[Abdominal TB. Peritonitis due to perforated intestinal TB & upper intestinal fistulas. Surgical treatment].

Nowadays tuberculosis--TB is most popular chronic infections disease in the world. The mortality is high, 3 million approximately death every year in the world. TB affects predominantly the lungs (pulmonary--90%) and exra-pulmonary) skin; bones; joints; urinary tract-UT; gastro intestinal tract-GIT; abdominal TB. There is an increase in diagnosed cases of pulmonary TB last years in Bulgaria. There are very rare cases of diagnosed abdominal TB described. We present a case operated from us in Multi Pro File Hospital Cherven Bryag. A 54 years old male patient with peritonitis due to perforated intestinal TB and upper intestinal fistulas. The patient was not aware of suffering from pulmonary TB in the past.

[Cervicovaginal infections during pregnancy as a risk factor for preterm delivery].

OBJECTIVE: To establish the incidence of cervicovaginal infections in patients with preterm and term deliveries. MATERIALS AND METHODS: 88 pregnancies with no previous detectable risk factors have been included in a retrospective study. 48 patients delivered at term and 40 had delivery between 24 and 37 weeks of gestation. A vaginal swab for bacterial infections and a cervical swab for detection of Chlamydia trachomatis infection, using PCR, have been performed in each case. The vaginal ecosystem has been appreciated according Nungent criteria. RESULTS AND CONCLUSIONS: C. trachomatis has been detected in 5% (2/40) of preterm deliveries and in 2.08% (1/48) of term deliveries. In preterm delivery group bacterial vaginosis has been isolated in 15% (6/40), Enterococcus spp. in12.5% (5/40) and Group B Streptococcus in 12.5% (5/40) of cases. In patients, delivered at term, bacterial vaginosis has been proved in 6.25% (3/48), Enterococcus spp in 8.33% (4/48), Group B Streptococcus in 4.17% (2/48) patients. Significant differences between both groups have been found in GBS and BV (p < 0.05). Although the difference C. trachomatis infection is not significantly higher in preterm delivery group, testing for C. tracomatis, using highly specific methods, along with vaginal swab are recommended as routine tests in pregnancy.

[Set for hermetization during transportation and draining of the pleural cavity]. / Set za transportna khermetizatsiia i drenirane na plevralnata kukhina.

In a situation of continuously growing road-and-traffic traumatism serious chest traumas with the presence of penetrating wounds are not a rare case. The correct transportation of the injured requires hermetization of the open pneumothorax with ensured draining of the pleural cavity in order to eliminate the possibility of the appearance of a valve pneumothorax. With the means, existing up to now, it is difficult to achieve hermetization during transportation and draining of the pleural cavity at the same time. The article presents the structure and the way of usage of the created by the authors so-called 'SET FOR HERMETIZATION DURING TRANSPORTATION AND DRAINING OF THE PLEURAL CAVITY'. The product is tested in an experiment on dogs. The SET is designed to render medical assistance in emergencies and to transport injured people with penetrating wounds in the chest wall and injuries in the lungs.

[Two methods of plastic reconstruction of extensive defects of the chest wall (experimental study)]. / Dva metoda za plastichna rekonstruktsiia na obshirni defekti na grudnata stena (eksperimentalno prouchvane).

The authors examine results from the experimental using two new methods for surgical reconstruction of broad defects of the chest wall. Our study was applied to 18 dogs separated in two series. In the first group of 8 dogs we used bone-muscle lambo for plastic reconstruction formed from the scapula and m.serratus anterior. This autotransplantation tissue was fixed for the neighbouring ribs limiting the defect of the chest wall. A good hermetisation of the pleural cavity and stabilisation of the chest wall was achieved. In the second group of 10 dogs the chest wall defects was closed with special antimicrobal chest prosthesis. It is built up by synthetic net and synthetic ribs. The antimicrobic qualities are being preserved for a continuous period of time. Histological the animals from the first group show the creation of a stabile fibrosis-bone-muscle laver which creates stability and hermetically of the chest cell. The synthetical ribs of the animals from the second group are tightly embraced by cellular tissue that passes through the openings of the ribs. The clinical observations of this methods are an object of another report of ours.

[Mammary gland carcinoma in men]. / Rak na mlechnata zhleza u m'zhe.

Over a 10-year period, a total of 403 patients with mammary gland carcinoma--398 women (98.8%) and five men (1.2%)--are operated in the Clinic of Thoracic Surgery & Oncology at the Military Medical Academy. The mean age in men, as compared to that in women, is nearly 12 years older. In one patient tumorectomy is done for "cleanliness" on account of the seriously impaired general condition. In the remainder the operative intervention is radical mastectomy after Patey or Pirogov, with meticulous axillary lymph dissection. In all men operated on, gynecomastia concurrent to the underlying disease is found. The histological patterns of mammary gland cancer in male patients is identical to the histological picture in women.

[Thymolipoma--a rare histological finding in patients with myasthenia gravis]. / Timolipoma--riadka khistologichna nakhodka pri bolni ot myasthenia gravis.

Over a 15-year period, thirteen thymolipomas are histologically demonstrated in a total of 182 myasthenia gravis patients undergoing thymectomy. The incidence of this rare histological diagnosis in the aforementioned group appears to be considerably higher than the one so far reported in the pertinent literature. In the series reviewed men in advanced age prevail which is by no means typical of myasthenia patients. The postoperative results are very good, with not a single fatal outcome being recorded. There are basically three types of histological findings in thymolipomas--fat tissue alone, fat tissue with thymic tissue in involution, and fat tissue with thymic tissue.

[Thymectomy in myasthenia gravis---experience with 173 surgical patients]. / Timektomiia pri myasthenia gravis--opit ot 173 operirani patsienti.

Over a 13-year period, 173 patients with myasthenia gravis--69 per cent men and 31 per cent women--undergo operative treatment in the clinic of thoracic surgery with oncology at the Military Medical Academy--Sofia. Most patients present generalized form of the disease. The operation consists in longitudinal sternotomy. In the last few years, a new approach to preoperative preparation and postoperative treatment of the patients is used. As the result of strict long-term postoperative monitoring, plasmapheresis application, immunomodulation and adequate intensive care, the rate of complications is greatly reduced with not a single fatal outcome being recorded.