Vol 72, No 6 (1991)

Five principal cliniconeurologic syndromes: cerebralofocal, hypothalamotruncal, hypertensiona- lohydrocephalic, asthenoneurotic, epileptic are distinguished. The manifestation of syndromes depended on the nature, localization and remoteness of the trauma. The disorder of the main nervous processes such as force, lability, mobility, concentration is revealed in these patients. The data obtained permit finding a true methodical approach to the treatment of patients with traumatic injury of brain.

The marked connection between the extent of disturbance of external respiration function and enteroparesis is revealed from the results of observation of 10 patients with retroperitoneal hematoma, the treatment tactics is determined.

From the results of treatment of 32 patients in the substitution of extensive (8—20 cm) defects of median, ulnar nerves on the level of a lower one third of forearm apd hand by means of different methods of autonervous plasty the authors conclude that the proposed methods recover sensitivity states necessary for the vital activity and improve trop- hicity of hand tissue.

A number of new transplants on vascular limbs— lateral border segment of scapular bone, greater trochanter segment, transplant from posterior surface of distal epiphysis of radial bone, transplant from posterior surface of styloid process have developed and employed. The given transplants are used for revascularization of osteosynthesis place and substitution of osseous tissue defects, permitting to reduce the terms of curability of patients with the sequels of traumas or diseases of osteoarticular apparatus of limbs.

The results of treatment of patients with traumas of proper patellar fold using Elizarov’s apparatus have been analyzed. The full loading of limb is given from the very first days after the operation, early function of joint is noted. Remote results are marked as favourable. The rational practical recommendation for treatment of traumas of proper patellar fold is presented.

Some data of clinicofunctional investigations of 87 patients with chronic obstructive bronchitis after manual and acupunctural therapy are presented. It is found that manual therapy of musculo- articular structures of ventilation apparatus provokes the reliable increase of contractile capacity of the respiratory muscles and decrease of sensory equivalents of the respiratory deficiency. Acupunctural therapy moderately affects the neuromotor system in patients with chronic obstructive bronchitis in the positive dynamics of the curve indices of flow-volume of forced expiration and bronchial resistance.

The appendix is susceptible to almost all types of pathology found in other parts of the intestine, except for specific diseases. A large number of published works are devoted to diseases of the appendix, but the question of their classification remains open. Even in the most authoritative manuals and monographs, only acute and chronic appendicitis are classified. In our opinion, the classification of diseases of the appendix, proposed by PF Kalitievsky [16], is also incomplete and irrational.

Recently, the frequency of endocrine forms of reproductive dysfunction has increased, among which hyperandrogenism occupies a significant place. Its share, according to various sources [1-3], varies from 21 to 36.4%. The ratio in blood plasma of protein-bound and free biologically active androgens depends on the concentration of sex-steroid-binding globulin (SSG), which is the transport protein for steroid hormones. SSG has the greatest affinity for androgens.

Populationally genetic analysis of neurogenic syncopes has been performed in 85 families with children and teenagers as probands. It is suggested that neurogenic syncopes may be considered the familial forms of pathology, corresponding to the principal characteristics of multifactorial diseases. Genetic and medium factors, promoting the manifestation of neurogenic syncopes, are distinguished and analyzed.

The course and outcome of severe traumatic brain injury (TBI) is more influenced by the degree and nature of cerebral blood flow disorders. Changes in blood circulation, in turn, depend on the state of the microvasculature, which ensures the transcapillary metabolism between blood and tissues. The most convenient object in the study of the microcirculatory network of the brain in patients is the vessels of the bulbar conjunctiva. This is due, on the one hand, to the fact that the vascular network of the outer and inner shell of the eyeball belongs to those few structures of the body that can be directly observed and photographed, on the other hand, the vessels of the bulboconjunctiva have the same source of blood circulation and innervation as the head brain.

The role of macrophages has been shown in all stages of tuberculous inflammation. They are the first protective barrier during the contact with myc- robacteries, they perform the functions of antigenp- resentating cells, stimulating the development of the specific clone of T-lymphocytes, macrophages being activated by T-lymphocyte lymphokines become the principal effector cells. The basis cytotoxic mechanisms are lysosomal, oxygen-dependent and tumor necrosis factor (TNF). Depending on the virulence and immunogenecity of mycrobacteries all these mechanisms may exert protective and injurious effect. Delayed sensitivity plays the main role in surrorting this process. The study and regulation of the function of macrophages remain the perspective trend of phthisiology.

The investigation of occupational traumatism for 1981—1989 is performed at the meat industry plants of the Saratov region. The main reasons of traumatism and principal traumatizing agents are revealed. The circumstances of the origin of occupational traumata are considered. The following prophylactic measures are presented: organizational, sanitary-and-hygienic, medical.

Here is a description of a synovioma, which is extremely rare in clinical practice. R., 50 years old, applied on 02.07.1990 with complaints of swelling of the right palm, the appearance of pain in the palm of the hand when washing the clothes by hand. At the end of 1987, shortly after my husband "squeezed his fingers tightly when holding the expander in his hand," a protrusion appeared on the palm of his hand, which began to slowly increase.

Stomach leiomyoma is a rare disease of the digestive system. At 369 operations for gastric neoplasms, we encountered non-epithelial formations in 3 cases, of which 2 had leiomyoma, and one had lymphogranulomatosis. Considering the relative rarity of gastric leiomyoma, we present our own observations.

In persons who have had hemorrhagic fever with renal syndrome (HFRS), destructive and functional disorders of the tubular apparatus of the kidneys persist for a long time, which can create prerequisites for the addition of a secondary infection and the development of pyelonephritis. Separately, the authors consider the intestinal microflora one of the possible sources of kidney infection, which is confirmed by the frequent detection of bactercuria in intestinal dysbiosis and the presence of dysbiosis in patients with pyelonephritis.