The Journal of V. N. Karazin Kharkiv National University. Series «Medicine»

5-9

Authors: S.О. Bychkov, R.М. Grynyov, L.N. Duchik

After the carried out experimental researches authors submit experience of performance 101 laparoscopic operation on organs of hepatobilear system with application of low temperatures influences. For cryoinfluences it was used the own designed cryoapplicator. The analysis of the received results allows to recommend more wide using of low temperatures at laparoscopic operations.

12-15

Authors: A.V. Martynenkо, M.I. Yabluchansky, S.V. Ostropolec

The method extending spectral analysis of heart rate variability (HRV) application for patients with sinus arrhythmia was proposed. The method is based on rhythmogram physiological clusterization that generalized as empirical smooth of time series. Рroposed method exactly split mixed signal on true independent sources: we obtain stochastic and harmonic sources when we split real HRV records and TP of harmonic source good correlated with expected TP value for patients’ age group. Thus method extends HRV technology for medical practice.

20-23

Authors: A.V. Skripchenko, M.V. Smelyanskaya, S.D. Peremot, A.V.Martinov

Associations of intracellular infections and trichomonadis in etiology of chronic inflammatory diseases of urogenitalis organs for men exposed in 97% cases. Thus the associations of three infectious agents come to light more frequent than all (more than 60%), one of which – richomonadis. A presence in the association of viral agent (HSV or CMV) stipulates more heavy clinical flow of disease of urogenitalis system.

31-36

Authors: A.I. Tsivenko, N.V. Cherkova, I.S. Panchenko, S.I. Zabroda

3879 medical cases of various gallstone disease types with laparoscopic cholecystectomy were analyzed. As a result it was found that more mild currency of the post operation period with less reaction of organism on operation trauma and less percent of postoperation complications is seen in patients undergone operation with ultrasound. Usage of ultrasonic influence is multifunctional: it allows to carry out simultaneously cavitation, coagulation, dissection of tissues in the field of intervention that warns billing, a bleeding, damage extrahe-patic bilious channels, necrosis of tissue and promotes decrease in- and postoperative complications

43-48

Authors: I.A. Bondarenko, N.I. Yabluchanskіy

The clinical parameters, indices of external respiration function (ERF) and heart rate variability (HRV) in patients with chronic obstructive pulmonary disease (COPD) against a background of the basic therapy were investigated. The study involved 105 patients with COPD in the stage of remission (36 female and 69 male) aged 60.49.6 with COPD lasting 10,1±5,3 years. The complex investigation demonstrated efficacy of the long-term basic therapy for COPD. Initial variations in the clinical state, degree of ERF and HRV parameters in patients with COPD depending on the gender, age, duration of the disease, term of smoking and initial level of total power of HRV spectrum and their different reactions against a background of basic therapy were revealed. The importance of HRV technology for control of the state of regulatory systems in patients with chronic obstructive pulmonary disease on the stages of basic therapy was proven.

53-58

Authors: K.V. Vovk, N.A. Bruev

The mutually aggravating influences of one disease on the clinical course of the other one are observed in the combination of ischemic heart-disease (IHD) and peptic ulcer (PU). The purpose of the present work is to determine the course features of the concomitant PU in the patients with IHD and possibilities of its drug correction. Examination of 114 patients was carried out under conditions of cardiological department of the Kharkov Regional Hospital; during the FGDS, PU (33,3%) was discovered in 38 of the patients with the IHD at the age of 30-65 (47,4±4,9). The course feature of the PU in combination with IHD is change of clinicolaboratory criteria, that shows up in 50% cases with pain syndrome with moderate monotonous intensity; presence of dyspeptic syndrome (in 34% cases) in the form of meteorism and diarrhea (in 27% cases) and constipation (in 42% cases); increase of secretory and acid-forming gastric function (17,1% cases); semination of mucous coat of stomach with helicobacterium infection (in 50% cases). Abnormality of the cardiovascular fitness with PU and IHD was accompanied by tachycardia, moderate increase of blood pressure and ST segment depression, that was predisposing to the rise of aggression factor in the mucous coat of stomach with impaired microcirculation, trophic disturbances and development of the PU (in 33%). The complex therapy in PU with IHD, including the use of clacid, ammoxicillin, pariet in combination with actovegin, results in improving of therapeutic effects and contributes to acceleration of healing of ulcerous defect of the mucous coat of stomach.

66-73

Authors: P.А. Garkaviy

265 AH patients investigated. 98 patients were taking CA, 85 – BB, 82 – ACE. Hydrochlorothiazide was added to one of the drugs if hypotensive effect was insufficient. BP was measured before, within 1, 2 weeks, 1,3 and 6 months after treatment. Two groups were identified during the tilt test: group 1 – normotensive orthostatic reaction (NOR), BP changes from -5 mmHg to +20 mmHg, and group 2 – hypotensive orthostatic reaction (HOR) – 20 mmHg and more SBP decrease and/or 10 mmHg and more DBP decrease. According to our data all three drugs effectively decreased BP, but the dynamics and grade of decrease varied. CA had the most powerful hypotensive effect, decreasing SBP and DBP already on the 1-st week of drug intake, especially in patients with HOR, both in clinostasis and orthostasis. CA therapy increased frequency of HOR on DBP on 5%. BB had less powerful hypotensive effect and in patients with HOR gradually decreased both SBP and DBP in clinostasis, and markedly in orthostasis. Within 6 months of treatment BB decreased SBP and DBP in patients with HOR in clinostasis in the lowest extent, and in larger extent in orthostasis. BB therapy increased frequency of HOR on SBP on 5%, and on DBP on 8%. ACE inhibitors had smooth hypotensive effect, seen after 1-st week of intake. Maximal temps of SBP and DBP decrease was seen in patients with HOR during 1-st – 2-nd weeks of treatment, both in clinostasis and orthostasis. During the first-second week period of treatment with ACE frequency of HOR increased on SBP from 17% to 24% and on DBP from 14% to 17% with further tendency of HOR frequency decrease to 21% on SBP and to 16% on DBP within 6 months. Out of three groups of hypotensive drugs (CA, BB, ACE) probability of HOR progressively increased when using CA and BB, and only when using ACE inhibitors increased temporarily.

79-84

Authors: E.I. Zalyubovskaya

91 patients have been examined to study the effectiveness of (ACE inhibitor) lysinoprile in various doses including its combination with carvedilol β-blocker as a complex treatment in ischemic heart disease patients with hert failure symptoms, diabetes mellitus 2 type (D) and metabolic syndrome (MS). The conclusion has been made that doses of lysinopril and carvedilol as a complex therapy in ischemic heart disease patients with hert failure symptoms, diabetes mellitus 2 type (D) and metabolic syndrome (MS) has a definitely positive effect concerning normalization of general cholesterol level (CH), triglycerids (TG), cholesterol lipoproteid of low density (CH-LPLD). Increasing lysinoprile dose allows to improve the level of CH-LPLD and lipoproteids of very low density (CH-LPVLD), and carvedilol promotes the reduction of CH, TG, CH-LPLD, CH -LPVLD levels. Combination of lysinoprile 2,5-5,0 mg with carvedilol 37,5-50,0 mg permits to increase the level of CH lipoproteids of high density.

88-93

Authors: N.M. Korenev , G.A. Borisko., T.A. Kostenko , O.A. Aphanasyeva

The adaptation capabilities (reaction to physical stress load) of 98 children, aged 16-18, born from fathers, who took part in liquidation of the Chernobyl nuclear disaster, as compared with adaptability of 53 children from the families with no radiation risk have been studied. Heart rate, blood pressure and echocardiogemo-ynamic indices were registrated at rest, on the first, the third and the fifth minutes after physical stress load. The adolescents born from the father-liquidators revealed a reduced reaction level to physical load. We recommend careful organization of physical training for such children.

98-105

Authors: T.I. Lyadova

At patient with acute viral hepatitis B three types of immune reactions were established, determined by the character of answer of principal regulators cytokines: normally reactive, dissociative, and hyporeactive, which are found in close correlation with the severity degree of weight, clinical signs and outcomes of disease. The got results allow to recommend the necessity of complex investigation of patients with acute viral hepatitis B with determination of markers of active viral replikation (DNA HBV) and level of principal regulators cytokine.

110-114

Authors: E.V. Ognivenko, N.N. Popov, E.A. Romanova

Antimicrobial immunity condition has been examined in 29 patients with purulent maxillary sinusitis in the exacerbation phase under insulin-dependent diabetes mellitus (group 1) and 29 chronic purulent maxillary sinusitis patients not suffering from endocrinopathies of any kind (group 2)/ Development of purulent maxillary sinusitis in persons insulin-dependent diabetes mellitus progresses against the background of the significant decrease of the main antimicrobial immunity factors aktivity, affinity of the produced antibodies, opsonizing properties of serum, and phagocytic biocidal activity of neutrophils. Neutrophil biocidity decrease is associated with malfunctions occurring in both oxygen-dependent and oxygen-independent ntimicrobial mechanisms.

119-124

Authors: P.I. Rynchak

120 patients with CHF and anemia were exemained. CHF of II FC was found in 49 patients, III FC – in 42 and IV FC in 29 patients. All patients had standart treatment. The level of hemoglobin, MKV, MCH, MCHC, hematocrite, serum iron, ferritine, erythropoetin, tumor necrosis factor α, interleukin 1β. It was found that the level of hemoglobin and serum iron in patients with CHF of ischemic genesis was decreased and it has direct relation to increased level of proinflammatory cytokins, which increases in parallel to incerasement of erythropoetin, which reflects cytokininducted appearance of anemia in patients with CHF as a result of erythropoesis inhibition.

129-140

Authors: Е.Е. Tоmina, N.I. Yabluchanskіy

Peptic ulcer etiology, pathogenesis and therapy literature review is offered. With the reoccurrence of interest to the meaning of autonomous nervous system in the genesis of ulceration, the research of regulatory processes using heart rate variability (HRV) analysis becomes strongly actual. Latest publication that contain separate HRV investigations in peptic ulcer patients are given.

150-167

Authors: V.P. Maliy, O.V. Volobueva, T.I. Lyadova

In a lecture are presented etiologic, epidemiology, patogenetic and clinical description of shigellosis. Basic approaches to diagnostics, medical treatment and prophylaxis of disease are represented.