[The possibilities of early diagnosis of tumorous lesions of colon patency and their preoperative correction].

Experiments in white rats were used in order 1) to create a model of obturative colon obstruction (OCO) and to prove a staged character of its development depending on the tone of the Bauhin's valve (the normotonic phase, spasm of the Bauhin's valve, dilatation of the Bauhin's valve) and 2) to study specific features of healing primary anastomoses after emergency resections of the colon. An analysis of clinical and rentgenological findings has confirmed the staged character of tumor lesions of the colon patency (TLCP). A working classification of them is proposed: stages of compensation (conventionally chronic); subcompensation (subacute) with three degrees of stages according to the experimental scheme of pathogenesis; decompensated (acute obturative colon obstruction). Typical rentgenological symptoms are first described and systematized for the stages of sub- and decompensation. In combination with the classification they make the basis for early diagnosis of TLCP, establishment of absolute indications for urgent operations and decision for the early intraoperative strategy. An original three-lumen probe for preoperative decompression and monitory purgation of the intestine, the method of intra- and postoperative decompression, correction of the intraintestinal status allowed to form primary anastomoses after urgent resections of the colon in 170 (63.7%) out of 317 patients with OCO. A scheme of control with the help of thermo-transducer is proposed for prognosis of a possible failure of the anastomosis.

[Estimation of efficiency of complex-method intestinal therapy using Nitella flexilis test-object for acute intestinal obstruction of various etiology].

The aim of our investigation was to define the presence of correlation between toxicity of intestinal contents and clinical and laboratory indices in the cases of ileus and peritonitis with the use of complex method of enteral therapy. Experiments have been carried out on internodal cells of Nitella Flexilis water plant. Efficiency of the given method (investigation of toxicity of the intestinal content with the use of test-object Nitella Flexilis) has been studied in 25 patients, who underwent correction of morpho-functional status of small intestine. Results of investigation have shown that changes in toxicity of intestinal content reliably reflect the nature and dynamics of the pathobiologic processes proceeding in GIS in treated patients suffering from acute intestinal impassability. Using the method of correction of morpho-functional status of small intestine decreases the role of "Intestinal factor" in formation of endogenous intoxication, which in turn results in early normalization of clinical and laboratory indices, favored process of early post-operational period, decreased rate of lethality and shortened rehabilitation period.

[Correction of the intraintestinal status in patients with diffuse peritonitis]. / Korrektsiia intraintestinal'nogo statusa u bol'nykh s rasprostranennym peritonitom.

Complex methods of intraintestinal status correction are proposed for patients surgically treated for general peritonitis. These methods consist of three main components: suppression of excessive bacterial colonization of gastrointestinal tract; binding of toxic substances and microorganisms; colonization of small intestine by physiological strains of bacteria. Original design of three-lumen tube for nasogastrointestinal intubation was used. Clinical study was carried out in 2 groups of patients. Study group consisted of 79 patients treated by proposed methods; only gastrointestinal intubation by three-lumen tube was performed in 44 patients (control group). Usage of the proposed methods led to dysbacteriosis correction and fast appearance of intestinal peristalsis, improved the course of postoperative period. The mortality was 8.9% in the study group and 13.6% in the control group.

[Hemocarboperfusion in the treatment of patients with an opiate abstinence syndrome]. / Gemokarboperfuziia v lechenii bol'nykh s opiinym abstinentnym sindromom.

The authors analyze of the results of applying hemocarboperfusion in treatment of opiate addiction. All the patients were treated in the Belorussian center of sorption methods of detoxication and plasmapheresis. It is shown that 4-5 procedures of hemocarboperfusion in combination with infusion and drug therapy allow to correct of withdrawal mental and somatic disorders.

[Characteristics of the method and reagents in fluorescent determination of effective and total concentration of serum albumin]. / Nekotorye kharakteristiki metoda i reaktivov dlia fliuorestsentnogo opredeleniia éffektivnoi i obshchei kontsentratsii syvorotochnogo al'bumina.

The characteristics of fluorescent essay of total and effective albumin concentrations by Zond-Albumin kit (experimental lot) were as follows: intraseries reproducibility in measurements not more than 1.6%, the error in serum dosage being mainly responsible for the total error. After unsealing the ampules the reagents may be stored at 5 degrees C for at least a week. Fluorescence intensity recorded in measurements in the majority of samples is stable for at least 50 min after addition of reagents. Measured values of total albumin concentration coincide with the results of measuring mass albumin concentration by bromocresol blue method, coefficient of linear correlation r = 0.98.

[The use of a biospecific antiproteinase hemosorbent in the combined treatment of acute destructive pancreatitis]. / Primenenie biospetsificheskogo antiproteinaznogo gemosorbenta v kompleksnom lechenii ostrogo destruktivnogo pankreatita.

Results of treatment of 32 patients with acute destructive pancreatitis are presented. Hemosorption on biospecific antiproteinase hemosorbent "OVOSORB" possessing the property of extraction of the excess of serine proteinases from blood plasma was used. High efficiency of the sorbent for treatment of destructive pancreatitis was shown. This effect was obtained at the expense of correction of hyperproteasemia, normalization of protein metabolism as well as prevention of the production and accumulation of middle molecule peptides possessing various pathological properties in the fluid media of the organism.

[Effectiveness of the biospecific antiproteinase hemosorbent "Ovosorb" in the comprehensive treatment of diffuse suppurative peritonitis and acute destructive pancreatitis in dogs]. / Effektivnost' biospetsificheskogo antiproteinaznogo gemosorbenta "Ovosorb" v kompleksnom lechenii razlitogo gnoinogo peritonita i ostrogo destruktivnogo pankreatita u sobak.

The authors examined the efficacy of the biospecific antiprotease hemosorption Ovosorb containing ovomucoid from duck egg protein as part of polyacrylamide gel, which was used in the multimodality treatment for experimental diffuse pyoperitoneum and acute destructive pancreatitis in dogs. Ovosorb effectively diminished proteasemia, restored the plasma inhibitory potential by eliminating dysproteinemia, suppressed the production of secondary peptide endotoxins. These effects of the hemosorbent promoted the regression of endotoxicosis and the significant reduction in experimental animal deaths.

[Treatment of diffuse purulent appendicular peritonitis with antiprotease sorbent "ovosorb"]. / Lechenie razlitogo gnoinogo peritonita appendikuliarnogo geneza s primeneniem antiproteaznogo sorbenta "ovosorb".

The authors studied the character of the therapeutic action of some links of protein metabolism in connection with the use of hemosorption with a biospecific antiprotease hemosorbent "ovosorb" in the complex treatment of 24 patients with diffuse purulent peritonitis of appendicular genesis. It was found that the antiprotease biospecific hemosorbent is marked by high efficacy in the correction of protein metabolism and the consequent systemic disorders in patients with peritonitis of an appendicular genesis. It is shown that "ovosorb" removes selectively from hemocirculation active forms of proteinase of their complexes with inhibitors and, in contrast to carbon sorbents does not possess unspecific sorption of the inhibitors of proteinases and other blood plasms proteins.

[The use of sorption detoxification methods for the prevention of dynamic intestinal obstruction in peritonitis]. / Ispol'zovanie sorbtsionnykh metodov detoksikatsii dlia profilaktiki dinamicheskoi neprokhodimosti kishechnika pri peritonite.

The effect of hemosorption on motor-evacuatory intestinal function was studied in 169 patients with different forms of peritonitis of appendicular genesis. Early inclusion of hemosorption into the complex of treatment contributed to restoration of motor-evacuatory function of the intestine in 2-3 days, as well as to prevention of development of early commissural ileus.

[A method of determining middle molecules]. / Sposob opredeleniia "srednikh molekul".

The authors suggest a method for the detection of 'medium molecules' to be used for rapid diagnosis of poisoning. They present their arguments in favor of a higher specificity of this method as against other rapid methods for 'medium molecule' detection in biologic fluids of the body. The authors' data evidence a high correlation between the results of the suggested method and gel filtration technique. The procedure may be used for the rapid diagnosis of peptidemia severity in the patients with grave endogenic intoxication and in cases when endotoxicosis is not the underlying condition.

[Hemosorption in the complex treatment of patients with suppurative peritonitis of appendicular etiology]. / Gemosorbtsiia v kompleksnom lechenii bol'nykh s gnoinym peritonitom appendikuliarnogo geneza.

Analysis of the results of treatment of 240 patients with generalized peritonitis of appendicular origin showed that the application of hemosorption led to noticeable and stable diminution of intoxication in 84% of cases. In the ++post-sorption period, the severity of endotoxicosis did not change essentially in 12% of cases and increased in the remaining cases. The therapeutic effect of hemosorption was found to be unstable in patients with signs of multiple organ insufficiency developing in prolonged poorly effective therapy as well as in patients with unrecognized abdominal abscesses, incompetence of the sutures of anastomoses, thrombosis of the mesenteric vessels, and early intestinal obstruction due to adhesions. Endotoxicosis intensified during hemosorption in patients with extensive epifascial phlegmons. It is proved that hemosorption applied repeatedly in the early postoperative period with due account for the individual features of the course of the disease ensures an optimal therapeutic effect.

[Hemosorption service in a clinic]. / Sluzhba gemosorbtsii v klinike.

The validation of the advisability of establishing an emergency detoxication service in Minsk is provided. It is demonstrated that the establishment of such a service made it possible to significantly improve the outcomes of treatment in patients with severe endotoxicosis of different genesis.

[Middle molecules--formation and methods of determination]. / "Srednye molekuly"--obrazovanie i sposoby opredeleniia.

Medium molecules have been detected by two methods, gel filtration and screening technique, in patients with diffuse purulent peritonitis and with chronic renal insufficiency. No close correlation between the findings of the two methods has been observed. The results lead to a conclusion that, despite being rapid and simple, the screening method is hardly adequate for cases with endogenous intoxication. Approaches to improvement of this method are discussed.