[Clinico-morphological disorders of homeostasis in burns-induced shock].
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Biomedical subjects
Publications and source records attributed to V G Tepliakov.
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The functional states of the polynuclear leukocytes examined on the original experimental sepsis model have been studied. It has been shown that the bioactive factors of the microorganisms define the functional states of the polynuclear leukocytes. The features of the different forms of the sepsis are explained with such phenomenon.
Two groups of rats with experimental wound infection caused by various Ps. aeruginosa strains were investigated. The development of the disease was characterized as benign in the group infected by the first strain. Infection was presented as local inflammation. As for the second strain, the infection having features of malignancy was often presented in the form of septicopyemia. It appeared that the difference between the clinical course of the two compared groups correlated with those in humoral immunity status. The animal reaction to administration of both strains was agglutinative antibody formation. Besides agglutination, antibodies formed against the first strain caused the expressed complement-dependent lysis of bacterial cells. No lysis of bacteria of the second strain was observed.
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.
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.
Application of algimaf, a new polymeric dressing, in local therapy of burn wounds is conducive to spontaneous epithelization of surface burns and favors effective autodermoplasty in thermal burns. Cytologic studies of the wound discharge and examination of the burn wound microflora qualitative and quantitative composition indicate a high therapeutic efficacy of the dressing.
In animal experiments on rabbits the effect of hyperbaric oxygen was studied on the functional state of the myocardium, the cardiac resistance to induced peroxide lipid oxidation, the structural and functional changes in the thyroid gland and the state of microcirculation in the conditions of experimentally induced hypothyrosis. It was demonstrated that hyperbaric oxygen has a favourable effect on the state of myocardium and microcirculation.
In 200 albino rats pathomorphological changes of different organs were studied during experimental staphylococcal sepsis (from 3 to 45 days of the disease), caused by intramuscular injection of 0.15-0.20 ml suspension of microbes (10(15) per ml) in 10% CaCl2 solution. Local piemic focus occurred first, followed by bacteremia and generalized sepsis manifest with secondary piemic foci in the viscera. In the cytologic imprints early stages of piemic metastatic focus formation in liver, kidneys and other organs were demonstrated. Microcirculatory, dystrophic changes, as well as lymphoid system suppression were revealed. The authors come to the conclusion that all the signs are similar to general morphologic criteria of sepsis in humans.
The reversible MAO-A inhibitor moclobemide (5 mg/kg) was shown to prevent seizures in rats during exposure to toxic oxygen (6 ata). Benzamide derivatives increased the latent period of oxygen seizures and decreased the lethality following hyperbaric oxygenation. The range of anti-MAO activity of moclobemide and clorgyline in the rat brain and heart after toxic oxygenation was studied. It was distinct from those in control animals. Clorgyline was found to be more active in inhibiting MAO during toxic oxygenation in the heart and moclobemide-in the brain. The possibility is shown to prevent oxygen seizures not only with irreversible MAO-A inhibitors (clorgyline), but also with reversible ones (moclobemide).
Daily exposures of rabbits to the HBO (2 ata, 1 hr) enhanced activity of glutathione-peroxidase for all 28 days of exposure. Other parameters of the antioxidative defence and the contractile function remained unchanged. The 2.5-ata oxygenation sharply reduced the activity of antioxidative enzymes, the antioxidative activity of lipids, and the tissue resistance against the induced peroxide oxidation of lipids. The heart contractile function was obviously worsened. Sites of necrosis appeared in the myocardium tissue. Increase in oxygenation seems to lead to changes of adaptation of the antioxidative system, but the exhaustion of the latter's power reserves potentiates the toxic effect of hyperoxia.
Experimental staphylococcal sepsis has been examined in the model suggested by the authors. Staphylococcus aureus culture in a 10% CaCl2 solution was injected intramuscularly to 230 adult albino rats. Fundamental signs of sepsis have been revealed: increased mortality (up to 28% in rats weighing 120-140 g) from day 1 to day 45 after infection, development of local infectious foci, bacteremia, septicemia and septicopyemia. The authors describe severe dystrophic changes in septic emboli and bacterial colonies in different organs.
It has been shown in experiments on dogs that following blood replacement with a plasma substitute up to 0.5-2.5 g/100 ml Hb at an oxygen pressure of 3 at. abs., the morphological changes seen in the cerebral hemispheres, heart, liver, kidneys and lungs assume an adaptation character and are rapidly reversible. Microcirculatory disorders were found to play the leading part in the genesis of cellular changes recorded. The blood analysis data revealed the relationship between the degree of hemodilution and microvascular permeability and overall shifts in energy formation. To reduce the functional tension in the organ tissue systems, it is advisable to exercise the correction of the plasma substitute composition by which the permeability of the histohematic barrier could be stabilized. The hemodilution technique may be applied under hyperbaric oxygenation both in surgery and other fields of medicine with on object of replacing donor's blood by hemodynamic plasma substitutes.
Rabbits subjected to hyperbaric oxygenation (HBO) for one month following ascending aorta stenosis developed less distinct hypertrophy and signs of myocardial dystrophy with a more distinct enhancement of the left ventricular contractility than animals with aortic stenosis kept under normal pressure. In rabbits with heart hypertrophy developing under HBO the increasing adaptive capacity of the myocardium was accompanied by an elevation in functional reserve of the sympathetic regulation apparatus. Apparently HBO aided the development of the optimum cardiac adaptation to a high afterload.
Formation of plasmatic membrane signal ATR in target cells containing growth peptide factors have been found in various mammalian tissues including neutrophils activated by formyl-peptide. Maximal development of the plasmatic membrane ATP was observed within 3 days in neutrophils of rats with septicopyemia. Production of superoxide anion in neutrophils of these rats was the highest also within 3 days and constituted 3.7 nmol/mg of protein as compared with 1.4 nmol/mg in controls; within the subsequent periods dynamics of the superoxide anion content correlated with the rate of plasmatic membrane signal ATP synthesis. The state of receptors to formyl-peptide was altered as follows: content of their binding sites in neutrophils was distinctly decreased at the beginning of septicopyemia and continued to decrease within later periods but the receptors affinity was not altered. Thus, production of superoxide anion was not related directly to amount of receptors to formyl-peptide, while it correlated with formation of the plasmatic membrane signal ATP. The phenomenon of the signal ATP synthesis in neutrophils occurred mainly at concentrations of formyl-peptide activating phagocytosis. Other immunocompetent cells-macrophages produced also the plasmatic membrane signal ATP, 28.1 nmol/mg of protein, after stimulation with formyl-peptide and their ATP-formating activity was the highest among the target cells studied. This suggests that plasmatic membrane signal ATP is involved in membrane transduction of a signal to activation of neutrophils and macrophages.
Certain biological and biochemical differences are found after biochemical and electron-microscopic examinations between different substrains of staphylococcus and Pseudomonas aeruginosa. The conclusion is made that in the development, course and form of septic process the important role is played not only by the type of infectious agent, but by its various substrains as well.