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One of the mechanisms of muscular involvement in RA patients was elucidated by identification of antibodies to skeletal muscle components (actin and tropomyosin). Clinical symptoms of skeletal muscles involvement in RA proved to be associated with elevated count of tropomyosin antibodies against an insignificant informative value of actin. Enzyme immunoassay with tropomyosin has established a direct correlation between the number of the antibodies and RA activity.

Algorithms for automated processing of curves reflecting respiratory function of the lungs (pneumotachygram, psyrogram, transthoracic pressure) in grave patients were developed. A system of monitoring the parameters characterizing real time pulmonary ventilation, gas exchange, respiratory mechanics and aerodynamics was created. The described algorithms for calculating the curves of respiratory functions permit examination of pulmonary function during spontaneous respiration of a patient.

Thirty-four patients in the early postoperative period after surgery on the lungs and mediastinum and 23 patients after cardiopulmonary bypass surgery have been examined. 187 studies of central hemodynamics and pulmonary function during cardiopulmonary bypass have been performed to investigate the correlation between pulmonary hemodynamics and parameters of respiratory mechanics in the early postoperative period after thoracic surgery. The studies have revealed reverse dependence of lung and chest compliance (C) on pulmonary artery diastolic pressure (PAPdiast) (r = -0.61, p < 0.05) in patients after thoracic surgery with clinical signs of cardiopulmonary failure. When analogous studies were performed in patients with intact lungs after aortocoronary bypass, C/PAPdiast correlation was more close (r = 0.880, p < 0.05). At the same time there is a correlation between C and extracellular fluid volume (r = -0.7). The above correlations to a great extent predetermine the pathogenesis of respiratory failure in the postoperative period.

The treatment experience of 205 children aged from 1.5 mos to 14 yrs with dermoid or epidermoid cyst was summarized. The external localization was noted in 196 (95.6%) children, internal--in 9 (4.4%). The difficulties most frequently occurred while differential diagnosis conduction of the tumor-like neoplasms, localized in the region of the nose bridge and on the anterior neck surface. The cyst relapse occurred in 2 (1%) children, during the operative intervention conduction the cyst capsule integrity was broken and, may be, all of her membranes were not dissected completely. The cyst malignancy was not noted.

The karyotype of 2715 patients suspected of chromosome pathology has been studied. Chromosomal aberrations in the system of autosomes has been revealed. A diagnostic programme promoting a selective screening of chromosome pathology in nonspecialized medical institutions is developed. Medical-social rehabilitation programme for patients with chromosome syndrome is worked out.

Opioid analgesics were used in 282 patients on the first-third day after heart, lung and abdominal surgery. The main indication for their use was pain syndrome. Adequate analgesia with tramal, nubain and moradol was noted in 73, 76 and 81% of cases. In marked pain syndrome after thoracotomy the most effective agents were moradol and morphine. Computer monitoring of the respiratory function in tramal analgesia has shown a decrease in lung ventilation, esophageal pressure, inhalation volume, O2 production. Tramal, nubain and moradol in analgesic doses did not inhibit respiration. In adequate analgesia there was a decrease in lung ventilation which was not accompanied by shifts in acid-base balance of the arterial blood. The above analgesics had no considerable effect on systemic hemodynamics, though the use of tramal decreased systemic blood pressure and the use of moradol decreased systemic blood pressure and total peripheral vascular resistance. Tramal was most effective for synchronization of spontaneous respiration with a lung ventilation device in prolonged ventilation, as well as for the arrest of muscular tremor in the postoperative period. Tramal was effective in 95% of patients in the early post-anesthesia and postoperative period.

The work deals with clinical appraisal of the course of the early postoperative period and the prevention and treatment of complications after reconstructive operations on the esophagus. The postoperative period was studied in 99 patients. Complications occurred in the early postoperative period in 48.5% of patients, obstructive processes in the lungs were of principal importance among them. The authors conclude that particular significance in the prevention of acute respiratory failure in patients after one-stage plasty of the esophagus should be attached to the early diagnosis of pulmonary complications, prolonged artificial lung respiration, and measures for maintaining normal passage of the respiratory tract (cleansing bronchoscopy, early activation of patients, adequate anesthesia). The main importance in reducing mortality after one-stage esophageal plasty belongs to the measures of prevention and treatment of incompetence of the sutures of the esophageal anastomosis and mediastinitis.

Monitoring-computed systems were used during the therapeutic-diagnostic process at the resuscitation department of the All-Union Surgery Research Center in more than 1,000 patients who underwent operations on the heart, coronary arteries, bronchi, trachea, and esophagus. The main importance is attached to examination of the cardiorespiratory system. More than 90 derived parameters characterizing intracardiac hemodynamics, ventricular contractility, and oxygen transport are calculated according to special programs. For evaluation of the function of the lungs in an automated regimen, 32 parameters characterizing lung ventilation, gas exchange in the lungs, mechanism of respiration, and metabolism are calculated. Monitoring-computed care makes it possible to appraise the patient's condition in a given situation, the transient nature of changes in the physiological systems of the organism under the effect of therapy, and helps in choice of the optimal regimens of artificial lung ventilation and the methods of treatment. Computed appraisal of hemodynamics by means of the algorithm of the nearest point was found to be correct in 93% of cases. Storage of the results in the computer memory ensures an operative approach to information on any of the patients.

Intra-aortal balloon contrapulsation (IABC) was used as part of combined treatment for acute cardiac failure following cardiac surgery in 17 patients. The monitoring of cardiac output and pressure inside the heart's cavities (using the thermodilution method) showed IABC to produce an obvious hemodynamic effect. Six patients survived. Acute myocardial infarction as a cause of cardiac failure considerably aggravated the outcome. The final result of treatment was not satisfactory in such patients. It is stressed that IABC should be started as early as possible (not later than 2-3 hours after signs of acute heart failure first appear).

Changes in lung ventilation and pulmonary mechanics have been studied after bronchoscopy (BS) performed in 22 patients with early postoperative bronchial patency disturbances. All in all the results of 27 BS procedures have been assessed. It has been found that according to the nature of respiratory changes the patients could be divided into 2 groups. In one group pulmonary mechanics improved right after the procedure. While in the other group BS was associated with an increase in aerodynamic bronchial resistance to inhalation, respiratory work and energy waste. The parameters returned to normal values within an hour. It was noticed that the second type of the reaction was characteristic of patients over 50 with low respiratory reserve, heart failure and hypoxemia. In such patients BS is recommended together with high frequency jet ventilation through a nasotracheal catheter.

The paper deals with comparative characterization of validity shown by current techniques for assessing hemodynamic parameters such as radiocardiography, echocardiography, Doppler cardiography, electroimpedance indicator separation, alveolar gas carbon dioxide concentration change technique, tetrapolar chest rheography and their potential role in the practice of intensive care and resuscitation units.

Tramal was given to 204 patients who were operated on the lung, heart, abdomen. During pain therapy, good and satisfactory results were on average obtained in 75% patients operated on the lung, in 77%, on the heart, in 89%, on the abdomen, in 70%, on the great vessels. The absence of the inhibitory effect of the drug on the respiratory center and its slightly marked sedative effect allow one to recommend the agent for application in the early period following the surgery when narcotic analgesics still retain their effect and a real risk of their overdosage exists. During prolonged artificial pulmonary ventilation in the early postoperative period and in impaired adaptation of the patients to a respirator, tramal aids normalization of lung mechanics and hemodynamic parameters without eliminating and suppressing the patients' consciousness and results in cessation of muscular shivering. Adverse effects of tramal are of no decisive clinical significance and occur mainly when the drug is rapidly injected into the vein.

It has been demonstrated in experiments on mice (CBA X C57BL) X F1, thymectomized and irradiated by 800 R, with the haemopoietic system restored by bone marrow (B-mice) that in these animals, as compared with the controls, the changes in cellular immunity (inhibition of natural killer cells and stimulation of individual functions of the phagocytizing cells) are accompanied by considerable inhibition of osteogenesis. Compensatory regeneration of broken thigh-bone in B-mice is delayed by 5--10 days in various elements of the regenerated tissue in comparison with normal mice. Anatomical formation of the provisional callus in B-mice is not completed on day 21 and approaches a 14-day regenerate of the controls. The obtained results suggest the participation of T-system immunity in the reparatory regeneration of bone tissue.

Actins, isolated from human sceletal and heart muscles, were studied using SDS polyacrylamide gel electrophoresis. They possessed similar electrophoretic mobility and molecular weight about 46000 daltons.

It was established that septic shock is a rare (0.2%) but the severest (5 of 6 patients died) complication in pulmonary surgery and is a consequence of the spread of postoperative wound infection or pyo-inflammatory process in the lung for which the operation was performed. The staphylococcus and nonfermentative Gram-negative bacteria prevail among the causative agents of septicemia. The most typical clinical signs of septic shock are acute circulatory insufficiency with rapid development of insufficiency of the function of the brain, kidneys, liver, and intestinal paresis in a febrile patient with a severe postoperative wound infection or in one operated on for a disseminated pyo-inflammatory disease in the lung. Precise determination of the indications for operation, careful preoperative treatment of the pyo-inflammatory processes, immediate establishment of the diagnosis, and timely removal of the localized focus of infection are important in preventing septic shock.