Biomedical subjects
Publications and source records attributed to R I Kaem.
The liver, kidney, skin biopsies are able to incorporate actively 3H-uridine, and the maximum rate of RNA synthesis over the hepatocyte nuclei in the peripheral zone of the biopsies corresponds to relevant rates in vivo. Only the skin biopsies were distinguished by total cell labelling. Liver, renal, skin capillary endotheliocytes can serve intertissue marker of the diffusion depth of 3H-uridine.
Clinico-laboratory studies were conducted in 46 patients with wound infection for the treatment of which carbon-dioxide laser was used, and in 78 patients who were operated on with a metal scalpel (control). It is shown that "excision" and "evaporation" of tissues took 15-45 minutes. Repeated interventions were performed in 15% of cases due to bleeding from vessels measuring 1.0-1.5 mm in diameter. After surgical debridement with a scalpel the number of microbes reduced from 10(7)-10(9) to 10(3)-10(4) per g. After exposure to the laser beam this value was 10(1) but on day 3-4 it was 10(5)-10(6). The extent of the zone of coagulation necrosis in the zone exposed to the laser beams measured up to 500 microns, and began diminishing only on day 7-9 of postoperation. Suppuration of the wounds in 56% of patients of the main group treated by operation was in conformity with the results of bacteriological and morphological studies. In the control group this index was 15.4%. It is concluded that the use of carbon-dioxide laser as a "light scalpel" with subsequent primary closure of the wound is inexpedient. Its use in preparing a wound for closure with secondary sutures has no advantages over radical surgical debridement.
An experimental model of sepsis is developed that allows one to reproduce septicopyemia and septicemia taking into account the biological properties of bacteria which determine sepsis dynamics, its form and localization of metastatic pyemic foci. The dependence of the sepsis manifestation upon the functional state of polynuclear leucocytes is revealed. The irreversibility of the process after the bacterial colonisation of the inner organs is shown a general increase of the histohematic barrier permeability facilitates the release of flora, mainly intestinal one, into the circulation and organs.
RNA synthesis in human neutrophils isolated from blood 2.5-67 hours after death of patients was studied by means of light and electron microscopy radioautography. The rate of RNA synthesis in neutrophils isolated from blood of cadavers was higher in comparison with the same parameter in neutrophils isolated from survivor's blood. The significance of this observation for resuscitation and transplantology is discussed.
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Laboratory criteria to differentiate diagnostically nonspecific aorto-arteritis with other forms of obliterating arterial diseases have been established by hemostatic, morphological and cytological investigations. Factors of plasmic hemostasis and platelet functional activity are able to indicate etiological cause of aortal lesion in noninvasive clinical examination. Identification of platelet--forming reaction type shows that nonspecific aorto--arteritis is characterized by "red" platelet formation and fibrinization of the body. Atherosclerotic stenosing proceeds by "white" thrombus formation associated with enhanced activity of platelet adhesion and aggregation.
The dynamics of sepsis development and the formation of metastatic foci have been studied using an experimental model. It has been established, that at the initial stages, the process manifests itself by bacteremia and endotoxemic shock, as well as by the complex of vascular disorders. The dependence of the formation of metastatic abscesses on the terms of the primary focus excision as well as the irreversibility of sepsis at the definite stage of infectious process have been studied. It is supposed, that the primary focus initiates the cascade activation mechanism of the factors, that determine the transition of bacteremia to the stage of septicopyemia.
The experimental Pseudomonas Sepsis was induced by various strains. Biological features of these strains were different and various forms of sepsis were induced. The authors suggested that biological features of microorganisms cause the development of different and various forms of sepsis.
Data on the experimental study of a new polymer coverage for treatment of burn wounds are presented in the article. Application of this coverage, which has a tanning and absorbing affect promotes formation of a dry eschar over a burn wound within the first two days after the accident. This allows to perform early chemical necrectomy on the 6-7th day after the accident. Microbiological investigations show that wound dissemination after application of the coverage remains low and is 3.5 +/- 0.1 per. 1.0 g of the tissue.
Time course of burn wound healing was studied in 32 patients with severe thermal trauma during tube hyperalimentation (TH). Similar study was conducted in 20 patients of the control group who did not receive TH. Early inclusion of TH in the complex of therapeutic measures stimulated some of the links of burn wound histogenesis: the formation of the demarcation swelling and rejection of the necrotic tissue occurred sooner, the leucocytic-macrophagal reaction was activated, and granulation and epithelialization processes were intensified. Thus, the use of the TH method in patients with burns makes it possible to conduct active surgical tactics for restoration of the lost skin area successfully as a result of which they recover within a shorter time than the patients of the control group.
Activated-charcoal cloth and dressings product based upon this material were applied for covering burn wounds. As a control served a gauze dressings with greases and solution topical drugs. The healing of deep thermal burns of 3rd degree on rabbits studied by a histological method was differed by a rapid decreasing of inflammation reaction, active epithelialization and soft scar formation. A clinical use in 15 burned patients was shown that in combination with enzymatic and antimicrobial drug solutions these materials accelerate healing and epithelialization of superficial burn wounds and improve treatment of deep burn wounds before autodermoplasty.
Rat granulation tissues were histologically and electron radioautographically examined at Days 7, 20, 30, 40, 53, and 60 after making a 3 X 4-cm2 wound in the back. During the entire period of cicatrization, alterations were shown to occur in the capillaries, as manifested by destructive changes in endotheliocytes, break in their contacts, thinning of the capillary wall with occasional lacerations, disintegrity of the basal membrane and, finally, vessel-composing cell dissociation and departure, as well as unusual arrangement among other cells and fibrous structures. On the basis of the findings it is proposed that the known diminished numbers of vessels during granulation tissue maturation involves not only disappeared vessels due to their progressive dystrophic changes, but the described unusual capillary alterations whereby the vascular wall cells are gradually converted to the cellular elements freely located in the interstitial tissue.
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The authors have developed the method of investigating the interaction between neutrophil leukocytes and macrophages using a modified model of experimental peritonitis by Gallily and Feldman. The results of electron microscopy studies with quantitative assessment of phagocytosis allowed to demonstrate the sequence of staphylococcus phagocytosis in the peritoneal cavity of rats during the development of experimental peritonitis as well as the interaction between neutrophils and macrophages.
Granulation tissue was examined in rats on the 20th and 40th day after wounding of the back. It was shown that by both the 20th and the 40th day the vessels with impaired typical structure could be revealed together with the normal ones in the granulation tissue. Specific rearrangement was observed in the structure of these vessels, consisting in the impairment of their wall integrity, separation of the constituent cells and their free position among the other cells and fibrous structures. This process is especially marked by the 40th day. 3H-thymidine was actively incorporated by some fibroblasts and rather often by the cells of both normal and degenerating vessels. The authors suggest the existence of an earlier unknown phenomenon of transformation of capillary vessels, common for both normal dermal and reparative processes after injury. The essence of the phenomenon consists in the fact that small dermal vessels get permanently disintegrated and are included into the composition of cellular elements of the interstitial tissue, and form again, providing for the physiological regeneration of dermal cells and fibrous structures.
The work was aimed at the elucidation of mechanisms of pathogenetic prevention of acute experimental pancreatitis induced according to the method of Arai. Pathological and biochemical examinations have shown that the application of PNA synthesis inhibitor 5-FU and cellular and intracellular membrane stabilizer-intralipid, infused at the beginning of the experiment, prevented the development of acute purulent pancreatitis.
The physico-chemical testing of charcoal cloth by means of adhesion and sorption techniques was performed. It was found that charcoal cloth with optimum activation degree can be used as dressing material. The morphological studies have shown an insignificant soft tissue response to activated charcoal implant in experimental animals and its in vivo stability at least for 2 months. It can be concluded that sorption activity of carbon fibers in respect to model low molecular substances can serve as a criterion of charcoal cloth selection for the application to burns and wounds.
The data obtained show that a great amount of deformed red blood cells, i.e. ovalocytes, cristate-shaped cells appear in the peripheral blood of patients with severe cutaneous burns during shock. In the most severe shocks a dramatic increase in degenerative forms of red blood cells in the blood has been observed. These are spheroids and spheroechynocytes frequently with impaired matrix structure. A correlation has been established between the progressing shock severity and the number of degenerative forms of red blood cells in the blood. Reversible changes of platelet fine structure were also noted.