[Correction of the glicemia level in elderly and senile patients with diabetes mellitus, operated for purulent-necrotic foot lesion].

Basing on the analysis of surgical treatment experience of 685 elderly and senile patients with diabetes mellitus, suffering purulent-necrotic affection of foot, the authors admit possibility of the insulinotherapy abolition before the operation in patients with for the first time diagnosed diabetes type II or in those, who before hospitalization received preparations in tablets, while the signs of intoxication are absent (extended purulent process, humid gangrene) and initial level of glycemia no more than 10 mmol/l.

[Indirect electrochemical blood oxidation in the prophylaxis of suppurative-inflammatory complications after transurethral resection of the prostate]. / Nepriamoe élektrokhimicheskoe okislenie krovi v profilaktike gnoino-vospalitel'nykh oslozhnenii posle transuretral'noi rezektsii prostaty.

To investigate efficiency of indirect electrochemical blood oxidation in prophylaxis of infectious complications, 28 patients were treated with 0.06% hypochlorite solution (2 infusions, 2-3 days before TURP). These patients belonged to a high-risk group of infectious complications (80% of them had chronic prostatitis, 8 patients had bladder stones, 8 had undergone cystostomy). The results demonstrated that the complication rate in the above prepared patients fell four times as compared to the control group and the postoperati hospital stay was reduced by 3 days.

[Change in indicators of metabolism and kidney function in intact rats after parenteral administration of sodium hypochlorite]. / Izmenenie pokazatelei metabolizma i funktii pochek u intaktnykh krys posle parenteral'nogo vvedeniia gipokhlorita natriia.

The changes of kidney metabolism, function and enzymuria activity of nephron epithelium cells after 4 days of parenteral administration of sodium hypochlorite 0.02% and 0.06% solutions were investigated in the experiments on 15 intact non-inbred rats of 200-280 g body weight. It was revealed that sodium hypochlorite induced metabolic damage to the kidney similar to ischemic one. The 0.02 and 0.06% solutions of sodium hypochlorite administered parenterally produced no negative effect on renal function. There was no significant rise of enzymuria activity in experimental groups compared to the controls. Moreover, enzymuria of four from six nephron epithelium cell enzymes decreased significantly to day 5 of the experiment. Metabolic damage and enzymuria activity changes were more pronounced in rats given parenteral 0.06% solution of sodium hypochlorite.

[Increase in structural-functional tolerance of kidney to ischemia upon parenteral administration of sodium hypochlorite in the pre-ischemic period]. / Povyshenie strukturo-funktsional'noi tolerantnosti pochek k ishemii pri parenteral'nom vvedenii gipokhlorita natriia v predyshemicheskom periode.

The opportunity of raising kidney structural and functional tolerance to ischemia with parenteral injections of 0.06% solution of sodium hypochlorite for 4 days in preischemia period was studied in experiment on 22 non-inbred rats of 200-280 g body weight. 90 minute ischemia was created by ligating the left and right kidney arteries, veins, ureters. Morphological and functional kidney data, enzymuria activity of nephron epithelium cells were registered, 80 and 33% of the rats survived 7 days after ischemia in the study and control groups, respectively. The control animals showed deterioration of the tubules function, high enzymuria. Thus, it is possible to raise kidney tolerance to ischemia by preischemic parenteral injection of sodium hypochlorite solution.

[The prognostic value of poly-organic insufficiency in patients with acute pancreatitis]. / Prognosticheskoe znachenie poliorgannoi nedostatochnosti u bol'nykh ostrym pankreatitom.

The results of surgical treatment of 148 patients aged from 18 to 83 years old suffering from acute pancreatitis (AP) were analyzed. Acute biliary pancreatitis (ABP) was determined in 49.3% of patients. The use of biochemical, ultrasound, endoscopic and laparoscopic methods of diagnostics permitted to determine the pathogenesis of AP and initial manifestation of polyorganic insufficiency syndrome (POIS). In 58.8% of patients mild intoxication syndrome was observed, in 41.2% it was considered severe. 56.1% of patients underwent surgical treatment that included laparocentesis, laparoscopy, and toxic exudate removement, drainage of abdominal cavity. In patients with ABP laparoscopic cholecystectomy and the drainage of common bile duct was performed. Total mortality was 5.4%. The wide introduction of endovideosurgical technologies permits to perform several actions in order to treat AP, to prevent POIS and pyo-necrotic complications and to achieve the decrease of mortality.

[New approaches to the choice of treatment and possibility of prognosis of the results in patients with diabetic foot]. / Novye podkhody k vyboru lecheniia i vozmozhnosti prognozirovaniia ego rezul'tata u bol'nykh s diabeticheskoi stopoi.

The author had elaborated the concept, claiming that the microangiopathy stage reflects the diabetes mellitus stage, basing on the sixteen-year experience of examination and treatment of 1100 patients with diabetic foot. It is necessary to plan the treatment of patient and to control its efficacy, taking into account the stage of the disease.

[Effects of sodium hypochlorite on the course of recovery of structural elements and functions of the kidneys in postischemic period]. / Vliianie gipokhlorita natriia na dinamiku vosstanovleniia strukturnykh élementov v funktsional'nykh sposobnostei pochek v postishemicheskom periode.

Kidney morphological structure, function and enzymuria were studied in experiment on 22 non-inbred rats of 200-280 g body weight with 90 min kidney ligature ischemia on day 3 and 7. In experimental group (11 rats) 1 ml 0.06% solution of sodium hypochlorite (SH) was injected intraperitoneally daily after kidney ischemic damage. 11 rats of the control group received 1 ml 0.89% SH solution in daily intraperitoneal injections. Morphological changes in renal structure, functional capacity of the kidneys, enzymuria on experimental day 3 and 7 were studied. It was revealed that SH injected in acute ischemic phase aggravated kidney cell damage. However, SH induced kidney reparative reaction on day 3. In the control group this reaction was registered only on day 7. It is suggested that SH may be an effective prophylactic modality against ischemic renal damage.

[Sodium hypochlorite in the treatment of bacteremic circulatory shock]. / Gipokhlorit natriia v lechenii infektsionno-toksicheskogo sosudistogo shoka.

17 patients with massive urinary infection and bacteriemic circulatory shock received a combined intensive treatment including indirect electrochemical blood oxidation (IEBO) with 0.06% solution of sodium hypochlorite (SHC). SHC intravenous infusions resulted in stabilization of arterial pressure within 24 hours. IEBO in the treatment of incipient bacteriemic shock improves prognosis.

[Application of auto-dermal hernioplasty for treatment of postoperative abdominal hernia]. / Primenenie autodermal'noi gernioplastiki dlia lecheniia posleoperatsionnoi gryzhi zhivota.

The results of surgical treatment of 98 patients with postoperative abdominal hernia, in whom various methods of autodermal hernioplasty were applied, were summarized. In 33 patients for the hernial defect closure deepithelized cutaneous strip was used, in 22--free cutaneous flap, in 12--the defect was closed with the help of free armourized autodermotransplant, in 10 patients--with free cutaneous flap in combination with lavsan mesh. Recurrency after application of cutaneous strip had occurred in 41% of patients, of cutaneous flap--in 36.3%, armourized flap--in 23.1%, after the combined plasty--in 20%. Insufficient blood circulation in transplant is the cause of high recurrency rate after doing the plasty using free flaps. To eliminate this shortage and to improve the results of surgical treatment in 20 patients there was applied original method of autodermal hernioplasty using deepithelized cutaneous flap on two nourishing pedicles. Recurrency had occurred in one patient during follow-up from 1 to 5 years.

[On the legality of the term "diabetic angiopathy of the lower extremities". Part III. The influence of the stage of the lower extremities' main artery occlusion on the severity of microangiopathy]. / O pravomochnosti termina "diabeticheskaia angiopatiia nizhnikh konechnostei". Chast' III. Vliianie urovnia okkliuzionnogo porazheniia maristral'nykh arterii konechnostei na tiazhest' mikroangiopatii.

In 40 patients with diabetic angiopathy of lower extremities in terminal stage during investigation of cutaneous biopsies using electronic microscopy it was established that changes in femoral skin are more pronounced than in a foot skin, showing more severe signs of microangiopathy in a preserved main blood flow zone. The author proposes a concept, according to which the angiopathy stage reflects the diabetes mellitus stage.