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Background. Nitrous oxide abuse (“laughing gas”, N2O) is common among young people attending nightclubs. Contrary to popular belief about the safety of N2O, in some cases neurological complications develop due to a deficiency of vitamin B12, the activity of which is blocked by N2O. Purpose of the study – to determine the typology and course of neurological disorders in a group of patients who regularly use “laughing gas”. To note the key diagnostic markers that allow verification of vitamin B12 deficiency induced by nitrous oxide consumption. To describe pathogenetic therapy features and follow-up. Materials and methods. The study included 12 patients (10 men and 2 women) aged 18 to 45 years (average age 29 years) with a diagnosis of B12-deficient myelopolyneuropathy induced by regular use of nitrous oxide. Results. The most common neurological complication of nitrous oxide abuse for more than 1 month was a generalized lesion of the peripheral nerves with acute or subacute distal symmetric sensory or sensorimotor axonal polyneuropathy. In the clinical picture, sensory complaints and disorders prevailed. Paresis developed in half of the cases. A typical neuroimaging symptom characteristic of funicular myelosis was rarely detected (16.7 %). A decrease in B12 vitamin level could most reliably be diagnosed only indirectly, by the presence of hyperhomocysteinemia (91.7 % of cases). In all cases that were followed-up, prolonged therapy with cyanocobalamin led to partial (n = 5; 62.5 %) or complete (n = 3; 37.5 %) regression of neurological symptoms. Conclusion. Caution regarding the use of nitrous oxide should be in all cases of predominantly sensory polyneuropathy with acute or subacute development in young and middle-aged people. A thorough history taking (targeted survey on the fact of nitrous oxide consumption) and diagnostics (testing the level of homocysteine, if possible methylmalonic acid) allow you to not miss a deficiency of vitamin B12, the treatment of the consequences of which with timely verification and adequate correction is quite effective. It is recommended that the level of homocysteine in the blood to be regularly monitored during the treatment (in order to achieve its normalization).

The estimation of greenhouse gas emissions was carried out by using model calculations of the dynamics of organic matter in organic soils and emissions of greenhouse gases (PEAT-GHG-MODEL). Emissions of CO2, CH4, N2O, NO and carbon accumulation in drained organic soil in reclamation «Kryukovo» system located in the Chernihiv province in the period 2000–2011 were modeled. The lot with vegetation type Community of Cārex humīlis / Cārex rhizīna was studied. The average rate of above-ground dry matter is 125–325 g/m2, the content of organic matter in dry matter of the plant is 45.5– 47.8 %. The average annual rates of CO2, CH4, N2O, NO emissions for the period 2000–2011 are 6.718 tons of CO2 – C ha–1 ∙ y–1; 2.960 kg of CH4 – C ha–1 ∙ y–1; 5.583 kg N2O and NO – N ha–1 ∙ y–1 respectively. The carbon accumulation in the soil varied from year to year, from 0.439 to 0.836 tons C ha–1 ∙ y–1. The estimations of annual variability of CO2, CH4, N2O and NO fluxes for the two contrasting GWL dynamics 2006 and 2010 years were given.

The problem of using nitrous oxide (“laughing gas”) is now important because young people often prefer this kind of entertainment. Regular short-term inhalation of nitrous oxide increases the risk of developing vitamin B12 deficiency, which is an essential cofactor of important metabolic processes. This article describes 2 clinical cases of neurological disorders in young adults who had used nitrous oxide. We demonstrate difficulties in the diagnosis, therapeutic tactics and prognosis.

Birth of a child is an unique time in the life of every woman. Unfortunately, labor is often one of the most painful and traumatic experiences suffered in woman’s life. In the modern obstetrics pain of labor and methods of its mitigation are the main problem for both, patients and medical staff. In this paper the most important steps of the development of labor analgesia were described.

Aim. To evaluate the influence of metformin on nitric oxide bioavailability in patients with type 2 diabetes mellitus (T2DM) regarding glycemic homeostasis, and to investigate a correlation between metformin dosage and NO levels in vivo. Materials and Methods. Two groups ? primary and control ? were assembled for the clinical section of this study. Patients with newly diagnosed T2DM on metformin therapy were included to the primary group, while drug-naive T2DM patients were enrolled as control subjects. Glycemic parameters and NO bioavailability was tested in both groups prior to and after the follow-up period. Experimental section was dedicated to the elucidation of potential dose-dependent effects of metformin on NO bioavailability. Mice were intraperitoneally infused with metformin at 0.5; 1.1; 5.6 mg per subject. Tissue detection of NO was performed with diethyldithiocarbamate (DETC) iron complexes to form mononitrosyl iron compounds (MIC) with paramagnetic properties. Control rodents were intraperitoneally infused with metformin without spin trapping. Results. We found nitrite and methaemoglobin (a marker for NO bioavailability) to increase in parallel along with glycemic compensation in the primary but not control group. In vivo rodent models showed linear correlation between accumulation of DETC/MIC and dose of metformin, as well as formation of dinitrosyl iron complexes, known as endogenous NO transporters. Conclusion. Our data suggests that metformin benefits glycemic homeostasis in T2DM as an NO donor via formation of dinitrosyl iron complexes.

The hormonal status of 38 surgical patients during anesthesia with nitrous oxide and Xe administered by similar methods showed that in contrast to anesthesia with N2O, Xe anesthesia helped not only preserve the adaptive potential, but even increase the defense potential of the organism during surgery. Xe anesthesia was associated with a 1.5 times less requirement in fentanyl, with the levels of stress hormones being better; Xe is the best alternative to nitrous oxide.

The impact of different variants of neuroleptanalgesia (NLA) on respiration immediately after gastric resection and cholecystectomy has been studied in two homogeneous groups of patients (30 persons each) after operations on the upper abdominal organs. In patients of group I NLA was performed using fentanyl (initial dose--7.5 micrograms/kg, maintenance dose--100 micrograms) supplemented with epidural blockade and isovolemic hemodilution. In patients of group II NLA was performed with graded administration of 100-200 micrograms fentanyl. In patients of group I right after surgery gas exchange during room air inhalation was unimpaired, while in patients of group II hypoxemia due to inadequate ventilation and metabolic acidosis were registered. It is concluded that the type of anesthesia management suggested has a protective effect on respiration in the earliest postoperative period.

Experience of treating 11 patients with knife wounds of the heart in a central district hospital is reviewed. Limited preoperative period, intensive therapy of hemorrhagic shock, readiness of a surgical and anesthesiological teams to perform a wide range of resuscitation procedures in the course of the operation, prophylaxis, timely and adequate therapy of complications arising in the postoperative period--all help to obtain good results.

A method of electron paramagnetic resonance was applied to the study of a possibility of paramagnetic centres formation in the nitrogen oxide reaction with saturated and unsaturated fatty acids and aromatic amino acids. Several paramagnetic centres are formed in interaction of NO2 with oleic acid at 20 degrees C. Saturated fatty acids formed no paramagnetic centres in the reaction with NO2. NO formed no paramagnetic centres not only with butyric, palmitic, and stearic acids, but also with oleic acid. The capacity of NO2 to form paramagentic centres with tyrosine in its saturated solution was revealed. In case of interaction between NO and NO2 with saturated phenylalanine and tryptophane solutions no formation of paramagnetic centres was observed. It is suggested that unsaturated fatty acids and tyrosine remnants of the membrane lipoprotein complexes could serve as peculiar targets with which NO2 interacted, and that formation of paramagnetic centres in the NO2 reaction with the mentioned substances was the primary act of the membrane damage.

The authors have studied the 5 years' survival of 403 cases of mammary gland cancer without development of recurrences and metastases. In 205 out of them ether-nitrous oxide anesthesia and in 198 fluoroxene-nitrous oxide anesthesia were applied. Postoperative Thiophosphamide (Thio-TEP) was administered to all the patients. The main factors characterizing the compared groups were identical in both of them. It has been proved that 5 years survival of mammary gland cancer cases rises when the patients undergo a complex treatment, and during the operation they are subjected to fluoroxene and not to ether.

Control values of local blood flow in the thalamus of alert dogs were 68.7 +/- 1.6 ml/100g/min and in their frontal cortex 84.8 +/- 2.9 ml/100 g/min. As a result of the hexenal anesthesia, the local blood flow decreased by 3 to 12 per cent of control values. The mild effect suggests that the anesthesia maintained with the 70% N2O is an acceptable procedure for studying the cerebral circulation.

The comparative changes in the amino acid composition of calf skin collagen after gamma-irradiation (doses from 100 to 1,000 Gy) in aqueous solutions under different gas atmospheres (O2, N2O, H2, vacuum) were investigated. The radiochemical yields of collagen amino acid residues destruction were determined. Under O2 (OH X, O2-) most of amino acids are destroyed with higher yields than under N2O. Leucine, valine, isoleucine, phenylalanine, arginine were the exception because of their high reaction rate constants with OH X and hydroxylation reactions. Under H2 (e-aq, H) and in vacuum (e-aq, OH X) the mechanism of collagen radiolysis changed due to its aggregation; the destruction of those amino acids which have high reaction rate constants with water radiolysis products was mainly observed (phenylalanine, tyrosine, histidine).