Objective: to analyze the nanostructure of human aortic intima in atherosclerosis and demonstrate the poten tial effect of Niodex on cholesterol plaques.

Materials and methods. Samples of intima were taken from those parts of aorta, where different stages of atherosclerotic chages were obvious. Aortic samples were incubated in a solution containing cyclodextrins. A solution of NIODEX, a propylene glycol ester of betacyclodextrin, was used in the study. A layer of aortic intima was formed on the glass slide surface with polylysine. The samples were placed into the working area of an atomicforce microscope (Integra Prima, NTMDT, Russian Federation), and their surfaces were scanned. The number of imaging points was 512; and the imaging regions were as follows: 100100 μm, 20002000 nm.

Results. Classification of nanosurface objects was performed and typical fragments (craters, ridges, and trabecular fibers) were identified, and quantitative assessment of their sizes was carried out. 27 fragments were identified as growing cholesterol plaques. 16 of them measuring 900—1200 nm were identified near ridges, and 11 near craters (600—1050 nm). Niodex caused destruction of lipid spots and smoothing of the intima surface. More than a half of the 27 identified objects (15) demostrated a 30% and more decrease in size (median 340—400 nm). A 10—15% decrease was registered in 7 fragments; in the remaining 5 fragments, the decrease in the lesion size was less than 10%.

Conclusion. Raw data permit to suppose that the effect of Niodex on the aortic intima results in decceleartion and decreased intensity of atherosclerotic plaque growth on the intima fragments.

Objective: to evaluate changes in characteristics of spontaneous platelet (Pt) aggregation in patients with obstetric complications associated with hereditary thrombophilia.

Materials and methods. Blood samples were taken from 52 recently confined women on the first day after labor; at that, ethic regulations for the preanalytical phase were followed. Determination of PlA1/ PlA2 polymorphism enotype was performed by means of amplificationrestriction analysis. Geometrical characteristics of patients' peripheral blood Pt aggregation were studied by means of AFM Integra Prima. The degree of confidence of the parameters under test was determined using the ttest, and the significance level was considered valid at P<0.05.

Results. A statistical analysis of the findings demonstrated that the length of Pt aggregates in healthy pregnant women was significantly higher than that in healthy nonpregnant women at all study phases. Patients with the P1A1/P1A2 polymorphism in the GP IIb/IIIa Pt receptor gene demonstrated increased widthm height, and density of Pt aggregates. The changes were most significant during the incubation phase lasting for 15 and 30 minutes. The study of geometric parameters of different exposures demonstrated the following: the longer the incubation period, the greater the difference between geometric parameters of the aggregates (e.g. height, length, and width).

Conclusion. The analysis of obtained data demonstrated that the presence of P1A1/P1A2 polymorphism in GP IIb/IIIa Pt gene receptor contributes to the decrease in the platelet response threshold and enhances the spontaneous Pt aggregation. The imaging of aggregates provides strong evidence for the accelerated growth of the aggregates in thrombotic complications of pregnancy.

Purpose. To study urea kinetics in the body after liver resection in the experiment.

Material and Methods. Experiments were carried out on 45 white female rats weighing between 180 g and 220 g. Liver resection (LR) was performed under ester anesthesia, wherein 15—20% of the organ weight was removed. Urea content was studied in biological fluids (arterial blood, venous — v.porta, v.hepatica, v.renalis — blood, choledochal bile, urine), and tissues of visceral organs (the thyroid gland, lungs, heart, liver, kidneys, spleen, stomach, intestine) on days 3, 7, and 14 after LR.

Results. LR, while reducing the urea content in the v. hepatica blood, does not lead to similar changes in the arterial blood. This is accompanied by increased urea reabsorption in kidneys and higher v.porta blood urea content, which, depending on the postoperative time, results either from reduced urea excretion into the small intestine lumen or from its greater production by enterocytes followed by metabolite intake into the portal blood flow. The urea intake from hepatocytes into the hepatic bile ducts did not change on day 3 after LR; however, it increased on day 7 and slowed down on day 14. LR caused no changes in the gastric tissues urea content; never theless, it led to its increased content in the duodenal and colonic tissues. Without affecting the cardiac muscleurea content, LR entailed its increase in the lungs and thyroid gland on postoperative days 3, 7, and 14. At the background of absence of similar changes in the arterial blood data indicates promotion of urea production by the cells of these organs or metabolite retention therein.

Conclusions. LR not only changes urea kinetics in the portal system organs, but also activates extrahepatic mechanisms aimed at preventing development of the arterial blood urea deficit because of its abnormal intake from the resected organ into the central blood flow.

Objective. To prove pathogenically the reasonability of multimodal anesthesia in patients with lung cancer to improve the efficacy of pain management.

Materials and methods. 74 patients (59 men and 15 women) aged 46 to 60 years with lung cancer were examined and treated. 42 patients (the main group) underwent surgery under multimodal anesthesia accompanied with epidural blockade, and 32 patients (the comparison group) were subjected to a surgical intervention under inhalation and intravenous anesthesia with mechanical ventilation. The surgeries including atypical lung resection, lobectomy and pneumonectomy were performed. In preoperative, intraoperative and early postoperative periods, the systemic hemodynamics parameters were determined; adrenaline, noradrenaline, dopamine, cortisol, insulin and glucose were measured in plasma, and acidbase balance parameters — in arterial blood. Pain intensity was assessed by the visual analog scale. Data processing was carried out using Microsoft Exсel 2000, STATISTICA6.0 and Biostat software. Normality of distribution was assessed by KolmogorovSmirnov test. Since the ordered sample did not follow the normal distribution law, the data are presented as a median (Me) and interquartile amplitude (25 and 75 percentiles).

Results. It has been found that the most significant pathogenic factor in patients being operated due to lung cancer under the standard anesthesia is the expressed activation of the sympathoadrenal system due to the impact of surgical stress. This is manifested by disorders of the central hemodynamic parameters, such as metabolism, nociception and oxygen balance. In surgeries carried out under multimodal anesthesia, the minimal changes of basic homeostasis parameters are registered; these changes are shorttermed, compensated and reversible. Pain syndrome upon completion of surgery and in the early postoperative period is either absent or mild.

Conclusion. It is more expedient to perform surgeries to remove malignant tumors in the lungs under the multimodal anesthesia, because these interventions are distinguished by high traumatic rate and having a «fine line» between compensation and decompensation of the basic vital functions in the perioperative period.

It was shown in the first part of the review that the alterations of systemic hemodynamics and microcirculation in acute blood loss led to the development of metabolic disorders and cell damage. The second part of the review highlights the methods of microcirculation and tissue oxygenation investigation. The focus is on modern biomicroscopy varieties and methods based on the laser technology. In particular, we discuss a method based on the mathematical analysis of microvascular blood flow oscillations (fluxmotion) to evaluate the regulatory mechanisms of microcirculation. The features of regional blood flow and microcirculation in different vascular regions of the body in acute blood loss, as well as during the subsequent reperfusion are considered. It was shown that microcirculatory alterations in a particular organ are largely determined by the structural and functional features of its blood supply, as well as by the role of this organ in the pathogenesis of acute blood loss. These changes can possess both adaptive and pathological significance depending on blood loss stage and severity.

Prediction of neonates' critical states outcome depending on lab test findings and clinical manifestations is one of the most important and difficult problems of modern critical care medicine.

Aim of the study. To evaluate changes in lab test findings and clinical manifestations in order to create individual timelines for critically ill neonates.

Material and methods.We examined 229 neonates with a gestational age of 25—42 weeks. Babies' health was assessed daily throughout their ICU stay using 105 parameters. Six patients enrolled in the study died, 220 enrolled patients survived. We analyzed 24 quantitative attributes affected by variable factor «Outcome» (according to the univariate variance analysis) that reflects early outcomes of a critical state.

Results. The study demonstrated that the main characteristics reflecting the severity of patient's condition and determining the outcome of a critical state are such parameters of the oxygenation status as total blood oxygen concentration, oxygen delivery index, oxygenation index, oxygen consumption index, and arterial oxygen extraction tension. The study demonstrated that neonates with favorable outcomes presented a steady increase in the oxygenation status parameters with concurrent decrease in the oxygenation index. At the same time, neonates with unfavorable out comes presented a steady decrease in the oxygen status parameters along with a significant increase in the oxygenation index. We determined that the arterial oxygen extraction tension did not comply with the reference limits even in case of a favorable outcome. The study demonstrated that a decrease in the oxygen consumption index in the unfavorable outcome group reflects a decrease in the metabolic rate in patient and indicates a terminal state of the disease.

Conclusion. The assessment of tissue oxygen consumption variations with time permits to estimate the effectiveness of the intensive care, create individual timelines, and predict outcome on an individual basis.

Purpose of the study. To evaluate the role of secondary brain damage factors in activation of vascularplatelet hemostasis in traumatic brain injury (TBI).

Material and methods. In the ICU, 30 patients with complex traumatic brain injury were examined and treated. In the posttraumatic period, in patient measurement of heart and vascular tone, platelets, hemoglobin, lactate, and active forms of oxygen in the blood were investigated.

The study results have showed that damaged brain secondary factors accompanying concomitant TBI (circulatory insufficiency, hypoxia, acidosis and increased free radical formation) represent at the same time nonspecificstimuli for platelets and cells of blood vessels that consequently, cause systemic activation of the vascularplatelet link within the hemostasis system.

Conclusion. Nonspecific systemic activation of the vascularplatelet hemostasis by secondary factors in the patients with concomitant TBI is one of pathogenetic components of ischemic brain damage.