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The work deals with the features of the course of gastric and duodenal ulcers in diabetes mellitus and the frequency and pattern of the complications. The authors recommend criteria for preparation for surgical treatment, methods for compensation of the disturbances of carbohydrate metabolism, and the methods of postoperative management of such patients. The late-term results and analysis of treatment are discussed briefly. The coexistence of peptic ulcer and diabetes mellitus is a rare occurrence. During a 20-year period 31 patients were treated at the clinic, 21 of them underwent operation, in 5 patients an operation was considered inexpedient, another 5 patients refused to be operated on. The postoperative period was free of complications in 19 patients, there were no fatal outcomes.

The authors show the results of experimental and clinical study of a single-row Pirogov-Mateshuk serous-muscular-subserous suture with the knots inside the lumen. It was demonstrated in experiments on 191 dogs that regeneration in the zone of anastomoses formed by a single-row suture is more perfect and occurs earlier than with the application of a double-row suture. Among 2,623 anastomoses formed on the esophagus, stomach, small intestine, colon, and rectum by means of a single-row suture, 1.5% were incompetent. The authors consider the single-row Pirogov-Mateshuk suture to be the method of choice.

The results of 676 radical operations for thyroid cancer are discussed. The choice of procedure was determined by tumor histology which was assessed using trephine biopsy. Extracapsular hemithyroidectomy was the basic procedure (420 out of 676 cases) used for the treatment of well-differentiated thyroid cancer affecting one lobe only. No fatalities were registered. Bilateral surgery was associated with paralysis of n. laryngeus in 1.5% of cases and with the nerve injury in 5.1%. With unilateral surgery, the parameter was 2.8%. The unilateral procedure offered the advantage of sparing the intact lobe which assured a decrease in thyrotropin and lower rates of relapse, hypothyrosis, hypoparathyroidism and paresis of n. laryngeus. Five-, ten- and twenty-year cumulative survival rates were 91.8, 87.8 and 71.6% whereas corrected rates--94, 93.6 and 92.9%, respectively.

The authors analyse the importance of the psychological barrier in the choice of the method of treatment in performing relaparotomy. Proceeding from the fact that the surgeon's psychological barrier is an objective factor aggravating the results of management of postoperative complications, the authors suggest that the indications for relaparotomy should be considered collectively. They believe that the second operation should be carried out by another, more experienced surgeon of the department. The surgeon who performed the first operation acts as an assistant during the relaparotomy.

Operations were performed on 865 patients for pararectal fistulas. The fistulas occurred after injury in 18 patients, histological examination revealed fistulous form of Crohn's disease in 14 patients, 12 patients had tuberculous paraproctitis. The late-term results of surgical treatment of chronic paraproctitis were studied in 560 patients according to the presence of concomitant hemorrhoids. One-stage excision of the fistula and hemorrhoidectomy was conducted in 329 patients. The fistula recurred in 1.3% of cases. Hemorrhoidectomy was not undertaken in 231 patients; a recurrence of fistula occurred in 6.1%. Therefore, to prevent recurrences of pararectal fistulas existing hemorrhoids must also be removed.

The authors have performed 25 experiments in dogs for the creation of compressive intestinal anastomoses with the help of permanent magnets. "End-to-end" and "side-to-side" anastomoses were formed on the large and small intestines. The magnets were eliminated together with necrotized tissues in the natural way on the 4-5th and 9-10th days after operation. Results of the application of "magnet" anastomoses in clinical practice (6 patients) are described.

Nineteen cases when the patients had different combinations of gastric disease with calculous cholecystitis are described. All the patients were subjected to simultaneous operations. No complications were noted. A conclusion is made that the simultaneous operation is the most rational method in such a combination of diseases. The authors believe that calculous cholecystitis can be responsible for postoperative complications after any operation.

Operations were performed in 1020 patients with acute cholecystitis, 530 of them were older than 60. The total postoperative lethality was 2,6% of cases, that in elderly and senile patients was 4,15% of cases. Among 530 patients older than 60, 275 patients (52%) were found to have coronary atherosclerosis and ischemic heart disease. Under consideration were particular contraindications from the cardio-vascular system against operations in the interval. The method described gives the opportunity to fulfil operations in 50% more cases among patients older than 60 having acute cholecystitis.

Causes of relaparotomies after operations for cholelithiasis are analyzed. The frequency of relaparotomies after cholecystectomies was 2.1%. Technical defects in performing operations were the cause of postoperative complications in 52.4% of the cases. Of 63 patients subjected to relaparotomy 23 patients died (36.5%). Prophylactics of complications after operations on bile ducts should be directed first of all to careful observation of the cholecystectomy technique.

The function of insular apparatus beta-cells and individual components of the contrainsular system were studied in 53 young patients with insulin-dependent diabetes mellitus. It was shown that early stages of the disease, including potential diabetes mellitus, are characterized by hyperinsulinemia, associated with an increased adrenocortical glucocorticoid function. Relative insulin insufficiency develops as diabetes progresses (subclinical stage of the disease) in the presence of persisting hyperinsulinemia and increasing aldosteronemia. An intensified adrenocortical function appears to be of an adaptive character at the preclinical stages of the disease. The concept of hormonal dissimilarity of the known forms of diabetes mellitus is documented with reference to the insulin-dependent forms in young subjects.

The results are presented of the studies of oxygen metabolism in the muscular tissue of patients with the thyroid goiter formation. An original method of the polarographic study allows one to observe the process of oxygen transport not only from the intracellular space into the cell, but also from the blood channel into the intracellular space. Oxygen utilization curve was recorded after prolonged ischemia (15 minutes) the oxygen recovery curve was noted, according to which the oxygen recovery rate coefficient, allowing to judge the circulation time and the vascular wall permeability, was counted by analogy with oxygen utilization rate determination. The ratio of these coefficients was used as an index for the tissue supplying with oxygen. The data are presented of studying 105 patients with different forms of the thyroid goiter formation. The informativeness of the utilization rate coefficient is examined for evaluating oxygen consumption by tissues. This index was practically equal in patients with diffuse toxic goiter, nodose euthyroid goiter and in the controls. At the same time the coefficient of oxygen recovery rate and the coefficient ratio of oxygen recovery and utilization rates were significantly elevated in patients with diffuse toxic goiter (1.3 +/- 0.21, 4.33 +/- 0.76) in comparison with the patients suffering from nodose euthyroid goiter (0.72 +/- 0.2, 2,95 +/- 0.66) and the controls (0.67 +/- 0.18, 1.8 +/- 0.37). In the patients with diffuse toxic goiter these indices returned to normal (0.44 +/- 0.11, 1.57 +/- 0.63) following the preoperative preparation.

At present effective diagnosis of deviations from euthyroidism in diseases of the thyroid gland presents certain difficulties. The most rational direction in the solution of this problem is introduction of quantitative methods into the diagnosis. Symptoms encountered in case histories of 1500 patients with goiter transformation were coded for this purpose according to the chosen algorhythm. Only those symptoms which were present in all the case histories were selected for this study. The data obtained were treated on "Ypapi-2" computer. A table in which every sign of the disease had a quantitative expression was drawn on the basis of the results. Diagnosis according to the mentioned mathematical table is more effective, and, besides, there is no subjectivism in the diagnosis.

The authors generalize their experience in the treatment of 528 patients with ulcerous pyloroduodenal stenosis, who accounted for 19.3% of all patients who were operated on and for 29.8% of those with complicated forms of peptic ulcer. All the patients underwent operation after brief (2-3 days) replacement of hydrogen ion deficiencies. Resection of the stomach was carried out in 418 patients, organ-preserving operations-in 102, gastroenteroanastomosis-in 8 patients. Total mortality was 2.5%. There were no fatal outcomes in organ-preserving operations. The incidence of postoperative gastric atony was 6.1% after organ-preserving operations and 4.9% after resection of the stomach.

Under analysis were 55 cases of toxic goiter associated with diabetes mellitus. All the patients were operated upon with good early results. A scheme for the choice of necessary preoperative dosage of insulin is recommended. The authors believe the combination of toxic goiter and diabetes mellitus to be an indication for surgery. Decompensation of diabetes mellitus in patients with thyrotoxicosis is associated with the increased amount of contrinsular hormones. The operations resulted in the improvement of the course of both diseases.

During 15 years 1663 intraabdominal operations on the rectum and colon were performed, relaparotomy resulting from the complications was fulfilled in 134 patients (8%). The main indication for relaparotomy was peritonitis (57 patients). Its sources were: incompetence of the colonic anastomosis suture, technical errors during the first operation, opening of the abscess into the abdominal cavity. Five types of the course of postoperative peritonitis were established: primary, atypical, artificial, perforative and necrotic types.

The authors give the definition of the term "complicated form" and classify the complications of gastro-intestinal carcinomas. The results of the treatment of 225 patients with complications of gastro-intestinal carcinomas are analyzed, 142 of them being subjected to urgent surgery. Complete occlusion ileus, peritonitis and continuous hemorrhage were considered by the authors to be indications for urgent operations.

Data are presented concerning the use of trepanobiopsy in preoperative diagnosis of diseases of the thyroid gland. No complications followed 188 trepanobiopsies; clinical diagnosis was changed after trepanobiopsies in 60 patients. Indications to trepanobiopsy in enlargement of the thyroid gland were worked out.