[Conservative methods of treatment of wounds during the great patriotic war (according to the magazine "the hospital case")].

The article investigates reasons of increase of labour-saving innovations and inventions made by physicians during the great patriotic war. It is proved that suggestions made during the analyzed period (1942) showed no much novelty and originality. From the article it follows that soviet physicians at the beginning of the Great Patriotic War had no proper knowledge about military surgery.

[Osmotic activity of plasma in plasmapheresis in patients with multiple myeloma]. / Osmoticheskaia aktivnost' plazmy pri plazmafereze u bol'nykh mnozhestvennoi mielomoi.

AIM: To control safety and efficiency of therapeutic plasmapheresis (PA) by osmolality, colloido-osmotic pressure (COP), total protein concentration before and after the procedure in patients with paraproteinemic hemoblastosis. MATERIAL AND METHODS: 20 patients with multiple myeloma have undergone 42 PA procedures conducted by two techniques: continuous flow centrifugation on blood fractioners or intermittent centrifugation of blood in plastic containers. The removed plasma volume averaged 1/3 (group 1) or 2/3 of the plasma volume (group 2). The removed protein reached 62-197 g. Isotonic sodium chloride solution and/or reopolyglucin (20-60 g) replaced the removed plasm. Total protein concentration was measured colorimetrically in biuretic reaction, plasma osmolality--cryoscopically and COP--on Knauer osmometer. RESULTS: PA leads to a short decline in osmolality (97.0-99.1%), of total protein concentration (82.8-78.6%) and of COD (79.2% in replacement with saline and 90.2% in replacement with dextran). During recovery after the procedure plasma osmotic activity and protein concentration return to the baseline. CONCLUSION: In elimination of 1/3 of plasma volume and crystalloid infusion, hemodilution promotes release of abnormal proteins from the tissues into the circulation and thereafter removal them from the organism. In removal of 1/2 and more of plasma volume, COP demans correction made by administration of colloids, e.g. solution of low molecular dextran. There is a potential danger of COD lowering several hours after PA due to different speed of dextran elimination and mobilization of protein reserve.

[The efficacy of high-dose chemotherapy and the transplantation of autologous hemopoietic cells in lymphogranulomatosis]. / Effektivnost' vysokodoznoi khimioterapii i transplantatsii autologichnykh gemopoéticheskikh kletok pri limfogranulematoze.

AIM: To determine clinical effectiveness of high-dose polychemotherapy (PCT) and transplantation of autologous hemopoietic cells (TAHC) in patients with lymphogranulomatosis (LGM). MATERIAL AND METHODS: 27 LGM patients aged 16-42 years who have undergone TAHC after high-dose PCT (BEAM--17 patients or CBV--10 patients). 4 patients given high-dose PCT were in the first-second complete remission (CR), 7 patients--in the first partial remission (PR). Prior to TAHC, 8 patients had one, two and more relapses of LGM, and 8 patients had no remission at all. Bone marrow, hemopoietic blood cells and both were transplanted to 17, 2 and 8 patients, respectively. Mobilization of hemopoietic blood cells and stimulation of hemopoiesis after TAHC were achieved using colony-stimulating factors. RESULTS: The treatment resulted in CR or PR (from 6 to 95 months) in 70.4% of patients. The remission duration varied depending on the disease phase at transplantation. Four patients who underwent TAHC in PR maintained it for 13-95 months (median 47.5 months). Lasting remissions (29-59 months) were achieved in 42.9 and 37.5% of patients who underwent TAHC in the first PR or in recurrent LGM. None of the patients was in remission longer than 2 years after TAHC if high-dose PCT was conducted in advanced tumor process due to resistant LGM or inadequate previous treatment. Infectious complications lethality early after the transplantation reached 7.4%(2 patients). CONCLUSION: High-dose PCT followed by TAHC is effective in LGM if the tumor is chemosensitive.

[Reestablishment of plasma proteins after plasmapheresis in patients with paraproteinemic hemoblastosis]. / Vosstanovlenie plasmennykh belkov posle plazmafereza u bol'nykh paraproteinemicheskimi gemoblastozami.

AIM: To study the effect of plasmapheresis (PA) on the changes in plasma total protein in the PA intervals in patients with paraproteinemic hemoblastosis (PPH). MATERIALS AND METHODS: 26 PPH patients underwent 80 PA procedures to remove macromolecular pathological proteins and diminish blood viscosity. Before PA the patients were examined hematologically, biochemically. Total protein concentration in plasma was measured before and after PA, in the removed plasma. RESULTS: PA promoted total protein lowering in plasma to 65-85% of the baseline irrespectively of PA technique. After PA the proteins gradually rose. Contents of circulation proteins were found unrelated to the number of PA procedures and averaged 70% of the PA-removed protein. CONCLUSION: The trends in recovery of plasma proteins after PA help to explain therapeutic effect in combination of PA with chemotherapy of paraproteinemic hemoblastoses.

[The monitoring of protein-volemic indices during plasmapheresis in patients with paraproteinemic hemoblastoses]. / Monitoring belkovo-volemicheskikh pokazatelei pri plazmafereze u bol'nykh paraproteinemicheskimi gemoblastozami.

We studied quantitative characteristics of plasma protein before, during and after 133 plasmapheresis (PA) procedures in patients with multiple myeloma and Waldenstrom's macroglobulinemia. A value of removed plasma volume (RPV) was calculated as a part plasma volume (PV) before PA with consideration of quantity and consequence of replacement solution. In the case when we removed 30% of calculated PV we replaced it only with electrolyte solutions. In the case of 50% PV removing, the replacement was a combination of low molecular weight dextran and electrolyte solutions (1:2) or 5% albumin and electrolyte solutions. The results support correlation between a level of total protein and RPV, kind of replacement solutions. We recommend two regression equations for efficient and safety planning RPV and for prediction of protein level after PA. This simple and fast method can be used for prognosis of critic PA parameters, to decrease a risk of side effects and for optimal use of albumin replacement solutions.

[Neocytapheresis in donors]. / Neotsitaferez u donorov.

Various techniques and blood separators were employed to obtain therapeutic doses of immature erythrocytes (neocytes) from blood of 18 donors. Regimens of neocyte apheresis, preparative efficiency of blood separators, morphofunctional and biophysical characteristics of neocytes obtained were compared. Neocyte apheresis shows promise for hematological patients dependent on red cells transfusion.

[Blood rheologic disorders in patients with polycythemia vera and their correction by therapeutic erythrocytapheresis]. / Gemoreologicheskie narusheniia u bol'nykh istinnoi politsitemii i ikh korrektsiia lechebnym éritrotsitaferezom.

The rheologic blood properties were studied in patients with polycythemia vera (PV) before and after erythrocytapheresis. The patients with PV showed a complex of hemorheologic disorders (high blood viscosity at different rates of deviation, intensified red blood cell aggregation, decreased deformability of these cells) found to be implicated in the disease pathogenesis. Erythrocytapheresis promoted the improvement of the rheologic characteristics such as dynamic blood viscosity and the red blood cell aggregation ratio.

[Therapeutic plasmapheresis using a cell separator]. / Therapeutische Plasmapherese mittels Zellseparator.

For the purpose of improving disturbances of the immunosystem 188 plasmaphereses were carried out in 64 patients. This reports deals with the results of 85 therapeutic plasmaphereses in 39 patients with rheumatoid arthritis, diabetes mellitus, and neurodermatitis or pregnant women with rhesus antibodies for diminishing antibody titres. The Soviet equipment of the type RK-0.5, PF-0.5 and FK-3.5 as well as the US devices Aminco and IBM were used. A decrease of the serum protein content from 9-13% appeared immediately after plasmaphereses with 1.3 l of plasma withdrawal per week and an average substitution of 40% of the protein loss by using a 5% solution of albumin. A continual control of this parameter is necessary.