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

6-11

Authors: M.I. Yabluchansky

The medical education activity of the Karazin Kharkiv National University was renewed with the Ukraine becoming an independent state. Historical roots and the actuality of the University medical education is the topic of the article. The main idea is that medical education in the Ukraine should turn toward the educational sphere. In this way the conflict of the interests caused by concentration in one place both the medical education and health care will disappear. This is going to be profit for everyone and for ordinary citizen in the first place. This means that whole country will be benefited.

16-21

Authors: V.G. Babijchuk

It has been shown that under hypothermia conditions the interactions between central and autonomous contours of cardiac activity regulation can be significantly changed, therefore the probability of paradoxical reactions of an organism to application of cardiotropic preparations increases. The change of a sign of chronotropic effect of cathecholamines (CA) and acethylcholine (AC) under hypothermia in a great extent is substantiated by an increase of blood brain barrier (BBB) permeability, that should be taken for consideration in practical medicine. Besides therapeutic cooling regimens contribute to a recovery of impaired rhythmicity of functioning of nerve and cardiovascular systems, in particular under conditions of emotional stress, that is one main causes of human disease appearing.

25-29

Authors: V.N. Dzuba, Yu.V. Nikitchenko, T.A. Shmonina

ATPase activity alterations in rats of different age groups during the total myocardial ischemia were studied. It was determined that only mitochondrial oligomycin-sensitive ATPase was sensitive to effect of the total myocardial ischemia. The fact that addition of magnesium ions in the incubation medium eliminated ischemic effect in 3-months old rats and weakened it in 24-months old rats pointed to important role of magnesium ions in structure-functional reconstruction of mitochondria under myocardial ischemia. Young 3months old rats were established to be more tolerant to myocardial ischemic damage thanold animals.

36-40

Authors: L.A. Grebeniuk, A.V. Popkov, V.A. Shchurov

The aim of this work is to analyze the influence of some factors on biomechanical behavior of the human skin in natural growth and in graduated lengthening with application of the Ilizarov fixator. 45 healthy individuals of various age and 104 patients suffering from congenital shortening of one lower limb or osteomyelitic sequelae have been examined. The limb discrepancy was eliminated by mono- and bilocal osteosynthesis with application of the Ilizarov fixator. The amount of lengthening comprised 3 - 14 cm, its relative value achieved 6 - 30%. Distraction started in 5 days following fixator placement. Biomechanical parametres were determined with the help of the device designed by A.A. Utenkin. The method allows for studying skin deformation properties - shift stiffness (S, kg/mm2) by minimal in time loading but constant in value moment, as well as for calculation of the amount of relative deformation (stretching,., %). The work reports on the effect of different factors – structural and age ones, conditions of reparative lengthening and processes of regeneration – on the mechanical behavior of the limb skin in shortening of different etiology and gradual traction for equalizing limb length. There is a number of factors having influence on the skin biomechanics of the human extremity: 1 structural peculiarities of the collagen bundles and elastic fibres in the papillary and reticular dermis layers (collagenous fibres make up 98% of the connective dermis tissue and provide its high stiffness). The conformation principle of the collagenous and elastic fibrillas and fibres is their spiral character. 2 - the type of the collagen viscosity in the dermis, especially in its deep layers; 3 - age factor; 4 - an amount and etiology of limb shortening in patients with the locomotor system orthopaedic pathology; 5 - the method of limb shape modeling (lengthening and deformity correction) in the conditions of the guided transosseous osteosynthesis (mono- and bilocal osteosynthesis); 6 - skin regeneration (Ilizarov effect) as a consequence of the formogenetic effect appearing in the conditions of tension stress.

44-47

Authors: E.G. Maksimenko, V.N. Savchenko

It was determined that the serotonin level in hypothalamus, brain stem, cerebellum and brain hemispheres lowers in rats with high audiogenic spasmodic activity as compared to rats with low excitability level, and the serotonin content in rats decreases in cerebellum and hypothalamus.

52-55

Authors: V.A. Moroz, V.P. Starenkiy

The purpose of the work based upon the treatment results of 29 patients with radiation injuries received in accidents are to determine optimum his treatment tactics. Special attention was focused on surgical rehabilitation and mistakes and inaccuracies, made during its carrying out. The calculation of the received dozes was carried out of the basis of the calculated simulation method of an accident in consideration of the source’s activity, geometry of the exposure and time of contact with it. The observation of the patient under considerations enables us to assert that in the acute period of the radiation injury (prior to 3 months after the accident) the reconstructive surgical treatment is expedient only in conditions of x-ray overexposure, with only surface injure of tissues, especially when there is their inflammatory response. For better remote results of treatment surgical rehabilitation of the consequences of a radiation trauma, including determination of the coretraction scope and the type of an operation, should be postponed for 6 months, which will enable to do it more precisely.

63-67

Authors: N.G. Strygelchyk

The potential mutagenic effects of new auxilary farmaceutical substancies (emulgators) was investigated. Under per os injection the substancies not induced the chromosomal aberrations in the narrow cells and dominant lethal mutations in male gametes of mouse. The results are discussed in connection to using at investigated substancies in pharmacology.

72-76

Authors: G.I. Taran

Morphometrical comparison of duplex kidney and ureter structural elements in children was done taking in account the gravity of the pathological process and methods of treatment. Morphological objects giving the possibility to prognose the method of surgical treatment and it’s outcome depending on the quality and quantity of changes of the duplex kidney structure were determined. The principal difference of quantitative changes of structural elements of a duplex kidney without the violation of urodynamics in moderate violation of the outflow of urine and also in a steadfast loss of the function because of the violation of urodynamics of a grave degree was confirmed.

81-84

Authors: Yu.B. Zakharchenko

The results of treatment the 34 patients with the acute purulent cholangitis was analysed. There were 9 men (26,4%) and 25 women (73,6%) in the age for 43 to 87. On the entrance those patients to the clinic their general condition were heavy, but some of them had middle weight condition. The possibility violation of the gall-ducts on the level of common bile ductwere conditioned with: the big stones have 18 patients (52,9%), which defied to endoscopiccholedocholithotraction; strictures of the ducts have 8 patients (24,7%); combination ofcholedocholithiasis with the strictures have 5 patients (14,7%); combination of the choledocholithiasis with parapapillar diverticulum have 3 patients (8,8%). The diagnostic program conclude of the clinical and laboratories methods investigations, ultrasound scanning, endofibroscopic investigation the top past of the gastro-intestinal tract, endoscopic retrograde cholangiopancreatography, cholangiomanometry, bacteriological cheek up of the bile. The treatment program included: the standard infussional therapy of acute cholangitis and the obstructive jaundice; the endoscopic sphincterotomy with following nasobiliar drainage; thelandmark endocholangial leading the complex antibacterial medicine Levosin. As the resultsof the treatment all patients with acute obstructive purulent cholangitis in all cases weremixed in the period of 4-9 days after the treatment starting, with were definite by the clinicalflowing and verified by the dates of laboratorical cheek up methods. All of these allowed tofulfil the radical surgical intervention on the common bile duct with the least risk for the patient. There was no lethal outcome.

91-96

Authors: A.V. Stepanov

Prior trials detected benefits from hyperbaric oxygenation therapy (HBOT) for patients with coronary artery diseases (CAD) and acute myocardial infarction. The aim of this study was to assess the changes in ANS in patients with CAD during session of HBOT by using the technique of HRV. The patients with CAD were subdivided into three groups in dependence of atmosphere pressure and contents of oxygen. We measured the total power (TP), low frequency component (LF) reflecting sympathetic and high frequency (HF) reflecting vagal activity, autonomic balance (LF/HF ratio) and LF and HF in normalized units (LFn, HFn). We observed significant increase under HBOT of TP, decreased LF/HF ratio because of changing in both branch of AHS and parasympathetic activity increased more significant than decreased sympathetic activity. In our point of view the changes in ANS depend of proportionally from oxygen tension in tissues coursed by HBOT. Our preliminary results showed that measurement of HRV is helpful in monitoring not only the circulation but also the common status of patients during the sessions of HBOT and it will be possible in the future to modulate the protocols of HBOT individually for certain patient. Increasing of vagal activity and total power with decreasing of sympathetic tone during of HBOT is the evidence of "relaxation" of circulation and ANS which less stressed by monitoring the body oxygenation. Adjunctive HBOT can improve prognosis in patients with CAD in various ways: the positive modifying of HRV is a sign of favorable changing in ANS; increasing of cardiac electrical stability; prevention of left ventricular dysfunction, progressing in Killip class and ventricular ectopic activity and presence of late potentials; restores of sinus nodal cells to neural modulations.

101-103

Authors: E.D. Khvorostov, A.I. Tsivenko, S.A. Bychkov

For the period from 1994 year 1486 patients with chronic and acute calculosus cholecystitis aged from 18 to 78 years old were operated in the hospital. 312 patients of them were subjected to operations on organs of the abdominal cavity in the earlier period. Peculiarities of the operative treatment in this group of patients are elucidated in the article, particularly carrying out of the videolaparoscopic cholecystectomy. Au thors based possibility and expedientness of fulfilment of videolaparoscopic cholecystectomy in patients subjected to operations on organs of the abdominal cavity earlier.

108-112

Authors: N.I. Yabluchansky, E.P. Kamenskaya

The object of the present study was to evaluate the clinical effectiveness of the beta-blockers and ACE- inhibitors treatment of hypertension patients. The group of patients included 72 persons aged from 27 to 68 (47±6,97) with a moderate hypertension remaining for 7,4±5,2 years. All patients were divided into 3 groups. The first group (27 patients) received monotherapy of the conjunctive from of enalapril and hydrochlorothiazide (2 tablets twice a day), the second group (10 patient) was getting metaprolol (100 mg/daytwice a day). The third group of patients received both medications simultaneously once a day. Heart ratevariability was obtained by using “Cardiolab 2000“ device. The total power of spectrum (TP, ms2) wasevaluated as a measure of the total neuro-humoral regulation. Power of spectrum in the very low (VLF, ms2), low (LF, ms2) and high (HF, ms2) frequency areas reflected the humoral, sympathetic and parasympatheticinfluences correspondently. The low and high frequency areas ratio was obtained as an index of the sympatho-vagal balance (LF\HF). According to the ТР value obtained in the baseline the patients were divided into the sub-groups with a satisfactory (ТР>1000 мс2) and low (ТР<1000 мс2) power of the total regulation. The treatment effectiveness in each group was evaluated by comparing its results in sub-groups withdifferent basal regulation status. The reliability of the discrepancies was obtained by using the Studentcriterion for 95% confiding interval. Positive influence of the ACE inhibitors and beta-blockers was observednot only in the arterial pressure dynamics but also in the neuro-humoral regulation status. The optimisinginfluence on the regulation systems became apparent not only as a growth of the total regulation but also asnormalization of its branch balance (first of all the sympatho-vagal balance). The combined therapy providedmore pronounced clinical result with smaller doses then the regular therapy. It also made the treatment lessexpensive.