[Analysis of the causes of incomplete structural and functional restoration of the skeletal muscles after severe traumatic injury to the limb (ultrastructural study)]. / Analiz prichin nepolnogo strukturno-funktsional'nogo vosstanovleniia skeletnykh myshts posle tiazhelogo travmaticheskogo povrezhdeniia konechnosti (ul'trastrukturnoe issledovanie).

The work is concerned with light-optic and ultrastructural analysis of the causes of incomplete structural and functional restoration of skeletal muscles after extensive trauma and replantation of the limb. It was found that posttraumatic myogenesis was limited due to change of some of the satellite cells from the myogenic type of development to differentiation with the formation of fibroblast-like cells. In distinction from the embryonal cells, the myoblasts form the surrounding basal membranes earlier which prevents their fusion and the formation of the myosymplast. The features of the macrophageal reaction, its permanency lead to accumulation of collagen in the interstitium. Progressing secondary neurogenic atrophy develops at the tissue level. The developing posttraumatic microangiopathies are the cause of secondary destructive changes in the muscles. The disorders of tissue nutrition and the progressing atrophic and destructive-degenerative processes gear the autoimmune mechanisms in the late periods which is conducive to stable chronicity of the pathological process in the muscle.

[Changes in electric excitability and metabolism in the muscles of replanted extremity]. / Dinamika izmeneniia élektrovozbudimosti i metabolizma v myshtsakh replantirovannoi konechnosti.

The authors have studied the dynamics of variation of redox enzymes in the muscles of replanted extremity in 40 adult dogs, which endured replantation of long-ischemized (18-21 degrees C, 4-6 h) extremities. It was discovered that during the postoperative period of observation (45 days) in the muscles of the replanted extremity are preserved obvious degenerative and dystrophic changes and decrease of metabolic and rehabilitation reaction. On the basis of the obtained data the authors employed the effective pathogenetic therapy.

[Features of the structural-functional organization of muscles of replanted rat limb]. / Osobennosti strukturno-funktsional'noi organizatsii myshts replantirovannoi konechnosti krys.

The article characterizes the structural-functional organization of fast and slow muscles of replanted rat limb by methods of light-optic, ultrastructural, and morphometric analysis. The results of the study allowed a conclusion to be drawn that the initial organization of the muscles is not restored in the late terms after replantation. New structural-functional units form in them which differ from the initial system of functioning and vitality provision. Grounds for advancement of destructive-degenerative changes are laid down in the newly formed system of neuro-muscular and vascular-tissue relations. The possible vascular, neural, and autoimmune mechanisms of timing of the pathological process in the replant muscles are discussed.

[The transplantation of a segment of pancreas and thyroid-parathyroid complex by using a microsurgical technic]. / O transplantatsii segmenta podzheludochnoi zhelezy i shchitovidno-parashchitovidnogo kompleksa s primeneniem mikrokhirurgicheskoi tekhniki.

The authors have developed indications to transplantation of the pancreas and the thyroid-parathyroid complex. Specific features of immunodepressive therapy are discussed. A technique of transplantation of the thyroid-parathyroid complex and results of 15 clinical transplantations are discussed.

[Characteristics of the course of regeneration process in the muscles of replanted rat extremities]. / Osobennosti techeniia regeneratornogo protsessa v myshtsakh replantirovannoi konechnosti krys.

The analysis of the changes in the muscles of replanted terminals in early and late stages was made by the method of electron microscopy. In early stages neurogenic atrophy was observed which progressed due to the destructive-regenerative process caused by incomplete innervation, deepening microcirculatory disorders and, likely, autoimmune reactions.

[Functional state of various organs in patients after replantation an revascularization of large segments of the extremities]. / Funktsional'noe sostoianie nekotorykh organov u bol'nykh posle replantatsii i revaskuliarizatsii krupnykh segmentov konechnostei.

The authors have analysed the results of functional examinations of some organs in 26 patients after replantation (9 cases) following complete (4) and subtotal (5) avulsion and after revascularization (17 cases) of large segments following severe mechanical injuries. It has been demonstrated that 4 to 6 months after the operation the disturbances in the electric activity of the brain and in the secretory and secretory functions of the kidneys have a reversible character and regress 2 to 5 years later. No functional disturbances concern-ing the thyroid gland, the cardiovascular system and the liver have been revealed in the patients who were examined 4 to 5 months following the surgery. The authors believe that after replantation or revascularization of a large segment of an extremity which was devoid of circulation for 5 to 7 hours the patients should be under medical control for the activity of the inner organs, first of all the brain and the kidneys for at least 2 paors to be able to correct their functioning in good time.

[Experimental and clinical substantiation of laser therapy of wounds and trophic ulcers]. / Eksperimenta'lno-klinicheskoe obosnovanie lazeroterapii ran i troficheskikh iazv.

The authors have studied the results of 120 experiments on 60 guinea-pigs and 110 rabbits who received the treatment of modelled fenestrated musculocutaneous wounds and trophic ulcers respectively on the replanted extremity and on the back with helium and neon laser until they healed completely. The authors have demonstrated that the laser therapy accelerates the process of reparative regeneration. In 50 intact rabbits who received local irradiation with helium and neon laser there was an increase in the activity of lysosome enzymes and in the protein metabolism values in the blood serum. The use of the helium and neon laser with the specific density of the irradiation rate of 2.5 mWt/cm2 and the exposition during 5 minutes in the treatment of trophic ulcers and persistent wounds in 56 patients as well as in 38 patients with consequences of injuries to the main blood vessels, the nerve trunks, the muscles and the tendons of the extremities before and after the reconstructive operations testifies to its high efficacy.

[Comparative study of electric excitability and metabolism in the assessment of vitality of the ischemized muscles of the amputated limb before replantation]. / Sravnitel'noe izuchenie élektrovozbudimosti i metabolizma v otsenke zhiznesposobnosti ishemizirovannykh myshts amputirovannoi konechnosti pered replantatsiei.

The authors have studied the dynamic changes of metabolic processes and the functional and the structural preservation of the muscles under the influence of heat ischemia (18-21 degrees C) on 29 amputated posterior extremities of 21 adult dogs of the both sexes. It has been shown that direct muscle excitability disappears 5 hours after the influence of heat ischemia, although after 6 hours of observation the values of the metabolic processes in the muscles made 35-40% of the basic level. The character of the changes in the muscle excitability gives an idea of the duration of action of heat ischemia and the preservation of vitality of the amputated extremity only up to the moment of its complete disappearance. The final irreversible ultrastructural lesions of the overwhelming majority of the myocytes appear during the period of 6 to 8 hours of action of heat ischemia.

[Transplantation of small segments of the pancreas with microvascular connections as one of the methods of treatment of diabetes mellitus]. / Transplantatsiia malykh segmentov podzheludochnoi zhelezy na mikro- sosudistykh sviaziakh kak odin iz metodov lecheniia sakharnogo diabeta.

Analysed were 3700 case records of the patients suffering from diabetes mellitus in order to establish direct indications for transplantation of small pancreatic segments. In procurement of the pancreas from 86 cadavers, it was established, that the subjects at the age under 40 were the ideal donors. In 34 experiments, the possibility of the performance of adequate conservation of the pancreas up to 6-8 h by the perfusion-free hypothermic method, intraorganic normothermal perfusion, transplant placing into the continuously oxygenated perfluoran solution or diluted blood, or in combined use of the two latter methods is shown. The results of 40 experiments on the dogs indicate that preservation and transplantation of 1/4-1/8 of the pancreatic mass are sufficient for maintaining normoglycemia.

[Floating cultures obtained from the thyroid of human fetuses]. / Flotiruiushchie kul'tury, poluchaemye iz shchitovidnoi zhelezy plodov cheloveka.

Floating cultures were obtained from fetal human thyroid. The method for preparing the cultures was described. The floating cultures finally consist of epithelial cell group--thyrocytes, stroma and one or some layers of fibroblastic cover. Thyroid hormones (thyroxine, triiodothyronine) were revealed during the cultivation period (40 days). Floating cultures obtained from fetal human thyroid can be used in clinical transplantation science.

[Implantation of semen receptacles in obstructive azoospermia using microsurgical technics]. / Implantatsiia spermopriemnikov pri obturatsionnoi azoospermii s primeneniem mikrokhirurgicheskoi tekhniki.

The authors describe the microsurgical technique of the implantation of 18 alloplastic seminal receptacles above the dissected channels of the epididymis in 9 men with obturation azoospermia. Because of no possibility to perform operations for the replantation of the reproductive tract the method described was considered to be the method of choice. In 6 of 9 patients mobile spermatozoa were found in the aspirated medium. The transcervical insemination in days of ovulation resulted in pregnancy in 2 women. The method of implantation of the seminal receptacles is thought to be the method of choice for the treatment of absolute male sterility resulting from obturation azoospermia.

[Stab wounds of the liver and injuries of the extrahepatic bile ducts and vessels and specific features of their surgical treatment]. / Koloto-rezanye raneniia pecheni i povrezhdeniia vnepechenochnykh zhelchnykh protokov, sosudov i osobennosti ikh khirurgicheskogo lecheniia.

The authors observed 24 patients with wounds of the liver and injuries of extrahepatic bile ducts and vessels. In 14 patients with stab-cut injuries of the liver catgut sutures were used, in 3 patients catgut sutures with suturing the portion of the greater omentum on the pedicle. The microsurgery technique was used in order to reestablish the integrity of the hepatic artery, portal vein and common bile duct. Three patients died.