[Thoracotomy and thoracoscopy in the treatment of patent arterial duct in infants weighing less than 2500 g].

BACKGROUND: Thoracoscopic clipping of the patent ductus arteriosus is an alternative to conventional surgical closure via thoracotomy in low birth weight infants. The aim of this study is to compare of these two groups of patients for the last 11 years. METHODS: We reported the data of 127 small children's who underwent standard transaxillary thoracotomy (101 patients - Group I) and video-assisted thoracoscopic surgery for patent ductus arteriosus clipping (26 patients - Group II). The two groups were compared for patients demographics, operative report and postoperative parameters. RESULTS: The groups were similar in terms of demographics and preoperative parameters. There was significant difference in mean operative time between open and thoracoscopic procedure (44.65 min vs 38.46 min; p<0.05). Duration of care in neonatal intensive unit and length of hospital stay were significantly shorter in the Group II (16.44 d vs 8.77 d; p<0.05 and 40.13 d vs 33.65 d; p<0.05). Early complication rates were equivalent between groups (6.93% vs 3.85%; p>0.05). Rate of long-term complications was dominated in the thoracotomy group (19.80% vs 0%; p=0127). CONCLUSION: Thoracoscopic ligation of the patent ductus arteriosus in infants less than 2500 g gave results better than open surgery.

[The CT-guided transthoracic biopsy of lung's and mediastinal tumors].

The results of 107 CT-guided transthoracic biopsies, conducted during 2005-2010 yy, were analyzed. The authors have shown the advantages of the core biopsy compared with the fine-needle aspiration biopsy (FNAB). Sensitivity of the first for the malignant tumors was 93%, while the FNAB sensitivity was only 75%. Though the core biopsy showed higher complication rates of the procedure. Both methods proved to be easy to use and should be used for the diagnostic purposes in cases of the peripheral lung tumors and mediastinal lymph nodes.

[Atherosclerosis of abdominal aorta and carotid arteries and its correlation with blood serum lipid levels in cholelithiasis]. / Ateroskleroz briushnoi aorty i sonnykh arterii i ego korreliatsiia s soderzhaniem lipidov v syvorotke krovi pri zhelchnokamennoi bolezni.

AIM: To elucidate relationship between cholelithiasis and presence and severity of atherosclerosis in abdominal aorta and carotid arteries. MATERIAL AND METHODS: Ultrasound investigation of vessels and abdominal organs, determination of blood serum total, high density lipoprotein cholesterol and triglycerides were carried out in 147 patients with and 167 without (controls) cholelithiasis (mean age 44.2+/-3.1 and 45+/-2.8 years, respectively). RESULTS: Among patients with cholelithiasis 73.2 and 67.6% had atherosclerosis of abdominal aorta and carotid arteries, respectively. This was significantly more than in controls. Compared with controls atherosclerosis of these vessels in all age groups was significantly more pronounced in patients with cholelithiasis. Moreover severity of atherosclerosis was directly related to duration and activity of cholelithiasis. Atherosclerosis of abdominal aorta and carotids was most pronounced in patients with cholelithiasis and concomitant hypertension, ischemic heart disease and obesity. Significant direct correlations were found between blood serum levels of total cholesterol, triglycerides and low density lipoprotein cholesterol and thickness of abdominal aortic wall and carotid artery intima media complex. CONCLUSION: The results evidence for the existence of association between cholelithiasis and presence and severity of atherosclerosis of abdominal aorta and carotid arteries.

[Dobutrex stress echocardiography: clinical and prognostic value, side effects]. / Nagruzochnaia ékhokardiografiia s dobutreksom: klinicheskoe i prognosticheskoe znachenie, pobochnye effekty.

AIM: To study informative value of dobutrex echocardiography (DEC) in diagnosis of myocardial ischemia and viability, in prognostication of angina pectoris and myocardial infarction (MI), evaluation of DEC side effects. MATERIAL AND METHODS: DEC was conducted in 74 patients with unconfirmed diagnosis (they had ischemic heart disease risk factors, atypical cardialgia) and 32 ischemic heart disease patients. RESULTS: DEC proved to be an effective diagnostic tool in diagnosis of myocardial ischemia in patients with new-onset atypical cardialgia (informative value 73.6%). This test gives prognosis of the disease and improves treatment policy in patients with angina of effort and MI. The most serious and frequent side effects of DEC arising at the highest dobutrex dose were paroxysmal tachycardias (3.76%) and ventricular arrhythmias (6.58%). In most cases (99.1%) they discontinued after the test and did not require antiarrhythmic treatment. Thus, the test is relatively safe. CONCLUSION: Echocardiography with dobutrex load should be used in practical cardiology more intensively.

[Fast neutrons in the treatment of malignant neoplasms]. / Bystrye neitrony reaktora v lechenii zlokachestvennykh novoobrazovanii.

More than 250 patients, mainly with locally advanced tumors of the head, neck and breast were treated with a I MeV beam of fast neutrons emitted from a BR-10 reactor. The fast neutron contribution to the total dose of the radical component of complex gamma-neutron therapy was 20-40%. Said modality was shown to improve the results of treatment for laryngeal and breast tumors. The 5-year actuarial survival following complex gamma-neutron therapy for laryngeal cancer was 89.25, while in controls--65.2% (p < 0.005). The 5-year actuarial overall survival in breast cancer patients treated with fast neutrons was 66.5%: gamma-neutron therapy alone--46.0% (p < 0.05).

[Use of reactor neutrons in the multimodal treatment of patients with breast cancer]. / Problema ispol'zovaniia reaktornykh neitronov v kompleksnom lechenii bol'nykh rakom molochnoi zhelezy.

The results of multimodality treatment are analyzed in 56 patients with local breast cancer. Combined gamma-neutron therapy with the use of fast reactor neutrons enhances the efficiency of breast cancer treatment and does not increase the number of radiation reactions and complications. The three-year survival increased from 44 +/- 12 to 75 +/- 9%. The test reactors specifically adjusted may be useful for the radiation therapy of patients with various malignant neoplasms. Combined gamma-neutron therapy is more promising for this purpose than neutron therapy alone.

[The prognostic significance of the blood flow volume of the abdominal cavity in peptic ulcer patients]. / Prognosticheskoe znachenie velichiny krovotoka briushnoi polosti u bol'nykh iazvennoi bolezn'iu.

A total of 25 patients with duodenal ulcer were examined. Central bloodflow, that of the abdominal cavity, and characteristics of the vegetative tone were studied by the variation pulsometry method. Disturbances were revealed in the hemodynamics, manifested by a drop in cardiac output (CO) and increase in the blood volume which were particularly pronounced in unfavourable course of the disease. It has been established that the abdominal cavity CO above 1.55 l/min suggests a favourable course of the disease, while its lower values are thought to be associated with unfavourable one. The influence of the vegetative nervous system on the abdominal cavity hemodynamics is not unidirectional.

[The efficacy of antibacterial treatment in chronic gastritis of Helicobacter etiology]. / Effektivnost' antibakterial'nogo lecheniia pri khronicheskom gastrite khelikobakternoi étiologii.

A study of 140 patients with chronic gastritis revealed Helicobacter pylori in the gastric antral mucosa in 100% and in the duodenum in 50%. There is a direct correlation between the presence and amount of Helicobacter pylori in the mucosa, lymphoplasmocytic infiltration, dystrophic changes of epithelium. Ampiox treatment proved beneficial both clinically and morphologically. After treatment Helicobacter pylori was absent in 65.7%, in the remaining cases it reduced by 5-10 times.

[Relationship between Helicobacter pylori and antral gastritis and gastroduodenitis]. / Vzaimosviaz' piloricheskikh khelikobakterii s aktivnost'iu antral'nogo gastrita, gastroduodenita.

Morphological data on the biopsies obtained from the antral gastric mucosa of 150 chronic gastritis and gastroduodenitis patients provided grounds for recognition of 3 degrees of gastritis activity. Helicobacter pylori (CP) occurred in the antral gastric portion in 100% of the cases. CP presence and mucosa contamination, plasmocytic infiltration, dystrophic changes in the surface and glandular epithelium were found to correlate. Administration of ampiox in a daily dose of 1.0 g for 10 days resulted in a rapid attenuation of painful and dyspepsia syndromes which ceased on treatment day 7. Endoscopically and morphologically, there were more rapid epithelialization of the erosions and inhibited activity of gastritis compared to the control group. In biopsies obtained on treatment week 3-4 CP was not registered in 67% of cases or was present in much less amounts. The control subjects manifested CP universally, the morphological positive trend was unremarkable.

[The effect of bile secretion on duodenal motility and intracavitary pressure]. / Vliianie sekretsii zhelchi na motoriku i vnutripolostnoe davlenie dvenadtsatiperstnoi kishki.

Open catheters were used to study the interdigestive motoric of the duodenum in 80 patients with chronic noncalculous cholecystitis and 30 patients with postcholecystectomy syndrome. Most frequently the patients showed hypomotor dyskinesias of duodenum (stages I-II) with an increase or decrease of the intracavitary pressure. Liobil produced a stimulating effect on the duodenal motor function. Patients with chronic noncalculous cholecystitis showed a clear increase of the amplitude of intestinal contractions. Patients with postcholecystectomy syndrome revealed after liobil administration an increase of the III phase time. In 9 patients formerly absent spontaneous rhythmic phase appeared.

[Clinical course and treatment of duodenal ulcer in women]. / Osobennosti klinicheskogo techeniia i lecheniia iazvennoi bolezni dvenadtsatiperstnoi kishki u zhenshchin.

Overall 260 women and 202 men were examined comparatively during duodenal ulcer exacerbation. 53.8% of the women demonstrated an atypical disease course. Fibrogastroscopy is a method of early diagnosis of duodenal ulcer in women. As compared to men, the size and depth of ulcers in women was less. Acid and peptic factor was also less pronounced. The four-week treatment with the use of the diet, antacids, gastrozepine and repair agents brought about ulcer healing in 82% of the women. The single and daily doses of antacids administered to women were 1.5 times less than in men. The use of H2-blockers is indicated in women with a severe course of peptic ulcer. The inclusion of antibacterial agents is indicated if the mucous membrane of the antral part of the stomach demonstrates Campylobacter pylori.

[The hemostatic state of patients with breast and lung cancer undergoing hypoxic radiotherapy]. / Sostoianie gemostaza u bol'nykh rakom molochnoi zhelezy i legkogo pri gipoksiradioterapii.

Parameters of functional status of the hemostatic system were studied in 76 breast and lung cancer patients in the course of radiotherapy using TTC-10 hypoxic gas mixture (oxygen--10% and nitrogen--90%) as radioprotector. The thrombophilic status of the blood in breast and lung cancer patients established prior to treatment was accounted for by increased functional activity of platelets, increased capillary blood coagulability, formation of dense clot and inhibition of fibrinolysis. In the course of hypoxyradiotherapy, blood thrombogeneity becomes lower due to a decrease in platelet adhesion.

[Biological effects of Gelatinol during artificial circulation]. / Biologicheskie éffekty zhelatinolia pri iskusstvennom krovoobrashchenii.

The levels of plasma fibronectin (FN) were investigated in patients during heart surgery using artificial circulation. Plasma FN levels were assessed by electroimmunoassay (rocket immunoelectrophoresis) and bioassay (aggregation of gelatin-coated microparticles). The application of gelatinol in hemodilution++ composition led to the depletion of bioactive Fn from 140 to 0 micrograms/ml, whereas immunoreactive Fn levels were slightly elevated. The in vitro experiments have shown that gelatinol inhibits the aggregation of gelatinol-coated microparticles and chemiluminiscence of neutrophils, stimulated by gelatin-coated particles. Gelatinol elimination from hemodilution++ composition resulted in the reduction of postoperative mortality and accelerated tissue reparation.

[A comparative assessment of gastric secretory function using a probe method and intragastric Ph-metry]. / Sravnitel'naia otsenka sekretornoi funktsii zheludka, izuchaemoi zondovym metodom i intragastral'noi Ph-metriei.

To compare informative value of probing and intragastric pH-metry, relevant examination was performed in 130 patients with chronic gastritis, 132 patients with noncomplicated peptic ulcer and 50 healthy subjects. pH values obtained with probing and intragastric pH-metry did not differ significantly in defects of gastric mucosa, superficial gastritis, peptic ulcer. In apparent atrophic gastritis intragastric pH-metry detected minimal secretion of H ions in all the patients, whereas probing failed to show it. Intragastric pH-metry is useful in recognizing duodenogastric reflux and decompensated acid stomach as shown by antral basal pH (below 2.0).

[A method of modified neuroleptanalgesia in lung surgery]. / Metod modifitsirovannoi neiroleptanalgezii v khirurgii legkikh.

A modification of neuroleptanalgesia (NLA) has been developed to be applied in operations on the lungs. It is based on the inclusion of indomethacin and diazepam into premedication, on the bolus administration of phentanyl, droperidol, and diazepam prior to the most traumatic stages of the operation, and on the subsequent infusion of phentanyl and droperidol. The modified technique of NLA has been applied in operations on 19 patients with lung cancer. The control (traditional NLA technique) consisted of 20 lung cancer patients. Evaluation of the endocrine response and venous blood plasma concentration of metabolites of polyunsaturated fatty acids showed a possibility for reducing the stress response to the operative trauma by using the modified NLA technique. The advantages of this method are well demonstrated in the course of the postoperative period as a lowered incidence of postoperative inflammatory complications.

[Gonadotropins and sex steroid hormones in women with exacerbated duodenal peptic ulcer]. / Gonadotropiny i polovye steroidnye gormony u zhenshchin s obostreniem iazvennoi bolezni dvenadtsatiperstnoi kishki.

Exacerbation of duodenal ulcer in women of the birth-giving period is characterized by an increase of blood prolactin, progesterone and estradiol that possess a protective action. Simultaneously the concentration of testosterone is elevated which reduces the resistance of the gastroduodenal mucosa. In menopausal women exacerbation of ulcer disease is accompanied by an increase of the FSH level, prolactin, luteinizing hormone and testosterone, significant reduction of estradiol.

[Droperidol, seduxen, fentanyl: a study of immune reactions in vitro]. / Droperidol, seduksen, fentanil: izuchenie reaktsii immuniteta in vitro.

Clinical concentration of droperidol, seduxen, fentanyl were studied for their effects on in vitro immunity reaction with lymphocytes from donors and patients with lung carcinoma. In the donors, the agents caused no changes in E- and EAC-rosette formation. In the patients with lung carcinoma, droperidol elevated the number of theophylline-sensitive T lymphocytes, lowered theophylline-resistant ones and eventually normalized a theophylline-resistant to theophylline-sensitive T cell ratio. Fentanyl, 5 ng/ml was demonstrated to increase amounts of early T lymphocytes. Fentanyl concentrations (5 and 25 ng/ml) decreased B lymphocytes. It was concluded that droperidol produced a positive action and fentanyl showed heterogeneous effects on E- and EAC-rosette formation in patients with lung carcinoma.

[Incidence, intensity and clinical manifestations of antral gastritis in duodenal ulcer in women and their relation to Campylobacter pylori]. / Chastota, vyrazhennost' i klinicheskie proiavleniia antral'nogo gastrita pri iazvennoi bolezni dvenadtsatiperstnoi kishki u zhenshchin i ikh sviaz' s Campylobacter pylori.

It was established during examination of 120 women with duodenal ulcer that in 48 percent of them the clinical disease manifestations were typical. In patients with an atypical disease course, the painful syndrome was not pronounced. It was not dependent on food intake or season. 34.2 percent of the patients had, instead of pains, a feeling of heaviness in the epigastric area, heartburn and eructation depending on the antral gastritis severity. The ulcers measured 5 mm and less in 75.6 percent of the cases. Superficial antral gastritis was recognized in 69.4 and atrophic one in 25.4 percent of the patients. Secretion appeared elevated in 48.3 percent of the patients. The duodenogastral reflux was established in 68.5 percent of the cases. 75 percent of the women showed Campylobacter pyloridis in antral mucosa.