[Activity of glutathione-dependent antioxidant system of the rat liver and blood depending on gamma-irradiation and diet].

The role of the glutathione-dependent antioxidant system in the prooxidant-antioxidant balance support was studied in the experiments with Wistar male rat under single gamma-irradiation (8 Gr dose), fed with unbalanced (as to animal proteins and antioxidant vitamins) diet and with addition of Aronia melanocarpa. Single gamma-irradiation of animals led to the decrease of selenium-dependent glutathione-peroxidase activity in the blood plasma and glutathione-S-transferase activity decrease in rat liver mitochondria. Animals which received the unbalanced food allowance under irradiation showed more expressed change of glutathione-dependent antioxidant enzymes activity, namely--proved decrease of glutathione-peroxidase and glutathione-S-transferase activity in liver microsomes and less expressed activation of selenium-dependent glutathione-peroxidase activity in the postmitochondrial fraction of laboratory animals liver. Introduction of the A. melanocarpa food supplement in the unbalanced diet of the laboratory animals which in vitro demonstrated expressed antioxidant and antiradical activity had no effect upon glutathione-peroxidase activity in the investigated tissues. Obtained data concerning significant decrease of the activity of glutathione-dependent antioxidant system and, particularly, of the selenium-dependent glutathione-peroxidase activity under the unbalanced diet condition may be useful in maintenance of prooxidant-antioxidant balance in the tissues of irradiated animals. Allowing for the above stated it is advisable to seek for new food additives which increase activity of the endogenous glutathione-dependent antioxidant enzymes for human tolerance improvement, especially under the unbalanced food allowance condition.

[Enforcing osseointegration of dental implantates spray-coated by bioceramics with the help of hyaluronic acid and hydroxyapatite gel in experimental conditions].

Influence of HAP-gel (2 g of 2% solution of hyaluronic acid mixed with 0,5 g of hydroxyapatite and 0,1 ml of colloidal silver) upon osseointegration in case of delayed introduction of titanium implantates in dog jaw. By scanning electron microscopy it was shown that solely use either of HAP-gel or of ceramic spraying increased direct contact area between bone and implantates in the 6 and 9 months time period. Combination of spray-coated ceramic with HAP-gel was effective in 3 months after implantation, when solely the HAP-gel or the ceramic spraying were little effective. In the following terms of experiment (6 and 9 months) significant differences between groups 3 and 4 (implantate with ceramic spraying but without HAP-gel in the alveolus and implantate with ceramic spraying and with HAP-gel in the alveolus) were not found. The area of implantate integration with jaw bone (cortical part of it was excluded) was equal to 80% and was maximal for the given conditions of the experiment.

[The performance of balloon Vater's ampulla dilatation in laparoscopic cholecystectomy as a method of choledocholithiasis treatment]. / Zdiisnennia balonnoï papilodylatatsiï pid chas vykonannia laparoskopichnoï kholetsystektomiï ia metod likuvannia kholedokholitiazu.

Experience of application of the antegrade balloon dilatation method for Vater's papilla sphincter during performance of laparoscopic cholecystectomy in patients with the gall-stone disease, complicated by choledocholithiasis, was presented. Short duration of hospital stay (5.5 days), low frequency of postoperative complications (4.5%), good late follow-up results witness the expediency of the method broad introduction into clinical practice.

[Laparoscopic intervention in patients affected by Chernobyl AES disaster]. / Laparoskopichni vtruchannia u khvorykh, shcho poterpily vnaslidok avarii na Chornobyl'skii AES.

Comparative analysis of laparoscopic interventions was conducted as well as their results and the frequency of complications occurrence in patients, who were the Chernobyl power atomic station disaster survivors and those who were not exposed to radiation.

[The clinico-functional assessment and work capacity of patients undergoing repeated operations on the mitral valve]. / Kliniko-funktsional'naia otsenka i trudosposobnost' bol'nykh pri povtornykh operatsiiakh na mitral'nom klapane.

A complex of examinations (ECG, echocardiographic and X-ray evaluations of heart volumes and cavities, treadmill-test) was performed in 82 patients before and after reoperations on the mitral valve. The type of recorrection was found to be associated with the degree of positive dynamics of the results. The data obtained contradicted to hyperdiagnoses of primary medical-labor examination commission establishing the II group of invalidism in 86 +/- 4% (M +/- m) of the examined patients. As a result of an analysis of all the data obtained the number of such patients was reduced up to 34 +/- 5%. A new approach to solving the problem of medical-labor examination was shown to be necessary for patients reoperated for mitral disease of the heart.

[The characteristics of the myocardial morphofunctional status of hypothyroidism patients]. / Osobennosti morfofunktsional'nogo sostoianiia miokarda u bol'nykh gipotireozom.

Electro- and echocardiography were used to examine the morphofunctional state of the heart in 19 patients with hypothyrosis during disease decompensation and after therapy with thyroid hormones. The hormonal blood content was measured by RIA. Nonspecific alterations of the electro- and echocardiographic readings characterizing hypothyroid myocardiodystrophy were discovered. Almost half of the cases manifested hydropericardium. The discovered myocardial alterations were marked by a slow positive dynamics. In patients over 45 years, they appeared irreversible in nature. The pericardial exudate resolved shortly after the euthyroid status was attained.

[Work capacity of patients after resection of post-infarction heart aneurysm]. / Trudosposobnost' bol'nykh posle rezektsii postinfarktnoi anevrizmy serdtsa.

The paper provides data of a ten-year follow-up of 51 patients who underwent postinfarction left ventricular aneurysmectomy in the All-Union Surgery Research Center with a view to verifying the degree of working capacity loss. In the long-term period, out of them 37 persons (72.5%) had Group II disability, 10 (19.6%) had easier managerial jobs (4 persons (7.8%) had not worked before surgery) and 3 (5.9%) retired on their old-age pension. The surgical therapy for postinfarction cardiac aneurysm significantly improves the functional status and physical working capacity in 72.5% of the patients.

[Factors determining the success of the surgical treatment of chronic postinfarct heart aneurysm]. / Faktory, opredeliaiushchie uspekh khirurgicheskogo lecheniia khronicheskoi postinfarktnoi anevrizmy serdtsa.

Evaluation of instrumental findings in relation to clinical course of the early postoperative period in 105 patients operated on for chronic postinfarction aneurysm of the heart demonstrated that regional left-ventricular contractility, particularly that of unscarred myocardial tissue, is the principal determinant of surgical success, followed by the severity of attendant coronary sclerosis and, consequently, the adequacy of the chosen surgical procedure. Preoperative congestive heart failure, indicative of disrupted left-ventricular myocardial compensatory potential, is an aggravating factor.

[Myocardial contractile function of the left ventricle in patients with congenital stenosis of the ostium aortae]. / Sokratitel'naia funktsiia miokarda levogo zheludochka u bol'nykh s vrozhdennym stenozom ust'ia aorty.

A study of 61 patients with congenital stenosis of the aortic ostium has shown that left ventricular myocardial dysfunction is related to the extent of myocardial hypertrophy. Progressive discrepancy between growing left ventricular myocardial hypertrophy and its blood supply resulted, at a certain point, in a qualitative change from compensatory to abnormal hypertrophy. The extent of left ventricular hypertrophy determined the severity of aortic stenosis and left ventricular dysfunction. The emergence of electrocardiographic signs of left ventricular hypertrophy and systolic overstrain is indicative of the defect acquiring a new quality--that of left ventricular and relative coronary insufficiency.

[Complex evaluation of the long-term results of resection of postinfarct aneurysms of the left ventricle]. / Kompleksnaia otsenka otdalennykh rezul'tatov rezektsii postinfarktnoi anevrizmy levogo zheludochka.

Late results of left ventricular postinfarction aneurysm resection were studied in 112 patients. The results were good or satisfactory in 84.7% of patients, who mostly showed no hemodynamically significant coronary arterial stenoses or with one major branch affected, and a dyskinetic aneurysm. Clinical improvement was accompanied by a significant increase in stress tolerance, an increase in maximum oxygen utilization per 1 kg body weight, a decrease in the proportion of oxygen debt to oxygen want and better myocardial contractility, evidence of increased physical working capacity of the postoperative patients. The results were poor in patients with multiple coronary arterial stenoses and heart failure uncontrollable by medication.

[Post-infarct cardiac aneurysm: clinical picture and contractile function of the myocardium in the remote period after surgical treatment]. / Postinfarktnaia anevrizma serdtsa: klinika i sokratitel'naia funktsiia miokarda v otdalennom periode posle khirurgicheskogo lecheniia.

Late results of surgery for chronic postinfarction aneurysm of the heart were reviewed in 48 patients. Comprehensive clinical and instrumental investigation demonstrated that aneurysm resection alone or in combination with aorto-coronary shunting or ventricular septoplasty resulted in clinical improvement in 60.4% of patients. However, surgery had basically no positive effect on left-ventricular myocardial contractility and pulmonary hemodynamics. The lack of positive changes in myocardial contractility is due to marked asynergy (akinesia) developing around the post-operative scar. The late postoperative outcome depends on both the type (akinetic or dyskinetic) of heart aneurysm, and timely referral for surgical treatment.

[Segmental contractility and geometry of the left ventricle of patients with isolated lesions of the mitral valve]. / Segmentarnaia sokratimost' i geometriia levogo zheludochka u bol'nykh s izolirovannym porazheniem mitral'nogo klapana.

Investigations showed that patients with "pure" stenosis of the left atrioventricular orifice as well as those with mitral insufficiency were characterized by left ventricular myocardial dysfunction expressed in a decrease of the index of left ventricular integral function--the ejection fraction and in change of geometry of the left ventricular cavity. Asynergy (hypokinesia) of the anterior wall segments and the posterior basal segment was revealed in patients with "pure" stenosis and "pure" mitral insufficiency. Hypokinesia in patients with primary mitral insufficiency was revealed in the anterior wall only. The above changes in the left ventricular segmental contractility can be regarded as a cause of left ventricular pump function disorder.

[Non-invasive methods of examination in evaluation of cardiac reserve and contractile function of the myocardium in patients with postinfarct cardiac aneurysm]. / Neinvazivnye metody issledovaniia v otsenke koronarnogo rezerva i sokratitel'noi funktsii miokarda u bol'nykh s postinfarktnoi anevrizmoi serdtsa.

Non-invasive diagnostic procedures (electrocardiography, spiroergometry, polycardiography) were compared with selective coronarography and left-side radioventriculography in 132 patients with chronic post-infarction aneurysm of the heart, in order to demonstrate their respective diagnostic values for the assessment of coronary and myocardial reserves of the heart. It was shown that physical stress tolerance, pO2max, the oxygen debt/oxygen requirement percentage ratio could be indicative of disturbed coronary reserve, while prolonged P wave and left-atrial deviation time, the number of abnormal Q and QS waves and increased resting myocardial contractility index (above 0.550) suggested impaired myocardial contractility.

[Clinico-hemodynamic correlations in patients with a postinfarct aneurysm of the left ventricle]. / Kliniko-gemodinamicheskie sootnosheniia u bol'nykh s postinfarktnoi anevrizmoi levogo zheludochka serdtsa.

Eighty-four patients with left-ventricular post-infarction aneurysm were examined, 74 of those showing clinical signs of circulatory insufficiency. Selective coronarography and left roentgenocinematoventriculography were performed in all cases. Volumetric parameters and the ejection fraction were estimated for the total and contractile segment of the left ventricle. Statistical treatment of the data thus obtained demonstrated a relationship between the segmental contractility and manifestation of clinical signs of circulatory insufficiency. The limits were established for increments in residual and end-diastolic volumes that lead to the development of clinical manifestations of circulatory insufficiency. An increased end-diastolic pressure seems to be indicative of reduced elasticity (pliancy) of the left-ventricular myocardium, as reflected in markedly disturbed segmental contractility of the left-ventricular wall.

[Myocardial function in the late period after an operation for aortocoronary shunting]. / Funktsiia miokarda v otdalennom periode posle operatsii aortokoronarnogo shuntirovaniia.

Thirty patients with coronary heart disease were examined prior to and 18.3 +/- 3 months after surgery, with 66% of the shunts proving to be patent. All patients were divided into 3 groups: group I--14 (47%) patients with patent shunts, group II--10 (33%) patients with partially patent shunts and group III--6 (20%) patients with occluded shunts. The group I and II patients displayed an improvement in the segmentary contractility and the integral function of the left ventricle as compared to the preoperative values. The group III patients showed a negative time-course of the segmentary and integral function of the left ventricle. In all cases of the impaired patency of the aortocoronary shunts there was progression of the atherosclerotic process in the basin of the shunted artery.

[Evaluation of myocardial reserve in patients with post-infarction heart aneurysm]. / Otsenka miokardial'nogo rezerva u bol'nykh s postinfarktnoi anevrizmoi serdtsa.

The author examined 22 patients with postinfarction heart aneurysm to evaluate the myocardial reserves of the preserved myocardium with the use of the strophanthine test. The time-course of changes in the central hemodynamics, contractile function and segmental myocardial contractility of the left ventricle was evaluated. It was disclosed that the positive inotropic effect of strophanthine depends on the degree of the atherosclerotic lesions of the coronary arteries supplying blood to the zone of the preserved myocardium. In patients with postinfarction heart aneurysm and multiple demonstrable lesions of the coronary artery, administration of strophanthine brought about the deterioration of myocardial contractility of the left ventricle. No relationship was found between the initial status of the hemodynamics and the inotropic effect of strophanthine.