Repeated operations in gastric and duodenal ulcers

The results of repeated operations in 165 patients were studied. A second operative intervention was indicated most frequently after closure of a perforating ulcer (h = 126). The character of the second operative intervention was determined by the method of the previous operation and the complication of the ulcer for which the operation had to be repeated, the patient's condition and age, and the urgency of the surgery. The mortality rate after repeated operative interventions was 3%.     

Causes of mitral valve re-stenosis and the ways of its prevention

The authors evaluated comparatively the results of surgical treatment of mitral stenosis in 203 patients after open mitral commissurotomy (OMC) (their personal experience) and the literature data concerning 168 patients who underwent closed mitral commissurotomy (CMC). The frequency of mitral stenosis recurrences with the use of both methods was determined. OMC was on a par with CMC in safety and exceeded it in efficacy. The frequency of mitral restenosis was considerably lower after OMC than after CMC (p less than 0.05). The authors claim that the main cause of mitral stenosis recurrences is residual stenosis developing in inadequate correction of the anomaly, while the principal preventive measure is OMC which makes it possible to separate the fused commissures completely, remove the subvalvar adhesions, and restore the mobility of the cusps.     

Approach through the temporal horn of the lateral ventricle for clipping of large dorsal type basilar bifurcation aneurysms

Summary The authors describe an approach through the temporal horn of the lateral ventricle which proved to be useful for clipping of a large dorsal type basilar bifurcation aneurysms. It facilitates the preservation of the perforating arteries behind the aneurysm, because it gives sufficient working space to move the aneurysm dome. Furthermore this approach avoids many of the disadvantages of other approaches, especially the risk of iatrogenic injuries of the Sylvian or Labe's vein.     

Interrelationship between the functional state of the central nervous system and lipid peroxidation level in brain following craniocerebral trauma

The interrelationship between the functional state of the CNS and brain metabolism was studied in animals following craniocerebral trauma. Lipid peroxidation and antioxidant activity of rabbit brain were investigated a day after craniocerebral trauma. An increase in conjugated dienes, TBA-reactive products (TBARP), and fluorescent Schiff bases (SchB), and a sharp decrease in antioxidant activity in all brain regions investigated were established. The possibility of regulation of the disturbed processes by artificial alteration of the functional state of the CNS was shown. It was found that the day after stimulation of injured brain by amphetamine (phenamin) or piracetam, the values of lipid peroxidation and antioxidant activity came to the same levels as for controls. On the contrary, the depression of the CNS by phenobarbital (luminal) was not accompanied by such positive reactions. The stimulants did not possess antioxidant activity in vitro experiments on a model system. Thus, it was shown that following craniocerebral trauma, the lipid peroxidation process can be regulated by modification of the functional state of the CNS alone without special antioxidant therapy.     

Early bronchoscopic and morphological diagnostics and prognosis in thermal inhalation trauma

Thermal injury is diagnosed by fibrobronchoscopy within the first 5 days after inhalation burn trauma in 73 patients (34% of the total number of patients hospitalized during the last 2 years). Pathological changes of the mucosa with predominant multiple ulceration at different levels of the tracheobronchial tree are detected in 44% patients and in more than 70% patients with acute respiratory deficiency. These changes determine variation and severity of thermal inhalation injury in the patients, and, together with morphofunctional characteristics, provide objective basis for the early diagnostics and prognosis. Translated fromByullelen' Eksperimental'noi Biologii i Meditsiny, Vol. 124, No. 8, pp. 221–225, August, 1997     

眼窝再造联合义眼座置入术

目的评价烧伤后用全厚皮片行眼窝再造术联合羟基磷灰石义眼座置入的疗效。方法对10例由于铁水、强酸、强碱及火药烧伤引起的眼窝闭锁进行手术治疗。其中已摘除眼球者6例，有残留萎缩眼球者4例。对8例眼部烧伤患者行一期羟基磷灰石义眼座置入同时行全厚皮片移植眼窝再造术，2例为义眼座置入后二期行眼窝再造术。皮片取自上臂或大腿内侧，包裹自制眼模在置人羟基磷灰石义眼座后置入眼窝内，上下眼睑行睑缝合术，术后6～10个月剪开睑缘，定制义眼片。结果经8～36个月(平均23．2个月)的随访，皮片均成活，义眼座无暴露，无继发感染，患眼上下穹窿形成好，放置义眼片后外观满意，无义眼片自行脱出现象。结论对一些已无结膜组织的严重烧伤患者，用全厚皮片行眼窝再造术是较为有效的手术方法。     

Intraoperative dilatation of the ilio-femoral segment combined with reconstructive operations on the femoral arteries in "multi-level" lesions in patients from the risk group

The authors analyse experience in the treatment of 96 patients at an increased risk of intervention. Ischemia of the lower extremities with relatively maintained peripheral vascular bed was the main criterion of an indicated operation. The malleolar systolic pressure index of at least 0.35 +/- 0.15 was considered essential in this case. With consideration for the risk, the interventions were carried out mainly under peridural anesthesia. Intraoperative dilatation of the iliac arteries was conducted under radiotelecontrol in combination with profundoplasty, thrombendarterectomy from the femoral arteries, and femoropopliteal autovenoplasty. The efficacy of the operations was appraised by intraoperative angiography, electromanometry, and blood flow measurement. The results were studied in follow-up periods of up to 3 years. In the group of 96 patients 8 had poor results. Amputation of the extremity was performed in different periods.     

Current methods of the treatment of varicocele

The results of complex examination and treatment of 172 patients with varicocele are presented. Roentgenoendovascular occlusion of the testicular vein was performed in 52 patients with the positive result in 43 of them. The disease recurrence was revealed in control examination 6 mos later in 9 patients. A new microsurgical operation of creating the double spermatico-venous++ anastomosis, which permits to accomplish the more complete correction of venous hemodynamics in the system of the testicular vein, to reduce the traumatism of the operation, to improve the conditions for normalization of spermatogenesis, is suggested. A recurrence of varicocele after its treatment by means of the microsurgical correction occurred in 1 patient. Of the 56 women, whose husbands suffered from infertility, after microsurgical operations performed for varicocele, the pregnancy resulted in 19.