[Multi-injection thoracic paravertebral anesthesia during breast cancer operations].

Radical and/or reconstructive operations on the breast are a common surgical procedure. Despite treatment advances, this surgical intervention is frequently associated with postoperative pain, nausea, vomiting. When used during breast cancer operations, multi-injection thoracic paravertebral anesthesia (TPVA) has the potential that is necessary for the long-term preventive treatment of pain with fewer numbers of complications. The authors compared TPVA with general anesthesia in 180 patients (with the morphologically verified diagnosis of breast cancer) when radical and/or reconstructive operations were performed on the breast. According to the type of anesthesia, the patients were randomly divided into 2 groups with 90 persons in each: (1) those undergoing TPVA with intravenous sedation; (2) those who were given the traditional multicomponent general anesthesia. Postoperative pain was much less in the TPVA group following 1, 3, 6, and 24 hours (p < 0.01) at rest and in motion. There is evidence suggesting that it is just the procedure that may become a main alternative to the traditional general anesthesia in a clinic that has sufficient experience with regional anesthesia and appropriate equipment, with minimum complications and a qualitatively better period of recovery.

[Effects of cerebrospinal fluid preparation from male and female patients with opiate dependence on rat open-field behavior]. / Vliianie preparata likvora patsientov s opiinoi zavisimost'iu muzhskogo i zhenskogo pola na povedenie krys-retsipientov v teste otkrytogo polia.

The effects of the intranasal administration of preparations made from the cerebrospinal fluid of male and female opiate users on the open-field rat behavior were studied. Behavioral differences were demonstrated in the effects of preparations from female and male cerebrospinal fluid. The administration of the "male" preparation produced a significant decrease in the locomotor activity and increase in the immobilization time and grooming duration, while the "female" preparation had the opposite effects. These differences may result from different content of endogenous and exogenous opiates and dopamine (and its metabolites) in the cerebrospinal fluid of male and female opiate users.

[Free-radical processes in the pulmonary macrophages of patients with pulmonary tuberculosis]. / Svobodnoradikal'nye protsessy v legochnykh makrofagakh bol'nykh tuberkulezom legkikh.

Free radical processes in the alveolar and interstitial macrophages were compared for patients with different forms of tuberculosis, chronic nonspecific pulmonary diseases and cancer of the lungs. Alveolar macrophages were found to have more active free radical processes than interstitial macrophages. Chronic transformation of pulmonary tuberculosis results in activation of free radical processes in pulmonary macrophages. Differences in the value of alveolar macrophages chemiluminescence maximum and time of its appearance may facilitate differential diagnosis between tuberculosis, chronic nonspecific pulmonary diseases and cancer of the lungs.

[Role of active forms of oxygen in inducing luminol-dependent chemiluminescence in macrophages]. / Issledovanie roli aktivnykh form kislodroda v induktsii liuminolzavisimoi khemiliuminestsentsii makrofagov.

The luminol-dependent chemiluminescence of mouse peritoneal macrophages during phagocytosis of opsonized zymosan was studied by using specific active oxygen scavengers and metabolic inhibitors. Extracellular hydrogen peroxide and superoxide anion were shown to contribute immensely to the induction of the chemiluminescence. The role of the hydroxyl radical was rather insignificant, whereas singlet oxygen was not involved in this process. The interaction between luminol and peroxide was shown to be peroxidase-dependent. An inhibitory analysis revealed that the interaction between luminol, peroxide and superoxide anion obeyed a hybrid enzyme-free radical mechanism.

[Effectiveness of the use of high-energy lasers in bronchology]. / Effektivnost' primeneniia vysokoénergeticheskikh lazerov v bronkhologii.

Bronchoscopy by laser radiation was performed in 141 patients. CO2 laser was used in 89 patients: 25 had pulmonary tuberculosis, 6 tumours, 35 stump inflammation, and 23 other diseases. YAG laser was used in 52 patients: 15 of them had tumours, 21 bronchial tuberculosis, 6 osteochondropathy and 10 other diseases. A good therapeutic result was obtained in most patients but in certain cases (malignant tumours) it was palliative. Special features and technical difficulties encountered during work with different types of lasers in fibroscopy under anesthesia and in fibrobronchoscopy under local narcosis are discussed. No complications were registered. Formation of the so-called "white thrombus" at the site of laser photodestruction was described which required removal during control bronchoscopy.

[The effect of serotonin on the functional activity of monocytes]. / Vliianie serotonina na funktsional'nuiu aktivnost' monotsitov.

The treatment of human peripheral blood monocytes with serotonin at concentrations 10(-3) and 10(-5) M over 20 minutes decreases a zymosan-induced luminol-dependent chemiluminescence of cells, whereas a 5 minutes treatment with serotonin at the concentration of 10(-5) M increases the chemoluminescence. The correlated change in monocyte capacity of secreting hydrogen peroxide has been registered. Serotonin activates, to a little extent, the monocyte capacity of phagocytizing the opsonised sheep erythrocyte. The maximum increase (2-3 times) of intracellular cAMP content and the decrease in cytosol cAMP-binding capacity are registered after a 5 minutes incubation. The lowering of the share of irreversibly bound in vitro cAMP under the influence of serotonin may suggest a preferable binding of cyclic nucleotide in vivo by regulatory subunits of cAMP-dependent protein kinase I.

[The cytolytic function of mononuclear phagocytes. II. Factors that determine the binding and lysis of tumor cells by activated macrophages]. / Issledovanie tsitoliticheskoi funktsii mononuklearnykh fagotsitov. II. Faktory, opredeliaiushchie sviazyvanie i lizis opukholevykh kletok aktivirovannymi makrofagami.

The effects of various modifiers upon the interaction of LPS- and BCG-activated macrophages with cells of mastocytoma P815 have been investigated. The efficiency of binding and lysis of the tumor cells is to a great extent determined by activation of the effector-cells, expression of the trypsin-sensitive receptors on the surface of macrophages, and by the type of target-cells. Introduction into the analytical system (effector-target) of unlabeled tumor cells or membrane preparations obtained from them inhibits substantially both binding and lytic activity of cytotoxic macrophages. If nontransformed cells or their membranes are applied, no significant changes in the investigated processes can be detected. Trypsinization of tumor cells as well as of activated but not resident macrophages modifies considerably the interaction of effectors with targets. The quantity of tumor cells bound with macrophages does not depend on the fact, which of the partners is subject to trypsinization, but it is much less than that of target-cells bound in the control. The incubation of activated macrophages with actinomycin D results in a substantial suppression of their lytic activity, whereas treatment of tumor cells with this inhibitor of protein synthesis leads to a considerable decrease in stability of the targets against lytic activity of the factor activated by effectors. The obtained data reveal the ways of selective binding and effective lysis of transformed targets by activated macrophages.

[The effect of exogenous peroxidase on the intensity of luminol-dependent macrophage chemiluminescence]. / Vliianie ékzogennoi peroksidazy na intensivnost' liuminolzavisimoi khemiliuminestsentsii makrofagov.

The influence of exogenous horse-radish peroxidase on the capacity of mouse peritoneal macrophages to luminol-dependent chemiluminescence induced by zymosan was investigated. It was revealed that peroxidase (1-50 mg/ml) increased the chemiluminescence in a dose-dependent manner. The maximum increase of the response (4-6 times) was obtained with the enzyme concentration being 10 mg/ml. It is found that peroxidase acts as a co-oxidant of the peroxide-dependent extracellular luminol oxidation. The including of the enzyme into macrophages makes it possible to register the intracellular chemiluminescence.

[The cytolytic function of mononuclear phagocytes. I. The dependence of the mechanisms regulating and realizing the cytolytic function of macrophages on their origin and the mode of activation]. / Issledovanie tsitoliticheskoi funktsii mononuklearnykh fagotsitov. I. Zavisimost' mekhanizmov reguliatsii i realizatsii tsitologicheskoi funktsii makrofagov ot ikh proiskhozhdeniia i sposoba aktivatsii.

It has been shown that the induction of cytolytic activity in macrophages cause remarkable metabolic and morpho-structural shifts in effector cells, such as: 1) an expression of trypsin-sensitive receptors responsible for macrophage binding to malignant cells; 2) some differences in macrophage sensitivity to the cAMP system modifiers dependent on the activation inducer nature; 3) an enhanced production of oxygen metabolites directly involved in oxygen-dependent cytotoxicity of macrophages; 4) augmentation of lysosomal contents and activation of lysosomal enzymes. The inhibitor analysis enabled us to identify the main lytic components acting in the process of cytolytic functioning of macrophages of different origin and activation.

[The enhanced relative intensity of cAMP-dependent protein phosphorylation in stomach tumors]. / Uvelichenie otnositel'noi intensivnosti cAMP-nezavisimogo fosforilirovaniia belkov v opukholiakh zheludka.

The activity of cAMP-dependent histone kinases (HK) and cAMP-independent casein kinases (CK) as well as cAMP level were assessed in gastric mucosa affected by various forms of gastritis as well as in gastric tumor and adjacent normal tissue. CK activity was higher whereas that of HK and cAMP level were lower in tumor and at a distance of 5-20 cm from its edge as compared to gastritis. CK/HK cAMP ratio in adenocarcinoma was 6 times that in normal tissue and 2-2.5 times that in gastritis. The data obtained and those published earlier suggest the relative increase in cAMP-independent protein phosphorylation with respect to its cAMP-dependent counterpart to be characteristic of human tumors.

[The trigger function of cAMP in regulating the chemiluminescence of macrophages exposed to ethanol]. / Triggernaia funktsiia tsAMF v reguliatsii khemiliuminestsentsii makrofagov pri vozdeistvii étanola.

The capacity of mouse peritoneal macrophages to luminol-dependent zymosan-induced chemiluminescence was investigated. It was revealed that a short-term incubation (5-10 min) of macrophages in 0.05-0.50% ethanol resulted in a dose-dependent reduction of chemiluminescent response. Ethanol induce a sharp 2-3 fold increase in the intracellular cAMP content after a 2 minutes incubation. The temporal and concentration correlation of both the processes suggests that the inhibition of chemiluminescence may be mediated by the intracellular cAMP content.

[Protein kinase activity and cAMP level in gastric mucosa in non-neoplastic diseases]. / Aktivnost' proteinkinaz i soderzhanie cAMP v slizistoi obolochke zheludka pri neopukholevykh zabolevaniiakh.

Activity of cAMP-dependent and -independent protein kinases as well as content of cAMP were studied in biopsy preparations of gastric mucosal membranes obtained from patients with superficial gastritis, erosion, ulcer, adenomatous polyps and ulcer after treatment with laser irradiation. All the patterns studied were similar in preparations of adenomatous polyps and normal mucosal membrane. Activity of cAMP-independent protein kinases was increased under conditions of erosion, ulcer, gastroduodenal reflux and, especially, in ulcer tissue treated with laser. However, the ratio between cAMP-independent and -dependent phosphorylation was increased only in 50% of ulcerous diseases and in gastroduodenal reflux. The equilibrium of cAMP-dependent and -independent phosphorylation was not altered in the other impairments studied even though benign proliferation was stimulated using laser irradiation.

[The instrumental diagnosis of disseminated lesions of the lungs]. / Instrumental'naia diagnostika disseminirovannykh porazhenii legkikh.

A study is presented of 52 patients with disseminated pulmonary lesions. Among them: histiocytosis X--17, alveolar microlithiasis--5, pulmonary phospholipoproteinosis--7, idiopathic hemosiderosis--14, primary pulmonary amyloidosis--1, primary diffuse lung tumours--8. All patients were subjected to complex bronchological examination including use of different biopsy transbronchial methods as well as open biopsy of the lung. The diagnostic value of the employed bronchial biopsies is discussed. A diagnostic algorithm of rarely met pulmonary disseminations has been developed. Recommendations on the use of different instrumental methods are formulated.

[Assessment of the reserve potentials of the circulatory system in patients in the postoperative period]. / Otsenka rezervnykh vozmozhnostei sistemy krovoobrashcheniia u bol'nykh v posleoperatsionnom periode.

The author discusses the results of studying in dynamics the cardiac output during infusion therapy conducted at the same rate in patients in the postoperative period. A pathogenetic scheme of the response of the cardiovascular system to the volume load is suggested.