[Feasibility of correction of blood aggregation properties in the course of extracorporeal hemosorption in atherosclerosis patients]. / Vozmozhnosti korrektsii agregatnogo sostoianiia krovi pri provedenii ékstrakorporal'noi gemokorrektsii bol'nym aterosklerozom.

Aggregation and rheological properties of blood were evaluated in 20 atherosclerotic patients after cryoplasmosorption. The change of the patients' plasma for extracorporeally modified autoplasma reduced coagulation potential, enhanced fibrinolysis and suppressed anticoagulation systems. Clinical efficacy manifested in decreased frequency and duration of anginal episodes, intensity of intermittent claudication. Biochemically, cholesterol levels and atherogenic index lowering was evident.

[The detoxifying function of the pulmonary parenchyma in patients with acute infectious lung destruction]. / Detoksitsiruiushchaia funktsiia legochnoi parenkhimy u bol'nykh s ostrymi infektsionnymi destruktsiiami legkikh.

The study of arteriovenous ratio of medium-molecular oligopeptides level in 32 patients with acute infectious lung destructions has established an important detoxicating role of the lungs in endotoxemia syndrome during pulmonary-pleural suppurations. It has been found that, with the pronounced endotoxemia syndrome, during catabolic phase of the disease the lungs turn from toxin filter into their source. Detoxicating capacity of the lung parenchyma was shown to be more dependent on the severity of general metabolic disturbances than on the dissemination of suppurative lung destruction.

[The clinical trial of a Russian membrane plasma filter in patients under therapy]. / Klinicheskaia aprobatsiia otechestvennogo membrannogo plazmofil'tra u terapevticheskikh bol'nykh.

35 procedures of plasmofiltration were conducted on the test series of domestic membrane plasmofilter in 25 patients suffering from atopic diseases, systemic affections of connective tissue, advanced atherosclerosis, etc. The filter proved promising in therapeutic patients. The procedure is easier to perform compared to centrifuge plasmapheresis, it can work under thin blood flow. However, centrifuge plasmapheresis has advantages over the above filtration in patients with hyperhydration, hemorrhagic syndrome, contraindications to large-dose anticoagulants.

[Cryohemosorption--a method of removal of lipoprotein-antibody immune complexes and other atherogenic substances in patients with atherosclerosis]. / Krioplazmosorbtsiia--metod udaleniia immunnykh kompleksov lipoproteid-antitelo i drugikh aterogennykh substantsii u bol'nykh aterosklerozom.

The efficacy of extracorporeal cryohemosorption was estimated in the treatment of atherosclerotic patients in terms of the autoimmune theory of the pathogenesis of this disease. There was a slight decrease in the plasma levels of total cholesterol and triglycerides, there was over 2-fold reduction in the plasma levels of fibrinogen and fibronectin. All major components of apo B-containing lipoproteins and immunoglobulin G were found as part of the cryoprecipitate. An extremely high concentration of lipid hydroperoxides in the precipitate suggest that cryoprecipitation removes not only autoimmune complexes, but highly-atherogenic peroxide-modified lipoproteins. The three-fold decrease in the levels of lipoprotein-antibody complexes resulted in lower atherogenicity of apo B-containing lipoproteins. It is suggested that the mechanism responsible for beneficial clinical action of cryohemosorption sessions is largely associated with the removal of autoimmune lipoprotein-antibody complexes and peroxide-modified apo B-containing lipoproteins than correction of lipid metabolism.

[The storage and preparation of autologous plasma for transfusions to patients with arteriosclerosis obliterans of the vessels of the lower extremities]. / O khranenii i podgotovke autoplazmy k transfuziiam bol'nym obliteriruiushchim aterosklerozom sosudov nizhnikh konechnostei.

An investigation of the regimen of storage and sorption of plasma in patients with obliterating atherosclerosis of lower extremity vessels has shown that the optimum regimen of storage of plasma is freezing (with addition of 1 thousand of heparin units per 100 ml of plasma) at t = -20 degrees C followed by thawing at t = +6(+/- 2) degrees C in running water before sorption. The optimal sorbent for sorption of plasma of patients with obliterating atherosclerosis of lower extremity vessels is "Actilen" charcoal. The optimal method of sorption is sorption after thawing the plasma. The sufficient degree of plasma purification can be reached in the ratio sorbent/sorbate for charcoal "Actilen" equal to 1:100 and a single perfusion of plasma through the column.

[Differentiated approach to the treatment of autoimmune ophthalmopathy]. / Differentsirovannyi podkhod k lecheniiu autoimmunnoi oftal'mopatii.

The results of comprehensive examinations and therapy of 67 patients with autoimmune ophthalmopathy are presented. In 80% of the patients the disease coursed along with thyrotoxicosis, in 10% thyroid function was reduced because of autoimmune thyroiditis, and in the rest autoimmune ophthalmopathy was an individual entity. A staged therapeutic complex for the treatment of this condition is suggested, aimed at correction of thyroid function (stage 1), followed by pathogenetic therapy including antiinflammatory measures, glucocorticoids and nonsteroid antiinflammatory drugs to arrest aseptic inflammation in the orbit, and immunosuppressive therapy to correct the immunity shifts. After clinical and immunologic remission was achieved, courses of maintenance therapy (nonsteroid antiinflammatory drugs) were carried out for 3-5 months monitored by blood analyses and ophthalmologic examinations, immunity status tests, CT clinical data. Choice of the treatment strategy was governed by the morphologic variant of ophthalmopathy, immunologic activity of the process, disease severity and pattern. Such an approach helped achieve positive results and clinico-immunologic remission, as well as timely prevent the progress of the disease.

[Therapeutic plasmapheresis in suppurative-septic surgery]. / Lechebnyi plazmaferez v gnoino-septicheskoi khirurgii.

The results of the clinico-laboratory analysis conducted in 69 patients with varying forms of acute purulent surgical infections have shown that the therapeutic plasmapheresis is attended by the improvement of the disease clinical picture, and attenuation of endotoxicosis by day 3 after the perfusion. Indications and contraindications for plasmapheresis in critical patients are considered, the causes of unsuccessful plasmapheresis procedures are analyzed, the ways for the improvement of this operation are outlined.

[The use of extracorporeal detoxication methods in treating infectious disease patients]. / Primenenie metodov ékstrakorporal'noi detoksikatsii pri lechenii infektsionnykh bol'nykh.

The article summarizes the results of 1090 operations of extracorporal detoxication (ED) performed on severe infectious patients. ED was realized by methods of hemosorption, plasmasorption, plasmapheresis for viral hepatitis, typhoid diseases and mixed infections. For each category of patients indications and counterindications for ED application were worked out. Positive results were marked at 54-92% of cases, depending on nosological forms, period of illness and ED type. The authors propose a scheme of indications, optimal parameters and criteria for ED efficiency estimation. ED methods adopted for Afghan conditions can be successfully used in other regions with dry and hot climate.

[Clinical testing of hemo- and plasmosorption on the Aktilen hemosorbent]. / Klinicheskaia aprobatsiia gemo- i plazmosorbtsii na gemosorbente "Aktilen".

The authors make an analysis of using hemosorption and plasmasorption in 43 patients with the help of fibrous sorbent "Actilen". The developed methods have a pronounced detoxicating immunocorrecting, rheocorrecting effect, exert mild aggressive influence on blood and can be used in treatment of surgical, therapeutic and infectious diseases. The following advantages are noted: high sorption and kinetic characteristics of the sorbent, domestic devices and materials, small volume of the filling of mass transfer devices, low cost.

[Intensive plasmapheresis: complications and their prevention]. / Intensivnyi plazmaferez: oslozhneniia i ikh profilaktika.

Upon the analysis of 246 plasmapheresis sessions performed for autoplasma provision, the correction of the blood rheology and the decrease in endogenic intoxication of 216 patients, it was stated that the frequency of various reactivity and complications comprised 12.9%. The causes of these complications and the means of their prevention were analyzed.

[The prospects for using extracorporeal detoxication methods in disaster medicine]. / Perspektivy ispol'zovaniia metodov ékstrakorporal'noi detoksikatsii v meditsine katastrof.

A lot of specific injuries caused by catastrophes provoke endogenic intoxication. In this situation the application of extracorporal detoxication methods will be conditioned by pathogenetical mechanisms of their action. There are indications for ED management in mechanical injuries, prolonged squeezing effects, thermal injuries, acute poisoning, irradiation injuries, acute infectious diseases, acute reactivity state. The experience of 163 operations on 111 wounded in catastrophes proves the worth-while character of work in this sphere. 10 variants of extracorporal operations including combined methods were applied.

[Effect of hemosorption on the elimination of an amphotericin B derivative in experimental studies]. / Vliianie gemosorbtsii na vevedenie proizvodnogo amfoteritsina B v éksperimente.

Possible extracorporeal removal of a novel water soluble derivative of amphotericin B (NWSDA) from the host was studied. The bench tests demonstrated that actilen, a fibrous carbon adsorbent, was the optimal carbon sorbent for sorption of NWSDA. It was shown in the acute experiments on animals that during the hemosorption the antibiotic blood concentration on the outlet of the column was significantly lower than that on the inlet. Still, the NWSDA concentration in the blood lowered slowly which was likely due to the return of the antibiotic to the blood from the tissues.

[The basic principles of extracorporeal detoxication in military field surgery]. / Osnovnye printsipy ékstrakorporal'noi detoksikatsii v voenno-polevoi khirurgii.

Extracorporal detoxication (ED) was used in 64 operations of 40 wounded with gunshot injuries, thermal burns and acoubarotraumata. ED was applied with plasmapheresis, plasmosorption, hemoxygenation, ultrafiltration and hemodialysis. Combinations of these methods also were used. Indications and contraindications for extracorporal management of blood were elaborated for each category of wounded. Alterations were made in the methods of operations with reference to the peculiarities of pathogenesis. Positive results were marked at 30 persons. The authors propose a scheme of indications, as well as basic principles and criteria of efficiency for ED management of surgical patients. The article makes a conclusion that these operations must be preferably realised at the stages of secondary care.

[The effect of therapeutic plasmapheresis on changes in the rheological properties of the blood in bronchial asthma patients]. / Vliianie lechebnogo plazmafereza na izmeneniia reologicheskikh svoistv krovi u bol'nykh bronkhial'noi astmoi.

Bronchial asthma runs its course in association with marked blood viscosity which lies in a decrease of deformability of red blood cells and suspension stability of red blood cells, an increase of their aggregation capacity and of whole blood viscosity, of platelet proneness to decelerated and little noticeable aggregation, in hyperfibrinogenemia and hyperglobulinemia. Therapeutic plasmapheresis produces a favourable action on changes of the rheological blood properties in bronchial asthma patients. Plasmapheresis entails an improvement of whole blood viscosity and red blood cell aggregation, accompanied, however, by aggravation of the aggregation properties of platelets. Therapeutic plasmapheresis can be used for correction of the syndrome of high blood viscosity in bronchial asthma patients.