[The relationship of AB0- and rhesus-phenotypes of erythrocytes with expression of intra-operational hemolysis in cardio-surgical patients].

The study sampling included patients with ischemic heart disease with mild (70 patients) and marked (36 patients) hemolysis after coronary artery bypass grafting under artificial blood circulation. During post-operation period the content of free hemoglobin in blood plasma, AB0- and rhesus-phenotype of erythrocytes were evaluated. It is established that in patients with marked intra-operational hemolysis as compared with cases of mild hemolysis the phenotypes of erythrocytes B(III), AB(IV), ccDEE, ccDEe are found reliably more often and 0(I)-phenotype is found reliably more rare. The risk factor of marked intra-operational hemolysis is a verification of ccD(E/e)-phenotype of erythrocytes and in case of different rhesus-phenotypes--blood type B(III) or AB(IV).

[Characteristic of the complement system in patients with ischemic heart disease with moderate and marked hemolysis after operations with cardiopulmonary bypass].

A study of the complement system in cardiosurgical patients with moderate (40 patients) and marked (18 patients) hemolysis after coronary artery bypass grafting in conditions of cardiopulmonary bypass was carried out. Before and after operation the content of D35+-, D55+-erythrocytes and reticulocytes in blood, free hemoglobin in blood plasma, indicators of the functional state of classical, lectin and alternative pathways of complement activation as well as concentration of its terminal complex in blood serum were analyzed. It was established that development of marked hemolysis was associated with higher (compared with moderate hemolysis) content of terminal complement complex and reticulocytes in blood before operation as well as deficiency of D55+- erythrocytes and low activity of alternative pathway.

[Factors of intravascular hemolysis in cardiosurgical patients after cardiopulmonary bypass procedures].

The study included patients with ischemic heart disease with moderate (52 patients) and apparent (23 patients) hemolysis after coronary bypass surgery in cardiopulmonary bypass (CB). The concentration of free hemoglobin in blood plasma, mechanical resistance and sorption capacity of red cells as well as the content of TBA-active products, cholesterol and phospholipids in red cells and reticulocytes levels in blood were studied before and after operation. It was shown that among patients with apparent post-perfusion hemolysis (in contrast to the patients with a moderate hemolysis) the sorption capacity of red cells and amount of reticulocytes in blood are increased before operation; level of TBA-active products in erythrocytes is increasing after operation. Development of moderate hemolysis is associated with the decreased mechanical resistance of erythrocytes and increased cholesterol/phospholipid-ratio in membranes before operation. Thus, individually-specified apparent post-perfusion hemolysis is based on free-radical mechanism of erythrocytes damage and moderate hemoglobin level is referred to mechanical trauma of blood cells during CB.

[Hypoxic preconditioning as novel approach to prophylaxis of ischemic and reperfusion damage of brain and heart].

Analysis of published data indicates that delayed hypoxic preconditioning essentially increases a cardiac and brain tolerance to ischemia-reperfusion. There are no experimental data in the literature on the neuroprotective effect of early hypoxic preconditioning in vivo. Clinical observations indicated that early hypoxic preconditioning exerts cardioprotective and neuroprotective effects. The single works testify that cardioprotective effect of delayed hypoxic preconditioning depend on the activation of inducible NO-synthase, KATP-channels and KCa-channels. Neuroprotective effect of hypoxic preconditioning is a consequence: (1) erythropoietin receptor stimulation and (2) an elevation of activity of PI3-Akt and ERK1/2 kinases. The supposed end effector of brain hypoxic preconditioning is MPT-pore.

[Radionuclide renal scintigraphy in assessment of nephroprotective effect of hypoxic preconditioning for myocardial revascularization under artificial circulation].

OBJECTIVE: Using renal scintigraphy to assess the nephroprotective efficacy of hypoxic preconditioning (HP) during myocardial revascularization under the conditions of artificial circulation (AC). MATERIALS AND METHODS: We examined a total of forty-seven patients with CAD (mean age 52.81 +/- 1.40 years) who endured coronary artery bypass grafting (CABG) under AC. All patients were randomly divided into 2 groups:patients (n = 16) who during CABG underwent HP (study group) and those (n = 31) without renal protection (comparison group). HP was performed in the mode of one cycle of 10-minute hypoxemia followed by a 5-minute period of reoxygenation. Dynamic radionuclide renal scintigraphy with 99mTc-DTPA was carried out before and 6-7 days after surgical treatment with calculating the parameters of the filtrating and excreting renal function. RESULTS: The comparison-group patients after CABG were found to have negative dynamics of the parameters of the renal filtration activity. Thus there was a significant decrease in the mean values of total and individually for each kidney glomerular filtration rate (GFR) combined with deceleration of the blood clearance. Besides patients of this group showed a significant increase in the mean value of the half-period of excretion of the indicator from the pelvicalyceal system of the left kidney and the parenchyma of the both kidneys. The study group patients showed no alterations in the values of the filtration activity of the kidneys as compared with the baseline measures, with the exception of the GFR of the right kidney. Thus a decrease in the filtration function of either one kidney or both kidneys under the influence of non-pulsating blood flow was observed only in three (19%) patients and was not pronounced. Alterations in the indices reflecting the excretory renal function in the study group were also insignificant. CONCLUSION: Radionuclide renal scintigraphy makes it possible to objectively and with a high level of the informative value to determine the degree and pattern of the effect of open-heart surgery on renal functional activity. HPC exerts a nephroprotective effect action on the renal functional activity in patients with endured open-heart surgery in the conditions of assisted circulation.

[Phenotropil use as premedication during out-patient stomatological treatment].

Clinical and pharmacological characteristics of phenotropil were given. Its efficiency in premedication of patients with different individually typological features during out-patient treatment was shown. Also its neurotropic effect and influence on some psychophysiological and hemodinamical indices were studied.

[Choice criteria of premedication in outpatient stomatologic department].

We have analyzed factors causing stress during out-patient dental treatment. The psychological characteristic of people with prevalence of sthenical and asthenical features were given and dependence of the effect of the medicine on individual features was shown.

[The interconnection between cytokines and the factors of bactericidal action of neutrophiles in patients operated on under the conditions of cardiopulmonary bypass].

The use of cardiopulmonary bypass (CPB) is associated with the development of a system inflammatory response. The subjects of the study were 48 patients with coronary heart disease (CHD), operated on under the condition of CPB. The following parameters were measured: the content of cation proteins and active oxygen forms in neutrophiles, the digesting capacity of these cells, and the serum levels of interleukins (IL)-1beta, 1ra, -4, -6, -8, and tumor necrosis factor-alpha (TNF-alpha). The measurements were made before performing coronary bypass surgery, and also 6 and 24 hours after surgery. The results showed that the levels of cytokines and the bactericidal activity of neutrophiles were elevated in CHD patients before surgery. The changes after surgery included an increased macrophageal digesting capacity with switching to oxygen-independent mechanisms, as well as increased levels of TNF-alpha, IL-1ra, and IL-1ra:IL-1beta. The changes were more prominent 6 hours after surgery. Oxygen-dependent killing was controlled mostly by IL-6 during the pre-operative period, and by this plus TNF-alpha 24 hours after surgery. The content of cation proteins in neutrophiles before surgery correlated with the concentrations of TNF-alpha and IL-8. These interconnections weakened 6 hours after surgery and became stronger 24 hours after it.