[Effects of the umbilical blood stem cells in experimental injury of myocardium].

Morphological, functional signs of myocardium affection and tolerance to physical loading in animals with isoproterenol-induced affection of myocardium after transplantation of a nuclear-containing cells (NCC) of umbilical blood were analyzed in comparison with a natural course of the model. There was proved, that a transplantation of a NCC promotes acceleration of processes of regeneration and restoration of the damaged myocardium in experimental animals. There were estimated the changes in localization of the transplanted NCC in the zone of damage, and capacity of the peripheral blood NCC, while they were transplanted, using intravenous injection, to migrate into the damage zone. The experimental data obtained need further complex analysis and permit to wait a positive effect while performing clinical investigations in the patients, suffering chronic diseases of the heart.

[Technology of blood preservation in the surgery of the abdominal aorta].

The results of surgical treatment of abdominal aortic aneurysm in 60 patients are presented. The Cell Saver was used in 22 (36.7%) patients for blood saving. The usage of the Cell Saver didn't effected the needs for red blood cells in the perioperative period.

[Prognosis of operative treatment outcome in patients with abdominal aorta aneurism].

There was analyzed the risk of surgical intervention in patients, suffering abdominal aorta aneurism, using the risk indices POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) and GAS (Glasgow Aneurysm Score). The theoretically obtained indices were compared with the real indices and the availability of the indices for the practice were determined. The investigation was done in 122 consequent patients, suffering infrarenal abdominal aorta aneurism, to whom the abdominal aorta prosthesis was performed in 2005-2007 yrs. Lethality was 9.8% and complications rate--51.6%. The ROC curve analysis (the interrelationship curve of false-positive and true-positive results) and the analysis of square under the curve were performed for the indices availability analysis. The indices did not reveal high specificity for the lethality prognostication.

[Anesthesiological support during performance of endovascular prosthesis for the infrarenal aorta aneurysm].

The results of treatment of 10 patients, suffering the abdominal aorta aneurysm, using the third generation bifurcational prosthesis Excluder, are presented. Endoprosthesis was performed under local infiltrating anesthesia (LIA) and light sedation, in one observation the LIA was incidentally changed to general anesthesia and artificial lung ventilation. In the early postoperative period the complications did not occur. LIA may be successfully applied if the patient was thoroughly prepared and informed, the arteries were accurately dissected and intravascular apparatuses inserted, as well as the performance of the aorta endoprosthesis for the abdominal aorta aneurysm was not durable.

[Application of recombinant erythropoietin during preparation for hepatic transplantation operation from the living kindred donor].

First experience of application of the blood autodonorship programme, using recombinant erythropoietin (Eprex) plus preparations containing iron during their preparation for partial hepatic resection, was analyzed. Realization of this programme had permitted to escape the performance of allogenic hemotransfusion in 71.4% of donors, in whom the right or left hepatic lobe was taken out and in 100%--the left lateral section. The erythropoietin dosage regimes in different types of hepatic resections in living kindred donors were proposed.

[Problems with infection in surgical hospital. Meeting with XXI century].

Uncontrollable application of antibiotics (AB), changing nature of microorganisms, insufficient intrahospital epidemiological control causes significant difficulties in the treatment of severe intrahospital infections. Strategy for the therapy quality improvement includes elaboration of the AB application formularies in every division, the nosocomial infections treatment protocols, restriction of certain AB application by special indications, the AB administration change in 48-72 h of its application in accordance to indications, and, if possible, change of the wide specter AB by preparations of more specific action, education of medical personnel on following prophylaxis regimen for hospital infections.

[New technologies in diagnosis and surgical treatment of the abdominal aorta aneurysm].

Modern views about occurrence, pathogenesis, and methods of diagnosis and surgical treatment of abdominal aorta aneurysm are adduced. Application of new highly informative diagnostic methods, an adequate anesthesiological support, differentiated methods of surgical intervention have permitted to reach marked progress in the treatment of patients with abdominal aorta aneurysm.

[Correspondence of intraabdominal pressure programmed by CO2 insufflator to pressure measured in bladder and stomach during laparoscopic operation].

There are presented the results of intraabdominal pressure measuring in 75 patients, to whom elective laparoscopic cholecystectomy was performed. Intraabdominal pressure was measured using direct and indirect methods in bladder and stomach. The results of measuring, using direct and indirect methods, are similar.

[Effect of preoperative care on intraabdominal and perfusion pressure in the abdominal cavity].

Data of measurement of intraabdominal pressure (IAP) and perfusion pressure in abdominal cavity (PPAC) in patients, to whom abdominal wall plasty, using synthetic net, was performed, including 42--without preoperative preparation (1st group) and 51 (2nd group)--after performance of preoperative preparation, applying combined anesthesia with artificial ventilation of lungs. In the patients of second group IAP after the operation was lower and PPAC--higher, in comparison with these indices in the first group.

[Morphological changes in the lungs and characteristics of thromboemboli in patients with thromboembolism of the pulmonary artery].

Basing on results of pathologoanatomical investigations, performed in 26 cases, the lungs changes in pulmonary thromboembolism were analyzed. It was shown, that an acute thromboembolism of a. pulmonalis main branches did not cause an acute necrosis of pulmonary alveolar tissue, but induces progressive diffuse changes of their microcircular bed, concomitant with pulmonary hypertension. In cases of chronical pulmonary thromboembolism the diffuse vascular sclerosis of the nonaffected lung and the alveolar tissue emphysema are formed, and in such cases the signs of pulmonary hypertension showing hypertrophy of the muscular vessels middle layer as well as their intima hyperplasia are revealed. This determines the expediency of earlier start of thrombolytic therapy conduction as well as surgical intervention in an acute pulmonary thromboembolism.

[Application of fluoroquinolons in practice of the intensive therapy departments].

The review on the most studied class of antimicrobal preparations - fluoroquinolons (FQ) - is presented. Peculiar attention is paid to FQ, which were registered in the Ukraine (ciprofloxacine, ofloxacine, gatifloxacine, moxifloxacine). The data concerning chemical structure, pharmacokinetics of FQ, obtained during last years, are presented. The advantages and faults of definite representatives of FQ class are depicted. Principles of clinical administration of FQ, basing on the departments passportization and determination of the microbic agents sensitivity, are adduced.

[Main principles of antibiotic prophylaxis and antibacterial therapy in abdominal surgery].

The principles of antibioticoprophylaxis and antibacterial therapy in abdominal surgery were expounded. There are adduced the most frequently revealed pathogenic microorganisms, inducing intraabdominal infection, the ways of lowering of the antibacterial therapy expenses, new approaches to application of immunocorrection and directed transport of antibiotics in surgery as well as empirical and etiotropic treatment, basing on the taking account of the spread and antibioticosensitivity of pathogenic microorganisms of nosocomial infections. There was shown, that concentration of interleucin-1beta and tumor necrosis factor-alpha in the blood serum is connected with the severity of patient state. Significant rising of this cytokines concentration constitutes the trustworthy criterion of the ineffective therapy and mortality risk. The influence of microorganisms and some antibiotics on induction of interferons was studied. Amoxicyllin, polymixin, vancomycin, cephalosporins and fluconazol are the most active inductors of gamma-interferon. Maximal efficacy of antibacterial therapy is possible only if an adequate surgical intervention was performed.

[Assessment of risk of thromboembolism in patients undergoing surgery]. / Otsenka riska vozniknoveniia venoznogo tromboza i émbolii u khirurgicheskikh bol'nykh.

The risk factors of venous thromboembolism (VTE) in 1146 patients who were underwent operated for the diseases of digestive organs, for obliterating atherosclerosis of abdominal aorta and peripheral arteries, diseases of bones and joints were studied. The methods of VTE prevention in these patients were studied. To evaluate the risk of VTE we designed the special chart. Three levels of risk of VTE: low, moderate and high were distinguished. The specific prophylaxis of the VTE using low molecular weight heparin fraxiparine was given to the patients moderate (90.7%) and high (93.3%) risk degree.