[The physiological aspects of the efficacy of reconstructive operations in arteriosclerosis obliterans of the lower extremities]. / Fiziologicheskie aspekty éffektivnosti rekonstruktivnykh operatsii pri obliteriruiushchem ateroskleroze nizhnikh konechnostei.

Reconstructive operations in the aorto-iliac and femoro-popliteal segments were performed on 281 patients with obliterating atherosclerosis. An attentive examination of the patients in the nearest postoperative period and within the first 5 years has shown different efficiency of the operation in different patients. Favorable changes took place in regional hemodynamics, while disturbances retained in microcirculation and function of the extremity. Another cause of insufficient efficiency of the interventions was an initial stable suppression of tissue respiration and oxygen utilization in the extremity tissues. The dynamics was positive during a year followed after that by new symptoms of progressing disease.

[Viability of tissues of the extremities and surgical tactics in stage IV arteriosclerosis obliterans]. / Zhiznesposobnost' tkanei konechnosti i khirurgicheskaia taktika pri IV stadii obliteriruiushchego ateroskleroza.

Amputation of the extremity was performed in 26 of 52 patients with the IV stage obliterating atherosclerosis. Clinical severity of the disease was confronted with results of special investigations. Three groups of such patients are described: with traumatic necroses, with ischemic necroses and with necrotic ischemia (criteria of its irreversibility are presented). Surgical tactics of treatment in the first group of patients may include sympathectomy with necrectomy. The outcome of treatment of the second group patients is determined by the efficiency of reconstructive operations. Amputation of the extremity is indicated to patients of the third group.

[Acid-base equilibrium, tissue oxygenation and hemodynamics in arteriosclerosis obliterans after sympathectomy]. / Kislotno-osnovnoi balans, oksigenatsiia tkanei i gemodinamika pri obliteriruiushchem arterioskleroze posle simpatéktomii.

The authors have shown that operation of lumbar sympathectomy increases the skin oxygenation level, increases the volume blood flow in the main arteries and gives rise to positive shifts in metabolic processes in the extremity tissues. The operation is most effective at the 2nd stage of the disease but is getting less effective at the third stage. At the 4th stage of the disease the operation is indicated but with limited necroses of distal parts of the extremity, intact blood flow not less than 40% of the normal, the leg skin oxygenation level higher than 30 mm Hg, shift of blood pH to subcompensated acidosis.

[Changes in several indices of gas exchange in dogs during the initial stage of Cannon's traumatic shock]. / Izmenenie nekotorykh pokazatelei gazoobmena u sobak v nachal'noi stadii travmaticheskogo shoka po Kennonu

In experiments reproducing traumatic shock according to Cannon on 35 dogs it was shown that metabolic acidosis developed in shock against the background of sharply elevated oxgen consumption at the very beginning of injury, when the arterial pressure exceeds considerably the inital level. In traumatic shock the brain is under the most favourable conditions of gas exchange and the skeletal musculature of the extremities--under the worst ones. It was concluded that in severe trauma, despite the strain of respiratory and cardiovascular system function the tissues of the brain and the skeletal muscles failed to obtain an adequate O2 quantity because of their sharply increases needs in oxygen, as well as of hemodynamic disturbances.