Vol 81, No 6 (2000)

I sincerely congratulate the creative and publishing teams of the renowned "Kazan Medical Journal" on the remarkable anniversary - the 100th anniversary of its foundation!

The use of multi pie leades significantly increases the possibilities of the electrocardiotopograpliic method in the diagnosis of myocardial infarction and makes it possible to determine more exactly localization and lesion size. The electrical heart field was studied by the R.Z. Amirov electrocardiotopography method using registration of 104 monopolar leads along the chest surface in patients with inferior and spread posterior myocardial infarction. Correlation of the dynamics of the ST segment with the dynamics of indices of the electrocardiotopogram QRS complex is revealed. A series of new diagnostic criteria of estimating the lesion zone making it possible to predict favourable and unfavourable organization of the necrosis zone is suggested.

The videothoracoscopic parasternal lymphade­nectomia method is developed. The adequacy of the removed tissue volume in the videothoracoscopic parasternal lymphadenectomia method is proved during the previously performed experiment on the corpses. Up to 1998 the authors performed 120 videotho­racoscopic paracternal lymphadenectomias in patients aged 27 to 73. The manifestation of the pain syndrome, the amount of injected narcotic analgetics, the hospitalization terms of patients, the number of intra- and postoperative complications, the results of cardiointervalography and pneumotachometry after the videothoracoscopic parasternal lymphadenectomia proved to be better than after similar interventions performed by the traditional (open) method preserving the removed tissue volume. The videothoracoscopic parasternal lymphadenectomia is a highly effective minimally thraumatic method in the diagnosis and treatment of the parasternal collector damaged by metastases which in the surgical treatment of the breast cancer of the central and medial localizations can be recommended as a choice method.

The importance of endotoxinemia and its role in immune disorders in bronchial asthma in children are studied. The pronounced correlation of the plasma endotoxin level with the attack rate, the increasse of the attack duration and remission prolongation is revealed. The immunologic indices change differently. The data obtained confirm the pathogenetic importance of endotoxinemia in bronchial asthma in children requiring new approaches to the therapy taking into account the revealed disorders.

The informativity of the ultrasonic examination, intravenous excretory urography, radioisotopic renography in the diagnosis of nephroptosis is studied. It is shown that the combined use of radiation methods makes it possible to establish the nephroptosis degree, to reveal the disorders of uro- and hemodynamics and to determine the choice of treatment tactics.

The functional echospondylography method which makes it possible without the use of the x-ray method to diagnose in patients the hypermobility in the cervical part of vertebral column is suggested. The examination can be repeated in process treatment and after it. The ultrasonic histographic study of the myofascial trigger points makes it possible using the numerical indices to estimate the degree of their activity in comparison with the histogram data of the unchanged muscle part and to estimate the treatment results by the histogram change.

Treatment of patients with urolithiasis (Urolithiasis) in modern urology is an important task associated with both medical and social and labor rehabilitation. According to NK Dzeranov's forecasts [5], in 2000 the number of patients with ICD will increase 1.8-2.0 times. The annual rate of primary morbidity of KSD is 0.1% [25]. Surgical intervention, being for several decades the leading method of treating KSD. fraught with serious complications. NK Dzeranov [5] indicates a high percentage of relapses of a more severe form of ICD, in which the number of nephrectomies increases to 11.5%. Poor surgical outcomes prompted clinicians to seek alternatives to open surgery.

Dissatisfaction with the final results of treatment of patients with acute pancreatitis prompts the search for new methods of diagnosis and therapy of this disease. Having experience in surgical treatment of 201 patients with various forms of pancreatic necrosis, we came to the conclusion that the classification should reflect the state of the parapancreatic cellular space. This is due to the following points. First, an extensive purulent-necrotic lesion of the retroperitoneal tissue is considered one of the main reasons for the development of the syndrome of endogenous intoxication, leading to plurivisceral syndrome, which in some cases is fatal. Secondly, the widespread inflammatory infiltrate of the parapancreatic space can have a favorable (resorption) and unfavorable (abscess formation) course, which requires the doctor to carry out timely diagnostic measures to verify the complications of the postoperative period. Thirdly, a purulent or infiltrative (in the form of a dense infiltrate) lesion can determine the volume of surgical intervention.

Normal gut microflora plays an important role in maintaining the host's health at an optimal level. Violation of its qualitative and quantitative composition, due to various exogenous causes, is usually defined as intestinal dysbiosis (DC).

The Stanford Faculty Development Program has successfully trained physicians for their tasks as clinical teachers in medical education. This program, based on seven educational categories, organizes the teaching process into a structure which then focuses attention on specific behaviors teachers can utilize to adapt their teaching for a wide variety of learners in many different settings. Experimental studies support this program’s effectiveness and suggest that if we are more thoughtful about how we teach and how we prepare others to teach, we will be more assured of enhancing medical education for all of our learners.

The organization structure of dermatological service to rural population in Tatarstan Republic is given. The registered morbidity rate in rural areas is 2.1 trimes lower than among people living in towns. One of the reasons is unavailability of specialized dermatological aid. The part of diseases remains unregistered, but this does not reflect the level of disease incidence. The introduction of early preclinical diagnosis methods of the industrial skin diseases at the premedical level that will make it possible to decrease dermatosis incidence in rural areas, is suggested.

November 2000 marked the 75th anniversary of the birth and 52 years of the medical, scientific, pedagogical and social activities of the honored scientist of the Republic of Tatarstan, Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology of the Kazan State Medical Academy Nina Lazarev us Kapelyushnik.

Leading geneticists from Russia, near and far abroad took part in the work of the congress. At the plenary sessions, reports were presented, the topic of which was the analysis of the medico-genetic service of the Russian Federation (A. Khodunova), the problem of human genetics (N. Bochkov), the relationship “genotype-phenotype” as a problem of human molecular genetics, medical genetics on the threshold of the XXI century, medical and genetic education at the university, decoding of the human genome.

In connection with the epidemic rise in our country of HIV infection, the new guidance dedicated to this most pressing problem is very timely and necessary for a wide range of doctors. The monograph was written by the staff of the All-Russian Center for the Prevention and Control of HIV Infection under the general editorship of Academician V.V. Pokrovsky, who heads this center. This work is one of the first guidelines on the clinical aspects of this infection in such detail. The book contains 5 chapters, a bibliography, an appendix, a list of abbreviations. It is based on the materials of our own observations of more than 1000 patients with HIV infection, carried out by the authors for 15 years, and this is its great advantage.