[The immediate and long results of treatment of posttraumatic fistulas of the rectum with application of modern laser technologies].

The immediate and long-term results of the posttraumatic rectal fistulae treatment in 134 patients were analyzed. The differentiated choice of surgical tactics, the use of modern laser methods and the original complex of diagnostic and treatment measures allowed to decrease the frequency of such posttraumatic complications from 19.0 to 7.9%. Good medical and social adaptadion and rehabilitation rates were achieved in 98.5% of patients.

[New methods of surgical correction of the puerperal anal sphincter insufficiency].

Treatment results of 612 patients aged from 17 to 71 years, with benign perineal diseases were analyzed. The rectovaginal fistula was diagnosed in 84 (13,7%), puerperal anal sphincter insufficiency - in 88 (14,4%) and rectocele was diagnosed in 139 (22,7%) of patients. 237 (38,7%) cases of perineal ruptures were analyzed retrospectively and 64 (10,5%) acute ruptures were analyzed prospectively. The suggested modified levatoroplasty includes the dissection of the proper fascia of the puborectal muscle, followed by the placation of the anterior muscle wall of the rectum and the posterior fascial sheet. After secure fixation of the first suture line, the second line sutures are applied on muscle tissue using monofilament resorbable material. The third line of the sutures connects anterior sheets of the proper fascia of the levators. Long-term follow up results were obtained in 80 (95,2%) of the operated patients. 63 patients reported excellent results, sphincter function had improved in 15 patients and operation had no effect in 2 cases.

[Surgical treatment of rectovaginal fistulae].

Results of treatment of 31 patients, aged 22-62 years, with rectovaginal fistula (RVG) were analyzed. RVG of the 1st degree of complexity was found in 7 patients; 19 women had RVG of the 2nd degree of complexity and the rest 5 patients had an RVG of the 3rd degree. During the surgery bringing down mucosa, the so called "tissue flap plasty" with the anterior sphincterolevatoroplasty was performed. Low-intensity laser irradiation was used for wound treatment postoperatively. Fistula recurrence was registered only in two patients.

[Surgical treatment of rectocele].

Results of surgical treatment of 163 female patients with rectocele aged 22-62 years were analyzed. Patients were divided into 3 groups: 68 women after transvaginal levatoroplasty formed the 1st group, 2nd group formed 73 patients after transperineal levatoroplasty and 22 patients after alloplasty of rectovaginal wall with prolene mesh presented the 3rd group. Differential individual approach is necessary by choosing the method of operative treatment. Levatoroplasty maintains or causes pathologic puborectal spasm in 90%. It leads to increase, maintenance or appearance of obstructive defecation. Preoperative defecography can not prognose the functional result of the operation. Transperineal levatoroplasty and rectovaginal wall alloplasty provide successful anatomic results, 90,5 and 95%, correspondingly.

[The lipolytic enzyme activity of the mitochondrial membranes of the digestive organs in heat stress in rats]. / Aktivnost' lipoliticheskikh fermentov membran mitokhondrii pishchevaritel'nykh organov pri teplovykh stressakh krys.

An augmentation of catalytic activity of phospholipase A and lysophospholipase A occurred in the liver mitochondria membranes and small intestine mucosa in rats subjected to heat. The augmentation of the latter's activity was significantly lesser in overheated rats.

[The effect of lipid peroxidation on the lipid and phospholipid composition of mitochondrial membranes during thermal incubation]. / Vliianie perekisnogo okisleniia lipidov na lipidnyi i fosfolipidnyi sostav membran mitokhondrii pri teplovoi inkubatsii.

Alterations in the content of lipids and phospholipids were studied in rat liver mitochondrial membranes after long-term heating at 37 degrees, pH 7.4, using FeSO4-ascorbate as inductors of lipid peroxidation. Under these conditions, activation of lipid peroxidation in mitochondrial membranes led to a marked increase in the rate of hydrolysis of phosphatidylethanolamine and lysophosphatidylethanolamine, to elevated synthesis of phosphatidylserine, sphingomyelin, phosphatidic and lysophosphatidic acids, diglycerides and cholesterol esters as well as to inhibit hydrolysis of phosphatidylcholine, cardiolipin and their lyso-derivatives.

[Phospholipid composition of the liver mitochondrial membrane in thermal stress]. / O fosfolipidnom sostave membran mitokhondrii pecheni pri teplovykh stressakh.

Content of phospholipids as well as activity of phospholipase A2 and lysophospholipase A1 were studied in the hepatic mitochondrial membranes of rats exposed to high temperatures. A decrease in the content of phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol and increase in fractions of cardiolipin, phosphatidylserine, phosphatidic acid and lysophospholipids were detected in liver tissue mitochondria after heat stress. Alterations of phospholipid levels in the mitochondrial membranes correlated with the rate (36-37 degrees and 41-43 degrees) and duration (2 and 4 hrs) of heat exposure. Under mild conditions of heat exposure, phospholipase A2 and lysophospholipase A1 were activated in rat liver mitochondrial membranes. With elongation of the heat effect up to 4 hr activation of the lipolytic enzymes was increased. Under most severe conditions of heat stress, a marked activation of phospholipase A2 was observed, while the activity of lysophospholipase A1 was decreased and approached to control values.

[Characteristics of oxidative metabolism of the gastrointestinal tract during adaptation of the rat to high temperatures]. / Osobennosti okislitel'nogo obmena zheludochno-kishechnogo trakta pri adaptatsii krys k vysokoi temperature.

Dynamic alterations in total respiratory metabolism, tissue respiration in various parts of gastrointestinal tract, respiratory and phosphorylating activity in mitochondria isolated from small intestinal mucosa were studied in rats, maintained during 30 days under conditions of high environmental temperature. Moderately high temperature caused a distinct redistribution of functional activity among various parts of gastrointestinal tract. A decrease in total respiratory metabolism occurred partially due to a decrease in tissue respiration, suggesting various role of these tissues in total body metabolism. Mitochondrial oxidation changed from alpha-ketoglutarate to succinate pathway depending on duration of the heat treatment. Higher temperatures caused a decrease in the mitochondrial respiration rate uncoupling of oxidative phosphorylation.

[Functional state of the mitochondria of the small intestine mucosa during heat stress]. / O funktsional'nom sostoianii mitokhondrii slizistoi obolochki tonkoi kishki pri teplovykh stressakh.

Rate of respiration and effectiveness of oxidative phosphorylation of intestinal mucosa mitochondria in rats revealed that adaptation to heat loads is accompanied by reversible switching over of the NAD-dependent and succinate ways of mitochondria oxygenation which maintains the normal existence of mucosal cells in conditions of heat stress. Severe heat stress disturbs the functional integrity of the oxygenation switching over and leads to disturbances of the rate of oxygenation and effectiveness of oxidative phosphorylation.

[Functioning of mucosal mitochondria of the small intestine in exposure of rats to high environmental temperature]. / Funktsionirovanie mitokhondrii slizistoi tonkoi kishi pri vozdeistvii na organizm krys vysokoi temperatury sredy.

Oxidative phosphorylation in mitochondria of small intestinal mucosa was studied after repeated overheating of rats. The hyperthermia affected the respiratory chains of mitochondrial membranes, facilitating the penetration of ADP, succinate, alpha-ketoglutarate and NADH across the membranes. Under these conditions thermostability of the respiratory chain multienzyme system was decreased and the rate of exogenous cytochrome c incorporation into mitochondrial membranes was altered. In the mitochondrial membranes from small intestinal mucosa there was noted development of latent impairments, the reversibility of which depended on the intensity and duration of hyperthermia.