[Discrete plasmapheresis for coronary heart disease].

AIM: To provide a rationale for the expediency and efficiency of discrete plasmapheresis (PA) in the package of therapeutic measures for coronary heart disease (CHD). SUBJECTS AND METHODS: 585 sessions or 120 cycles of low-volume therapeutic PA were performed in 91 patients with CHD. The parameters of blood lipid composition, hemocoagulation, rheology, and endotoxicosis were studied. RESULTS: Removal of 100% circulating plasma volume per treatment cycle could achieve a significant positive result of abnormally higher homeostatic parameters. The levels of high-density lipoprotein cholesterol, antithrombin III, and albumin did not decrease significantly. CONCLUSION: Low-volume discrete PA is a pathogenetically sound and effective method to affect homeostasis in CHD.

[The use of modern information technologies in the work of clinical-diagnostic laboratory in the surgical hospital].

Using the personal experience of exploitation of complex informative system, which automatises the work of diagnostic laboratory, authors propose some ideas. The original ways of improving the quality of laboratory diagnostics, decreasing time of diagnostics and easing the interpretation of results were suggested. The problem of results' interpretation considering different reference values is highlighted.

[Use of lornoxicam for analgesia in the early postoperative period]. / Primenenie lornoksikama dlia obezbolivaniia v rannem posleoperatsionnom periode.

Lornoxicam was used for analgesia in 64 patients on days 1-2 after extensive interventions. The drug efficiency and safety were evaluated depending on the dose and route of administration. Intravenous infusion of lornoxicam in a daily dose of 24 mg (basic therapy) did not involve the use of opioids in 35% patients and its analgesic effect was higher than that of promedol monotherapy. Combined therapy with lornoxicam and promedol allows reduction of promedol dose by 25-50% and the incidence of untoward effects by 27-44%.

[The lipid profile in patients with obesity who have undergone vertical gastroplasty]. / Lipidnyi "profil'" u bol'nykh s ozhireniem, perenesshikh vertikal'nuiu gastroplastiku.

The effect of vertical banded gastroplasty (VBG) on the lipid profile in obese patients is considered. The antiatherogenic effect of VBG and of the following weight loss consists in significantly decreased plasma triglycerides, increased content of high-density lipoproteins and decreased atherogenic coefficient. Patients with hypercholesterolemia have significantly lower total plasma cholesterol by the period of the body mass stabilization. The effect of VBG is compared with that of other methods of correction of dyslipidemia. The possibility to improve this effect is also discussed.

[A new method for urea detection in biological fluids]. / Novyi metod dlia opredeleniia soderzhaniia mocheviny v biologicheskikh zhidkostiakh.

A modified urease hypochlorite method for measuring urea in biological fluids is described. Its novel feature is the use of 4-hydroxycoumarin as ammonia acceptor. This compound has never been used for this purpose, and it has a number of advantages over traditional phenol and its derivatives: the measurement is performed in just two steps, the compound is nontoxic and used in low concentrations, and the accuracy of measurements is higher due to decrease of the systemic error. Results of urea tests with the new kit are presented. The kit contains ready-to-use components in tablets and stabilized concentrated solutions of sodium hypochlorite and alkali. The characteristics of the kit are as follows: linearity of determination up to 25 mmoles per liter, deviation from linearity no more than 7%, and sensitivity up to 0.7 mmoles/liter.

[The role of lactate acidosis and enzyme hyperactivity in evaluating hypoxic organ disorders in patients following cardiopulmonary byøass]. / Rol' laktatatsidoza i giperfermentemii v otsenke gipoksicheskikh organnykh povrezhdenii u bol'nykh, operirovannykh na serdtse v usloviiakh iskusstvennogo krovoobrashcheniia.

One hundred and fifty patients after cardiopulmonary bypass surgery have been examined. It has been shown that overall enzyme activity should be taken into consideration when determining the genesis of postoperative hyperenzymemia and diagnosing the topical (organic) damage. High lactate level (6-8 mmol/l) reflects profound circulatory hypoxia and shows a great likelihood of secondary damage of parenchymatous organs in patients after cardiopulmonary bypass surgery. Marked lactatacidosis combined with a 5-10-fold increase in enzyme activity in the early postoperative period is an unfavourable prognostic sign. Prolonged antagosan (trasilol) administration during cardiopulmonary bypass surgery may be one of the techniques preventing and correcting hypoxic organ damage.

[Enzyme and isoenzyme tests in the diagnosis of myocardial infarct during aortocoronary bypass]. / Fermentnye i izofermentnye testy v diagnostike infarkta miokarda pri aortokoronarnom shuntirovanii.

The authors assess the diagnostic value of several enzyme and isozymic tests used in the diagnosis of myocardial infarction in aortocoronary shunting (ACS): the diagnostic sensitivity and specificity, as well as the significance of both positive and negative results, and the diagnostic efficacy of every test have been estimated. Ninety-one patients subjected to autovenous ACS have been examined for the total creatine kinase (CK), lactate dehydrogenase (LDH), aspartate and alanine aminotransferase activities, and for the activities of CK and LDH isozymes. The results evidence a high diagnostic value of CK and LDH isozymes measurements. A comprehensive study of these isozymes is a reliable criterion of the diagnosis of myocardial infarction. If myocardial infarction in ACS is diagnosed on the basis of the total enzymic activities, measurements of the transaminases and LDH are advisable; investigation of CK total activity is of poor informative value.

["False-positive" cytologic diagnoses]. / O "lozhnopolozhitel'nykh" tsitologicheskikh diagnozakh.

In a series of 30,000 cytologic examinations carried out in patients with lung pathology, 20 results were considered false-positive for cancer. However, in 5 of them, malignancy was subsequently confirmed. These data were analysed to identify patterns of lung cancer in which cytologic samples are likely to be misinterpreted as false-positive.