[Application of C-QUR V-Patch system while performing preperitoneal alloplasty for small and middle umbilical hernias].

Own experience of application of a system C-QUR V-Patch, manufactured by "Atrium" (Maquet Getinge Group) firm while performing preperitoneal alloherniolasty for small and middle umbilical hernias, was summarized. In this implant polypropylene mesh, covered by layer of preparation of omega-3 class of polyunsaturated fatty acids, capable of bioabsorption, joined with a newest technologies of a space memory. Its application guarantees lesser traumaticity and duration of operation, absence of peritoneal damage, small sizes of operation wound, what permits to accelerate significantly the patients' working ability restoration, as well as to achieve a quality of their life improvement.

[Ultrasonic diagnosis of choledocholithiasis].

Potential of ultrasonic examination for diagnosis of choledocholithiasis was analyzed in 47 patients. Ultrasonic scanners Acuson 128XP and SONOLINE Elegra with 2-9 MHz sensors were used. Choledocholithisis was diagnosed during transabdominal echography in 38 (80.9%) patients. Method of ultrasound-assisted "vibratory" palpation for diagnosis of mobile concrements of the common bile duct is presented. Causes of 2 (4.3%) false-positive and 7 (14.9%) false-negative results of examination are analyzed.

[Clinical and ultrasonic diagnosis of colon diverticulitis and its complications].

Clinical presentations and ultrasonic criteria of colon diverticulitis and its complications in 31 patients (14 men, 17 women) were analyzed. Diverticulitis of the colon was diagnosed at ultrasonic examination (USI) in 23 (74.2%) of 31 patients. USI was carried out with device "SONOLINE Elegra" (Siemens) with convex and linear multifrequency sensors (2-9 MHz). All the patients were examined in scanning regimens of grey scale, tissue harmony, color doppler and energetic Doppler. In some patients with pain syndrome and absence of diverticulitis symptoms according to trans abdominal ultrasonic examination additional transrectal and transvaginal scanning were performed. Clinical picture and ultrasonic criteria of colon diverticulitis and its complications as well as limitations of ultrasonography in diagnosis of this disease were analyzed. In 8 (25.8%) patients false-negative results were seen, there were no false-positive diagnostic mistakes.

[Radiodiagnosis of acute appendicitis]. / Luchevaia diagnostika ostrogo appenditsita.

Sixty acute appendicitis suspects with unclear clinical picture were examined with high-frequency ultrasound and native CT. The results of the examinations were compared with clinical data, surgical findings and histological evidence. Acute appendicitis was in 39 patients, other diseases of abdominal cavity and small pelvis--in 21. Sensitivity of CT was 95%, specificity--91.3%, accuracy--96.6%. Sensitivity of US was 92.3%, specificity--100%, accuracy--95%. The above parameters for non-invasive diagnostic methods were similar to ones for laparoscopy. Native CT and US are highly precise methods for diagnosis of acute appendicitis. They are preferable in unclear clinical situations, atypical location of the appendix, in children, elderly and aged patients, and in patients with mental disorders.

[Effect of captopril on myocardial ischemia, intracardiac hemodynamics and regional left-ventricular contractility in patients with stenocardia]. / Vliianie kaptoprila na ishemiiu miokarda, vnutriserdechnuiu hemo- dinamiku i regionarnuiu sokratimost' levogo zheludochka u bol'nykh so stenokardiei.

Technetium-99m pertechnetate equilibrium ventriculography was used to evaluate the effects of captopril in a single dose of 50 mg on the changes in ST segment depression during the identical bicycle ergometer exercise, as well as on systemic and regional hemodynamic parameters in 10 patients (mean age 52 years) with Functional Classes II-III exercise-induced angina pectoris. During exercise performed 45 and 90 minutes after captopril, ST segment depression decreased by 30 +/- 0 (p less than 0.05), and 32 +/- 10% (p less than 0.02), respectively as compared to baseline ST segment displacement. Following 90 minutes after the drug administration, end-systolic volume reduced both at rest and during exercise, resting stroke volume increased from 71 +/- 4 to 76 +/- 4 ml (p less than 0.01), whereas exercise stroke volume rose from 69 +/- 3 to 74 +/- 3 ml (p less than 0.03); with the drug, ejection fraction showed a 5% increase (p less than 0.02) at rest and a 4% increase (p less than 0.02) on exercise. Thus, captopril had a beneficial effect on the hemodynamics and reduced myocardial ischemia in patients with exercise induced angina.

[Comparative effectiveness of class I anti-arrhythmia drugs and the algorithms of their selection in patients with ventricular arrhythmia]. / Sravnenie éffektivnosti i algoritmy podbora antiaritmicheskikh preparatov I klassa u bol'nykh s zheludochkovymi narusheniiami ritma serdtsa.

The efficacy of 7 well-known Class I antiarrhythmic agents were retrospectively and by+crossover compared in 2 groups of patients treated in hospital in different years for ventricular arrhythmias. Class IC agents proved to be the most potent in the two groups of patients. The following algorithm is proposed to choose Class I agents: if quinidine or mexiletine is beneficial in the same patients, the other drugs will be also effective. If disopyramide fails to be beneficial, allapinin , ethacizine , propaphenon will be the most effective. When allapinin produces effects, ethacizine and propaphenon show their highest potency, but when each of them fails, a combination of antiarrhythmic agents should be used.

Photometric determination of tungsten in rocks with trihydroxyfluorones.

The interaction of tungsten(VI) with a series of 2,3,7-trihydroxyfluorones in the presence of cationic and non-ionic surfacants has been studied. Optimal conditions for the formation of the complexes and their spectrophotometric determination have been found. Possible mechanisms for the effect of the surfactants are suggested. The method developed has been applied to determination of trace tungsten in rocks and silts.

[Pharmacodynamics of the new beta blockader corgard (nadolol) in patients with stress-induced angina pectoris]. / Farmakodinamika novogo beta-blokatora korgarda (nadolola) u bol'nykh so stenokardiei napriazheniia.

Antianginal effect of a new beta-blocker corgard (nadolol) was studied in 17 male patients with stable stress angina, aged 42 to 56, in comparison to obsidan and placebo. An original method was used to assess the extent and duration of antianginal effect consisting in repeat identical treadmill exercise coupled with continuous ECG monitoring. Corgard was shown to produce a marked antianginal effect as reflected in significantly reduced ST depression and elevation of angina of effort for more than 24 hours after a single 80 mg dose. Compared to an adequate dose of propranolol, corgard is 20-25% more effective in terms of markedness, and at least 14 hours more effective in terms of duration of the effect.

[Exercise-induced attacks of variant angina pectoris]. / Pristupy variantnoi stenokardii pri fizicheskoi nagruzke.

Ten coronary patients showing no signs of controlled myocardial infarction and responding with transient ST rise to bicycle-ergometric exercise were investigated. ST rise was also recorded from the same leads during a spontaneous attack and cold testing. Coronarography revealed mild coronary arterial lesions. No ST elevation was recorded when bicycle-ergometric test was repeated in the presence of obsidan or corinfar treatment, and the test was negative in most cases.

[Sustak pharmacodynamics in effort stenocardia]. / Farmakodinamika sustaka u bol'nykh so stenokardiei napriazheniia.

Sustak pharmacodynamics was studied in 32 patients with stable angina pectoris of effort during acute tests with dosaged physical exercises repeated a tone-hour intervals. The results were compared with those in placebo. It is shown that the duration and pronounced character of the antianginal sustak effect varies widely in different patients. The maximum effect of the drug in a dose of 6.4 mg was encountered one hour after medication and was characterized by reduced depression of the ST segment by 54% during physical exercise and alleviation of the pain syndrome. The drug caused a statistically significant reduction of arterial pressure, an increase in the pulse rate at rest and a decrease of this value during exercise. The antianginal effect of sustak was particularly manifest in patients with low tolerance of physical exertion and in patients in whom the attack of angina pectoris was attended by marked dyspnea.

[Method of studying the pharmacodynamics of anti-angina drugs by means of repeated exercise tests]. / Metod izucheniia farmakodinamiki antianginal'nykh preparatov s pomoshch'iu povtornykh nagruzovhnykh testov.

A method for studying the effect of anti-anginal agents was elaborated. It comprises the appraisal of ST segment depression dynamics in individually dosaged physical exercise repeated in the same volume at interval of one hour after a single dose of the agent that is studied had been taken. Continuous monitoring with subsequent computer treatment was used for ECG recording and analysing. The administration of placebo in 14 patients with angina of effort had no effect on the hemodynamic parameters determining the requirements of the myocardium for oxygen or on the depth of ST segment depression during physical exercise to which the patients were repeatedly exposed for 6 hours; at the same time, a statistically significant decrease in the severity of the pain syndrome was revealed. The average deviation in the magnitude of ST segment depression during repeated exercises was 11.2%. The method may be used in approbation of drugs and selection of effective anti-anginal therapy.

[Comparative pharmacodynamic study of Cordanum and obzidan in stress angina pectoris patients]. / Sravnitel'noe farmakodinamicheskoe izuchenie kordanuma i obzidana u bol'nykh stenokardiei napriazheniia.

The effect of different single doses of beta-blockers cordanum (talinolol) and obsidan was comparatively studied in 10 patients with angina pectoris of effort. The pharmacodynamic study was performed according to an original technique consisting in a sequence of monitored repeated identical treadmill exercise. The effect of the drug was evaluated by the reduction in ST-segment depression during exercise. Hemodynamic effect of cordanum was 1.7 lower than that of obsidan. The reduction of ST-segment depression effected by cordanum was 2.6 lower than in case of the corresponding doses of obsidan. The effect did not correlate with the heart rate and the double product; it terminated within 4--5 hrs.

Electrocardiographic exercise testing and ambulatory monitoring to identify patients with ischemic heart disease at high risk of sudden death.

Prognostic significance of ambulatory electrocardiographic monitoring and exercise testing was studied in 144 patients with established ischemic heart disease. A follow-up study showed that 10 sudden deaths occurred within 2 years. The univariates most strongly associated with the subsequent occurrence of sudden death included reduced maximal exercise heart rate, exercise-induced frequent ventricular arrhythmias, complex ventricular arrhythmias revealed by 24 hour ambulatory electrocardiographic monitoring and onset of S-T segment depression during exercise testing. Groups of patients at very high and very low risk of sudden death were identified using conjunction and inclusive disjunction of the foregoing variable. The presence of bivariate and trivariate combinations was associated with an increase up to 20-fold in the incidence of sudden death. Patients with the poorest prognosis were those who stopped exercise before achieving a high heart rate and who exhibited either pronounced electrocardiographic abnormalities during stress testing or complex ventricular arrhythmias during ambulatory monitoring. Combinations of exercise variables identified patients at a very high risk of sudden death, whereas combinations of monitoring variables appeared to be preferable for defining groups of patients at very low risk. The results obtained suggest that the two methods carry different prognostic information and, therefore, may complement each other in identifying potential victims of sudden cardiac death.

[Use of long-term monitoring observation and a physical load test for detecting persons with a high risk of sudden death among chronic ischemic heart disease patients]. / Primenenie dlitel'nogo monitornogo nabliudeniia i testa s fizicheskoi nagruzkoi dlia vydeleniia lits s vysokim riskom razvitiia vnezapnoi smerti sredi bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa.

During a two-year follow-up of 144 patients who had recovered from myocardial infarction and who were subjected to the physical load test and ECG recording for 24 hours by Holster's method 10 cases of sudden death were encountered. A statistically significant correlation was revealed (p less than 0.001) between a definite combination of the results of the physical load test and ECG monitoring and the subsequent sudden death. The study showed that these methods may be considered mutually complementary in detecting individuals with a poor prognosis. The results of the analysis may be used as criteria in the selection of individuals who are threatened most with sudden death.