Synthesis and neurotropic properties of nitrogen derivatives of o-carborane and (3)-1,2-dicarbaundecaborate

Pharmaceutical Chemistry Journal -     

Anesthesiologic management of clinical orthotopic liver transplantation

The first clinical experience of anesthesiological management during 6 orthotopic liver transplantations (5 primary operations and 1 retransplantation) in 2 males and 3 females, aged 20 to 52 years, is presented. The method of general anesthesia is described--the use of veno-venous bypass without systemic heparinization and rapid infusion system. Hemodynamic, temperature, metabolic and coagulologic homeostasis disturbances are analysed at different stages of orthotopic liver transplantation, especially upon reperfusion of the donor organ. The tactics of infusion-transfusion therapy, as well as correction of electrolyte disturbances and blood coagulation disorders are being discussed. Different intraoperative complications are characterized. It is concluded that anesthesiological management of liver transplantations is one of the most complex problems of modern anesthesiology which takes joint effort of a large team of specialists: surgeons, anesthesiologists, perfusiologists, transfusiologists, and laboratory assistants specializing in different areas.     

Relationship between the chemical structure and neurotropic activity in a series of nitrogen-containing derivatives of (3)-1, 2-dicarbaundecarborate

Pharmaceutical Chemistry Journal -     

The effect of the graft contraction rate on the intraoperative hemodynamics in orthotopic heart transplantation]

Intraoperative hemodynamics has been studied during orthotopic heart transplantation (OHT) in 36 recipients, aged 14 to 56 years, with spontaneous contractions of the graft. It has been established that patients with HR greater than 110 beats per min were in most cases characterized by normal central venous pressure (CVP) and venous blood oxygenation parameters. In lower HR, CVP is considerably higher and the indexes characteristic of the adequacy of cardiac output to body oxygen requirements are deteriorated. Right after OHT there is a reverse dependence between HR and CVP, with the lowest CVP values corresponding to HR intervals 101-120 and 121-140 per min. It has been concluded that tachycardia in the intraoperative period ensures a more effective function of the transplanted heart.     

The use of ultra-high doses of insulin for the treatment of severe heart failure during cardiosurgical interventions]

The experience is reviewed on the use of superhigh insulin doses 1200 to 3800 U (31.4 +/- 5.3 U/kg) for the treatment of acute heart failure in 17 patients subjected to open heart surgery. Symptoms of heart failure refractory to catecholamines and vasodilators were accompanied by marked hyperglycemia (23.1 +/- 4.3 mmol/l). It was impossible to discontinue assisted circulation. In 82.3% of patients myocardial contractility upon insulin administration improved considerably, which led to discontinuation of assisted circulation with moderate inotropic support. Possible mechanisms ensuring the efficacy of massive insulin therapy in patients with acute heart failure are discussed.