Publications by authors named "Khubutiia M"

Orthotopic liver transplantation (OLT) remains the only and radical method of treating patients with terminal stages of chronic diffuse hepatic diseases (cirrhoses), of patients with various congenital metabolic lesions of the liver, autoimmune diseases characterized by lesions of bile ducts, as well as series of both primary and secondary tumorous hepatic lesions. Liver transplantation is one of the most complicated operative interventions. Difficulty of OLT is determined by multifactorial and well-coordinated work of various medical services at the pre-, intra- and postoperative stage of management.

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In the formation and development of the national specialized toxicological service the important role was played by legislative initiatives, distinguished with continuity and improvement of the quality of care in acute poisoning, principles of interaction of units of service. Since the beginning of the organization of specialized toxicological service in the country, without taking into account the regional regulations, there were published over thirty ones, impact and significance of which can be very positively evaluated by formed a unique and authoritative national school of clinical toxicology, with its wealth of organizational, methodological and diagnostic and treatment practices, valuable scientific and human resources.

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The combined method of hernioplasty with the use of biologic and sunthetic implants has been worked out. 12 patients have been operated on: the "open" technique was used in 5 patients, the rest 7 have been operated on laparoscopically. The use of dura mater as an implant for hernioplasty allows avoiding tissue tension by muscle sheath plasty.

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Severe sepsis and septic shock remain the most serious problem of critical care medicine today with a mortality of 25-80%. Bacterial endotoxin is of considerable importance in the pathogenesis of sepsis. A selective hemosorbent in which endotoxin adsorption is accomplished via its binding to a synthetic peptide (LPS-A) has been recently designed in Sweden.

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Unlabelled: The study compared the efficiency of percutaneous coronary interventions (PCI) into infarction-related coronary artery (IRCA) in high-risk patients with acute myocardial infarction (AMI), that were fulfilled 12-24 hours since the pain syndrome onset or during recurrent ischemic episodes 3 days after successful thrombolysis. In the first group (68 patients) invasive restoration of blood flow was fulfilled in 3 days (at average 48 hours) after AMI onset due to recurrent ischemia. In the second group (56 patients) IRCA recanalization was fulfilled in 12-24 hours (at average 20 hours) since pain syndrome onset due to clinical signs of unfavorable outcome high risk.

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The study found bone exchange disorder manifested by accelerated bone resorption, retarded bone formation, and the loss of the bone mineral density (BMD) of the axial and peripheral skeleton in 19 men (39 observations) 66 +/- 44 months following orthotopic heart transplantation (OTHT) and in 92 men 45 +/- 28 months after cadaveric kidney transplantation. An accelerated bone resorption, more pronounced in cadaveric kidney (CK) recipients, is associated with hyperparathyroidism (HPT) and renal dysfunction, while bone formation retardation is associated with a decrease in insulin-like growth factor-1 level. An increase in osteoprotegerin level is of compensatory character.

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The authors analyze the pathogenetic significance of hyperhomocysteinemia, antiphospholipid syndrome, the hyperexpression of cell adhesion molecules, inflammation, and oxidative disorders for, as well as the role of viral infections in the development of coronary artery disease of the grafted heart. The paper shows that viral infections in recipients lead to the development of proinflammatory, proatherogenous, and prothrombogenous status, expressing themselves in an increase in the corresponding laboratory markers in recipients' blood plasma, and points out the role of viral infection in the pathogenesis of coronary artery disease of the transplanted heart. Control and treatment of viral infections, as well as pharmacocorrection of proinflammatory, proatherogenous, and prothrombogenous status would made it possible to influence the development of coronary artery disease of the grafted heart.

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Sixty-five coronary patients were subjected to aortocoronary bypass surgery. Three groups were distinguished: 1) controls-no filters; 2) patients in whom hemotransfusion (40 mu) and infusion filters were used during and on day 1 after surgery; and 3) in whom leukocyte filters for filtering residual perfusate from artificial circulation device were used in addition to the filters used in group 2. In the controls plasma level of leukocytic alpha-glycoprotein after artificial circulation increased 22 to 36 times, whereas in groups 2 and 3 it did not increase at all.

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The experience of the use of noninvasive assisted circulation in patients with cardiac pathology is summarized. It has been demonstrated that rhythmic pneumo-compression of the lower extremities, abdominal compression, muscular electrical stimulation of the lower extremities and the abdomen have a pronounced effect on circulation compartments with low pressure. All the above pre-determines the role of these techniques in the management of cardiac failure and in intensive care.

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The analysis of their own observations, criteria of determination of organism intoxication degree, methods of an acute ileus treatment are adduced. The effectiveness of an active organism detoxication method plasmapheresis was noted.

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The article discusses the results of applying for the first time Soviet-made "Modul" and "Yasen" artificial ventricles of the heart (AVH) in a left ventricular bypass regimen in patients with refractory cardiac insufficiency. Improvement of AVH design and rational tactics of attendant drug therapy allowed the period of the safe application of the AVH in the organism to be increased to more than 8 days.

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The paper presents a generalized experience in the surgical treatment of patients with frequent attacks of paroxysmal tachycardia associated with additional cardiac conduction pathways, that are not affected by the drug treatment. The results are described of 27 operations of destruction of anomalous cardiac conduction pathways. The use of a special ultrasound destructor permits the surgeon to perform the operation on the functioning heart, thus providing maximal radical surgery with minimal cardiac trauma and best effects.

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