[Teeth autotransplantation as an alternative to dental implantation]. / Autotransplantatsiya zuba kak al'ternativa dental'noi implantatsii.

The stages of preoperative planning and surgical treatment of compromised teeth by the method of autotransplantation of a tooth are presented on the example of two clinical cases. The autotransplantation method can be considered an alternative to dental implantation when strictly adhering to the surgical protocol and careful selection of patients.

[Case report of impacted mandibular third molar extraction using marked surgical bur]. / Udalenie retinirovannogo tret'ego molyara nizhnei chelyusti s ispol'zovaniem markirovannogo khirurgicheskogo bora.

Third molar extraction is a very common manipulation in dental practice, which involve risks of injury of the important adjacent anatomical structures. In order to prevent such complications, the authors suggest using marked surgical burs providing maximal control of the tooth dissection.

[Preventive surgical treatment of ulcer disease].

The state of gastric secretion in ulcer disease patients was investigated. Acidity was estimated by a computed analysis of 24 hour acidogastromonitoring with apparatus AG-24 MP "Gastroscan-24". The examination of 739 patients with chronic duodenal ulcers included 139 (18.8%) patients with exacerbation, 306 (41.1%) with bleeding, 185 (25%) after suturing the perforation, 59 (8%) with stenosis + 50 healthy subjects. A correlation was found between the efficiency of antisecretory drugs and "malignancy" of the course of ulcer disease. An aggressive type of the course of ulcer disease was determined in 178 patients with indications for operation, but the operations were not performed, in 102 out of them long-term results were followed up. The long-term results of operative treatment of uncomplicated ulcer were followed up in 181 (59%) patients.

[Strategy of surgical treatment of ulcer disease].

Results of treatment of 688 patients who have undergone palliative operations for complicated forms of gastric and duodenal ulcer, and 2,269 patients after radical surgery were analyzed. It is demonstrated that pharmacotherapy is ineffective in 9% patients with uncomplicated ulcer, in 32% patients with previous ulcer bleeding, and in 29% patients after suturing of perforated ulcer. The role of preventive operation is demonstrated: postoperative complications in this group are revealed rarely compared with those operated for complicated forms of the disease.

[Rehabilitation of patients after suturing perforated duodenal ulcer]. / Rebilitatsiia bol'nykh posle ushivaniia perforativnoi iazvy dvenadtsatiperstnoi kishki.

516 patients with perforated duodenal ulcer were operated, 396 of them underwent palliative operations. Long-term results were studied in 237 patients. Determination of individual sensitivity to H2-blockers of histamine receptors with 24 hour pH-metry demonstrated tendency towards reduction of therapeutic effect time, and in 17-18% cases--resistance development. Individual selection of drugs with diet, obligative antihelicobacter therapy with eradication control permit to reduce ulcer recurrence rate from 65.5 to 4.8%. Success depends on organisation of rehabilitation and prophylactic treatment.

[Application of different textile vascular grafts in the aorto-femoral location and ways for their improvement]. / Primenenie razlichnykh tekstil'nykh sosudistykh transplantatov v aortobedrennoi pozitsii i puti ikh sovershenstvovaniia.

A comparative analysis of 220 reconstructions of the aortofemoral segment with the application of vascular prostheses of firms "Sever" and "Vascutek" was made. It was established that in patients with obvious anemia and hemodilution (hematocrit less than 25%, hemoglobin less that 80 g/l) an important condition for less total blood loss was to impart the zero surgical porosity to the graft wall at the preoperative stage. However, the biological impregnation used for these purposes reinforces the inflammatory component in the implantation of the vascular graft. The authors propose to use a more inert polytetrafluoroethylene film to impart the zero surgical porosity to the graft wall.

[The use of the synthetic material Vitaflon in cardiac surgery on the growing organism]. / Primenenie sinteticheskogo materiala "Vitaflon" v kardiokhirurgii rastushchego organizma.

Clinico-experimental investigations of Vitaflon in cardiosurgery of growing organism have shown that Vitaflon is a firm, plastic and good material for patches of different size and form, has high thrombus resistance. Inflammatory alterations in the surrounding tissues were not pronounced. The ingrowth of the connective tissue elements into the pores of the patch and its endothelialization were noted. Since 1996 the material has been used as patches in surgical correction of congenital heart diseases. The follow-up of the patients during 4 years failed to find symptoms of recanalization, thrombotic and infectious complications. Vitaflon can be widely used as a plastic material in cardiosurgery for congenital heart diseases.

[The ways of improvement of surgeons' training at the Department of Managerial Medical Staff of the Military Medicine Academy]. / Puti sovershenstvovaniia podgotovki khirurgov na fakul'tete rukovodiashchego meditsinskogo sostava Voenno-mediitsinskoi akademii.

The urgent need to discuss with military surgeons the problem of improvement of educational process in the faculty of managerial medical staff of the Military-and-Medical Academy under the new social-and-economic conditions against the background of the RF Armed Forces reformation has prompted the authors to write this article. The first report deals with the problems of general organization of educational process taking into account the needs for surgeons with higher military education and creation of certified specialized surgical care in the Troops. The authors suggest that all people with interests at stake should express their opinion concerning this problem.

[Experimental and clinical research on the Russian Vitaflon blood vessel prosthesis]. / Eksperimental'no-klinicheskoe issledovanie otechestvennogo proteza krovenosnykh sosudov "Vitaflon".

The authors have performed an experimental and clinical assessment of a new graft. In 37 mongrel dogs 49 experiments were carried out with the implantation of grafts "Vitaflon" into different parts of the arterial and venous bed. It was shown that the domestic graft from modified polytetraftoroethylene had high biological inertia, good plastic properties, zero surgical porosity, strength and reliable "taking" by the recipient's organism. Following the experimental work the prosthesis "Vitaflon" (30-50 cm long and 8 mm diameter) was implanted in the femoro-popliteal-tibial position to 15 patients suffering from obliterating atherosclerosis of the lower extremity arteries. The period of follow-up observations was about 12 months. Thrombosis took place in two grafts in the early postoperative period. Other shunts were functioning well which was confirmed by the clinical picture and dopplerography.

Conclusions from Ufa, Russia, drinking water dioxin cleanup experiments involving different treatment technologies.

The city of Ufa, in the Bashkortostan Republic of Russia, is believed to have dioxin contamination of its water supply from 30 years of gas ejections, sewage and buried sludge from the Chimprom industrial factory, and possibly other sources. A project was developed to provide technology at relatively low cost for treating dioxin contaminated water in routine and also in emergency situations. This paper describes the results of the 15-year research project to remove dioxins from drinking water. Three different methods were experimentally tested for efficiency at removing dioxins from tap water. The methods used were: (1) ozonization plus filtration through powder sorbents, (2) filtration through sand, and (3) filtration through granulated sorbents. It was found that the method of filtration through granulated sorbents was most effective at removing dioxins from water: 90-95% of all PCDD and PCDF isomers were removed from water samples. This research also shows that the most toxic congener, 2,3,7,8-TCDD, can be removed effectively and efficiently. In addition, there are no significant differences between the extractability of PCDDs and PCDFs. Reductions in exposure to humans from contaminated drinking water can be accomplished via sorptive water treatments for relatively reasonable cost, making this a practical approach. This method of decreasing toxic chemicals is being implemented in Ufa, Russia.

[The coronary hemodynamic characteristics of patients with ischemic heart disease and unaltered coronary arteries (the diagnosis of "small-vessel disease")]. / Osobennosti koronarnoi gemodinamiki u bol'nykh ishemicheskoi bolezn'iu serdtsa s neizmenennymi koronarnymi arteriiami (k diagnostike "bolezni malykh sosudov").

No abnormalities in the main stems and branches of the first-second order coronary arteries were found in 78 (13%) out of 586 patients with coronary heart disease, (484 males and 102 females). The incidence of coronary heart disease in the absence of coronary artery changes has profound sex-specific differences: 11% in males and 24% in females. Seventy-eight patients all suffered from exercise-induced angina pectoris of various degree. The linear velocity of blood flow in the coronary arteries in patients with normal coronary arteries was found to be, on an average, a third lower than in healthy individuals, and the volumetric blood flow velocity was twice less than that in healthy persons. Coronary angiography revealed a slow vascular filling with a contrast medium and its long-term washout and the absence of the capillary phase of vasculature filling. The findings suggest that coronary arteries can be involved in the bed of intramural branches.

[Features of the diagnosis of tumors of the small intestine complicated by hemorrhage]. / Osobennosti diagnostiki opukholei tonkoi kishki, oslozhnennykh krovotecheniem.

Among 5,190 patients with gastrointestinal hemorrhage in 14 (0.27%) the bleeding was caused by tumor of the small intestine. The success of recognition of tumors of the small intestine complicated by bleeding is determined to a great measure by the sequence of the diagnostic procedures. It is most rational to begin the examination with endoscopy of the stomach and duodenum. In the absence of abnormalities in these organs rectosigmoidoscopy or colonoscopy is undertaken next. If the source of the bleeding is not detected in this case, then the small intestine is examined by means of probe radioenterography. During the operation, at the peak of bleeding, the authors search for its source along the "track" of blood by palpating the small intestine.

[Correlation of arterial pressure in the forearm with blood pressure in the ascending aorta]. / O korreliatsii arterial'nogo davleniia na pleche s davleniem krovi v voskhodiashchei aorte.

Forearm blood pressures obtained by auscultation were compared with the data of pressure recording in the ascending aorta during diagnostic catheterization in 243 patients with coronary heart disease, arterial hypertension and some malformations of the heart. With indirect measurement, systolic blood pressure was shown to be sufficiently reliable and to characterize systolic pressure in the ascending aorta with assurance, the pressure in the aorta being slightly less (some 10%) in approximately half the cases. The regression equation for systolic pressure in the ascending aorta against forearm pressure is as follows: Y = 0.96X - 1. Measurement of diastolic pressure in the ascending aorta yields less accuracy, so it is advisable to use two regression equations: (1) Y = 0.98X - 1 for a diastolic pressure of 80 mm Hg or less and (2) Y = 0.85X + 2 for a pressure of greater than 80 mm Hg. Thus, ascending aorta pressure values required for invasive hemodynamic studies may be satisfactorily calculated from the data of blood pressure auscultative measurement.

[Effect of truncal subdiaphragmatic vagotomy on the pain syndrome in patients with chronic recurrent pancreatitis]. / Vliianie stvolovoi poddiafragmal'noi vagotomii na bolevoi sindrom u bol'nykh khronicheskim retsidiviruiushchim pankreatitom.

Truncal subdiaphragmatic vagotomy with pyloroplasty was used in 28 patients with chronic relapsing pancreatitis, 19 of them were inclined to alcohol abuse. In 27 patients followed-up during 3 years, 18 were delivered from pain attacks resulting from chronic pancreatitis, the attacks became rarer and less intense in 4 patients, 3 patients had single attacks of pancreatic colic. In 2 patients the results of treatment were assessed as unsatisfactory due to often admission to the hospital for pain attacks. They were not found to have increased excretory and endocrine insufficiency of the pancreas in this period, but had mental disorders.

[Organization of medical services for the victims of the earthquake in the city of Spitak, Armenian S.S.R]. / Organizatsiia okazaniia meditsinskoi pomoshchi postradavshim v épitsentre zemletriaseniia--g. Spitake Armianskoi SSR.

Sanitary losses in the city of Spitak were about 47.8%, injures of the middle and critical degree being diagnosed in 9.5%. During the first period (from December 9 to 14, 1988) patients admitted to the hospitals predominantly had traumas of the head, chest, extremities, vertebral column (86.3%). The crush syndrome and position compressions and their combinations with total cooling during this time were diagnosed in 61 victims (19%), and during the whole period of work--in 63 (7.6%). Success of treatment of the patients with this pathology was promoted by their having obtained qualified surgical and anesthesiological aid before evacuation to medical institutions of the Center in full value in combination with temporary admittance to the hospital at an average for 12-18 hours up to complete arrest of shock. During the first steps of evacuation the amputation of extremities was fulfilled in 3 cases.