Sovetskaia meditsina最新文献

Postoperative levels of insulin and morphological pattern of beta-cells of islets of Langerhans were studied in 27 esophageal cancer patients following one-stage esophageal resection or repair with the gastric pedicle graft and extracavitary cervical shunt. There is a postoperative inhibition of secretory activity of the insulin pancreatic apparatus which recovered on 120 postoperative day. These shifts resulted from dystrophy of the beta-cells.

Oxygen-dependent metabolism of peripheral neutrophils was compared for viral hepatitis and acute yersiniosis patients. The metabolism inhibition was seen in both the diseases with lower values for viral hepatitis. Neutrophil function was dependent on the disease gravity. Its recovery went in parallel with other clinical and laboratory signs of convalescence. A luminol-dependent chemiluminescence test is proposed for differential diagnosis of viral hepatitis with jaundices in generalized bacterial infection.

The authors provide the long-term results of cholecysto-digestive + anastomoses in 59 patients operated on for nontumorous diseases. The gallbladder anastomosed with the upper parts of the alimentary tract preserved reservoir and concentration functions, ability for visualization during cholecystocholangiography. The discrete pulse mechanism of bile secretion via the bile diverting anastomoses and their antireflux function eliminated the risk of chronic pancreatitis and terminal cholangitis. The recovery of deranged liver functions and excretory functions of the pancreas were traced during the postoperative period within 2 to 21 years.

As many as 56 patients with uterine myoma underwent conservative myomectomy. In 40 patients (group I), it was performed by laparotomy and in 16 (group II) ++trans-cervically under the control of hysteroscopy. The group I patients' age amounted on the average to 33.2 +/- 0.6 years, in group II, it was 46.3 +/- 0.8 years. Before operation the size of the uterus ranged from 6 to 32 weeks of pregnancy. Uterine incisions were made with regard to the site of myomatous nodes and the architectonics of the myometrium and vessels. To additionally strengthen++ sutures on the uterus, use was made of containing which provided for more favourable conditions for the formation of the scar on the uterus. Every second patient of the reproductive age manifested menstrual function improvement and 4 women conceived. The data obtained point out that the carrying out of conservative myomectomy is desirable in different age groups. The choice of the surgical technique is dependent on the primary site of myomatous nodes, their dimensions, the patient's age and concomitant extragenital pathology.

To evaluate objectively the degree of the urodynamics recovery in patients with nephrostomy in the postoperative period and to determine the optimal times of removing the nephrostomy drainage tubes, a ++video-urodynamic study was carried out. It consisted in combined antegrade X-ray TV ++pyelo-ureteroscopy and ++trans-fistula pyelomanometry. To measure the degree of the effect of retroperitoneal pressure on urodynamics, intraperitoneal pressure was also evaluated. The volumetric rate of the perfusion of the radiographic contrast substance ranged from 1 to 7 ml/min. As many as 108 patients with nephrostomy were examined within different times after the operation. Urodynamics was regarded as recovered, if the difference between pelvic and intraperitoneal pressure did not exceed 12 cm H2O, with the volumetric rate of perfusion being different. In 76/108 patients (70.4%), adequate passage of urine in the ++upper urinary tract was determined, which allowed one to attempt nephrostomy closing. In 32/108 patients (29.6%), the results of the study were viewed as unsatisfactory which required continuation of the draining of the pelvi-calyceal system by the nephrostomic drainage tubes. Repeated investigation carried out after 5-10 days revealed the normalization of the urodynamic characteristics. No complications were recorded after the nephrostomic drainage tubes were removed.

Computed tomography (CT) findings were compared with operative ones for 50 patients with esophageal and proximal gastric cancer. In diagnosis of metastases to the upper abdominal and retroperitoneal lymph nodes ST sensitivity reached 93.3%, specificity 85% and accuracy 90.3%. The best diagnostic results were obtained in detection of metastases to the nodes of the celiac trunk branch and paraaortal fat (94.2%). Lower CT resolution appeared in diagnosis of perigastric node metastatic involvement in the primary tumor location in the proximal stomach.