Gas exchange and pulmonary hemodynamics in obese patients during epidural anesthesia and spontaneous respiration

The function of external respiration, gas and ABB of blood, hemodynamics of the lesser circulation were studied during abdominal operations in patients with the IV degree obesity performed under conditions of epidural anesthesia with spontaneous respiration. On the basis of clinical and laboratory findings a conclusion was made on the adequacy of the method of epidural anesthesia with spontaneous respiration resulting in a considerably less amount of pulmonary complications.     

Selection of the method of renal revascularization in arteriosclerosis of the renal arteries

The work has analyzed results of 91 transaortal endarterectomies and 66 prostheses of renal arteries with the autovein. A preliminarily arterialized autovein is proposed as an autotransplant. The arterialization is achieved by inclusion of the autovein in the peripheral arterial system where the vein is gradually transformed and within 10-12 weeks its structure and biomechanical properties become closer to those of the artery of the musculo-elastic type. Preliminary arterialization excludes dilatatory changes of the autovenous transport.     

Value of the quantitative analysis of the number of natural killer cells of peripheral blood in surgical patients with suppurative-inflammatory processes

The amount of natural killer cells (NKC) was found to lessen in 87 patients with pyo-inflammatory processes. The amount of NKC became considerably greater after liquidation of the purulent inflammation focus and improvement of the patient's state. The dynamics of the course of the inflammatory process and effectiveness of treatment can be followed by results of determination of NKC.     

Radical correction of tetralogy of Fallot in infants under 1 year of age

The article generalizes the experience in surgical treatment of Fallot's tetrad in 20 infants. Radical correction of the anomaly was carried out under extracorporeal circulation and deep hypothermia with reduced volume rate of perfusion. Plastics of the conus arteriosus alone was performed in 6 patients, transanulus and the pulmonary trunk in 4 patients. Two patients died, the hospital lethality was 10%. A clinical effect was produced in all the other patients. The relation of systolic pressure in the left ventricle to that in the right ventricle was 0.56 +/- 0.1, the systolic pressure gradient between the right ventricle and the pulmonary artery was 18 +/- 4.2 mm Hg. Various degree of regurgitation at the pulmonary valve was revealed after the operation in all patients. It was maximum (34 +/- 10%) in transanulus plastics.     

Human selenium status and glutathione peroxidase activity in north-west England

Nutritional selenium deficiency disease, due to low soil selenium content, is well recognized in British livestock. The adequacy of the selenium status of 25 healthy human volunteers, 50 blood donors, 94 general medical patients and 106 allergy clinic patients was investigated in 1987/8 by measuring serum selenium concentration and platelet glutathione peroxidase activity. Mean serum selenium concentration for the entire study population was 92 micrograms/l. Significant linear correlations between serum selenium concentration and peroxidase activity indicate that a substantial proportion of both healthy volunteers and medical patients are of low selenium nutritional status. Twenty-five per cent of healthy volunteers and 50 per cent of medical patients had serum selenium values below those required for full expression of selenium-dependent enzyme activity. Deficiency of the antioxidant activities of selenium and selenium-dependent enzymes may be relevant to geographical differences in morbidity from a wide range of human disease states.     

Preventive systemic cyclosporin A in risk keratoplasty

Systemic cyclosporin A prophylaxis was applied in 18 high-risk corneal transplants. Immunoreactions occurred in three cases. They correlated with too low serum level of cyclosporin A. Two of them could be reversed by an increase of cyclosporin A dosage in combination with an intensive corticosteroid therapy. Four corneal transplants failed from persistent severe basic disease. Eleven corneal transplants remained clear during the follow-up (5-33 months). A constant trough cyclosporin A serum level of 100-120 ng/ml has been shown to exert efficient immunomodulating effects. We currently judge a postoperative prophylaxis period of 6 to 12 months with cyclosporin A to be sufficient in most high-risk cases.     

The prevalence of autonomic neuropathy in the primary glaucomas

The results of systemic autonomic nerve function studies in patients with closed-angle glaucoma and ocular hypertension are reviewed. Autonomic neuropathy has been demonstrated in 58% of patients with closed-angle glaucoma and 42% of ocular hypertensive subjects, with significantly increased prevalence in ocular hypertensives with narrow iridocorneal angles. The implications are discussed, with particular reference to the pathogenesis of raised intraocular pressure.     

Possibilities of the clinical use of a new Soviet laser device on the anterior and posterior segments of the eye

A new Soviet laser device for multiple-purpose ophthalmologic application is described. The design is based on neodymium-doped glass laser with radiation at a 1.06 micron wavelength in a Q-spoiled mode and YAG laser with radiation frequency doubling at a wavelength of 0.532 micron in continuous operation. Clinical potentialities of this laser design in the treatment of abnormalities of the anterior and posterior segment of the eye were studied in the treatment of 48 patients (48 eyes). The results evidence that the device is fit for coagulation as well as for mechanical destruction of tissue.