[Results of urolithiasis treatment in pilots with the use of a new domestic lithotripter "Kompakt" during remote lithotripsy]. / Rezul'taty lecheniia mochekamennoi bolezni u letnogo sostava s ispol'zovaniem metoda distantsionnoi litotripsii na novom otechestvennom litotriptere "Kompakt".

Results of treating urolithiasis in pilots on new Russian lithotriptor Kompakt were analyzed. Length of the shock-wave pulse is 0.3-0.4 microsecond w/o the negative phase prevents damaging of the kidney tissue. Urolithiasis was treated in 45 pilots in 69 ESWL sessions: 6.2 concrements, mostly in calyces renales (95.6% of the patients), were crushed. In more than 30% of the patients concrements were no larger than 5 mm and in 66.7% of the patients they were X-ray negative (urate). Concrements were crushed in all 45 patients into fine-dyspersated fragments (< 3 mm). At no time after ESWL complications or secretory-excretory dysfunctions of kidneys were observed. In-hospital examination following 1.5-2 mos. since ESWL did not detect residual fragments in urinary tracts of the pilots. No renal or any other pathologies were found. All the patients were admitted to flight.

[Experience of the 7th Central Military Clinical Aviation Hospital in early diagnostics, treatment, rehabilitation, and expert evaluation of cholelithiasis in flying personnel]. / Opyt raboty 7 Tsentral'nogo voennogo klinicheskogo aviatsionnogo gospitalia po rannei diagnostike, lecheniiu, reabilitatsii i ékspertnoi otsenke kholelitiaza u letnogo sostava.

The Seventh Central military clinical aviation hospital is experienced in performing laparocholecystectomy (LCE) in pilots afflicted with cholelithiasis (CL). In the period from 1990 to 2001, 92 operations were carried out after which 80 patients (87%) were permitted to fly. Medical discharge of 12 patients (13%) was associated not with CL but with some morphofunctional shifts caused by concomitant diseases. Seven to five-yr. follow-up of the 80 pilots who had returned their flying status after LCE showed their good tolerance for the flight loads.

[The lithotriptor "Compact" used in urinary bladder diseases]. / Litotripter "Kompakt" v lechenii mochekamennoi bolezni.

The stroke-wave complex "Compact" is the first home-produced lithotriptor with electromagnetic system of stroke-wave generation and ultrasonic diagnosis. During its development it was possible to achieve the optimal parameters of focused waves, good technical characteristics and economic indices. The clinical use of lithotriptor has shown its efficiency in nephrolith and ureterolith remote destruction in the absence of complications connected with negative influence of stroke waves on kidneys and surrounding organs and tissues.

[Distant pulse-wave lithotripsy in the Central Clinical Air Force Hospital ]. / Prioritetnaia distantsionnaia udarno-volnovaia litotripsiia v tsentral'nom voennom klinicheskom aviatsionnom gospitale.

With participation of the specialists from the 7th Central Military Clinical Aviation Hospital 4 pulse-wave complexes "Urat-P", "Urat-P2", "Ulitho", "Cholelithotriptor" were developed and introduced into clinical practice of the hospital. Distant pulse-wave lithotripsy was conducted 3035 patients (358 persons from flying staff). It is the main method of urolithiasis treatment, especially in the flying staff. Its efficiency is more than 96%. The modern models of lithotriptors are effective in destruction of biliary and urinary calculi and the applied parameters of wave impulses don't impact on the organs and tissues. The sphere of use of pulse-wave effect in the clinical practice was extended.

[Laparoscopic cholecystectomy in the treatment, rehabilitation and clinical health certification of the flying personnel with cholelithiasis]. / Laparoskopicheskaia kholetsistéktomiia v lechenii, reabilitatsii i ékspertize letnogo sostava s zhelchnokamennoi bolezn'iu.

Applicability of laparoscopic cholecystectomy (LSCE), a modern approach to the treatment of cholelithiasis, to rehabilitation, and military medical and military aviation certification was evaluated. Since 1994, 303 LSCE operations, including to 97 patients-aviators, have been performed by way of penetrating the abdominal wall with a standard laporoscopic stand (K-Chtorz, Germany). After introduction of LSCE, only 9 operations (2.9%) were fulfilled with the conventional technique. Immediate results of treatment of aviators were satisfactory and characterized by a good cosmetic effect, more rapid recovery of the motor activity, minimal complications (2.2%), absence of severe post-operational pancreatic/biliary dysfunctions, and expedited course of treatment.

[Lumbar sympathectomy in atherosclerosis obliterance of lower limb arteries and age of the patients]. / Poiasnichnaia simpatéktomiia pri obliteriruiushchem ateroskleroze arterii nizhnikh konechnostei i vozrast patsientov.

In the elderly and old patients with atherosclerosis of lower limb arteries, ultrasonic dopplerography assisted study of hemodynamics in foot with use of Valsalva and corinfar tests was carried out. It is revealed that these patients retain high reaction to sympathetic influences. The obtained data were the base for use of lumbar sympathectomy in 419 patients over 65 years as an independent method of surgical treatment and in combination with reconstructive operations on major arteries. Good results were obtained in 70.1% operated patients, satisfactory results--in 22.7%. There were no significant differences in the results of lumbar sympathectomy between this age group and younger patients.

[Current approaches to the diagnosis, treatment and expertise of cholelithiasis in pilots]. / Sovremennye podkhody k diagnostike, lecheniiu i ékspertize kholelitiaza u pilotov.

Data on the modern mechanisms of forming the cholelithiasis and the new methods of its treatment are presented. There have been examined 337 pilots of the helicopter aviation with the professional length of service of 10 year and more, the cholelithiasis has been revealed in 107 cases. In the course of treatment there have been used the preparations of ursodeoxycholic acid (urosan), remote shock-wave lithotripsy and laparoscopic cholecystectomy. There is demonstrated the high efficiency of these methods during examination of 106 patients who after passing the air-force medical board are pronounced for proceeding their flying activity.

[The work experience of the Central Military Aviation Research Hospital in the occupational rehabilitation of flight personnel after lithotripsy]. / Opyt raboty TsVNIAG po professional'noi reabilitatsii letnogo sostava posle litotripsii.

The evolution of the domestic-certified lithotriptors has made a complete professional rehabilitation of all pilots (100%) suffered from urolithiasis without operative intervention possible. Of 156 pilots who have been exposed to remote shock-wave lithotripsy (RSWL) in recent three years 120 individuals (93%) had the urate stones in the renal calyces. Before introducing the RSWL in clinical practice such concrement were recognized as inoperable and the urolithic pilots have no prospects for continuation of their flying activities. After the RSWL application there was a decrease in the secretory-excretory renal function due to the disturbed urodynamics by the migratory fragments of crushed stones in the renal system. The recovery of renal function occurred after complete passage of the crushed stone fragments. Depending on the composition of a crushed concrement, severity of inflammatory process taking place in the kidneys and urinary tracts, the special program of countermeasures to prevent relapsed lithogenesis was recommended for use by the patients. The relapse of renal stone formation after RSWL application was noted in 4 (3.2%) pilots. In these pilots, the concrements were recrushed by the mentioned method and professional qualification of above individuals was retained. Until recently, the treatment of cholelithic disease was recognized as a purely surgical problem--with the introduction of RSWL of renal stone into clinical practice there appeared real possibility to apply the similar approach to crushing the gallstones. To attain these ends, the experimental studies with the use of lithotriptor "URAT-P" have been performed. 140 gallstones of 0.5 to 2.0 cm in size were crushed. The parameters of shock waves are determined.(ABSTRACT TRUNCATED AT 250 WORDS)

[Current problems in the diagnosis, treatment and prevention of cholelithiasis in flight personnel]. / Nekotorye aktual'nye voprosy diagnostiki, lecheniia i profilaktiki kholelitiaza u letnogo sostava.

In 50% of afflicted pilots, cholelithiasis is asymptotic and develops with the minimum anatomicomorphological changes of the biliary system. An early diagnostics of cholelithiasis in the pilots will enable one to treat them timely with the aim of returning the pilots to flying activity in the future. The introduction of nonsurgical treatment methods into the clinical practice with an application of distance shock-wave cholelithotripsy will elevate the percentage of pilots returning to flying activities. A need for developing domestic special devices for cholelithotripsy is ripe.

[Early thrombotic complications after femoro-popliteal segment surgery]. / Rannie tromboticheskie oslozhneniia posle operativnykh vmeshatel'stv na bedrenno-podkolennom segmente.

The work analyses the causes of early postoperative thromboses which occurred after reconstructive operations on the femoro-popliteal segment in 293 patients. Early postoperative thromboses are a frequent complication in reconstructive operations on the vessels and develop in 27% of cases mostly in the first days after the operation. The most frequent causes of early thromboses were deficient distal arterial blood circulation, technical and tactical errors of the intervention, and insufficiently corrected postoperative therapy. It is pointed out that combination of reconstructive operations on the main vessels with lumbar gangliectomy has a favorable effect on the results of treatment and prevention of early thromboses. The use of microsurgical techniques reduces the probability of the development of early postoperative thromboses. In the absence of an effect of repeated operative interventions, in increase of ischemia and intoxication the limb must be amputated before gangrene develops.

[Lumbar sympathectomy in patients with arteriosclerosis obliterans of the lower extremities and diabetes mellitus]. / Poiasnichnaia simpatéktomiia u bol'nykh s obliteriruiushchim aterosklerozom arterii nizhnikh konechnostei i sakharnym diabetom.

In 72 patients with obliterative atherosclerosis of the arteries of the lower extremities and diabetes mellitus, the lumbar sympathectomy was performed. A good result was noted in 35 of them, amputation of the extremity was performed in 8 patients. Lumbar sympathectomy is indicated to the patients in initial stages of the disease.