Архив 14 Январь 2010

V.V.Mekhedko, E.I.Nazarov
National Medical Academy of Postgraduate Education named after P.L.Shupyk,
All-Ukrainian association of ozone therapists and manufacturers of the equipment.
Research-and-production enterprise Econika, Ukraine,
www.ozonetherapy.org
Prolapsus of internal genitals gives up to 15 % among indications to surgical treatment of women in gynecologic hospitals of Ukraine. The tactic peculiarity in management of patients in the postoperative period is prevention of inflammatory complications as the rate of such complications makes up to 25 %. Usually various antiseptics are applied for sanitation of vaginal postoperative wounds, but for today such preparations are not so effective, causing allergic reactions and irritations, and do not influence local immunity of a wound.
The aim of the work is to study the effect of the ozonized olive oil on local immunity of a vaginal postoperative wound in women in whom extirpation of the uterus through the vagina have been performed on the basis of laboratory investigations.
In order to study reparative processes in the vaginal postoperative wound and a condition of local immunity we took discharge from the vagina before surgery, then wound secretion was taken from the vagina on ??, , V, V day after surgery for determination the amount of secretory immunoglobulin A (SIgA), as well as washouts from the vagina before surgery and on the 7th day after surgery – for studying phagocytosis activity and a level of immunoglobulins A, M, G by a method of radial immunodiffusion by Manchini et.al. [1].
Depending on the method of treatment of the vaginal postoperative wound the patients have been divided into 2 groups. The first, basic group, consisted of 30 patients who were made applications of the ozonized olive oil to the vaginal wound prepared by barbotage of the olive oil with ozone-oxygen mixture with ozone concentration of 50 mg/l for 60 min. The second, control group, comprised 30 women who have been made sanitation of the vaginal postoperative wound by usual antiseptics.
While investigating a condition of vaginal local immunity of women before surgical intervention, we found out that the amount of immunoglobulins, a level of phagocytic number, phagocytic index, and values of Ig G, A, M did not differ in washouts from the vagina in both groups.
??In the basic group of women contents of Ig A became by 18 %, IgG?  by 9 % higher than in the control group on the 7th day after surgery with simultaneous reduction of IgM by 33 %. Phagocytic index of neutrophils in wound exudate was considerably higher in the basic group, against the background of application of the ozonized olive oil? by 57 % in comparison with the control group, and phagocytic number was higher by 51 % accordingly
Before surgical treatment the values of secretory immunoglobulin A did not differ essentially in both groups. Against the background of application of the ozonized olive oil to the vaginal wound the amount of SIgA after operation increased by 20 % in comparison with the control group on the 1st day, on the 3rd day – by13 %, on the 5th day – by22 % and on the 7th day – by 15 % ??onclusions.
? 1. We received confirmation of the positive effect of the ozonized olive oil on local immunity that had caused additional migration of immunocompetent cells in the postoperative wound.
2. Increased level of secretory immunoglobulin A in wound secretion which positively affected the course of the wound process confirms immunomodulating effect of the ozonized olive oil. Application of the given medical complex also had the expressed action on dynamics of phagocytic number and phagocytic index.
? Thus, advantage of the method of treatment of vaginal postoperative wounds with the ozonized olive oil before treatment by traditional antiseptics consists in acceleration of reparative processes in the wound and immunostimulating effect. It allowed to recommend it for application in treatment of postoperative wounds in gynecologic departments.
The literature:
1. Mancini G., Carbonara A., Heremans I. Immunochemical quantitation of antigens by single radial immunodiffusion // Immunochemistry.?  1965.?  V. 2. p. 235-254.

V. V.Mekhedko, E.I.NazarovNational Medical Academy of Postgraduate Education named after P.L.Shupyk,
All-Ukrainian association of ozone therapists and manufacturers of the equipment.
Research-and-production enterprise Econika, Ukraine, www.ozonetherapy.org
As it is known, ptosis and prolapsus of the internal genitals make up to 28 % in structure of gynecologic diseases. The basic method of treatment of this disease is surgery. But microbic contamination of the operative wound occurs during surgical intervention, and the rate of postoperative inflammatory complications has no tendency to reduction and makes from 7 up to 25 %. The basic method of prevention of such complications is sanitation of postoperative wounds by antiseptics, but researches of efficacy of their application have shown their insufficient effect We have developed and introduced into practice a method of treatment of vaginal postoperative wounds with the ozonized olive oil which was prepared by barbotage of 100 ml of oil with ozone-oxygen mixture for 120 min with ozone concentration of 50 mg/l. We have applied the prepared ozonized oil in the form of applications to a vaginal postoperative wound daily, from the end of the operation up to discharge the patient from hospital.
The aim of the work is study of general immunity condition in patients with ptosis and prolapsus of the internal genitals who are preparing for surgery and changes in the postoperative period in treatment of wounds by traditional antiseptics and with application of ozone therapy.
To control efficacy of treatment womens condition of general immunity has been studied before operative treatment and on the 7th day of the postoperative period [1, 2].
The first, control group, comprised 30 women in whom sanitation of the vagina after surgery was made by antiseptics. The second, basic group was made by 30 patients in whom the ozonized olive oil was applied to the wound. The group of comparison was made by 20 women of the corresponding age without genital prolapsus.
While investigating the immune status of women with genital prolapsus before surgery we have found impairments of immune homeostasis which was determined by -lymphopenia (reduction of D3 + 1.4 time), decrease in the level of -suppressors (CD8 +) 1.3 time, B-lymphocytes (CD22 +) 1.2 time and natural killers (CD16 +) on an average 1.4 time in comparison with healthy women. Parameters of humoral immunity have also been lowered: serum IgG?? 1.7 times; IgA 1.6 times and IgM 1.7 times in comparison with healthy women that were evidence of formation of secondary immune insufficiency in women with genital prolapsus. Levels of circulating immune complexes, phagocytic index and phagocytic number were almost identical to those of healthy women.
On the 7th day after surgery a group of women where ozonized olive oil was applied to the vaginal wound were observed to have an increase in practically all parameters of cellular and humoral immunity: -lymphocytes (CD3 +) have increased by 14.7 %, helpers (CD4 +) by 12.0 %, suppressors (CD8 +) – by 25 %, B-lymphocytes (CD22 +) by 43.5 % and natural killers (CD16 +) by 41.7 %. Along with growth of amount of B-lymphocytes their functional activity increased too the amount of serum IgG has grown by 6.2 %, Ig by 21.1 %. Parameters of phagocytic index and phagocytic number reliably increased as well. Such immune response confirms the fact that stimulation of the immune response of the mucous membranes can result in stimulation of immune mechanisms of protection both in the mucous membranes and all over the organism. There were no positive dynamics observed in using the traditional methods of treatment of postoperative wounds by antiseptic preparations. It should be noted that healing of the postoperative wounds in women of the basic group occurred by a primary intension, in the control group complications were observed in 20 %. Hospital stay of patients of the basic group with application of the ozonized olive oil was by 2.7 days less after surgery than of the controls.
Conclusions.
On the basis of analysis of the results obtained, we have received confirmation of the positive effect of the ozonized olive oil on general immunity due to significant restoration of parameters of cellular and humoral parts of immunity.
Thus, advantage of the method of treatment of vaginal postoperative wounds by applications of the ozonized olive oil in comparison with traditional methods shows that besides acceleration of wound healing process, there is an improvement of parameters of general immunity that allowed to recommend it for application in treatment of postoperative wounds in gynecologic departments.
1. McCluskie M.J., Davis H.L. Mucosal immunization With DNA vaccines//Microbes Infect., 1991 – 1, P. 685??- 698.
2. Mancini G., Carbonara A., Heremans I. Immunochemical quantitation of antitgens by singl radial immunodiffusion // Immunochemistry. 1965. V. 2. p. 235-254.

E.I.Nazarov
Scientific-industrial venture Econika, Odessa, Ukraine

Keywords: ozonetherapy, arteriovenous difference, blood oxygen.

A bad distribution of methods of objective evaluation of physiological effect of ozone on the organism is one of the significant problems of ozone therapy. The given paper presents the preliminary data of using the method of express-measuring of venous blood saturation with oxygen as an index of completeness degree of the ozone therapy course.
We have made a conclusion being based on the literature review analysis that the most characteristic effect of ozone on the organism is its influence on the oxygen metabolism (OM). There have been described three main mechanisms of ozone influence on OM: 1) decreased hemoglobin affinity with oxygen (Rokitansky O., 1982); 2) decreased microviscosity of the erythrocyte membrane; 3) vasodilatation by NO-syntase activation (Gustov A., Kotov S., 1992). It is evident that these factors should firstly influence on oxygen transport in the distal parts of the arterioles, gas exchange in the tissues and cellular respiration. There is a convenient integral index of tissue oxygen intake ??? venous blood saturation with oxygen (VBS). In contrast to arterial blood saturation (AVS), VBS is extremely sensitive to parameters of the erythrocyte membrane, constant of hemoglobin affinity with oxygen, oxygen exchange intensity in tissues and micropearmiability of the arterioles.
To measure VBS level we have constructed a device that measures the level of oxyhemoglobin (HbO) and hemoglobin (Hb) in the venous blood. VBS is calculated by the formula OH/(OH+H). The work of the device is based on the principle of two-ray spectroscopy. The device is a part of the apparatus ???BOZON-AHTMO(produced by SIV Econika) for automatization of the autohemotherapy major (AHTM) process. This device takes a patients blood automatically, ozonizes it and returns the ozonized blood to the patient. The duration of the autohemotherapy major procedure is 10-15 min. The device display shows concentration values of Hb, HbO and VBS as well as partial oxygen pressure in the venous blood (POPV). POPV is calculated by the Hills equation for pH=7.4. The paper presents data in the units of POPV for pictorial presentation. The partial oxygen pressure in the arterial blood?  POPA was evaluated according to the indications of the device NONIN-9500The Figure 1 presents typical examples of POPV registration of patients??? blood during the course of AHTM. The arterial blood saturation with oxygen was within 95-98% in all patients and wasnt practically changed during the ozone therapy. According to the Hills equation this value corresponds to POPA 97 mm Hg. On the contrary, the value of VBS and POPV undergoes considerable changes. As an example we present the POPV dynamics in practically healthy elderly man (Fig.1). It shows moderate age changes of POPV. Three sessions of autohemotherapy (100 ml of blood, the ozone dose is 4 mg) practically returned POPV to the norm. The arteriovenous difference of oxygen pressure (AVOP=POPA-POPV) increased from 39 to 52 mm Hg, i.e. by 33%. At the level of self-evaluation the patient notes sharp improvement of tolerance to physical exertions and life quality. The second patient with a diagnosis of hereditary peroneal amyotrophy of Charcot-Marie noted episodic refusals in setting leg muscles in motion before treatment that were accompanied by falling down, pain and paresthesia in the legs as well as distal hyposthesias.
It is seen in the Figure that the disease is characterized by sharp reduction of OM. Before treatment AVOP was 26 mm Hg. The figure shows that the course of autohemotherapy major consisting of 5 procedures caused normalization of POPV. The number of the ozone therapy procedures was determined like in the first case from the dynamics of POPV normalization. On the whole AVOP increased to 50 mm Hg (i.e. by 92%) after the course of the ozone therapy. Normalization of POPV was accompanied by reduction and disappearance of pain in the legs and gait improvement. Episodes of ataxia were not repeated during the course of the ozone therapy. The analysis made by the end of a month???s interval since starting treatment showed some increase of VBS. In future it is intended to manage the patient by the course of peroral intake of the ozonized distillate with two month???s interval between the courses. Each course consists of 5 intakes of 200 ml of the ozonized distillate with a concentration of 15 mg/l. Such application proved to be correct while using it in one of the patients relative suffering from the same hereditary disease. The follow-up period was 2 years. The patients condition was satisfactory during this period.
On the whole we consider that the application of the devised measuring device for VBS may improve considerably the planning of the ozone therapy course and optimize the course as to the periodicity and number of the ozone therapeutic procedures.

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