[Estimation of regional blood flow in reimplanted segments of upper extremity].

AIM: To examine the state of regional circulation in replanted segment of upper limb and hand, to determine diagnostic and prognostic value of radionuclide scintigraphy. MATERIAL AND METHODS: The study included 26 patients who underwent replantation of upper extremity segments. The control group included 12 patients who underwent autologous transplantation of toes on hand. All patients underwent isotope scintigraphy, ultrasound Doppler and pulse oximetry. Groups were comparable by gender, age, severity of injury. RESULTS: Depending on postoperative course two groups were determined: with favorable (27 patients) and complicated postoperative period (11 patients). Two types of regional circulation were identified according to dynamic scintigraphy: prevalence of blood flow in operated limb (type 1); prevalence of blood flow in healthy limb, or equal volumetric blood flow in operated and healthy limbs (type 2). Favorable early postoperative period was associated with prevalence of blood flow in operated limb. Only in 2 (7.7%) patients patients in this group acute arterial thrombosis was diagnosed. At the same time thrombosis of microanastomosis occurred in 45.4% of cases in the second group what is 5.5 times higher than in the first group. CONCLUSION: Significant prevalence of blood flow in operated limb is favorable prognostic sign of the early postoperative period. On the other hand the identity of blood flow or prevalence of such in healthy limb predispose to acute vascular complications in replantate or autoplantate. Radionuclide scintigraphy provides detailed assessment of regional blood flow in operated limb. However clinical monitoring has leading role in diagnosis of acute circulatory disorders in replantate or autoplantate.

[DYNAMICS OF APOPTOTIC MARKERS (INTERLEUKIN-2 AND TNF-α) IN THE BLOOD SERUM OF CHILDREN WITH CHRONIC GASTRODUODENITES].

UNLABELLED: The aim was to investigate apoptotic dynamics by IL-2 and TNF-α levels in the blood serum of children with chronic gastroduodenites. MATERIALS AND METHODS: There were examined 90 children with chronic gastroduodenitis. Cytokine level in the serum was studied at admission and in dynamics. RESULTS: Chronic gastroduodenitis is accompanied by the increase of IL-2 and TNF-α concentration thus reflecting the activity of apoptotic processes. The decrease of the markers' (IL-2 and TNF-α) levels after 10-11 days, 3 and 9 months after treatment indicates the decrease of apoptotic activity. In hyperplastic and atrophic gastritis there has been registered the highest and the lowest concentration of the markers, respectively. H. pylori contributes to the TNF-α production mainly.

PECULIARITIES OF THE COURSE OF THE UPPER ALIMENTARY TRACT DISEASES IN CHILDREN WITH BRONCHOOBSTRUCTIVE SYNDROME.

UNLABELLED: The aim of the study was to improve the tactics of treatment of bronchoobstructive syndrome (BOS) in associative course with gastroesophageal reflux disease (GERD) in children. MATERIALS AND METHODS: 180 children aged 6-16 with diseases of the respiratory organs with BOS and GERD symptoms were examined: 85 of them--with bronchial asthma (BA), 34--with an acute course of pneumonia, 29--with recurrent obstructive bronchitis. Comparison groups were composed of 93 children, the number of practically healthy children (the control group) was 28 persons. The analysis of risk factors of associative pathology development, roentgenographic study, investigation of the function of external respiration (FER) (peak flowmetry, spirometry), intracavitary pH-metry, esophagofibrogastroduodenoscopy (EFGDS) and ultrasonic investigation (USI) of the organs of the gastro-intestinal tract (GIT) were carried out. RESULTS: Diseases of the respiratory organs with BOS in the groups of the patients under investigation in 43.9% of cases on an average associated with GERD. In a severe course of bronchial asthma GERD was detected 3,4 times more frequently in the boys, while in a lengthy course of pneumonia with BOS--1,9 times more frequently in the girls. Chronic gastritis (ChG) and chronic gastroduodenitis (ChGD) in BA were revealed in 40.6% of the patients, in pneumonia--in 45.7%, in recurrent bronchitis--in 33.3% of the patients. Peculiarities of pre-morbid background of BA and GERD associative course were exhibited by gestosis, threat of abortion, intrauterine hypoxia of the fetus, social troubles of the family. Manifestations of BA in children in 36% of cases were observed 6-12 months after the onset of GERD. The designed individual anti-reflux programs in complex therapy of respiratory organs' diseases with BOS associated with GERD reduce the frequency of exacerbations and hospitalizations of patients with BA, improve their life quality.

[Clinical and laboratory symptoms of space-occupying hepatic lesions and their prognostic value].

Rational complex diagnostic approach has a critical importance in diagnosis of space-occupying hepatic lesions. Results of clinical and special examinations permit to assess the state of hemostasis and functional reserve of liver, to predict the surgical risk and correct treatment tactics.

[Functional reserve in benign volumetric lesions]. / Funktsional'nyi rezerv pecheni pri ee dobrokachestvennykh ob''emnykh obrazovaniiakh.

For evaluation of functional status of hepatocytes in patients with benign volumetric growths of the liver (BVGL) of various genesis the authors performed radionuclide investigation with the use of Tc99m. At the same time the terms of maximal accumulation of the preparation Tmax' the period of half elimination from the liver (T1/2) and the time of entering of the drug into the bowel (T bowel) were evaluated. Basing on the results of the analysis of clinical examinations in 67 patients before and after operations (51 patients with BVGL and 16 patients of control group), the authors have revealed correlation between the size, site disposition of volumetric growth and function of hepatocytes of intact parenchyma of the liver. The results have evidenced that the rate of decrease in functional values of the liver in groups of patients with BVGL < 5 and > 5 cm in diameter significantly (p < 0.05) differed in parameters Tmax (33.3 and 78.3%) and T1/2 (50 and 95.7% of cases, respectively. It has been determined that the more is the size of the growth and the deeper it located in hepatic parenchyma the more significant is the decrease of function of hepatocytes. Comparison of the results of examination in patients with BVGL of various genesis before and after various surgical intervention of decompressive type has revealed significant (p < 0.05) improvement of functional capacity of hepatocytes, depending on the above factors. The results of investigation made it possible to substantiate differential approach to surgical policy in uncomplicated BVGL depending on the size of the tumor (< 5 and > 5 cm in d.), location and position of the growth in the organ, as well as adequately evaluate effectiveness of surgical intervention.

[Various biochemical indicators of the cerebrospinal fluid in acute carbophos poisoning]. / Nekotorye biokhimicheskie pokazateli tserebrospinal'noi zhidkosti pri ostrom otravlenii karbofosom.

The study was performed to evaluate the levels of some enzymes (AST, ALT, HGTP, LDG) and free amino acids (aspartic, glutaminic, glycine, isoleucine, leucine) in liquor of 37 subjects who got poisoned with a Malathion insecticide. Their condition was diagnosed as moderate and severe. The liquor was obtained on poisoning day 1, 3, 10, 14 and 21. The liquor levels of enhancement mediatory amino acids, aspartic and glutaminic, rise early in poisoning, while concentration of inhibition mediator glycine tends to decline. Progress of intoxication brings about a rise in LDG and GGTP activity attributed to a membranotoxic effect of the insecticide.