[Parameters of ocular hydrodynamics in case of major neck blood vessels compression by thyroid nodules]. / Pokazateli gidrodinamiki glaza pri kompressii magistral'nykh sosudov shei uzlovymi obrazovaniyami shchitovidnoi zhelezy.

AIM: to study aqueous humor secretion and outflow in patients, whose major blood vessels of the neck got compressed by thyroid nodules. MATERIAL AND METHODS: Ocular hydrodynamics was assessed in 60 patients (119 eyes) with uni- or bilateral benign thyroid nodules compressing the major neck blood vessels. RESULTS: Most patients demonstrated a significant decrease in parameters of aqueous humor secretion and outflow. After decompression, ocular hydrodynamics usually improved reaching its normal level. CONCLUSION: Compression of the major neck blood vessels by thyroid nodules impedes drainage of the aqueous humor and serves as a risk factor of secondary phlebohypertensive glaucoma.

[Computed tomography in diagnostics of extravasal influence of thyroid nodules].

AIM: To estimate role of contrast-enhanced MDCT in diagnosis of common carotid arteries and internal jugular veins compression by thyroid nodules. MATERIAL AND METHODS: Contrast-enhanced MDCT of neck and mediastinum was performed in 15 patients with benign thyroid nodules in addition to conventional clinical survey and Doppler imaging of common carotid arteries and internal jugular veins. Thyroid volume ranged from 71.4 to 296 cm3. Cervical great vessels deviation, their dislocation and deformation because of compression were revealed in 14 patients. Partial and complete compression within transverse processes of cervical vertebrae was diagnosed in 7 cases. It was concluded that dislocated common carotid arteries per se can compress and deform internal jugular veins. Blood flow in veins is absent if they are compressed throughout. If jugular vein is compressed behind sternum only its ectasia may be observed. RESULTS: Vascular geometry was restored after extravasal compression elimination. Contrast-enhanced MDCT should be included into survey program of patients with thyroid nodules.

[Results of combined surgeries for cancer of the colon complicated with stomach and duodenal fistulas].

Positive results of combined surgeries in locally advanced cancer of the colon complicated with gastric fistula (3 patients) and duodenal fistula (1 patient) are presented. Effective treatment of these patients requires complex examination, good preoperative preparation, perfect anesthetic management, adequate operation and intensive postoperative (including antibacterial) therapy.

[Antioxidative effects of isoflavon genisteine-8-C-glycoside in vitro and in vivo].

Bioflavonoids (polyhydroxyphenols) are ubiquitous components of plants, fruits and vegetables; these compounds are efficient scavengers of free oxygen radicals and peroxides. The aim of this study was to investigate the antioxidative effects of genistein-8-C-glycoside (G8CG) isolated from the flowers of Lipinus luteus L. G8CG dose-dependently inhibited membrane lipid peroxidation and prevented GSH oxidation in human red blood cells and rat liver homogenates under tert-butylhydroperoxide-induced oxidative stress and single whole-body gamma-irradiation (1 Gy) of rats.

[Choice of surgical method in rectal cancer]. / Opyt khirurgicheskogo lecheniia raka priamoi kishki.

Based on randomized study of 589 patients radically operated for rectal cancer, rational surgical policy was developed. Efficacy of rectal resection depending on the approach, scope of mesorectumectomy and anal demucosation was studied, comparison of purulent complications number, sphincter function and early recurrence in 315 patients was carried out. It is demonstrated that methods of rectal resections with lowest per cent of purulent complications lead to the worst functional results and increase number of local recurrences. Differential approach to choice of resection or extirpation method is proposed, clear indications are formulated.

[Results of treatment of external intestinal fistulas]. / Rezul'taty lecheniia naruzhnykh kishechnykh svishchei

Results of treatment of 771 patients with external intestinal fistulas were analyzed. Duodenal fistulas were diagnosed in 47 patients, small-intestinal - in 366, large-intestinal - in 329, mixed - in 26, combined - in 3. Patients were divided into 2 groups: group 1 - 341 patients treated from 1983 to 1992, group 2 - 430 patients treated from 1993 to 2002. In group 1 - 294 (86.2%) patients underwent surgery, in group 2 - 405 (94.2%) patients. Differential approach to choice of treatment method, intraaortic therapy before and after surgery, use of developed devices for treatment of non-formed fistulas permitted to improve results of treatment and to reduce lethality from 10.3% in group 1 to 3,3% in group 2.

[Dynamics of structural changes in rat liver after single dose of gamma-irradiation]. / Dinamika strukturnykh izmenenii v pecheni krys posle odnokratnogo vozdeistviia gamma-izlucheniia.

Histological changes and alterations in biophysical and biochemical parameters in liver of gamma-irradiate rats have been investigated. The gamma-irradiation of the whole body of rats with a single dose of 1 Gy did not cause any impairments of beam structure of rat liver, but resulted in the lymphocytic infiltrations of portal tracts which were not accompanied by formation of spotty areas of necrosis in adjacent areas of lever parenchyma. gamma-Irradiation stimulated proliferation of the hepatocytes and induced time-dependent mitochondrial structure lesions. Post-irradiation changes in cell cytoplasm appeared as disordering in reticulum-endothelial system, among them enlarging and fragmentation of its cisterns, cytoplasmic vacuolization, enhancement of the number of lysosomes and of the lipid inclusion contents. These facts revealed the mobilization of the additional energy resources for recovery of metabolic processes in rat liver. Post-irradiation increase of the level of the hepatocyte membrane lipid peroxidation products preceded liver morphological alterations. The membrane lipid microviscosity decreased in 1 and 3 days after irradiation. As a result of damages of hepatocyte membrane, the activity of the alanin- and asparagin-aminotransferases in blood serum increased 6 hours after. We can conclude that the whole body single gamma-irradiation with a dose of 1 Gy leads to the reversible but significant damages to the rat liver cell membrane structures. These damages might be the reason of radiation-induced liver morphological alterations.

[Treatment of the formed intestinal fistula after resection of the ileum near the ileocecal angle]. / Lechenie sformirovannykh tonkokishechnykh svishchei posle rezektsii podvzdoshnoi kishki vblizi ileotsekal'nogo ugla.

The results of 28 patients with formed small intestine fistulas after resection of portions of the small intestine of different length were analyzed. In 15 patients the terminal part of the iliac was not more than 10 cm, in 13 patients it was completely ablated. The reconstructive operation for closure of the fistulas was performed in 3.5 months at an average since the moment of putting the fistulas. The enteroenteral anastomosis next to the blind gut was formed to 12 patients, enterocecal--to 8 patients. Long-term results were good in 15 patients, satisfactory--in 5.

[Effect of gamma-linolenic acid on microsomal oxidation in the rat liver following gamma-irradiation]. / Vliianie gamma-linolenovoi kisloty na sistemu mikrosomal'nogo okisleniia pecheni krys pri gamma-obluchenii.

The antioxidant and radioprotector properties of gamma-linolenic acid isolated from the seeds of Borago officialis were studied on rats gamma-irradiated to a dose of 1 Gy. The irradiation caused an increase in the content of malonaldehyde in microsomal liver fraction and disturbed the metabolism of xenobiotics. The administration of gamma-linolenic acid in the form of a commercial drug Neoglandin (daily dose, 150 mg/kg, p.o.; over 1, 3, or 7 days after irradiation reduced the level of lipid peroxidation (for all treatment schedules), normalized the activity of NADPH-oxidase, NADH-oxidase, and NADPH-reductase, and increased the content of cytochromes P-450 and b5 as compared to bothirradiated and control animals.

[Organ-salvaging operations in tumors of renal parenchyma]. / Organosokhranoiushchie operatsii pri opukholiakh parenkhimy pochki.

An original method of kidney resection with the use of ultrasonic surgical destructor-aspirator is proposed. The method was applied in the treatment of 19 patients (20 renal resections and 1 tumor enucleation). No complications occurred. The use of ultrasonic destructoraspirator in renal resection enabled isolation of all the intraparenchymatous tubal structures of the kidney, each of them could be ligated and cut if visualization is adequate. This provided a complete hemostasis on the wound surface of the kidney and hemostatic suturing of the kidney wound became unnecessary. This method of renal resection reduced hospital stay of the patients because they had no hemorrhages, purulent complications and urinary fistulas.

[Choice of surgical treatment method for peptic ulcer of operated stomach]. / Vybor sposoba khirurgicheskogo lecheniia pepticheskikh iazv operirovannogo zheludka.

The analysis of immediate and long-term results of surgical treatment in 98 patients with peptic ulcer of operated stomach is presented. The choice of surgical method was determined by the disease cause. Reconstructive stomach resection by Bilrot-II in Roux modification was operation of choice in peptic ulcer with non-hormonal factors of ulcerogenesis. When hormonal cause of ulcerogenesis was suspected, even in unknown origin of hypergastrinemia, the extirpation of gastric stump is indicated. Trunkal vagotomy can be performed as an additional surgical method only. Favorable surgical outcomes were seen in 90 (91.8%) patients. Long-term results from 2 to 15 years were studied in 74 (82.2%) patients. They were recognized as good in 48 (53.3%) patients, as satisfactory--in 12 (13.3%). The recurrence of the disease was seen in 4 (4.4%) patients. 10 patients died due to causes not associated with stomach diseases.

[Effects of surgical intervention and intravascular irradiation of blood with helium-neon laser on the state humoral autoimmunity in oncological patients]. / Vliianie khirurgicheskogo vmeshatel'stva v vnutrisosudistogo oblucheniia krovi gelii-neonovym lazerom na sostoianie gumoral'nogo autoimmuniteta u onkologicheskikh bol'nykh.

Humoral autoimmunity of patients with malignant gastrointestinal tumors was studied by different variants of enzyme immunoassay. In the preoperative period the frequency of detecting autoantibodies binding to DNA and components of external and internal membranes of cells of different tissues was not higher in patients (n-55) than in donors (n-45). Beginning from the 7th postoperative day all patients were found to have a significantly increased level of autoantibodies to DNA (p less than 0.01), fibroblasts (p less than 0.01), hepatocytes (p less than 0.01), islet cells (p less than 0.01), hepatic or pancreatic microsomes (p less than 0.05). There was a tendency towards normalization of these level by the 21st day in all cases. In patients (n-10) treated by blood intravascular laser irradiation after the operation the level of IgG (but not IgM) autoantibodies to DNA by the 14th postoperative day was significantly (p less than 0.01) higher than that in patients whose blood was not exposed to radiation. It is suggested that the discovered humoral immune reaction is a necessary component of wound immunity and develops in response to hetero-organic autoantigens which are unmasked in injury of the tissues during the operation. Laser therapy ensures a more intensive development of this reaction without altering its direction.

[Efferent detoxification therapy in the complex treatment of diffuse suppurative peritonitis]. / Efferentnaia detoksifikatsionnaia terapiia v kompleksnom lechenii razlitogo gnoinogo peritonita.

Upon the analysis of efferent combined therapy for diffuse purulent peritonitis in 130 patients, it was found that efferent detoxication promotes elimination of intoxication, correction of homeostasis abnormalities, recovery of basic systems of the body, a decrease of postoperative lethality and complications. The choice of the optimal detoxication method should be individual and adjusted for a peritonitis stage and a concrete clinical purpose.

[Experience with using extracorporeal methods of detoxification in acute diseases of the organs of the abdominal cavity]. / Opyt primeneniia ékstrakorporal'nykh metodov detoksikatsii organizma pri ostrykh zabolevaniiakh organov briushnoi polosti.

Results of treatment of 295 patients are presented. Among them there were 128 patients with diffuse purulent peritonitis, 109 with acute pancreatitis and 58 with destructive cholecystitis. In the complex treatment extracorporeal methods of detoxication therapy were included: plasmapheresis, hemo- or lymphosorption, perfusion ofautologous blood through the xenogenous spleen. Indications to each of the methods are considered. It was found that when using the therapy in question clinical symptoms of endotoxicosis were eliminated 1.5 times quicker and the leukocytic intoxication index was corrected more successfully as well as was the level of toxins of middle molecular mass, functional activity of blood neutrophils, immune link of homeostasis and ++cardio-hemodynamic parameters.