Maternal serum screening for Down syndrome in the first trimester: experience from Belarus.

We have carried out a large retrospective study of alpha-fetoprotein (AFP), free-beta human chorionic gonadotrophin (hCG) and pregnancy-associated plasma protein (PAPP-A) in the first trimester of pregnancy. Unlike other studies all women had routine ultrasound dating, carried out during a nuchal translucency measurement project. A total of 13,477 serum samples were tested for AFP and 11,659 for free beta-hCG.

[The surgical treatment of heart defects in active infectious endocarditis].

Aim: To elucidate significance of early diagnosis and results of surgical treatment of valvular defects in active infectious endocarditis (AIE).

Materials And Methods: Surgical outcomes were analyzed for 437 AIE patients with active AIE. The operation was made 10 months, on the average, after AIE onset.

Population-based differences in thyrotropin and thyroxine distributions in healthy newborns revealing results from independent reagent evaluation.

An independent evaluation of reagents for the determination of thyroxine and thyrotropin from dried blood spot samples taken from newborns between the third and fifth day of life revealed striking differences in the thyrotropin distribution among newborns from Byelorussia. An analysis of the thyrotropin distribution from Byelorussian newborns showed that 40% of samples had over 5 mIU/l blood. In other European populations comparable in respect to timing of blood collection, this fraction varied from only 1% (Stockholm, Sweden) to 3.

[The surgical treatment of multiple myomas of the left heart].

5 patients with multiple left heart myxomas have been followed for 30 years. There were 4 females and 1 male at the age of 20-50 years. Two-dimensional echocardiography was used for the proper diagnosis in all cases.

Recurrence of the R408W mutation in the phenylalanine hydroxylase locus in Europeans.

The relative frequency of the common phenylalanine hydroxylase (PAH) mutation R408W and its associations with polymorphic RFLP, VNTR, and short-tandem-repeat (STR) sites in the PAH gene were examined in many European populations and one representative North American population of defined European descent. This mutation was found to cluster in two regions: in northwest Europe among Irish and Scottish peoples, and in eastern Europe, including the Commonwealth of Independent States. This allele was significantly less frequent in intervening populations.

[A trial of the use of EMIKS and LIKS disk prostheses over 10 years].

A total of 2575 EMIKS and LIKS prostheses were implanted to 2309 patients from January 1, 1983 to January 1, 1993. The results were assessed in 1349 patients with primary isolated prostheses of the mitral (PMV), aortic (PAV), and mitral and aortic (PMV + PAV) valves. Mitral valves were replaced in 592 patients, with hospital mortality 3.

[Prosthesis of the aortic valve by a loose allograft].

A procedure has been developed to prepare live aortic allografts, which consists in taking a valve early after a donor's death, sterilizing it in antibiotics and freezing it to -190 degrees C in the presence of the cryoprotective agent dimethylsulfoxide. The preservation of valve tissue is evidenced by morphological studies. The first 3 operations for aortic valvular diseases were performed.

First-trimester diagnosis of duodenal stenosis associated with oesophageal atresia.

Duodenal stenosis associated with oesophageal atresia was diagnosed by ultrasound at 12 weeks' gestation. The diagnosis was made by recognition of a double bubble sign which was more pronounced when a vaginal transducer was used. Post-abortion autopsy confirmed the diagnosis.

New neonatal thyrotropin enzyme immunoassay with fluorimetric detection: comparison with time-resolved fluoroimmunoassay.

This short communication compares a novel fluorimetric microplate enzyme immunoassay (FEIA) with a commercial time-resolved fluoroimmunoassay for the determination of thyrotropin in dried blood spots. The evaluation was performed using a retrospective study design with newborn blood samples from three screening centres. Non-parametric Spearman rank correlation analysis revealed highly significant positive correlation between methods: rs = 0.

[Clinical aspects, diagnosis and surgical treatment of rupture of the mitral valve chordae].

The authors generalize experience in surgical treatment of 121 patients with mitral incompetence caused by rupture of the chordal threads. Prosthetics of the mitral valve was conducted in 103 patients, plastic correction--in 18 patients. Study of the etiomorphological aspects of the problem showed destruction of the fibrous framework of the chorda to be a compulsory component of rupture of the chordae of various origin.

[Active valvular infective endocarditis: problems of surgical treatment].

The authors analyze the results of surgical treatment of patients suffering from active endocarditis with impairment of the mitral, aortal and tricuspid valves and their combinations in 242 patients operated on during 1969 to 1989. The total hospital mortality is at the level of world statistics and constitutes 15.3% (37 patients died).

[Heart valve bioprostheses of the "Bionix" series. 6-year experience with the mitral valve replacement].

The main cause of cardiac valve bioprosthesis dysfunction is mechanical rupture of the cusps consequent upon the development of "fatigue" tensions and calcification of the biologic tissue. The technology of "Bionix" prostheses manufacturing implies prevention of these complications by means of supporting frameworks of variable rigidity (dumping stroke loads) and the use of a calcinosis inhibitor in the process of chemical stabilization. Experimental research confirms the certain effectiveness of such an approach to solving the problem of bioprosthesis durability.

[Experience in the use of Soviet-made disk prostheses EMIKS and LIKS].

Experience in the application of and disc prostheses in 614 patients in generalized. Mitral prosthetics was conducted in 256, aortic in 229, and mitral++-aortic in 129 patients. Hospital lethality was, respectively, 3.

[Reoperations in patients with EMIKS and LIKS prostheses].

The frequency, terms, techniques, and the results of reoperations on patients with EMIKS and LIKS prostheses are analysed. In the period between June, 1983 and December, 1989, 994 EMIKS prostheses and 210 LIKS prostheses were implanted in 1,015 patients. In this period 22 reoperations were performed which accounted for 0.

[Reoperations after insertion of heart valve prosthesis].

The authors analysed 167 repeated operations after heart valve prosthetics, which were conducted from 1978 to 1988. The operations were undertaken for the second time mainly in a severe contingent of patients. The reasons for the repeated operations were specific complications according to which 2 groups of patients were set apart: with dysfunction of the prosthesis of noninfectious origin and with prosthetic endocarditis.

[Unsolved problems of the surgical treatment of dissecting aneurysms of the ascending aorta (analysis of complications)].

It is shown that various complications occurring after surgical treatment of dissecting aneurysms of the ascending aorta with or without aortic insufficiency depend mainly on the methods of correction applied and the etiology of the disease. As the result of the study the authors conclude that the Bentall-De Bono and Cabroe's operations are radical methods for surgical management of dissecting aneurysms of the ascending aorta irrespective of the etiology of the disease. Wide introduction of these operative methods into the clinical practice led to an essential decrease of hospital mortality and the frequency of complications in the immediate and late-term postoperative period.

[Surgical treatment of endocarditis following heart valve prosthesis].

Experience of many years in surgical treatment of prosthetic valve endocarditis (RVE) is analyzed. Patients whose condition was serious were operated on for a second time: 91.6% had preoperative functional class IV, in half of them circulatory disorders were of stage IIB--III; 62.

[Comparative evaluation of Soviet-made mechanical prostheses in the mitral position].

The authors appraised comparatively the 25 ball prosthesis (group 1), the rotational-disk prosthesis (group 2) and the prostheses (group 3) in 180 patients who underwent operation in the period between 1983 and 1988. The hospital lethality was 7.5% in group 1, 2.

[Choice of the correction method and results of surgery in patients with mitral, aortic and tricuspid defects of the heart].

The article analyses the results of surgical correction of tri-valvular heart diseases in 132 patients who were operated on between January, 1973 and March, 1986. Total hospital mortality was 20.4%.

[Long-term results of the surgical treatment of aneurysm of the ascending aorta in combination with aortic valve insufficiency].

Four of 28 patients who were operated on died in late-term periods, four from advancing cardiac failure and one died 5 years after an operation from cardiac tamponade. In the group of four patients one underwent Cabrol's operation, three were operated on by the Bentall-De Bono method. The condition of 25 patients considerably improved and they were related to the II and I functional classes.

Surgical treatment of dissecting aneurysm of the ascending aorta: immediate and late results.

The authors describe experience gained with surgical treatment of dissecting aneurysm of the ascending aorta in the period from 1978 to 1987. 30 patients were operated on using the techniques proposed by Bentall, De Bono and Carbrol. All patients exhibited the presence of annulo-aortic ectasia.

Surgical treatment of infective endocarditis in the active stage.

The study summarizes the results of surgical treatment of active infective valvular endocarditis (IE) in two cardiac surgical centres in Hungary and the Soviet Union between 1969-1987. Most (92.9%) of the 241 patients operated on were in severe condition pre-operatively (NYHA Class III and IV), their mean age was 38.