[Influence of the human blood serum on contractility and beta-adrenoreactyvity of the isolated human myocardium].

On strips of the isolated myocardium of right hearts auriculum of the 43 patients with ischemic illness of heart and 9 patients with heart diseases of various ethyology at statement venous canule during aorto-coronary shunting, estimated influence of adrenaline (10(-9)-10(-4) g/ml) on amplitude caused by electrostimulus (1H, 5ms, 25-30 V) contractions, and also inotropic and adrenomodulation activity of serum blood (in dilution 1 : 10000, 1: 1000, 1 : 500, 1: 100, 1 : 50, 1: 10 and 1 : 5) nonpregnant women. Direct dependence of amplitude of contraction on size of fraction of of blood emission on Teyholts is revealed. It means, that strips of right auriculum myocardium reflect contractility of a left ventriculum myocardium. Adrenaline in concentration 10(-7)-10(-6) g/ml dependent of dose raised amplitude of the caused contraction not influencing it in concentration of 10(-9) and 10(-8) g/ml (the constant of dissotiation has 2 x 10(-7) g/ml), that as a whole, speaks about decrease in efficiency of activation beta-AP. Blood Serum in dissolutions 1 : 10000-1 : 50 did not influence on amplitude of contraction, and in dissolutions 1 : 10 and 1 : 5 strengthened it, that speaks presence in blood the endogenous activator of myocyte contractility (EAMC). Serum showed beta-adrenomodulation activity that speaks presence in it endogenous sensitizer of beta-adrenoreceptors (ESBAR) and endogenous blocker of beta-adrenoreceptors (EBBAR). In particular, in experiences with adrenaline in subthreshold concentration (10(-8) g/ml) serum showed ESBAR-activity (in dissolutions 1 : 1000, 1 : 500, 1 : 100 and 1 : 50), and in experiences with adrenaline in as much as possible effective concentration (10(-6) g/ml) serum showed ESBAR-activity (in dissolutions 1 : 50 and 1 : 10) and EBBAR-activity (in dissolutions 1:500) Hence, containing in blood serum endogenous modulators of beta-adrenoreactivity - ESBAR and EBBAR can modulate efficiency of beta-adrenoreceptors activation of human cardiomyocytes. It speaks about perspectivity of application of ES BAR analogues in cardiology.

[Surgical strategy in active infective endocarditis]. / Khirurgicheskaia taktika pri aktivnom infektsionnom éndokardite.

In the cardio-surgical department of the regional clinical hospital of Kirov oblast 117 patients (83 men and 34 women) with active infective endocarditis of native heart valves were operated upon: with injury of the aortal valve (61), mitral (37), mitral and aortal (16), tricuspidal (2), mitral, aortal and tricuspidal (1). During 10 days the patients were examined and prepared for operation which included intensive antibacterial, cardiotropic and immunomodulating therapy. Then the operation of prosthesing the valve, mainly with domestic prostheses "LIKS-2" and Karboniks-1 was performed. Lethality was 7.6%. Recurrent endocarditis took place in 6% of cases. In reoperations cannulation of the femoral artery and retrograde cardioplegia were used. In repeated mitral prosthesing right side thoracotomy in the 4th intercostal area was used as the approach. The surgical strategy for active infective endocarditis should consist of maximally rapid examination of the patient, rapid intensive preparation for the operation performed in maximally early terms.

[Surgical treatment of interventricular septal defects caused by penetrating heart wounds]. / Khirurgicheskoe lechenie defektov mezhzheludochkovoi peregorodki na pochve pronikaiushchikh ranenii serdtsa.

Seven cases of traumatic defects of the interventricular septum are described. All the patients were subjected to operations. The operations were fulfilled under conditions of the artificial blood circulation. The authors believe the greatest difficulties to occur when correcting defects localized in the muscular part of the apical area of the septum. One patient died within 4 years after the operation due to recurring cardiac fibrillation and chronic heart failure.