[Balloon angioplasty of the radial artery in critical hand ischaemia]. / Ballonnaia angioplastika luchevoi arterii pri kriticheskoi ishemii kisti.

Presented herein are the results of treatment of five 63-to-72-year-old patients (four men and one woman) with critical upper limb ischaemia, which is one of rarely encountered pathologies. All patients suffered from type 2 diabetes mellitus. Two of them had end-stage renal disease (ESRD) and for 2 years were on haemodialysis. Four patients had gangrene of 1 finger and one patient had gangrene of 2 fingers. The main diagnostic methods included duplex scanning with measuring the gradient of pressure between the humeral and radial arteries, and MSCT angiography. The patients with ESRD received conservative therapy with the use of prostaglandin E1 and after limitation of necrosis sustained amputation of the fingers. Three patients were successfully managed by recanalization and balloon angioplasty of the radial artery's occluded segment. The patients underwent follow-up examinations at 1, 6, 12, 18 and 24 months. During this period two patients with ESRD died. They had no relapses of critical ischaemia of the hand but developed gangrene of toes and were both subjected to successful balloon angioplasty of the crural arteries. One patient at 18 postoperative months was found to have reocclusion of the radial artery with hand pain at rest. He was subjected to successful repeat balloon angioplasty of the radial artery. CONCLUSION: Timely restoration of blood flow in this situation reduces the frequency of amputation. Percutaneous balloon angioplasty may become a method of choice in treatment of patients with critical hand ischaemia caused by occlusive lesions of arteries of the forearm.

[Results of reconstructive surgery for carotid artery occlusion in ischemic stroke survivors].

The authors report results of reconstructive surgery in 316 patients with carotid artery (CA) occlusion operated after ischemic stroke. Its efficiency is estimated with reference to the degree of neurologic deficiency and treatment schedule. The results confirm effectiveness of reconstructive surgery on CA for the prevention of stroke relapses and promotion of surgical rehabilitation.

Diagnostics and surgical treatment of pathological deformation of the carotid arteries.

The most effective way of preventive maintenance of sharp and chronic disturbances of brain blood circulation are reconstructive operations on branches of an arch of an aorta. Pathological deformation meets far quite often in clinical practice and is the reason of cerebral-vascular insufficiency of various degree, including ischemic strokes. Research objective - improvement of diagnostics and tactics of treatment of the patients with pathological deformation of carotid arteries. 132 patients have entered into research with various kinds of pathological deformation. Have been made 143 reconstructive operations. Indications to operative treatment revealed by means of duplex investigation and angiography. At the same time defined hemodynamic changes on carotids with an obligatory estimation of a condition intracranial vascular channel. By the indication to operative treatment of the given category of patients it is considered: hemodynamic significant pathological deformations of an internal carotid, pathological deformation of an internal carotid in a combination with embologenal plaque, pathological deformation of an internal carotid with all types of atherosclerotic plaques narrowing a vessel gleam on 60% and more, in the presence of symptoms of cerebral-vascular insufficiency, especially at transient ischemic attacks and at an ischemic stroke. Positive clinical effect has been reached at 100% of patients with I and II degree chronic vascular-brain insufficiency, at 80,6% of patients with chronic vascular-brain insufficiency of III degree, and at 45,8% of patients which in the anamnesis have transferred sharp infringement of brain blood circulation.

[Resection of the stomach with excision of the small curvature and selective vagotomy in primary and reconstructive surgery of gastroduodenal ulcers]. / Rezektsiia zheludka s issecheniem maloi krivizny i selektivnoi vagotomiei v pervichnoi i rekonstruktivnoi khirurgii gastroduodenal'nykh iazv.

Experience in surgical treatment of 261 patients with complicated gastroduodenal ulcer is summarized. A new improved method of resection with subtotal excision of the small curvature and selective gastric vagotomy, creation of a gastric stump in the form of a proximal reservoir and distal tubular canal was used. In 144 cases this method was performed as repeated or reconstructive surgery in post-vagotomic ulcers. The follow-up was 5 years, long-term results were evaluated in 166 patients with the Visik scale. Excellent and good results were seen in 151 (91%) patients, satisfactory -- in 13 (7.8%), and a poor result (recurrence of ulcer) -- in 2 (1.2%) patients.

Roentgenoendovascular treatment of Conn's syndrome.

This paper describes the first in the world experience with the treatment provided in 1990 to a female patient suffering from hypereldosteronism associated with adenoma of the left adrenal. The treatment consisted in endovascular destruction of the adrenal, which was performed by means of acute occlusion of the adrenal venous bed using a sclerosing agent. The intervention resulted in a decrease of arterial pressure (AP) from 240/140 to 130/80 mm Hg. The patient has been followed up for 13 years. No recurrence of the disease has been recorded. AP is within normal.

[Treatment of hydatid cysts' residual cavities (experimental and clinical study)]. / Obrabotka polosti kist pri gidatidnom ékhinokokkoze (éksperimental'no-klinicheskoe issledovanie).

Experimental series of 60 cotton rats and 150 white mice infected with echinococcus showed that 80-100% glycerin and 3% peroxide solution were effective scolicidal solutions for inactivation of the parasite. 344 patients have been operated on for hydatid disease with inactivation of the parasite by means of these scolicidal solutions. Glycerin during the surgical management of the hydatid cysts is effective and harmless in uncomplicated hydatid liver disease and any hydatid pulmonary cysts. Glycerin is contraindicated in complicated hydatid liver disease because of immunity disturbance. In complicated hydatid liver disease management of the hydatid cysts by 3% peroxide is effective and harmless. It is necessary to correct the hydatid liver disease patients' immunity in the preoperative and postoperative periods. Tactivin and antiechinococcus drug SK-1 are effective immunomodulators in hydatid liver disease.

[Homeopathic preparation Cheblin-CK-1 in the pathogenetic therapy of echinococcosis]. / Ispol'zovanie gomeopaticheskogo preparata Cheblin-CK-1 v patogeneticheskoi terapii ékhinokokkoza.

This study was experimental and clinical. The experiments were made on 80 cotton rats. The clinical study covered 289 patients operated on for echinococcosis. Earlier studies indicated that echinococcosis is accompanied by secondary immunodeficiency and amino acid metabolic disorders. The homeopathic drug Cheblin-CK-1 used normalized amino acid metabolism 40 days after treatment in these patients. The same properties were displayed by homeopathic drugs.

[Radiographic endovascular correction of hyperaldosteronism in patients with arterial hypertension]. / Rentgenoéndovaskuliarnaia korrektsiia giperal'dosteronizma u bol'nykh arterial'noi gipertenziei.

The authors describe a new method of X-ray endovascular destruction of the adrenal in patients with arterial hypertension and hyperaldosteronism. Destruction of the adrenal is accomplished by acute occlusion of its venous channel by introduction of a 3% thrombovar solution through a catheter installed in the central vein of the suprarenal gland. This method was applied in 22 patients with arterial hypertension; essential hypertension with secondary hyperaldosteronism was found in 18 of them, renoparenchymatous hypertension in 2, aldosteroma of the left adrenal in one, and Itsenko-Cushing's disease in one patient. Acute occlusion of the adrenal venous channel was achieved in 20 patients. The intervention normalized blood pressure in 16 and reduced it significantly in 4 patients.

[Various aspects of surgical treatment of vasorenal hypertension]. / Nekotorye aspekty khirurgicheskogo lecheniia vazorenal'noi gipertenzii.

The results of examination and treatment by surgery of 103 patients with vasorenal hypertension are analysed. Retromboses and restenoses of the reconstructed renal arteries and grafts and uncorrected hyperaldosteronism were the most frequent causes of the poor results. Adequate reconstruction of the renal arteries leads to correction of hyperaldosteronism in patients with normal or high activity of plasma renin. Low-renin secondary hyperaldosteronism in patients with vasorenal hypertension is an indication for simultaneous correction.

[Radionuclide ventriculography in the evaluation of left-ventricular function in patients with arterial hypertension]. / Radionuklidnaia ventrikulografiia v otsenke funktsii levogo zheludochka u bol'nykh arterial'noi gipertenziei.

Systemic and intracardiac hemodynamic parameters were examined in 29 patients with arterial hypertension by radionuclide ventriculography. No impairments were found in resting left ventricular pump function in the patients. Left ventricular diastolic function exhibited 24 and 34.5% reductions in left ventricular filling rate and its peak filling rate, respectively, as well as a 44.8% increase in peak filling rate time. To assess the potentialities of myocardial adaptation to a postoperative decrease in blood pressure, artificial hypotension test by using the antihypertensive agent naniprus was performed in 15 patients. This test identified a group of patients with pronounced left ventricular diastolic dysfunctions who required a goal-oriented preoperative preparation. It also defined the principles of this preparation.

[A method of portalizing the venous blood flow of the left adrenal gland]. / Sposob portalizatsii venoznogo krovotoka levogo nadpochechnika.

The authors, having studied the long-term results of the operation of creating the renoportal venous anastomoses in patients with severe and malignant course of arterial hypertension, revealed anastomotic thrombosis in presence of hypotensive effect. Developed in the experiment and employed in 7 patients was the technique of dosaged narrowing the central left adrenal vein with the aim of achieving its thrombosis, inclusion of the collateral routes of the left adrenal blood outflow into the system of the portal vein and inactivation of aldosterone in the liver.

[Treatment of clavicular fractures in children]. / Lechenie perelomov kliuchitsy u detei.

The authors describe a method of treatment of fractures of the clavicle with the help of closed reposition and fixation with the plaster bandage with a hook-semihoop. In 92 children good results were observed within the period from 6 to 10 years.

[Treatment of multiple fractures of bones of the hand and finger phalanges in children]. / Lechenie mnozhestvennykh perelomov kostei kisti i falang pal'tsev u detei.

Results of treatment of 41 children are analysed. Early surgical treatment of the wounds, recovery of all the anatomical structures and closed reposition gave good and satisfactory results in most of the children.