The surgical treatment of a large postoperative ventral hernia in patients over 60

Breech presentation occurs in 3-5% of deliveries and can be managed by either a trial of vaginal breech delivery (TOVBD), external cephalic version (ECV) or Caesarean section. A postal questionnaire was completed by 82% of Scottish consultant obstetricians and revealed wide variations in practice. Eighteen percent never offered ECV. Among those who did consensus was lacking on some contraindications. One-quarter sometimes performed ECV before 37 weeks gestations despite the possibility of spontaneous version. Only 70% restricted ECV to one or more designated operators thereby maintaining levels of expertise. Variations were demonstrated in the use of tocolytics, and pre and post procedure investigations. Following failed ECV 28% considered a repeat attempt and 56% a TOVBD. TOVBD was not offered as first line management by one-fifth of respondents. Those who did varied in the pre-procedure investigations performed. Guidelines are required to ensure safe, consistent practice and avoid unnecessary Caesarean sections.     

Kinetics of rupture of ductile sheet material at the concluding stage of deformation

Institute of Strength Problems, Academy of Sciences of the Ukrainian SSR, Kiev. Translated from Problemy Prochnosti, No. 12, pp. 18–25, December, 1988.     

Reticular inhibition of evoked potentials of the ventro-basal thalamus and somatosensory cortex of the rat brain

In rats immobilized with d-tubocurarine conditioning electrical stimulation (100/s, 300 ms) of the central grey matter, reticular formation of the midbrain and medulla depressed focal potentials in thalamic ventro-basal complex and somatosensory cortex evoked by electrical stimulation of the forelimb or medial meniscus. The average threshold current for conditioning stimulation of these structures was 70, 100 and 120 muA. A comparison of intensity and duration of evoked potentials depression (for two-fold threshold stimulation of the brain stem) is failed to detect any difference between the stimulated structures: immediately after conditioning stimulation the amplitude of the cortical evoked potentials and post-synaptic components of the evoked potentials in the ventro-basal complex were 50-60% less than control amplitude (p less than 0.01) the depression persisting for 0.5-1 s. The presynaptic component of the thalamic evoked potentials was depressed only after three five-fold threshold conditioning stimulation. The brain stem stimulation did not cause any facilitatory effect on focal potentials evoked by maximal and submaximal stimulation of the forelimb or medial lemniscus.     

Effect of pharmacotherapy of affective disorders on the psycho-semantics of alcoholic patients

90 alcoholic patients (II stage of alcoholism) with secondary affective disorders (anxiety, depression) were divided into 4 groups. The patients of the first group received the GABA receptor ligand baclofen during 3 weeks. Sybazon preparation was used in the second group, while the patients of the third group were treated with amitriptyline. Placebo was applied in the forth group. The clinical psychological tests demonstrated that all drugs caused quite effective relief of affective disorders. Psychosemantic tests application showed that the pharmacotherapy caused positive changes in patients of 1-3 groups. These changes touched on both system of personal estimations and relations of personality to himself and to the world around i.e. psychosemantic sphere. Such changes in psychosemantic sphere were not observed in the 4-th group of patients (placebo). Besides it was revealed that each drug caused some specific changes in psychosemantic sphere. The result obtained were supposed to have some theoretical value in comprehension of brain-psychics relations as well as the applied significance for adequate choice of affective disorders pharmacotherapy of alcoholic patients.     

The oxidant and antioxidant systems in patients with stable stenocardia and with a history of small- and large-focus myocardial infarcts

A study was made as well as a comparison of values of the cholesterol (Chs) lipid fractions concentrations, and of those of the lipid peroxidation processes activity (LPP) and the gluthathione antioxidant system (AOS) status in male subjects aged from 45 to 59 years, healthy individuals and patients with stable angina pectoris and myocardial infarction (micro- and macrofocal) during cicatrizing stage (health resort rehabilitation stage). In patients with various forms of IHD total cholesterol is raised as are atherogenic lipoproteins, and atherogenicity index, intensification being noted of LPO along with a considerable decrease in functional potencies of AOS. Similar pattern of changes of LPO and AOS in patients with stable angina pectoris and myocardial infarction (MI) during cicatrization stage certainly warrants correction of these systems not only in acute phase of MI but at the stage of rehabilitation as well.     

The choice of surgical approach in the resection of abdominal aorta

The abdominal aorta aneurism (AAA) surgery experience in 110 patients was analysed. The topographic-anatomic investigations were conducted, a new surgical access to suprarenal and infrarenal AAA parts was proposed.     

Constructing the Russian combined-cycle cogeneration plant and mastering its operation

The main results obtained from the development, construction, mastering, and operation of the PGU-450T combined-cycle power plant are described.