[Actual privy councilor V.V. Pelikan (1790-1873) and his 'Dissertatio medico chirurgica inauguralis de aneurysmate' (ST. Petersburg, 1816). Part 3]. / Deistvitel'nyi tainyi sovetnik V.V. Pelikan (1790-1873) i ego 'Dissertatio medico chirurgica inauguralis de aneurysmate' (SPb, 1816.) Chast' 3.

The article deals with the analysis of the translated for the first time from Latin to Russia and introduced into scientific use 'Dissertatio medico chirurgica inauguralis de Aneurysmate' (St. Petersburg, 1816) written by Associate Professor of the Imperial Medical and Surgical Academy, then holder of the highest orders of the Russian Empire, Actual Privy Councillor V.V. Pelikan (1790-1873). Part 3 of the article presents selected fragments from the dissertation with brief author's comments on the description of methods of palliative (dressing) and radical (compression, ligature) treatment of aneurysm.

[Bleedings after reconstructive operations on the aorta, its branches, and peripheral arteries (on materials of the Department of Vascular Surgery A.N. Bakulev ICVS of the Academy of Medical Sciences of the USSR, 1961-1983)]. / Krovotecheniia posle rekonstruktivnykh operatsii na aorte, ee vetviakh i perifericheskikh arteriiakh (po materialam otdeleniia khirurgii sosudov ISSKh im. A.N. Bakuleva AMN SSSR, 1961-1983 gg.).

The authors retrospectively analysed episodes of bleeding after reconstructive operations on the aorta, its branches, and peripheral arteries. The sources of information were the archival medical records of the Department of Vascular Surgery of formerly the Institute of Cardiovascular Surgery named after A.N. Bakulev under the USSR Academy of Medical Sciences (now known as the National Medical Research Centre of Cardiovascular Surgery named after A.N. Bakulev) over the period from 1961 to 1983. A total of 3,787 operations on the aorta and arteries had been performed over that time period. Bleedings were observed in 170 cases (4.5% of all interventions), with the mortality rate amounting to 25.3%. Of these, 72 bleedings (42.3%) were primary, to have developed from anastomoses or sutures of the artery, with 38 (22.3%) being secondary (arrosive) and 10 (5.9%) related to hypocoagulation. In the remaining 50 (29.4%) episodes, the blood had leaked from tissues (en masse). Of these, no source of bleeding had been identified in 8 (4.7%) cases. The subjects of investigation were the terms of bleeding onset, localization, causes, dependence from suture material. The authors suggested a tentative classification of postoperative bleeding. It was determined that 50.6% of these events had developed within the first 24 postoperative hours. Primary bleedings were found to have more often occurred from sutures of the thoracic aorta (58.3%) and arrosive ones from the femoral artery (60%). The causes of primary bleedings were determined to be as follows: cuts of the vascular wall by suture material (66.7%) or needle entry holes (15%), defects between sutures of an anastomosis (14%), defects of an autovein in the area of an anastomosis (2.8%), separation of fibers of the graft in the area of an anastomosis (1.4%). Also analysed are the methods of final arrest of haemorrhage. The authors believe that this historical experience may be used to improve qualification of vascular surgeons.

[About History of Scientific Clinical Schools in Russia: Certain Disputable Issues of Methodology of Studying Problem].

The article considers particular key methodological aspects of problem of scientific clinical school in national medicine. These aspects have to do with notion of school, its profile, issues of pedagogues, teachings and followers, subsidiary schools and issue of ethical component of scientific school. The article is a polemic one hence one will find no definite answers to specified questions. The reader is proposed to ponder over answers independently adducing examples of pro and contra. The conclusion is made about necessity of studying scientific schools in other areas of medicine and further elaboration of problem.

[The medical support of the Karelia front and its rear during the Great Patriotic War in 1941-1945].

The defense of the Zapolyarie continued from July 1941 to November 1944. The Karelia front with its medical service and rear institutions was organized in August 1941 for defense implementing. The medical support of the Karelia front and its rear was complicated by characteristics of transport system of the region, severe climate conditions, unfavorable epidemiological situation and insufficient number of medical institutions. In short terms, military and civil medical workers succeeded to organize system of evacuation of the wounded and ill persons, to develop hospital base of front of more than 17 thousand beds and to stabilize epidemiological situation. As a result, at relatively low surgical activity (20.9%) and hospital lethality (0.1%) medical workers of the Karelia front and its rear succeeded to return into service 84.2% of wounded and ill persons that is one of the highest indices in comparison with medical institutions of the oblasts of the central region of Russia. It is worth to emphasize that one of the characteristics of the front affected benevolently its medical support, was effective functioning of the Arkhangelskii state medical institute than being in rear, reoriented its pedagogic, research and curative activities to needs of war times.

[FROM THE A.M. GORKII ALL-UNION INSTITUTE OF EXPERIMENTAL MEDICINE TO THE IDEA OF ORGANIZATION OF THE ACADEMY OF MEDICAL SCIENCES OF THE USSR (1932-1942)].

Te idea of establishment of the USSR Academy of medical sciences was advanced by I.V. Stalin in 1932 as alternative to organization of the All-Union institute of experimental medicine. However, instead of the USSR Academy of medical sciences the All-Union institute of experimental medicine was established as the USSR highest research institution in the field of medical and biological sciences. The All-Union institute of experimental medicine, initially organized for resolving theoretical and practical problems of medicine, with time ceased to cope with its assignment. The main cause of dissatisfaction on part of the USSR government became its isolation from practical medicine, functioning of the USSR people's commissariat of health care and subordinated research institutes. The definitive loss of scientific authority of the All-Union institute of experimental medicine occurred after the beginning of the Great Patriotic War during its evacuation from Moscow in 1941 and re-evacuation in 1942. As a result, in the USSR government was developed concept of establishment of the Academy of medical sciences as an independent structure similar to the All-Union Academy of agricultural sciences, assigned to unify theoretical and applied medical science under single supervision. This issue together with fate of the All-Union institute of experimental medicine was considered in December 1942 at two sessions of the Board of the USSR people's commissariat of health care. Thereupon, the establishment of the USSR Academy of medical sciences was entrusted to the USSR people's commissariat of health care under consultative collaboration of administration of the All-Union institute of experimental medicine.

[Selected pages of history of vascular surgery in Russia (contribution of Russian surgeons to world vascular surgery)].

The article describes the most significant for Russian surgery personalities, facts, and events of the last 180years. An emphasis is placed upon those works, discoveries or operations made by Russians for the first timein the world's practice. To such we refer N.J. Pirogov's topographical anatomy of vessels (1837), N. V. Ekk's portocaval anastomosis (1877), A.A. Yanovsky's lateral arterial suture (1889), S.S. Bryukhonenko's artificial circulation unit (1923-1924), Yu. Yu. Voronoy's renal replantation onto femoral vessels (1933), V.P. Demikhov'stransplantation of vital organs (1946-1959), V.I. Kolesov's mammary-coronary anastomosis (1964),F.A. Serbinenko's endovascular neurosurgery ( 1979), E. I. Chasov's intracoronary thrombolysis by E.I. Chazov( 1974), endovascular prosthetic repair of the thoracic aorta by N.L. Volodos ( 1985) and a series of other facts.

[Professor Iosif Khaimovich Rabkin and his priorities in roentgenoendovascular surgery].

The article is dedicated to outstanding Soviet and Russian interventional radiologist, Professor I. Kh. Rabkin and his priorities in the development of roentgenoendovascular methods of diagnosis and treatment of arterial and venous diseases. Virtually simultaneously with American surgeons, I. Kh. Rabkin not only worked out anew method of intravascular stenting of arteries with spirals made of shape-memory metal ( nitinol) but was the first in the world who in 1984 successfully stented the external iliac artery in a 56-year-old male patient with stage IV limb ischaemia.

[Why infusion surgery did not start clinical transfusiology?].

The article is devoted to the history of blood transfusion in the XVII century. The theoretical basis of the method was the publication in 1628 in London W. Harvey hypothesis about the circulation of blood, and the practical - conducted in 1656 in Oxford K. Wren experiments to inject of various liquids into the bloodstream. Methods for blood transfusions from animals to animals in February-April 1667 developed in England R. Lower and E. King. The priority of the first transfusion of blood from the animal to man belongs to France. June 15, 1667 in Paris J.-B. Denis and barber-surgeon P. Emmerez using the Lower-King method transfused blood of a lamb to patients suffering from anemia. During the 2nd half of 1667 -- the spring of 1668 R. Lower, E. King and S. Pepis in England, J.-B. Denis and P. Emmerez in France, G. Riva and P.Manfredi in Italy, B. Kauffmann and M. Portmann in Germany had several successful blood transfusions. A total of 19 procedures done 10 sick people and 2 healthy man, but in the spring of 1668 public opinion related the death of a patient to the procedure. The Paris court held in April 1668 limited the blood transfusions, which in 1678 has been discontinued by law, without offering no impact on its renewal in the XIX century.

[Contribution of military surgeons participants of the great patriotic war to solving the problem of rendering medical care to the wounded with lesions of blood vessels].

review in the article are opinions and experience of outstanding academic military surgeons, participants of the Great Patriotic war: Burdenko N N., Kupriyanov P.A., Akhutin M.N., Banaitis A.I., Elansky N.N, Petrovsky B.V., and others. The methods they worked out and practically implemented made it possible to substantially improve the outcomes of gunshot wounds and vascular lesions.

[The organization of surgical care in Russian army during 1812 Great Patriotic War].

The article considers the characteristics of surgical care to warriors of Russian army during 1812 Great Patriotic War. Such conditions are analyzed as damaging action of French weapons, types of combat wounds, organization and forces of military sanitary service of Russian troops, surgeons' support with means of supplying surgical care to the wounded and arsenal of surgical aids. On the basis of given materials analysis a preliminary conclusion is made that surgical care in Russian army in 1812 not only was on the sufficiently high level but it played a specified role in the victory of Russian weapon.

[Role of vascular surgery by experience of the Great Patriotic War (1941-45) (To the 65th anniversary of the Victory in the Great Patriotic War)].

During the Great Patriotic War, military medicine gained a wide and versatile experience in organization of rendering medical care for and treatment of millions of the wounded in exceptionally complicated circumstances. The most important mission encountered by the medical service, i. e., salvation and treatment of soldiers was accomplished with honour: more than 72.3% of the wounded and 90.6% of diseased soldiers and officers were returned to the ranks by the Russian medical profession. Soviet surgeons contributed significantly to solving problems of field surgery as a whole and vascular surgery in particular.

[Delivery of the surgical services to the wounded with injuries of major vessels].

According to consolidated data the frequency of injuries of blood vessels during the Great Patriotic war 1941-1945 was 2.3-4.9%. In the first and the second period of the war the temporary hemostasia on the battlefield was delivered via surgical tubing, tamponade or compressing bandage; the final--via deligation of the arteries in the wound or overlap of hemostatic clamp or the amputation was performed. In the process of delivering of the knowledgeable medical assistance garrot was removed, traumatonesis was performed and the final hemostasia was performed via vasoligation in the wound or along it, than transfused. In some hospitals were organized special units for patients with injuries of vessels. In the third period of the war the main method of primary and secondary hemostasia was vasoligation in the wound or along it. The vessel suture was performed rarer than in the first and the second period. The methods of treatment and prophylaxis of complication of vessel's injury were examined.

[Rank, honors, and titles of N.I.Pirogov].

The author analyzed the career of the great Russian surgeon Nicolay Pirogov (1810-1881). The analysis of Pirogov's honors shows that despite of early European and all-Russian fame, serving heartily and fervently, he passed all scales of "The table of ranks" and didn't step over the honors, getting them in strict sequence. It shows that he didn't reach after ranks, honors. These honors were finding the eminent doctor, surgeon, teacher, scientist and public figure of Russia in the 19th century.

[The initial period in the formation of cardiac resuscitation service at the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences (1948-1973)].

The paper describes and analyzes the initial period in the formation of cardiac resuscitation service at the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, from the first heart operation performed in the USSR to the setting up of the resuscitation-anesthesiology department. On September 24, 1948, A. N. Bakulev was the first in the USSR to make an operation for congenital heart disease, the successful outcome of which predetermined anesthetic maintenance and antishock measures as well. On May 1959, the Institute of Thoracic Surgery, U.S.S.R. Academy of Medical Sciences, began performing heart operations under extracorporeal circulation. The number of postoperative complications has increased due to the higher severity of diseases and the complexity of open heart surgery. This has made the rehabilitative period require that vital function recovery specialists should participate more frequently (Smirenskaya Ye. M.), which ultimately give birth to a resuscitation department in January 1967 (Levant A. D.) and its transformation to a resuscitation-anesthesiology department on October 31, 1973 (Malyshev V. D.).