Zbornik. Vojnomedicinska akademija (Yugoslavia)最新文献

The clinical findings in 63 patients with xanthomas were analysed. Among them 5 had xanthelasmas and normal lipids. The largest group (37) consisted of females with xanthelasmas and heterozygotic form of hyperlipoproteinemia (HLP) type II. In this group HDL cholesterol values (1,5 mmol/l) were normal and ischemic heart disease (IHD) was rare. However, in 14 males HDL values (1,1 mml/l) were low while IHD was common. Cholesterol deposits in the folds of the palm (xanthochtomia striata palmaris), tuberous xanthoma and peripheral artery changes were characteristical findings for all three patients with HLP type III. In patients with HLP type IV and eruptive xanthomas, obesity was common finding (4/4) and disturbed glycoregulation (2/4) and triglyceride values were very high (X = 61,1 mmol/l).

The results of a five-year examination of the pasteurized milk, yogurt, cottage cheese and butter supplies for the patients' kitchen of the MMA for contamination with organochlorine pesticides are presented. The representative samples were analysed every month and the results were expressed as the mean value of the analysed samples for the every year of examination. The obtained values for organochlorine pesticides were recalculated for the contents of milk fat and milk products according to the requirements of the Regulations for the maximum permissible pesticide quantities in foodstuff. With same exceptions, in all the analysed samples of milk and milk products the content of pesticides were within the standard norms the last two years. The decreasing tendency, that is, gradual disappearing of DDT and its metabolites from milk and milk products has been pointed out.

The retrospective analysis of 1781 patients with bronchogenous carcinoma treated at the Institute of Pulmonary Diseases of the Military Medical Academy within the period 1971-1980 is presented. In 86% cases the disease was discovered according to symptoms because of which the patients had consulted physicians. The time between the onset and the detection of the disease was more than 3 months in the majority of patients and more than 6 months in one third of the patients. In the largest number of patients the disease was detected late when chances for successful intervention were diminished. Only in one third of the patients the disease was localized. Aiming to early detection of bronchogenous carcinoma it is essential to have good knowledge of symptoms both by patients and primary care physicians.

In the experiments on pigs wounds on the muscle-connective tissues of the thighs were made at 50 meter range by projectiles of military Rifles M 48, M 70, M 16A FAL (the length of the wound canal from 214 to 228 mm), M 91/30 and Dragunov (the length of the wound canal from 160 to 164 mm). The mass of tissue excised at primary surgical debridement was taken as a criterium of the primary devitalization of tissue, the amount of the transferred energy was calculated as well as other parameters of the terminal ballistics. Shooting through the glycerine-soap blocks under the same conditions were parallelly performed. The examinations have shown that the degree of the primary mechanical injury depended on the amount of the transferred energy, which depended not only on the high initial velocity of the bullet but also on the disintegrated, deformed and fragmented bullet after passage through the tissue. The mass of the excised tissue can be a reliable criterium for evaluation of wound severity. There is a good correlation with the volume of the cavity in the soap blocks so that they can be used in experiments as simulant biological media.

Hearing impairment was examined in a group of 1073 soldiers artillerymen during regular training of shooting from artillery weapons of different calibers. Immediately after shooting the transient increase of hearing threshold (fatigue) of different degrees was found in 907 (84,25%) of the examined. Contusion and rupture of the eardrum were more commonly found in the right ear which confirmed the "phenomenon of screening". At admission it was found that 22,5% of soldiers suffered from different diseases of the ear, nose and throat while at discharge this percentage was increased for 6,4%. A significantly higher number of blast ear injuries were found in soldiers with positive ORL findings compared to those who had normal findings before shooting. There is no correlation between the caliber of artillery weapons and the degree of hearing impairment.

The analysis of 243 cases with perforative eye injuries with intraocular foreign bodies was performed. Of them 183 were caused by non-magnetic and 60 by magnetic foreign bodies. The increased number of perforative injuries caused by non-magnetic foreign bodies was observed (71,2%). A large number of non-magnetic foreign bodies contained copper (76%). In 74% cases non-magnetic foreign bodies were found in the posterior eye segment. By introducing modern diagnostical and surgical methods (1976) the percentage of removed non-magnetic foreign bodies is significantly higher (93%) compared to the previous period (1961-1975).

Spectral analysis of noise and graphical illustrations of total noise levels at working places of assistants of engineering machines in road building activities were performed. Also, otoscopic and audiometric examinations were carried out in 134 assistants of engineering machines. In spite of a relatively intensive noise of a larger number of the examined machines, new perceptive hearing impairment during army service were not found, except for 10,45% cases detected on the day of entering the Y.P.A. service. Absence of acoustic trauma can be explained by short total exposure since 6 months are spent on road building as well as short daily exposure since the working day lasts four hours for assistants and their helpers when working with engineering machines.

Within a two-year period urgent endoscopy due to bleeding from the upper digestive tract was performed in 209 patients, that is, 4,6% of all endoscopies. The cause of bleeding was detected in 84% of the examined patients. The most common cause of bleeding was: gastroduodenal ulcer, erosive esophagogastroduodenitis, malignant gastric neoplasm, and, in a smaller percentage, peptic postresection ulcer and esophageal varices. Analysing causes of a relatively high percentage of nonidentified bleedings the authors insist on detection of small lesions as well as indirect signs of mucosal alterations as possible causes of bleeding.

In 86 patients with primary HLP type IV over 50% were detected at systematical examinations of non-commissioned officers so that the number of male patients is uncommonly very high, 80, (93%). The highest number of patients--66 (92,5%) belonged to the age group 41-60 years. The analysed group showed the increased incidence of: obesity (60,5%), disturbed glycoregulation (45,3%), arterial hypertension (34,9%), ischemic heart disease (26,7%), hyperuricemia (23%), occlusive peripheral artery disease (16,3%), low values of serum cholesterol concentration LVG (X = 0,98 mmol/l), markedly decreased fibrinolytic activity (eugolobulin fibrinolysis 240 +/- 29 min) and hyperinsulinism (in 9 of 13 patients). Eruptive xanthomas were found in 7 (8,1%) patients. Due to male predominance the incidence of cholelithiasis is lower than expected (8,1%).