[The effect of an extracranial occlusive lesion of the branches of the aortic arch on the status of the intracranial circulation]. / Vliianie ékstrakranial'nogo okkliuzionnogo porazheniia vetvei dugi aorty na sostoianie vnutricherepnogo krovoobrashcheniia.

Unilateral occlusion of extracranial cerebral arteries results in asymmetric intracranial flow rate against unaffected regional tissue circulation. Multiple occlusions entail reduction of intracranial circulation even in satisfactory collateral circulation. Reduction of tissue cerebral circulation occurs in well-defined occlusive processes with decompensated collateral circulation in the absence of carbogenic vascular responses. Co2 reactivity may serve a criterium of collateral circulation status and a positive prognostic sign in surgery planning.

[Regional cerebral blood flow as dependent on the nature of the occlusive lesion of the branches of the aortic arch]. / Sostoianie regionarnogo mozgovogo krovotoka v zavisimosti ot kharaktera okkliuzionnogo porazheniia vetvei dugi aorty.

A 133Xe radionuclide investigation was employed for examination of regional cerebral circulation with 5% carbogen mixture loading in patients with occlusions of the aortic arch major arteries. It was established that a positive response to carbogen mixture inhalation indicates a compensated cerebral circulation irrespective of the arterial lesion type and number. The negative vascular response is associated with uni- or bilateral reduction of the regional cerebral circulation depending on the type and severity of the arterial involvement.

[The function of the heart ventricles in patients with a lesion of the aortic arch branches]. / Sostoianie funktsii zheludochkov serdtsa u bol'nykh s porazheniem vetvei dugi aorty.

Radionuclide equilibrium ventriculography was used to examine general and regional ejection fractions and velocity characteristics for both cardiac ventricles in 28 patients with occlusions of the aortic arch branches consequent to aortic arteritis of atherosclerosis. In nonspecific aortic arteritis (NAA) even young patients have myocardial dysfunction comparable to that in the elderly with atherosclerosis. However, as shown by the nitroglycerin test, these patients preserve functional reserves of the myocardium. Right ventricular hyperfunction observed in NAA patients may result from increased postload due to possible hypertension. The above myocardial shifts should be considered when deciding on reconstructive surgery on the aortic arch branches.

[Radiodiagnosis of echinococcosis of the lungs]. / Luchevaia diagnostika ékhinokokkoza legkikh.

The paper is devoted to analysis of radio-diagnostic findings of 79 patients with parietal round pulmonary formations. All the patients were investigated by x-ray and ultrasound, perfusion scintigraphy of the lungs with a postural test was performed in 43 of them. Diagnostic x-ray and echographic methods were compared and evaluated in terms of defining the origin of pulmonary formations. The origin of pulmonary formations was established by x-ray in 50 of 79 patients (63.3 per cent) whereas ultrasound findings proved correct in 74 of 79 patients (93.6 per cent). Perfusion scintigraphy can be recommended to patients with pulmonary echinococcosis only for limited indications when a necessity arises to assess the lesser circulatory state in terms of patients' functional operability.

[Roentgeno-endovascular dilation of aortic coarctation]. / Rentgenoéndovaskuliarnaia dilatsiia koarktatsii aorty.

The potentialities of roentgeno-endovascular dilation (RED) of various types of coarctation and aortic stenoses were studied in 12 patients aged 9 to 27. RED was performed by two Grüntzig's catheters with balloons not less than 7 mm in diameter. The main criterion of RED efficacy was a gradient of systolic pressure which was on the decrease by 25-40 mm Hg after using one catheter, and by 40-70 mm Hg after using both catheters. The same method was applied to dilation of stenosis of the abdominal aorta. The proposed method is low invasive and most effective in patients with aortic segmentation of segmental type, and makes it possible to avoid in many cases surgical intervention.

[Radionuclide diagnosis of interstitial pulmonary edema]. / Radionuklidnaia diagnostika interstitsial'nogo oteka legkikh.

Perfusion scintigraphy of the lungs has shown that a reverse direction of postural reactions of the pulmonary blood flow is observed in patients with mitral valvular disease: perfusion of the upper lung rather than the lower lung increases. It is accounted for by the action of gravitation on capillary hydrostatic pressure resulting in the localization of interstitial edema in pulmonary venous hypertension mainly in the lower lung, its microcirculatory bed being compressed and the blood flow redistributed to the opposite upper lung. Therefore successive perfusion scintigraphy of the lungs in the vertical position and in the lateral position with a RP administered twice, can serve as a sensitive test for diagnosis of interstitial lung edema in various pathological conditions.

[Dynamics of reserve possibilities of the cardiorespiratory system and pulmonary perfusion after surgical correction of congenital heart defects with arteriovenous blood output]. / Dinamika rezervnykh vozmozhnostei kardiorespiratornoi sistemy i legochnoi perfuzii posle khirurgicheskoi korrektsii vrozhdennykh porokov serdtsa s arteriovenoznym sbrosom krovi.

The dynamics of spiroveloergometric parameters and perfusion scintigraphy of the lungs with a postural test in 129 patients with congenital heart diseases were studied before and at different terms after surgical correction of the disease. It was established that main spiroergometric parameters were improved within the period from 3 to 6 months. However, normalization of physical working ability in the group of women took place about one year later than in men.

[Indicators of hepatic and intracardiac hemodynamics in the surgical treatment of liver cirrhosis]. / Pokazateli pechenochnoi i vnutriserdechnoi gemodinamiki pri khirurgicheskom lechenii tsirroza pecheni.

Under analysis are results of operative treatment of 54 patients with cirrhosis of the liver. Most satisfactory hemodynamic results were obtained after endovascular embolisation of the splenic artery as the increased general hepatic blood flow and simultaneously decreased splenic blood flow, better indices of intracardiac hemodynamics. The method of peritoneoatrial shunting is most perspective in patients with cirrhosis of the liver at the stage of decompensation of portal hypertension. But possible overloading of the heart must be borne in mind.

[Radionuclide and ultrasound studies in liver cirrhosis with portal hypertension]. / Radionuklidnoe i ul'trazvukovoe issledovaniia pri tsirroze pecheni, s portal'noi gipertenziei.

Combined radionuclide and ultrasonic investigations (USI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation were used for determination of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of protal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis.

[Background correction in inhalation scintigraphy of the lungs using 133Xe]. / Korrektsiia fona pri ingaliatsionnoi stsintigrafii legkikh s 133Xe.

Based on the regularity of decreasing the blood volumes from the internal edge of the lung to its periphery the authors proposed a method of gradient background correction in inhalation scintigraphy of the lungs with 133Xe. The background is detached on each image line separately for the right and left lungs. Software was developed for the implementation of this technique of background correction for any computer with a FORTRAN-IV translator.

[Echography and cholescintigraphy in the diagnosis of calculous cholecystitis]. / Ekhografiia i kholestsintigrafiia v diagnostike kal'kuleznogo kholetsistita.

The authors note high significance of results of echocholescintigraphy in diagnosis of acute and chronic calculous cholecystitis. Preoperative echographic diagnosis of destructive changes in the gall bladder wall was shown to be possible.

[Scintigraphic study of pulmonary blood flow in congenital heart defects with left-to-right shunts]. / Stsintigraficheskoe issledovanie raspredeleniia legochnogo krovotoka pri vrozhdennykh porokakh serdtsa so sbrosom krovi sleva napravo.

A scintigraphic study of the lungs in 107 patients suffering from congenital heart defects with left-to-right blood discharge has demonstrated that disorders of pulmonary flow distribution are a common finding in cases of open ductus arteriosus and interventricular septum defects. They develop due to the hemodynamic effect of shunted blood current to the pulmonary artery and intensify as pulmonary hypertension progresses. Irregular pattern of pulmonary flow affects the efficiency of gaseous exchange and determines functional severity of the disease together with pulmonary hypertension and the extent of blood discharge.

[Diagnostic importance of radionuclide scintigraphy of the lungs in mitral stenosis]. / Diagnosticheskoe znachenie radionuklidnoi stsintigrafii legkikh pri mitral'nom stenoze.

The author shows close correlation between the degree of regional redistribution of the pulmonary blood flow using the radionuclide scintigraphy data and a mean pressure value in the left auricle and pulmonary artery in patients with mitral stenosis. In the course of disease development the index of upward-downward blood flow redistribution and the value of mean pressure in the pulmonary artery showed an increasing degree of correlation that indicated the development of the angiospastic component. A tendency to irregular growth of vascular resistance of the right and left lung was demonstrated. Blood flow deficiency in the right lung observed in these patients that depended on the degree of blood pressure elevation in the pulmonary artery, pointed to the predominant growth of right lung resistance.

[Regional pulmonary ventilation and blood flow in patients with mitral valve stenosis according to radionuclide study]. / Regionarnaia legochnaia ventiliatsiia i krovotok u bol'nykh mitral'nym stenozom po dannym radionuklidnogo issledovaniia.

It is shown, on the basis of ventilation and perfusion scintigraphy, that marked pulmonary flow redistribution from basal to apical departments, combined with relatively normal distribution of ventilation volumes, is a regular feature of mitral stenosis combined with pulmonary hypertension. The quantitative assessment of the intensity of pulmonary perfusion redistribution can be used as a measure of pulmonary hypertension. Also, a right-to-left unbalance was established in the pulmonary flow distribution, manifested as hyperperfusion of the left lung.

[Pulmonary blood flow in tetralogy of Fallot based on radioisotope scanning data]. / Sostoianie legochnogo krovotoka u bol'nykh tetradoi Fallo po dannym radioizotopnogo skanirovaniia.

The perfusion scanning of lungs in 26 patients with Fallot's tetrad has shown disease to be accompanied in most cases by the disturbed distribution of the pulmonary blood flow. The authors have shown that its manifestations are either a unilateral deficiency of perfusion throughout one of the lungs or regional defects of perfusion restricted by part of the lung. Scanning of the lungs by I13 albumin microaggregate proved to be useful in the assessment of the degree of the intracardiac output of the venous blood into the arterial blood flow.