[Determination of antioxidative potential of biological fluids by using semiconductor chemical sensors]. / Opredelenie antioksidatnogo potentsiala biologicheskikh zhidkostei s pomoshch'iu poluprovodnikovykh khimicheskikh sensorov.

A procedure has been developed for determining the concentrations of superoxide anion radical (SOAR) in aprotonic fluids by using semiconductor chemical sensors. SOAR life in pure solutions is 6.3 hours. Supplements of biological fluids (blood, urine, plasma) increase the rate of SOAR death. There is a great difference in the reaction rate of SOAR with biological fluids in apparently healthy and ill individuals. It is suggested that the above procedure opens vistas both for studies of vital activity and for diagnosis of abnormalities.

[Pharmacokinetic validation of intra-arterial lymphotropic antibiotic therapy of pyo-inflammatory diseases of organs of the peritoneal cavity]. / Farmakokineticheskoe obosnovanie vnutriarterial'noi limfotropnoi antibiotikoterapii gnoino-vospalitel'nykh zabolevanii organov briushnoi polosti.

Intraarterial infusion of antibiotics provided a 1.39-2.84-fold regional increase in the antibiotic concentration as compared to that after the intravenous infusion in the organs and tissues of the abdominal cavity affected by an inflammatory process. Regional intraarterial lymphostimulation provided a 1.31-1.64-fold increase in the antibiotic resorption from the affected organs and tissues of the abdominal cavity to the relevant regional lymph nodes. Combined intraarterial administration of the antibiotic and lymphostimulant made it possible to provide high antibiotic concentrations in both the affected organs and tissues of the abdominal cavity and the respective portions of the regional lymphatic system.

[Pharmacokinetics of gentamicin after its regional endolymphatic and lymphotropic administration to dogs]. / Farmakokinetika gentamitsina pri regionarnom éndolimfaticheskom i limfotropnom ego vvedenii sobakam.

It was shown that intralymphatic+ inguinal administration of gentamicin provided its high concentrations in central lymph, blood and ++para-aortic lymph nodes and increased the antibiotic levels in the abdominal organs 2.33 to 6.66 times as compared with its intramuscular administration while lymphotropic retroperitoneal administration of gentamicin provided more prolonged maintenance of the antibiotic therapeutic concentrations in lymph of the thoracic lymphatic duct, central blood, ++para-aortic lymph nodes and the abdominal organs in comparison to its intramuscular administration. Intralymphatic+ inguinal administration of drugs providing the highest concentrations in all the organs of the abdominal cavity and the ways of the infection penetration is useful in therapy of severe inflammatory diseases of the abdominal organs inclined to generalization and lymphotropic retroperitoneal administration of drugs is useful in therapy of less severe purulent inflammatory processes in the abdominal cavity.

[Accumulation of gentamicin in biological fluids, organs and tissues during regional lymphotropic therapy with antibiotics]. / Nakoplenie gentamitsina v biologicheskikh zhidkostiakh, organakh i tkaniakh pri limfotropnoi regionarnoi antibiotikoterapii.

Gentamicin distribution in biological fluids, organs and tissues, lymph nodes was studied on 70 dogs. Three administration routes were compared: lymphotropic, intramuscular and regional subcutaneous. The lymphotropic route for the drug administration was recommended not long ago. It was shown that the lymphotropic route provided the antibiotic accumulation mainly in some of the abdominal organs as compared to intramuscular administration. Regional lymphotropic administration of the antibiotic to the experimental animals resulted in higher gentamicin levels in the regional lymph nodes and regional organs as compared to the levels observed after the antibiotic regional subcutaneous administration in the same doses.

[Ultrasound findings in the zone of cholecystectomy and their role in prognosis of paralytic ileus development]. / Rezultaty ultrazvukovogo issledovaniia zony kholetsistéktomii i ikh rol v prognozirovanii razvitiia dinamicheskoi kishechnoi neprokhodimosti.

A comparative analysis of 112 patients' case histories with calculous cholecystitis has revealed that morphological alterations of the gallbladder wall and in the perevesicular area as well as the operative techniques are essential for the wound healing and ultrasound picture in cholecystectomy zone. Ultrasound investigation within postoperative 24 hours enables a significant prognosis of the onset of intestinal paresis, its severity and duration. This is important for conducting early prophylactic measures.

[Extended autologous venous plastic surgery in occlusive diseases of the femoral artery]. / Protiazhennaia autovenoznaia plastika pri okkliuzionnykh porazheniiakh bedrennoi arterii.

The author analyses the results of thrombus excision ++ with continued autologous venous plastic surgery in extended atherosclerotic occlusion of the femoral and popliteal arteries in 47 patients. He suggests a classification of occlusion of the femoral artery according to their extent and recommends accordingly the type of operation. The techniques of the suggested autologous venous plastic surgery of the artery is discussed in detail and the late-term results are shown. The author claims pen thrombus excision with total autologous venous plastic surgery to be the best operation in prolonged and total occlusions of the femoral artery.

[Combined surgical operations in the abdominal cavity and retroperitoneal space]. / Sochetannye khirurgicheskie operatsii v briushnoi polosti i zabriushinnom prostranstve.

The authors discuss their experience in combined operations on the organs of the abdominal cavity and retroperitoneal space in 366 patients whose ages ranged from 16 to 81 years. In 96 patients (26.2%) the operations were carried out for emergency indications and in 270 (73.8%) in a planned order. The authors substantiate the expediency of performing combined operations by a low mortality rate (1.9%) (in carrying out the operations separately the mortality rate comes up to 15%) and by an economical effect.

[Structural changes of blood vessels and bile ducts in pathology]. / Izmeneniia arkhitektoniki krovenosnykh sosudov i zhelchnykh protokov pri patologicheskikh protsessakh.

Examination of 305 liver specimens of human cadavers of various age and study of the findings of intravital contrast examination of the duct and vascular system in 130 patients aged from 22 to 84 years revealed changes in the architectonics of the vessels and bile ducts in pathological processes. In healthy individuals the enlargement of the length and diameter of the vessels and ducts and increase in the depth of distribution of their intrahepatic branches from the surface of the liver ware regular in character and depended on the size of the liver and the age; they were marked by a straight linear course without sharp bends and dilatations. The length, diameter, the angles at the junction, and the direction of the course of the vessels and ducts changed sharply in inflammatory processes in the liver and bile ducts, focal lesions, and cirrhosis. Irregular enlargement of the diameter of the vessels and ducts and their marked tortousness were noted. The changes in the duct system were in direct dependence on the pressure in the biliary tract, the higher the pressure, the greater was the dilatation of the ducts at all levels.

[Combined treatment of generalized acute peritonitis]. / Kompleznoe lechenie ostrogo razlitogo peritonita.

The results of examination and treatment of 166 patients were studied. The patients were divided into 3 groups: in the 1st (80 patients) acute generalized peritonitis was treated according to the conventional surgical canons, in the 2nd (54 patients) interchangeable plasmapheresis was added to the conventional treatment, in the 3d (32 patients) the whole complex of treatment was used--the routine method together with extracorporeal detoxication and staged sanatations of the abdominal cavity. Including plasmapheresis and staged sanatations in complex of treatment of acute generalized peritonitis intensifies the effect of treatment. The intervals between the staged sanatations and sessions of plasmapheresis depend on the stage and course of peritonitis. In the conventional method of treatment of acute generalized peritonitis according to the authors' observations the mortality rate made up 39%, when plasmapheresis was included it lowered to 30%, and when combined treatment was used mortality rate dropped to 22%. The data of this study demonstrates the potential and efficacy of combined treatment of acute generalized peritonitis with the use of interchangeable plasmapheresis and staged sanatations of the abdominal cavity.

[The arteriolymphatic administration of antibiotics in treating patients with suppurative-inflammatory diseases of the abdominal cavity organs]. / Arteriolimfaticheskoe vvedenie antibiotikov pri lechenii bol'nykh s gnoino-vospalitel'nymi zabolevaniiami organov briushnoi polosti.

Experimental study of pharmacokinetics of Gentamicin was carried out in 23 dogs. Three different modes of its intralymphatic administration were used: intranodular inguinal, lymphotropic retroperineal and arterio-lymphatic. It has been established, that arterio-lymphatic mode of introduction of antibiotics (as well as regional endolymphatic and lymphotropic) warrants high concentration of antibiotics in venous blood and lymph. The peculiarity of arteriolymphatic administration is regional effect of accumulation of the antibiotic in organs and tissues of abdominal cavity of corresponding arterial region. Arteriolymphatic infusions of antibiotics have been introduced into complex of drug treatment of patients with pyogenic and inflammatory disorders of abdominal organs. The clinical testing has revealed high curative effect of this made of antibiotics administration.

[Ultrasonic evaluation of the course of the wound process after cholecystectomy]. / Ul'trazvukovaia otsenka techeniia ranevogo protsessa posle kholetsistéktomii.

The authors conducted 101 ultrasonic studies in patients in the early period after cholecystectomy. They studied the ultrasonic semeiotics of the course of the wound process in the zone of the operation. Three types of an uncomplicated course of the wound process in the zone of the operation were determined. An image of the sutured site of the gallbladder with no additional structures in the subhepatic space was encountered in most cases (variant I). In other cases (variants II and III) areas indicative of the accumulation of fluid in the subhepatic space and in the projection of the gallbladder site were visualized. This calls for a case follow-up and, in some cases, for preventive treatment.

[Catheter dilatation in combined and generalized arterial occlusion and stenosis of pelvic and lower limb arteries]. / Kateternaia angiodilatatsiia pri sochetannykh i rasprostranennykh okkliuzionno-stenoticheskikh porazheniiakh arterii taza i nizhnikh konechnostei.

The article discusses the possibilities and tactics of radiologically-guided intravascular angioplasty in extended and combined occlusive-stenotic lesions of the lower limb arteries from experience gained in 116 intravascular dilatations in 78 patients. The authors show that it is really possible to perform catheter angioplasty in patients with extended and combined occlusive-stenotic lesions of arteries of the pelvis and lower limbs with compulsory use of spasmolytic and anticoagulant therapy during the operation and, in addition, also disaggregate therapy in the postoperative period. Extended occlusions of the femoral artery, beginning from the opening of the deep femoral artery, should be managed by a retrograde popliteal approach.

[Diagnostic value of cholinolytics in the surgical treatment of peptic ulcer]. / Diagnosticheskoe znachenie kholinolitikov v khirurgii iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

From study of the results of treatment of 157 patients with gastric and duodenal ulcer by an individual approach to the choice of the operative methods according to the results of prognostic tests, the authors revealed a high practical significance of using cholinolytics for diagnostic purposes. The choice of the method of surgical treatment with due regard for the prognostic evaluation of the effect of vagotomy on the gastric motor and acid-producing functions determined a 8.4% reduction of the frequency of postoperative motor-and emptying complications of gastric activity, and a 6.8% reduction of the incidence of recurrent ulcer.

[Intralymphatic antibacterial therapy of acute cholecystitis]. / Endolimfaticheskaia antibakterial'naia terapiia ostrogo kholetsistita.

Clinical examination of 34 patients showed that lymphotropic administration of antibiotics creates concentrations in organs and tissues involved in the inflammatory process in acute cholecystitis which are 1.63-14.95 times higher than those produced by intramuscular injection. Study of the course of the clinical picture of the disease in 122 patients with acute destructive cholecystitis revealed the high efficacy of this method of antibiotic therapy: the laboratory indices of the inflammation became normal within a shorter period of time, the inflammatory process in the gallbladder was arrested more rapidly, the number of postoperative complications fell 2.6 times, and the terms of hospital-stay of the patients reduced by 1.3 times. Lymphotropic antibiotic therapy is more pathogenetic in the management of acute destructive cholecystitis.

[The effect of absorbent materials with drugs on wound healing]. / Vliianie absorbiruiushchikh materialov s lekarstvennymi preparatami na ranevoi protsess.

Absorptive hydrophilic materials (MAH) containing dioxydin and terrilytin as drug components were studied in experiments on guinea pigs infected with K-11 strain of E. coli. The results showed that the wounds in animals who did not receive treatment were cleaned by the 14th day, while the wounds in animals treated by applications of MAH with dioxydin and terrilytin became clean on the 3rd day, i. e. 5 times quicker. Absorptive hydrophilic materials containing dioxydin and teriilytin were easily handled, easily applied and removed, they did not injure the granulation tissue, and intensified growth of peripheral epithelialization. Thus, experimental study showed absorptive hydrophilic materials containing dioxydin and terrilytin to be highly effective in the treatment of purulent wounds, which allows them to be recommended for clinical use.

[Method of pancreatoduodenal resection and intraoperative prevention of acute pancreatitis]. / Tekhnika pankreatoduodenal'noi rezektsii i intraoperatsionnoi profilaktiki ostrogo pankreatita.

In the period from 1988 to 1991 the authors carried out 27 pancreatoduodenal resections with 11.1% mortality. From analysis of the results they formulated the main technical principles of this operation and suggested a complex of intraoperative measures for prevention of acute postoperative pancreatitis. The complex included application of a 5-fluorouracil-containing covering of the pancreas at the stage of exposure of the complex which will be removed; individualization of the methods for treatment of the pancreatic stump depending on the diameter of the pancreatic duct; the use of prolene in forming the pancreaticoenteroanastomosis; intraoperative administration of cephalosporins and dioxidine followed by antibacterial therapy; application of microsphere with cytostatics to the pancreas at the operation end for prolongation of pancreatic secretion suppression.

[Determining the predisposition to post-vagotomy peristaltic disorders in surgical treatment of peptic ulcer hemorrhage]. / Opredelenie predraspolozhennosti k postvagotomicheskim motorno-évakuatornym narusheniiam pri khirurgicheskom lechenii iazvennykh gastroduodenal'nykh krovotechenii.

Analysis of the results of organ-preserving operations in 246 patients with ulcerous gastroduodenal hemorrhages revealed a predisposition to motor-evacuation disorders of gastric performance, which plays an essential role in the individual choice of the operation in patients with ulcerous gastroduodenal hemorrhages. This makes it possible to reduce the number of postvagotomy complications linked with disturbed passage of food in the stomach and duodenum.

[One-row continuous suture in abdominal surgery]. / Odnoriadnyi nepreryvnyi shov v abdominal'noi khirurgii.

One-row continuous suture (OCS) was used in 3605 patients while placing anastomoses in different parts of the digestive tract, extrahepatic bile ducts and pancreas as well as suturing after gastrostomy and choledochotomy. Two techniques of OCS were used. In 526 patients OCS was used for biliary tract surgery with complications rate 1.3%. In surgery of the stomach and small intestine OCS was used in 2606 patients; the insufficiency rate of stomach and small intestine anastomoses was equal (0.04%). In surgery of colon and rectum OCS was used in 405 patients; insufficiency rate was 1.5%. In surgery of the pancreas this suture was used in 70 patients without complications after surgery. Analysis of the data shows high reliability of OCS for anastomoses in abdominal surgery and allows to recommend its wider use in clinical practice.

[An experimental model of acute purulent peritonitis]. / Eksperimental'naia model' ostrogo gnoinogo peritonita.

There are important shortcomings in all the existing models of acute peritonitis. The original model, most close to clinical conditions, has been proposed. The grey rabbits of 1.5-2.0 kg were used in experimental trials. The 5 cm laparotomy has been performed in all the rabbits under thiopental anesthesia. In rabbits of the control group the wound was closed without any manipulations in abdominal cavity. In the other animals the terminal part of the small intestine (15-18 cm) was isolated with two intestinal forceps and saline solution was injected inside. The intestine content was aspirated and mixed with the rabbits blood. The punctate without blood was injected in rabbits of the 2d group; in the 3d group-the mixture of punctate and blood (5 ml of blood per kg of body weight); 10 ml per kg were injected in rabbits of the 4th group; 15 ml per body weight-in the 5th group. In rabbits of the 1st, 2d and 3d groups there were no signs of peritonitis 7 days after the injection. In animals of the 4th and 5th groups clinical, morphological and bacteriological sings of acute peritonitis were detected. The severity of its course depended on the amount of blood in the mixture that was used for irritation of peritoneum. All animals of the 5th group died by the end of the 4th day. Thus, the use of 10 ml of autopunctuate of terminal part of small intestine in combination with the animals blood (10 ml per kg), is the most proper model of peritonitis, that is most close to clinical situations and enables to study its phases and test various methods of treatment.

[Surgical tactics in drainage of the thoracic duct]. / Khirurgicheskaia tekhnika drenirovaniia grudnogo limfaticheskogo protoka.

A method of finding the thoracic lymphatic duct, paracentetic method of its opening, method of the fixation of the catheter, ensuring a longlasting withdrawal of the lymph, are described.