[Direct angioplasty of the left main coronary artery with a pericardium flap].

Surgical treatment of stenosis of the left main coronary artery (LMCA) is a special problem, a number of questions of surgical strategy for this lesion still remain unsolved. The question of direct plasty dilatation of LMCA has not lost its actuality. Operations were made on 6 patients in whom direct plasty dilatation of LMCA with a flap from autopericardium was performed for local, not lengthy constriction which was located in the initial and middle part of LMCA. The operations were made under conditions of extracorporeal circulation, moderate general hypothermia (about 32 degrees C), pharmacohypothermic cardioplagia with external cooling of the heart. In all cases there was good restoration of cardiac activity and the absence of myocardium ischemia at the postoperative period. The restoration of the anatomical lumen of LMCA by this method facilitated sufficient blood flow along LMCA. Five years later all the patients are alive, one patient has external angina of the 11 functional class.

[Technique of endarterectomy from pulmonary artery in chronic thromboembolic pulmonary hypertension].

The article gives detailed description of a technique of pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension. The method is based on the experience of the world leader in surgical treatment of this disease--the clinic of California, San Diego headed by Stuart Jamieson, cardiothoracal clinic Papworth Hospital in the only center in Great Britain, where PE is performed and on the experience obtained by the collective of the Department of hospital surgery of the medical department of the St. Petersburg state University and the City multi-field hospital.

[Method of punction transcutaneous cholecystostomy and device for accomplishment]. / Sposob dlia punktsionnoi chrezkozhnoi kholetsistostomii i ustroistvo dlia ego osushchestvleniia.

The author has developed a mode of punctional transcutaneous cholecystostomy--under ultrasound scanning control and the device for its accomplishment. The mode and the device provide increase of safety of the operation and the possibility of usage of ultrasound scanning without special punctional transducer. The results of clinical application of the developed method and the device in patients with acute cholecystitis are effective.

[The effect of physical training loads on the body function of sailors on a long cruise]. / Vliianie treniruiushchikh fizicheskikh nagruzok na funktsional'noe sostoianie organizma moriakov v dlitel'nom plavanii.

The article studies the influence of physical exercises at sports simulators upon the state of some bioenergetic systems of seaman's organism in the conditions of a 4-month cruise. The article discloses the dynamics of maximum oxygen consumption, pH value, the quantity of buffered bases and standard bicarbonate in blood; activity of lactic dehydrogenase and its isoenzymes in serum; activity of lactic dehydrogenase, alpha-glycerophosphate dehydrogenase, etc. in lymphocytes of peripheral blood. The authors discuss the reasons of changes that take place in aerobic and anaerobic processes of cells and the whole organism.

[Intensification of surgical activities in the department of general surgery]. / Intensifikatsiia khirurgicheskoi raboty v obshchekhirurgicheskom otdelenii.

The authors intensified and improved considerably the qualitative indices of surgical activity in a department of general surgery by means of simple and practicable organizational measures and by changing the tactics of surgical management of some diseases. This allowed the conclusion that the number of beds in the department must be reduced by 15 without reduction of the staff, which will not affect the activity of the department unfavourably. The organization of a resuscitation department without additional expenses is planned at the cost of the measures mentioned above.

[Transdiaphragmatic bronchopleural fistulas as complications of subdiaphragmatic abscesses]. / Chrezdiafragmal'nye bronkhoplevral'nye svishchi kak ozlozhnenie poddiafragmal'nykh abstsessov.

The authors had 21 patients with various types of transdiaphragmatic bronchopleural fistulas which development as secondary complications of a subdiaphragmatic abscess as a consequence of late diagnosis, ineffective drainage, and use of transpleural approaches to the abscesses. Clinical and radiological diagnosis including contrast fistulo- and pleurography, bronchography and bronchoscopy, and contrast endoscopic examination of the stomach and other organs made it possible to determine the character and localization of the transdiaphragmatic fistula and the condition of the sprained organs. The therapeutic tactics were determined by the form and causes of the transdiaphragmatic bronchopleural fistulas. Nineteen patients recovered, 2 died. The success of treatment depended on the time when operative drainage was begun and on its rational application on bronchological cleansing, and on other components of complex treatment.

Prosthetic sockets of polymerized metal: materials, design, technology.

The process of fabricating polymerized metal sockets for above-knee and below-knee prostheses is described. The technique is based on pulse stamping of metal blanks over a matrix imitating the negative mould of the stump and subsequent polymeric coating by vibro-vortex spraying. The monitoring of more than 500 patients fitted with metal-polymer sockets since 1978 is reported.

[Evaluation of regimens for the simultaneous and sequential administration of cytostatics in the combined chemotherapy of disseminated forms of breast cancer]. / Otsenka rezhimov odnovremennogo i posledovatel'nogo vvedeniia tsitostatikov pri kombinirovannoi khimioterapii rasprostranennykh form raka molochnoi zhelezy.

Fifty-eight patients with disseminated breast cancer were randomly divided into 2 study groups. All patients received 4-week courses of combination chemotherapy with vinblastine, thiotepa and 5-fluorouracil. In study group I, the drugs were injected simultaneously once a week, while, in study group II, the treatment schedule was as follows: vinblastine--on days 1 and 2, thiotepa--day 3 and 5-fluorouracil--on day 5, weekly. Leucopenia development was significantly more frequent in study group 2.

[Survival kinetics of breast cancer patients undergoing combined chemotherapy for recurrences and metastases]. / Kinetika vyzhivaemosti bol'nykh rakom molochnoi zhelezy, podvergavshikhsia kombinirovannoi khimioterapii po povodu retsidivov i metastazov.

The results of a comparison of survival rates for 156 cases of recurrent and disseminated breast cancer treated by different schemes of chemotherapy are presented. The survival rates for cases with apparent therapeutic effect were significantly higher than in those without such effect. Statistical methods of kinetic evaluation of treatment effectiveness failed to establish a significant difference in survival rates for patients given combination chemotherapy and those treated by standard procedures.

[Comparison of various physico-chemical properties of pig and cattle myeloperoxidases]. / Sravnitel'noe issledovanie nekotorykh fiziko-khimicheskikh svoistv mieloperoksidaz svin'i i korovy.

The myeloperoxidases possessing the specific activity of 500 000-700 000 of o-dianisidine units per 1 mg of protein were isolated and purified from the lysosome-like granules of pig and cattle neutrophylic leukocytes. The absorbance spectra for the enzymes in the visible region are identical; their molecular weight is 140 000-160 000. The enzymes are made up of two subunits, each containing a heavy (m. w. 68 000) and a light (m. w. 10 000) polypeptide chains. The pH optimum for myeloperoxidase oxidation of o-dianisidine lies around 5.8-6.2 for both enzymes. The dependence of the reaction rate on H2O2 concentration does not obey the Michaelis--Menten kinetics. The optimal concentrations of the reaction substrates are 0.34 mM for o-dianisidine and 0.075 mM for H2O2. The amino acid composition and the peptide maps for pig and cattle myeloperoxidases are in many ways similar, showing no coincidence of enzymes, however, in terms of antigenic determinants. The similarities of some physico-chemical properties of pig and cattle enzymes and their immunological differences are discussed.

[Use of adriablastin in the combination chemotherapy of disseminated breast cancer]. / Primenenie adriablastina v kombinirovannoi khimioterapii disseminirovannogo raka molochnoi zhelezy.

A course of combination chemotherapy using adriamycin was given to 68 patients suffering from disseminated breast tumor. Objective and symptomatic improvement was registered in 53 cases. Out of 45 patients with bone metastases, a distinct clinical effect was observed in 41 cases. Out of 10 bed-confined cases, seven became self-dependent. Mean remission in the cases of bone metastases was 6.4 months.

[Comparison of the efficacy of imidazole-carboxamide and of a combination of nitrosomethylurea, vincristine and dactinomycin in disseminated melanoma]. / Sravnenie éffiktivnosti imidazol-karboksamida i kombinatsii nitrozometilmocheviny, vinkristina, daktinomitsina pri disseminirovannoi melanome.

A randomized cooperative study comparing 2 regimens of chemotherapy (DTIC--150mg/m2 iv days 1, 2, 3, 4, 5 and a combination of vincristine--1.4 mg/m2 iv days 1, 8, 15, nitrosomethylurea--200 mg/m2 iv days 3, 5, 10, 12 and dactinomycin--0.3 mg/m2 iv days 1, 3, 5, 8, 10, 12) was carried out in 114 patients with disseminated skin melanoma. A combined chemotherapy course given to 58 patients was followed by complete response (CR) in 8 cases (13.7%) and partial response by over 50% (PR)--in 6 cases (10.4%). In 56 patients treated with DTIC, CR was registered in 4 patients (7.1%) and PR in 9 (16%). Patients resistant to one regimen did not respond to the other.

[Use of adriablastine in the combined chemotherapy of breast cancer patients with bone metastases]. / Primenenie adriablastina v kombinirovannoi khimioterapii bol'nykh s kostnymi metastazami raka molochnoi zhelezy.

Twenty patients with generalized breast cancer metastasizing in bones were subjected to treatment by a combination of adriablastine with cyclophosphane or adriablastine with cyclophosphane, 5-fluoruracil, vincristine using repeat 8-day cycles with 3-week intervals between them. A considerable subjective and sympathetic improvement was noted in 13 patients. Of 14 patients in whom bone metastases were associated with tumor involvement of different soft tissues and organs the tumor regression was gained in 8 patients. Side effects in all these cases were similar and mostly related with the use of adriablastine: nausea, vomiting, alopecia.

[Combined drug treatment of far-advanced forms of breast cancer]. / Kombinirovannoe lekarstvennoe lechenie daleko zashedshikh form raka molochnoi zhelezy.

Seventy patients with breast cancer (stage IIIb--IV) were randomized by an "envelope" method into 2 groups, each including 35 persons. Patients of the first group were injected vincristin, 5-fluoruracil, methotrexate (once a week), cyclophosphane (3 times a week) and prednisolone daily during 3 weeks. The duration of the course of treatment was 4 weeks. The therapy course was repeated with an interval of 1--2 months. Patients of the second group in addition to the analogous treatment were subjected to ovariectomy with subsequent continuous administration of prednisolone, testosterone-propionate or synoestrol. An objective effect was noted in 24 patients of the first group (71.4%), the complete remission being gained in 4 of them. An average duration of the remission--7.6 months. An objective effect was noted in 31 patients of the second group (88.5%), the complete remission--in 4 of them. An average duration of the remission--10.7 months. Primary mammary tumors and metastases in regional lymph nodes proved to be mostly susceptible to the conducted therapy. Lung and pleural metastases were found to be less susceptible. No grave complications due to this kind of treatment were noted.