The morphometric characteristics of the blood microcirculatory bed of the ovary and uterine tube in rats with aseptic inflammation and after the use of a carbon-mineral sorbent]

Morphometrical investigation of the blood microcirculatory bed has been performed using the material from nonpregnant rats. Changes in volumetric density of the arterial and venous parts of the microcirculatory bed in the ovary and uterine tube after application of the spherical carbonate-mineral sorbent (SUMS-1) demonstrate a corregating effect of the sorption applied.     

Emergency Resection in Treatment of Diverticular Disease of Colon Complicated by Peritonitis

Of a consecutive series of 25 patients with peritonitis secondary to colonic diverticular disease all, except one with faecal peritonitis, underwent some form of emergency resection.All the three patients with faecal peritonitis died, but the 22 with purulent peritonitis survived. The average duration of the emergency admission of the 22 survivors was 25.4 days, and in nine (41%) of them intestinal continuity had been restored by the end of that admission.Thus some form of emergency resection is the operation of choice in patients with spreading peritonitis due to diverticular disease of the sigmoid colon.     

Therapeutic form of doxycycline hydrochloride for intravenous administration in the treatment of suppurative-septic diseases]

Efficacy of doxycycline hydrochloride administered intravenously was studied in treatment of severe purulent inflammatory diseases such as pneumonia, lung abscesses, pyothorax, skin and soft tissue infections, peritonitis, purulent cholangitis, etc.. Doxycycline showed significant advantages over tetracyclines: prolonged action, higher efficacy and good tolerance. Favourable results were observed in 85 per cent of the cases.     

Gentacycol--a delayed-action form of gentamicin in the treatment of suppurative infection]

Efficacy of gentacycol was studied in the treatment of various purulent infections. It was used in therapy of hematogenic and traumatic osteomyelitis, wound infections, soft tissue abscesses, purulent diffuse peritonitis as a complication of comissural ileus or appendectomy, pyothorax, destructive pneumonia and mediastinitis. Gentacycol ++ was also used for the prophylaxis in cholecystectomy, herniotomy and other conditions. The favourable results were stated in 93 per cent of the cases.     

Experimental and clinical study of nitazol as an antibacterial drug in the complex treatment of peritonitis

Antibacterial properties of the Soviet drug nitazol which is a derivative of imidazole were studied. It was shown that nitazol in a dose of 4-8 micrograms/ml was highly active against gram-negative nonsporulating anaerobes, gram-positive anaerobic cocci and spore-forming Clostridia spp. Unlike metronidazole, it was efficient against both standard and clinical strains of facultative anaerobes such as E. coli, S. aureus and Klebsiella spp. isolated from patients with peritonitis and being poly-resistant to antibiotics. It was found in vitro that the antibacterial effect of nitazol was higher when it was used in combination with some antibiotics. It was demonstrated on experimental models of peritonitis caused by Staphylococcus spp. and E. coli in mice that nitazol used alone or in combination with gentamicin had a favourable effect on the animal survival and lifespan. The combination of nitazol with gentamicin was applied in the combined treatment of appendicular peritonitis in 80 children and its high therapeutic efficacy was stated. Nitazol is useful as an antibacterial drug in the combined treatment of children with purulent peritonitis.     

Effectiveness of gentamicin sulfate in suppurative-inflammatory processes of varying localization]

Antibiotic sensitivity of 486 strains of grampositive and gramnegative organisms isolated from patients with purulent infections was studied in vitro. Gentamicin was shown to be highly active as compared to kanamycin and other antibiotics against the main causative agents of purulent inflammatory infections including multiresistant E. coli, Proteus, Ps. aeruginosa, Staphylococcus. High efficiency of gentamicin in therapy of peritonitis, septic conditions, purulent postoperative wounds, infections of the urinary tract, pneumonia, etc. (197 patients) was shown. Positive results were obtained in 87.4 per cent of the cases. Side effects, such as albuminuria, hyperthermic reaction, rash, pruritis were registered in 3 per cent of the patients.     

Use of cefoperazone in clinical practice]

The bacteriological and clinical efficacy and side effects of cefoperazone were studied in 45 patients with severe and moderate purulent inflammatory diseases. The study showed that its bacteriological and clinical efficacy was high in cases with peritonitis, cholecystitis, respiratory and urinary infections, as well as those of the eye and soft tissues. The general clinical efficacy amounted to 95.6 per cent. The number of the side effects was insignificant. This made it possible to recommend the use of cefoperazone in the therapy of many purulent inflammatory diseases, as well as in empirical therapy.     

Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.     

Microflora of patients with purulent septic diseases in the Moscow region

The microflora of clinical material (blood, wound discharge, abdominal exudate, pleural exudate, milk in mastitis, as well as feces in dysbiosis of the large intestine), obtained from patients with purulent septic diseases in the Moscow region was studied. The study revealed the change of microflora from surface biotopes to closed cavities of the body. Gram-positive cocci, primarily coagulase-negative staphylococci, mainly epidermal, were shown to play the leading etiological role in the development of purulent septic diseases. The development of bacteriemia was found to be caused by the penetration of staphylococci from local pyoinflammatory foci (appearing in purulent mastitis, wounds, peritonitis, pleural empyema and pleuritis), as well as by the translocation of staphylococci and Escherichia coli from the large intestine in dysbiosis.     

Antibacterial therapy in disseminated purulent peritonitis

Analysis of 156 records relating to patients at the age of 15 to 85 years with extended purulent peritonitis of the surgical and gynecological genesis (the toxic phase, VI category ASA) showed that combination of programmed sanitation laparotomy and intensive antibacterial therapy performed as short-term courses before, during and after the operation with an account of the information on the nature of the microbial associations and antibioticograms was an efficient procedure in treatment of severe peritonitis. It was indicated in treatment of patients with polyorgan deficiency. When the surgical treatment was adequate early antibiotic therapy allowed to decrease the number and intensity of postoperative complications: the frequency of abscessing in the abdominal cavity and formation of intestinal fistulas lowered 2 and 1.5 times respectively. Such a decrease was also observed in asthenic patients with lowered protective reactions to development of new infectious foci in the abdominal cavity complicating the peritonitis process. It was also possible to prevent with that procedure the infection generalization and development of peritoneal sepsis. With application of the procedure to such patients (20 per cent) lethality lowered 2-fold.     

Mortality causes of the moustached tamarin (Saguinus mystax) in captivity.

From January 1987 to November 1990, 125 adult Saguinus mystax died at the CRCP. Enteritis/colitis (26%), hypoglycemia/cachexia (19%), and parasitic enteritis (13%) were the most common causes of death. Less common were purulent peritonitis (9%), lobular pneumonia (8%), and hemorrhagic gastroenterocolitis (6%). These results confirm the high frequency of gastroenteric lesions reported in Callitrichidae in captivity.     

Iron metabolism disturbance as a marker of the severity of pathology in resuscitation patients

Forty-eight patients of resuscitation wards were examined, including 15 patients with purulent peritonitis, 12 patients with acute pancreatitis, 11 patients with thermal skin damages, and 10 patients with severe acetic acid intoxication. An increase in the serum iron, ferritin, and free hemoglobin contents of blood plasma influenced the severity of endotoxicosis. This was expressed in progressive fever, increase in the leukocytic intoxication index and concentrations of low-and middle-molecular-weight substances on erythrocytes and in the blood plasma, intensification of lipid peroxidation, and insufficiency of the antioxidant defense system, which resulted in the development of multiple organ failure in patients with the above-mentioned diseases.     

Peritoneal macrophages from patients on continuous ambulatory peritoneal dialysis show a differential secretion of prostanoids and interleukin-1 beta.

In vitro secretion of the prostanoids PGE2 and PGI2 and of the cytokine IL-1 beta by peritoneal macrophages obtained from CAPD patients during episodes of peritonitis and infection free periods, was determined, after culturing with or without 5 micrograms/ml of LPS. The release of PGE2 and PGI2 as measured by its stable metabolite 6-keto-PGF alpha was determined in 10 episodes of peritonitis and 10 infection free periods. IL-1 beta release was determined in 14 episodes of peritonitis and 20 infection free periods. PGI2 release from macrophages declined sharply during peritonitis both in the absence and presence of LPS in the culture medium (p less than 0.005). A tendency to decreased PGE2 release was found during peritonitis, when macrophages were cultured in the absence of LPS. In the presence of LPS, the same amounts of PGE2 were released during peritonitis and during an infection free period. On the other hand, peritoneal macrophages released significantly more IL-1 beta during peritonitis as compared to an infection free period, provided that the cells were in vitro stimulated with LPS. In view of the interregulatory effects between prostanoids and macrophage cytokines in their production, these findings may indicate that the impaired release of PGI2 during peritonitis has allowed the macrophages to secrete more IL-1 beta after in vitro stimulation with LPS. This implies that PGI2 and PGE2 may play a distinct role in the regulation of cytokine secretion by these cells.     

Diverticulitis with rupture and fatal peritonitis in a Sumatran orangutan (Pongo pygmaeus)

A 30-year-old male Sumatran orangutan (Pongo pygmaeus) presented with signs of depression, lethargy, anorexia, and diarrhea that progressed to acute colic. Exploratory laparotomy revealed fibrinopurulent peritonitis and 50 cm of devitalized small intestine. The surgically resected small intestine contained several mucosal diverticula along the mesenteric attachment; one had ruptured, resulting in peritonitis. Fifteen days after surgery, the orangutan's abdominal incision dehisced. Repeated laparotomy revealed dehiscence of the distal intestinal anastomosis site, as well as extensive adhesions and purulent exudate. The defect was repaired, and the abdomen was extensively irrigated and closed, but the animal died within 24 hours. To our knowledge, this is the first report of diverticulitis in a great ape. Diverticulosis should be considered in the differential diagnosis for great apes that present with signs of depression, lethargy, anorexia, and/or diarrhea.     

State of the nonspecific humoral factors of the body's natural resistance in patients with suppurative and septic infections having various ABO system blood groups]

The results of surveying 140 patients with severe purulent and septic infections of staphylococcal etiology, when compared with the distribution of the blood groups (as classified according to the ABO system) in 180 healthy donors, revealed that generalized purulent infections occurred most frequently in patients with blood groups A (II) and AB (IV), and more seldom in patients with blood groups O (I) and B (III). The average content of lysozyme, complement and normal antibodies to E. coli, as well as the average level of general bactericidal activity in the blood sera of the patients were considerably lower than in the blood sera of healthy donors; at the same time content of lysozyme, complement and normal antibodies in the blood sera of patients having different groups of blood did not reflect the degree of their predisposition or resistance to staphylococcal infections. The general bactericidal activity of the blood serum was found to correlate with the degree of predisposition or resistance to purulent septic infections of staphylococcal etiology to a greater extent than other characteristics.     

Effect of intravascular laser irradiation of blood on the status of the adrenergic and cholinergic structures of the small intestine in experimental peritonitis

In the experiment performed on 60 mongrel dogs the effect of intravascular laser radiation of blood (ILRB) to adrenergic and cholinergic fibers of the small intestine has been studied at treatment of experimental generalized suppurative peritonitis. At treatment of the experimental peritonitis by means of traditional method only one month after its termination a positive reaction to acetylcholinesterase (AChE) is noted, structural organization of cholinergic fibers corresponds to the norm, and density of their plexuses increases. Application of ILRB at treatment of the experimental peritonitis facilitates to increasing density of the cholinergic fibers already on the 21st day after termination of the treatment; their AChE increases essentially, their structural organization corresponds to the norm. In cytoplasm of neurons of the muscular-intestinal plexus a positive reaction to AChE is revealed; this demonstrates their increased functional activity. The small intestine adrenergic apparatus at peritonitis undergoes less manifested structural-chemical alterations. After termination of treatment by means of traditional methods it corresponds to the norm on the 7th day, and after ILBR treatment----on the 3d day. Thus, application of ILBR in treatment of the experimental peritonitis enhances the development of regenerative processes in adrenal and cholinergic structures of the small intestine, facilitates a more manifested demonstration of compensatory-reparative possibilities of the organism.     

Clinical and radiation diagnosis of circumscribed peritonitis complicating duodenal perforation

This paper deals with the results of ultrasound (US) and multislice computed tomography (MSCT) in patients with perforated duodenal ulcer in different periods after the onset of the disease, with varying clinical manifestations, and in the postoperative period. A comparative analysis of the results of radiation studies has indicated that X-ray study is a basic technique that defines treatment policy in the early development periods of perforation; US study (USS) reveals a change in the duodenum, fluid and infiltration outside the duodenum. As circumscribed peritonitis progresses, USS allows the diagnosis of abdominal abscesses and infiltrations. Out of the radiation techniques, MSCT is of most importance in the diagnosis of interintestinal abscesses and in the determination of syntopy of purulent cavities.     

Trace element levels in the experimental peritonitis

Electron transfer from iron or copper ions to oxygen is an important example of cellular free radical initiation. Oxygen derived free radicals have been implicated as mediators of cellular injury in several model systems. To evaluate the importance of iron, copper and zinc levels on lipid peroxidation in peritonitis, we measured peritoneum malondialdehyde (MDA) as a marker of lipid peroxidation, zinc, copper, and iron levels during an animal model of intraperitoneal sepsis. Additionally the effects of the free radical scavenger alpha-tocopherol administration was studied. The peritoneum MDA, iron, copper and zinc levels were increased after induction of peritonitis with Escherichia Coli. The treatment with alpha-tocopherol was decreased the peritoneum MDA, iron and copper levels significantly, except the zinc level (p < 0.001, p < 0.001, p < 0.001, respectively). Additionally the alpha-tocopherol treatment for three days prior to injection of E.Coli more decreased MDA, copper and iron levels than that of the treatment with alpha-tocopherol at the time of injection of E. Coli (p < 0.001, p < 0.001, p<0.001, respectively). Our results indicated that copper, iron and zinc had important effects on peroxidation events in E. Coli induced peritonitis, and alpha-tocopherol treatment can improve the oxidant status.     

Removal of oil by walnut shell media

Studies were conducted to evaluate the oil sorption capacities of walnut shell media. Sorption capacity is the weight of oil picked up by unit weight of a sorbent. Initial oil pick-up by walnut shell media on pure oil and oil on aqueous medium was evaluated. Batch kinetic studies were conducted to evaluate the equilibrium time required by walnut shell media for sorbing oil. For pure oil medium, sorption capacities of 0.30g/g, 0.51g/g and 0.58g/g were obtained for standard mineral oil, vegetable oil and DoALL Bright-Edge oil, respectively. The results showed sorption capacities of 0.56g/g, 0.58g/g and 0.74g/g for standard mineral oil, vegetable oil and DoALL Bright-Edge oil, respectively, for oil on aqueous medium. It was found that sorbed oil could be recovered from walnut shell media by applying pressure. The study showed that walnut shell media can be used as a sorbent for oil removal.     

Morphological changes caused by the dermonecrosis factor of the causative agents of cholera and various other intestinal infections

Intra- or subepithelial focal purulent inflammation with necrosis of exudating leucocytes during 1-2 days is developed in consequence of intradermal injection of the living cholera vibrios, cultured on membrane agar, or their supernatants. Sometimes coagulative necrosis of cover epithelium arises without preliminary purulent inflammation stage from the very beginning. Intradermal injection of living cholera vibrios leads to the development of coagulative necrotic foci in derma too. The vascular genesis of alterations mentioned above is supposed.