Search

Modulating effects of some drugs and HBO on adaptation reaction have been studied in 74 surgical patients. Investigation methods included cardiac rhythm record (statistical analysis with histogram plotting--sympathetic activity index), tcpO2, tcpCO2, SaO2, finger pulse amplitude (vasomotor tone evaluation), and evaluation of changes in arterial pressure and heart rate. The treatment included intravenous propranolol (0.92-1.38 micrograms/kg/min) or cordanum (1.85-2.7 micrograms/kg/min) or clonidine (0.018-0.037 microgram/kg/min) or dalargin (0.55-0.83 microgram/kg/min) HBO-100% O2 for 1 h at 1.5 ATA during increase of sympathetic activity. The results indicate that all drugs and HBO modulate the adaptation response of the organism and improve the outcomes of surgery.

Changes in the levels of free myoglobin and lipid peroxidation products (hydroperoxides and malonic dialdehyde) were studied in cancer patients. Their baseline levels were found to be higher in patients with cancer of the lung, large bowel, and rectum than those in controls, which indicates higher lipid peroxidation, which led to the destabilization of cellular membranes and seems to cause baseline hypermyoglobinemia. There was a drastic rise in the levels of free myoglobin in the first 24 postoperative hours. The duration and severity of hypermyoglobinemia were much higher in the complicated than uncomplicated postoperative period. There was a less rise in malonic dialdehyde concentrations, whose peak was observed on days 1-2 postsurgery. The content of hydroperoxides decreased in the first 24 postoperative hours and began gradually increased from day 2. The correlation between the concentrations of myoglobin and malonic dialdehyde suggests that there is an association between hypermyoglobinemia and the status of cellular membranes.

The paper presents the authors' own findings and a review of papers published in the Russian and foreign periodicals in the past 20-25 years, which are dedicated to the problem of preoperative parenteral diet. The authors consider preoperative parenteral diet to be indicated in severe exhaustion and impaired intestinal tubal patency. A regimen of preoperative parenteral diet should generally last no more than 5-7 days. To follow this, the preoperative parenteral diet promotes a significant reduction in the incidence of postoperative pyoseptic complications and postoperative mortality, providing considerable economical implications.

The time course of free myoglobin content and the rate of lipid peroxidation were simultaneously studied in cancer patients. The initial concentrations of myoglobin, hydroperoxides and malonic dialdehyde (MDA) were found to be higher than the control values, thus suggesting the increased rate of lipid peroxidation in these patients, which was responsible for destruction of cell membranes. Within the first 24 hours after surgery, there was a drastic release of myoglobin, its levels being sometimes higher in case of a complicated postoperative period than those in its smooth course. The increase in content of MDA was less marked, by reaching its maximum on days 1-2. The postoperative levels of hydroperoxides was considerably decreased, yet it began gradually increasing on day 2. The rather high correlation coefficients between the content of myoglobin and MDA suggest that there is a relationship between hypermyoglobinemia and the state of cell membranes. However, surgical intervention, enhancing lipid peroxidation, concurrently activates the mechanisms aimed at maintaining cell homeostasis.

Initial hypermyoglobinemia was found in patients with cancer of lungs, large intestine and rectum. Within early postoperational period under favourable conditions moderate increase in content of free myoglobin was detected, most pronounced in patients with lung cancer. Maximum concentration of myoglobin was estimated within first postoperational day, normalization occurred within 3-4 days after the operation. In patients with postoperational complications (peritonitis, pneumonia, sepsis, etc) increase in content of myoglobin was more distinct (1.6-2-fold) and was maintained within the longer period. Increase in content of blood plasma myoglobin occurred usually before manifestations of clinical symptoms related to postoperational complications.

A new method of studying carbohydrate metabolism is described. It involves glucose injection according to a certain glucose law, followed by measurement of the dynamics of its concentration in the peripheral blood and computation, based on the models suggested, of the quantitative characteristics of metabolism; compartment of glucose distribution, maximum assimilation of glucose from its supply, and so forth. The individual characteristics of carbohydrate metabolism are shown to change within broad ranges (from 0.92 to 0.11 g/min). Materials on the method reproducibility are provided.

The authors discuss the mechanisms of compensatory reactions of the human vegetative nervous system, its central and peripheral parts, in breathing a gaseous hypoxic mixture. Five types of neurovegetative reactions of the organism aimed at maintaining the oxygen balance in blood were distinguished. The interrelationship of values reflecting the activity of the central and peripheral parts of the vegetative nervous system in exposure to emergency effects is discussed.

Responses of the autonomic nervous system, its central and peripheral parts, in the human organism exposed to a hypoxic gas mixture were studied to reveal the relationship between the parameters indicative of the activity of the central and peripheral parts of the autonomic nervous system in loading tests. The different autonomic responses of the organism to stress were of high prognostic value since they allowed for a preoperative assessment of surgical risks in surgical patients.

The paper is concerned with the data on change in the blood level of ACTH, STH, TSH, cortisol, T3, insulin, C-peptide during a 25-minute session of respiration using a gaseous hypoxic mixture with 10% oxygen (GHM-10). The investigation was performed in 23 healthy volunteers. Change in the hormonal status, characteristic of a moderate stress-reaction, was observed in 60% of the examinees. It was found out that during a GHM-10 session a degree of change in function of the studied factors of the endocrine system showed correlation with change in the activity of the autonomic nervous system.

In 22 patients who were in a resuscitative unit the authors analyzed variations in cardiac rhythm by using informative criteria. It was shown that varying severity of a patient's status was characterized by different values of the informative criterion chosen and obtained from an analysis of appropriate time cardiac interval sequence. The presented results suggest that in terms of the information theory, the analysis of cardiac rhythm is principally suitable for operative control of the functional state of the patient who is in an intensive care unit.

The paper is concerned with the results of investigation of the body composition and albumin circulation using a method of whole-body radiometry, extracellular liquid volume--by a 40K-RP, the level of cortisol, T3, insulin, C-peptide in the blood plasma by a radioimmunoassay in 30 breast cancer patients. A decrease in cellular body mass, an increase in extracellular body mass and total body fat, a decrease in the sizes of all pools and albumin synthesis rate were revealed before the initiation of specific cancer therapy. Ten days after the discontinuation of therapy the above indices returned to normal.