[Toxicological screening of biological fluids]. / Skrining toksichnosti biologicheskikh zhidkostei.

Analysis of the results of evaluation of the complement activity, toxicity of the urine, low molecular weight fraction of the blood, and blood cell hemolysis confirmed the suggested simplified model of endotoxicosis and showed that evaluation of the complement activity and urine toxicity is sufficient for tentative laboratory diagnosis of endotoxicosis. Proceeding from these data it is possible to evaluate the patient's status and predict the disease outcome. Laboratory diagnosis is made using a biological test system and toxicity analyzer.

[A new method for total complement activity analysis and its clinical significance]. / Novyi metod opredeleniia obshchei aktivnosti komplementa i ego klinicheskoe znachenie.

A test system consisting of a short-term suspension culture of mobile cells (bovine semen) is suggested for evaluating the complement activity. A simple and effective rapid method for evaluating the complement activity is based on the use of this system. Clinical application of this method helps evaluate the disease severity and predict the patient's condition in various diseases.

Functional activity of human hepatocytes under traumatic disease.

Absorption and fluorescent cytophotometry techniques were applied to studies of RNA as well as of total glycogen and its fractions as the parameters of functional activity of the hepatocytes in patients with severe mechanical trauma, both with and without autointoxication (AI). Slides were stained with gallocyanine-chromalums to determine the RNA content and were processed by the fluorescent PAS-reaction for the glycogen content. To trace the dynamics of RNA and glycogen contents in the liver punction biopsies were done in the same patients. A quick increase in the RNA content took place in both groups of patients at the first period (within the first 3 days) of traumatic disease. At the second period of disease the hepatocyte RNA content in patients without AI was found to decrease up to the initial level whereas that in patients with AI increased on the average by 36% of the initial values. The total glycogen content in hepatocytes of all the patients changed insignificantly in the course of disease but its labile fraction in patients with AI decreased to 70% of the total. The increase of hepatocyte synthetic activity and the maintenance of the high glycogen level are indicative of the large compensatory potential of the liver that enables it to carry an intensive functional load under AI conditions.

[The treatment of soft-tissue wounds by using sorbent bandages]. / Lechenie ran miagkikh tkanei s ispol'zovaniem sorbiruiushchikh poviazok.

On the basis of experimental and clinical researches the authors has found out that the sorption via wound using activated carbonic fibrous material if started at an early post shock period could be considered as an effective method of treatment of severe mechanic injuries with a vast wound surface. This method contributes to the favourable outcome of local wound healing and diminishes the number of complications mainly of purulent-septic nature. The positive influence of sorbent applied directly on wound after surgical treatment consists in promoting tissue metabolism, and reducing the risk of inflammatory processes. There are straight manifestations of general detoxicating effect: diminishing of catabolism processes, reducing of toxic metabolite concentration, stimulating of immune system, falling the rate of toxemia. As a result the number of complications has diminished 40%, and the number of lethal cases--15%.

[Posttraumatic liver failure]. / Posttravmaticheskaia pechenochnaia nedostatochnost'.

An examination of 166 patients was performed at the early postshock period of trauma disease. Results of the investigation of the functional and morphological state of the liver, factors of pathogenesis of posttraumatic hepatic insufficiency are analyzed.

Flow cytometric assay of lysosome-activated leukocytes as cellular marker of health status.

Rapid analysis of the lysosomal system state in human peripheral blood leukocytes was carried out by means of flow cytometry of diluted blood supravitally stained with acridine orange. For each of the subjects studied (26 healthy donors, nine donors with a weak cold-like infection and 30 patients with severe wounds), all the leukocytes were distributed into two distinct cell peaks: one with activated (A) and one with inactivated (I) lysosomal apparatus. It is shown here that whereas the mean cell frequency ratio of the former to the latter peak (A/I) of healthy donors was 1.18 (SD = 0.35) and was consistent with a Gaussian distribution, this value was statistically significantly increased in patients with cold-like symptoms (mean = 2.72, SD = 0.59, P < 10(-5), forming a bimodal distribution when pooled with data for healthy donors, and it increased dramatically (up to 40 times) in patients suffering the aftermath of severe wounds. Therefore, this method, needing only a few drops of the patient's blood and taking 10-15 min, can serve as a marker of health status. In addition, we show that activation/inactivation of the lysosomal apparatus of human leukocytes in vivo proceeds in an 'all-or-none' fashion. It will be possible in the future to enhance the technique by means of evaluating the A/I cell frequency ratio for separate leukocyte types.

[A cytophotometric study of the RNA and glycogen content of human hepatocytes at different stages in the development of traumatic disease]. / Tsitofotometricheskoe issledovanie soderzhaniia RNK i glikogena v gepatotsitakh cheloveka na raznykh étapakh razvitiia travmaticheskoi bolezni.

Absorption and fluorescent cytophotometry techniques were applied to studies of RNA, glycogen and its fractions in hepatocytes of patients with hard mechanic trauma, both with and without endointoxication. For measuring RNA and glycogen contents, slides were stained by gallocyanin-chromalum or underwent fluorescent PAS-reaction, respectively. The repeated aspiration biopsy material was used for investigation of RNA and glycogen contents in dynamics. A quick increase in RNA content took place at the first stage (within the first 3 days) of traumatic illness of both the groups of patients. At the second stage of illness the hepatocyte RNA content in patients without endointoxication was seen to decrease to the initial level, whereas that in patients with endointoxication increased from the initial level by 36%. At different stages of illness the total glycogen content is changed insignificantly in the course of illness, but its labile fraction decreases to 70% of the total glycogen in patients with endointoxication. The increase of hepatocyte synthetic activity and the maintenance of the normal glycogen level may suggest a sufficient compensatory possibility of the liver, in spite of a high functional load under endointoxication.

[The use of the principles of military field surgery in rendering medical care to the victims during catastrophes]. / Ispol'zovanie printsipov voenno-polevoi khirurgii pri okazanii meditsinskoi pomoshchi postradavshim vo vremia katastrof.

Despite the existing differences in medical care of war and catastrophe casualties it is possible to apply a variety of organizational and management principles of military medicine for the disaster medicine. The authors express the opinion that in case of big catastrophes the medical service could operate by means of rapid deployment units formed on the basis of territorial principle.

[Endotoxemia in severe mechanical trauma and the sorption methods of its treatment]. / Endotoksikoz pri tiazheloi mekhanicheskoi travme i sorbtsionnye metody ego lecheniia.

Different methods of sorption detoxication used at the early postshock period in 249 patients with severe mechanical injuries and experimental investigations in 144 rabbits have shown the early sorption detoxication to be a pathogenetically justified method in the complex treatment of critical patients. The application sorption and, under clinical conditions, enterosorption reduce the endogenous intoxication, normalize the parameters of homeostasis, lessen the amount of complications and lethality. The authors do not recommend using hemosorption in critical patients at the early post-shock period.

[Endotoxemia as a problem of clinical surgery]. / Endotoksikoz kak problema klinicheskoi khirurgii.

The authors have formulated a modern concept of endotoxicosis. The ideas of its essence were formed on the clinical model of the severe associated mechanical trauma. Principles of the complex treatment of endotoxicosis are described.

[The content of glycogen and its fractions in human hepatocytes in traumatic disease]. / Soderzhanie glikogena i ego fraktsii v gepatotsitakh cheloveka pri travmaticheskoi bolezni.

A cytofluorometric study was made of the total glycogen and its of fractions in liver cells of patients with hard mechanic trauma with or without intoxication. For studying glycogen dynamics in the course of traumatic illness, the aspiration biopsy material was obtained (30 patients) using repeated liver biopsy of one and the same patient. The total glycogen was found to change insignificantly in liver cells of patients with traumatic illness, both under favourable conditions and with intoxication, and at the normal level. The labile glycogen fraction in liver cells of patients with traumatic illness without intoxication is contained almost at the normal level (80-95%) of the total glycogen and is not changed for a long time. At that time the relative content of the labile glycogen fraction decreases appreciably in some cases to 45-50% due to intoxication development. A relative content of the labile glycogen fraction in hepatocytes with hard mechanical intoxication correlates well with the degree of intoxication. This makes hepatocyte glycogen microfluorometry a diagnostic tool in measuring the functional state of liver in the course of intoxication.

[Potentials of infusion therapy in enhancing the detoxification effect of hemosorption in patients suffering from suppurative-septic complications of mechanical injury]. / Vozmozhnosti infuzionnoi terapii v usilenii detoksikatsionnogo éffekta gemosorbtsii u postradavshikh s gnoino-septicheskimi oslozhneniiami mekhanicheskoi travmy.

Under study was the application of microvasoplegia as a method of preoperative management in fulfilling hemosorption in patients with pyo-septic complications of a severe mechanical trauma. The method of infusion and medicamentous therapy used before hemosorption is described. Laboratory examinations of the enzyme toxemia level have shown pathogenetic grounds of the complex method of treatment. Positive clinical results were obtained.

[Structure and sorption properties of regenerated hemosorbent SCN]. / Struktura i sorbtsionnye svoistva regenerirovannogo gemosorbenta SKN.

Stepwise desorption of protein components from the hemosorbent SCN after hemoperfusion was studied, and their molecular weights were determined. It was found that hard alkaline regeneration and oxidation with nitric acid do not affect the hemosorbent structure, composition and potentiometric characteristics. The regenerated hemosorbent can be successfully used for adsorbtion of extraneous low- and medium-molecular weight components to clarify microbiological liquids.

[Hemosorption in the treatment of toxemia and septic conditions after severe mechanical trauma]. / Gemosorbtsiia v lechenii intoksikatsii i septicheskikh sostoianii posle tiazheloi mekhanicheskoi travmy.

Under study was the significance of hemosorption in complex therapy of patients with complications resulting from a severe mechanical trauma. Lethality was found to decrease from 68% to 45%. The results obtained allow the use of hemosorption to be recommended for the treatment of endogenous intoxication in patients with complications of a severe mechanical trauma.

[Distribution of radioactive tetanus toxin at the subcellular level]. / K voprosu o raspredelenii radioaktivnogo stolbniachnogo toksina na subkletochnom urovne.

Experiments were carried out on rabbits for detecting the distribution of radioactive tetanotoxin between subcellular fractions of tissues of the central nervous system. It has been found out that a parenteral administration of tetanotoxin-35S results in a quick rise of the tissue radioactivity. The radioactivity of the free ribosome fraction remained most constant and high, which might be an indication of a high acceptory capacity of these organelles to tetanotoxin. For some periods of an acute tetanus intoxication, a rather high tropism of tetanotoxin of synaptosome, microsome and myelinic fragments was found.

[Neurologic manifestations of ischemia of the lower extremities following vascular injury]. / Nevrologicheskie proiavleniia ishemii nizhnikh konechnostei pri povrezhdenii sosudov

Disorders of magistral vessels are accompanied by disturbances of motor and sensorial functions which may be erroneously qualified as traumas of the nervous stems. Such mistakes may lead to a late restitution of the magistral vessels and consequently to a necrosis of the extremities or severe disorders of functions. These disorders are not always climineted after a late renewal of the magistral blood. In this relation a clarification of the diagnosis may exert a certain indluence on the selection of treatment, inasmuct as traumas of the magistral arteries urgen surgical treatment while as injury of the nerves are not in need of such special measures.