[Ultrasonic diagnosis of abdominal foreign bodies]. / Ul'trazvukovaia diagnostika inorodnykh tel briushnoi polosti.

Experience with ultrasonic examination (USE) in diagnosis of foreign abdominal bodies in 23 patients is reviewed. Foreign abdominal bodies have specific echosemiotics. It is demonstrated that USE provides maximal information about sizes, structure, location of foreign abdominal bodies, their depth of location and relationship with abdominal organs. It makes sense to make in some cases a differential diagnosis with inflammatory infiltrates and abdominal abscesses, fetus, gastric bezoar. It is necessary for this to use additional X-ray and endoscopic methods. USE helps to decide on optimal surgical approach and gives information for repeated surgery that permits to reduce the time of relaparotomy.

[The use of the carbon dioxide laser in acute surgical infection of the soft tissues]. / Ispol'zovanie uglekislotnogo lazera pri ostroi khirurgicheskoi infektsii miagkikh tkanei.

Clinico-laboratory studies were conducted in 46 patients with wound infection for the treatment of which carbon-dioxide laser was used, and in 78 patients who were operated on with a metal scalpel (control). It is shown that "excision" and "evaporation" of tissues took 15-45 minutes. Repeated interventions were performed in 15% of cases due to bleeding from vessels measuring 1.0-1.5 mm in diameter. After surgical debridement with a scalpel the number of microbes reduced from 10(7)-10(9) to 10(3)-10(4) per g. After exposure to the laser beam this value was 10(1) but on day 3-4 it was 10(5)-10(6). The extent of the zone of coagulation necrosis in the zone exposed to the laser beams measured up to 500 microns, and began diminishing only on day 7-9 of postoperation. Suppuration of the wounds in 56% of patients of the main group treated by operation was in conformity with the results of bacteriological and morphological studies. In the control group this index was 15.4%. It is concluded that the use of carbon-dioxide laser as a "light scalpel" with subsequent primary closure of the wound is inexpedient. Its use in preparing a wound for closure with secondary sutures has no advantages over radical surgical debridement.

[Kidney and pancreas transplantation in patients with insulin-dependent diabetes mellitus]. / Transplantatsiia pochki i podzheludochnoi zhelezy bol'nym insulinzavisimym sakharnym diabetom.

The article analyses the results of one-stage transplantation of the kidney and pancreas in three patients suffering from insulin-dependent diabetes mellitus with diabetic nephropathy in the stage of terminal renal failure which called for programmed hemodialysis. The specific features of early postoperative management of patients are described, particularly the various routes of drug administration.

[Interactions of mononuclear cells of peripheral blood with islet cells in vitro]. / Vzaimodeistvie mononuklearov perifericheskoi krovi s ostrovkovymi kletkami in vitro.

Peripheral blood mononuclear cells from Type I diabetic patients health donors or Wistar rats were cultured with rat islet cells for 18 h. Then TNF content of the medium and basal and stimulated insulin release were determined. Mononuclear cells from both healthy donors and diabetic patients could inhibit the insulin release with no correlation to TNF content. Addition of lipopolysaccharide resulted in a 5-7 times increase of TNF content of the medium followed by a more pronounced inhibition of insulin release. Rat mononuclear cells inhibited the beta-cell function almost completely and initially produced large amounts of TNF. The data indicate that inhibition of insulin release by blood mononuclear cells in vitro does not reflect anti beta-cell specific cellular immunity, involves cytokines and, probably depends upon the initial properties of the cells.

Islet cell transplantation in type I diabetes mellitus: evaluation of humoral immune response.

Four males and three females ranging in age from 20 to 35 years and afflicted with complicated Type 1-diabetes for more than 8 years underwent islet cell allotransplantation (ATx, 6 cases) and xenotransplantation (XTx, 1 case). Precultured islet cells derived from human or bovine fetal pancreata were injected into the m. rectus abdominis. Immunosuppression was not applied. Plasma C-peptide and islet cell surface antibodies (ICSA) were continually measured both before and until the twentienth week following islet cell transplantation. All recipients were subdivided as "responsive" (RR, 3 males) or "non-responsive" (NRR, 1 male and 3 females), according to the dynamics of their ICSA levels. All 3 RR (1XTx and 2 ATx) showed a peak of ICSA two weeks after cell injection. Subsequent ICSA levels had the tendency to either diminish or increase. Heterogeneity of preoperative antibody level, especially in NRR, was also observed. No associations between ICSA and ATx or XTx, age at diabetes onset, or duration of the disease was found. Only one RR with XTx had a reduced daily insulin requirement and a significant C-peptide response similar to the dynamics of ICSA levels. A greater mass of available bovine islet cells might be responsible for this effect.

[Effect of pancreatic islet cell culture allotransplantation on the clinical course of proliferative diabetic retinopathy]. / Vliianie allotransplantatsii kultur ostrovkovykh kletok podzheludochnoi zhelezy na klinicheskoe techenie proliferativnoi diabeticheskoi retinopatii.

The authors describe the effect of intramuscular human fetal pancreatic islet cell (IC) culture transplantation on the clinical course of proliferative diabetic retinopathy (PDR). Four patients with the preterminal stage of PDR were followed-up no less than 2 yrs. after transplantation. A marked and stable improvement of the eye fundus clinical picture and visual acuity was observed in 3 of these 4 recipients. Correlation of the improvement of the ophthalmic status with the therapeutic effect of fetal IC culture allotransplantation on other diabetic complications like polyneuropathy and glomerulosclerosis was noted.

[Changes in the C-peptide concentration in the blood of patients with diabetes mellitus after the transplantation of cultures of pancreatic islet cells]. / Izmeneniia kontsentratsii C-peptida v krovi bol'nykh sakharnym diabetom posle transplantatsii kul'tur ostrovkovykh kletok podzheludochnoi zhelezy.

The time course of the blood level of C-peptide was studied in 20 patients with insulin dependent diabetes mellitus in the course of 1 year after human fetal pancreatic islet cell allotransplantation. All the recipients suffered from a labile type of diabetes complicated by polyneuropathy, glomerulosclerosis and progressive retinopathy. C-peptide concentration was determined by a radioimmunoassay using Behring-Werke AE kits (FRG). The recipient were divided into 3 groups with relation to the preoperative level of C-peptidemia (with a low level 0.17 +/- 0.06 ng/ml, a mean level 0.9 +/- 0.11 ng/ml and a high level 3.07 +/- 0.24 ng/ml). One-two days before cell culture allotransplantation the mean concentration of C-peptide was 0.3 +/- 0.02 ng/ml. One-two weeks after transplantation it rose up to 0.89 +/- 0.11 ng/ml (p less than 0.01), by the end of the 1st month it reached 2.85 +/- 0.54 ng/ml, in 2-3 months it was lowered up to 1.98 +/- 0.21 ng/ml and remained at this level in the next months decreasing up to 1.4 +/- 0.36 ng/ml and approximated the preoperative levels by the end of the year. The same time course was noted in all 3 groups irrespective of the preoperative levels and differed in quantitative indices only. Stabilization of a course of disease, normalization of some biochemical indices, disappearance or weakening of a degree of concomitant symptoms and a decrease in an exogenous dose of insulin were noted.

[Osmoregulatory function of the kidneys in diabetes mellitus]. / Osmoreguliruiushchaia funktsiia pochek pri sakharnom diabete.

In 42 patients with insulin dependent diabetes mellitus of average and grave forms with preserved glomerular renal function without signs of dehydration and hypovolemia renal function was investigated by maximum osmotic urine concentration (on dry food for 36 h) which was assessed on the basis of maximum osmolarity of urine and renal capacity for osmotic dilution of urine (on the 2nd hour after water load per os, 20 ml per 1 kg of body mass) assessed on the basis of the clearance of osmotically free water from 100 ml of the glomerular filtrate. Disorder of function of osmotic urine concentration revealed in 1/4 th of the patients, was moderate; it was most frequent in complication of disease with diabetic glomerulosclerosis, less frequent in diabetic angiopathies and was absent in patients without vascular lesion. Disorder of the capacity of the kidneys for osmotic urine dilution was revealed in 50% of the patients, it was probably of functional nature and was mainly associated with raised permeability of nephron distal segments for water.

[Vacuum treatment in the surgical management of suppurative wounds]. / Vakuum-vozdeistvie pri khirurgicheskoi obrabotke gnoinykh ran.

Vacuum treatment was used in 116 patients with purulent wounds. It was established that the vacuum treatment of purulent wounds was effective but after surgical treatment. It considerably decreased the amount of microbes in wound tissues, had no harmful effects and improved clinical results of healing the wounds after putting early sutures.

[Results of transplantation of pancreatic islet cell cultures to patients with diabetes mellitus]. / Rezul'taty transplantatsii kul'tur ostrovkovykh kletok podzheludochnoi zhelezy bol'nym sakharnym diabetom.

Altogether 110 intramuscular pancreatic islet cell (PIC) culture transplantations were performed in diabetes mellitus patients from April 1981 to May 1984 at the Research Institute of Transplantology and Artificial Organs, USSR Ministry of Health: 65 allotransplantations of human fetal PIC and 45 xenotransplantations fo swine fetal PIC. Immunosuppressive therapy was not employed. The paper is concerned with an analysis of a therapeutic effect of the IC cell cull culture transplantation on 30 patients who were followed-up for not less than 1 year after operation. A pronounced and long-term antidiabetic effect was observed in wost of the recepients subjected to the intramuscular human fetal PIC culture transplantation: demand in exogenous insulin decreased, a durable stabilization of a course of disease in patients with labile diabetes mellitus was observed, and in patients with such diabetic complications as polyneuropathy, retinopathy and glomerulosclerosis certain regress of these complications was observed. As to the results of the intramuscular swine fetal PIC culture xenotransplantation the authors note that xenogenic transplantation as compared with IC culture allotransplantation possesses a less noticeable offect on diabetes mellitus complications.

[Implantation of semen receptacles in obstructive azoospermia using microsurgical technics]. / Implantatsiia spermopriemnikov pri obturatsionnoi azoospermii s primeneniem mikrokhirurgicheskoi tekhniki.

The authors describe the microsurgical technique of the implantation of 18 alloplastic seminal receptacles above the dissected channels of the epididymis in 9 men with obturation azoospermia. Because of no possibility to perform operations for the replantation of the reproductive tract the method described was considered to be the method of choice. In 6 of 9 patients mobile spermatozoa were found in the aspirated medium. The transcervical insemination in days of ovulation resulted in pregnancy in 2 women. The method of implantation of the seminal receptacles is thought to be the method of choice for the treatment of absolute male sterility resulting from obturation azoospermia.