[Potential of artificial high-frequency jet lung ventilation during laryngeal resection with the use of endoprostheses].

The objective of the present work was to enhance safety of general anesthesia and concomitant artificial high-frequency jet lung ventilation (HF ALV) during laryngeal resection followed by endoprosthetics in 48 patients with laryngeal cancer. Thirty three patients underwent intraoperative transdermal transtracheal HF ALV (TT HF ALV) through a thin catheter inserted into tracheal puncture prior to surgery. In 15 patients, intraoperative trans-catheter HF ALV (TC HF ALV) was performed through an intubation tube the end of which was positioned above the operative site. The study made it possible to develop indications to the choice of anesthetic modalities with the use of TT HF ALV and TC HF ALV on an individual basis for laryngeal resection with subsequent endoprosthetics. In addition, a rational method was developed for the maintenance of respiratory function during one-step laryngeal resection and cervical lymphodissection without formation of tracheostoma.

[Maintenance of respiratory function during direct laryngoscopy in patients with laryngeal neoplasms].

The objective of the present work was to improve the safety and control of anesthesia during diagnostic direct laryngoscopy in patients with laryngeal neoplasms. A total of 120 patients with laryngeal neoplasms underwent planned diagnostic direct laryngoscopy with partial or total tumour biopsy. The patients were allocated to three groups of 40 subjects each depending on the mode of maintenance of their respiratory function during surgery. Group 1 included patients undergoing tracheal intubation with volume-targeted artificial lung ventilation (ALV), group 2 was comprised of patients given high-frequency injection AVL through the ventilation channel of an operating laryngoscope (I HF AVL), and group 3 was constituted by patients given transdermal trans-catheter HF ALV (TC HF ALV). The patients' condition was evaluated by measuring hemodynamic parameters, pulseoxymetry, and capnometry. The majority of the patients fairly well went trough the anesthesia with adequate cardiorespiratory fitness. In 15 (12.5%) cases, volume-targeted AVL and I HF AVL during anesthesia were associated with the development of hypoxia caused by airway obstruction and the lack of adequate ventilation. Patients in the TC HF ALV group developed very few complications during anesthesia and surgical intervention that created no serious risk for their health. An algorithm of the choice of the method for the maintenance of respiratory function during direct laryngoscopy with laryngeal tumour biopsy is proposed based on the differential approach that takes into account the degree of laryngeal obstruction, anticipated difficulties of <> laryngoscopy, and indications to the use of someone or other AVL modality in individual patients.

[Biological and physico-chemical properties of Yersinia pseudotuberculosis bacterial culture having the fra-operon Yersinia pestis].

The biological and physico-chemical properties of cultures of two isogenous recombinant variants of Yersinia pseudotuberculosis were studied. The cell genomes of the cultures are distinguished from one another only by the presence or by the absence of the fra-operon, which is a determined attribute of the plague microbe capsule-forming process. The expression of the attribute is amplified by rising the microbial biomass cultivation temperature and stimulates the decrease in the viability of the bacteria and adaptation potential in vitro. In the warm-blooded owner organism the microbes of the capsule-forming recombinant variant are characterized by the greater residual pathogenicity and immunogenic ability to the experimental plague of the laboratory animals as compared to the reference-variant cells. These specific features could be explained by more expressed colonizing ability of the capsule-forming microbes provided by owner cells' stability to the phagocyte process.

[Choice of lung ventilation at suspension laryngoscopy in patients with laryngeal neoplasms].

Three methods of artificial ventilation (AV) (volumetric, high-frequency injection, and high-frequency percutaneous transtracheal jet ventilations) were studied in 340 patients when laryngeal tumors were removed, by using a Stortz laryngoscope under multicomponent general anesthesia and local airways anesthesia. Examining the parameters of respiration and circulation in the use of three AV methods has indicated the advantages of the high-frequency percutaneous ventilation that ensures the prevention of aspiration complications and steady-state values of gas exchange and blood circulation, including in those with laryngeal stenosis and at a high risk for hemorrhage.

[Energy loss by the body during gastrectomy]. / Energopoteri organizma vo vremia rezektsii zheludka.

A method for calculation of the loss of energy by an organism of a patient at the time of gastric resection is presented. It is shown that for the 2h of operation, a patient losses the amount of energy which is almost equal to the basal metabolism for 24 hours.