[Surgical treatment strategy for common peritonitis in the elderly patients.]

Despite the obvious progress in the treatment of secondary peritonitis common forms, the results are far from satisfactory, especially among patients of older age groups. In some cases, a single surgical intervention is not enough for a complete elimination of the intra-abdominal infection source, which leads to repeated sanitation interventions, the order and timing of which are currently not strictly regulated. The effectiveness of the treatment algorithm, which considers a differentiated approach to planned surgical interventions in a short time in patients with severe pathomorphological changes in the abdominal cavity, was studied. The results of treatment using planned sanitation interventions demonstrated the effectiveness of the developed algorithm, allowing to reduce the overall postoperative mortality by reducing the proportion of abdominal sepsis in the structure of adverse outcomes.

[Indications and surgical results of chronic colostasis treatment]. / Khirurgicheskoe lechenie khronicheskogo kolostaza.

AIM: To define the surgical indications in patients with chronic colostasis who were operated using original technique and to access obtained results. MATERIAL AND METHODS: It was analyzed the results of surgical treatment of 81 patients with chronic colostasis in remote postoperative period. We have proved that extended left-sided hemicolectomy with rectosigmoid resection, positive mesentery root rotation and transposition of right large bowel to left part of abdominal cavity, creation of new ligamentary apparatus provide favourable remote results and increase life's quality of operated patients. RESULTS: Complex analysis of clinical, morphological and functional results before and after medical therapy allowed to define indications and optimal period for surgical treatment in patients with chronic decompensated colostasis.

Synthesis of photochromic 1,2-dihetarylethene using regioselective acylation of thienopyrroles.

[formula: see text] The influence of catalysts, acid chlorides, and solvents in the acylation of methyl 2-methyl-4H-thieno[3,2-b]pyrrole-5-carboxylate was studied. Conditions for the regioselective acylation processes were found. Thienopyrrole-based photochrome was synthesized for the first time.

[Thermal stability and functional properties of human hemoglobin in the presence of aliphatic alcohols]. / Termostabil'nost' i funktsional'nye svoistva gemoglobina cheloveka v prisutstvii alifaticheskikh spirtov.

Differential scanning microcalorimetry was used to study thermal stability of the ferro- and ferriforms of hemoglobin at pH 7.4 in phosphate buffer and in buffer mixtures of methanol, ethanol, 1-propanol. Denaturation of the human hemoglobin molecule composed of four subunits was cooperative transition. The thermostability of the hemoglobin forms decreased in the order of carboxyhemoglobin (TD = 82.0 degrees C) > oxyhemoglobin (71.0 degrees C) > methemoglobin (67.0 degrees C). The aliphatic alcohols as cosolvents decreased the hemoglobin stability because of loosening the structure of the globin moiety by disturbing its hydrophobic contacts and hydrogen bonds. These alcohols reduced the oxygen affinity for hemoglobin probably due to perturbation of the R<-->T equilibrium by the decreased bulk dielectric constant of the solvent. Oxyhemoglobin and methemoglobin was converted to hemichrome by high alcohol concentrations.

[Damage to erythrocytes caused by the interaction of nitrite-ions with hemoglobin]. / Povrezhdeniia éritrotsitov, initsiirovannye vzaimodeistviem nitrit-ionov s gemoglobinom.

The formation of two hemoglobin forms (methemoglobin and nitrite methemoglobin) in native human erythrocytes in the presence of sodium nitrite in suspension was shown. In normal erythrocytes, the interaction of intracellular oxyhemoglobin with nitrite ions results in the formation of methemoglobin, whereas in metabolically exhausted erythrocytes, this leads predominantly to the formation of nitrite methemoglobin. The nitrite methemoglobin reacts with hydrogen peroxide to form reactive intermediates (e.g. peroxynitrous acid) and the products of hemoglobin destruction. During the storage of erythrocyte suspensions containing methemoglobin and modified nitrite methemoglobin, differences in the forms of erythrocytes and the degree of their hemolysis were revealed. It is assumed that the formation of methemoglobin leads to the destruction of erythrocytes.

[Acute tumorous obstruction of the colon in elderly and senile patients]. / Ostraia opukholevaia neprokhodimost' obodochnoi kishki u bol'nykh pozhilogo i starcheskogo vozrasta.

The authors present the results of surgical treatment of 106 elderly and senile patients. In 30 patients admitted in a extremely severe condition the acute intestinal obstruction was combined with peritonitis. Postoperative mortality in this group of patients was 86.7% in spite of intensive treatment. In 28 patients generalization of the process was detected and they were given palliative interventions for liquidation of acute intestinal obstruction. Postoperative mortality in this group was 39.2%. Conventional radical operations were fulfilled on 48 patients. Postoperative mortality in this group was 20.8%. Later on the intestinal patency was reestablished in 15 patients. The data obtained show the possibility to widen the indications to radical operative interventions and to improve results of treatment of such patients.

[The clinico-laboratory characteristics of errors in the diagnosis of chronic gastritis]. / Kliniko-laboratornye osobennosti oshibok pri diagnostike khronicheskogo gastrita.

The authors analyze results of a study of 100 patients with chronic gastritis showing secretory insufficiency with a dubious diagnosis. Endoscopy and intragastric pH-metry were used. The diagnosis of chronic gastritis was confirmed in 35 patients and of them with secretory insufficiency only in 21 patients that evidences inadequate attention to the complaints, anamnesis, incomplete examination and use of laboratory and other data.