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The aim of the study is to estimate clinical effectiveness of fibrinolysis inhibitor Tranexam in neurosurgical patients with intracranial tumors. The medication was prescribed to 78 patients from 27 to 65 years old. The control group consisted of 57 patients. The following criteria were assessed to estimate the impact of the medication on hemostasis: APPT, PT index, TT, fibrinogen, ATIII activity, factor XII-derived fibrinolysis, spontaneous euglobulin lysis. Blood sampling was drawn at the following stages: after the induction of anesthesia, before Tranexam injection, 30 minutes after Tranexam injection, on the next day after the surgery. Blood from jugular and peripheral veins was analyzed simultaneously. The medication caused significant decrease of fibrinolytic activity. The use of Tranexam was followed by bleeding reduction in the wound. The duration of surgical hemostasis in the main group was 11,7 +/- 3,3 minutes which is significantly lower than in the control group (18,1 +/- 3,1 minutes) (p = 0,034). Drainage blood loss was lower in the main group (267 +/- 23 ml a day) than in the control group (340 +/- 28 ml a day). Medication injection during diffuse bleeding from small vessels led to quick and visible bleeding reduction. Thus Tranexam decreases the risk of intraoperative blood loss in the patients with brain tumors.

Neurosurgical interventions on the skull base including craniofacial block-resections were fulfilled on 36 patients aged from 16 through 73 years. Preoperative management of the patients was made mainly at the intensive therapy room. It included correction of water-electrolyte, protein metabolism, anemia. The key moments in the anesthetic management of such operations were maintenance of an adequate level of neurovegetative blockade, sufficient level of volemia by means of creating hypervolemic hemodilution, prophylactics of air embolism.

The purpose of the study was to define the parameters of intraoperative monitoring, which allowed the prediction of complications due to surgery for posterior cranial fossa in children and the planning postoperative treatment tactics. The hypnotic propofol and a combination of the narcotic analgesic fentanyl and alpha 2-adrenoblocker clofelin were used to induce and maintain anesthesia. All patients were operated on in the sitting position. Hemodynamic parameters, arterial blood saturation, end-expiratory carbon dioxide tension, and central venous pressure were intraoperatively studied. As electrophysiological monitoring, the authors studied electroencephalograms and brainstem auditory evoked potentials by an Indeaver monitor (Nicolet). The investigators analyzed readings and data on admission to the operating suite, at the stages of anesthesia maintenance and surgery. The findings were used to define indications for anesthesia using the narcotic analgesic fentanyl and alpha 2-adrenoblocker clofelin in the postoperative period.

Enzyme preparation exhibiting glycolytic activity yielding chitooligosaccharides along with N-acetyl-D-glucosamine was obtained from the red king crab (Paralithodes camtschaticus) hepatopancreas. The results of the analysis confirmed the presence of endo- and exochitinase activities in the preparation. HPLC showed that the hydrolysis products of chitin and chitosan did not contain D(+)-glucosamine, which is indicative of the absence of deacetylase and, apparently, exochitosanase activities. A comparison of the dependence of the enzyme preparation activity on temperature and pH of the incubation medium suggests that chitinase and protease activities are exhibited by different enzymes.

The paper provides the results of a complex experimental and clinical study of the effects of infusion solutions of hydroxyethyl starch (HES 200/0.5--Refortan and HES 130/0.4--Voluven) on hemostatic and systemic hemodynamic parameters in patients operated on for neurosurgical pathology of the brain. The HES solutions are shown to have a more pronounced volemic effect and a slightly higher hypocoagulation effect on the hemostatic system (as compared with physiological solution); the latter does not, however, achieve its clinical value with the used doses of the solutions.

Digestive proteinases of various taxa of invertebrates of the Northern seas have been studied: crustaceans Paralithodes camtchaticus, Pandalus borealis; molluscs Chlamys islandicus, Buccinum undatum, Serripes groenlandicus, and echinoderms Strongylocentrotus droebachiensis, Cucumaria frondosa, Asterias rubens, and Grossaster papposus. The presence of two proteolytic activity peaks in the acid (pH 2.5-3.5) and low alkaline zones (pH 7.5-8.5) and a similar proteinase spectrum have been revealed in digestive organs of the studied animals. The proteolytic activity in digestive organs of the Barents Sea invertebrates exceeds significantly that of terrestrial homoiothermal animals, which seems to be an extensive compensation for poor differentiation of the digestive system and for low substrate specificity of the enzymes as well as for cold conditions of the habitat. The principal qualitative difference between vertebrates and invertebrates consists in that the latter have no pepsin activity, but do have the cathepsin activity that is absent in vertebrate digestive organs. Contribution to the acid proteolysis is made by lysosomal cathepsins, rather than by pepsins. Activity in the alkaline and neutral pH zones is provided by serine proteinases. In digestive cavities of invertebrates, hydrolysis of proteins and mechanical processing of food occur only in the low alkaline zone, whereas acid proteolysis has intracellular lysosomal localization.

Our study confirms the presence of chitinolytic, chitosanolytic, and deacetylase activities in the hepatopancreas of the red king crab, related to the specific diet of this species. The maximum rate of chitin/chitosan hydrolysis by an enzyme preparation from crab hepatopancreas occurs at 36.5-37.0 degrees C. Two pH optimums have been found for the enzymatic reaction under mildly alkaline and acidic conditions for both exo- and endochitinase activities. The enzyme preparation is most affine to partly deacetylated chitin with an acetylation degree within 40-50%.

The investigation has shown that solutions of hydroxyethyl starch included in complex infusion therapy facilitate stabilization of hemodynamics in neurosurgical patients during surgery. Refortan exerts a more pronounced effect on the indices of hemodynamics as compared with voluven, but its modifying action on the hemostasis system is also more pronounced. These medicines used in doses 6-8 ml/kg fail to have substantial effects on efficiency of hemostasis in the brain wound and do not increase risk of postoperative hemorrhagic complications.

An enzyme preparation was isolated from the Paralithodes camtschaticus hepatopancreas that exhibited chitinase and chitosanase activities. Treatment of chitin and chitosan with this preparation decreased their viscosity-average molecular weights by 96 and 41%, respectively. The chromatographic profiles of the products of chitin and chitosan hydrolysis suggested that the crab hepatopancreas in rich in endochitinases. Enzymatic digestion of chitosan increased its solubility and moderately reduced the extent of its acetylation. A mathematical approach was proposed for calculating the molecular weights of chitosan fractions from weight-average molecular weights determined viscometrically.

Enzymatic preparations from king crab hepatopancreas were shown to be capable, in principle, of producing protein hydrolysates. Hydrolysis of protein-containing waste of deep-water prawn and king crab occurs most successfully at pH 8.0-8.5 and 50-55 degrees C for 5-6 h in the presence of 6 g enzyme per kg substrate. The total chemical composition of the hydrolysates, the molecular weight distributions of proteins and polypeptides, and the contents of free amino acids were studied in dry hydrolysates.

Dry enzymatic hydrolyzate was derived from the protein containing wastes of the Iceland scallop fishery using the complex of proteinases from the king red crab hepatopancreas. The finished product contains not less than 80% of free amino acids and the lowest peptides. Leucine, isoleucine, arginine, lysine and aspartic acids account for to 50% of free amino acids. The applicability appraisal of proteinaceous hydrolyzate from the wastes of the Iceland scallop fishery to use them as the constituents in the nutrient medium for microorganisms was conducted. The approbation of hydrolyzate in the composition of nutrient medium on the test--cultures indicated the high sensibility and germinating capacity of microorganisms.

The results of the study of the reactogenicity, safety and immunological activity of Russian cultural vaccine against hepatitis A are presented. The vaccine was found to have specific safety, moderate reactogenicity and pronounced immunological activity. In addition, the study of the prophylactic efficiency of the vaccine in the pre-epidemic period of the outbreak of hepatitis A morbidity in a group exceeding 14,000 adults was carried out. The study revealed high prophylactic efficiency of the vaccine (its efficiency rate was equal to 97.7%). On the basis of materials thus obtained vaccine "Hep-A-in-Vac" was recommended for use in medical practice for the prophylaxis of hepatitis A among adults.