[Impact of abdominal cavity open EHF irradiation on activity of adhesive process in peritonitis].

In experiment on 45 rats a purulent peritonitis was simulated. There was established, that on background of a standard therapy for peritonitis application of abdominal cavity open irradiation of extreme high frequency (EHF) have promoted rapid stabilization of the lipid metabolism indices and the blood coagulation system, the reduction of intensity of lipids peroxidal oxidation processes and severity of systemic inflammatory reaction. Under the influence of complex treatment the severity of adhesive process was reduced in 5.4 times, comparing with such in animals, to whom a standard treatment was conducted only. The revealed pathogenetic aspects of the adhesions formation witnesses the expediency to add EHF irradiation to complex therapy of peritonitis.

[Evaluation of intestinal viability on a simulation model of a small ileus based on determination of dielectric parameters].

Interrelationship between dielectric parameters and level of ATPH before and during ischemia, as well as with indices of survival after elimination of strangulation, was estimated on a simulation model of strangulation ileus in rats. The data obtained permit to suppose, that parameter tg δm may be used as effective noninvasive criterion of diagnosis in real time for estimation of the intestinal wall state in strangulation. Resection of the infringed intestine without elimination of strangulation is necessary in tg δm less than 2.20, in tg δm more than 2.36 the elimination of infringement is indicated, because there exist possibility to restore intestinal function after ischemic-reperfusion injury. Tactics of treatment in intermediate meanings of tg δm is not determined, but its measurement before reperfusion may help in estimation of a small intestine viability and choice of surgical tactics in its ischemia.

[Intraabdominal hypertension syndrome in patients with abdominal sepsis].

Investigations were conducted in 53 patients, operated on in 2013 yr for abdominal sepsis (AS). The patients state severity was determined in accordance to the systemic inflammatory reaction and the polyorgan insufficiency severity. In 28 patients (group I) AS was diagnosed, in 14 (group II)--severe AS, in 11 (group III)--a septic shock. Tactics of surgical management of the patients have included two main measures: the infection origin control (source control), and control of the affected organ function and systemic defense mechanisms (damage control). In all the patients in AS the intraabdominal pressure rising was revealed. Syndrome of intraabdominal hypertension was noted in 10 (18.9%) patients (in 4--while presence of severe AS, and in 6--in septic shock). Lethality was the highest in intraabdominal hypertension degrees III and IV (11 of 25 patients have died).

[The features of sclerotic development in junction-ureteral segment of children with congenital hydronephrosis].

A comprehensive clinical, laboratory, instrumental and morphological study of children with congenital hydronephrosis has been carried out. We compared the clinical features of pyelonephritis at children with primary pyelonephritis and congenital hydronephrosis. Bacterial inflammation was dominated symptom at the children with primary bacterial pyelonephritis, whereas children with hydronephrosis had low-grade clinical changes and significant renal functional impairment. Clinically and prognostically more frequent severe unilateral disease was left-side hydronephrosis. For the first time the morphological changes of junction-ureteral segment at the operated children with congenital hydronephrosis have been analyzed. We've established that the evolution of changes correlates with age. Dysplastic and hypoplastic changes take place mainly in muscle layers in younger 3 years old children, in elder children the phenomenon of atrophy and sclerosis dominates over the other pathologic changes. The hystologic picture depends on lateralization of lesions: dysplasia of muscle layers is on the left side, mucous inflammation--on the right.

[Comparative estimation of the application efficacy for ceftriaxon and Hepacef combi preparations in the abdominal infection treatment].

A positive experience was described in the work, concerning application of Hepacef combi (cefoperazon/sulbactam, manufactured by "ARTERIUM" (Corporation, Ukraine) in the treatment of inflammatory-purulent diseases of abdominal organs as a method of empirical therapy. There was the preparation action efficacy estimated together with the diseases outcomes analysis, and possible recommendations for its application suggested. The preparation may be recommended for application as the empirical therapy agent in the abdominal infection treatment.

[Enhancing efficacy of the primary antibacterial therapy for intraabdominal infections].

The positive experience of their own for combined application of Hepacef and Ornizol preparations (manufactured by firm ARTERI-UM, Ukraine) as an empirical antibacterial therapy for intraabdominal infections was summarized. The preparations efficacy, the disease outcome and possible recommendations for their application in the intraabdominal infection treatment were estimated.

[Antibacterial therapy of severe intra-abdominal infections].

The experience of meropenem (Mepenam, manufactured by Corporation ARTERIUM, Ukraine) application as empirical therapy in severe intraabdominal infections was presented. The diseases outcome and the preparation efficacy were estimated, recommendations concerning its application in the treatment of severe intraabdominal infections were done.

[Preclinical diagnostics and correction of the disturbed renal blood flow in the children presenting with diabetic nephropathy].

The present study included 86 children aged between 7 and 17 years with type 1 diabetes mellitus from 1 to 15 years in duration. In all the patients, renal blood flow was investigated with the use of ultrasonic dopplerography. The results of the study suggest disturbances of intrarenal hemodynamics that manifested themselves as enhanced resistance of renal arteries from periphery to the centre in the patients at the hyperfiltration stage of diabetic nephropathy (DN) in conjunction with the reduced velocity of blood flow in inter-lobular and segmental arteries. In contrast, the patients at the microalbuminuric stage of diabetic nephropathy exhibited increased resistance and reduced velocity of blood flow in the main renal veins. In 35 patients presenting with diabetic nephropathy, hemodynamic correction was achieved by the application of the traveling pulsed magnetic field (TP-MF) to the renal region using an AMO-ATOS-E apparatus (Russia). This treatment resulted in normalization of the characteristics of renal blood flow. It is concluded that TPMF has good prospects for the use as a component of the combined treatment of diabetic nephropathy.

[Complex treatment of pulmonary abscesses and pleural empyema in patients with severe thoracic trauma].

The results of complex treatment of 40 injured persons with severe thoracic trauma, in whom pulmonary abscesses and pleural empyema had occurred postoperatively, were analyzed. Complex treatment of pulmonary abscesses and pleural empyema, using the methods of a local superhighfrequency irradiation of purulent foci have promoted their accelerated regression occurrence and reduction of a systemic inflammatory reactions severity, as well as prophylaxis of secondary purulent-septic complications, permitting to achieve lethality lowering and to escape practically reoperations performance.

[Surgical tactics in acute paraproctitis].

Individualized tactics of radical surgical treatment, applied in 100 patients, suffering an acute paraproctitis, was presented. Performing comparative estimation of the treatment results in 110 patients, in whom the conventional surgical approaches were applied, there was established, that an active surgical tactics secures essential reduction of the patients stationary treatment duration, the rate of the disease recurrence occurrence and transformation into the chronic illness.

[Application of preparation quadrocef in the treatment of surgical sepsis].

Comparative estimation of the treatment result of severe abdominal infection, using cefalosporins of the fourth generation maxipim and Quadrocef (Arterium, Ukraine) was accomplished. High efficacy of Quadrocef preparation and possibility of its application as a first-line preparation for severe infections was proved.

[The change of some indices of coagulogram in rats in experimental pancreonecrosis under the influence of electromagnet irradiation of extremely high frequencies].

The dynamics of changes of some coagulogram indices under the influence of electromagnet irradiation of extremely high frequencies was studied in rats in conditions of experimental pancreonecrosis. Irradiation of abdominal cavity in animals, using electromagnet irradiation with the 6.5 mm wave length, reduces hypercoagulation shifts essentially and raises the plasm anticoagulant and fibrinolytic activity.

[Investigation of anti-inflammatory action of electromagnetic irradiation of extremely high frequencies in experiment].

There were studied some mechanisms of the effect realization of the extremely high frequency electromagnet irradiation, including modification of the organism immune status as an answer on the irradiation action, manifested by mobilization of ripe CD4+ and CD8+ T-lymphocytes, the interleukins (IL) concentration enhancement, including, IL-1, IL-10, as well as the levels lowering of IL-6 and C-reactive protein in the blood serum. There was established, that using a switching on the intermediate signal systems it is possible to induce the directed (antiinflammatory) answer of organism towards the effective parameters of electromagnet irradiation.

[Surgical tactic in patients with high risk of occurrence of the intestinal anastomoses sutures insufficiency].

The prognosis criteria for development of the intestinal anastomoses sutures insufficiency were elaborated, basing on analysis of the risk factors occurrence. Surgical tactic of treatment of the patients was substantiated, depending on the risk grade presence. In presence of high or moderate risk of the sutures insufficiency occurrence the methods of the deferred intestinal anastomoses formation were elaborated, excluding necessity of multistage intraabdominal operative interventions performance. Introduction of curative-diagnostic approach proposed promotes lowering of postoperative complications rate and lethality.

[Regional vasotropic and hepatotropic therapy in the complex treatment of postoperative purulent peritonitis].

In 8 patients, operated for postoperative spreaded purulent peritonitis, umbilical vein was catheterized, postoperatively angiographic investigation was performed, leaving catheter in tr. coeliacus or a. mesenterica superior, through which regionary hemodilution, using drop infusion of 20 mcg of alprostan during 3-4 days. Additionally, to all the patients intraportal hemodilution with hepatoprotector thiotriazoline infusion was performed. Application of the treatment measures complex proposed had assisted an early restoration of splanchnic microcirculation, significant lowering of endogenic intoxication severity, rapid restoration of hepatic functional activity, reduction of systemic inflammatory answer expression.

[Application of ultra high frequency irradiation in prophylaxis and treatment of complications of infectious pancreonecrosis].

Local super high frequency irradiation was applied in 9 patients, suffering the pancreonecrosis (PN) inflammatory-purulent complications. Introduction of local super high frequency irradiation to the complex of treatment permits to prevent the PN purulent complications occurrence, to improve the immediate results of the patients treatment.

[Comparative characteristic of respiratory pattern responses to kainic acid microinjections in different parts of the nucleus ambiguous]. / Sravnitel'naia kharakteristika reaktsii patterna dykhaniia na mikroin''ektsii kainovoi kisloty v razlichnye otdely dvoinogo iadra.

In rats, local chemical isolation of neurones by the kainic acid helped to investigate into comparative role of different parts of the n. ambiguus in respiratory control mechanisms. We disclosed specific peculiarities of responses of rhythm and respiratory pattern to chemical isolation of different parts of the n. ambiguus. In particular, it was found that consecutive isolation of the left and right rostral parts of the n. ambiguus caused a significant decrease of the respiration rate and respiratory volume and also resulted in irreversible cessation of respiration in 83% of experiments. Isolation of symmetric medial parts of the n. ambiguus resulted in bradypnoe and a decrease of pulmonary ventilation; maximal respiratory effect was recorded after kainic acid injection in the symmetric part only, thus the irreversible cessation of respiration was recorded in 50% of experiments. After isolation of symmetric caudal parts of the n. ambiguus we observed an insignificant decrease of the respiration rate without significant changes of the respiratory volume, and number of the respiration cessation was minimal: 33%.

[Functional condition of gallbladder after stomach resection by Roux]. / Funktsional'noe sostoianie zhelchnogo puzyria posle rezektsii zheludka s anastomozom po Ru.

This study examined the results of surgical treatment of 90 patients with ulcerative stenosing disease of the stomach and duodenal ulcer between 1984 and 1995. 30 patients (study group) underwent stomach Roux resection. Truncal vagotomy with stomach Bilroth-I resection (control group) was made in 20 patients, 20 patients had a truncal vagotomy with pyloroplasty according to Heineke-Mikulicz (control group), and 20 patients had a selective proximal vagotomy with gastroduodenostomy by Joboulay (control group). Motor and evacuation functions of gallbladder were assessed by dynamic US and radioisotope scintigraphy. After a Roux stomach resection and a stomach Bilroth-I resection, respectively, hypokinetic and hyperkinetic types of the gallbladder's dyskinesia was established. After a selective proximal vagotomy with gastroduodenostomy by Joboulay and truncal vagotomy with pyloroplasty according to Heineke-Mikulicz essential change of the gallbladder refractive function wasn't observed.

[The role of the intestine in the pathogenesis of the multi-organ dysfunction syndrome in diffuse peritonitis]. / Rol' kishechnika v patogeneze sindroma poliorgannoi disfunktsii pri rasprostranennom peritonite.

Extraction of oxygen (O2), ultrastructural organization of intestinal macrophages and translocation of microorganisms were studied on 50 male rats of Wistar line in 2, 6, 12, 24 and 48 hours after the stimulation operation performance (control group) and modelling of an acute purulent peritonitis (APP)--basic group. Increase of common and lowering of intestinal extraction of O2 in early terms of the APP occurrence, accompanied by intensive reproduction of microorganisms and change of intestinal biocenosis, was noted. These infringements correlated with translocation of microorganisms through mesenteric lymphatic nodes--ductus toracicus--systemic blood flow (basic way) in term up to 24 hours and through portal vein--hepar--systemic blood flow (additional way)--up to 48 hours after the APP beginning.