A Technique for Absolute Haemostasis

Background. Acute bleeding of parenchymal organs in blunt soft tissue traumas, sharp force injuries, bullet and shrapnel wounds is often life­threatening due to hypoxia combined with haemorrhagic shock. Hypoxia and haemorrhagic shock develop due to a continuous blood outflow from multiple gaping non­contractile blood vessels. A safe and effective organ­preserving surgery in parenchymal haemorrhage has not been developed to date.Materials and methods. A survey of scientific and patent literature has been conducted on techniques for parenchymal bleeding haemostasis based on topical cooling and heating­aided surgical interventions. Sources were mined in the Espacenet, Google Patent, eLibrary, Google Scholar, Web of Science, Scopus and PubMed databases.Results and discussion.An original method for parenchymal bleeding arrest was proposed in Russia at the end of the 20th century. The method is based on a safe transverse organ compression at vascular trunk to provide safe ischemia of the injured organ portion and using topical wound heating to trigger blood clotting. The compression is done with a surgical tool usually used for a gentle gastric or gut constriction. Mechanical  compression is applied at a force that ensures a complete constriction of the organ’s blood vessels arresting blood outflow from gaping vessels of the wound. Local hyperthermia of the wound surface is provided by a solid sterile object application with a smooth and slippery surface at +42–45 °C. Ischaemia and heating of the bleeding part of parenchymal organ are halted in 5–15 min. An adequacy criterion for the method is absolute haemostasis.Conclusion.An immediate arrest of blood supply to the wound surface complemented by heating at +42–45°С untill absolute haemostasis has been shown a sole rapid haemostatic technique effective in all forms of parenchymal haemorrhage. The entire peritoneal surface irrigation with 50% glycerol of pH 7.4 at +37–42 °С is advised to prevent postoperative abdominal adhesions at completion of surgery

Синдром Николау: некротическая активность лекарств и способы предотвращения постинъекционных абсцессов (в память о профессоре Ласло Гемзе)

Post-injection abscess, which is the sad finale of Nicolau syndrome, continues to attract the attention of researchers due to the need to clarify the causes of this iatrogenic disease in order to develop effective measures for its prevention. For many years, researchers from all over the world have tried from different perspectives to explain the mechanism of the drugs effect that causes post-injection pain syndrome, infiltration, inflammation, erimatous skin damage, necrosis and abscess (Nicolau syndrome), but to no avail. This has been done only in recent years. There are findings in Russia that show that drugs considered to be of high quality today, in some cases, in addition to specific pharmacological activity, may have necrotic activity of a non-specific nature of action. The findings showed that according to the established pharmaceutical practice and in full compliance with the pharmacopoeia requirements for the quality of medicines, pharmaceutical products produced by different pharmaceutical companies, as well as those included in different series of the same pharmaceutical company, may have different compositions (formulations), contain different ingredients, therefore they may have different physico-chemical properties. In this regard, drugs of different serial numbers and/or different manufacturers, which are considered high-quality today, can be hypertonic solutions, have acidifying or alkalizing activity, have alcohols, aldehydes and heavy metal salts in denaturing concentrations. This is the reason that in some cases drugs have necrotic (cauterizing) activity. In this regard, to prevent Nicolau syndrome, it is proposed to reduce the physico-chemical aggressiveness of drugs. Today, this can be done successfully by diluting them with water for injection 2 to 8 times before injection.Постинъекционный абсцесс, являющийся печальным финалом синдрома Николау, продолжает привлекать внимание исследователей из-за необходимости выяснения причин развития этой ятрогенной болезни для разработки эффективных мер ее профилактики. Многие годы исследователи всего мира с разных сторон пытались объяснить механизм действия лекарств, вызывающих постинъекционный болевой синдром, инфильтрацию, воспаление, эритематозное повреждение кожи, некроз и абсцесс (Nicolau syndrome), но безуспешно. Это удалось сделать лишь в последние годы. В России удалось обнаружить, что лекарства, считающиеся сегодня качественными, в некоторых случаях помимо специфической фармакологической активности могут обладать некротической активностью неспецифического характера действия. Было показано, что по сложившейся фармацевтической практике и в полном соответствии с фармакопейными требованиями, предъявляемыми к качеству лекарств, лекарственные средства, произведенные разными фармацевтическими компаниями, а также входящие в состав разных серий одной фармакомпании, могут иметь разные составы (рецептуры), содержать разные ингредиенты, поэтому могут иметь разные физико-химические свойства. В связи с этим лекарства разных номеров серий и/или разных производителей, считающиеся сегодня качественными, могут являться гипертоническими растворами, обладать закисляющей или защелачивающей активностью, иметь в своем составе спирты, альдегиды и соли тяжелых металлов в денатурирующих концентрациях. Именно это является причиной того, что в некоторых случаях лекарства имеют некротическую (прижигающую) активность. В связи с этим для профилактики синдрома Николау предлагается уменьшать физико-химическую агрессивность лекарств. Сегодня это успешно можно сделать с помощью их разведения водой для инъекции в 2–8 раз перед инъекцией

Physico-Chemical Properties of Antiseptics in Surgery: What is not Taken into Account in Treating Long-Term Non-Healing Wounds

The treatment of long-term non-healing wounds in the conditions of purulent surgery departments, widely uses solutions of chemotherapeutic and antiseptic agents. The most common are the solutions of 3–6 % hydrogen peroxide and solutions of 2–10 % sodium chloride. As a rule, solutions of these drugs are used to treat non-healing, particularly, purulent wounds, bedsores and trophic ulcers. Therefore, solutions are injected into the wound area repeatedly in the form of course therapy. The findings show that the mechanism of action of these drugs and the effect of treating long-term non-healing wounds is largely determined by such physical and chemical factors of their local interaction as concentration of the main ingredients, osmotic, alkaline activity and local temperature. The findings point out the leading role of the local temperature and the dependence of the local effect on the concentration. They describe the essence of the innovative method of treatment

DIAGNOSTIC VALUE OF THE DEJA VU PHENOMENON IN THE CLINICAL PICTURE OF GLIAL BRAIN TUMORS

In growing glial tumors, epileptic seizures are the first and only symptom of the disease in more than a third of cases. The seizure is commonly characterized by only psychopathological disorders that are frequently ignored by both patients and physicians. The deja vu (DV) phenomenon may be one of such symptoms. Its specific feature is that it occurs in both healthy individuals and patients with various brain pathologies. This investigation was undertaken to study the implication of the DV phenomenon in the clinical picture of glial brain tumors (GBT). One hundred and sixty-one subjects (mean age 29,2±6,4 years; males 47%), including 129 healthy individuals and 32 patients with GBT, were examined. In the clinical picture of GBT with seizures, DV is a common symptom that is encountered in the involvement of predominantly the right temporal lobe and accompanied by generalized convulsive attacks and olfactory hallucinations. DV in GBT occurs more than once daily; its duration is a few (as many as 5) minutes; DV is characterized by a negative emotional tinge and attended by fear

Физико-химические свойства антисептических средств: что мы не учитываем в лечении длительно незаживающих ран

The treatment of long-term non-healing wounds in the conditions of purulent surgery departments, widely uses solutions of chemotherapeutic and antiseptic agents. The most common are the solutions of 3–6 % hydrogen peroxide and solutions of 2–10 % sodium chloride. As a rule, solutions of these drugs are used to treat non-healing, particularly, purulent wounds, bedsores and trophic ulcers. Therefore, solutions are injected into the wound area repeatedly in the form of course therapy. The findings show that the mechanism of action of these drugs and the effect of treating long-term non-healing wounds is largely determined by such physical and chemical factors of their local interaction as concentration of the main ingredients, osmotic, alkaline activity and local temperature. The findings point out the leading role of the local temperature and the dependence of the local effect on the concentration. They describe the essence of the innovative method of treatment.При лечении длительно незаживающих ран в условиях отделений гнойной хирургии широко используются растворы химиотерапевтических и антисептических средств. До сих пор распространено применение растворов 3–6 % перекиси водорода и 2–10 % натрия хлорида. Как правило, растворы этих лекарственных средств используют для лечения незаживающих, в частности гнойных, ран, пролежней и трофических язв. Поэтому растворы вводят в область ран многократно в виде курсовой терапии. Показано, что механизм действия указанных лекарственных средств и эффект лечения длительно незаживающих ран во многом определяется такими физико-химическими факторами их локального взаимодействия, как концентрация основных ингредиентов, осмотическая, щелочная активность и локальная температура. Указывается ведущая роль локальной температуры и зависимость локального эффекта от концентрации. Описывается сущность инновационного способа лечения

THE HEMOSTATIC ACTIVITY OF BIS (2-AMINOETHAN-1-SULFONATE) CALCIUM

Objective: It is known that local or systemic injection of hemostatic drugs is used to reduce blood loss and number of blood transfusions in patients with hypocoagulation and hemorrhagic diathesis. However, the analysis of literature data shows that the drugs applied for the control of bleeding, traditionally used in medical practice, are not effective enough. This study deals with the systemic hemostatic activity of bis (2-aminoethan-1- sulfonate) calcium in the experiment.Methods: Experimental work in vitro is performed on the blood of healthy male donors, under conditions in vivo it is done on intraperitoneal injection in male rats. Thromboelastography was carried out with apparatus Thromboelastography (TEG) 5000 (Haemoscope Corporation, United States). The influence of first synthesized derivative and ethamsylate on functional activity of platelets was studied using a platelet aggregation analyzer Biola 230LA†(Russia). Experimental evaluation of the system specific hemostatic activity in vivo was carried out using the model of parenchymatous bleeding in mature male rats. The interference came amid registration of bleeding stop time and extent of blood loss.Results: Bis (2-aminoethan-1-sulfonate) calcium shows procoagulation and proaggregant activity both in vitro and in vivo. Proaggregatory effect of bis (2-aminoethan-1-sulfonate) calcium is successfully implemented in the systemic hemostatic activity in terms of parenchymal bleeding, surpassing the control group and the group of etamsylate.Conclusion: The results of these studies reveal potentially high systemic hemostatic activity of bis (2-aminoethan-1-sulfonate) calcium, urging the need for further study on this compound and its analogs to create on their basis highly efficient, selective correctors of the hemostatic system

Itt1p, a novel protein inhibiting translation termination in Saccharomyces cerevisiae

BACKGROUND: Termination of translation in eukaryotes is controlled by two interacting polypeptide chain release factors, eRFl and eRF3. eRFl recognizes nonsense codons UAA, UAG and UGA, while eRF3 stimulates polypeptide release from the ribosome in a GTP- and eRFl – dependent manner. Recent studies has shown that proteins interacting with these release factors can modulate the efficiency of nonsense codon readthrough. RESULTS: We have isolated a nonessential yeast gene, which causes suppression of nonsense mutations, being in a multicopy state. This gene encodes a protein designated Itt1p, possessing a zinc finger domain characteristic of the TRIAD proteins of higher eukaryotes. Overexpression of Itt1p decreases the efficiency of translation termination, resulting in the readthrough of all three types of nonsense codons. Itt1p interacts in vitro with both eRFl and eRF3. Overexpression of eRFl, but not of eRF3, abolishes the nonsense suppressor effect of overexpressed Itt1p. CONCLUSIONS: The data obtained demonstrate that Itt1p can modulate the efficiency of translation termination in yeast. This protein possesses a zinc finger domain characteristic of the TRIAD proteins of higher eukaryotes, and this is a first observation of such protein being involved in translation

УРОВЕНЬ ЭНДОТОКСИНА КРОВИ У ПАЦИЕНТОВ С СЕПСИСОМ КАК РАННИЙ ПРЕДИКТОР ЛЕТАЛЬНОСТИ

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Local postinjection injurious subcutaneous tissue arising in injections solutions with different medicines osmotic activity

In 50 patients with subcutaneous injections of anesthesiology-resuscitation and 40 piglets vivarium solution 17 drugs with hypo-, iso-and giperosmotic activity features investigated rassasyvaniya postinjection medication infiltratis and formation of local lesions. It was found that when piercing interstitial tissues may bruise and bleeding due to injury to needle injection of blood vessels, and when medical infiltrirovanii tissue may be irritation, inflammation and necrosis due to excessive activity gyperosmotic solutions. Shown that the aggressiveness of local injection, and their damaging dehydrating effect may be due to excessive gyperosmotic due to the high total concentration of dissolved components, and to prevent local toxicity postinjection require dilution with water for injection of fluids until izoosmotic level.При подкожных инъекциях 50 пациентам отделения анестезиологии-реанимации и 40 поросятам вивария растворов 17 лекарственных средств с гипо-, изо- и гиперосмотической активностью исследованы особенности рассасывания постинъекционных медикаментозных инфильтратов и формирования локальных повреждений. Установлено, что при прокалывании тканей возможно внутритканевое кровотечение и кровоподтек из-за ранения инъекционной иглой кровеносных сосудов, а при медикаментозном инфильтрировании клетчатки возможно ее раздражение, воспаление и некроз из-за чрезмерной гиперосмотической активности растворов. Показано, что локальная агрессивность растворов для инъекций и их повреждающее действие могут быть обусловлены чрезмерной гиперосмотичностью из-за высокой суммарной концентрации растворенных компонентов, поэтому для предотвращения постинъекционных повреждений требуется предварительное разведение растворов или немедленное обкалывание возникшего медикаментозного инфильтрата водой для инъекции вплоть до изоосмотического уровня