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The protective effect produced on the kidneys in tourniquet shock by thiol agents possessing antioxidant properties (unithiol, cystamine) was compared with that of a preparation of cell capsules of L. bulgaricus (CCLB). Tourniquet shock was modeled under ether Raush anesthesia by applying 8 turns of a rubber tourniquet to the hind limbs for 6 hours. Thirty minutes before removal of the tourniquet animals of the first group were given an injection of 1 ml of physiological solution, animals of the second group--20 mg/kg of unithol, those of the third group received an injection of 20 mg/kg of cystamine hydrochloride. Animals of the fourth group received 50 mg/kg of CCLB in 1 ml of physiological solution 7 days before the experiment. A marked protective effect of CCLB on the kidneys in tourniquet shock was established. According to the degree of the protective effect on the tissue of kidneys in tourniquet shock, the studied agents come in the following order: CCLB, cystamine, unithiol.

The nephrotic syndrome is characterized by proteinuria, hypoalbuminemia and hypercholesterolemia. Hypercholesterolemia is in some cases a risk factor for atherosclerosis in this group of patients. The lipid plasma spectrum was studied in 45 patients with the nephrotic syndrome. Most pronounced changes of the lipid composition of the plasma were revealed in patients with systemic lupus erythematosus and a special form of mesangio-proliferative glomerulonephritis which is characterized by a torpid course and rapid development of chronic renal failure. Plasma atherogenicity was calculated according to the index of plasma atherogenicity. A high atherogenicity index was revealed in patients with an association of the nephrotic syndrome and arterial hypertension. Plasma atherogenicity is determined mainly by the level of high-density-lipoprotein cholesterol.

The author reviews the structure of nephropathies on the basis of an analysis of the clinicomorphological data obtained during the follow-up of 3000 patients examined at the nephrological center. In a group of primary glomerulonephritis, the mesangioproliferative form occurred most frequently (68%), the membranoproliferative form was encountered in 27.2% of cases, and the membranous form in 1.8%. Over the recent years not a single case of acute glomerulonephritis has been observed. Analysis of the diagnostic criteria allowed the antibody variety only to be regarded as an independent pattern of rapid-progressing glomerulonephritis. Equally to the manifestations of glomerulonephritis proper, mesangial proliferation should be also viewed as a possible nonspecific response to the other pathological processes. Focal glomerulosclerosis as a disease entity is to be excluded from the nomenclature of glomerulonephritis.

The studies performed proved the ability of the drug partusisten (in a dose of 10 mg/day) to effectively reduce an elevated potassium level in the serum of chronic sufferers with glomerulonephritis and initial renal insufficiency. Normal concentrations of Ca, K and Na in relevant patients remained unchanged except a slight rise in K urinary excretion this suggesting an extrarenal mechanism of K redistribution consequent to the action of beta 2-adrenergic agents.

The study of 226 patients with acute calculous cholecystitis provided arguments in favour of I. V. Davydovsky ideas on pyoresorptive fever: there was suppuration, resorption, protein loss. Anthropometric parameters remained stable in the presence of hypoalbuminemia, hypovolemia. Hypoproteinemia is attributed to stress evident from high cortisol level in the plasma from hospitalized patients. These shifts in nutritional status are unfavorable for forthcoming surgery. Transcutaneous transhepatic puncture and laparoscopy of the gall bladder are able to correct unwanted effects and prepare the patients for radical surgery.

To assess the effect of partusisten (fenoterol) on excretory function of the kidneys, the drug was administered per os in a dose of 10 mg/day for 7-10 days in 17 chronic glomerulonephritis patients with initial forms (stages I-IIA) of renal failure. A dramatic increase of glomerular filtration, a certain rise of tubular reabsorption, a reduction of blood concentration of nitrous residues were revealed, which was accompanied by electrolyte shifts and hemodynamic changes characteristic of partusisten. It is concluded that partusisten can be used as a drug ameliorating excretory function of the kidneys in chronic glomerulonephritis patients with initial forms of chronic renal failure.

The paper is concerned with the description of clinical, x-ray and morphological investigation of 123 bronchoalveolar cancer patients. Three types of this disease were defined: nodular (homogeneous and nonhomogeneous), pneumonia-like (infiltrative and infiltrative-nodular) and mixed (focal-disseminated, focal-nodular and focal-infiltrative). These types of bronchoalveolar cancer are most probably stages of the same tumor process. Clinical and x-ray signs of each type showed correlation with a morphological picture of a tumor. Shadow nonhomogeneity as one of the main x-ray signs of bronchoalveolar cancer was shown to be determined by the "alveolar" structure of a tumor, a tendency to the formation of small cavities, filled with viscous mucosa and air. Correct clinical and x-ray diagnosis in all types of bronchoalveolar cancer (before the use of the morphological methods) was established in 45.5% of the patients.

The article deals with material on 161 patients with the mediastinal form of lymphogranulomatosis. Variants of the X-ray picture and clinical manifestations of the disease are described. The authors list the indications for the use of bioptic methods of examination--prescalene biopsy, transthoracic needle biopsy, transtracheobronchial puncture, and mediastinoscopy. Comparative characteristics of the diagnostic value of these methods is given. Ten patients were treated by radical removal of the affected mediastinal lymph nodes, a satisfactory late--term result was produced in 8 of them.

As many as 16 patients with nephrotic syndrome (NS) of varying etiology and 10 patients without the NS were examined for ultrastructure of lymph capillaries of the kidney. Many-staged changes, from regenerative to destructive ones, associated with proteinuria growth and formation of the NS were revealed in lymph capillaries of the kidney. Patients with the NS of long standing manifested irreversible destructive processes--destruction of the capillary walls, karyopyknosis and cytoplasm coagulation. Microcirculatory disorders may be regarded as one of the mechanisms implicated in nephropathy progress.

Findings of the prospective examinations of 39 patients with mechanical jaundice of nontumoral genesis have shown that clinical and biochemical resolution of jaundice with the recovery of liver function come within 5 days after endoscopic papillosphincterotomy or continuous transnasal biliary drainage. A considerably decreased level of endotoxemia and indirect correction of volemic disorders were noted in parallel. Thus, bile passage is recovered and bile hypertension is eliminated against the background of endoscopic interventions on the major duodenal papilla which results in a considerably decreased risk of the coming radical operation.

The presented study evaluates the feasibility of recombinant activated factor VII (rFVIIa) (NovoSeven) to control bleeding in 28 patients with thrombocytopenia of different etiology (idiopathic thrombocytopenic purpura – 4/28, acute myelocytic leukemia – 10/28, acute lymphoblastic leukemia – 2/28, non-Hodgkin's lymphoma – 8/28, aplastic anemia – 2/28, chronic hepatitis C – 2/28) complicated with hemorrhagic syndrome. The platelet count in the selected group of patients varied from 3 × 109/l to 80 × 109/l (mean 31 × 109/l). Some of the patients suffered from coagulopathy (associated with hepatitis – five cases, associated with sepsis – 10 cases, and associated with bleeding – six cases). All patients experienced severe bleeds: postoperative – eight cases, CNS – seven cases, epistaxis – four cases, gastrointestinal – three cases, pulmonary hemorrhage – one case, after central line placement or other invasive manipulation – five cases. The majority received supportive treatment with FFP and/or PLT and RBC transfusions, which was unsuccessful. A mean dose of 86 mg/kg rFVIIa (range 41–114 mg/kg) was administered as an intravenous bolus injection. Fifteen patients received the treatment once, 11 patients were given a second dose of rFVIIa, and two patients received three doses. Laboratory haemostatic tests revealed a reduction of the PT of 1.5–2 times compared with the levels before administration of rFVIIa (Table ​(Table1).1). Thromboelastography (TEG) was performed in 18 patients. Before administration of rFVIIa the reaction time (R) was within the normal range, but the kinetic time (K) was prolonged and the maximum amplitude (MA) decreased, both results indicating a low platelet count. After administration of rFVIIa, eight patients appeared to have improved TEG parameters, in seven cases these parameters worsened, and in three cases the TEG parameters remained unchanged (Table ​(Table2).2). In 16 cases bleeding stopped 10–30 min following the injection, and decreased dramatically in six cases. Six patients did not achieve effective hemostasis after administration of rFVIIa. Bleeding reoccurred in seven cases after 6 hours and more following infusion of rFVIIa. In 25 cases no adverse events were reported; two patients developed high temperature (38.7°C and 39.0°C) within 15 min after the injection of rFVIIa. The described observations suggest efficiency of rFVIIa in controlling the postoperative and spontaneous bleeding in patients with various types of thrombocytopenia. Nevertheless, the laboratory tests do not always correlate with clinical efficiency of this treatment. Table 1 Table 2

Among the vast literature on bone fractures, fractures of the upper articular end of the thigh deserve special attention, since here, more than in other parts of the skeleton, we also encounter difficulties related to treatment.

A large number of clinical and experimental works are devoted to the study of trophic disorders in peripheral nerve injuries.The authors were mostly interested in the mechanism of trophic disorders and their treatment.The most frequent tissue trophic disorders were observed in the injured with peripheral nerve injuries. In the vast majority of cases these were gunshot wounds that partially or completely violated the integrity of the nerve trunk, accompanied by a prolonged suppuration process, which left more or less significant traces in the whole body, in the damaged nerves and in the surrounding soft tissues.

It can be noted with satisfaction that there is unanimity among traumatologists regarding the principles of fracture treatment.

Since the discovery of the tubercle bacillus by Koch and the elucidation of the genesis of the osteo-tuberculosis process, a fairly significant number of the most diverse methods of treating this disease have been proposed until now.

In the conditions of socialist industry, with the systematic facilitation of labor, the widespread introduction of mechanization, automation and remote control, the task of completely eliminating industrial injuries becomes quite real. To solve this problem, " first of all, it is necessary to analyze materials about injuries, compare them with data from previous years and identify the main causes of accidents.

The study of rheumatic diseases has attracted exceptional research attention in recent years. Along with the precise detailing of the classification of rheumatic diseases of the joints, the clinical characteristic of rheumatic diseases is revisited and clarified. Recently, the biochemical properties of the body and the entire course of metabolism in rheumatic infection have also been subjected to detailed study. In the present report, which is part of the general work carried out in our clinic to study rheumatism, we present data characterizing variations in chloride in the blood and urine in rheumatic diseases.

This year marks the 25th anniversary of the scientific-pedagogical and medical-social activities of Professor Mikhail Osipovich Friedland

This report is based on our experience in the treatment of 51 burned. The burns were caused by an explosion of an oil storage tank. Most of them were affected by the face, auricles, scalp, upper and lower extremities, buttocks, back, almost all had conjunctiva of the eyes. 1 patient, along with a burn, had a closed fracture of the forearm bones. One had a state of clinical death, from which he was removed by resuscitation measures.

In addition to Soviet orthopedists, specialists from many countries (Poland, Bulgaria, Hungary, East Germany, Austria, France, USA, etc.) took part in the work of the congress. More than 80 reports were heard on the education of correct posture in children, the occurrence and prevention of scoliosis, their conservative and surgical treatment. For the prevention of scoliosis, first of all, measures are needed to eliminate the conditions for the development of this deformity, the identification of the so-called prescoliotic forms. These forms are found in more than 40% of children of preschool and early school age. This manifests itself in the form of minor postural disturbances, asymmetric position of the shoulders, shoulder blades and other changes. Radiographically already at this stage, in a standing position, it is possible to determine some deviation of the spine to the side.

Studies on the liver state from the functional-morphological point of view in patients with acute and chronic secondary cholangitis have revealed in all cases the involvement of hepatic parenchyma with the development of cholangiohepatitis. In its acute course and timely performed operative interventions the process in the liver tends to subside. The authors consider that due to the absence of pure forms of cholangitis this term seems to be questionable, and they recommend to substitute it in all cases by the term cholangiohepatitis.

The results of endoscopical sampling methods, as described in this study, were performed on 5276 patients with different pulmonary lesions. Illustrations were made of the diagnostic possibilities of biopsy methods and their dependence on size and localization of pulmonary lesions. Most appropriate sequence was outlined for the use of different sampling methods.

A hypothesis of the development of drug-induced nephropathy has been reviewed. The authors believe that the body sensitization to different drugs underlies drug-induced nephropathy. The sensitization may develop in the presence of congenital or acquired abnormalities leading to hemodynamic disorders in the kidneys.

Puncture biopsy of the kidneys was carried out in 15 patients with different renal lesions. General clinical, laboratory, light microscopy and electron microscopy of the biopsy specimens were employed. Electron microscopy revealed varying changes in the endotheliocytes of the lymphatic capillaries (increased functional activity, destruction of the lymphatic capillary wall). The diagnostic and prognostic value of the findings is discussed.

The paper presents data of a luminous microscopy of the liver that were obtained by aspiration biopsy in 23 patients with hepato-cerebral dystrophy in comparison with 25 patients with cirrhosis of a hereditary etiology. In the majority of the cases (21 from 23) the method of puncture biopsy of the liver provides the diagnosis of cirrhosis in hepatocerebral dystrophy. The complex use of histochemical methods and especially staining for reticuline and cuprum significantly increases its informativeness. In 15 of 28 patients cirrhosis was of a mixed character (postnecrotic and portal), in 5 patients--postnecrotic and in a preneurologic stage it corresponded to the initial features of portal cirrhosis. The damage of the liver precedes the brain damage and is connected with an excessive accumulation of cuprum in it, the amount of which is significantly higher (559 +/- 89 mkg/g of dry weight) in the patients with hepato-cerebral dystrophy in comparison with the patients with cirrhosis of some other etiology (111.0 +/- 19.0 mkg/g of a dry weight).