ABSTRACT
In coincidence of chronic phthisic pleuritis in a rigid stage with pulmonary tuberculosis operative intervention is indicated of a pleuropulmonectomy type, what is a complex situation for performance and preservation of the patient's functional state. Pleuropulmonectomy in some patients is complicated by empyema and pathological processes in bronchi. Possibilities of operative interventions application, alternative to pleuropulmonectomy, were studied. Of 48 patients, to whom pleuropulmonectomy is indicated in accordance to data of clinic-roentgenological investigations, in 7--simultant operative treatment were conducted with positive results.
Subject(s)
Pleurisy/surgery , Pneumonectomy/methods , Thoracoplasty/methods , Tuberculosis, Pulmonary/surgery , Adult , Antitubercular Agents/therapeutic use , Female , Humans , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/pathogenicity , Mycobacterium tuberculosis/physiology , Pleurisy/drug therapy , Pleurisy/microbiology , Pleurisy/pathology , Pneumoperitoneum, Artificial/methods , Treatment Outcome , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/pathologyABSTRACT
The authors are analyzing the epidemic situation in Ukraine and the epidemiology of chronic tuberculous pleuritis (CTP). They are suggesting 206 pleurectomy results of operated patiens. Restrictive type of venting disorders before surgery occurred are in 26.4% cases, 36.2% and 100%, respectively at 1; 2 and 3 stages of CTP. Reducing the number of patients with this type of violations occurred if 6.9 times, 11.7 times and 3.3 times respectively to operated in case of 1, 2 and 3 stages of CTP. Improvements and other positive functional parameters are submitted. The authors conclusion: pleurectomy is the method of functional rehabilitation at CTP cases.
Subject(s)
Pleura/surgery , Pleural Cavity/surgery , Pneumonolysis/methods , Tuberculosis, Pleural/surgery , Adult , Chronic Disease , Female , Humans , Male , Middle Aged , Pleura/pathology , Pleural Cavity/pathology , Recovery of Function , Tuberculosis, Pleural/pathology , Tuberculosis, Pleural/rehabilitation , UkraineABSTRACT
Expression of alpha-receptors of estrogen (RE) in accordance to immunohistochemical (IHC) labeling in gastroduodenal mucosa cells was studied up in patients, suffering the ulcer disease and without it. In 4 patients (group I) a gastroduodenal mucosa affection was revealed, they were operated on for hemorrhage from gastroduodenal ulcers; in 3 patients (group II) gastroduodenal mucosa affection was not observed; in 4 patients (group III, control), a mammary gland cancer was diagnosed, a positive reaction on alpha-RE was noted. In groups I and II the biopsies were studied, obtained from pylorus and gastric fundus, as well as from duodenal ampula, and in a group III--obtained from the tumor. In a control group a positive labeling of nuclei was revealed in biopsies. In patients of groups I and II the alpha-RE expression by cellular nuclei was not revealed, but, the lots of positive IHC labeling of cytoplasm in glandular and stromal mucosal cells of the investigated gut were noted. Positive IHC labeling of cytoplasm for alpha-RE witnesses about sensitivity to them in norma and pathological processes. But, a trustworthy difference of alpha-RE expression by cellular nuclei was not noted. For confirmation or denial of this hypothesis further clinical and IHC investigations are needed.
Subject(s)
Breast Neoplasms/metabolism , Duodenal Ulcer/metabolism , Estrogen Receptor alpha/metabolism , Estrogens/metabolism , Peptic Ulcer Hemorrhage/metabolism , Stomach Ulcer/metabolism , Adult , Aged , Breast Neoplasms/complications , Breast Neoplasms/pathology , Cell Nucleus/drug effects , Cell Nucleus/metabolism , Cell Nucleus/pathology , Duodenal Ulcer/complications , Duodenal Ulcer/pathology , Duodenum/drug effects , Duodenum/metabolism , Duodenum/pathology , Epithelial Cells/drug effects , Epithelial Cells/metabolism , Epithelial Cells/pathology , Estrogen Receptor alpha/genetics , Estrogens/pharmacology , Female , Gastric Mucosa/drug effects , Gastric Mucosa/metabolism , Gastric Mucosa/pathology , Gene Expression , Humans , Immunohistochemistry , Intestinal Mucosa/drug effects , Intestinal Mucosa/metabolism , Intestinal Mucosa/pathology , Male , Middle Aged , Peptic Ulcer Hemorrhage/complications , Peptic Ulcer Hemorrhage/pathology , Stomach/drug effects , Stomach/pathology , Stomach Ulcer/complications , Stomach Ulcer/pathologyABSTRACT
Genetic-hormonal regulation plays a key pathophysiologic role in a blood loss on background of complicated gastroduodenal ulcer disease, but a clinical significance of some genes of compensatory steroidogenesis remains unrevealed. Examination of 63 patients, using a chain reaction with polymerase (CRP); analysis of length of restriction fragments (CRP-RFLP) and immunohistochemical investigation of gastroduodenal mucosa were performed on the base of a Sumsky Rural Clinical Hospital. Trustworthy difference of distribution of polymorphic genes ESR1 and VKORC1 in patients of both gender in presence of the ulcer hemorrhage was not revealed, excluding genotype A/A VKORC1, what trustworthy more frequently was revealed in women (p < 0.05). There was established, that intact zone of gastric fundus owes immunoreactivity towards alpha-receptors of estrogen in nuclei of epitheliocytes and stromocytes. Diagnosis of polymorphic gene VKORC1 and expression of the estrogen receptors may serve the base for pathogenetic therapy in patients with hemorrhage occurrence.