[More than half a-century at the head of Journal "Vestnik Khirurgii im I.I Grekova"].
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Biomedical subjects
Publications and source records attributed to S M Lazarev.
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Consecutive surgical treatment of bilateral hernias leads to the appearance of recurrences in 67% of the operated patients. An important etiological moment of the appearance of the repeated, by turns recurrences in the two-steps elimination of a bilateral inguinal hernia is the symptom of tension and pulling the lateral muscles of the abdomen from one side to the other. The proposed method of a one-step surgical treatment, using the suprapubic access by the developed technique, allows reduction of recurrences to 2.2%.
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The problem of studying injuries inflicted by different kinds of self-defense weapons is of great interest both to medical workers of different specialties (experts in forensic medicine, surgeons, toxicologists etc.) and to criminologists. Cases from practice of clinical and forensic medicine show that shots from pistols PB-4 with cartridges of traumatic action depending on the distance and the injured area as well as on other dynamic parameters of the interaction of the shell and the obstacle can cause injuries of different degrees of severity.
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The experimental work performed in 6 dogs was aimed at studying the dynamics of morphological alterations of the interatrial septum (IAS) tissues in the place of occlusion of the endovascular appliance ("ASO") and around it on the right and left atrium side at different terms after operation. A defect of the animals' interatrial septum in the area of the oval fossa was modeled artificially and then abolished with the "ASO". No substantial differences were revealed between processes of organization of thrombotic masses and formation of the endothelium on the "ASO" from both atria. The endothelium on the micropreparations on the "ASO" surfaces was formed as early as by the 14th day after its implantation in the heart IAS.
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Changed size and forms of the right and left ventricles of the heart and intraventricular hemodynamics were studied in 5 patients after closing the defects of the interventricular septum with an intravascular device. It was found that after occlusion of the defects by the safe and atraumatic endovascular device the right ventricular myocardium of the heart relaxed, the stroke index became less, the ejection fraction became greater, the diastolic diameter of the right ventricle decreased, and of the left ventricle increased. The indices of the regional contraction function of the tri-cuspid and output sectors of the input part and external and pulmonary output sectors of the right ventricle were found to normalize.
Arrhythmogenic dysplasia of the right ventricle (ADRV) is a congenital pathology of the heart resulting in the appearance of ventricular tachycardia that considerably increases risk of sudden death in young people. Up to now, however, the diagnostic criteria of this pathology have not been completely developed. An original method was used to study specific features of the regional contractile function (RCF) of the right ventricle and its diagnostic potentials in ADRV. The regional contractility of one of the right ventricle sectors was proved to decrease more than twice which corresponds to localization of additional conductive ways detected during the endo-electrophysiological examination of the heart. Changed indices of RCF should be referred to "great" angiographic criteria of diagnostics of ADRV.
Clinico-experimental investigations of Vitaflon in cardiosurgery of growing organism have shown that Vitaflon is a firm, plastic and good material for patches of different size and form, has high thrombus resistance. Inflammatory alterations in the surrounding tissues were not pronounced. The ingrowth of the connective tissue elements into the pores of the patch and its endothelialization were noted. Since 1996 the material has been used as patches in surgical correction of congenital heart diseases. The follow-up of the patients during 4 years failed to find symptoms of recanalization, thrombotic and infectious complications. Vitaflon can be widely used as a plastic material in cardiosurgery for congenital heart diseases.
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The use of an original device developed by the authors which was introduced in the blood flow in experiments in dogs has confirmed the presence of coiled blood flow in different parts of the aorta. The rate, direction and angle of coiling were calculated. The results obtained suggest that the fact of coiling the blood flow should be taken into account when constructing new models of artificial valves of the heart in order to decrease the energy value of the cardiac output, to prevent injury of the formed elements of blood and thrombogenesis.