[Unusual neoplasm in the scrotum].

A clinical case of scrotal atavism in the form of bone plate, which simulated neoplasm of scrotal organs and has not been previously described, is presented in the article. In our opinion, the tumor is a vestige of Bakulyum, an organ, which disappeared in Homo sapiens. The patient was successfully operated in the outpatient surgical department with good functional and long-term results. After 1-year follow-up, there were no complaints or recurrence. The patient had normal sexual function.

[Effect of lumbar (perirenal) procaine blockade on microcirculation and exchange proteoglycans with experimental gonarthrosis].

Experimental studies on guinea pigs of both sexes (n = 30). Experimental animals are awicea into equal groups oJ 10 animals: 1--the control group (intact animals), 2--the comparison group (modelling of gonarthrosis by crossing his own patellar ligament has been made, exposure 6 months), 3--the main group (animals with gonarthrosis treatment was carried out by performing lumbar procaine blockade (LPB) with an interval of 3-5 days three times). We establish that after a course of LPB in gonarthrosis marked increase in the density of the injected channel in the articular and periarticular structures, which reflects a growth in the microcirculation, and more intense accumulation in the basic substance of epiphyseal cartilage PAS (+) indicates the material to increase the level of proteoglycan in articular cartilage.

[THE DNA DIAGNOSTIC OF PSEUDOMONAS INFECTION].

The modern laboratory diagnostic of pseudomonas infection, including bacteriologic analysis with subsequent identication of agent, is time-consuming and it is not every time effective because of modifiability of characteristics of the mentioned agent. The article presents the laboratory mode of identification of Pseudomonas aeruginosa based on electrophoresis analysis of DNA isolatedfrom wound samples or microbial mass grew on solid nutritional medium. The wound sample or pure growth is placed into physiological solution and is warmed under 990C. This action results in DNA releasing into supernatant which sample is underwent to standard horizontal electrophoresis in agarose gel with ethidium bromide. The presence on electrophoregrams of three bands of DNA fluorescent in ultraviolet with size of fragments about 10,000, 6000-8000a and less than 750 pairs of nucleotides testifies the presence of P. aeruginosa in the analyzed biomaterial. The given mode permits to identify both chromogenic and pigment-free strains of P. aeruginosa and to differentiate them of other representatives of non-fermentative gram-negative bacteria and most significant genera and species of family of Enterobacteriaceae. The identification of P. aeruginosa in wound sample using the proposed mode implementing without its bacteriological analysis, can be used as technique of express diagnostic of pseudomonas infection.

[Varicocele in second adulthood and elderly men].

The prevalence ofvaricocele in second adulthood and elderly men was evaluated. It was found that varicocele in this age group occurs in 15.8 % of cases , whereas in men up to 35 years - in 18.3 % of cases. 88.5 % of men older than 35 years had children. Varicocele is often asymptomatic. The course of varicocele includes compensation and decompensation stages. Proportion of adulthood and elderly patients with decompensated stage ofvaricocele in the structure ofurological disease was 0.34 %. Pain is the main manifestation of varicocele at the stage of decompensation in second adulthood and elderly men. For surgical correction of varicocele in such patients, Sayfan technique seems appropriate, which uses transinguinal mini assess (2.5-3 cm incision) allowing to identify and eliminate most of the possible causes of pain: infantile hernia, benign tumors of adipose tissue, fibrotic changes in the tissues along the ilioinguinal nerve. This minimally invasive technique can be used in outpatient surgery. 18 patients underwent surgery using this technique. There were no early postoperative and long-term complications. At 1 to 3 years after surgery, 13 patients were re-examined, and relapses were not revealed.

[Significance of macroanatomic variants of cavatesticuilar and renotesticular communications in the genesis of right testicular phlebectasia].

The anatomical study of 188 retroperitoneal organocomplexes by direct methods of measurement and nonparametric Spearman correlation analysis explains the significance of different types of right cavatesticular and renotesticular communications in the genesis of expansion of right testicular vein. In 74% of cases, right testicular vein (TV) ends in the inferior vena cava (IVC), and in 26% of cases--in the right renal vein (RRV). When TV ends in IVC, quantity anomaly (doubling TV) is observed in 6.94% of cases; when TV ends in RRV, such anomaly is observed in 40.9% of cases. The width of right TV in the case of its end in IVC was 3.39 ± 0.1 mm, and left TV--2.95 ± 0.1 mm (n = 144), ie, right TV 0.5-1 mm wider than the left TV (P = 0.0008). Correlation analysis showed a weak relationship between the width of the right TV and lack of ostial valve at the end in IVC (r = -0.16, n = 144, P = 0.05). Associations of width of right TV with other factors (lack of ostial valves in the end in RRV, high location of RRV, width of the RRV, angle of return of TV to RRV, deposition of TV entry to the hilum of kidney or IVC) have not been reliably established. The moderate relationship between the width of right TV and type of entry of right inferior segmental renal vein in TV was established (r = 0.63; n = 6; P = 0.05). In a study, among all types of macroanatomical relationships with right TV, a single variant with important role in ectasia of TV was revealed--an entry of inferior segmental renal vein in the retroperitoneal segment of right TV.

[Effect of vagosyimpathetic block on the central hemolymphodynamic and regional hemodinamic in lesser circulation].

Our experimental study was undertaken to determine the effect of bilateral novocaine vagosympathetic block (VSB) on central hemolymphodynamic and regional hemodinamic in lesser circulation. Follow-up period lasted for 4 hours. No statistically significant arterial pressure changes were detected. Studies of stroke index (SI) and general peripheral vascular resistance (GPVR) changes indentified the development of two responses: (1) a 60% SI decline and PVR increase were accompanied with elevation (mean 37%) of volumetric lymph flow rate within 15-30 min following VSB: (2) there was only a 40% SI elevation and GPVR decline. Rheopulmographic findings detected the reduction of volumetric pulmonary blood flow following VSB, and the decline of both pulmonary tissue-filling and venous bed capacity demonstrated by a significant fall of diastolic wave amplitude within 30 min following VSB. Histologic findings verified the reduction in pulmonary blood-filling following VSB.

Biomatrix on the basis of polypropylene mesh and fetal fibroblasts.

A technology for obtaining a biomatrix on the basis of polypropylene mesh, used in clinical surgery, and cultured fetal fibroblasts is proposed. The method was developed on experimental animal cells. It includes culturing of rat fetal fibroblasts on fibers of a polypropylene mesh, treated with wheat germ lectin. This technology can be used for obtaining a biomatrix with fibroblasts of different origin. This biomatrix can be used in experimental and clinical surgery for dressing and stimulation of effective healing of mechanical injuries to the connective tissue.

[Comparative study of centralized and decentralized outpatient surgical services]. / Sravnitel'naia otsenka rezul'tatov raboty tsentralizovannoi i detsentralizovannoi ambulatornoi khirurgicheskoi sluzhby]

The results of work of decentralized and centralized out-patient surgical service in two regions of the city of Novokuznetsk are compared. The authors make a conclusion that the centralized out-patient surgical service has a number of advantages as compared with the decentralized service since it allows to concentrate the material resources, to improve the staff of specialists, to widen the volume and spectrum of the medical care and makes prerequisites for profitable work of the institution under conditions of the market relations and competition.

[A rare complication of conduction anesthesia in the treatment of finger injury]. / Redkoe oslozhnenie provodnikovoi anestezii pri lechenii panaritsiia.

At the present time novocain still remains the anesthetic of choice in ambulatory surgery and traumatology. In practical work the 2% and 0.5% solutions are used. The 2% solution of novocain can in some cases (in patients prone to angiodystonic reactions) cause a persistent spasm of digital arteries that results in irreversible alterations in finger tissues down to the development of gangrene. This fact was confirmed in experiments with 2% solutions of novocain. It is proposed to follow the recommendations on using the 0.5% and 1% solutions of novocain for regional anesthesia in fingers. Such anesthetics as Lidocain and Trimecain should be used more widely since they possess more pronounced and continuous anesthetizing properties.

[A pathogenetic classification of closed thoracic trauma]. / Patogeneticheskaia klassifikatsiia zakrytoi torakal'noi travmy.

Based on experimental and clinical data the authors propose a classification of closed thoracic traumas which allow to form relatively similar groups among patients with closed thoracic traumas having orientation of the leading pathogenetic factor. The proposed classification allows to form rational curative programs as early as at the prehospital and early hospital stages.

[Changes in central lymph flow dynamics in the acute period of experimental severe closed chest injury]. / Izmeneniia tsentral'noi limfodinamiki v ostrom periode tiazheloi zakrytoi travmy grudi v éksperimente.

Experimental study of changes in central lymph flow dynamics in closed chest injury (CCI) showed that the lymphatic system responds mainly by increasing the rate of lymph escape. Progressive diminution of the lymph flow in encountered only in the cardial type of CCI. In the hemorrhagic form of CCI the lymph flow increased in the first minutes after the trauma in half of the cases and then reduced (below the initial values). Increase of the resorption-transport function of the lymphatic system in CCI is considered as a compensatory-adaptational mechanism directed at maintaining interstitial homeostasis. Reduction of the rate of lymph flow in the cardial and hemorrhagic forms of CCI is likely to suggest the development of insufficiency of lymph flow dynamics. A correlation analysis revealed a relationship of the rate of lymph flow to the central hemodynamic and external respiratory parameters.