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Phlebopathy is an ambiguously interpreted term. In the Russian literature, it implies functional disorders of the venous system, albeit not seriously jeopardizing, however substantially decreasing quality of life. Phlebopathies may be induced by different causes, not infrequently common with the risk factors of chronic venous insufficiency. The present work deals with the classification, pathogenesis and epidemiology of phlebopathies, as well as the results of the original studies on management of hormone-induces phlebopathy. Hormone-induced phlebopathy - symptoms of phlebopathy or chronic venous insufficiency induced by long-term intake of combined oral contraceptives (COCs). To optimize treatment of the pathology concerned, we examined three groups of female patients (112 women) suffering from hormone-induced phlebopathy of the lower limbs. In Group One patients, COCs were discontinued with no administration of venotonic agents. Group Two patients along with withdrawal of COCs were given Antistax, as well as elastic compression. Group Three patients continued receiving COCs accompanied by simultaneous treatment with Antistax. During the study, we determined the malleolar volume, also assessing the degree of subjective symptoms, and quality of life. It was shown that withdrawal of COCs alone was not sufficient to stop symptoms of phlebopathy. Antistax efficiently stops the majority of these clinical manifestations, even on the background of intake of contraceptives. The maximal effect was observed in discontinuation of the COCs, intake of Antistax and prescription of elastic compression.

Varicose eczema is a frequently occurring complication due to chronic venous insufficiency. In view of the fact that the complicated forms of chronic venous insufficiency (classes 4-6 according to the clinical classification CEAP) are associated with the presence of dermatological lesions, the reliable diagnosis of the given pathology presents a matter of great concern. For the phlebologist end, not infrequently, for the dermatologist the diagnosis of varicose eczema may be difficult because of the diversity of its manifestations. Also, there is a number of diseases that look like varicose eczema but require a different approach to the treatment. The Russian literature practically lacks the works related to varicose eczema. The problems of the diagnosis and treatment including the organizational aspects have not been worked out. The surgeons hold that this disease is dermatological whereas the dermatologists view it as surgical. As a result, the majority of patients do not receive adequate treatment. The paper describes the phlebologist's standpoint of the problem of varicose eczema. Part II of the paper reviews the differential diagnosis of varicose eczema.

Varicose eczema is a prevalent complication of chronic venous insufficiency. In view of the fact that the complicated forms of chronic venous insufficiency (classes 4-6 according to the clinical classification CEAP) are marked by the presence of dermatological changes, the reliable diagnosis of the given pathology is fairly pressing. The diagnosis of varicose eczema may be difficult for the phlebologist and, not infrequently, for the dermatologist because of the diversity of its manifestations. Besides, there is a number of diseases which resemble varicose eczema but require a different approach to their treatment. The Russian literature practically lacks the papers related to varicose eczema. The problems of the diagnosis and treatment including organizational questions have not been worked out. The surgeons regard this disease as dermatologic whereas the dermatologists consider it as surgical. As a result, the majority of patients do not receive adequate treatment. This paper covers the phlebologist's viewpoint of the problem of varicose eczema.

Clinical and physiological effects of pressure-regulated ventilation of the lungs using the inverse rate of inhalation to exhalation (PCV-IR) were studied in two groups of patients. No appreciable advantages of this mode of pulmonary ventilation in comparison with common ("volumic") method were observed in group 1 patients (following open-heart surgery) with moderately expressed respiratory disorders (PaO2/FIO2 = 340c13 and index of lung comprometation 0.7c0.04). At the same time, the level of the peak inhalation pressure in the airways at PCV-IR was reliably lower than during common artificial ventilation of the lungs (AVL). In patients with grave respiratory disturbances (PaO2/FIO2 = 93c10 and index of lung comprometation 6.88c0.56) application of this scheme brought about an improvement of pulmonary biomechanics and gas exchange, but the hemodynamics was virtually the same. It is noteworthy that the process of PCV-IR adaptation required a thorough preliminary "adjustment" of the ventilation parameters and took rather a long time in the majority of patients. Positive effects of PCV-IR may be due to several mechanisms: a slowing down (ramp-like) flow, limitation of the upper pressure during inhalation, prolongation of exhalation in comparison with inhalation, and a regulated level of internal positive end expiratory pressure. PCV-IR is recommended as a variant of respiratory support in the treatment of patients with severe involvement of the lungs, when the potentialities of common AVL are exhausted.

Altogether 120 studies with a dynamic kidney phantom (DKP) were conducted permitting one to imitate the normal functioning of the kidneys or different pathological states of the organ. The studies were conducted with the help of a gamma-chamber of MV-9100 type using a computer system SEGAMS (Hungary) and a chronoscope RIKh-5M-01. On completion of the experiment the activity-time curves were plotted characterizing the time course of the passage of a radioactive tracer through phantom cylinders that imitate the kidneys. The results obtained have demonstrated DKP potentialities for the imitation of various renal functional states. Studies with a DKP make it possible to select an optimum regimen for research and to assess the quality of performance of nuclear medical diagnostic equipment.

Altogether 78 patients aged 12 to 62 with polycystic kidney disease were examined. Of these, 36 were examined while primary diagnosis was established; 42 patients were observed during treatment. Renoscintigraphy with 131I-hippuran and 99mTc-DTPA angionephroscintigraphy with 99mTc-dimercaptosuccinic acid, 99 Tc-tin-gluconate, 99mTc-cyton and nephroscintigraphy with 107Hg-neohydrine were used. Renoscintigraphy was used to evaluate renal excretory function. It was computerized, 20-25 sequences with 1 min. exposure. Angionephroscintigraphy consisted of 3 stages: (1) indirect radionuclide angioscintigraphy of the kidneys to evaluate the renal blood flow; (2) nephroscintigraphy to evaluate the anatomotopographic condition of the kidneys and the amount of the functioning parenchyma; (3) nephroscintigraphy using a Pinkhol collimator to specify the anatomotopographic condition of the kidneys. Based on angionephroscintigraphy 3 degrees of renal lesion were singled out: mild (43.2% of the cases), moderate (24.3%) and severe (32.5%). In renoscintigraphy moderately expressed unilateral changes prevailed in 49.4% of the cases, pronounced unilateral changes in 8.6%, moderate bilateral changes in 31.3% and demonstrable bilateral changes in 6.5%. In 4.2% of the cases no changes were found on the computerized renograms. The diagnostic value of reno- and angionephroscintigraphy in polycystic kidney disease was 92.6%. The study has shown a high efficacy of radionuclide methods in the evaluation of the process over time, therapeutic results and the elucidation of the familial nature of the disease.

Forty patients with temporal epilepsy were operated on with a stereotaxic technique. Eleven patients had a unilateral localization of the epileptic focus, and in 29 bitemporal foci were diagnosed. In evaluating the results of the treatment the dynamics of the epileptic fits, the peculiarities of changes in the mental status, and the degree of social adaptation were taken into consideration. A postoperative improvement was achieved in 73% of the patients with monotemporal lesions, while in those with bitemporal epilepsy and distinct persistent mental disorders the state was improved in 44% of the cases. Indications for the choice of the zone of destruction depending on the clinical peculiarities of the lesion are presented.

42 patients with isolated mitral valve defect were divided into two groups: without cardiac complications -- and with acute myogenic heart failure, after implantation of a mitral valve prosthesis. In the first postoperative hours, a decrease in cardiac output and pulmonary hypertension were observed in both groups. By the end of the 1st postoperative day, cardiac output reached in both groups the initial level, but in patients of group 2 only thanks to catecholamine administration. The poor functional state of the heart before surgery is consequently the main cause of the fact that surgical intervention is not immediately followed by normalization of haemodynamics. Acute heart failure occurs in the early postoperative period in patients with an extremely impaired left ventricular pump function and with depleted myocardial reserves. In these patients, special attention must be given during surgery to myocardial protection.

Altogether 244 persons were examined. Of them 221 patients suffered from the syndrome of arterial hypertension, 23 were controls. Standard renoscintigraphy with 131I-hippuran was performed in all the patients. Routine indices: Tmax, T1/2 and T delta (RP retention mean time) were used as criteria for the assessment of renograms. The diagnostic accuracy of disorders of renal excretory function in patients with arterial hypertension by the results of assessment of renograms using routine indices was 65% only. The introduction of a new index T delta made it possible to raise the accuracy of examination by 35% as a result of the diagnosis of disorders of central hemodynamics.

A total of 127 patients were examined to determine the efficacy of the use of sonography, angionephroscintigraphy and roentgenocontrast angiography in renal tumors and the importance of these methods in diagnostic studies with suspicion for a renal tumor. All the patients were given ultrasound and radionuclide examination, 86 roentgenocontrast angiography. The study has shown a high sensitivity of all three methods in the diagnosis of sizable renal lesions though each one has a different diagnostic tendency. In vascularized tumors the combined use of sonography and angionephroscintigraphy practically ensures 100% diagnosis in a patient even at the out-patient stage of examination. The main difficulties occur in the differential diagnosis of hypovascular sizable tumors when the comparison of the results of all three methods makes it possible to establish correct diagnosis. The advantage of sonography is the absence of traumatism, that of angiography a possibility to determine the functional activity of both involved and intact kidneys. Roentgenocontrast angiography plays the leading role in defining the involvement of the renal and cava inferior veins by a tumor thrombus.