[Surgical treatment of lung injuries and diseases in patients with blunt chest trauma]. / Khirurgicheskoe lechenie povrezhdenii i boleznei legkikh u patsientov s zakrytoi travmoi grudi.

OBJECTIVE: To establish the indications for optimal open lung surgery in patients with severe blunt chest injury. MATERIAL AND METHODS: Hematomas, lung wounds and purulent pulmonary complications were studied in four groups of victims. Causes of injuries included road accidents (n=426), falling and beating (n=387), catatrauma (n=217), squeezing the body with a massive weight (n=46). Majority of victims (n=731, 67.9%) were transferred to the hospital within 1-5 hours after injury; 345 (32.1%) patients were transferred from other hospitals to treat combined injuries of head, chest, abdomen and complications within 1-49 days after injury. RESULTS: Lung surgery was applied in 48 patients. Typical resections and pneumonectomies made up 77.1%. Indications for surgery included lung wounds complicated by pulmonary hemorrhage grade IIa and severe hemothorax, intrapulmonary hematoma ≥6 cm with high risk of bleeding and suppuration, gangrene, gangrenous and purulent abscesses of aspiration genesis, lung cancer first diagnosed in victims. Postoperative mortality was 14.6%. Twelve victims with unrecognized deep lung wounds and pulmonary root rupture were not operated. Thus, 5.6% of victims with severe blunt chest trauma need for open lung surgery.

[Mechanical damage and spontaneous esophageal perforation].

The article presents the results of treatment of 95 patients with iatrogenic damages and perforations caused by other reasons and spontaneous rupture of the esophagus. A defect of the esophagus was formed in thoracic part in 67.4% cases. Combined suppurative complications such as a neck phlegmon, mediastinitis, pleural empyema, pericarditis, pneumonia and lung abscess occurred in prevalent majority of patients. Surgical interventions were performed through cervical, thoracotomical and laparoscopical accesses. Different plastic methods of covering sutures of the esophagus were used in conditions of suppurative inflammation in 33 patients. An inconsistency of sutures was noted in 6 (18.2%) cases. Postoperative lethality consisted of 34.6% in spontaneous rupture of the esophagus and it was 11.9% in case of other damages.

[A case of severe eye contusion in proliferative diabetic retinopathy].

A case of successful treatment of sequelae of severe ocular trauma associated with proliferative diabetic retinopathy is represented. Improvement of electrophysiological parameters proves that this condition is not an absolute contraindication for surgery and sometimes not eye preserving only but functional effect can be achieved

[Experimental intraocular introduction of blood serum of patients with endophthalmitis]. / Vnutriglaznoe vvedenie syvorotki krovi patsientov s éndoftal'mitom v éksperimente.

Effects of blood serum from patients with endophthalmitis, who systematically received gentamicin at therapeutic dose, exerted on the retina of healthy rabbits were experimentally studied. A moderate toxic effect produced by gentamicin on the retina, when it was administered in the vitreous body of rabbits, was detected yet on day 1 of the experiment. Changes of retinal electrogenesis were aggravating and, beginning from day 7, there were noted profound changes of the functional activity in all retinal layers. According to the results, the blood serum from patients with endophthalmitis, who were systematically receiving gantamicin at therapeutic dose, does not virtually have any negative effect on the functional condition of the retina and can be used for intracavitary administration.

[Peculiarities of neoplastic epidemiologic studies in children residing near nickel producing facilities]. / Osobennosti izucheniia épidemiologii opukholevykh zabolevanii u detei, prozhivaiushchikh v raionakh razmeshcheniia predpriiatii po proizvodstvu nikelia.

Studying risk factors of malignancies in children who reside near nickel metallurgic enterprise covers creation of a register for long-term epidemiologic monitoring. The article presents possible ways to obtain reliable information from various sources, deals with their positive and negative aspects for electronic database.

[Gunshot wounds of the chest and abdomen in peacetime]. / Ognestrl'nye raneniia grudi i zhivota mirnogo vremeni.

320 gunshot wounds of the trunk in peacetime are analyzed. Wounds from hunting rifle (71.2%) dominated, penetration into pleural or abdominal cavity was revealed in 89.4% cases. Thoracoabdominal and combined wounds of the chest and abdomen reached 23.8%. Significant destruction of the soft tissues and bones, multiple damages of organs were seen often. Causes of infectious complications and lethal outcomes were analyzed. Improving of care quality has reduced lethality from 21.8 to 15.6%.

[Deacetylation of chitin under homogeneity]. / Deatsetilirovanie khitina v gomogennykh usloviiakh.

Chitin isolated enzymatically from Antarctic krill shells was dissolved in aqueous NaOH by freezing and thawing to create homogenous conditions. Deacetylation was performed at room temperature or heating. The degree of deacetylation, molecular weight, and dynamic viscosity of solutions were estimated in chitosan samples. Deacetylation of chitin under homogenous conditions was optimized. Chitosans with molecular weights of 180-220 and 250-300 kDa were obtained from the chitins of Antarctic krill and Northern shrimps, respectively.

[New prospects in the treatment of intraocular infection]. / Novye perspektivy v lechenii vnutriglaznoi infektsii.

Clinical trials were carried out on 55 patients (55 eyes) divided into 2 groups. The main group consisted of 27 patients treated by a therapeutic complex including vitrectomy with ozonized normal saline and the controls (28 pts) were treated by vitrectomy with intravitreal administration of 0.4 mg gentamicin. The diagnosis was made by clinical and laboratory methods. The volume of liquid used in vitrectomy was recorded. Ozonized saline was to be used within the period during which the therapeutic concentration of ozone was retained. Ozonized saline in therapeutic doses is not toxic and in contrast to antibiotics, is characterized by a wide spectrum of effects. Hence, vitrectomy with ozonized normal saline is a new effective method for treating endophthalmitis.

[Restoration of retinal functional activity after surgical treatment of its detachment in patients with different eyeball injuries]. / Spetsifika vosstanovleniia funktsional'noi aktivnosti setchatki posle khirurgicheskogo lecheniia retinal'nykh otsloek pri razlichnom kharaktere povrezhdeniia glaznogo iabloka.

Nineteen case histories are analyzed: 1) 6 patients with postperforative detachment of the retina; 2) 8 patients with detachment of the retina after a penetrating wound with introduction of a foreign body; and 3) 6 patients with postcontusion detachment. The restoration of the alpha and beta ERG waves depended on the type of injury: after penetrating wounds, the changes in the retinal electrogenesis were the most manifest during the initial and early postoperative period; foreign bodies aggravated and decelerated the regeneration of visual function, contusion trauma of the eye is the most unfavorable factor complicating the restoration of visual functions; involvement of the paired (intact) eye is typical, as is changed functional reaction of the retina in injuries of all types.

[Functional and morphological features of vitreoretinal proliferation after penetrating wounds of eye complicated by hemophthalmos (immunohistochemical and electron microscopy study)]. / Funktsional'no-morfologicheskie osobennosti vitreoretinal'noi proliferatsii posle pronikaiushchikh ranenii glaza, oslozhnennykh gemoftal'mom (immunogistologicheskoe i élektronno-mikroskopicheskoe issledovanie).

Comprehensive (optic, electron, and fluorescent microscopy) morphological analysis of vitreous fragments removed in vitrectomy after penetrating wounds of the eye complicated by hemophthalmia showed that blood and damaged cells of pigment-free ciliary epithelium and the glia play an important role in the development of proliferative processes in the ophthalmic cavity. Immunohistochemical studies revealed active expression of immunoglobulins A and G and of HLA-DR antigen on immunocompetent cells and abnormal expression of HLA-DR in pigment-free ciliary epithelium and the glia, confirming the autoimmune origin of inflammatory disorders.

[Experimental and morphological results of using carbon foam in the formation of the locomotor stump after enucleation]. / Eksperimental'nye i morfologicheskie rezul'taty vzhivleniia uglerodnoi peny dlia formirovaniia oporno-dvigatel'noi kul'ti posle énukleatsii.

Syntactic carbon foam implants were used for the formation of the stump after unilateral enucleation in 24 rabbits. Clinical follow-up of the experimental animals demonstrated positive results of using syntactic carbon foam for plastic ophthalmosurgery. No complications, such as migration, infection, denudation, or rejection were observed in the immediate or late periods after surgery. Results of morphologic examinations of tissues adjacent to implants, carried out at different terms, are presented.

[Clinical aspects of injury to the eye inflicted with gas pistols for self-defense]. / Klinicheskie aspekty porazheniia glaz gazovym ognestrel'nym oruzhiem samooborony.

The clinical picture of an injury inflicted with gas pistols represents polymorphous changes and severe injury to the organ of vision, involving not only the anterior segment, but the deep structures as well. Analysis of the status of the damaged eyes and the mechanism of injury permitted us to distinguish 3 clinical groups in terms of the intensity of exposure to this or that factor: 1) chemical burn of the cornea and conjunctiva (65 patients); 2) chemical burn with elements of thermal involvement and impregnation of tissues with particles of gunpowder that failed to burn and slight or medium-severe contusion of the eyeball (31 patients): and 3) severe thermochemical burn with grave contusion of the eyeball, sometimes with rupture of membranes (6 patients). Hence, we may conclude that the consequences of using gas weapons differ from those described in the Status of Gas Weapons Application and in advertising materials by a much greater severity, and in 11.7% cases such injuries led to complete irreversible loss of vision. Obviously the shortest distance from which it may be allowed to shoot from gas pistols should be increased to 1 meter.

[Current aspects of the problem of tonsillar disease]. / Sovremennyi aspekt problemy tonzilliarnoi bolezni.

The paper presents current concepts and the author's data on morphofunctional organization of lympho-epithelial symbiosis of the palatine and pharyngeal tonsils in children operated because of tonsil disease (chronic tonsillitis and chronic adenoiditis). The structure and functional significance of the areas of the epithelium reticulation as immune regulatory tonsil compartments and their possible role in pathogenesis of tonsillogenic complications are discussed.

[Experimental and morphological results of implantation of carbon felt in plastic surgery of the locomotor stump and accessory system of the eye]. / Eksperimental'nye i morfologicheskie rezul'taty vzhivleniia uglerodnogo voiloka dlia plastiki oporno-dvigatel'noi kul'ti i pridatochnogo apparata glaza.

Carbon felt (carbotextime) was used to form a stump after enucleation and for plastic repair of the accessory system of the eye in 56 rabbits. Sixteen of these animals were controls in whom silicon implants were used. Comparative analysis of clinical follow-up of experimental animals showed good results of using carbon felt in plastic ophthalmic surgery. Use of silicon implants was associated with a more manifest inflammatory reaction, and there were cases of the implant migration and spontaneous rejection. No complications in early or late postoperative periods were observed in the experimental group. Results of morphologic studies of the tissues adjacent to the implant in various periods postoperation are presented in detail.