[Extracorporeal methods of hemocorrection in the combined treatment of patients with purulent surgical infection of soft tissues complicated by sepsis].

Extracorporeal methods of hemosorption and detoxication were used in treatment of 293 patients with purulent surgical infection of soft tissues complicated by sepsis. In 35 patients with the same nosology the methods in question were not employed. An analysis of the clinical observations has shown that lethality in the main group was reduced to 23.

[Optimization of indirect electrochemical detoxication in the treatment of different endogenous intoxications and multiple organ failure syndrome in resuscitation practice].

The authors have made a statistical analysis of clinical groups of patients in the units of resuscitation and intensive therapy of a general profile and of the archive materials of a laboratory of extracorporeal hemocorrection. The ultraviolet and laser photomodification of autoblood, hemosorption, plasmapheresis, ultra- and hemofiltration were used in the complex treatment of these patients. In the experimental group there were 190 patients on whom 333 operations of extracorporeal hemocorrection were made with using indirect electrochemical detoxication (IECD).

[Effects of extracorporeal hemo-correction on lipid peroxidation in patients in critical states].

The article presents an analysis of immediate influence of extracorporeal hemocorrection upon the indices of lipid peroxidation in resuscitation patients of a surgical profile. It was found that hemosorption, ultrafiltration and their combination exert a moderate detoxicating effect on lipid peroxidation products. The detoxicating effect of plasmapheresis is negligible.

[Extracorporeal hemocorrection in acute pancreatitis].

An experience with using 340 operations of extracorporeal hemocorrection in complex intensive therapy of 160 patients with acute pancreatitis has been generalized. In 111 of these patients (69%) pancreatic necrosis complicated by the syndrome of multiple organ failure was diagnosed. Based on the mechanisms of medical efficiency the authors have developed differential indications for using different extracorporeal technologies depending on the clinico-laboratory profile of the endogenous intoxication, structure and degree of organic and systemic dysfunctions.

[Classification of acute dysfunctions of organs and systems in multiple organ failure syndrome].

A classification of acute dysfunctions of the vital organs and systems in cases with multiple organ failure is proposed. It is suggested to assess the function as satisfactory, compensatory sufficiency, decompensated insufficiency, or failure. Clinical laboratory criteria of such rating are offered.

[Disorders of immunity in chest and abdominal injuries].

Under study were disturbances in the immune competent system in 245 patients with injuries of the chest and abdomen in dynamics of the early posttrauma period. Specific features of the disturbances were analyzed in the complicated and noncomplicated course of the trauma disease. The informative value and prognostic significance of certain indices are discussed as well as approaches to immune correction.

[Fibrinogen metabolism in juvenile uterine bleeding].

The levels of fibrinogen, monomeric fibrin soluble complexes (MFSC), fibrin-fibrinogen degradation products (FDP), and the status of blood coagulation and fibrinolytic systems were studied in girls suffering from juvenile uterine bleedings. Fibrinogen and MFSC levels were found lowered and FDP concentration increased in such bleedings. Fibrinogen concentration correlated with the activities of the coagulating and fibrinolytic systems, and the MFSC level only with the coagulating system activity.

[Antibacterial and detoxification therapy in acute appendicitis].

An analysis of clinical effectiveness of antibacterial therapy, photomodification of autoblood, hemosorption and their combinations was made in 395 patients with acute appendicitis. It was established that no antibacterial and desintoxicating therapy is required in catarrhal appendicitis. The prophylactic application of photomodification of autoblood is thought to be most expedient for phlegmonous appendicitis at the postoperative period, a combination of antibacterial therapy and photomodified autoblood--for gangrenous appendicitis, a combination of antibacterial therapy, photomodification of autoblood and hemosorption--for appendicular diffuse suppurative peritonitis.

[The possible reasons for an increase in the concentration of middle-weight molecules in pathology].

Human plasma and blood were treated by kaolin, thromboplastin, streptokinase, phytohemagglutinin, hydrogen peroxide, and Fe2+. An increase in the amount of median-mass substances was found after incubation. The obtained data showed that activation of limited proteolysis, immunity, and peroxidation could be the cause of increase of median-mass substances in pathological conditions.

[Crohn disease].

Among 2,443 patients who underwent operation for acute appendicitis in a period of 9 years 19 had Crohn's disease. The specific features of the clinical picture and the morphological changes are described. The diagnosis and surgical tactics in Crohn's disease are discussed.

[Endogenous intoxication in chest and abdominal injuries].

Results of clinico-laboratory examinations of the endogenic intoxication in patients with injuries of the chest and abdomen are presented. Correlative relationships of the endogenic intoxication parameters and their association with the degree and character of injuries were established, the clinical informative value and prognostic significance of certain laboratory tests were determined. A conclusion is made on the necessity of a correction of endogenic intoxication in complex treatment of these patients.

[The effect of autotransfusion of photo-modified blood on the growth of Walker's carcinosarcoma].

The study deals with the influence of autotransfusion of blood treated with ultraviolet light on the growth of experimental Walker's carcinosarcoma in rats. Animals of the study group survived longer than controls. Autotransfusion of the photo-modified blood did not influence tumor growth rate.

[A method of studying the absorbent phase of phagocytosis].

A method has been developed for examining phagocytosis, making use of the Soviet latex RFD-48. Optimal conditions of the procedure were specified, and results of measurements in normal subjects and patients and laboratory animals presented.

[Photomodification of autologous blood in surgery].

The use of the method of autologous blood photomodification in surgery is discussed on basis of generalized experience of the Leningrad Research-Practical Center of Blood Photomodification (3,000 procedures conducted in over 2,000 patients). The current state of the problem, the main mechanisms of the therapeutic action of the procedure, and the clinical efficacy of the method in various surgical diseases are dealt with. The possible complications and the means of their prevention are deal with.

[Perfusion across a medium of lyophilized xenogeneic spleen in peritonitis and septic shock].

The article presents results of an experimental study of hemoperfusion through slices of lyophilized xenogeneic spleen in peritonitis and septic shock in rabbits which demonstrated longer life and survival of the animals. The mechanisms of curative effect of the procedure and discussed. Two clinical observations of using the method in septic patients are presented.

[Limited proteolysis activation syndrome in surgery].

Under consideration is an original author's conception, formulated previously, of the syndrome of activation of limited proteolysis as an obligatory pathogenetic link of all pathological processes including the alteration at the tissue level as applied to surgical diseases. A universal character of the syndrome in acute and chronic surgical diseases and traumas, its role in their pathogenesis was shown in 1107 patients and 130 experimental animals. Variants of the course of the syndrome in different diseases are considered both in the postoperative and posttraumatic periods.

[Endogenous toxemia in surgery].

An analysis of the mechanisms of the development of endogenous intoxication was used to consider its role in pathogenesis of most serious surgical diseases and traumas and their complications. The role of endogenous intoxication is shown in the development of multiple organ insufficiency. Methods of extracorporal hemocorrection in treatment of endogenous intoxication are substantiated.

[Pathogenesis of experimental peritonitis].

It was found that joint action of two independent factors is necessary for the development of peritonitis. They are: prolonged infection of the abdominal cavity and an inflammatory process caused by an extraperitoneal source. Investigations of the endogenous intoxication, system of regulation of the aggregate state of blood, immunity, esterase and antitrypsin activity in dynamics of the development of experimental peritonitis and septic shock were performed.

[Therapeutic choices in spontaneous pneumothorax].

Questions of conservative and operative treatment are considered on the basis of studying 259 patients with spontaneous pneumothorax. In most of the patients the lung was spreaded by a single or permanent active aspiration of air from the pleural cavity. However, due to great amount of recurrences after the conservative treatment it should be more often followed by operative methods of treatment.