Vol. 1 No. 1 (2009): VESTNIK of KSMA

In the given work the history of formation and development of the Kyrgyz state medical academy of name I.K. Ahunbaeva is shown. Authors have tried to tell short about stages of development of medical academy and about activity of visible scientists- physicians which have prepared the whole galaxy of highly skilled doctors-experts and science officers.

Resolution ofRSFSR PKC of July, 10th, 1930 about acm:5':on of students into KazGMI was of great historical importance. The outstanding statesman, professor S.D.Asfendijarov was appointed a rector of KazGMI on December, 2, 1930. The 225 students began their studies at the preparatory courses
since the 1st of February. Among first-year students there was 51.9% of Kazakh students, 11,4% of
oriental nationality students, 36,7% of Russian students. By 193- the staff of KazGMI was fully com­
pleted, but the material-technical base of the high school was extremely poor. In 1936 the first graduates received their diplomas.

The history of formation, scientific activity and modem condition department of physical methods of treatment with the course of traditional medicine are given in this artical.

Article narrates history of chair of forensic medicine of the Kirghiz State Medical Acade­my. 

The article is dedicated to the history and development of the hospital therapy chair. The chair was established in 1941 in Kyrgyz State Medical Institute (KGMI) that now is known as Kyrgyz State Medical Academy of Ahunbaev I.K. at the beginning of the Great Patriotic War with the help of scientists from Harkov, Leningrad that were evacuated in Frunze, the capital of Kyrgyz SSR in connec­tion with military operations. The article is about contribution of staff of the chair during 70 years in preparation of health care specialists, delivering assistance to the health care system and the contribution of the chair to the development of medical science development and medical education in Kyrgyzstan.

Describe history of creation соurse and clinic of occupational diseases as a basis of occupational health service of Kyrgyzstan.

The article expresses the way establishment and develop perspectives of Hematology
Science Centre. The Centre hematology was build on the basis of docent course of Internal Deseases
Department of Medical Academy of the Kyrgyz Repablic.

History of chair of psychiatry under Kyrgyz state medical institute has been started since 1942. In history of its development there are 3 the main periods connected with activity and heritage of
famous, outstanding clinician professors N.V.Kantorovich, A.I.Durandina and V.V.Solojenkin. Over the time of working chair of psychiatry was and still is scientific-educational, methodological and treatment-diagnostic center in preparation of specialists in the system of mental health protection. There has been changed several staff generation and tradition founded by founders and still are stable in the chair.

Профессор Кожокматов Сатынды Кожокматович начал свою трудовую деятельность в шахтерском горо­де Сулюкта, Ляйлякского района, Ошской области, как хирург общего профиля. Много лет он заведовал хи­рургическим отделением, выполняя сложнейшие опера­ции на грудной и брюшной полостях. Выезжал на все вызовы, оказывая помощь и урологическим, и гинеко­логическим больным. Он же был и анестезиологом, впервые в г. Сулюкта внедряет эндотрахеальный нар­коз. Среди хирургических больных в отделении все же доминировали больные с повреждениями костей опор­но-двигательного аппарата, которые требовали особого внимания, знания, умения вовремя соориентироваться в обстановке и принять соответствующее решение. При­ходилось неоднократно спускаться в шахту, изучать обстановку под землей, выявлять причинные факторы травматизма при авариях, обвалах и т.д.

Information about heads of department, main directions of their scientific activity and preparing  of young scientific generation is given in the article along with the personnel and scientific orientation of the department in the modern stage.

Article narrates history of chair of Anaestesiologi and Intensive care of the Kirghiz State Medical Academy.

To have an accurate investigations of patient and for patting the exact diagnose, it is very important to study the Anatomy in the field of Medicine.
Important role of studying normal and topographical anatomy is to understand the process of develop­ment of different diseases. Sufficient knowledge is required in the field of anatomy for the beginners of medicine to have a control on different variants of conditions, ranges from the normal physiologic process to the pathologic state. Teaching of Normal and Topographical anatomy includes lectures and practical classes. For the preparation of classes, students are furnished with methodical recommenda­tions, charts and samples of different body parts.

The system of monitoring and estimation of activity if system, bodies and organizations of public health services allowing is developed to define a degree of achievement of final results of activity if bodies both organizations of public health services and monitoring of realization of the State program of reforming and development of public health services of Republic of Kazakhstan For 2005-2010 years.

When working on preparations, more attentions to be paid to analyz the content of heavy metals and its analogues in plants which grows on different soil sorts.

В условиях рыночной экономики показатели качест­ва превратились в главный фактор конкурентной борь­бы и научно-технического прогресса [1]. Одним изуниверсальных подходов в существенном повышении качества является применение инновационной модели
управления организацией - системы менеджмента каче­ства (СМК) в соответствии с международными стандар­тами ISO серии 9000 [4, 8].

ЭФФЕКТИВНОСТЬ ИНТЕРАКТИВНЫХ ИГР ПРИ ИЗУЧЕНИИ ХИРУРГИЧЕСКИХ ЗАБОЛЕВАНИЙ ДЕТСКОГО ВОЗРАСТА

The author, having analysed in nurseries of treatment-and-prophylactic establishments of the South Kazakhstan area, analyzed correct conducting the case record, a design of the diagnosis and orga­nizational activity of medical institutions.

In the article the public health services system in which is reflected the tendency to increase in quantity of unsatisfied consumers of medical services and accordingly quantity of the examinations connected with professional medical activity is saved.

In this article the social - historic nature (base) and becoming of nursery and education in Kyrgyz Republic are considered.

In the conditions of growing informatization of medicine the important task of medical edu­cation required immediate decision is a generation and development of Information culture of students, as an integral condition of successful social adaptation and efficient professional activity. The develop­ment of information culture is a complex, multiply-aspect problem, solving of which requires involve­ment of all phases of continuous education. Now it is conducted scientific researches in department, de­voting to teaching of Information subjects in the system of medical education.

The epidemiologic situation on HIV-infection in KR (2006) and the results of educational pro­gram on HTV/AIDS for the six-year students are presented in this research. The epidemiologic situa­tion on HIV-infection becomes complicated and number of patients with extraordinarily wide spread op­
portunistic infectious is increased every year. After studies o f HIV/AIDS module the average learning curve of students raised from 42,04% to 83,72%. This fact proves necessity of HIV-infection issues in­stitutionalization and curriculum review with adding the HIV-module to all courses.

Microbiology department of Kazakh National Medical University has more than 40-years ex­perience of conducting microbiology Olympics. Subject Olympics helps students to repeat material in interesting form. It helps lecturers to determine the survival of knowledge, the strong and poor places in program. It helps direction to compare faculties, student’s groups, lecturers, to determine preparedness rate depending on language or form of teaching (grant, contractual). In case of organizing Microbiology Olympics between Universities it is possible to compare knowledge rate of their students.

In this article reflected the role postgraduate education in system of continuous education which is stipulated, first of all, that it is responsible for updating and enrichment of a mental potential of a society by qualified experts.All over the world it recognize, that rising of an educational level of people is connected to height of a quality of life. Investments in education become the most profitable disposition of the capital. It is more and more countries with dynamically developing economy pass to system of continuous education. Such transition is a way of overcoming of devaluation and undemandly knowledge received in "final" basic education.

Введение. Новые задачи и ориентиры высшего об­разования, связанные с реформами системы здраво­охранения, вариативность его содержания, многообра­зие образовательных систем привели к становлению во многом новых организационных форм, методов и средств обучения. Совершенствование системы профес­сиональной подготовки будущих специалистов в ВУЗе связано, прежде всего, с использованием инновацион­ных образовательных технологий.[4,5 ].

Введение. Радикальные социально-экономические преобразования выдвинули целый ряд сложнейших ор­ганизационно-правовых и экономических проблем по реформированию системы здравоохранения. Изменение условий функционирования государственных структур в сфере здравоохранения Кыргызской Республике, пе­реход к рыночным отношениям, сформированные взаи­моотношения медицинской науки и практики заставля­ют искать совершенно новые подходы к организации и методическому обеспечению подготовки, переподго­товки и повышению квалификации специалистов сис­темы здравоохранения [1].

Teaching and stimulating functions of educational speech situations, used at the classes of Foreign Language allow to raise the effect of study and to achieve the definite aim in methodics, calling the students to communicate in Foreign language

Training of specialists with higher pharmaceutical education for pharmaceutical branch is car­ried out in KSMA since 1981. In total more that 1200 specialists were graduated from. The tcachir process is conducted in accordance with State educational standard. The necessity of development educational standard on “Pharmacy” specialty is deduced.

Existing system of higher pharmaceutical education doesn’t completely correspond to moden requirements of pharmaceutical education branch. The necessity of higher pharmaceutical education re­forming with purpose of rising of quality of training of specialists according to international standards is grounded.

РОЛЬ ИНТЕРАКТИВНЫХ ИГР В ПРОЦЕССЕ ОБУЧЕНИЯ НА КАФЕДРЕ ГОСПИТАЛЬНОЙ ДЕТСКОЙ ХИРУРГИИ

In this article the results of pedagogical experiment on applying multimedia technology in course on normal physiology is described. This experiment took place during two years. The main pur­pose of this experiment was investigation of efficacy of realization in lecture course theoretically based functions of multimedia in lectures. As the result of this investigation the problem of search optimal conditions for best understanding of lectures material by audience have been solved.

Research of premises has revealed «Critical points» Microbic pollution in «Pure premis­es»: handles o f doors, an extract (lattice), switches of an electricity, a working surface of tables, walls. 2 bowl for washing utensils which mismatch ST RK on parameters Total Microbic number. «Critical points» Microbic pollution at research equipment places o f connection additional tubes to ex­haust outlets are - to cranes, dummies for filling, control panels the equipment. They mismatch ST RK on parameters Total Microbic number and Sanitary rules and norms on parameters of a bacterium of kind E. coli. Have been made offers in the program of the sanitary actions spent at factory, in particular on change of periodicity of processing washing and by disinfectants as premises, and equipment, to im­prove the control over change and clearing of technological clothes.

Lymphoid tissue of organs of respiratory system gives reaction and it is reconstructed at changes of conditions of an environment. Localization of lymphoid structures depends on character and degree of their participation in immune processes. Histological research is obviously important for the detailed description of a microscopic structure of immune system in conducting portion at adaptation and deadaptation an organism to high mountains.

The morphological changes in the large blood vessels walls of the rats after the influence of the lead are described in the article. The principal changes pass in the sleepy and leg arteries.

At now the problem of influence extremely condition of highmountain to organism of human and animals be left over actual problem. In frame of this problem almost still not study the reaction of white blood for influence highmountain hypoxia and other extremely condition of highmountain. Practi­cally still not study morfofunction changes of white blood cells during the readaptation and have being on a high.

Parasitic diseases, aside from negative influence upon health of the people, inflict the human society enormous economic damage. In this connection special importance gains the early diagnostics of parasites and full discovery all invasive people that allows reducing the expenses on treatment sick and
reducing the inflicted social-economic damage. Serological reactions at present are a main method pri­mary diagnosis in system action on early diagnostics of parasites.

In experiences on rats was show, that small thyroid hormones doses increase organism stability to antagonistic stressors influence - heat (t 42°C during 3 h) and cold (t 4-6°C during 3 h) of different complexity - isolated and combined with immobilization, because activate myocardial local stress-limited systems - heat shock proteins (HSP 70) and antioxidant (superoxiddismutase, catalase, whole an­tioxidant activity) in the result of their specific action on cell genetic apparatus. Obtained data prove the important role of thyroid hormones in organism antistress-system.

Experimental research of animals under antimony intoxication indicates the increase of some cellular enzymes activity during the initial stage of toxic effect. At the late time the decrease of these en­zymes activity is observed that is connected probably with the inhibition of inductive phase of cellular metabolism and cell energy processes. During the final stage of intoxication ultrastructural damages of subcellular structures are found.

Structural changes in cerebrum' neurons after experimental and clinical traumatic head injury were studied at white mongrel rats. In the results of investigation pericyteal edema, neurons' necrosis with swelling, cell's lysis and intracellular content release were observed. There were vessels emptying,
slumpt capillaries, perivascular edema in peripheral areas of lesion territory. In the presence of brain cor­tex undamaged state among neurons majority the apoptosis occurred as chromatin condensation, cytop­lasm shrinkage.

Several neuronal populations are selectively vulnerable to cell death after traumatic brain in­jury (TBI) in experimental models and in man. Both necrotic and apoptotic cell death have been de­scribed after experimental and clinical TBI. A common feature apoptotic cell death were determined in the injured cortex at 6 rats in the acute posttraumatical period. The cortex ipsilateral and contralateral to the impact site exhibited apoptosis with varying staining intensities in 7 days after injury.

The anatomy of the mediastinal lymph nodes is researched on the 151 complex of organ taking from human cadavers different age. It reveals the different varies of location of the mediastinal lymphnodes. In the topography of the mediastinal lymph nodes is discovered individual and age-specific fea­tures.

The lymphangions of the left lymphatic collector of the heart is surveyed on 134 corpses ma­ture age persons (35-60 years) of either sex. The investigation is indicated that left lymphatic collector of the humans heart at the mature age consists in 45-60 lymphangions. From them: 30-35 is situated in the
intraorgan vessel, 15-25 in the extraorgan vessel. Is quantify the myocytes of the lymphangions, and the length, width and capacity of the lymphangions in the intra and extraorgan vessel o f the humans heart at the mature age.

After researches was establish antimicrobial activity plant extracts obtained by SC-C02 ex­traction. Propose to research medical means on their basis —ointment, suppositories and other for en­large assortment of native phytopreparations.

The morphological changes in the large blood vessels walls of the rats after the influence of the lead are described in the article. The principal changes pass in the sleepy and leg arteries.

 There has been an increase in the activities of Family Physician Groups with regard to social protection of patients with community-acquired pneumonia. This has led to an increase in the number of patients under constant medical observation (bronchial asthma, pneumonia, acute respiratory viral diseases), in the accessibility of in-patient hospital treatment for children and the elderly. However, the rate of patients with urgent states and delivery of emergency services to them remains high.

After decay o f the alliance has occurred the transformation of the economy in liberally-market relations. These change straight and obliquely influence upon condition of medicine. As a result of examinations of the rural population Kochkor region were revealed patients with pathology of liver, as confirms about hyperendemic region on alveococcosis.

The aim of this study was to detect if smoking and work at high altitude was associated with obstructive ventilation defect (OVD). 1484 workers (1292 males, 192 females), aged 18-61 years (mean age 38.0 ± 9.3), working at high altitude mining company in Kyrgyzstan, were screened for lung func­tion. Spirometry was performed to compare people with different smoking duration and working shiftrotations at altitude 4,000 m (N=1140) with those working full-day at middle-altitude (N=64) and never working at high altitude (N=280). Though bronchial obstruction was similarly prevalent in patients working at high and low altitude and 8.4% was the mean prevalence of (FEV|/FVC < 70%), flows of high altitude workers except for peak expiratory flow (PEF) was less, and work at high altitude was as­sociated with OVD - OR 1.53. Smoking had a greater association with OVD, and it doubled the OVD probability. To conclude, though lung function of people working shift rotations at high altitude was similar to people not exposed to it, smoking was the most meaning factor to cause bronchial obstruction, whereas high altitude emerged to be less harmful.

At present the problem of glaucoma is one of the most serious problems of the modem oph­thalmology. One of the most important morbidity rates of people is primary disablement. In connection with it the author has studied the dynamics of primary disablement as a result of this pathology for the period from 1989 to 2008. It is noted that if in the 80‘ glaucoma has taken the 4th place among causes of disability then beginning from 2001 glaucoma is the main cause of disability and takes the 1st place in the Kyrgyz Republic.

In this article it’s analyzed the indexes of extension, morbidity, late hospitalization and post­ operative lethality from complications of ulcer disease in the country and its regions in last five years (2004-2008 yy.) according to the statistical data of the Kyrgyz Republican medical-information centre. It is shown, that for last five years it is noted the decline of tendency o f extension and morbidity of UD in the Republic, at the same time in such regions as Bishkek city, Issyk-Kul oblast it’s being kept a high level o f UD morbidity, and it remains high indexes of late hospitalization and postoperative lethality from complications of UD.

The influence of aggregate traumatic pathologic volume - the perifocal brain swelling, ische­mia and intracranial formations on the outcome of management of patients with severe skull brain trau­ma was analyzed. Data from 57 patients aged from 15 to 72 years treated in the neurotraumatological clinic were studied. Computed tomography and magnetic resonance imaging are the basic methods in di­agnostic of severe skull brain injuries.

Prof. S.I. Irghanov, E.E. Iskakova. Adenomyosis of the postmenopausal age women. Despite the theory that the decrease in oestrogen levels following menopause should lead to the atrophy, regres­sion and resorption of endometriosis, wi did not see difference in the extent of disease in this age groupe.
Endometriosis is the continued growth of endometrial tissue outside of the uterine cavit.

Aim - studying of frequency of a left ventricular hypertrophy (LVH) and changes of heart geometry depending on level of blood pressure at dialysis patients. Material and methods. 40 dialysis patients have been divided into 3 groups depending on level of blood pressure (BP): hypotonics (BP = 100/60 mmHg. and lower), normotonics (BP = less than 139/89 mmHg.) and hypertensive patients (BP = 140/90 mm Hg. and higher). According to EchoKG LVH it is diagnosed for 55 % of patients. Results. Thus, among dialysis patients eccentric type- of LVH is more often. Severe anemia at hyperten­ sive persons significantly increases IMMLV. Great liquid volume in interdialysis period, especially at hypotonics, leads to a volume left ventricular overload.

Some racial, ethnic and climate-geographic differences in prevalence, progression rate and responses of patients to therapeutic implications were revealed to this time. Questions about these fea­tures among subjects of mongoloid race, including Kyrgyz, seriously are not investigated yet. Aim: to study clinical and functional features of chronic glomerulonephritis (CGN) among Kyrgyz people in mountainous conditions.

Combined action galvano-mud and balneotherapy on the course of stomach peptic ulcer is studied. Clinical —methods of examination of patient including galvano-mud, gastric juice acidity posi­tive dynamic determination were assessed. Good endurance of suggested method of treatment by pa­tients is established. The effeteness of galvano-mud and balneotherapy of stomach peptic ulcer in maintained for 6 mounds after treatment in die patients

Six samples of the 1% spirituous solution of the brilliant green and 1% spirituous solution of the salicylic acid in the different concentrated ethanol is prepared and their antimicrobical activity is determined.

The suppositories on the basis of the fir oil were elaborated for treatment of infectious diseas­es. The antibacterial activity was learned by means of microbiological measures.

A complicated epizootologic and epidemiological situation on zoonotic infection is de­scribed in the article. It caused by veterinary service problems, rules violation of domestic animal keep­ing. These diseases do a colossal economic damage, because of working ability decrease, domestic ani­mal loss, and necessity of carrying out of a widespread arrangements on epizooty consequences elimina­tion, which require huge material and labour costs.

Comparative analysis of endemic goiter spreading and providing of specialists-endocrinologists in Chu, Osh and Djalal-Abad regions of the KR is carried out. Improving of endemic goiter problems, more expressed in Osh region is revealed. Insuffiency of endocrinologists staff is pre­served more expressed in Chu region, where the coefficient of combining is high. It is necessary to con­tinue an active work in revealing and treating endemic goiter. A requirement in qualified endocrinolo­gists is preserved.

The aim of research is to study the age of the menarche, character of menstrual cycle, to compare the characteristic of clinical course of labor, its duration and result of delivery between the women living in high mountains Tien - Shan (Kyrgyzstan, c. Naryn 1800-2200 m. 1und s), Himalaya (Nepal, c. Bhaktapur 1402 - 2791 m. 1. un. s) and Arabian peninsula (Yemen, duan Al-Govera 2200- 2800 m. 1. und. s). For this purpose we have included 150 pregnant women admitted for delivery in the maternity ward of the Bhaktapur hospital, Nepal, 80 pregnant women which delivered in the maternity department of Al- Govera hospital, Yemen, and 60 delivered women c. Naryn. The main age of me­narche of the delivered women living in high mountains was 14,2 ± 0,1; 14,8 ± 0,land 14,1± 0,1. The spontaneous abortion is women living in low altitude was found 1.7 times less then women living in high altitude (1,9% and 5,3% respectively) Apgar score of 40% newborn infant’s revealed 6-7 points.

The problem iron deficiency anemia in Kyrgyzstan. For the last years we can't observe a mor­bidity falling of iron deficiency anemia and the problem its treatment stays actual. In a given article shows morbidity research data in Kyrgyzstan and have learned and influenceof anemia to the gestation andlabor which depends on ways treatment with the help antinemic nutrition and iron preparations.

Iodine - amplypulsoforesis at iodine deficit diseases raises a level of the contents of iodine in the urine during 3-6 months

The results of introduction of strategy for liquidation iodine deficiency in Kyrgyzstan are studied. The concentration of iodine in urine of 45,2% pregnant women was below 100 microg/1, the median urine of the pregnant women was 111 microg/1. There iodine status was not optimal. It is rec­ommended to conduct an individual iodine prophylaxis in risk groups.

Levels and phenotypes of alpha-1-antitrypsin in 109 Kyrgyz patients with chronic obstruc­tive lung disease are studied with the purpose of assessment of the role of the genetic susceptibility to COPD. Among the investigated patients, serum AAT deficiency is found in 10 patients (9,2%), with 68,0±21j2 mg/dl at the average. Among the deficiency patients, one patient has PiZZ, 3 - PiMZ pheno­type.

A structure, dynamics of parasitic diseases registered in republic are analyzed in article. Structure of parasitic diseases is changed in dynamics, infection with enterobius vervmicularis, echinicoccus and lamblia intestinalis increases.

We have examined 217 people in the age group from 60 to 91 using the random sampling re­search method. Anthropometric measurements have been made for every patient (height, weight, wastesize). Also data concerning the arterial pressure of patients have been collected. Also, the 2nd type of diabetes mellitus risk factor has been assessed with the help of the ADA (American Diabetes Associa­tion) tests. Carbohydrate metabolism abnormalities have been recorded in 99 cases (50.5 %), out of them explicit diabetes mellitus diagnosed in 56 cases (28.6%).

Many various occupational pulmonary diseases occur in welders. Great difficult for diagnostic appear in the cases of toxic injury of lung. In article describe in-patient case as an example of toxic pneumonitis, give principle of diagnostic of occupational disease.

For studying efficiency of six monthly therapies Beklazoni Eco Easy Breath (BEEB) 26 patients, suffering bronchial asthma (BA) middle heavy and heavy current, registered in the dispensary of policlinic № 7 Bishkek city have been observed. Within six months treatment patients were on BEEB in a doze of 500-1000 mg/day. Efficiency of treatment was estimated based on expressiveness of daytime and night symptoms of asthma, parameters of external breath function (EBF), ACT questionnaire (Asthma Control Test) and tolerances to physical loading. After a six month BEEB treatment, it was observed a decrease in both daytime and night symptoms of asthma, parameters FEV1/BCP, maximal volumetric speed of exhalation on a piece of 25-75% FBCP and a distance, which patients passed in the step-by-step test authentically grew. A significant increase took place in parameters of a level of control over asthma on all points of ACT questionnaire.

86 patients with front abdominal hernia have been operated for hemioplasty with usage ; polypropylene meshes. 21 patient had inguinal hernia among them 7 patients with recurrent hernia. 65 patients have been operated with ventral hernia, among them 50 patients with post-operational hernia and 19 with recurrent hernia. Liechtenstein method was applied on 12 patients with inguinal hernia, Darcy method was applied on 5 patients with inguinal hernia and modified Stopp method was applied on 4 patients with double inguinal hernia. Complications in post-operational period were not found. In the case of medial ventral hernia after excision of skin with hypodermic tissue coupled with post-operational scar and hernial sac the dissection of 1/2 of leaf of external and internal oblique muscles aponeurosis on either sides was made by Ramirez method, this made it possible to suture without intention the innir sides of rectus muscle uninterruptedly by polypropylene thread by edge to edge and to liquidate diastasis of aponeurosis up to 20 cm. The “On lay” polypropylene mesh “On lay” was laid over and sutured; the hypodermic tissue was drained with 1-2 drainages with connection to vacuum system. In postoperational period in 6 patients were stated a seroma and in 2 patients it was observed with hypodermic tissue suppuration and wound healing with secondary intention. Hospital stay term of patients with ventral hernia was in average not more than 10-12 days, with inguinal hernia —7-8 days.

CHOOSING OF SURGICAL TREATING METHOD OF CHRONIC DUODENAL DISEASE

Duly and correct diagnostics of perforated piloroduodenal ulcers is one of the leading reasons for the outcome of their treatment.  The applied complex methods of diagnostics, taking into account the features of clinical displays in aggregate with radiological and endoscopic methods of inspection, have allowed in 100,0 % of cases to avoid diagnostic errors, and in 77 cases (6,1%) – to avoid unnecessary operative interventions. Insufflations of air in a crater of a ulcer during fibrogastroduodenoscopy with radiology survey of the belly cfvity, as well as laparoscopy data allow to make the diagnosis correctly with a greater degree of reliability.

These days, despite of successes of medicament therapy of a stomach ulcer, surgeons should not prematurely get rid of the usual techniques, because indications to operative treatment of not compli­cated, aggressively proceeding ulcer with annual aggravations, will not disappear completely. Due to
modern considerations, now, surgical treatment is made taking into account ethiopatogenesis of a sto­mach ulcer. In XXI century surgeons prefer organs saving methods of treatment of a stomach ulcer - var­ious variants of vagotomy with piloro- or duodenoplasty. These operative interventions, if executedtechnically competently, on high-quality level, provide to the operated patients high quality of life.

Focal cystic-arachnoiditis of the brain (FCAB) - is a relatively rare pathology of the brain in most cases accompanied with the prominent drug treatment resistant epileptic activity (16-60% of cas­es). Possibilities o f treatment tactics and methods of influence to the epileptic focus optimization were studied on 92 patients with FSAB. After evaluation of the treatments results in all three groups it was found that there was a significant prevalence of positive results in a group of patients who underwent multiple subpial transsection (MST), where elimination of epileptic seizu(62,5% of cases) and solitary epileptic episodes during postoperative period were observed in 9 patients (20,1% cases in this group). Complete elimination of seizures was archived only in 13,3% and 16,7% of cases in groups of patients that were operated without MST and received drug treatment respectively. Next conclusions were made: MST is an effective and safe method of treatment of the focal paroxysmal activity in FCAB; this method can be recommended to this type of patients as a method of choice.

Results of diagnosis using computed tomography and magnetic resonance imaging in 63 pa­tients with pituitary adenomas have presented. Out of the patients 52 underwent surgical excision. Me­thods and results of surgical interventions demonstrated.

In present research discussed the results of 192cases operation ligation of internal iliac arteries used as radical way to stop massive obstetric bleedings and possibilities (87 cases) of conducting organ safe operations (bleeding stop avoiding uterus removal).

Cases of history of 181 patients with acute appendicitis, at whom during treatment, diagnosis mistake was done, were analyzed. The method of access conversion is presented.

The authors have studied 248 operation cases, performed upon 225 patients with big and giant forms of hydatid disease of lungs. Preference was given to organ-saving and sparing operations in spite of big cyst sizes. The reasonability of using the developed way of suture ligation of bronchial fistu­las for post operational prophylaxis is pointed out in this article.

The examples of combined lesion by hydatid disease of lungs and rare localization are pre­sented in the work. Preference in the diagnosis was given to radiation methods of investigation. The rea­onability of the implementation of an echinococcectomy is pointed out as the first phase out of com­bined lesioned lungs.