Osmolar gap in the clinical practice and the way of decrease the quantative data of osmolar gap by using fundamentally new method measuring of osmolality.

Measurement of osmolality of biological liquids is particular importance for value osmoregulation. The aim of our research was measuring osmolality of blood serum and urine by using fundamentally new measuring method of osmolality; method allows decreasing the quantitative data of osmolar gap. The study was conducted on 44 patients with cardiac insufficiency and 77 women in the III term of pregnancy under the test of Zimnicki. Osmolality of biological liquids - blood serum and urine was measured by using fundamentally new method - new conductance-measuring method of osmolality. The method is based on the total specific electroconductivity of available electrolytes in the liquid to be measured. The electrical scheme and methodical rule of this method is based on the two patents about measurement osmolality, those patents are received by G. Gelbakhiani (#1521039 and #4719485/14). This method implies to measure the total sum of electrolytes all dissolved salts in the biological liquids. By this way this method allows to measure blood and urine osmolality with high precision, which reduces osmolar gap.

[Changes of pH and kinematic viscosity of the contents of gall-bladder at the pre-gallstone stage of cholelithiasis].

The aim of the work was to study the indicators of pH and kinematic viscosity of the contents of the gall-bladder at receiving B-portion and their changes after a 7-hour period according to the biliary sediment of patients and to establish their link to the infection. Total 31 patients aged 25-55 with biliary sediment in lumens of their gall-bladders (a general group) and 5 healthy patients (a control group) were studied by us. In all cases the markers of the virus of Hepatitis B in blood serum were determined and ultrasonic examination of gall-bladder was carried out by us prior to the duodenal intubation. B-portion was subjected to bacteriological research for aerobes and anaerobs, and pH and kinematic viscosity (eta=mm(2)/sec) were determined. The patients from the control as well as from the general group after a 7-hour period were redetermined pH and Kinematic viscosity of B-portion. Kinematic viscosity was determined with a capillary viscosimeter, and pH was fixed by a method of potentiometer. Statistical treatment was undertaken by the method of ANOLA p<0,05. During the duodenal intubation the mean value of pH within the control group was fixed at 6.74, and the mean value of the kinematic viscosity was 1.34, and after a 7-hour period the same indicators constituted 6.87 and 1.35 mm(2)/sec, respectively. The same indicators within the general group during duodenal intubation were the following: 7.26 and 1.99 mm(2)/sec, and after a 7-hour period the same indicators were 7.78 and 2.19 mm(2)/sec, respectively. There was a significant statistical difference between the mean values of pH and kinematic viscosity of the contents of gall-bladder of the patients from the control and general groups. During a 7-hour period, there was also a significant statistical difference between the changes of the same indicators. The difference was even greater in case of infection. Following the above-mentioned we can conclude that in case of sediment in the lumen of gall-bladder, inclination of pH to alkalinity and increase in kinematic viscosity of the contents is one of the most important criteria of lithogenicity of gall-bladder contents, and one of the reasons for such changes is chronic infection of a gall-bladder.

[Correlation of infection with the physical and chemical characteristics of gall bladder contents].

The aim of the study was to investigate pH and viscosity (h) of gall bladder contents during cholelithiasis and establishment of their correlation with bacterial and HBV infections. Seventy-eight patients undergone the planned cholecystectomy were investigated. 5 healthy persons (control group) were also involved into the study. In all cases the markers of HBV (Anti-HB core IgG, Anti-HB core IgM, HBsAg) in blood were detected, also bacteriological analysis of gall bladder tissue was performed. In 78 cases (I group) pH of gall bladder contents was measured, in 29 cases (II group), also viscosity of gall was studied. In the control group pH and viscosity were detected. Statistical analysis was performed using ANOVA method. Bacteriological study revealed presence of bacterial infection in gall bladder tissue in 34 cases (43,6%), in 30 patients Anti-HB core antibodies were found in the blood, in 13 cases (16,7%) coincidence of bacterial and HBV infection was documented. Mean indexes of pH and viscosity appeared to be significantly higher in the operated group (pH--7,30, h 2,1 mm(2)/sec), then in the control group (pH--6,74, h--1,34 mm(2)/sec); this indexes were highest in the infected patients. Thus, according to results of the study, changes of pH and viscosity of gall bladder contents could be considered as the useful indexes of initial stage of cholelithiasis and their values depend on the presence of bacterial or HBV infection of gall bladder.