[Gastroduodenal ulcers in the practice of joint endoprosthesis].

The gastroduodenal ulcer rate and the gastrointestinal hemorrhage occurrence probability after total endoprosthesis of the hip and knee joint were studied. Of 526 patients in 4 (0.7%) after the total joint endoprosthesis operation the gastroduodenal ulcer had occurred, demanding the urgent treatment measures conduction. It is mandatory to conduct an adequate prophylactic measures to the patients, suffering pronounced gastropathy, according to anamnestic data available.

[Rational application of the pneumatic tourniquet in the knee joint endoprosthesis].

Two different methods of the pneumatic tourniquet application were used while the knee joint prosthesis in two groups of patients: during the all operation and during the stage of implantation of artificial joint components. It is preferent to reduce the pneumatic tourniquet application duration to realize its positive qualities, to secure optimal adhesion of cement and costal bed and also to make less severe the consequences of intra- and postoperative period. The data obtained trust that the procedure, used by us, constitutes an optimal method of the pneumatic tourniquet application while the knee joint cement prosthesis.

[First experience of bilateral hip joint prosthesis using DePuy ASR system].

Simultaneous bilateral hip joints prosthesis owes advantages over two-staged procedure, including the patients stationary treatment shortage, as well as duration of total operative time, total period of his disablement and financial expenses. Decision about application of such operations must be done individually, comparing the real criteria of risk for patient's life.

[First experience of the hip joint prosthesis using DePuy ASR system].

The system of the hip joint total endoprosthesis DePuy owes undoubted advantages over standard metal-polymer systems and constitutes the optimal one on the modern stage of endoprosthesis development for young patients, it permits to escape the revision prosthesis. Early return of the patients to labour activity and short period of adaptation constitute economical efficacy of the construction applied.

[Efficacy of intraoperative apparatus autotransfusion of the blood in revisional endoprosthesis of the hip joint].

Significant blood loss and the methods of its compensation constitute one of the main problems of revisional prosthesis of big joints. Application of a patient's blood constitutes the most available and secure way of the problem solution at the modern stage of surgery evolution. The apparatus autotransfusion of the blood owes prominent place in the system of the blood saving, solely as well as in combination with autodonoring and preoperative hemodilution. In the patients, to whom the revisional prosthesis of the hip joint was performed, using intraoperative apparatus autotransfusion of the blood and the donor's erythrocytes, the red blood indexes were investigated on the stages of operative intervention and postoperative period. Application of apparatuses, such as Cell Saver, constitutes optimal and secure method of the blood oxygentransporting function restoration in the revisional prosthesis of big joints operations.

[Hemodynamic features of operations with tourniquet in orthopedic surgery]. / Gemodinamicheskie osobennosti operativnykh vmeshatel'stv pod zhgutom v ortopedii.

The investigation was carried out in group of 38 patients where total arthroplasty knee joints operations were planned and performed. The operations have been performed under general or regional anesthesia. Usage of a knee joints arthroplasty technique under a compression with tourniquet in conditions of a general anaesthesia, is accompanied by a hypertensive syndrome requiring for a hemodynamic correction. The decompression after prosthetic repair is integrated to a recirculation hypotension especially expressed with usage of hypotensive drugs. The obtained data prove the regional methods of an anaesthesia as more reasonable for total arthroplasty of knee joints.

[Preoperative patient blood preservation as an alternative to donor blood transfusion during joint endoprosthesis surgery]. / Predoperatsionnaia zagotovka krovi bol'nogo kak al'ternativa transfuzii donorskoi krovi vo vremia vypolneniia operatsii éndoprotezirovaniia sustava.

In 79 patients, to whom total endoprosthesis of the knee and hip joints were performed, the efficacy of preoperative blood preparation was studied up. The method is effective and secure alternative to the donor blood transfusion in orthopedic surgery. Taking into account the ability of patient with rheumathoid arthritis to restore the hemoglobin level, the expediency of preoperative blood preparation in them must be determined individually.

[The use of thrombin to decrease postoperative hemorrhage after total hip and knee replacement]. / Ispol'zovanie trombina dlia umen'sheniia posleoperatsionnoi krovopoteri pri total'nom éndoprotezirovanii sustava.

We used thrombin locally in order to decrease the post-operation hemorrhage in 25 patients after total hip and knee prosthesis. Thrombin application reduced post-operation hemorrhage by 70-80%. There was no negative impact of thrombin on wound healing.

[The influence of contrykal on intraoperative blood loss during endoprosthesis implantation of the hip joint]. / Vliianie kontrikala na intraoperatsionnuiu krovopoteriu pri éndoprotezirovanii tazobedrennogo sustava.

Application of the proteases inhibitors constitutes one of possible pharmacologic methods of the blood loss compensation during performance of operative intervention in orthopedics, especially for endoprosthesis of the main joints. Application of contrykalum for endoprosthesis of the hip joint is expedient, if prognosticated intraoperative blood loss exceeds 1000 ml. Efficacy of preparation was not established for the lesser blood loss cases.

[Impact of anesthesia methods on the course of perioperative period in endoprosthesis of the hip joint]. / Vliianie metodov anesteziï na techenie perioperatyvnogo perioda pri éndoprotezirovanii tazobedrennogo sustava.

The impact of methods of anesthesia on the course of perioperative period was studied up in 132 patients, to whom the total endoprosthetics of the hip joint was performed. The occupation in the operation room term and analysis of the postoperative pain syndrome occurrence with its cupping served as comparative categories for general and regional methods of anesthesia. Central neuronal blockade, epidural and spinal anesthesia have predominant significance for enhancing of the intraoperative and postoperative analgetic defense.

[Analysis of complications of operation for appendicular peritonitis in children]. / Analiz oslozhnenii posle operatsii po povodu appendikuliarnogo peritonita u detei]

Complications, occurred after the operation for appendicular peritonitis in children, were analyzed. The frequency of the complications occurrence in patients with an acute catarrhal appendicitis had constituted 1.4%, with phlegmonous one--3.5%, gangrenous--12.1%, gangrenous appendicitis with local restricted peritonitis--18.9%, with diffuse purulent peritonitis--42%. The dependence of the complications frequency on character and severity of primary changes in abdominal cavity was established.

[Total endoprosthesis of knee joint for the severe deformity of the femoral and tibial condyles]. / Total'noe éndoprotezirovanie kolennogo sustava po povodu vyrazhennoi deformatsii myshchelkov bedrennoi i bol'shebertsovoi kostei]

The method of knee joint endoprosthesis for its pronounced deformity was proposed. As a transplant there was applied the ceramic hydroxiapatite, manufactured according to special technology. The implant was fixed on the transplant adjusted.

[Rational methods of cutaneous plastic surgery using local tissues in open injuries of the hand]. / Ratsional'nye sposoby kozhno-plasticheskikh operatsii s ispol'zovaniem mestnykh tkanei pri otkrytykh povrezhdeniiakh kisti.

Based on the experience with treating 214 patients, the authors distinguished the most frequent types of traumas to the hand, or fingers, which required the performance of the cutaneoplastic operations, and systematized the variants of such operations with the use of local cutaneous flaps. The primary cutaneous plasty, and as well the complex postoperative treatment of the patients with open injuries to the hand permitted to reduce the incidence of postoperative complications from 46 down to 15%, shorten the duration of treatment by 1-2 weeks.

The role of purinergic and adrenergic transmitters of the sympathetic system in the control of arterial blood pressure variability.

Variability of mean arterial pressure (MAP) was examined in chronically instrumented, conscious, freely moving rats with pharmacologically altered efferent sympathetic influences on the cardiovascular system. MAP was recorded for 30 min beat-to-beat, using a computer under both control and experimental conditions: after administration of adrenoceptor antagonists (prazosin or phentolamine) or under P2X receptor inactivation produced either by desensitization with alpha, beta-methylene ATP or by PPADS blockade. Inhibition of adrenergic sympathetic effects on the cardiovascular system produced long-lasting and stable decrease in MAP. Prazosin did not modify MAP variability whereas phentolamine enhanced it. Under P2X receptor desensitization MAP decreased, the hypotensive effect being accompanied by a significant increase in MAP variability. A similar increase in MAP variability was observed after PPADS administration, while MAP level was not changed. Administration of PPADS in combination with phentolamine increased MAP variability more significantly than each of the drugs given separately. Changes in MAP variability under the various experimental conditions were not consistently correlated with changes in heart rate variability. We propose that ATP, being a mediator of sympathetic vasoconstriction, participates in baroreceptor-induced stabilization of MAP level.