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Biomedical subjects

V I Smirnova

Publications and source records attributed to V I Smirnova.

At least 19 recordsLinked to original sources
PubMed1998

[Use of serotonin for treatment of patients with diabetic angiopathies].

In 26 patients (female 11, males--15) with diabetic angiopathy (necrosis of the foot or toes) local measurement of pO2 by transcutaneous mode was carried out before and during introduction of serotonine adipinate. Simultaneously with evaluation of pO2 in 14 patients electromyography (EMG) was made. Serotonine adipinate was introduced intravenously with a speed of 5.0-10.0 mg per hour. In this group mean age of the patients made up 57.4 years, mean values of initial pO2 25.6 mm Hg, and mean indices of pO2 at the moment of serotonine treatment 38.5 mm Hg. Average increase of pO2 during serotonine infusion was registered as 50.4% in comparison with mean initial data. In all 14 patients, who underwent simultaneous measurement of pO2 and registration of EMG, reinforcement of electrical activity of smooth muscles (SM) of various intensity and increase in tissue pO2 were detected. Improvement of microcirculation (increase of transcutaneous pO2, reinforcement of electrical activity of SM as a result of serotonine introduction) evidences that functional and morphological changes of serotonine receptors of SM are involead in genesis of diabetic angiopathy. The data obtained showed that in diabetes mellitus, besides insulin deficiency, insufficiency of such an endogenous factor as serotonine duclops. Thus, serotonin should be used for prophylaxis and treatment of diabetic angiopathies.

Adipates↗
PubMed1996

[Selective electroenterogastrography. I].

A new model of electroenterogastrograph has been designed. Besides of amplification it can divide the total bioelectrical activity into several flows, and distinguish potentials specific to the certain organ or its part. Each flow is depicted on a separate channel of the electroenterogastrograph. It makes it possible to increase the diagnostical value of the method. It is necessary to learn specific parameters of potentials of the organs to be tested. To register electrogastrogram it is necessary to use frequencies of 0.04-0.07 Hz; electroduodenograms 0.18-0.22 Hz, etc.

Duodenum↗
PubMed1995

[Electrophysiology of the central nervous system in effective anesthesia].

In authors' opinion, the more precise methods for controlling the depth and efficiency of general anesthesia are those which are based on the direct control over the intraoperative status of the central nervous system which reflects the time course of the status in question. Whether monitoring of the early components of somatosensory evoked potentials could be used for multimodality anesthesia was analysed. As high as 50% or lower decreases in the amplitude of the complex N19-P23 were typical of adequate defense, irrespective of anesthesias. The authors provide evidence for the efficiency of their procedure for controlling the depth and efficiency of general anesthesia. Some electroencephalographic phenomena of anesthesia were analysed with computed monitoring. The authors showed that there was a relative value of such signs of inadequate anesthesia as interhemispheric asymmetry by the leading spectral frequency and the power index of deep rhythms. Despite the procedure used (neuroleptic analgesia, ataralgesia, inhalation anesthesia, etc.), the effective anesthesia exhibited pronounced power peaks, otherwise there was a chaotic activity of the central nervous system. The physiological and clinical values of the phenomena detected are discussed in the paper.

Anesthesia, General↗
PubMed1994

[Endogenic vasomotor function and smooth muscle insufficiency in the vascular microcirculation].

The paper outlines the previously unknown smooth muscle insufficiency in terms of its etiology, pathogenesis, diagnosis and treatment. It has been shown that drug administration leads to smooth muscle insufficiency which is eliminated by serotonin both in vitro and in vivo. The clinical manifestations of smooth muscle (SM) insufficiency are eliminated by serotonin, irrespective of whether it has been caused by the use of drugs or impaired smooth muscle innervation. The mechanism of vascular rhythmic oscillations in the microcirculatory bed, the so-called endogenous vasomotility (EV) has been decoded. The mechanism of EV regulation is due to the fact that platelets constantly (continuously) adsorb serotonin from the enterochromaffin cells of the gastrointestinal tract and constantly (continuously) release it into the microcirculatory bed, thereby providing the continuum of entry of the stimulant to the SM fibers which are able to contract at this time. The summation of these contractions of smooth muscle contractions in the microcirculatory bed maintains their vascular tone and yields the pattern of EV. The paper also describes the earlier unknown properties of hemoglobin and myoglobin to cause smooth muscle spasm and to accelerate platelet destruction. A correlation between the EV and vascular platelet hemostasis is described in terms of these properties. The continuous mechanism of EV is impaired and it transforms to intermittent (final) vascular platelet hemostasis.

Animals↗
PubMed1994

[Use of dalargin in the intensive therapy of critical conditions].

The paper analyzes whether the national synthetic leukenkephalin analogue dalargin can be used in the prevention and treatment of postoperative polyorgan deficiency. Dalargin has been experimentally demonstrated to be effective in preventing impairments in transcapillary fluid exchange, by stopping the development of pulmonary edema. The use of the drug in the intra- and postoperative period in patients undergone cardiac surgery during general assisted circulation reduced the incidence substantially and decreased the severity of respiratory distress syndrome. The experimental and clinical findings suggest that dalargin has pulmono-, hepato-, and pancreatoprotective properties. Thus, dalargin should be used in the multimodality intensive care of postoperative polyorgan deficiency.

Animals↗
PubMed1993

[Intraoperative monitoring of abdominal organs under combined general anesthesia].

The authors analyse the early components of somatosensory evoked potentials (SSEP) during anesthesia in prolonged and traumatic operations on the abdominal organs (gastrectomy, hemihepatectomy, pancreatoduodenal resection, etc.). A total of 69 patients were examined, among them 32 underwent operations under conditions of classical NLA, 16 with the narcotic analgetics replaced by moradol, and 21 under modified NLA with dalargin. The results of the study and analysis of literature data allow monitoring of the early components of somatosensory evoked potentials to be considered a highly sensitive test for appraising the depth and adequacy of the modern methods of general anesthesia and to be recommended for use, at least in particularly difficult and venturesome operations. It is shown that most significant in the discussed plan is not the absolute value, but changes of the N19-P23 amplitude in the stages of the operation. Increase of the studied SSEP component by 20% and more in relation to the basal level (SSEP amplitude in the patient after adequate preanesthesia) is evidence of insufficient analgesia. Change of N19-P23 latency is less demonstrative. Monitoring of the early components (N19-P23) of SSEP showed that to ensure effective analgesia in prolonged concurrent and combined operations, if the NLA method is chosen, administration of fentanyl in a dose of no less than 12 micrograms/kg/hour is necessary. It is shown that replacement of narcotic analgesics, within the limits of the conducted NLA, by moradol, an agent of the group of agonists-antagonists is poorly effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1993

[Anesthesia and infusion-transfusion therapy in extensive combined surgeries].

The article discusses 434 one-stage concurrent and combined surgical interventions in the cavities. The type of anesthesia and the volume of infusion-transfusion therapy were determined for each type of combinations. A concurrent-combined method, i. e. combined endotracheal (NLA with Kalipsol) and epidural anaesthesia is advisable in supertraumatic interventions (evisceration of the organs of the true pelvis, hemicorporectomy). The method of dissociative total intravenous anesthesia must be used for patients with heart diseases, especially in patients with various disorders of the conduction system. The specific features of this method is exclusion of nitrous oxide and reduction of the doses of Phentanyl, (which produce a negative effect on the conduction system of the heart) and increase of the doses of Kalipsol and droperidol, which allows the operation to be conducted in full volume in these patients. Agents for NLA with Dalargin are preferable for general anesthesia in patients undergoing operations on the hepatopancreatoduodenal zone. In other concurrent and combined operations on patients without concomitant heart diseases, NLA and NLA in combination with Kalipsol may be used; the last-named is particularly valuable in massive blood loss, when the hemodynamics are insufficiently stable. Particular attention is given to extensive, traumatic interventions attended by massive blood loss. The performance of hypervolemic hemodilution to the main stage of the operation is suggested, which makes it possible to stabilize hemodynamics at the peak of the hemorrhage. With the chosen tactics of anesthesia and infusion-transfusion therapy the incidence of complications and the lethality rate in such extensive operations were significantly reduced.

Analgesics, Opioid↗
PubMed1993

[Prevention of infectious complications in heart surgery patients with dalargin].

The authors studied the effect of dalargin, a Russian produced synthetic analogue of regulatory opioid peptides on the incidence, severity, and outcomes of infectious complications in cardiosurgical patients with congenital and acquired heart diseases. The use of dalargin in the complex of multicomponent anesthesiological protection--neuroleptanalgesia, facilitated relative limitation of the sequelae of stress-induced secondary immunodeficiency in the form of increased risk of the development of postoperative purulent and inflammatory diseases. This resulted both in reduction of lethality from infectious complications, anterior purulent mediastinitis among others, and in decrease of the absolute number and percentage of postoperative complications of infectious etiology. This points to the principal possibility of formation by means of dalargin of the corresponding level of adaptation to the damaging action of surgical stress, which is evidently mediated by optimization of neurovegetative protection in particular due to the antistress properties characteristic of the synthetic opioid hexapeptide.

Adjuvants, Immunologic↗
PubMed1992

[Molecular mechanisms of antioxidant action of dalargin on the liver in experimental cholestasis].

Changes of antioxidant activity of dalargin in the liver after naloxone (100 micrograms/kg) administration were examined in experiment on 144 rats with cholestasis. It was found that dalargin inhibited the activity of xanthine oxidase by 32-37% in different time periods after the injection. Dalargin and naloxone, when used in combination, had no effect on the enzyme activity. Glutathione-S-transferase activity rose by 38.0% and 21.8% on hour 1 and 3 after the injection, respectively, while simultaneous injection of dalargin and naloxone induced no changes in the enzyme activity after 1 hour, though decreased it by 36.8% and 26.4% on hour 3 and 5, respectively. Dalargin inhibited lipid peroxidation by 29-35%, simultaneous injection of dalargin and naloxone raised lipid peroxidation by 109.2%, 80.7% and 25.7% after 1, 3 and 5 hours, respectively. Dalargin injection elucidated a marked tendency to lowering of blood release of the liver-specific enzymes histidase and urokaninase in line with enhancement of their activity in the liver. A combined injection of dalargin and naloxone promoted high release of histidase and urokaninase in blood and did not change histidase activity in the liver in all cases. Urokanidase activity elevated in 5 hours. It was noticed that dalargin raised leu-enkephalin levels in the liver 3.5-fold 1 h after the injection. The reduced dalargin antioxidant effect coupled with naloxone pretreatment demonstrated indirect action of the neuropeptide on the liver via neuron receptors of the liver.

Animals↗
PubMed1991

[The role of the surface antigens of Pseudomonas pseudomallei in the pathogenesis of melioidosis].

As established with the use of electron-immunochemical techniques, glycoprotein antigen 6 is the outer membrane component of P. pseudomallei cell wall, while glycoprotein antigen 8 is localized on the cell surface as a capsule-like formation. Antigen 6 plays no perceptible role in the realization of the pathogenic properties of the infective agent, but serves as a reliable sign in the differentiation of P. pseudomallei strains into serovars. Subcultures, defective in the synthesis of antigen 8, have sharply reduced virulence for laboratory animals. As revealed in this study, the pathogenetic action of antigen 8 is linked with its pronounced antiphagocytic function. Thus, antigen 8 is considered to be one of the key pathogenicity factors of P. pseudomallei.

Animals↗
PubMed1991

[Features of general anesthesia and infusion-transfusion therapy in extensive surgery of the organs of the abdominal cavity].

The article discusses variants of infusion-transfusion therapy (ITT) in early stages of expanded operations on the abdominal organs attended by massive blood loss (2 to 4 BCV and more). Seventy-three patients were examined, they underwent resection of the liver (30), pancreatoduodenal resection (37), or removal of a retroperitoneal tumor (6 patients). On the basis of precise study of central and peripheral hemodynamics, acid-base equilibrium, and blood oxygen transport function the authors find it necessary to increase the volumes of ITT to 70-80% BCV in the first stage of the operation with a colloid/crystalloid ratio of 1:4. The described method makes it possible to avoid critical fluctuations of cardiac output and blood pressure in massive bleeding. At the same time, such hemodilution causes no considerable decrease in hemoglobin concentrations (which was 79.0% of the initial level at the beginning of the main stage) and specific oxygen transport (85.0%, respectively). In absolute expression the specific oxygen transport before the hemorrhage is 465 + 29 ml/min/m2, which significantly exceeds the critical value. The authors believe the ITT method to be indicated in inevitable blood loss and absence of serious cardiovascular diseases. From comparative analysis of the different variants of general anesthesia, the authors conclude that the following combination of agents is preferable for the discussed category of patients: phentanyl, droperidol, seduxen, kalipsol (ketamine), and dalargin. Their balanced use ensures stability of the main homeostasis indices in all stages of the intervention; the hepato- and pancreatoprotective properties of dalargin are also of importance.

Abdomen↗
PubMed1991

[Various aspects of using minor regulatory peptides in anesthesiology].

Dalargin is a Soviet synthetic analog of leu-enkephalin. It was used in a complex of anesthesiological protection (in the form of permanent infusion at a rate of 40-55 micrograms/kg/h) in 331 patients who suffered different operations on the heart, lungs and abdominal cavity. Potential mechanisms of the protective action of the drug were studied in experimental surgical distress. It was found advisable that dalargin may be included into combined general anesthesia to maintain intraoperative organ protection, to stabilize vital functions of the patient at the most crucial and traumatic stages of intervention, and to decrease requirements of narcotic analgetics. It is assumed that dalargin may interact with peripheral opiate receptors. The interaction is likely to be viewed as the main mechanism by which the protective properties of the drug are realized.

Abdomen, Acute↗
PubMed1991

[Effects of dalargin on hemodynamics of anesthesized rats during truncal vagotomy].

I/v dalargin injection (20-25 g/kg) to narcotized rats in case of total myoplegia effectively protect hemodynamic changes under nociceptive stimulation. Bilateral truncal vagotomy partially decrease the protective effect of dalargin. Protective effect of the medicine results in activation of central and peripheral opioid receptors.

Anesthesia, General↗
PubMed1991

[Intraoperative computed EEG monitoring for evaluating the adequacy of general anesthesia].

The article analyses the possibilities of computed EEG monitoring for evaluation of the magnitude and adequacy of the modern methods of general anesthesia: NLA, NLA with halothane inhalation, NLA including Kalipsol bolus administration. An original coefficient, called the adequacy index (AI), was found, which reflects the percentage contribution of deep rhythms (delta and theta) to the total power of the EEG in the range of 0 to 20 Hz. It is shown that the dynamics of this index correlates with the degree of the blocking of entry of sensory nociceptive information into the CNS. The lower boundary of AI-70% was determined, below which the generally accepted signs of anesthesia inadequacy appear: hyperactivity develops, a shift of pH in the acid direction occurs, and the base deficiency increases. It is suggested that determination of AI is used as a highly sensitive and operative test for routine monitoring of the patient's intraoperative condition and express diagnosis of inefficacy of anesthesia.

Anesthesia, General↗
PubMed1990

[The design of a diagnostic test system based on magnetic sorbents and liposomes].

The results obtained in the study of the possibility of using magnetic sorbents for the construction of a diagnostic assay system based on the antigen-antibody interaction are presented. As a model, Yersinia pestis capsular antigen and immunoglobulins to it have been used. A solid-phase immunofluorescent liposomal assay method has been developed; this method can be used for the detection of biopolymers in the sample under study and for the determination of their activity.

Acrylic Resins↗
PubMed1990

[Use of dalargin in complex anesthesiological protection during operations on the abdominal organs].

The authors analyse experience in the use of the synthetic analogue of ++leu enkephalin dalargin in multicomponent balanced anesthesia in operations on the abdominal organs in 36 patients. With the use of the suggested method the intraoperative expenditure of narcotic analgesics is 6 times less but the efficacy of the anesthesia remains the same. Study of the activity of the liver-specific enzymes (histidase and urokinase) in blood plasma and biopsy material taken from the liver and the content of malonic dialdehyde in the hepatic biopsy specimen revealed hepatoprotective properties of dalargin. The decrease of the total peripheral resistance and increase of the elasticity of the arterial reservoir++ in the main group as compared to these values in patients treated by the traditional method were considered by the authors to be the consequence of the autonomic priming effect of the opiopeptide used. It is concluded that the use of synthetic analogues of endogenous opioids (dalargin) in the anesthesiological protection complex in operations on the abdominal organs is expedient.

Adult↗