Non-invasive methods of examination in evaluation of cardiac reserve and contractile function of the myocardium in patients with postinfarct cardiac aneurysm

Non-invasive diagnostic procedures (electrocardiography, spiroergometry, polycardiography) were compared with selective coronarography and left-side radioventriculography in 132 patients with chronic post-infarction aneurysm of the heart, in order to demonstrate their respective diagnostic values for the assessment of coronary and myocardial reserves of the heart. It was shown that physical stress tolerance, pO2max, the oxygen debt/oxygen requirement percentage ratio could be indicative of disturbed coronary reserve, while prolonged P wave and left-atrial deviation time, the number of abnormal Q and QS waves and increased resting myocardial contractility index (above 0.550) suggested impaired myocardial contractility.     

Analysis of protein concentration in the urine of children with metabolic nephropathy, crystal-calcium crystalluria

We compared the efficacy of a routine sulphosalycilic acid method and a new technique of pirogallolic red staining for urine protein assay in children with metabolic nephropathy, crystal-calcium crystaluria. The former method was found ineffective in proteinuria diagnosis in children with metabolic nephropathy. The pirogallolic method appeared more effective as it detects microproteinuria and therefore allows accurate diagnosis, control of its treatment and finally to improve the results of therapeutic and prophylactic measures.     

Sequential urn designs with elimination for comparing K > or =3 treatments

A fully sequential procedure is proposed for comparing K > or =3 treatments with immediate binary responses. The procedure uses an adaptive urn design to randomize patients to the treatments and stopping rules are incorporated for eliminating less promising treatments. Simulation is used to assess the performance of the procedure for several adaptive urn designs, in terms of expected numbers of treatment failures and allocation proportions, and the effect on estimation at the end of the trial is also addressed. It is concluded that the drop-the-loser rule is more effective than equal allocation and all of the other designs considered. The practical benefits of the procedure are illustrated using the results of a three-treatment lung cancer study. It is then shown how the sequential elimination procedure may be used in dose-finding studies and its performance is compared with a recently proposed method. Several possible extensions to the work are briefly indicated.     

Efficacy of transcutaneous endobiliary procedures in patients with obstructive jaundice

Transcutaneous endobiliary procedures (TEP) were performed in 378 patients with obstructive jaundice (OJ). External decompression of the biliary ducts was carried out as the first stage of treatment in all the patients with OJ of various etiology. This procedure led to reduction of cholangitis symptoms and hepatic failure, improvement of general condition of the patients before radical surgery. Endoprosthesis of the bile ducts made in 121 patients allowed physiological passage of bile into the intestine and improved quality of life especially in inoperable patients with hepatic and pancreatoduodenal tumors. During external drainage in 27 (7.1%) patients dislocation of drainage of the common bile duct occurred. Postoperative lethality was 8.5%. After open surgeries 2 (1.2%) patients died.