Vol 80, No 5 (1999)

The works of A.V. Kibyakov, devoted to the physiology of mediators, and above all his discovery of the participation of chemicals in the transmission of nerve impulses in the sympathetic ganglion of a cat, served as one of the cornerstones in the foundation of modern neurophysiology. Research A.V. Kibyakov for many decades determined the scientific interests of his immediate students and followers.

The experiences with primate models of E.coli sepsis with emphasis on the responses of the hemostatic system and the mechanism of these responses with emphasis on the role of phospholipid microparticles in mediating disseminated intravascular coagulation, (DIC) are discribed. Understanding the principles of how the hemostatic system responds to inflammatory stress depends on viewing this system as a collection of mediator and regulator factors. They are integrated into a balanced system consisting of four functional quadrants. Depending on circumstances this system is designed to control either the patency or the integrity of the cardiovascular system.

The efficiency of preductal (trimetazidin), essentiale, li postabil and vitamin E in acute myocardial infarction and unstable stenocardia is estimated. It is shown that in unstable stenocardia and in the acute period of myocardial infarction the high level of lipid peroxide oxidation and the decrease of erythrocyte stability are observed. The clinical efficiency of antioxidants in the treatment of the acute forms of ischemic heart disease is proved: the antianginal effect is achieved, readaptation possibilities of patients to physical loads are increased, effect of anti rhythmical drugs is intensified, myocardial infarction size is limited (especially in using preductal). The presence of pronounced antioxidant and membranoprotective properties in preductal, lipostabil, essentiale comparing well with α-tokopherol is proved. It is shown that preductal manifests the antianginal effect by the microcirculation system and metabolism correction. Antioxidants promote the decrease of blood elements sledge and increase of the number of perfused capillars.

The structure and incidence of neurotic disorders were studied in patients with ischemic heart disease, bronchial asthma and duodenal ulcer resistant to somatotropic therapy. Significant peculiarities negatively affecting the efficiency of somatotropic therapy: increased incidence of hyposthenic neurasthenia, mixed trouble and depressive disorders, phobic manifestations as well as phenomena of somatophorm disfunction of vegetative nervous system are revealed. The data obtained indicate the increase of specific gravity of neurotic disorders in patients with resistant forms of somatic diseases complicating the pathogenesis and clinical picture of the disease, and promoting the decrease of the efficiency of somatotropic therapy.

The complex diagnosis algorythm of acute destructive cholecystitis based on the use of a diagnostic table is developed. It is suggested to estimate the disease dynamics in repeated investigations by the change of “diagnostic states”. The obtained algorythm is examined in two control groups: in 75 patients operated as to various cholecystitis forms as well as in 92 patients hospitalized because of extreme indications and treated conservatively. In both control groups — in single examination (88 cases) sensitivity of the method is 91,7%, specificity is 97,3%, accuracy is 96,6%, in dynamic examinations (78 cases) they are 92,3%, 100%, 95,6%, respectively.

The catheterization of subarachnoid space was used which made it possible to perform the adequate anesthesia in lower extremity amputation, adenomectomy and phlebectomy, and the prolonged anesthesia in the immediate postoperative period. The catheterization of subarachnoid space has the following advantages: anesthesia comes earlier, its level is higher, it is easily performed, dozes of drugs are less.

The dynamics of clinicolaboratory indices and destabilization of membranes in patients with active glomerulonephritis is studied in the treatment with dimephosphone (54 persons), prednizolone and/or cyclophosphamide (66), dimephosphone combined with prednizolone and/or cyclophosphamide (24) is studied. The most clinical and membranostabilizing effect is achieved in 2—4 weeks that can be used for revealing sensitivity or resistance to dimephosphone and solving the problem of the utility of the further therapy. In the treatment of active glomerulonephritis the combined use of dimephosphone with prednizolone and/or cyclophosphamide has advantages of the isolated use of dimephosphone or immunosupressive therapy since it eliminates the problem of resistance to the drug.

Reliable differences between disease incidence of persons loving in the rural region and having varions material and housing conditions: good, satisfactory or bad are defined by family members behaviour: use of annual holiday, relations in a family, smoking, use of alcohol. Disease incidence of members of various rural family types statistically reliably differs in families with various levels of medical activity: low, medium and high. Unfavourable social and hygienic behaviour social level of medical activity in forming disease incidence of rural population by family types are establishhed.

The complex evaluation method of the immune status in children with atopic dermatitis using hemogram is developed on the basis of mathematical simulation. The linear regression is used as complex evaluation of the immune status in children with atopic dermatitis does not require special knowledge of programming and computer, it is simple and can be applied in every medical institution supplied with personal computers.