[Ambulatory anesthesia in surgical practice in children].

A brief historical overview of the stages of development of outpatient surgery and anesthesiology is provided. It displays features of pre-selection and evaluation of patients for pediatric ambulatory surgery, the relation to the problems of preoperative fasting, anesthesia with concomitant diseases, the relative and absolute contraindications to outpatient surgeries in children. The research discusses the need and form of administration of sedative drugs in premedication in children of different ages, their influence on the recovery time after anesthesia. Compares methods of induction and maintenance of anesthesia, the possible use of volatile and intravenous anesthetics in ambulatory surgery in children, the advantages and disadvantages of given methods, as well as options for their combination with regional blocks. Pays attention to the postoperative analgesia and control of postoperative nausea and vomiting, consider their side effects.

[The effect of metoclopramide on the hypophyseo-ovarian relations in patients with amenorrhea resulting from body mass loss]. / Vliianie metoklopramida na gipofizarno-iachnikovye vzaimootnosheniia u bol'nykh s amenoreei, sviazannoi s poterei massy tela.

The levels of FSN, LH, prolactin, estradiol, and progesterone were investigated in the blood of 26 women with hypothalamic amenorrhea (in 17 of them it resulted from body mass deficiency) before and during metoclopramide therapy (the drug was administered at a daily dose of 20 mg for 1 = 9 mos). The administration of the drug per os in 3 h resulted in a considerable rise of the blood level of prolactin in patients with body mass deficiency. Regular administration of the drug in this group normalized the anovulatory cycle in 5 women and caused pregnancy in one woman. In the authors opinion, this effect was due to a decrease in dopaminergic inhibition of the anterior pituitary lobe and the restoration of the mechanism of positive feedback between the ovaries and pituitary gland.

[Effect of proton irradiation of the hypophysis on its gonadotropic and thyrotropic functions in patients with prolactinoma]. / Vliianie protonnogo oblucheniia gipofiza na ego gonadotropnuiu i tireotropnuiu funktsii u bol'nykh s prolaktinomami.

In order to study the effect of proton beam irradiation on prolactinoma cells and hypophyseal intact cells tests with i.v. administration of TRH (200 micrograms) and LH-RH (100 micrograms) were performed in 16 women with prolactin-secreting adenomas before and in 2 mos.-2 years after irradiation of the pituitary body with a high energy narrow proton beam (1000 MeV) at a dose of 40-120 Gy. A curative therapeutic effect of proton therapy which was low with respect to reproductive function recovery, was combined with lowered functional reserves of hypophyseal thyrotrophs and gonadotrophs. The informative value of the tests with the releasing hormones was shown for the determination of damage of hypophyseal intact cells. The results suggest refractivity of adenomatous lactotrophs to radiation exposure and the hypothalamic level of disorder of ovarian function regulation in this pathology.

[Dopamine in the pathogenesis of normogonadotropic amenorrhea]. / Dofamin v patogeneze normogonadotropnoi amenorei.

A total of 108 patients with normo-gonadotropic amenorrhea and 25 normal females were investigated. Three dopamine-dependent parameters were under study: maximum range of changes in the blood levels of luteinizing hormone (LH) and follicle-stimulating hormone, hypophyseal response to thyrotropin releasing factor (TRF) and prolactinemia-dependent therapeutic effect of bromocriptine. Significantly increased range of the serum gonadotropin levels, increased reaction of hypophyseal thyrotropic hormone to TRF and higher therapeutic efficiency of bromocriptine was revealed in hyperprolactinemic patients versus those with normo-gonadotropic amenorrhea. The results obtained are indicative of the decreased dopaminergic tension of the tuberoinfundibular system in hyperprolactinemic amenorrhea and increased one in normoprolactinemic patients. In 15 out of 32 normoprolactinemic patients bromocriptine therapy normalized their menstrual cycles. The range of spontaneous changes in the blood levels of LH was supposed to be a prognostic criterion for the assessment of bromocriptine therapeutic efficiency. A relative hypophyseal deficiency of dopamine was suggested in some of normoprolactinemic patients.

[Gonadotropic activity of the hypophysis and ovarian endocrine function in hyperprolactinemic amenorrhea]. / Gonadotropnaia aktivnost' gipofiza i éndokrinnaia funktsiia iaichnikov pri giperprolaktinemicheskoi amenoree.

Radioimmunoassays were used repeatedly to determine prolactin, LH, FSH, estradiol and progesterone at different time intervals (days, months, weeks) in 50 women with hyperprolactinemic amenorrhea. Nine patients had x-ray signs of hypophysial adenoma. The intact state of the portal system, hypophysis gonadotrophs and thyrotrophs was confirmed using LH-RH and TRH tests. Proceeding from the comparison of gonadotrophin and sex steroids and the analysis of the blood LH fluctuation amplitude after repeated measurements, it was concluded that the gonadotropic basal secretion was disturbed in hyperprolactinemic amenorrhea and that a single determination of an elevated gonadotrophin level in the blood was not enough to diagnose primary ovarian insufficiency.

[Change in the incidence of HL-A antigens in diabetes mellitus]. / Izmenenie chastoty vstrechaemosti antigenov sistemy HLA u bol'nykh sakarnym diabetom.

Changes in the incidence of the HLA system antigens (A1, A2, A3, A9, A10, A11, A19, A28, A29, B5, B7, B8, B13, B14, B15, B16, B17, B18, B21, B22, B27, B35, B37, B40, B41) was studied in 1134 healthy persons and in 147 patients with diabetes mellitus. In comparison with healthy persons, patients with juvenile diabetes mellitus (62) displayed a significant increase in the incidence of antigens B8, B15, B35, and A10, and patients with adult diabetes mellitus with normal weight (35)--of antigen B8. When adult diabetes mellitus was accompanied by obesity (50) a significant rise in the occurrence of antigen A10 was revealed.