Vol 52, No 3 (1971)

In 1935, testosterone was synthesised from cholesterol; in the same year, it was found that this hormone, besides its virilising effect, influences urinary nitrogen excretion by steadily reducing it, mainly through urea, and increases animal weight. The development of testosterone derivatives with a selective anabolic effect and a weak androgenic effect has created new opportunities in experimental endocrinology. As therapeutic agents, anabolics entered medical practice following reports of their successful use in the treatment of osteoporosis.

Most acute and especially chronic infections are accompanied by an imbalance in protein metabolism. In this case catabolic processes begin to prevail over anabolic ones and a negative nitrogen balance develops. Timely restoration of disturbed protein metabolism, especially in heart and liver, is extremely important. A significant achievement in this area has been the therapeutic use of new androgenic preparations, testosterone derivatives with an enhanced anabolic effect.

The emergence of new antiarrhythmic drugs has significantly expanded the possibilities for combating various forms of heart rhythm disturbances. To control paroxysmal tachycardia we used Inderal in 44 patients with supraventricular and ventricular paroxysmal tachycardia and paroxysmal atrial fibrillation and flutter. The drug was administered intravenously in doses of 5 to 10 mg to 37 patients, and in 7 patients the drug was given orally during a tachycardia attack, up to 80-100 mg for 1-1.5 hours. When administered intravenously, Inderal seizures were stopped at the time of injection and after a few minutes in 29 patients, and when administered orally - in 5 patients.

The laparoscopy room at the central district hospital is best organised in one of the existing operating theatres or in a separate room close to the operating theatre. We have set aside one of the operating theatres for this purpose, which is also convenient in that it makes it possible to provide qualified surgical care in case of complications. The equipment of the operating theatre makes it easier to set up an endoscopy room. Other endoscopic examinations, such as bronchoscopy, etc., are also carried out in the same operating theatre.

Despite advances in modern anaesthesiology, the management of anaesthesia in severe gastric cancer patients, as well as the correction of essential somatic functions during the anaesthetic and post-operative periods, are still difficult tasks.

Taking into account that loss of digestive and reservoir functions of the stomach, forced discharge of insufficiently processed food from the stomach stump into the intestine are the main causes of postgastroresection disorders, one of us (V.A. Baulin), in experiment on 27 dogs, developed  a new modification of economy resection of the stomach according to Bilrott II with partial suturing of the adducting and abducting loop of anastomosis. 

In recent years, surgical interventions on the pancreas have expanded to include the resection of different parts of the pancreas. If metabolic disorders (protein, carbohydrate, fat, water-salt) associated with pancreatic pathology have been studied to some extent, there is still much uncertainty in the issues of microelement exchange in pathological conditions and various surgical interventions on the pancreas.

Advances in urology are largely related to advances in anaesthesiology. Of great interest is the anaesthesiological support for operations for malignant bladder lesions. Bladder extirpation combined with bladder grafting from the intestinal tube and transplantation of the ureters into the graft place significant demands on the surgical and anaesthetic teams due to its duration, traumatic nature and labour-intensive nature.

The issue of closed injuries of the spleen in children has not yet been sufficiently discussed in the literature. From 1950 to 1968, 70 children aged from 5 to 16 years were operated on in our hospital for closed injuries of the spleen, of which 45 (40 boys and 5 girls) had isolated ruptures.

We analysed the medical records of 53 patients who had undergone magnetic diascleral surgery followed by removal of the eye and whose histological examination revealed retinal detachment. The patients were predominantly young men (20-40 years old). The vast majority of the patients were admitted to inpatient treatment early (1-3 days) after the injury.

Many hypotheses and theories have been proposed over the years to explain the etiology and pathogenesis of this severe complication of pregnancy. The immunological theory of late toxicosis in pregnant women was proposed a long time ago. Proponents of the allergic hypothesis were a number of domestic scientists (K. K. Skrobansky, K. P. Ulezko-Stroganova, A. I. Serebrov, M. A. Petrov-Maslakov) who, based on pathomorphological and experimental studies, created a coherent theory of late pregnancy toxicosis due to maternal sensitization by chorionic elements.

Ultraviolet irradiation in the last 1.5-2 months of pregnancy in women has become widely used in practice as one of the most effective means of specific prevention of rickets. It is known that under the influence of ultraviolet rays the 7-dehydrocholesterol present in the skin is converted into vitamin D3. In addition, ultraviolet rays have a stimulating effect on the body through the nerve endings of the skin and internal organs.

In our clinic over the last 17 years new variants of pharmacodynamic pain management in labour have been widely used. This takes into account not only the analgesic activity of these pharmacodynamic options, but also their labor-accelerating effect, mainly on the duration of the first period of labour. Moreover, we have seen that combinations of modern analgesics and antispasmodics, which have protective effects on uterine motility in labor, are also effective means of preventing a variety of disorders of uterine contractility, preventing uterine muscle fatigue and manifestations of uterine contractions discoordination.

The issue of uterine sarcomas is poorly understood. This seems to be due to the relative rarity of the disease. In the Russian literature, uterine sarcoma was first described by N.F. Tolochinov in 1869. Then about 45 reports of single cases were published, and in 1949 A.S. Apetov cited 22 cases of sarcoma without indication of the histological structure of the tumour.

In the treatment of chronic pneumonia, antibiotics are at the top of the list. To date, observations have accumulated about the adverse effects of antibiotic therapy on the normal microflora of the human gut. We examined children with chronic pneumonia who were in a sanatorium. Bacteriological diagnosis of intestinal dysbacteriosis was guided by the guidelines presented in the methodological materials of the Moscow Research Institute of Epidemiology and Microbiology.

We studied secretory and motor functions of the stomach in 84 patients with peptic ulcer disease (age, 19-50 years) before and after a course of ultrasound therapy in a complex of sanatorium treatment. The patients received diet no. 1, a circular shower every other day and ultrasound therapy.

Closed gallbladder injuries are attributed by some authors to previous gallbladder disease. One of our observations supports such a conclusion and describes the difficulty of establishing a correct diagnosis.

We studied 40 patients with acute purulent peritonitis (age, 1 to 82 years). Reasons of peritonitis development were the following diseases: acute appendicitis - in 24 patients, acute cholecystitis - in 3 patients, pinched hernia and adhesive intestinal obstruction - in 7, perforation of the stomach and duodenum - in 3, cancer of abdominal organs - in 2, thrombosis of small intestine mesentery vessels - in 1, abdominal trauma with intestine injury - in 3. All the patients underwent surgical intervention with the abdominal cavity lavage with furacilin solution and drainage. Total 44 operations were performed, 27 of which - under anesthesia by A.V. Vishnevsky, 12 - under ether-oxygen intubation anesthesia, 5 - under combined anesthesia.

Reconstructive plastic surgery of the urinary tract is one of the current problems of modern urology. We aimed to develop a more rational method of bladder plasty with a section of large intestine, and to study the onset of changes in the resected bladder and intestinal graft. In the search for optimal methods of surgical interventions on the bladder, we used the method of closing extensive bladder defects with a flattened demucosal segment of the colon on a vascular stalk.

In recent years a number of tables for the Maclakov tonometer have been proposed by various authors in our country and abroad. The task before us was to evaluate the accuracy of the proposed tables and to select one of them for application in practice.

Primary gallbladder cancer is quite rare. In vivo diagnosis is extremely difficult. According to our data 6 (0.03%) out of 20 087 cancer patients were diagnosed with gallbladder cancer during 16 years.

Human anthrax is a relatively rare occurrence. It is even more difficult to find anthrax in a woman at the time of childbirth. I. S. Bezdenezhnykh and L. N. Devyatova believe that in very rare cases intrauterine anthrax infection is possible. However, we found no such reports in the available literature. We observed the birth of a healthy child from a woman with anthrax.

We observed congenital haemolytic jaundice in 4 brothers: Yakov, aged 38, Gregory, aged 36, Ivan, aged 28, and Alexander, aged 24.

Despite great advances in the control of infectious diseases, acute intestinal infections are still very common. Of course, in the elimination of infectious diseases, in particular the group of acute intestinal diseases, the main role belongs to preventive measures, but in the overall set of anti-epidemic measures of essential importance is the therapeutic section of the work. This article highlights some issues of the clinical picture of dysentery and food poisoning. Early diagnosis of an infectious disease is the main factor in the effectiveness of the whole complex of anti-epidemic measures.

Failure theory has been intensively developed over the last 5-7 years and is being used to investigate the causes of failure in complex technical systems. This talk aims to show the possibilities and ways of using this theory in medicine. Before turning to specific examples, let us briefly outline some basic concepts.

The monograph is devoted to a relatively new issue - the role of gastric function in the metabolic processes of the body as a whole.

On 17 March 1971, after a long and serious illness, Professor Reveka Izrailovna Lepskaya died at the age of 86.

On 31/1 1971, Professor Vladimir Vsevolodovich Tretyakov of the Ufa Medical Institute died suddenly.