[Pathomorphological peculiarities of hemomicrocirculatory bed of the small and large intestine in acute peritonitis].

Experimental comparative morphological investigation of hemomicrocirculation bed (HMCB) of the small and large bowel wall was performed in dynamics of an acute serous peritonitis. Spreaded aseptic peritonitis was simulated using injection of 5 ml of gamma-caraginen (Sigma, USA) in 1 ml of isotonic solution of sodium chloride. On the early stage of peritonitis (in 12 h from beginning of the experiment) in mucosa of small bowel nonsignificant venuls dilatation and the capillary lumen reduction were observed. In 1 day (reactive stage of peritonitis) in mucosa the quantity of capillars have had reduced significantly, comparing with such observed previously. On the 2-nd day (toxic stage of peritonitis) some capillary dilatation in intestinal villi and crypts coexistant with the blood rheology disorders in a form of stasis, change in permeability of the vessels walls, predominantly of the venous, was noted. On the 3-d day (late stage) the arteriol's spasm have had reduced, capillary paralytic dilatation was revealed. The staged course of experimental peritonitis with the HMCB changes, characteristic for every stage, was confirmed, basing on analysis of the investigation result.

[Endovascular laser coagulation in the treatment of varicose disease the the lower extremities].

The experience of treatment of 55 patients, suffering varicose disease of the lower extremities, using endovascular laser coagulation in combination with crossectomy and operation according to Babcock method, was analyzed. Good and excellent results were achieved in 53 (96.4%) patients, complications have had occurred in 1 (1.8%).

[Application of the ASSES scale for the assessment of patient state severity and outcome prediction of acute pancreatitis].

There was estimated the severity state in 129 patients, suffering an acute pancreatitis, using the ASSES, SAPS, APACHE II and V. S. Savelyev's scales. Trustworthy differences of their values were established in survivors and the dead patients immediately after admitting to the hospital, before the operation, in 1-2 and 3-4 days after the operation. The best accuracy in predicting of outcome after the patient admittance to the hospital and in early postoperative period was noted while using the ASSES scale. The sum more than 13 points after admittance to the hospital and before the operation, as well as more than 16 points on the first-second and the third-fourth postoperative days, according to the ASSES scale, witnesses unfavorable prognosis of the disease.

[Application of a modified hematological index of the intoxication severity in prognostication of peritonitis outcome].

A modified hematological index of intoxication was proposed for estimation of the immune system reaction in patients with peritonitis. Critical values of the index are determined, permitting to prognosticate high possibility of lethal outcome.

[Application of the leukocyte indices for prognostication of peritonitis outcome].

While examination of 49 patients, in whom peritonitis was diagnosed, the values of 18 leukocyte indices were determined, trustworthy differences of the indices were established in survivors and dead patients. Critical values of the indices, permitting to prognosticate high possibility of lethal outcome occurring, were determined.

[Etiological structure and sensitivity to antibiotics of the infection process pathogens in general surgical hospital].

The studying of the species and their sensitivity to antibiotics of mostly spread infection factors constitute one of the main trends in intrastationary infection prophylaxis. In 307 patients, suffering the infection processes of various localization, such as purulent wounds, cholecystitis, cholangitis, peritonitis etc., there were studied up the species and sensitivity to antibiotics of the microorganisms determined. Staphylococcus spp. and E. coli were determined most frequently, somewhat rarely--P. aeruginosa, K. pneumoniae, Proteus spp., Enterobacter spp., E. faecalis, S. pyogenes, C. albicans and Citrobacter spp. The factors determined were most sensitive to imipenem (72,09% of sensitive clones), carbenicilline (61.9%), meropenem (60.49%) and ceftriaxone (58.33%).

[Severity of illness index in patients with an acute sepsis].

The analysis of prognostic value of APACHE II scale in estimation of the severity state in patients with an acute sepsis was presented. There was proposed the scale of estimation of the severity state in patients with an acute sepsis.

[Morphological criterions of the hepatic functional reserve assessment in cirrhosis of the liver]. / Morfologicheskie kriterii otsenki funktsional'nogo rezerva pecheni pri ee tsirroze.

The results of histological and morphometric investigations of intraoperative hepatic biopsy material in 124 patients with cirrhosis were presented. It was established that the character and degree of severity of hepatic morphological changes constitute the principal factors influencing immediate and remote results of surgical treatment in patients with cirrhosis. There were delineated three types of morphological changes in hepatic cirrhosis, permitting to rationalize the tactic of treatment, to improve the results of the patients surgical treatment.

[The late results of deportalization of the pancreatic blood flow in patients with type-1 diabetes mellitus]. / Otdalennye rezul'taty deportalizatsii krovotoka podzheludochnoi zhelezy u bol'nykh sakharnym diabetom I tipa.

Late follow-up result of the pancreatic blood flow deportalization using distal splenorenal anastomosis conduction in 16 patients with type-I diabetes mellitus was studied up. The diabetes mellitus course stabilization was promoted by performance of operation.

[The surgical treatment of a nonparasitic liver cyst]. / Khirurgicheskoe lechenie neparazitarnoi kisty pecheni.

The results of surgical treatment of nonparasitogenic hepatic cyst in 24 patients were summarized. The cyst enucleation was performed in 19 of them, segmental edge hepatic resection--in 3, left-sided hemihepatectomy--in 2. The one-chamber cyst was revealed in 21 patient, the multichamber one--in 3. Cancer in the cyst was revealed in one observation while histologic examination.

[The role of immunopathological factors in severe forms of insulin-dependent diabetes mellitus]. / Rol' immunopatologicheskikh faktorov pri tiazhelykh formakh insulinozavisimogo sakharnogo diabeta.

Immunogrammes of 31 patients with grave forms of insulindependent diabetes mellitus were reviewed. The illness has been characterized as a systemic immunopathologic process combining autoimmune and infectious-and-allergic components realized by organ and tissue abnormalities; it evolves against the manifest background of allergy of both delayed anl immediate types, impairement of the humoral and cell-mediated immunity function, pathogenetic activity of endogenous proteases, the complement system components and interferon.

[Effects of venous splenorenal shunt surgery on the morphofunctional state of the liver, kidneys and spleen]. / Vliianie operatsii venoznogo splenorenal'nogo shuntirovaniia na morfofunktsional'noe sostoianie pecheni, pochek, selezenki.

In the experiment on 18 mongrel dogs it was demonstrated that in exclusion of the blood of the splenic vein from portal circulation early after splenorenal shunting, the impairment in morphofunctional state of the liver, kidneys and spleen is noted. One month after the operation, incomplete reparation in the liver and left kidney, and complete reparation in the right kidney and spleen was noted.

[The prognosis of liver failure in patients with liver cirrhosis under surgical treatment for portal hypertension]. / Prognozirovanie pechenochnoi nedostatochnosti u bol'nykh s tsirrozom pecheni pri khirurgicheskom lechenii portal'noi gipertenzii.

On the basis of studying the intraoperative biopsy specimens in 44 patients with hepatic cirrhosis and portal hypertension syndrome, who had a distal splenorenal anastomosis been created, the authors have distinguished three types of morphological changes--A, B, C. A significant dependence between the type of cirrhosis and pronouncement of hepatic failure after the operation and life-time of a patient after the operation as well has been established. Type C has the greatest risk, type B requires differential approach, type A is prognostically favourable concerning both the outcome of the operation and life-time of a patient.

[The placing of a distal splenorenal anastomosis in liver cirrhosis patients]. / Nalozhenie distal'nogo splenorenal'nogo anastomoza u bol'nykh s tsirrozom pecheni.

The results of treatment of 79 patients with hepatic cirrhosis and different manifestations of portal hypertension, who had a distal splenorenal anastomosis been created, were studied. The features of hepatic failure after the operation were noted in 37 (46.8%) patients. Of them; 18 died. Within a five-year period, 56.4% of the patients are alive. The lifetime was the shortest in patients with ascites which developed after bleeding from the esophageal and gastric varices. The authors stress the importance of the development of criteria for evaluation of risk factors and efficacy of the operation.