[Surgical treatment of acute purulent inflammatory processes in the pelvic area].

The article gives the results of laparoscopic treatment of 126 patients with the acute inflammatory diseases of annexums of womb and pelvis-peritonitis using ozone solution of antibiotics in the process of operative period. The dynamic laparoscopy was done in 17 cases. Advantages of ozonotherapy were determined during the endosurgical treatment of abscess-inflammatory diseases of the organs of small pelvis in women.

[Social-hygienic characteristics of patients on hemodialysis]. / Sotsial'no-gigienicheskaia kharakteristika bol'nykh, nakhodiashchikhsia na gemodialize.

The results of a sociological inquiry held at 7 Moscow inpatient facilities on the basis of "a questionnaire designed for studying the social-and-hygienic life conditions of artificial-kidney patients" are described in the paper. They are indicative of that a majority of patients have a sufficiently high assessment of their life quality although they experience a constant need in hemodialysis and their vital activity is significantly limited in view of such severe pathology as chronic renal insufficiency. This can be regarded as a positive factor within a system of measures undertaken in the treatment of the above disease.

[Functional status and seasonal changes in white blood cells in submarine personnel in the Kola Polar region]. / Funktsional'noe sostoianie i sezonnye izmeneniia sistemy beloi krovi u podvodnikov v usloviiakh Kol'skogo Zapoliar'ia.

Evaluated was potentiality of the blood leukocyte count analysis proposed by L.H. Garkavi et al. (1985-1990) within the program of submariners health monitoring. Leukograms of 573 sailors on active service in a large nuclear submarines unit and 455 divers of a formation of ships removed from an active unit of nuclear submarines for utilization. Seasonal variations in the functional state of submariners were revealed. The most noticeable differences in these two large groups of sailors were associated with particular months. Results suggest, first of all, serious adaptive loads on the physiology of submariners on military service in the Kola polar. Burden of these loads varies with seasons and has some peculiar features which means that health-improving programs should be developed for each season and each specific group of submariners, and Garkavi's method should be standardized to be applicable to the Kola polar population.

[Urapidil effects on oxidative stress in hypertensive crises]. / Vliianie urapidila na okislitel'nyi stress pri hypertonicheskikh krizakh.

Urapidil effects on oxidant stress were studied in 36 patients with hypertension stage I-III running with crises. Acute hypertensive crisis was managed by intravenous injections of urapidil (20-50 mg) for 5 min. After that for a week they received urapidil monotherapy followed by combined treatment for another week (quinapril--25 mg/day or ramipril--5-10 mg/day in combination with hypothiaside--25 mg/day; lokren--20 mg/day or atenolol--50-100 mg/day and diltiazem--180-360 mg/day) to stabilize arterial pressure finally. Oxidant stress was estimated by lipid peroxidation (LPO) and state of antioxidant system (AOS). Catabolism and anabolism were evaluated by blood levels of hydrocortisone and insulin. LPO, AOS, the blood hormones were measured before management of hypertensive crisis, immediately after it and 1, 3, 7 and 14 days after. Before the crisis treatment LPO was found high. Urapidil administration reduced levels of hydrocortisone, dienic conjugates, lipid peroxidation, oxidant stress rate (OSR). Later, LPO and OSR slowly increased. It is concluded on validity of the antioxidants use in hypertensive patients with crises.

[Nitric oxide and lipid peroxidation as factors in endogenous intoxication in emergency states]. / Oksid azota i perekisnoe okislenie lipidov kak faktory éndogennoi intoksikatsii pri neotlozhnykh sostoianiiakh.

K coefficient which is an integral indicator of the unbalance in the system lipid peroxidation--antioxidant system (LPO-AOS) and content of nitrite, nitric oxide end product, were followed up in 31 patients with concomitant brain injury, in 24 patients with burn injury and 72 patients in hypertensive crisis. Coefficient K was estimated by serum levels of dienic conjugates, malonic dialdehyde, lipid peroxidation degree, alpha-tocopherol, ceruloplasmin on the disease day 1, 3, 7 and 14. Nitrite serum levels rose by day 14 in all the patients and were the highest in hypertensive crisis patients. Coefficient K was significantly elevated in all the patients compared to controls being maximal in patients with concomitant brain injury. Thus, activation of LPO and biosynthesis of nitric oxide contribute much to endogenic intoxication in patients on critical care.

[Lipid peroxidation and antioxidant system in inhalation injury]. / Perekisnoe okislenie lipidov i antioksidantnaia sistema pri ingaliatsionnoi travme.

Thirty-five patients (aged 45 +/- 2.0 years) with isolated inhalation injury were examined on days 1, 3, and 7 after the injury, Serum concentrations of lipid peroxidation (LPO) products (dienic conjugates, malonic dialdehyde, and degree of lipid oxidation) were increased in all terms of investigation. Studies of the antioxidant system (AOS) showed a decrease in endogenous alpha-tocopherol during all terms, while ceruloplasmin content gradually increased. LPO/AOS imbalance was the most expressed on day 7 after the injury, which indicates intensification of LPO processes in the victims. The results pathogenetically validate the use of antioxidants in combined therapy of patients with inhalation injuries. LPO/AOS imbalance should be evaluated in these patients.

[Lipid peroxidation during enteral correction of experimental blood loss]. / Sostoianie protsessov perekosnogo okisleniia lipidov pri énteral'noi korrektsii éksperimental'noi krovopoteri.

Time course of lipid peroxidation and the state of antioxidant system of dog blood in an experimental haemorrhage were studied. Increases of conjugated dienes, malonic dialdehyde, Shiff's bases contents, lipid peroxidation degree were revealed. Enteral correction of the haemorrhage by the glucose-aminoacid saline enriched by mafusol promotes a decrease of lipid peroxidation.

[The dynamic of biochemical stress reaction inductors in various tactics for surgical treatment of patients with a combined trauma of cranium and lower limbs ]. / Dinamika biokhimicheskikh induktorov stress-reaktsii pri razlichnoi taktike khirurgicheskogo lecheniia bol'nykh s sochetannoi travmoi cherapa i nizhnikh konechnostei.

In 31 patients after a craniocerebral trauma combined with a trauma of locomotor system (CCCT), and in 28 patients with only a limb fractures a time course (1, 3, 7, and 14 days) of biochemical stress reaction inductors (cortisol, serotonin, histamine, lipid peroxidation products) in various tactics of surgical treatment was studied. It was established that CCCT in a significantly stronger degree increases cortisol and lipid peroxidation products' levels than an isolated locomotor system trauma. An early postponed surgical intervention in lower extremities in CCCT results in the same increase in the biochemical stress reaction inductors as a late postpone surgical intervention in the lower extremities. In an early postponed osteosynthesis in CCCT patients, a mean term of hospital stay was 67 days, and in a late postponed one 117 days. The disability period was correspondingly 200 vs 315 days.

[Lipid peroxidation and antioxidant system functions in patients with gastroduodenal ulcerous hemorrhages undergoing conservative and surgical treatment]. / Sostoianie perekisnogo okisleniia lipidov i antioksidantnoi sistemy u bol'nykh s gastroduodenal'nymi iazvennymi krovotecheniiami pri konservativnom i operativnom lechenii.

The results of examination of 53 patients have shown that greater intensity of lipid peroxidation and less activity of the antioxidant system of blood are more pronounced in the operated patients. The authors recommend to include antioxidants in the complex of medical measures.

[Biochemical criteria for assessing the severity of the status of wounded patients with gunshot damages to the chest and abdomen]. / Biokhimicheskie kriterii otsenki tiazhesti sostoianiia ranenykh s ognestrel'nymi povrezhdeniiami grudi i zhivota.

The biochemical assessment of severity was made in 34 patients with thoracic and abdominal gunshot wounds (12 uncomplicated; 11 with purulent, and 11 non-purulent complications). The levels of hormones, biogenic amines, lipid peroxidation (LP) indices, and antioxidant system (AOS) in serum were studied in 1, 3, 7, 14 days after admission. It was documented that the integral indices: cortisol/insulin and LP/AOS ratios were the most informative biochemical criteria for the assessment of severity of the injured patients. A high informative significance of these indices in the assessment of severity of homeostatic disturbances is pathogenetically substantiated due to stress-realizing (cortisol and free-radical LP components) and stress-limiting (insulin and AOS components) factors.

[Effect of the angiotensin-converting enzyme inhibitor ramipril on the processes of lipid peroxidation on the status of the endogenous antioxidant system in patients with myocardial infarction]. / Vliianie ingibitora angiotenzin-prevrashchaiushchego fermenta ramiprila na protsessy perekisnogo okiseleniia lipidov i sostoianie éndogennoi antioksidantnoi sistemy u bol'nykh s infarktom miokarda.

57 patients with macrofocal through-and-through myocardial infarction (MI) formed two groups. The control one (37 patients) received conventional treatment and the study one (20 patients) received adjuvant ramipril beginning from day 1 of MI and over the observation period. The patients were examined on day 1, 3, 10 and 20 from the moment of admission. MI patients of all the studied groups exhibited high level of lipid peroxidation (LP) products in the serum. Ramipril treatment produced marked correcting influence on conjugated dienes, malonic dialdehyde and degree of lipid oxidation. In MI patients on ramipril conjugated dienes level was the lowest on MI day 1-3, and malonic dialdehyde on MI day 10-20. Ramipril treatment limited alpha-tocopherol and ceruloplasmin increase in the serum. It is shown that in the mechanism of a positive effect of angiotensin-converting enzyme inhibitors in MI not only their direct pharmacological action can be involved but also a correction of LP processes and antioxidant system disturbances.

[Effect of the histamine H2-receptor antagonist zantac on lipid peroxidation an antioxidant system in patients with gastroduodenal hemorrhage of ulcer etiology]. / Vliianie blokatora H2-retseptorov histamina--zantaka na perekisnoe okislenie lipidov i antioksidantnuiu sistemu u bol'nykh s gastroduodenal'nymi krovotecheniiami iazvennoi étiologii.

High lipid peroxidation rates and lower antioxidative protection were found in the serum of 64 patients with gastric (n = 20) and duodenal (n = 44) ulcers complicated by hemorrhage. The administration of zantac, a histamine H2-receptor blocker, considerably reduced lipid peroxidation and enhanced antioxidative activity, which positively affected the clinical course of diseases. The findings have led to the conclusion that zantac may have antioxidative properties.

[Effect of morphine derivatives on the function of glucocorticoid receptors in shock]. / Vliianie proizvodnykh morfina na funktsiiu gliukokortikoidnykh retseptorov pri shoke.

The effects of opiate receptor agonists and antagonists on the function of glucocorticoid receptors in the hepatic cytosol were examined in male Wistar rats weighing 180-240 g. With the Scatchard analysis, in vitro experiments by using labelled ligands revealed that the pure opiate agonist morphine in the wide range of concentrations (0,01-10,0 mM) failed to affect the function Type II glucocorticoid receptors, though inhibited the function of Type III glucocorticoid receptors in the dose-dependent manner. Buprenorphine and diprenorphine depressed the function of Types II and III glucocorticoid receptors. Buterphanol, an opiate receptor antagonist-agonist, like naltrexone, an opiate receptor antagonist, decreased the function of Type III glucocorticoid receptors, but modulated that of Type II glucocorticoid receptors by lowering the association constant of the ligand-Type II glucocorticoid receptor complex, but by enhancing the density of Type II glucocorticoid receptors. In vivo studies established that butorphanol dose-dependently increased the density of Type II glucocorticoid receptors in the hepatic cytosol and elevating blood pressure in rat traumatic shock. Whether glucocorticoid receptors involve in the mechanism of the antishock effect of morphine derivatives is discussed in the paper.

[Nonsteroidal antiinflammatory agents as modulators of glucocorticoid function of receptors]. / Nesteroidnye protivovospalitelnye preparaty kak moduliatory funktsii gliukokortikoidnykh retseptorov.

The modulating effect of nonsteroidal antiinflammatory drugs (analgin, amidopyrine, sodium salicylate) on the function of types II and III glucocorticoidal receptors of cytosol in the Wistar rat liver was studied by Scatchard's and Laynuiver-Bark's analyses and dissociation rate constants for steroid-receptor complexes, by using natural and artificial glucocorticoids having a high specific activity. Analgin was not competitive in inhibiting the function of type II glucocorticoid receptors, decreased the association constant, increased the dissociation rate constant and reduced the elimination half-life of the labelled triamcinolone acetonide from the receptor. The density of type III glucocorticoidal receptors was many times increased with analgin. Amidopyrine had no noticeable effect on the function of type II glucocorticoidal receptors, however, repeatedly enhanced the density of type III glucocorticoidal receptors. Sodium salicylate was not competitive in suppressing the function of type II glucocorticoidal receptors and increased the number of sites of binding 3H-corticosterone to type III glucocorticoidal receptors. The latter fact can explain the mechanism of action of these drugs.

[Effect of dibunol on lipid peroxidation and alpha-tocopherol level in the rat heart in acute hemorrhage]. / Vliianie dibunola na perekisnoe okislenie lipidov i uroven' alpha-tokoferola v serdtse krys pri ostroi krovopotere.

The authors studied the effect of a single injection of dibunol in a dose of 120 mg/kg on lipid peroxidation (LPO) and alpha-tocopherol (TP) level in the heart muscle in acute blood loss. The LPO products and alpha-tocopherol level were determined simultaneously in a heart homogenate 2 hours after the blood loss. It was established that the loss of blood leads to activation of LPO and reduction of the TP level in the myocardium. Dibunol injection inhibited LPO activation, reducing the content of LPO products to that in animals with a false operation (without blood loss), and increased the TP level also to that in a false operation. The decrease of the TP level in acute blood loss depends, evidently, on increased mobilization of TP from the myocardium due to the increased level of catecholamines (CA), while the increase of TP under the effect of dibunol occurs due to its inhibited mobilization from the myocardium, which is mediated by reduction of the CA level.

[Effect of alpha-tocopherol on lipid peroxidation in the liver in acute blood loss]. / Vliianie alpha-tokoferola na perekisnoe okislenie lipidov v pecheni priostroi krovopotere.

The effect of single administration of alpha-tocopherol at a dose of 50 mg/kg on lipid peroxidation, content of alpha-tocopherol in liver tissue and on the activities of some enzymes in rat serum was studied under conditions of acute blood loss. The rate of lipid peroxidation in liver tissue and activities of aspartate- and alanine-transferases in blood serum were increased while content of alpha-tocopherol in liver tissue was decreased under the conditions of acute blood loss. These effects were abolished after tocopherol administration. Use of alpha-tocopherol as an antioxidant drug proved to be suitable for pathogenetic correction of metabolic impairments in acute blood loss.

[The effect of dibunol on lipid peroxidation and the alpha-tocopherol level in the lungs of rats with acute blood loss]. / Vliianie dibunola na perekisnoe okislenie lipidov i uroven' al'fa-tokoferola v legkikh krys pri ostroi krovopotere.

Experiments on linear male rats were made to study the pathophysiological mechanism of the synthetic antioxidant dibunol on the levels of primary and end products of lipid peroxidation (LPO) and of alpha-tocopherol (TP) in the lungs in acute hemorrhage. Dibunol in a dose of 120 mg/kg injected 5 min after the hemorrhage inhibited LPO to the level in intact animals and raised the content of TP to the level seen in operated animals without any hemorrhage. The conclusion is drawn about a possibility of using dibunol for correction of disturbed pulmonary metabolism in urgent conditions associated with blood loss.

[Pathogenetic bases of the use alpha-tocopherol and emoxypin in acute hemorrhage]. / Patogeneticheskoe obosnovanie primenenie alfa-tokoferola i émoksipina pri ostroi krovopotere.

The accumulation of lipid peroxidation (LP) products and decrease of alpha-tocopherol (TP) content were demonstrable in the heart, lungs, kidneys and liver after acute blood loss. Injection of TP acetate inhibited LP and raised the content of endogenous TP in the heart, lungs and liver. The antioxidant emoxypin increased the reduced oxygen tension in the liver and kidneys after blood loss. The drug prevented the reduction of the glucocorticoid type II receptor level and increased the content of the type III receptors in liver cytosol of hemorrhagic animals.