[Laws and regulations affecting the development of national service of clinical toxicology].

In the formation and development of the national specialized toxicological service the important role was played by legislative initiatives, distinguished with continuity and improvement of the quality of care in acute poisoning, principles of interaction of units of service. Since the beginning of the organization of specialized toxicological service in the country, without taking into account the regional regulations, there were published over thirty ones, impact and significance of which can be very positively evaluated by formed a unique and authoritative national school of clinical toxicology, with its wealth of organizational, methodological and diagnostic and treatment practices, valuable scientific and human resources.

[The training of medical and scientific manpower in the system of postgraduate medical education].

The research was held within Petrovsky National surgery center and revealed certain regularities and trends testifying the necessity of further strategic and tactic development of training of graduated specialists through the innovative optimization of effectiveness of post-graduate training of medical personnel. The inclusion of social psychological monitoring of educational process is obligatory. The implementation of sociological monitoring in any institution providing post-graduate training has to be a powerful tool for enhancing quality and efficiency of training of medical professionals. This approach presupposes modernization of training programs accounting the innovations and research data.

[Autonomic cardiovascular regulation in patients with tics and Tourette syndrome].

Autonomic cardiovascular regulation has been assessed in patients aged 4-15 years with Tourette syndrome (n = 22) and other tic disorders (n = 48). Symptom significance was estimated by a number of hyperkinetic episodes per 20 minutes, tic scale and variants of the disease course. The functional condition of autonomic nervous system was studied clinically and using spectral analysis of heart rate variability in both upright and supine positions. Negative correlation between the ratio of sympathetic and vagus influences and severity of the disease was found: the severer were tic symptoms, the stronger was a trend to vagotonia (beta = -0.36; p < 0.0025; F > 4.0). In orthostatic test, patients with Tourette syndrome demonstrated an unfavorable hypersympathicotonic type of cardiovascular system reaction. Patients were treated during 4 weeks with glycinum (0.2 +/- 0.1 mg/day), phenibutum (0.5 +/- 0.25 mg/day), clonazepam (1.5 +/- 0.5 mg/day), tiapride (200 +/- 100 mg/day), haloperidol (1-1.5 mg/day), rispolept (2 mg/day). There was no negative effect of the drugs on heart rate variability. On the contrary, the therapy reduced hyperkinetic symptoms and corrected autonomic influences on the sinus rhythm. It is suggested that changes in autonomic cardiovascular regulation might be of secondary character and do not need any special correction.

[The role of the Russian Surgery Research Center, Russian Academy of Medical Sciences, in the postgraduate training of medical staff]. / Rol' Rossiiskogo nauchnogo tsentra khirurgii RMN v poslediplomnom obuchenii meditsinskikh kadrov.

The paper presents a comprehensive analysis of the experience gained by the Russian Surgery Research Center over 40 years in improving the qualification of physicians and middle-level medical workers. It outlines teaching methods, shows the efficiency of flexible and mobile technologies in improving the qualification of medical staff, which are based on an individual differential approach to each student and which are oriented to satisfy the needs of a specific health care facility that has sent a specialist to be trained, provides evidence for that it is expedient and effective to improve the qualification of medical staff on the basis of a research institution, by taking into account the fact that the students will introduce new methods and technologies into practical public health care.

[Significance of anesthesiology and intensive care in the development of reconstructive surgery (as exemplified by the scientific school of the Academician B.V. Petrovskii)]. / Znachenie anesteziologii i reanimatologiii v obespechenii razvitiia rekonstruktivnoi khirurgii (na primere nauchnoi shkoly akademika B.V, Petrovskogo).

B. V. Petrovsky, the creator of one of the leading surgical schools, realized, that surgery cannot develop without anesthesiological and resuscitation support. He actively promoted measures which ensured rapid transformation of such branches as anesthesia and postoperative care into independent disciplines. Introduction of neuroleptanalgesia, high-quality artificial ventilation of the lungs, prolonged regional and combined anesthesia, protection of the myocardium and brain, bronchofibroscopy, extracorporeal detoxication, assisted circulation, and computer monitoring allowed the performance of the most sophisticated interventions on the heart, aorta, lungs, esophagus, liver and bile duct, and peripheral vessels. Progress in anesthesiology and reanimatology promoted the development of new trends in reconstructive surgery, such as repair microsurgery, organ transplantation, endovascular and endoscopic surgery.

[B. V Petrovsky's scientific school at the turn of two centuries]. / Nauchnaia shkola B. V. Petrovskogo na rubezhe dvukh stoletii.

The paper shows how Academician B. V. Petrovsky's scientific school has been set up and how it has developed. Three stages of its development are identified: 1) the establishment and formation of the school on the basis of the department, the development of large areas of surgery (cardiovascular, thoracic, and esophageal surgeries) in 1951 to 1963; 2) the development of the school within the research institute-department system, the setting up of its branches, specialized services in the country, organizational and methodological management of its related research institutes in 1963 to 1989; and 3) the present period marked by the design and introduction of high technologies, the development of topical research problems (transplantation of the heart and liver, including related, miniinvasive surgery, computer-aided monitoring, telemedicine, as well as staff training). Four world's priorities of the school are noted. They included as follows: diaphragmatic plasty on a vascular pedicle for various abnormalities; the world's richest experience in surgically treating gunshot wounds of the large blood vessels during military actions; discovery of the physiological mechanisms of the function and properties of the valve-aorta complex of the human aortic root; the design and successful clinical application of nitinolic memory prostheses to endoprosthesis. The paper predicts how surgery will develop in the 21st century.

[Diagnostic and prognostic aspects of myxoma syndrome]. / Diagnosticheskie i prognosticheskie aspekty miksomnogo sindroma.

The analysis is presented of clinicomorphological and laboratory characteristics of myxoma syndrome which are of prognostic value. Early diagnosis of the syndrome is essential in making decision on the intraoperative and long-term postoperative treatment policy.

[Myxoma syndrome]. / Miksomnyi sindrom.

The paper provides the follow-up findings of patients with cardiac myxomas according to the presence or absence of the myxomal syndrome. It is shown that it is a multiorgan abnormality wherein the cardiac myxomas that are prone to primarily multiple growth, extraseptal and/or multifocal fixation are associated with the changes in the hypothalamus-pituitary-adrenal and renin-angiotensin-aldosterone systems, skin spotty pigmentation, neoplasms in the viscera, skin, and fat. These specific features emphase the predictive value of the myxomal syndrome, which predetermines that its early diagnosis should be made in routine clinical practice.