[Experience in organizing medical care for the servicemen of the Baku garrison during the armed conflict of 1990]. / Opyt organizatsii meditsinskoi pomoshchi voennosluzhashchim Bakinskogo garnizona v khode vooruzhennogo konflikta 1990 goda.

The article gives a brief description of tactical and medical situation of Baku garrison during military conflict, and also the data concerning the character and the structure of sanitary losses, and the volume of medical care. Organizational, transportation, personnel and logistic problems of medical support of troops are also described. The proposals are given how it is possible to settle these problems in the preparatory period.

[Unsolved problems in the surgical treatment of complicated ulcers of the stomach and duodenum]. / Nereshennye voprosy operativnogo lecheniia oslozhnennykh iazv zheludka i dvenadtsatiperstnoi kishki.

The article generalizes an experience of a number of surgical collectives of the Military Medical Academy with the surgical treatment of complicated gastroduodenal ulcers by organ-preserving operations. The authors recommend wider use of such interventions in acute complications of ulcer disease (perforation and bleedings). It is important to abstain from performing such operations on planned patients with very high gastric secretion in order to decrease the amount of recurrences after vagotomy, to choose an adequate draining operation in stenosis. In young patients vagotomy should be combined with antrumresection.

[A titration method of determining the acidity of opaque gastric juice in emergency surgery]. / Titratsionnyi metod opredeleniia kislotnosti neprozrachnogo zheludochnogo soka v urgentnoi khirurgii.

The data presented show great practical significance of titration methods of the investigation of gastric secretion. 220 comparative determinations of acidity of the gastric juice have shown the presence of admixtures of mucus, blood and bile in the gastric content to overstate the indices of the colorimetric titration method without a practical effect on the electrometric one which is known to be more precise.

[Effect of a drainage operation on gastric secretion in patients with duodenal ulcer after vagotomy]. / Vliianie dreniruiushchei operatsii na zheludochnuiu sekretsiiu bol'nykh iazvoi dvenadtsatiperstnoi kishki posle vagotomii.

The work analyzes alterations of gastric secretion in 687 patients subjected to various kinds of vagotomy in combination with or without draining operations on the stomach for ulcer of the duodenum. Draining operations were established to decrease activity of gastric secretion. The Jaboulay gastroduodenal anastomosis proved to be less beneficial since 50% of the patients had the positive insulin test and ulcer recurred almost in 11% of the cases. Results were most favorable after vagotomy in combination with pyloroplasty after Finney and Heineke-Mikulicz. The disease recurred after these interventions in 7 and 8% correspondingly.

[Central hemodynamics in man during decompression of the lower extremities]. / Tsentral'naia gemodinamika cheloveka vo vremia dekompressii nizhnikh konechnostei.

Experiments were performed to study the effect of leg decompression in the head-down position at -15 degrees. The method of chronic catheterization was used, pressure was measured in different areas of the cardiovascular system, blood was withdrawn for biochemical analysis. The effect of leg decompression was compared with that of lower body negative pressure. Decompression produced changes in PAP and CVP that were similar in sign but different in magnitude. The decompression-induced changes in PAP and CVP were primarily determined by the area of exposure. Using previous data, a monograph was constructed to evaluate PAP and CVP variations as a function of the decompression mode and site.

[Central circulation in the healthy human being during 7 days of head-down tilt and decompression of different body areas]. / Tsentral'noe krovoobrashchenie zdorovogo cheloveka vo vremia 7-sutochnoi antiortostaticheskoi gipokinezii i dekompresii razlichnykh oblastei tela.

The effect of 7-day head-down tilt (-15 degrees) and decompression of various body parts (lower body-LBNP, upper body in the area of the hydrostatically indifferent point-UBNP, and local negative pressure applied to both calves-LNP) on central circulation was investigated on eight healthy test subjects who, for 10 days, had catheters (Swan-Ganz) implanted into the pulmonary and radial arteries. It was shown that, when calculated by square centimeter of the decompression area, the effect of UBNP on central venous pressure (CVP) and pulmonary artery pressure (PAP) was 3-4 times greater than that of LBNP or LNP. This indicates a high sensitivity of this body part to the exposure. During the 7-day study, CVP and PAP showed the most distinct changes. By the 7th hour of the head-down tilt study, CVP remained unchanged and systolic PAP increased by 5.5 mm Hg (27%) (p less than 0.05). This was paralleled by a decrease of plasma aldosterone and renin. By the 2nd day of the study, CVP and PAP were close to the pretest level; on the 3rd day, they began to decline and remained about 3 mm Hg lower than the pretest values to the end of the study (p less than 0.05). During this same period, the contractility of the right heart (the mean rate of right ventricular pressure increment) decreased by 34% (p less than 0.05) and its work by 27% (p less than 0.05). By the 24th hour after the study (the recovery period), CVP and PAP were close to the pretest values, whereas heart rate, cardiac index and oxygen tension in the mixed venous blood were significantly higher than the pretest values (p less than 0.05). The factors responsible for these changes and the potential application of the catheterization technique in biomedical investigations during real space flight are discussed.

[Surgical tactics in acute hemorrhage from the upper segments of the digestive tract]. / Khirurgicheskaia taktika pri ostrykh krovotecheniiakh iz verkhnikh otdelov pishchevaritel'nogo trakta.

Results of diagnosis and treatment of 1337 patients with esophageal and gastroduodenal hemorrhages were analyzed. The diagnostic and curative endoscopy is recommended. Variants of tactics of the operative and conservative treatment are proposed for the conditions of specialized hospitals of emergency medical service.

[Coronary circulation in healthy men during postural changes and decompression of the lower half of the body]. / Koronarnoe krovoobrashchenie zdorovogo cheloveka vo vremia postural'nykh vozdeistvii i dekompressii nizhnei poloviny tela.

The effect of postural changes (ortho- and antiorthostatic tests) and LBNP on coronary circulation was investigated in 11 healthy male test subjects. Volume blood flow velocity and pressure were measured and blood flowing from the heart was withdrawn using a Ganz catheter implanted into the coronary sinus. A thin Teflon catheter was implanted into the brachial artery. When the test subjects were transferred from the recumbent to the head-up position, their left ventricular oxygen consumption decreased by 3.2 ml/min (21%) and coronary blood flow by 23.8 ml/min (19%), while coronary vascular resistance increased by 32%. When the test subjects were transferred from the head-up to the head-down position (at -15 degrees), coronary oxygen consumption and blood flow increased by 5.5 (46%) and 45.3 (44%) ml/min, respectively, and coronary resistance decreased by 36%. In this situation the LBNP test (-30 mm Hg for 20 min) caused a reduction in oxygen consumption and coronary blood flow by 4.4 (25%) and 37.3 (25% 7 ml/min, respectively, and an increase in coronary resistance by 58%.

[Vagotomy in combined treatment of patients with stomach ulcer complicated by hemorrhage]. / Vagotomiia v kompleksnom lechenii bol'nykh iazvoi zheludka, oslozhnennoi krovotecheniem.

The nearest and remote results of using vagotomy in 80 patients with gastric ulcerous hemorrhages are analyzed. The authors recommend this operation in combination with pyloroplasty, suturing or dissection of the ulcer of the stomach.

[Central blood circulation in the healthy human being during 7 days' head-down tilt hypokinesia]. / Tsentral'noe krovoobrashchenie zdorovogo cheloveka vo vremia 7-sutochnoi antiortostaticheskoi gipokinezi.

The effect of 7-day head-down tilt (-15 degrees) and lower body negative pressure on circulation and oxidative metabolism was investigated on 13 healthy male test subjects. For 7-10 days they had Swan-Ganz catheters implanted in the pulmonary artery and a special cannula in the radial artery. The most marked changes were seen in the pulmonary artery pressure (PAP) and central venous pressure (CVP) that varied in a phase-like manner. By the 7th hour of bed rest the PAP increased significantly; this was followed by increases in the total lung resistance and the right ventricle function, as well as by a slight decrease of renin and aldosterone. Beginning with bed rest days 2 or 3 the PAP and CVP declined and remained lowered, as compared to the pretest level, till the end of bed rest. The responses to LBNP tests changed by bed rest day 2. Possible mechanisms of the above changes at rest and during LBNP tests are discussed.