[The characteristics of anaesthesiologic service in territories with low density of population settlement].

The data of the study of sociological and expertise survey of physicians of surgery profile and anaesthesiologists-reanimators is presented. The Delphi technique was applied to determine the qualitative degree of interrelationship of elements? Characteristics in the functioning of the anaesthesiologic service. These studies are topical because of serious issues of anaesthesiologic service in the territories with lower density of population settlement to be resolved through the enhancement of its overall functioning.

[Optimization of treatment of acute cholecystitis in elderly and senile patients].

The investigation includes results of treatment of 456 elderly and senile patients. The patients were divided into 3 groups. The main group consisted of 178 patients treated with live bacterial preparation sporobacterin included in the complex therapy. The first control group (171 patients) and the second (107 patients) were given antibiotics in the complex therapy. If there were no medical effect in the patients of the main and first control groups percutaneous and transhepatic cholecystostomy were made under US control. In the second group there was operation of cholecystectomy. In addition to generally accepted methods of assessing the state of the patients, the leukocytic index of intoxication, index of organism resistance and index of blood leukocyte shift were investigated. High anti-inflammatory effect of sporobacterin was proved in treatment of acute cholecystitis in elderly and senile patients, especially when using percutaneous and transhepatic cholecystostomy.

[The bed resources planning in the reanimation and intensive care clinic departments].

The medical technological, administrative and statistic information received from data base of annual medical statistical reports, operating statements of corresponding department heads, results of expertise of 5 municipal curative preventive institutions are considered. The analyzed data relates to medical care provided to the patients suffering with diseases of cardiovascular organs and neurological, traumatological, neuro-surgical and surgical pathology. The algorithm and design matrix are developed for planning the amount of beds in the reanimation and intensive care clinic departments up to 2015.

[Acute surgical pathology of abdominal organs in the Orenburg Region]. / Ostraia khirurgicheskaia patologiia organov briushnoi polosti v Orenburgskoi oblasti.

A dynamic prognostication scheme was elaborated with respect to a potential demographic situation among the adult population on the basis of a study of prevalence of severe surgical diseases of the abdominal cavity. It makes it possible to plan a further surgical-service promotion, to forecast potential complications and to define measures of how to cut the number of such complications.

[Effectiveness of sporobacterin in the prevention and treatment (of postoperative wound infections)]. / Otsenka éffektivnosti ispol'zovaniia sporobakterina v profilaktike i lechenii.

Peculiarities of penetration of living bacterial cultures of Bacillus strain into the structures of the abdominal wall, their positive influence upon the reparative regeneration of surgical wounds were studied in experiments in 240 rats. It was found the living bacterial preparation to be expedient to use as an antagonist of pyogenic infection for purulent postoperative wounds and in order to prevent its development. The clinical antiinflammatory and stimulating the reparative process effects of sporobacterin were studied in 50 patients with infectious wound complications after urgent and scheduled operations. A prophylactic effect was noted in 145 patients operated on for complications of cholelithiasis and commissural ileus. Sporobacterin was proved to give better results of treatment as compared with traditional methods of antiinflammatory therapy with antibiotics.

[Pathogenetic mechanisms of bacterial cholangitis in mechanical jaundice (experimental histological study)]. / Patogeneticheskie mekhanizmy bakterial'nogo kholangita pri mekhanicheskoi zheltukhe (éksperimental'no-gistologicheskoe issledovanie).

In 89 rats with experimentally induced mechanical jaundice the infectious process was modeled by intragastric administration of E. coli and B. subtilis. The study included the investigation of the main routes and time intervals of dissemination, organ content of microbes labeled with 3H-thymidine, as well as of structural and functional peculiarities of the interaction of animal tissues with the microbes in cholestasis development dynamics and under the condition of biliary tract decompression. It was established that under the condition of mechanical jaundice viable bacteria from the alimentary tract penetrated the organs of peritoneal cavity through the blood and lymph flow. In the liver, the endogenous agents of surgical infections, and E. coli, in particular, were found to aggravate the inflammatory and necrobiotic processes. B. subtilis did not cause any inflammatory or other pathologic process in the tissue of liver.

[The causes of complications and mortality in acute diseases of the abdominal organs]. / Prichiny oslozhnenii i letal'nosti pri ostrykh zabolevaniiakh organov briushnoi polosti.

A retrospective analysis of 854 case histories of patients who died in surgical hospitals of Orenburg Province from 1996 till 1998 has shown that 67% of the patients had infectious complications including 32.5% of suppurations of the postoperative wounds. Other causes of complications and lethality were established. Main ways to reduce their amount are determined.

[Surgical treatment of intraoperative injuries and cicatricial strictures of extrahepatic bile ducts]. / Khirurgicheskoe lechenie intraoperatsionnykh povrezhdenii i rubtsovykh striktur vnepechenochnykh zhelchnykh protokov.

The analysis of 70 cases of surgical treatment for intraoperative injuries and cicatricial strictures of extrahepatic bile ducts was carried out. In 25 patients surgical procedure was restorative and in 45--reconstructiver. Most common causes of corrective operations were: iatrogenic injuries of extrahepatic bile ducts (14) and cicatricial strictures of hepaticocholedochal duct due to intraoperative trauma (31). The problems of operative technique in performing biliobilio-, hepato-hepatico and hepatico-jejuno-anastomoses are considered. There were three deaths in the early postoperative period: 2 patients died of hepatic failure, pyogenic cholangiogenic intoxication caused by cholangioectasies and intrahepatic abscesses, and 1-due to generalyzed peritonitis caused by acute gastric ulcer perforation. Special attention is paid to the choice of the method of prolonged drainage used in reconstructive as well as in restorative operations.

[Epidemiologic and immunologic parameters in the assessment of endemic goiter in the Orenburg region]. / Epidemiologicheskie i immunologicheskie pokazateli v otsenke zobnoi éndemii v Orenburgskoi oblasti.

Epidemiological investigations were carried out in 2328 children in the districts of the Orenburg district. Iodine deficiency was detected in the children living in the districts having low concentrations in the water and foodstuffs. There was a deviation of immunological parameters from the normal values in the children of the same districts.