bilayers inversely depends on the degree of hydration, which is described in the Tanner model with consideration of the self-diffusion of water molecules in the hydrophobic moiety of the bilayer. The permeability of the bilayer, the coefficient of distribution of molecules between the water and lipid phases, and the coefficient of self-diffusion of water in the hydrophobic moiety of the bilayer were estimated.

[Preliminary results of lymphatic chemotherapy in the treatment of rectal cancer]. / Predvaritel'nye rezul'taty limfaticheskoi khimioterapii v lechenii raka priamoi kishki.

Preliminary results of treatment of 28 patients with cancer recti, in whom lymphatic chemotherapy was applied and operative intervention as well, were studied. The results of treatment in control group, consisting of 28 patients, to whom neoadjuvant systemic chemotherapy was conducted, are adduced. Comparative analysis performed have shown that general toxic signs occurred three times lesser in patients of the main group, than in a control one; the postoperative complications was two times lesser. In one-year follow-up in the main group the recurrences and metastases were absent, in a control group the tumor recurrence had occurred in 3 (10%) of patients.

[Possibility of combined surgeries in locally advanced rectal cancer]. / Vozmozhnosti vypolneniia kombinirovannykh khirurgicheskikh vmeshatel'stv pri mestno-rasprostranennoi forme raka priamoi kishki.

Results of treatment of 28 patients with locally advanced rectal cancer are analyzed. Abdomino-perineal extirpation of the rectum with colostomy was performed in 11 patients, abdomino-anal resection with colo-anal anastomosis--in 10, Hartmann's operation--in 7. In 18 cases resection of the posterior wall of the urinary bladder was performed simultaneously, in 3--resection of the ureter with allotransplantation, in 5--supravaginal amputation of the uterus. Eleven patients survive one year after surgery. General status evaluated with Karnovsky's scale was 80-90% in 5 patients, 60%--in 4, and 40% in 2 patients. Seven patients survive three years after surgery. Karnovsky's scale index was 80% in 3 patients of them, 60%--in 3, and 30%--in 1 patient. Four patients survive 5 years with 60% (3 patients) and 40% (1 patient) general status index. It is recommended to perform combined surgeries for rectal cancer in invasion of the tumor into neighbouring organs. They don't make worse immediate results of treatment and relieve patients of complications due to spread of rectal cancer into the urinary organs.

[Correlation between clinical course and otitis media purulenta chronica and tonicity of autonomic nervous system]. / Zavisimost' klinicheskogo techeniia khronicheskogo gnoinogo srednego otita ot tonusa vegetativnoi nervnoi sistemy.

The study of the autonomic status of the body in 38 patients with different forms of chronic purulent otitis media (CPOM) has demonstrated that patients with exacerbation or complication of CPOM were for the most part sympathotonics and normotonics. The former had more persistent disease with more frequent recurrences.

[The morphology of regional lymphatic nodes in lymphotropic therapy of acute otitis media]. / Morfologiia regionarnykh limfaticheskikh uzlov pri limfotropnoi terapii ostrogo srednego otita.

Lymphotropic therapy (LT) was given to rabbits with experimental acute otitis media. The response was good. Reduced vascular blood filling, edema tissue detritus, fibrin, more compact location of lymphocytes in the lymph node cortex reflected normalization of the lymph node structure and improvement of the drainage function.

[Efficacy of antioxidant therapy in patients with acute and chronic purulent otitis media]. / Otsenka effektivnosti antioksidantnoi terapii bol'nykh ostrym i khronicheskim gnoinym srednim otitom.

The examination of 90 patients referred to hospital for otitis media purulenta (OMP) and 25 healthy subjects included assessment of lipid peroxidation by content of malonic dialdehyde and intensity of chemoluminescence. Enzymes of antioxidant system were also measured (superoxide dismutase and catalase in blood plasma and wash-offs from the acoustic meatus and postoperative cavities). The measurements gave different values for the above parameters for healthy and OMP subjects. Conventional treatment reduced levels of LPO products and raised the activity of antioxidant enzymes, but control values were reached only in adjuvant parenteral administration of lipostabil and local administration of alpha-tocopherol. Also, earlier relief of clinical symptoms shortened the hospital stay.

[Soil pollution by heavy metals in certain agricultural areas of Bashkortostan]. / Zagriaznennost' tiazhelymi metallami pochv nekotorykh sel'skokhoziaistvennykh raionov Bashkortostana.

Three soil-climatic regions of Transural Bashkortostan exemplify a problem of soils pollution with heavy metals. The metals content of soil in the regions is near or slightly exceeding the background level. The studies revealed some features of the metals spread in soil of the regions studied. The metals content of soil in the regions do not restrict agricultural utilization of those soils.

[The dynamics of the signal-averaged ECG in myocardial infarct patients]. / Dinamika signal-usrednennoi EKG u bol'nykh infarktom miokarda.

To study the dynamics of signal-averaged ECG and late potentials (LP) in the first month of myocardial infarction (MI) and the impact of coronary reperfusion on them, examinations were made of 98 patients with primary myocardial infarction, in 69 of whom coronary reperfusion was achieved. LP was found to be detectable just in the first hours of MI, their stabilization (steady-state appearance or cessation) mainly occurred at day 3 of the onset. LP detection at this time allowed them to be predicted before the patients' discharge (70% sensitivity and 95% specificity, 82% predictive value in the first 24 hours of MI, LPs are characterized by more instability than those in the subsequent period of the patients' hospitalization. Thrombolytic therapy and coronary artery patency have no impact on the frequency of LP recording and parameters of signal-averaged ECG. No significant difference was found in the frequency of recording LP in anterior and inferior MI before discharge. The frequency of LP recording does not depend on the sex and age of a patient, the maximum creatine phosphokinase levels, and the presence of postinfarction angina pectoris and heart failure.

[Comparison of the data of 24-hour ECG monitoring and the condition of the coronary bed in patients with the variants of the course of unstable stenocardia]. / Sopostavlenie dannykh sutochnogo monitorirovaniia EKG i sostoianiia koronarnogo rusla u bol'nykh s razlichnymi variantami techeniia nestabil'noi stenokardii.

A total of 232 patients with various clinical types of unstable angina pectoris were examined. All the patients underwent coronary angiographic studies, 24-hour ECG monitoring. In 40.5% of the patients, 24-hour monitoring revealed transient ST segment changes which were not accompanied by pain in 47% of the cases. ST segment changes were equally encountered in patients with one-, two-, and three-vessel disease in the presence or absence of pain. Ischemic ST segment changes generally occurred with an anginal episode in patients with crescendo unstable angina, whereas in those with more prolonged and intensified pain and angina at rest in particular, silent myocardial ischemic episodes were significantly more frequently recorded, which were more common in these patients with multivessel disease.

[Hemodynamic effects of intravenous allapinine in patients with myocardial infarction]. / Vliianie vnutrivennogo vvedeniia allapinina na gemodinamiku u bol'nykh infarktom miokarda.

Single intravenous allapinine, 30 mg, given to patients with acute myocardial infarction, including those with moderate circulatory insufficiency, fails to affect central hemodynamic parameters or has a favourable action: normalizes pulmonary diastolic pressure, cardiac index, diminishes total peripheral vascular resistance. The agent also produces a weak antihypertensive effect and increases heart rate.

[Pharmacodynamics of allapinine during long-term infusion in patients with chronic ischemic heart disease and frequent ventricular extrasystole]. / Farmakodinamika allapinina dlitel'noi infuzii u bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa s chastoi zheludochkovoi ékstrasistoliei.

During a prolonged (24-hour) intravenous administration in a dose of 126 mg, allapinine produced a stable pronounced antiarrhythmic effect in 90% of the patients with frequent premature ventricular contraction and adverse reactions in the central nervous system in 65% of the cases. However, the latter effect of allapinine is short-term and ceased independently without altering the infusion rate. More serious adverse effects (hypotensive reactions, proarhythmic effects) occurred in 4% of the cases.

[Unstable stenocardia: prognostic significance of painless forms of myocardial ischemia during hospitalization and in the remote period]. / Nestabil'naia stenokardiia: prognosticheskoe znachenie bezbolevykh form ishemii miokarda vo vremia gospitalizatsii i v otdalennom periode.

Variants of unstable angina pectoris were compared upon examination of 366 relevant patients. 24-h ECG monitoring registered painless ST shifts in 75 of them. Treatment at hospital produced results independent of ischemia form (painful or painless). However, the analysis of long-term response for 10 patients demonstrating episodes of ischemia at discharge suggests that in spite of numerous adjustments of treatment in 70% of the patients the risk of unfavorable outcome seems great.

[The effect of x-ray irradiation on the cytochrome P-450-dependent mono-oxygenase system of the liver in different animal species]. / Vliianie rentgenovskogo oblucheniia na tsitokhrom P-450-zavisimuiu monooksigenaznuiu sistemu pecheni u razlichnykh vidov zhivotnykh.

The whole X-irradiation (7 Gy) of male rat, mouse and guinea-pig caused in general similar alterations in the content of cytochrome P-450 and aminopyrine-N-demethylase activity in liver microsomes. On the 5-7th day after irradiation the parameters were 39-79% of the normal level. The same postradiation changes were observed in females of these animal species but in females of rats and guinea-pigs the effect was less expressed. The depression of activity in liver microsomal cytochrome P-450-dependent monooxygenase system has been concluded to be one of the characteristic features of acute form in radiation damage.