Vol 81, No 5 (2000)
The editorial board of the "Kazan Medical Journal"
Abstract
The 100th anniversary of the founding of the "Kazan Medical Journal" - one of the oldest and most authoritative periodical medical scientific publications in our country. Being a journal of a wide medical profile, intended for practitioners of rural and urban medical institutions, he made a great contribution to the system of improving medical care for the population, improving its quality by increasing the knowledge and qualifications of doctors. The journal played an important role in the formation of the Kazan medical school and in the promotion of its scientific achievements throughout the world.



Theoretical and clinical medicine
"Kazan Medical Journal" -100 years: past and present
Abstract
The centenary is a worthy milestone for every periodical. To set such a high bar in conditions far from favorable - against the background of historical cataclysms, the most severe breakdown of political worldviews and economic structures that radically influenced the development of all areas of science, and in particular medicine - fell to a few scientific journals. An attempt to impartially assess the contribution of the "Kazan Medical Journal" to the development of science, the training of medical personnel from the height of the years he lived in this article will hardly succeed. The chronological presentation of events will inevitably be warmed by a feeling of deep respect for the memory of those outstanding scientists who in different years led the journal or collaborated with it, and will require a lot of warm words about them.



Health and work: the search and achievements of occupational medicine at the turn of the two centuries
Abstract
In the 1948 UN Declaration of Human Rights, the rights to work and health are considered fundamental. The history of human society has convincingly and long ago proved that labor and health, their relationship and place in the scale of human values are among the priority problems of life. The area of scientific knowledge and practical human activity that unites these two most important values is, first of all, occupational medicine.



Structural studies of fibrinolysis: how to disassemble a clot
Abstract
Fibrin is degraded by the fibrinolytic system wich a plasminogen activator converts plasminogen to plasmin, a serine protease that cleaves specific bonds in fibrin leading to solubilization. To elucidate the biophysical processes involved in conversion of insoluble fibers to soluble fragments, fibrin was treared with either plasmin or the combination of plasminogen and its activator, and morphologic changes were observed using scanning electron microscopy. Initial changes in the fibrin matrix included creation of many free fiber ends and gaps in the continuity of fibers. With more extensive digestion, free fiber segments associated laterally, resulting in formation of thick fiber handles. Supernatants of digesting clots, containing soluble derivatives, were negatively contrasted and examined by transmission electron microscopy large complex fragments containing portions of multiple fibers were observed, as were piaces of individual fibers and smaller fragments. Some large fragments had sharply defined ends, indicating that they had been cleaved perpendicularly to the fiber direction. Other fibers showed splayed ends or a lacy meshwork of surrounding protofibrils. Fibrinolysis was also followed by confocal microscopy of plasma clots labeled with colloidal gold, so that changes at the lysis front of hydrated clots could be examined in real time. Clots made up of thin fibers were cleaved more slowly than clots made up of thick fibers, even though individual thin fibers were cleaved more rapidly. These results indicate that fibrinolytic degradation results in larger pieces than previously identified, and that plasmin digestion proceeds locally by transverse cutting across fibers rather than by progressive cleavage uniformly around the fiber. A model is proposed for the crawling of plasmin across fibrin fibers.



Polysynaptic reflex complexes in clinical neurology
Abstract
The results of the study of spinobulbospinal reflex during 25 years in healthy people and in various nervous system diseases with affection of afferent and efferent systems, subcortical formations of brain and muscles (facial muscle contracture, miofascial pain syndrome) are given. It is shown that the inconstancy of many reflex characteristics (latency, amplitude, response duration, manifestation) is its basic property in normal conditions. In central nervous system pathology the stabilization of the m entioned parameters comes showing disorder of the program of formation and performance of motion.



MRI morphometric signs of impaired cerebrospinal fluid circulation in patients with syringomyelia
Abstract
The results of morphometric examination of 98 patients with syringomyelia are given. The combination of syringomyelia with various degree of cerebellar tonsil falling is established. The comparative analysis of subarachnoid space sizes on the level of the posterior cranial fossa and craniovertebral passage in patients with syringomyelia and cerebellar ectopia of various degree as well as in patients without tonsil ectopia and control group is performed. The morphometric patterns of liquor circulation disorders are established.



Dynamics of psychovegetative disorders in participants in modern wars
Abstract
Twenty modem war participants who have had a mild brain trauma in Afganistan war were engaged in 7,00±0,30 year follow-up study. The basic vegetative state, regulatory brain system function, emotional state (MMPY, Scmiscek-Litman test, Spilberger questionnaire) were investigated in the follow-up study. The increase of nonspecific brain structure dysfunction clinical characteristics: suchas vegetative dysfunction with elevation of sympathetic activity and emotional shift to depressive and hypochondric disturbances was found.



The level of antibodies to Chlamydia pneumoniae and Mycoplasma pneumoniae among patients with bronchial asthma
Abstract
The level of antibodies to chlamydia pneumoniae (Cp) and Micoplasma pneumoniae (Mp) in 65 patients with bronchial asthma in the clinical remission phase is studied. To reveal antibodies to Cp the indirect immunofluorescence reaction was used, to reveal antibodies to Mp the indirect immunoenzymic analysis method was used. In diagnostic titer the antibodies to Cp were found in 23 patients and antibodies to Mp were found in 25 patients (38%) of 65. In 6 (9,2%) of them the antibodies to Cp were also determined. In patients of seropositive and seronegative groups the differences on some anamnestic and laboratory data, accompanying somatic pathology in medical complex were revealed. |



The role of brachytherapy in the treatment of tumors of the trachea and bronchi
Abstract
The original methods of the radical and palliative endobronchial and combined radiation treatment of patients with primary and relapsing cancer of trachea and bronchi and the approaches to the calculation of dosimetric radiation plans are developed and suggested. The possibility of combining endobronchial radiation therapy, distance radiation therapy and laser destructionof the tumor, is studied. The indications to endobronchial radiation therapy are formulated. The suggested method of the endobronchial and combined radiation treatment significantly extended the possibilities of organsaving treatment of patients with primarily multiple metachronous and synchronous cancer and made it possible to formulate the new approaches to the radical treatment of patients with locally spread cancer of trachea.



On temporary pacing after heart surgery under cardiopulmonary bypass
Abstract
On the basis of 93 observations the conclusions on the indications to the temporal postoperative electrocardiostimulation are made. It is established that it should be carried out in bradyarrhythmia. In cardiasthenia not connected with conduction disorders, electrocardiostimulation is not effective. Temporal epicardial electrodes should be sutured both in the stable and in transitional transversal heart block as well as for prevention in traumatic manipulations in the conduction tract zone because of danger of the “late” block occurrence. Duration of the temporal electrocardiostimulation should not exceed nine days. It is necessary to implant the constant electro- cardiostimulator in the traunsversal heart block being retained more than nine days.



Clinic of staphylococcal intestinal dysbacteriosis in children
Abstract
The variants of the course of staphylococcic intestine dysbacteriosis in 264 children aged one month to 7 years are studied. In babies with decreased colonizational resistance the pathogenic staphylococcus contamination in 79 — 92,3% of the cases is accompanied by the clinical infection symptomatology of gastroenteric tract and various extraenteric manifestations. In children over one year the given microbiocenosis disorder variant in 45 — 59,5% of the cases takes the course of asymptomatic bacteria carrier Saureus in intestine. Subcompensated forms are characterized by moderately pronounced clinical symptomatology. The infants infected by pathogenic staphylococcus in the first months of life are subjected to the development of allergodermatoses, staphylococcic infection, hypotrophy and anemia.



Clinical variants of the non-erythema form of ixodid tick-borne borreliosis
Abstract
The patients with the nonerythematous form of borreliosis (83 persons) were observed in the epidemic seasons of 1997—1999. The organ pathology often develops on the background of the general infections syndrome. The clinical variants of the early period are described: arthromyalgic, similar to influenza, regional lymphadenitis, neurologic, cardiovascular, hepatitis, mixed.



Surgical tactics for closed injuries intestines
Abstract
The results of surgical treatment of 64 patients with closed intestine injuries: duodenum traumas (17), small intestine traumas (39) and closed large intestine traumas (8) are presented. During operative interventions in patients with duodenum injuries after the defect suture it is obligatory to carry out the prolonged nasoduodenal intubation and decompression, wide drainage of the retroperitoneal space, abdominal cavity. In the cases of injuring more than 1 /3 of the circumference it is necessary to form duodenojejunoanastomosis or to take duodenum out of the passage. In large intestine injuries the operative intervention is carried out in two stages.



A new technique of evisceration with one-stage plasty pelvic organs
Abstract
The evisceration procedure of pelvic organs with the one-moment recovery of continuity of the urinary tract and intestine is developed. The work is based on the experience of surgical treatment of 56 patients with locally widespread forms of the pelvic organ cancer after evisceration. The complications after the operation were found in 19 (36,5%) patients, of which 8 (15,3%) patients died. The remote results are studied in 42 patients. The two-year survival rate index was 76,8+1,7%, three-year—64,1+1,5%, five-year—49,5+1,5%. In surgical treatment of the pelvic organ cancer the evisceration is an adequate and oncolo-gically justified operative intervention. With the one-moment reconstructive intervention the evisceration makes it possible to reach the optimal results and to improve the life quality of the radically operated patients.



Criteria for the functional state of the intestine and endotoxicosis in total intestinal intubation
Abstract
It is established that intestinal debitomanometry reflects the state of motor and evacuational function of the intestine and can be used as a criterion of the intestinal intubation duration. The ultrasound examination of the abdominal cavity makes it possible to estimate the morphologic and functional state of the intestinal wall in patients with diffuse peritonitis. In this case the intoxication index makes it possible to control and correct the detoxication therapy. The study was carried out in 38 patients aged 42—64 operated for the diffuse peritonitis. The control group consisted of 30 patients operated for the pancreatobiliar zone pathology.



Case-conduction novocaine blockades in the complex treatment of patients with fractures of the leg bones
Abstract
In experiments on rats and in examination of two groups of 31 patients the use of novocaine blockades of lumbar sympathetic nodes in the combined treatment of patients with shin fractures on so-called unfavourable levels — on the boundary of the middle and lower third — is well-grounded. Their use normalizes the drainage function of veins and lymphatic vessels decreases the pulse blood flow deficit on the fracture side, improves microcirculation.



Purulent-inflammatory complications after surgical operations for bladder cancer
Abstract
Incidence of suppurative-inflammatory comlica- tions after surgical treatment in 618 patients with invasive urinary bladder cancer is studied. The urinary bladder resection is carried out in 306 of them, the cystectomy with various methods of urine removal — in 312 of them. The basic suppurative-inflammatory complications in the postoperative period are acute pyelonephritis and peritonitis. After the urinary bladder resection without ureterocystoneostomy the seirous pyelonephritis is found in 8% of the patients, with ureterocysto-neostomy — in 37,8% of the patients, the purulent pyelonephritis in 10,1% of the patients. The pyelonephritis and peritonitis complicated the course of cystectomy in 19,3% and 22,7% of the cases, respectively.



Stages of therapy for newborns born to mothers with mycoplasma infection
Abstract
The state of newborns in women with micoplasma infection is studied to develop the tactics of their management from the first days of life. It is shown that the current antenatal diagnosis, prevention of the perinatal fetus pathology, and adequate therapy in postnatal period promote the significant decrease of residual forms of the micoplasma infection and the prevention of infant disability.



Reviews
Acceleration of wound healing under the action of a new pyrimidine drug xymedon
Abstract
40 years have passed since a group of scientists led by prof. N.V. Lazarev were the first to synthesize drugs of the pyrimidine series - methyluracil and pentoxide. Their successful use in surgical practice is explained by the ability of these agents to stimulate the processes of reparative regeneration.



Ultrasound and molecular genetic diagnostic methods for Rh-isoimmunized pregnancy
Abstract
Hemolytic disease of the newborn (HDN) in Russia is diagnosed in approximately 0.6% of them [6]. There are 19 main erythrocyte group systems that combine more than 100 antigens, as well as numerous private and common erythrocyte antigens with other tissues [9]. Typically, the baby's red blood cells have some of the paternal antigens that the mother does not have. At the same time, HDN usually develops due to incompatibility between the fetus and mother for Rh or ABO antigens, rarely for other antigenic systems (due to their lower immunogenicity).



Short articles



To the pathogenesis of perioral dermatitis
Abstract
Perioral dermatitis (PD) is a skin disease of the face characterized by a rash of non-follicular pinkish-red papules and solitary shiny pseudopustules in the perioral and/or periorbital region. It occurs mainly in women of young and middle age, often acquires a torpid course, tolerant to treatment. The study of PD is especially important due to insufficient knowledge of its etiological and pathogenetic mechanisms and the lack of effective methods of therapy.






Surgical tactics for ulcerative gastroduodenal bleeding in the practice of air ambulance
Abstract
Analysis of the results of treatment of patients with ulcerative gastroduodenal bleeding based on the annual reports of surgical departments of city and district hospitals of the Chuvash Republic shows that in recent years the number of patients with gastrointestinal bleeding has increased, as well as the number of operated patients (see table).



Epidemiology
The influence of environmental factors on the immune status
Abstract
In the 90s of the 20th century, a steady upward trend in the incidence of the population was observed in Russia, and to date, both total, and infant and maternal mortality are high [3]. The state of health of the population has thus crossed a critical line. There is a need for the most effective measures aimed at creating a human-friendly environment, ensuring the safety of food and water, in combination with the correct demographic policy and promotion of a healthy lifestyle.



Assistance to the practicing physician
Achievements and challenges in tobacco control in the United States
Abstract
During 1999, the US Centers for Disease Control and Prevention published a series of reports that identified the 10 most significant advances in human health since 1900. The main criterion for selecting achievements was their impact on mortality, morbidity, and disability in the population. The significance of these data goes beyond national specifics, and with some reservations, they reflect the global progress in health care in the 20th century.



Conferences



Book review
Health of the population of the Republic of Tatarstan on the threshold of the third millennium
Abstract
Negative changes in public health indicators, which began long before the reforms of the 1990s, have become especially pronounced in recent years. Modern conditions are characterized by pronounced regional differences in indicators of health and the development of medical care for the population, due to the level of adaptation of the economy and the social sphere of specific territories. In this regard, it is important to study the regional patterns of the formation of public health and the problems of providing medical care.


