[Status of the protective gastric mucosal barrier in patients with alimentary-constitutional obesity before and after creating a "small stomach"]. / Sostoianie zashchitnogo bar'era zheludka u bol'nykh alimentarno- konstitutsional'nym ozhireniem do i posle formirovaniia "malogo zheludoczka".

The authors examined 131 patients with degree III-IV alimentary-constitutional obesity before and after operation for formation of a "small stomach". The average body weight of the patients before surgery was 145 +/- 2.28 kg. In the first 12 postoperative months it reduced by 41.9 +/- 1.76 kg as compared to the initial weight. Diminution of body weight in the second year was statistically insignificant. All patients underwent endoscopy of the esophagus and stomach before and after the operation with appraisal of the degree of macroscopic changes of the mucous membrane. The incidence of chronic gastritis and esophagitis reduced in the postoperative late-term periods more than 1.5 times, that of erosive lesions more than 10 times. Targent measurement of the transmural potential difference (TPD) of the esophagus and stomach was conducted in 36 patients. The TPD value is much less in patients with obesity than in the control group of healthy individuals. After operation the TPD value grows significantly which is due to changes of the diet regimen, reduced amount of the ingested food, reduction of body weight, and improved processes of microcirculation in the mucous membrane of the gastrointestinal tract.

[Role of K+, Na+, and Ca2+ ions in the cardiodepressive action of blood plasma in burn shock and the crush syndrome]. / Rol'ionov K+, Na+ i Ca2+ v kardiodeppressornom deistvii plazmy krovi pri ozhogovm shoke i sindrome dlitel'nogo razdavlivaniia.

Ion-selective electrodes were employed to measure the concentration of K+, Na+ and Ca2+ in blood plasma of rabbits with burn shock or crush syndrome (CS). No significant changes in the plasma concentration of Na+, and Ca2+ were found under both pathological conditions. The plasma concentration of K+ in burn shock significantly increased from 3.06 +/- 0.73 (control) to 5.28 +/- 2.65 mM (n = 10), whereas in CS from 3.42 +/- 1.03 to 4.92 +/- 1,29 mM (n = 8). The rise of K+ concentration in the control plasma to the maximal values seen in the "burn" and "syndrome" plasma led to an increase in the duration of intracellular action potentials (AP) but did not substantially change the amplitude of isometric contractions of the papillary muscles of rabbit heart. Meanwhile the similar rise of the duration of intracellular AP during perfusion of the papillary muscles with the "burn" and "syndrome" plasma was accompanied by an appreciable drop of the amplitude of isometric contractions. It is suggested that elevation of K+ concentration in blood plasma, inducing an increase in the duration of intracellular AP of cardiocytes may be responsible for changes in the ECG in burn and CS. At the same time inhibition of myocardial contractility in burn shock and CS is virtually not linked with hyperkalemia.

[Disorder of electromechanical coupling in the cells of the myocardium in protracted crush syndrome]. / Narushenie élektromekhanicheskogo sopriazheniiav kletkakh miokarda pri sindrome dlitel'nogo razdavlivaniia.

Experiments on papillary muscles of normal (control) rabbits and of those with the compression syndrome (CS) were made to explore the action of the control and "syndromic" blood plasma on electric and contractile activity of the myocardium. Isometric contractions of myocardial preparations were recorded at varying stimulation frequencies (0.1-2 Hz). Intracellular rest potentials (RP) and action potentials (AP) were led away with the aid of glass microelectrodes filled with 2.5 M KCl. The replacement of Tyrode solution by the control plasma raised the amplitude of papillary muscle contractions, that being greater as regards the muscles from rabbits with the CS. The "syndromic" plasma (diluted by Tyrode solution in a 1:1 ratio) markedly inhibited the amplitude of contractions of papillary muscles from both the control rabbits and animals with the CS. Reduction of the contractions induced by the "syndromic" plasma seen in all the preparations was followed by two patterns of changes in electrical activity of myocardial fibers. In one pattern, the RP, the amplitude and duration of the AP declined. In the other, on the contrary, the changes were reduced to a greater AP duration. The conclusion is made about the absence of a direct relationship between the decrease in myocardial contractility and changes in intracellular potentials induced by the "syndromic" plasma. It is suggested that the "syndromic" plasma deranges the process of stimulation and contraction coupling in heart papillary muscles.

[Oxygen tension in different organs and tissues and hemodynamic indices during tourniquet shock]. / Napriazhenie kisloroda v razlichnykh organakh i tkaniakh i nekotorye gemodinamicheskie pokazateli pri turniketnom shoke.

Experiments were made on 160 rats to examine the time course of changes in oxygen tension (pO2) in different organs and tissues during tourniquet shock. It was ascertained that pO2 in the liver was reduced before the tourniquets were removed from the limbs, in the presence of normal characteristics of the central and systemic hemodynamics. After circulation in the limbs was resumed following 6 hours of ischemia, pO2 in the liver and kidneys was reduced, respectively, to 26.8 and 48.6% of normal for 4 hours. It was disclosed that these changes preceded the shifts in circulation. pO2 in the small intestine, skin and muscles also fell to 97, 80.8 and 79.4%, respectively, within the same period of time. Oxygen tension in the cerebral cortex remained high within all the periods of tourniquet shock. pO2 fall in the cerebral cortex was seen only in the agonal period in the presence of deep disorders in circulation and respiration.