[Study of mechanical work of the heart in patients with toxic goiter by means of electrokymography]

A study was made of the electrokymogram (EKG) of the left and the right ventricle of the heart in 54 patients suffering from toxic goiter chiefly with a marked clinical picture of the disease. Electrokymography permitted to detect enlargement of the ventricles. Excited pulsation of the ventricles with a rapid rise in systole and a sharp fall in diastole pointed to myocardial hyperfunction. Rapid and energetic contractions of the heart led to intensification of the oscillatory movements of the heart in the chest cavity, and to its rotation. A low-wave pulsation with small frequent waves of low amplitude pointed to a reduction of the contractile function of the myocardium; this was also indicated by the increase of the latent EKG time and the paradoxical movements at the beginning of systole. After the effective treatment the EKG of the ventricles showed almost no difference from the curves of healthy individuals. Changes in the character of the ventricular pulsation in toxic goiter were observed already at the early phase of the disease when some of the patients still displayed no changes in the ECG, and no X-ray data pointing to the affection of the heart were as yet evident. In the presence of phenomena of cardiac insufficiency the EKG objectively proved the presence of changes in the myocardium. The EKG data corresponded to the severity of the clinical picture of the disease. Electrokymography serves as a valuable method for analysis of the function of myocardium of the ventricles in toxic goiter.

[Diagnosis of pulmonary hypertension with the aid of electrokymography]

Electrokymography was carried out in 198 patients with cor pulmonale and mitral defect with clinical signs of elevated blood pressure in the pulmonary circulation. The electrokymographic signs of pulmonary hypertension were developed, as well as those for the evaluation of the functional state of the myocardium of both ventricles. In making the diagnosis of elevated--pressure in the pulmonary artery system of special importance is the analysis of the electrokymogrammes of the pulmonary artery, right atrium and right ventricle, and the determination of the pulse wave speed along the pulmonary vessels. The study of the electrokymogrammes and their comparison with the clinical pattern permitted to classify all the electrokymographic criteria of pulmonary hypertension into true and relative ones, requiring verification. A differentiated analysis of the systolic and diastolic phases of the left and right ventricles was conducted. All the phases of the cardiac cycle were calculated with due regard of the contractions rate. The phase analysis permitted to assess separately the functional state of the myocardium of both halves of the heart. Electrokymography helped to reveal pulmonary hypertension that could be often diagnosed with its aid at an early stage. It permitted to diagnos an initial reduction of the contractile finction of the right ventricle.

[Combined method of rectopexy in rectal prolapse with the use of skin autoimplants]

During 1964-1973 twenty six patients were operated upon for grave rectal prolapse (6 patients after 1-2 unsuccessful operations elsewhere). The combined method of rectopexy by means of skin autoimplants after the technic suggested by B.A. Barkov was employed. All patients recovered and were completely rehabilitated, the follow-up being from 2 to 10 years. No recurrences were noted.