Objective: to evaluate the effects of the immunostimulants panavir and derinate on a postresuscitation process in animals of different sexes.

Material and methods. The investigation was made on 200—250-g albino rats of both sexes in winter. Circulation  was  stopped  by  intrathoracic  ligation  of  the  cardiac  vascular  bundle  in  ether<anesthetized  rats  for  10  min. Functional recovery of the central nervous system and changes in sex steroid hormones were assessed in the postresuscitation period. The investigation used two immunoactive drugs: panavir 0.02 mg/kg and derinate 150 μg/kg. Either agent was intramuscularly injected twice: at 3 0 minutes after resuscitation and on the following day.

Results. The injected drugs were ascertained to have a positive effect on functional recovery of the brain. Their use was shown to modify the sex steroid hormone  profiles  in  both  males  and  females  in  the  early postresuscitation period.

Conclusion. The findings suggest that the immunoactive agents are able to affect the nervous and  endocrine  systems  in  critical  conditions.

Objective: to substantiate the efficacy of bipolar impulses of different shapes and duration.

Method. The investigation used the dynamic model II of the mammalian ventricular cardiomyocyte membrane in the guinea-pig, proposed by Luo and Rudy (1994—2000). The cardiomyocyte membrane was acted by substituting the current density of the impulse under study. The threshold impulse energy ratio considered as an integral index of the threshold action (a measure of efficiency) of an impulse measured in μA² ms/cm⁴ was then calculated. A comparison was made between a classical quasi<sinusoidal impulse, a stepwise quasi-sinusoidal, rectilinear, classical trapezoidal, trapezoidally modulated (the presence of high-frequency, high-amplitude oscillations of current) impulse and its unmodulated equivalent, and a trapezoidal low<angle front tail impulse of the duration equal to that of the classical quasi-sinusoidal one. The shape of the impulses corresponded to the 100-ohm resistance of the chest. Results. The most effective impulses  proved  to  be  a  quasi-sinusoidal  stepwise  impulse  (229.6  μA² ms/cm⁴ ),  next  a  classical  quasi-sinusoidal  impulse (249 μA² ms/cm⁴ , +9%) and a trapezoidal low<angle front tail one (253.0 μA² ms/cm⁴ , +10%). The trapezoidally modulated impulse (397 μA² ms/cm⁴ , +73%) turned out to be lowest effective (in the threshold impulse energy ratio). The other  impulses  were  intermediate  between  the  above  impulses  in  the  following  order:  a  modulated  trapezoidal impulse equivalent (272.0 μA² ms/cm⁴ ), next a rectilinear impulse (273.5 μA² ms/cm⁴ ), and a classical trapezoidal one (307.0 μA² ms/cm⁴ ).

Conclusion. In terms of the excitation threshold of the Luo-Rudy model of the guinea-pig cardiomyocyte membrane, the most effective impulses are quasi<sinusoidal stepwise, next quasi<sinusoidal and trapezoidal low-angle front tail ones.

Objective: to evaluate the effects of the immunostimulants panavir and derinate on a postresuscitation process in animals of different sexes.

Material and methods. The investigation was made on 200—250-g albino rats of both sexes in winter. Circulation  was  stopped  by  intrathoracic  ligation  of  the  cardiac  vascular  bundle  in  ether<anesthetized  rats  for  10  min. Functional recovery of the central nervous system and changes in sex steroid hormones were assessed in the postresuscitation period. The investigation used two immunoactive drugs: panavir 0.02 mg/kg and derinate 150 μg/kg. Either agent was intramuscularly injected twice: at 3 0 minutes after resuscitation and on the following day.

Results. The injected drugs were ascertained to have a positive effect on functional recovery of the brain. Their use was shown to modify the sex steroid hormone  profiles  in  both  males  and  females  in  the  early postresuscitation period.

Conclusion. The findings suggest that the immunoactive agents are able to affect the nervous and  endocrine  systems  in  critical  conditions.

The paper discusses promises for clinical use of substrate antihypoxants.

Objective: to investigate the efficacy of succinate containing  substrate  antihypoxants  on  systemic  oxygen  consumption,  blood  buffer  capacity,  and  changes  in  the  mixed venous blood level of lactate when they are used in gravely sick patients and victims with marked metabolic posthypoxic disorders.

Subjects and methods. The trial enrolled 30 patients and victims who had sustained an episode of severe hypoxia of mixed genesis, the severity of which was evaluated by the APACHE II scale and amounted to 23 to 30 scores with a 46 to 70.3% risk of death. The standard infusion program in this group involved the succinate-containing drug 1.5% reamberin solution  in  a  total  dose  of  800  ml.  A  comparison  group  included  15  patients  who  had  undergone  emergency  extensive surgery for abdominal diseases. 400 ml of 10% glucose solution was used as an infusion medium. Oxygen consumption (VO₂ml/min) and carbon dioxide production (VCO₂ml/min) were measured before infusion and monitored for 2 hours. Arterial blood gases and acid-base balance (ABB) parameters and mixed venous blood lactate levels were examined. Measurements were made before and 30 minutes after the infusion of reamberin or glucose solution.

Results. Infusion of 1.5% reamberin solution was followed by a significant increase in minute oxygen consumption from 281.5±21.2 to 310.4±24.4 ml/min. CO₂ production declined (on average, from 223.3±6.5 to 206.5±7.59 ml/min). During infusion of 10% glucose solution, all the patients of the comparison group showed a rise in oxygen consumption from 303.6±33.86 to 443.13±32.1 ml/min, i.e. about 1.5-fold. VCO₂ changed similarly. The intravenous infusion of 800 ml of 1.5% reamberin solution raised arterial blood buffer capacity, which was reflected by changes in pH, BE, and HCO₃. There was a clear trend for lactate values to drop in the mixed venous blood. The intravenous injection of 400 ml of 10% glucose solution caused no significant changes in major ABB indicators, which reinforced the statement that there is a difference in the metabolism of these substrates.

Conclusion. The succinate-containing drugs are able to compensate for metabolic acidosis. Their use is followed by increased oxygen consumption  and  activated  aerobic  oxidation  processes.  The  basis  of  their  antihypoxant  properties  was  thought  to  be recovered intracellular aerobic metabolic processes due to corrected intracellular metabolic acidosis and increased blood  buffer capacity.

Objective: to describe the first experience with an enteral feeding regimen used as part of combination therapy in a patient after small intestine transplantation (SIT).

Materials and methods. The results of treatment in a 48year-old male after heterotopic SIT for short bowel syndrome were given. The extent of the graft was 250 cm. The combination treatment aimed  to  restore  graft  functions  and  included  immunosuppressive,  infusion,  transfusion,  antibacterial,  antiviral,  and detoxification therapies and parenteral and enteral feeding (EF). Our elaborated EF regimen was divided into 3 steps: 1) early enteral therapy (on day 1) using a monomeric saline enteral solution and a specialized formula containing pharmaconutrients (glutamine, antioxidants, and tributyrine); 2) incorporation of a semielemental formula (on day 5); 3) use of polymeric  formulas  and  clinical  nutrition.  Laboratory,  ultrasound,  radiological,  and  endoscopic  monitoring  and  biopsy were performed.

Results. The combination treatment using stepwise EF could satisfy a patient's protein-energy needs. Restoration of histological structures in the graft mucosa was observed during morphological examination on day 7. At enteroscopy, the intestinal mucosa was pink with prominent villi, motility, and bile-colored chyme. On day 7, there was a 150-ml self-colored stool. Data confirmed that the intestinal graft restored absorption and parietal digestion. On day 30, the patient was switched to polymeric formulas and curative diet. By the discharge from hospital, on day 86, his body mass index was 23.1 kg/m².

Conclusion. The positive treatment results in the patient became possible after SIT due to improvement of surgical techniques, current immunosuppression, and a comprehensive approach to treating him in the postoperative period. Our elaborated stepwise EF regiment is an important component of combination therapy after SIT and facilitates  the  restoration  of  the  major  functions  of  the  transplanted  intestine  and  its  preparation  for  the  assimilation  of polysubstrate formulas and natural foods. 

The polymorphism of μ-opioid receptor is one of the most studied polymorphisms that affect the activity of narcotic analgesics. Despite that there are a large number of publications dealing with the problem, the obtained results are not being currently used in clinical practice. The purpose of this review is to describe the impact of this polymorphism on the perception of pain and sensitivity to narcotic analgesics. It is shown that patients with the G118G genotype of μ-opioid receptor are tolerant to narcotic analgesics and need a larger dose to achieve the desired effect than that in normal genotype. At the same time, the likelihood of side effects associated with the use of narcotic analgesics does not significantly differ between the carriers of normal genotype and those of the A118G, G118G genotypes.