Vol 72, No 6 (1991)
Theoretical and clinical medicine
Clinicophysiologic characteristics of patients with traumatic injury of brain in a distant period
Abstract
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.
A new method of operative treatment of funnel deformation of chest
Abstract
A new method of surgical treatment of funnel deformation of chest on the apparatus of external fixation by means of perosseous distractional osteosynthesis is developed and used in clinic in 15 patients. Two variants of arranging Elizarov’s apparatus are proposed. Good cosmetic and functional results are obtained.
Differentiational correction of muscles of external rotators of femur in congenital dislocation
Abstract
External rotatory contracture in hip joint appears in some cases in the process of correction of the proximal part of femur. Incomplete and low dislocations of femur are stated to be characterized by absolute shortening of short external rotators and high forms of dislocations — by shortening of middle gluteal muscle. The methods of correction of the length of these muscles in the process of treatment of the dislocation of femur are suggested. The comparative analysis of treatment results of the congenital dislocation of femur in 159 persons by the methods, developed by the authors and traditional methods is presented. The positive result of the treatment is received in 95,4% patients.
Recovering treatment of extensive defects of hand nerves
Abstract
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.
Device for the correction of proxi-mal part of femur
Abstract
In the practice of surgeons there are two difficulties in the correction of proximal part of femur: the true interorientation of bone fragments and their fixation in osteosynthesis. The authors have developed a device for the determination of coordinates of proximal part of femur and a device for the fixation of bone fragments. The principal diagrams of devices and their application methods are presented in this paper. The use of these devices allowed to perform the operative correction of proximal part of femur in 54 patients.
The use of osteal transplants in microsurgery
Abstract
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.
Transposition of muscles in the treatment of chronic osteomyelitis
Abstract
The procedure of monosegmental transpositions of skeletal muscles for plastic closure of osteal cavities has been developed, and 9 operations in 8 patients with chronic osteomyelitis have been performed. There were basic technical rules for the performance of the operations: necrsequestrectomy up to capillary hemorrhage out of osteal tissue, mobilization of muscles up to nourishing vessels and fixation of transferred part in osteal cavity by means of suturing by épimysium, prevention of muscle strangulation by relief incisions on fascia and skin in the projection of transferred graft in tight wound suturing or by partial wound suturing with the following covering of muscle surface by reticular skin graft, performance of the operation in 3 stages in the pronounced acute conditions of the process. Healing of the operative wound is attained in 100% patients. Osteomyelitis relapse within 12 months is not noted. Limited skin necrosis is revealed in postoperative period in 2 patients.
Treatment of traumas of proper patellar fold using elizarot’s apparatus
Abstract
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.
Premature Ventricular Excitation Syndrome
Abstract
In the first issue of the journal "Therapeutic Archives" for 1941, an article was published by prof. LM Rakhlina "On persistent shortening of the interval P — R (Q) of the electrocardiogram" [5]. In it, the author, for the first time in the domestic literature, reported on a patient suffering from heart disease, whose electrocardiographic picture was described in 1915 [9]. Later, this disease was called the Wolff-Parkinson-White (WPW) syndrome, after the names of the authors who, based on the results of the analysis of 11 observations, identified a special clinical and electrocardiographic syndrome [10]. In 1944, the term "ventricular premature excitation syndrome" (preexcitation, preexitation) was proposed, which is widely used in modern literature [8].
Efеcacy of manual and acupunctural therapy in patients with chronic obstructive bronchitis
Abstract
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.
Modern classification of the disease of the appendix
Abstract
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.
The method of renal colic cupping with simultaneous regional stimulation of ureters for expulsion of concrements
Abstract
The paper presents the results of the use of the method of renal colic cupping with simultaneous regional stimulation of ureters for expulsion of concrements, which is attained by running anesthetic solution and medicinal agent mixtures into lateral cellular tissue space of pelvis in the first-aid surgery^ The treatment method has been employed in Æ patients with ureteral calcili with sizes no more thaJv 10 mm, and in 52 patients it provoked independent passage of concrements in the terms from 2 to 10 days. The efficacy of the use of this treatment is noted in patients of heightened risk (elderly age, accompaning diseases etc.) with ureteral calcili as well as in patients whom endovesical treatment methods are contra-indicated.
The relationship of transport proteins and some hormones in polycystic ovary syndrome
Abstract
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.
Advanced aspects of oncogyneco- logy
Abstract
The experience of the leading specialists-onco- gynecologists of the republic is presented. The survival fate of patients with ovary carcinoma is stressed to be determined by the diagnosis quality of polyclinic physicians and by true estimation of the pattern and stage of tumor growth during operations. Advanced training for doctors, diagnostic ultrasonic; and endoscopic equipment for medical institutions are necessary.
Populationally genetic analysis of neurogenic syncopes
Abstract
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.
Indices of unspecific protection in children with vegetative disturbances
Abstract
There are pathologic shifts in the system of phagocytic protection in children with vegetative disfunction, with the degree of shifts depended on the type of vegetative reaction. They are to a great degree manifested in children with parasympathotonic and dystonic type of vegetative reaction. The lowering of phagocytosis reserve, low locomotor macrophage function and decrease of lysozymic activity of blood serum are typical for them.
The state of the microcircular bed in patients with severe traumatic brain damage
Abstract
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.
Social hygiene and healthcare management
The reasons occupational traumata in meat industry
Abstract
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.
Reviews
Participation of alveolar macrophages in pathogenesis of tuberculous inflammation
Abstract
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.
Morphofunctional features of the liver in shock
Abstract
Based on the modern views on shock as a process, the pathogenetic basis of which is the disorder of regulatory mechanisms, systemic disorders of the microcirculation of cell metabolism, it seems quite natural that multiple organ failure develops in shockogenic injuries. Among the organs most sensitive to extreme influences, a special place is occupied by the liver, which has become a classic object for studying the structural and metabolic manifestations of shock and its complications. At present, there is no doubt that in severe mechanical and thermal injuries, many clinical and laboratory criteria for post-aggressive states can be largely due to the severity of morphofunctional changes in the cellular composition and structural components of the liver [18, 47].
Short articles
Synovioma of the palm
Abstract
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.
Inflammation of two vermiform processes in one patient
Abstract
The presence of two vermiform processes in one patient is rare. Considering this, as well as the difficulties of diagnosis, we decided to share our observation. G., 28 years old, was admitted to the surgical department of the city hospital No. 2 in Naberezhnye Chelny on December 26, 1977, on an emergency basis, 8 hours 30 minutes after the onset of the disease. The doctor on duty at admission was diagnosed with partial adhesive intestinal obstruction (?).
Leiomyoma of the stomach
Abstract
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.
Compression-destruction osteosynthesis for fractures of long bones
Abstract
In the treatment of fractures of long tubular spines, transosseous compression-distraction osteosynthesis (TCDO) has become widespread in recent years. We would like to share our own experience of using this method in the conditions of the Central District Hospital. We observed 64 people with fresh fractures of long bones, who underwent CHKDO in the trauma department of the Central District Hospital. Most of them were people of the most working age - from 14 to 60 years old.
The state of the microflora of the colon in persons who have had hemorrhagic fever with renal syndrome
Abstract
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.
Large omentum cyst in a child
Abstract
Diagnosis of omentum cysts presents significant difficulties. They are found by chance on the operating table or at the section. The possibility of developing severe complications in this pathology dictates active surgical tactics, regardless of the child's age.