[Ligation in the treatment of serous cubital bursites].

The serous cubital bursitis is a frequent disease in general surgical practice. Many treatment modalities has been worked out, such as bursa resection, fluid aspiration, the use of perflourdekaline etc. The suggested method included ligation of the cubital articular bursa with several skin sutures after fluid aspiration. The method showed high efficacy and in suitable for outpatient implementation.

[Ambulatory treatment varicosity of the lower limbs]. / Ambulatornoe lechenie varikoznogo rasshireniia ven nizhnikh konechnostei.

Experience of ambulatory treatment of 260 patients with varicosity of the lower limbs (chiefly with trombovar) is summarized. An original technique of sclerotherapy is proposed. A differential approach to management of horizontal reflux is developed. Peridural anesthesia is recommended as an optimal method in ambulatory surgery. Use of these methods reduces the rate of complications and to make sclerotherapy cheaper.

[Clinico-physiological assessment of the mechanisms of compensation and paracompensation in patients with mitral stenosis]. / Kliniko-fiziologicheskaia otsenka mekhanizmov kompensatsii i parakompensatsii u bol'nykh mitral'nymi stenozami.

The paper presents the results of an examination of 292 patients with Stages II-V mitral stenosis. Clinical, roentgenological, and electrocardiographic characteristics of the defect were analysed. Physical fitness and gas exchange during exercise were studied in 183 patients with Stages III and IV mitral stenosis. The findings were compared with the intensity of tissue oxygen exchange and the levels of myocardial myoglobin. The patients with mitral stenosis exhibited lower exercise tolerance that was more pronounced in Stage IV. The patients also displayed characteristic profound disturbances in work energy regimen, lower reserve potentialities and functional mobility of the cardiorespiratory system. The pronounced changes in the acid-base balance and gas composition of their capillary blood in Stage IV mitral stenosis during exercise may be explained by a sharply marked arteriolar barrier in the pulmonary circulation (a paracompensatory reaction). The comparison of physiological and clinical findings has enabled the relationship of mechanisms responsible for compensation and paracompensation to be evaluated at various stages of mitral stenosis.

[Differences in the ultrastructural reorganization of the myocytes of the atria and ventricles in the stages of the correction of mitral heart defects]. / Razlichiia v perestroike ul'trastruktury miotsitov predserdii i zheludochkov na étapakh korrektsii mitral'nykh porokov serdtsa.

Ultrastructure and stereomorphometry of the myocardium biopsies from 12 patients are studied at various periods of the correction of mitral vitium cordis under the conditions of total body hypothermia. It is shown that compensatory changes enhance the morphological differences between the left atrium cardiomyocytes in stenosis of the mitral aperture and those in left ventricle in deficiency of mitral valve. By the end of operation the ventricle cardiomyocytes are damaged at a higher degree showing the pronounced myofibrillary contracture. The atrium myocytes having a labile protein-synthetic apparatus are more resistant to the damaging effect of operation. Morphofunctional specialization of different heart compartments should be taken into consideration in diagnostic practice.

[Emergency correction of traumatic mitral valve insufficiency under craniocerebral hypothermia]. / Ekstrennaia korrektsiia travmaticheskoi mitral'noi nedostatochnosti v usloviiakh kraniotserebral'noi gipotermii.

Data of emergency correction of traumatic mitral insufficiency in 15 patients after closed mitral commissurotomy under conditions of craniocerebral hypothermia without artificial blood circulation are presented. Prostheses of the mitral valve were made in 3 patients, plastic valve-preserving interventions--in 12 patients. One patient died. The authors consider that in most cases with traumatic insufficiency of the mitral valve after closed commissurotomy it is possible to perform valve-preserving operations, craniocerebral hypothermia being a reliable method of their maintenance.

[Ultrastructure of cardiomyocytes during mitral valve replacement in non-perfusion hypothermia]. / Ul'trastruktura kardiomiotsitov pri protezirovanii mitral'nogo klapana v usloviiakh besperfuzionnoi gipotermii.

The ultrastructure of biopsy specimens obtained from the left ventricle was examined at varying stages of mitral valve replacement under non-perfusion hypothermal protection (at 27-28 degrees C). In patients with clinical stage IV mitral incompetence, cardiomyocytes were shown to combine signs of marked hypertrophy and decompensation. Despite the initial plastic muscular cell incompetence, there are only small changes in their ultrastructure and myofibril contracture in the pre-occlusion period, which subside by the end of long-term (up to 37 min) occlusions. For the myocardium, reperfusion is the most damaging, but the damages, though widely diverse, are regarded mainly as moderate and reversible. Over again the electron microscopic finding provide good evidence for the feasibility of performing complicated cardiac surgeries with prolonged reversible exclusion of blood circulation under non-perfusion hypothermia.

[Work capacity of mitral stenosis patients before and after mitral commissurotomy]. / Trudosposobnost' bol'nykh mitral'nym stenozom do i posle mitral'npi komissurotomii.

Analysis of the working capacity of 1,000 patients who underwent mitral commissurotomy showed that 67.0% of individuals who were operated on for grade III stenosis and 27.99% of those operated on for grade IV stenosis resumed work. Frequent exacerbations of rheumatism and changes in the myocardium and valvular apparatus are among the causes of the decrease in the number of persons who resume work after the operation. Another reason is overestimation of the group of invalidity or its unjustified qualification