Emergency surgery in complicated forms of stomach cancer in middle-aged and elderly patients

The data on the treatment given to 312 cases of stomach cancer at city district hospitals in Leningrad were evaluated: 243 patients were more than 60 years old, concomittant pathology was apparent in 231 cases, 252 patients were hospitalized to avoid a fatal outcome and 161 patients were urgently operated on for such complications of stomach cancer as bleeding, perforation, peritonitis, and obstruction. Optimal extent of intervention was not determined in some cases due to the extremely poor condition of the patient, insufficient competence of the operating team and inadequate equipment. Radical surgery was performed in 31 cases, palliative resection--11 and other palliative and tentative procedures in 119 cases. The highest postoperative lethality rate (30.9%) was recorded in cases of minimal intervention limited to suturing of vessels and perforations as well as peritoneal cavity draining. Postoperative lethality was reduced to 15.5% and the same conditions whenever radical surgery, palliative resection or interventions eliminating complications by removing the primary cause were carried out. Removal of primary tumor eliminated complications radically, lowered postoperative mortality rates and improved the end results of treatment.     

Simultaneous operations in surgical practice

Simultaneous operations (SO) is an actual problem of abdominal surgery. Two-three surgical diseases can be treated simultaneously thus shortening the total period of the patient's staying at hospital, increasing the economical efficiency of the treatment. An analysis of 192 SO on 94 patients and of 42 laparoscopic SO has been made. Considerable difficulties in performing planned surgical care due to specific conditions of the region make the SO in the Amur regional clinic a perspective method of improving the population health and prophylactics of progressing surgical diseased in the Amur oblast.     

Behavioral Control of Respiration in Sleep

Three experiments are presented involving behavioral control of sleeping respiration during all-night sleep recording. Probability and latency of the breathing response to an auditory signal revealed that control over sleeping respiration was obtained in all sleep stages and was maintained over several nights. This control was especially marked when failure to respond was punished (contingency procedure) by increasing the intensity of the signal (Experiments 2 and 3). Few awakenings occurred to the signal but signs of brief arousal (bursts of alpha activity, increases in EMG activity, EEG “speeding”) often accompanied the behavioral response. Overall sleep patterns were only minimally disrupted by the procedure. Demonstrating behavioral control over sleeping respiration may be a promising step toward the development of behavioral therapies for certain sleep apnea disorders and hypoventilation syndromes.     

Behavioral responsivity during recovery sleep

Previous research has shown that REM-deprived subjects are more likely than non-REM-deprived subjects to perform an operant response during subsequent REM sleep when punishment (full awakening) for failure to respond was used. The present study used the same punishment procedure while attempting to extend these findings to other sleep stages. Response latencies were compared for six subjects under each of two conditions: Normal sleep occurring from 2300 to 0700 and recovery sleep occurring from 0700 to 1300 after 24 hr of continuous wakefulness. Alpha activity, EMG increases, stage shifts, and body movements were assessed to determine the amount of arousal associated with behavioral responding under both conditions. In general, response latencies lengthened during recovery sleep indicating a diminished ability to respond while no differences in arousal were evident.     

Emergency operations in complicated forms of cancer of the colon

Direct outcomes of 215 urgent operations for complicated forms of carcinoma of the colon were analyzed. Operations for acute ileus were performed in 147 patients, for perforation of the bowel and peritonitis in 45 patients, for profuse intestinal bleedings in 23 patients. The lethality after the urgent operations was 32.5%. Operations with the removal of the primary tumor give better direct and remote results.