[Regional perfusion and oxygenation in the early resuscitation period following prolonged clinical death]. / Regionarnaia perfuziia i oksigenatsiia v rannem postreanimatsionnom periode posle dlitel'noi klinicheskoi smerti.

Cardiac output distribution and oxygen supply in the period starting from 15 min after resuscitation to 7 h were studied in 23 dogs exposed to 10 min clinical death caused by blood loss. The ratio of supra- to subdiaphragmatic bloodstream was virtually unchanged. Redistribution of the flow in favor of hind limb muscles was observed in the subdiaphragmatic region only between the 15th and 30th minutes. Reduction of oxygen transport during prolonged hypoperfusion (2-6 h) was associated with increased oxygen utilization in all areas which was expressed most of all in the supra-diaphragmatic region and in limb tissues and the least so in the splanchnic area, with oxygen consumption remaining at the initial level or surpassing it. A close relationship was revealed between oxygen transport and consumption in the supradiaphragmatic sector and posterior limb tissues combined with critical levels of pO2 and HbO2 in outflowing blood. Stably surviving animals differed from those dead in 1 sec by a lesser depression of the bloodstream and oxygen transport in the body on the whole and in the supradiaphragmatic region, a lesser oxygen consumption by the supradiaphragmatic region at the 15th-30th minutes, and a higher O2 consumption in 3-6 h under conditions of more marked spontaneous hypothermia.

[Change in the metabolic functions of the lungs and the content of biologically active substances in the blood of patients with the adult respiratory distress syndrome]. / Izmenenie metabolicheskikh funktsii legkikh i soderzhanie biologicheski aktivnykh veshchestv v krovi bol'nykh respiratornym distress-sindromom vzroslykh.

In 48 patients operated on for peritonitis of different etiology the postoperative period was complicated by the onset of adult respiratory distress syndrome. A considerable increase in the blood level of biologically active compounds (adrenalin, noradrenalin, histamine, serotonin) and the activation of kinin system have been observed. Marked humoral shifts trigger a sequence of reactions manifested in microcirculation disturbances and the onset of tissue hypoxia, thus inducing the damage of metabolic lung functions and the development of adult respiratory distress syndrome.

[Absorption and release of biogenic amines by the lung during the restorative period after hypovolemic hypotension]. / Pogloshchenie i vysvobozhdenie biogennykh aminov legkimi v vosstanovitel'nom periode posle gipovolemicheskoi gipotenzii.

The processes of serotonin and histamine absorption and release by the lungs were studied in dogs during 1 to 3.5 hour hypovolemic hypotension and during 24 hours after blood retains fusion. Absorption of biogenic amines by the lungs tended to increase in all the animals under hypovolemic hypotension. In the group of non-survivors the serotonin absorption by the lungs in the post-terminal period remained increased, while in the group of survivors it came down to normal soon, though the histamine release was increased. The above processes were aggravated in the group of animals whose lungs were affected by oleic acid. It resulted in the absorption of histamine instead of its release. The intensified absorption of biogenic amines by the lungs was accompanied by a quick fall in cardiac output, by the increase in resistance of systemic and pulmonary circulation.

[Effect of nootropic agents on the brain bioelectrical activity and on the indices of neuromediator metabolism in the acute period of severe craniocerebral trauma]. / Vliianie nootropov na bioélektricheskuiu aktivnost' mozga i pokazateli neiromediatornogo obmena v ostrom periode tiazheloi cherepno-mozgovoi travmy.

Clinico-biochemical examination and EEG were conducted in 39 patients with severe craniocerebral trauma who were given nootropic agents in a complex of intensive therapy measures. Four types of changes of monoamine metabolism in treatment with piracetam were revealed which were combined with two types of EEG changes. The authors recommend the time for beginning piracetam therapy depending on the level of traumatic injury to the brain.

[Participation of the lungs in the absorption and liberation of biogenic amines in the postresuscitation period]. / Uchastie legkikh v pogloshchenii i vysvobozhdenii biogennykh aminov v postreanimatsionnom periode.

After revival from a 10-minute clinical death caused by acute blood loss the transport of biogenic amines to the lungs in dogs did not increase for 3 hours. Their absorption by the lungs was replaced periodically by their liberation; both processes were intensified for serotonin but weakened for histamine. In 6-9 hours during the period of hypoperfusion and reduction of the transport of amines to the lungs the intensity of absorption and liberation of serotonin by the lungs were normalized, while these processes for histamine remained diminished. The content of biogenic amines in arterial blood reduced. Twenty-four hours later, under conditions of normalization of hemodynamics, the transport of histamine to the lungs and its concentration in blood were still reduced, while the transport and absorption of serotonin by the lungs, as well as its content in arterial blood, increased; this was attended by an increase in total pulmonary resistance and the development of moderate hypoxemia. Animals who died subsequently had a higher level of serotonin in arterial blood but a lower level of histamine. The role of the lungs in homeostasis of blood biogenic amines in the postresuscitation period is discussed.

[Disorders of systemic hemodynamics in the acute period of severe craniocerebral trauma]. / Narusheniia sistemnoi gemodinamiki v ostrom periode tiazheloi cherepno-mozgovoi travme.

Disorders of systemic hemodynamics were studied in 68 patients in the acute period of severe cerebrocranial trauma. Three types of systemic hemodynamics were revealed: normodynamic--in corticohemispheric level of brain injury, hypodynamic--in injury to the stem, and hyperdynamic--in hemispheric-subcortical damage. The authors consider the hyperdynamic and hypodynamic types of the responses of systemic hemodynamics as a prognostically unfavourable sign.

[Hormone-active paragangliomas of the base of the skull]. / Gormonal'no-aktivnye paragangliomy osnovaniia cherepa.

Biochemical examination of 15 patients with paragangliomas (PG) of the base of the skull was conducted. The content of epinephrine, and norepinephrine, dopamine, and dopa in urine and the content of serotonin and histamine in blood and tumor tissue were studied. Comparison of the biochemical findings with the vegetative symptomatology allowed 3 groups of PG to be distinguished: catecholamine-secreting, serotonin-secreting, and hormone-inactive. The group of serotonin-secreting tumors of the base of the skull has not been described in the literature. The conducted research shows that tests for biogenic amines must be performed not only for diagnostic purposes but also for prognosticating possible surgical complications.

[Korsakoff's syndrome in the clinical picture of craniocerebral injury]. / Korsakovskii sindrom v klinike cherepno-mozgovoi travmy.

The localization and the nature of brain lesions are among the most debatable issues in Korsakoff's syndrome (KS). In 28 patients with head trauma the neurological investigation and CT scans helped to distinguish between the following stages of KS progress and reversal: (1) whole brain response with consciousness deterioration and psychomotor excitement; (2) predominantly focal involvement of the right hemisphere; (3) regression of KS clinical manifestations.

[Disorders of viscero-autonomic and neurohumoral regulation in tumors of sellar-diencephalic localization]. / Narusheniia vistserovegetativnoi i neirogumoral'noi reguliatsii pri opukholiakh selliarno-diéntsefal'noi lokalizatsii.

Twenty-nine patients with varying degrees of hypothalamic lesion were studied for disorders of viscero-vegetative and neurohumoral regulation. Three types of impairments were identified: intact under-compensated, reduced, and perverted. The type of disorders was found to correlate with the degree of the impact of the pathologic process on the hypothalamic structures. It is emphasized that preoperative examination of the central hemodynamics and biogenic amines allows the prediction of their impairment in the postoperative period.

[Use of L-DOPA in the complex treatment of severe craniocerebral injuries]. / Primenenie L-DOFA v kompleksnom lechenii tiazheloi cherepno-mozgovoi travmy.

The article is based on an analysis of the results of clinicobiochemical study of 15 patients with severe craniocerebral trauma (SCCT) whose intensive multiple-modality treatment included the use of L-DOPA. All the patients presented with direct traumatic lesions of the subcortical structures attended by diminished excretion of dopamine and DOPA. A favourable clinical effect was related to the use of DOPA which indicates that it is advisable that the drug be included into the combined therapy of severe injury to the brain attended by dysfunction of the subcortical formations.

[Status of biogenic amine metabolism in tumors of chiasm-sellar localization]. / Sostoianie obmena biogennykh aminov pri opukholiakh khiazmal'no-selliarnoi lokalizatsii.

Histamine, serotonin, and catecholamine metabolism was studied in 47 patients with tumors of diencephalic localization. It was shown that the degree of involvement of the hypothalamus in the tumor determined the different character of metabolic changes of biogenous amines. Three stages of biogenous amine metabolism were distinguished: activation, compensation, and exhaustion. The degree of metabolic changes manifestation before the operation determined to a great measure the organism's reaction to it. The work substantiates the necessity for taking into consideration the metabolism of biogenous amines before undertaking surgery.

[Reaction of the sympathetic-adrenal system of patients with tumors of the sellar-diencephalic region in the postoperative period]. / Reaktsiia simpatiko-adrenalovoi sistemy u bol'nykh s opukholiami selliarno-dientsefal'noi oblasti v posleoperatsionnom periode.

The character of the reaction of the sympatheticoadrenal system (SAS) to operation in 51 patients with tumor of the sellar-diencephalic area was studied. A dependence was demonstrated between the character of postoperative SAS activity and the degree of involvement of the subthalamic area and the doses of hydrocortisone given in the postoperative period. The necessity of taking into account the condition of the SAS in conducting intensive therapy in neurosurgical patients in substantiated.

[Changes in the state of the histamine--diamine oxidase and serotonin--monoamine oxidase systems and the activity of the sympatho-adrenal system following experimental occlusion of the aortic trifurcation in dogs]. / Izmenenie sostoianii sistem gistamin--diaminoksidaza, serotonin--monoaminoksidaza i aktivnosti simpatiko-adrenalovoi sistemy pri éksperimental'noi okkliuzii trifurkatsii aorty u sobak.

Experiments on 12 dogs have shown that alterations in the intrasystemic parameters of histamine-diamine oxidase, serotonin-monoamine oxidase, adrenaline-noradrenaline and in the intersystemic patterns of adrenaline-histamine indicate the biological adaptation under conditions of embolism of aorta trifurcation induced by 3-hour occlusion. Alterations in the activity of the enzymes studied underlie the adaptational syndrome. During 6-hour occlusions the activity of monoamine oxidase was relatively decreased. Meanwhile the content of serotonin and noradrenaline remained at a high level. These amines might participate in the development of pronounced hypoxic impairments seen in the course of the observation period. It is recommended that adrenoblockers and inhibitors of synthesis of serotonin or serotonin-reactive structures may be used for correction of metabolic disorders.