[Hemostatic disorders in patients with pancreonecrosis at the stage of purulent complications]. / Narushenie pokazatelei gomeostaza u bol'nykh s pankreonekrozom v stadii gnoinykh oslozhnenii.

The responses of blood coagulation and fibrinolysis show a clear phase course in patients with pancreonecrosis in the dynamics of the postresuscitation period. There were different changes in the phasic pattern of hemostatic disorders in survivors as compared with a group of deceased patients. With a good outcome, there was a twofold reduction in the concentration of fibrinogen as compared with the normal values and an increase in whole blood fibrinolytic activity on days 21-23. The increased whole blood fibrinolytic activity in the group of survivors in the presence of invariably decreased Hageman-dependent plasma fibrinolytic activity in both groups of the patients suggests that formed blood cells contributes to the process of recovery.

[The specific features of lipid metabolism and changes in the plasma activity of transaminases in patients with sepsis]. / Osobennosti lipidnogo obmena i dinamiki aktivnosti transaminaz plazmy krovi bol'nykh sepsisom.

A parallel study of changes in the activity of transaminases and the parameters of lipid metabolism was conducted in patients with sepsis or septic shock, receiving renal replacement therapy. The multiple baseline increase in the activity of gamma-glutamyltranspeptidase was observed in about 50% of the patients and the elevated level of triglycerides and very low density-lipoprotein cholesterol in all the examinees. In case of the baseline multiple increased activity of gamma-glutamyltranspeptidase as compared with the normal physiological values, the probability of a good clinical outcome was some 67%, in the survivors, the activity of the enzyme significantly increasing during therapy. In the absence of the baseline multiple increased activity of gamma-glutamyltranspeptidase, there was a good clinical outcome provided that there were positive changes in triglycerides and very low-density lipoprotein cholesterol during therapy and its probability was about 33%. It is concluded that the activity of gamma-glutamyltranspeptidase and the concentration of triglycerides and very low-density lipoprotein cholesterol may be used to evaluate the efficiency of treatment and as predictors of the outcome of treatment in patients with sepsis and septic shock.

[The characteristics of changes in lipid metabolism indices of patients with severe mechanical trauma]. / Osobennosti izmenenii nekotorykh pokazatelei lipidnogo obmena u bol'nykh s tiazheloi mekhanicheskoi travmoi.

The paper contains the study results of some lipid-metabolism indices in patients with severe mechanical injury. Changing concentrations of total cholesterol, triglycerides and of different lipoprotein fractions in blood plasma are demonstrated. It was established that the investigated lipid-metabolism indices reflect a degree of liver malfunction in severely impaired homeostasis. It can be stated on the basis of comparing the study results with the clinical outcome that the dynamic concentration of total cholesterol in blood plasma is an important prognostication factor. Changing ratios of high-density lipoproteins, low-density lipoproteins and extra-low-density lipoproteins were observed in survivors yet by day 15, which is indicative of a commencing dislipidemia.

[Basic characteristics of lipid metabolism in patients with sepsis during kidney replacement therapy]. / Osnovnye pokazateli lipidnogo obmena u bol'nykh sepsisom pri zamestitel'noi pochechnoi terapii.

The changing indices of lipid metabolism were studied in patients with sepsis who were undergoing the substitution renal therapy. A sharp reduction of high-density lipoproteins (HDLP) and a higher concentration of triglyceride (TG) and of an extremely low-density lipoproteins (ELDLP) were shown in the blood plasma of such patients irrespective of a clinical outcome. The positive dynamics of TG and ELDLP concentrations as observed in the process of treatment was considered to be a good prognostication sign in sepsis and septic shock.

[Spectrum of plasma lipoproteids in patients with severe mechanical trauma]. / Spektr lipoproteidov v plazme krovi bol'nykh, perenesshikh tiazheluiu mekhanicheskuiu travmu.

Changes in the plasma lipoprotein spectrum were studied in patients with severe mechanical trauma. These changes were shown to be associated with the severity of injury and with the age of patients. The steady-state reduction in the plasma concentrations of cholesterol in patients aged under 55 years who have a serious mechanical trauma may be considered to be a poor predictor. In patients above 55 years, the severity of their condition may be judged from the changes in the concentration of high density lipoproteins: the positive changes in this parameter are indicative of a good clinical outcome.

[Kinetic modeling during continuous hemodiafiltration in patients with sepsis and multiorgan failure]. / Kineticheskoe modelirovanie pri postoiannoi gemodiafil'tratsii u bol'nykh s sepsisom i poliorgannoi nedostatochnost'iu

Kinetic simulation in terms of urea and creatinine is the best way of prescribing a dialysis dose and assessing its quality as it considers differences in a patient's body weight, the level of catabolism, the rate of equilibration, including the recirculation phenomenon noticeably observed under shock. A 2-pool model of distribution of urea and creatinine was employed in the study. The latter was carried out in 31 patients (17 males and 14 females) with sepsis and multi-organ failure receiving 50 sessions of continuous hemodiafiltration (CHDF). The mean duration of CHDF was 73.8 +/- 7.0 (4.0-207.0) hours, the daily volumes of a substitute, a dialysate, and an effluent (filtrate + dialysate) were 33 +/- 1.0 (5.0-60.0), 43.9 +/- 0.8 (2.6-62.0), and 80.4 +/- 1.6 (12.0-122.3) liters a day, respectively. An analysis confirmed the high efficiency of CHDF close to that of the daily volume-body weight ratio and showed that such conditions of the procedure are optimal in maintaining azotemia at the subnormal level irrespective of the degree of cababolism.

[Indicators of lipid metabolism in patients in critical condition]. / Pokazateli lipidnogo obmena u bol'nykh v kriticheskikh sostoianiiakh.

Plasma lipid metabolism was studied in critical patients with severe combined injuries. Decrease in cholesterol concentration and increase in triglyceride concentrations were more pronounced in patients with lethal outcomes. The authors conclude that plasma cholesterol and triglyceride concentrations can be used as prognostic signs in patients with severe combined injuries.

[Effect of occlusive cerebral ischemia on functional status of the internal organs]. / Vliianie okkliuzionnoi ishemii mozga na funktsional'noe sostoianie vnutrennikh organov.

Biochemical parameters characterizing visceral functions were measured in the plasma of rats with brain ischemia induced by double occlusion of the carotid arteries. Functional insufficiency of the viscera is gradually forming in the course of occlusive ischemia of the brain. Functional insufficiency of the liver was observed in animals with severe neurological deficiency and subsequent lethal outcome. In rats resistant to ischemia, visceral dysfunctions develop in a certain succession, starting from the pancreas and followed by the myocardium, liver, and kidneys.

[Lactate kinetics during constant hemodiafiltration in critically severe patients with the systemic inflammatory response syndrome and multiple organ failure]. / Kinetika laktata pri postoiannoi gemodiafil'tratsii u kriticheski tiazhelykh bol'nykh s sindromom sistemnogo vospalitel'nogo otveta i poliorgannoi nedostatochnost'iu.

High-volume hemodiafiltration is a new approach to the treatment of critical patients with generalized inflammatory reaction and multiple organ failure. Increase of the liquid exchange during the procedure is fraught with the development of secondary metabolic disorders in cases when lactate-based buffer is used (with high amounts of lactate). This study was undertaken to evaluate the consequences for the acid-base balance in patients with hypoxia and circulatory failure. Twelve patients (6 men and 6 women) with APACHE II score 25 were examined. The major treatment modality was continuous hemodiafiltration. The results indicate that lactate-buffered solutions can be used in critical patients, because they do not cause a notable increase in the blood lactate levels due to its good utilization. Moreover, it is associated with correction of disorders in acid-base balance. No negative clinical consequences were observed after using lactate anion in high concentrations as the major buffer compound.

[Regional perfusion and oxygenation in the early resuscitation period following prolonged clinical death]. / Regionarnaia perfuziia i oksigenatsiia v rannem postreanimatsionnom periode posle dlitel'noi klinicheskoi smerti.

Cardiac output distribution and oxygen supply in the period starting from 15 min after resuscitation to 7 h were studied in 23 dogs exposed to 10 min clinical death caused by blood loss. The ratio of supra- to subdiaphragmatic bloodstream was virtually unchanged. Redistribution of the flow in favor of hind limb muscles was observed in the subdiaphragmatic region only between the 15th and 30th minutes. Reduction of oxygen transport during prolonged hypoperfusion (2-6 h) was associated with increased oxygen utilization in all areas which was expressed most of all in the supra-diaphragmatic region and in limb tissues and the least so in the splanchnic area, with oxygen consumption remaining at the initial level or surpassing it. A close relationship was revealed between oxygen transport and consumption in the supradiaphragmatic sector and posterior limb tissues combined with critical levels of pO2 and HbO2 in outflowing blood. Stably surviving animals differed from those dead in 1 sec by a lesser depression of the bloodstream and oxygen transport in the body on the whole and in the supradiaphragmatic region, a lesser oxygen consumption by the supradiaphragmatic region at the 15th-30th minutes, and a higher O2 consumption in 3-6 h under conditions of more marked spontaneous hypothermia.

Role of cAMP in regulation of activity of acid hydrolases of rat heart and liver during ischemia and after recirculation.

The interrelation between intracellular cAMP content and activity of lysosomal hydrolases was studied in rat liver and heart during ischemia of varying genesis and after recirculation. The activity of acid phosphatase (AP) and cathepsin D (CD) was determined in the fraction enriched with lysosomes (FEL) and in the supernatant fraction (SF) at 30,000 x g. Ischemia of isolated perfused heart of 20 to 60 min as described by Langendorff was accompanied by an increase in the SF/FEL ratio. Postischemic reperfusion resulted in a further increase in this ratio. In a terminal state induced by cardiac arrest of 10 min and within the first postresuscitation hours the SF/FEL ratio in the rat liver also increased. Processing of the liver FEL with 0.025% concentration of detergent Triton X-100 was also indicative of lability of lysosomal membranes during recirculation. The intracellular cAMP content changed differently. During ischemia of the myocardium, the cAMP level rose by 40 min and remained increased after 20 and 40 min of reperfusion. The cAMP content in the liver decreased after 10 min of circulatory arrest and increased in the postresuscitation period achieving its peak 4 h after resuscitation. Intra-abdominal injection of lyposomes with incapsulated cAMP to rats in the postresuscitation period and the study of the effect of dibutyryl-cAMP, caffeine and isoproterenol on the activity of acid hydrolases of ischemic heart and after postischemic reperfusion showed that an increase in the cAMP content achieved in various ways was conducive to stabilization of lysosomal membranes.

[Characteristics of the activation of lysosomal enzymes in the rat liver after death and during resuscitation]. / Osobennosti aktivatsii fermentov lizosom pecheni krys pri umiranii i posle ozhivleniia organizma.

Alterations in activity of lysosomal acid phosphatase and cathepsin D, as well as of hepatocyte ultrastructure were studied in rat liver tissue after experimental heart arrest within 10 and 30 min and during the early post-resuscitation period. Cathepsin D free activity in a supernatant fraction as well as both enzymatic activities in lysosomal fraction were increased after 30 min heart arrest. Activity of acid phosphatase and cathepsin D in lysosomes was decreased, while the activity of the free enzymes was increased within 1 and 4 hrs after resuscitation. Triton X-100 (0.025%) caused labilization of lysosomal membranes. Alterations in ultrastructure of hepatocytes were observed within 30 min of the heart arrest and within first hour of the post-resuscitation period. The lysosomal membranes tended to normalization within 24 hrs after the post-resuscitation period, whereas the enzymatic activity remained elevated. Role of lysosomes in regulation of intracellular metabolism is discussed.

[Membrane damage in brain subcellular structures in terminal states and in the postresuscitation period]. / Povrezhdenie membran subkletochnykh struktur golovnogo mozga pri terminal'nykh sostoianiiakh i v postreanimatsionnom periode.

Animal experiments were made to study and compare enzymatic activity of brain tissue mitochondria and microsomes treated and untreated with Tween-80 and Triton-X-100. In Mongolian gerbils, the 10-minute brain ischemia induced by bilateral carotid occlusion led to the labilization of the membranes of microsomal fractions, which did not return to normal an hour after resuscitation. The destructive effect of ischemia combined with clinical death from mechanical aspnyxia was similar to that of Triton-X-100. The ten-minute clinical death from ventricular fibrillation due to electroshock in dogs labilized lysosomal membranes. During the first hour after resuscitation and especially during the first 24 hours, the treatment of crude mitochondria with Tween-80 did not activate alkaline phosphatase and plasminogenic activator as compared with the control group.

[Effect of visible light on animal biochemical and physiological parameters]. / Vliianie vidimogo sveta na biokhimicheskie i fiziologicheskie parametry zhivotnogo.

The animals perception of the visible spectrum with waves length 450, 540, 680 nm of the same light intensity has been studied. The effect of visible light on rats has been estimated by some functional and biochemical parameters in vivo and in vitro. The whole complex of results obtained gives a chance to suppose that the light energy of visible spectrum redistribution in animal's tissues has a principal role in the regulation of animal's metabolism depending on the spectral structure of the incident light.

[Biochemiluminescence of the human body surface]. / Biokhemiliuminestsentsiia s poverkhnosti tela cheloveka.

Biochemiluminescence of human body surface was studied with a modern photometric apparatus. It was shown that different parts of the body surface had different radiation levels. Open parts of human body (face, palms) and feet had the highest radiation level. The maximum radiation was detected in the blue spectrum range. The intensity of such biochemiluminescence was about 10 photons/sec/cm2.