[Clinical classification of extrapulmonary tuberculosis].

The authors propose a clinical classification of extrapulmonary tuberculosis, which is based on the standard reporting signs. They give the definitions of classification criteria established in any locations of tuberculous infection: etiology (tuberculosis, BCG infection, tuberculoallergic lesions), the extent and activity of a process with regard to clinical and morphological stages; bacterial isolation with consideration of the drug resistance of Mycobacteria; the nature of complications and sequels, etc. The characterization of local lesion includes the determination of organ-dependent clinical forms of tuberculosis; the type and form of complication; residual and sequels.

[Active genital tuberculosis with peritoneal involvement in women]. / Aktivnyi tuberkulez zhenskikh polovykh organov s vovlecheniem v protsess briushiny.

The paper presents the results of a study of clinical and laboratory features in patients with active genital tuberculosis with peritoneal involvement. It has been shown that patients with active genital tuberculosis involving the peritoneum show a more pronounced clinical picture and changes recorded by laboratory studies than those with a restrictive process. A growth of the number of patients with specific peritonitis, an unwarranted increase in the volume of surgical interventions, lack of systemic data on this category of patients under the present condition make it necessary to make further studies of this problem.

[Specific features of tuberculosis of peripheral lymph nodes with specific process in the respiratory organs]. / Osobennosti tuberukuleza perifericheskikh limfaticheskikh uzlov pri spetsificheskom protsesse v organakh dykhaniia.

102 patients with verified tuberculosis of the peripheral lymph nodes (TPLN), including 40 patients with specific process in the respiratory apparatus, were examined. The lymph nodes of the neck were found to be primarily affected in such patients (89%); by the 2nd month, conglomerates develop from such nodes, with the latter evolving into fistulas (44.4%) and into abscesses (40%). A high specificity and sensitivity of the test with the blood serum for adenosine deaminase were proven. Different types of anti-tuberculosis antibodies are isolated with various rates; therefore, it is advisable to study the answers to all serological reactions.

[Surgery on tuberculosis lymphatic system and abdominal organs]. / Khirurgiia tuberkuleza limfaticheskoi sistemy i organov briushnoi polosti.

The paper presents data on surgery for tuberculosis of the lymphatics and abdominal organs. Removal of tuberculosis-affected peripheral lymph nodes during etiotropic therapy yields positive therapeutical results in 84.6% of patients. The efficiency of early operations has been first evidenced by a dynamic study of the systemic immunity. Complicated abdominal tuberculosis is encountered in 44.2% and forced emergency and planned operations on the abdomen to be performed; good late results should be consolidated by combined bactericidal therapy.

[Laparoscopy in the complex diagnosis abdominal and genital tuberculosis]. / Laparoskopiia v kompleksnoi diagnostike abdominal'nogo i genital'nogo tuberkuleza.

Laparoscopy may detect pathognomonic signs of rashes on the visceral peritoneum, enlarged mesenteric lymph nodes, a profound commissural process in the small pelvis and Douglas space to identify abdominal and genital tuberculosis. The examinees were also found to have a prior tuberculosis of other sites or a contact with bacillary patients. Laparoscopy shows a 19.7% increases in the diagnostic potentialities by morphologically verifying the diagnosis based on biopsy specimens.

[Adenosine deaminase in differential diagnosis of peripheral lymph node tuberculosis]. / Adenosindezaminaza v differentsial'noi diagnostike tuberkuleza perifericheskikh limfaticheskikh uzlov.

Examining the activity of serum adenosine deaminase in 112 patients with lymphadenopathy of various etiology revealed its increase (at the discriminant level equal or exceeding 20 U/l) in 86% of 50 patients with active tuberculous infection. The specificity of the parameter as a test for tuberculous peripheral lymph nodal lesion is 90.3%, the positive and negative prognostic significances are 83 and 89%, respectively, the diagnostic efficiency is 88.4%.

[Penetrating gunshot wounds of the chest: the surgical procedure and treatment times and outcomes]. / Ognestrel'nye pronikaiushchie raneniia grudi: khirurgicheskaia taktika, sroki i iskhody lecheniia.

On the basis of data obtained during the war in Afghanistan the article analyses surgical management and the results of treatment in three groups of patients with chest wounds. The authors consider that the efficiency of treatment could be improved by gaining time during evacuation period and providing the earliest surgical care to the wounded. Indications and peculiarities for various surgical interventions were ascertained depending on the character of trauma and subsequent pathological disorders. The article proves the necessity of preventive sanitation of pleural cavity, gives the data concerning the period and outcome of treatment.

[Non-surgical sanitation in patients with obstetrical and gynecological infections]. / Neoperativnaia sanatsiia u bo'lnykh s akusherskim i gine- kologicheskim sepsisom.

The intra-aortic++ introduction of a complex of drugs was performed to 34 patients with sepsis of obstetric-gynecological etiology. The disease appeared in 23 patients after extrahospital abortions, in 7 patients after delivery, in 4 patients after operation of cesarean section. Septic pneumonia took place in 23 patients. Antiseptic treatment was also used in all the patients. Recovery was noted in 32 of 34 patients, 23 of them were discharged from the hospital without removal of the uterus. Conclusion may be made that the intra-aortic++ administration of drugs is a highly effective method of treatment of obstetric-gynecological sepsis.

[Contraindications for lumbar sympathectomy in patients with obliterative lesions of arteries of the legs]. / Protivopokazaniia k poiasnichnoi simpatéktomii u bol'nykh s obliteriruiushchim porazheniem arterii nizhnikh konechnostei.

The authors consider that it is the correct choice of patients for lumbar sympathectomy which is responsible for good remote results in 84.3% of patients subjected to the operation.

[Intraoperative hemodilution during reconstructive surgery on the aortofemoral segment]. / Intraoperatsionnaia gemodiliutsiia pri rekonstruktivnykh operatsiiakh na aortobedrennom segmente.

The authors analyze results of using the intraoperative hemodilution with the help of the mannite plasma in 20 patients with obliterating lesions of the lower extremity vessels. Its influence on the central hemodynamics, water-electrolyte homeostasis, functions of the kidneys, liver, coagulating blood system were studied. The advantages of such method of autohemotransfusion are shown.

[Central and peripheral circulation in arteriosclerosis obliterans of the lower extremities before and after surgical treatment]. / Tsentral'noe i perifericheskoe krovoobrashchenie u bol'nykh obliteriruiushchim aterosklerozom nizhnikh konechnostei do i posle khirurgicheskogo lecheniia.

The authors have studied changes in hemodynamics by the method of integral rheography of the body and radioisotopic study of the time of bloodflow in 110 patients with obliterating atherosclerosis who were subjected to sympathectomy or reconstructive operations on the vessels. The positive effect of operations manifested itself in improvement of the central and regional hemodynamics.

[Correction of the regional blood flow in obliterating vascular lesions of the legs]. / Korrektsiia regionarnogo krovotoka pri obliteriruiushikh porazheniiakh sosudov nizhnikh konechnostei.

Results of different methods of treatment of 712 patients with obliterating injuries of the lower extremity vessels were followed for the period from 1974 to 1980. Complex conservative therapy was used in 225 patients. Good results were observed in 1/3 of the patients. Operations were fulfilled in 487 patients: 273 lumbar sympathectomies (bilateral in 28%) and 214 reconstruction operation on the arteries. The prognosing of effects of sympathectomies gave positive results in 84.3% of patients. Good remote results after reconstructive operations were observed in 72,5% of patients. The authors emphasize a short-term effect of reconstructive operations below the inguinal ligament.

[Intra-arterial infusion in the treatment of severe forms of occlusive vascular diseases of the lower limbs]. / Vnutriarterial'nye infuzii v lechenii tiazhelykh form obliteriruiushchikh porazhenii sosudov nizhnikh konechnostei.

The clinico-instrumental investigation of results of intraarterial infusions of acetylcholine chloride in 82 patients with obliterating lesions of the vessels of lower extremities has revealed high therapeutic effect of the drug. The treatment allowed avoiding amputation of the extremity in the overwhelming majority of patients with serious degrees of ischemia.