[Approaches to objective assessment of the individual weight bearing in patients after total endoprosthesis of the hip joint].

An algorithm for the detection of weight bearing on the lower extremity after total endoprosthesis of the hip joint was developed, taking into consideration the parameters of the morphometric structure, type of pathology, method of treatment, the resulting extremity functioning and social and every-day conditions. The individual rehabilitation measures after endoprosthesis were performed in three steps and corrected depending on changes in the parameters in question. The amplitude of movements in the joint after using the method of calculation of the weight bearing on the lower extremity became close to normal in 26 patients after completion of the rehabilitation course and the statistic-dynamic indices of the extremity became stable.

[The diagnosis and treatment of wounds to the lumbar area].

An analysis of results of treatment of 228 patients with wounds of the lumbar region has shown that in 66.2% of cases they were not penetrating, in 33.8% they were penetrating. In 42 patients there were injuries of internal organs and of the vessels of the abdominal cavity and retroperitoneal space. The casualties must be examined under conditions of the emergency operating room and which in addition to thorough revision of the wound must include subsidiary methods of examination: USI, survey radiography of the thoracic and abdominal cavities and diagnostic survey laparoscopy, if necessary.

[The topographoanatomical features of "parapancreal" fatty spaces and ways of spread of the pathological process in acute destructive pancreatitis].

Three corpses of humans and 24 organocomplexes were used to study specific features of the structure of peritoneal-fascial space of the retroperitoneal area. The determined specific features helped to establish certain regularities of spread of the pathological process in 92 patients with acute destructive pancreatitis.

[Surgical micro-neuroanatomy of the formations in the posterior cranial fossa as applied to retrosigmoid and transcondyloid approaches]. / Osobennosti khirurgicheskoi mikroneiroanatomii obrazovanii zadnei cherepnoi iamki primenitel'no k retrosigmoidnomu i transkondilliarnomu dostupam.

Modern concepts on the surgery of the tumors of the cranial basis and those of posterior cranial fossa, in particular, reside on the expertise in microarchitecture of the region. The method of injection in brain vascular system using a marked block preparation enabled to preserve anatomically correct correlations of nerves and blood vessels, as well as of other brainstem structures, and to study the microtopography of this region using the microscope and microinstruments. The study was performed using 10 block preparations of posterior cranial fossa. The microneuroanatomy of middle and lower petroclival zones was studied in detail, and the rationality of the usage of suboccipital retrosigmoidal and lateral transcondillary approaches to the pathological structures within this zone is substantiated.

[Causes of unsuccessful attempts of laparoscopic cholecystectomy]. / Prichiny neudachnykh popytok laparoskopicheskoi kholetsistéktomii.

Based on an analysis of personal observations and literature data the authors made an analysis of the frequency and causes of unsuccessful laparoscopic cholecystectomy (LChE) resulting in laparotomy (conversion). LChE was successful in 217 of 233 operations. In 16 patients (6.9%) conversion was performed. According to the summary data of the literature on 150,000 cases of LChE the frequency of conversion was from 0.9 to 18%. The frequency of conversions was found to depend on the strategy of determining the indications for LChE and on the level of technological maintenance of operations. Three groups of the causes of conversion were set up on the basis of an analysis of publications about 498 cases of unsuccessful attempts of LChE and 16 personal observations: pathomorphological (393--78.9%; 7--43.8%); iatrogenic (99--19.9%; 7--43.8%) and technico-instrumental (6--1.2%; 2--12.4%). The pathomorphological causes lead to noncomplicated conversion and indicate to the limited use of LChE for the concrete patients. The iatrogenic and technico-instrumental causes appear all of a sudden and require emergent laparotomy. So the total frequency of conversion can not be a criterion for the assessment of complications after LChE. It is expedient to make a special analysis of the causes of transition to laparotomy and to distinguish the complicated and not complicated conversion.

[Variants and regularities of hepatic artery topography (practical aspects)]. / Varianty i zakonomernosti topografii arterii pecheni (prikladnye aspekty).

Variants of forming of the arteries of upper abdomen were studied. Peculiarities of their location in different variants were considered using 75 visceral complexes. A description of the original variant of hepatic artery is given. 2 laws of arrangement of the arteries in the upper abdomen were formulated corresponding with all the anatomic variants known that explain predominant location of right and left hepatic arteries.

[Computer modelling of the organs of the upper abdominal cavity]. / Komp'iuternoe modelirovanie organov verkhnego étazha briushnoi polosti.

Method of creation computer models of upper floor of abdomen organs: liver, gallbladder, duodenum, pancreas, stomach, blood vessels with using computer system "DUCT" was described. Details of modelled structures of the cylindric and complicated forms were noted.

[The "flickering" phenomenon in the right atrium]. / Fenomen "mel'kaniia" v pravom predserdii.

To specify characteristics and reasons of flickering in the right auricle (FRA) detected at two-dimensional ECG, 278 patients with innocent cardiac murmur (ICM) and 93 patients with congenital heart disease (CHD) underwent clinical and ECG examinations. FRA was found in 34.5% of ICM and 57.0% of CHD patients. Topographic-anatomical, ECG, intraoperative comparative investigations suggested that FRA may result from the eustachian valve movements and fenestration-filament structure of the endocardium at the opening of the inferior vena cava, interatrial septum, coronary sinus valve, base of the atrioventricular cusps. The movement of the eustachian valve was followed through the cardiac cycle. It is thought advisable that FRA characteristics should be taken into consideration for valid understanding of right atrial circulation in normal and CHD conditions.

[Roentgenological diagnosis of acute lesions of the lungs with disorders of blood circulation and vascular permeability]. / Rentgenodiagnostika ostrykh porazhenii legkikh s narusheniem krovoobrashcheniia i sosudistoi pronitsaemosti.

To specify differential and diagnostic criteria of hemodynamic and non-hemodynamic pulmonary edema, canine experimental simulation (15 trials) of different types of abnormal hemodynamic and lung capillary permeability parameters was carried out. The X-ray pictures of 71 patients with and acute diffuse lesion of the pulmonary vascular channel (including 51 with adult respiratory distress and 20 with hemodynamic pulmonary edema) was analysed. The findings substantiated the possibility of making a differential diagnosis of pulmonary edema of various genesis. Symptom complexes, typical of predominantly higher permeability of the lung capillaries and hemodynamic disturbance, were formulated.

[Dynamic study of heat exchange in the lungs]. / Dinamicheskoe issledovanie teploobmena v legkikh.

Elevation of air temperature in the breath arrest was noted in healthy subjects, whereas a decrease of the temperature occurred in rapid and deep breathing. Heat exchange did not depend on sex or physical development, whereas the temperature of the air depended on the range of maximal breath volume.