RESUMEN
AIM: To present results of VAC application in children with complicated wounds of anterior abdominal wall combined with intestinal and/or biliary fistulas. MATERIAL AND METHODS: For the last 7 years 8 patients aged from 1.5 months to 15 years with infected postoperative wounds of anterior abdominal wall complicated by intestinal fistulas (6), biliary and intestinal fistulas (1) and biliary fistula (1) have been treated at the surgical department â2 of Russian Children's Clinical Hospital. All patients received complex medical therapy and local VAC-therapy. RESULTS: Granulation and wound's size reduction were observed within first 7 days of VAC-therapy application in 5 (62.5%) children. In 4 (50%) patients at least 1 intestinal fistula has been closed in 15 days after VAC-therapy initiation on the average (range 7--24). Closure of all fistulas and wounds healing were observed in all patients in 28 days (range 16--42) after VAC-therapy initiation on the average. CONCLUSION: VAC-therapy is safe and effective treatment of complicated wounds of anterior abdominal wall combined with intestinal and/or biliary fistulas in children.
Asunto(s)
Traumatismos Abdominales , Pared Abdominal , Terapia de Presión Negativa para Heridas/métodos , Complicaciones Posoperatorias , Traumatismos Abdominales/complicaciones , Traumatismos Abdominales/cirugía , Pared Abdominal/patología , Pared Abdominal/cirugía , Abdominoplastia/efectos adversos , Abdominoplastia/métodos , Adolescente , Fístula Biliar/etiología , Fístula Biliar/fisiopatología , Fístula Biliar/cirugía , Niño , Preescolar , Fístula Cutánea/etiología , Fístula Cutánea/fisiopatología , Fístula Cutánea/cirugía , Femenino , Humanos , Lactante , Fístula Intestinal/etiología , Fístula Intestinal/fisiopatología , Fístula Intestinal/cirugía , Masculino , Moscú , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
Insulinoma in most cases is monohormonal orthoendocrine tumor. This fact limits its searching area by a pancreas. However the insulinoma's clinical picture can be caused by other pathology. Therefore the main task of visual the tumor but also to use all the possibilities of each method for defining type of surgery and avoiding such errors and complications, as pancreatorrhage, damage of bile or pancreatic duct, necrosis of duodenal wall, etc. On the basis of our own experience of endoscopic ultrasound for 61 patients with 66 insulinomas, we have allocated the basic variants of insulinoma ultrasound pictures: hypoechoic, heteroechoic, isoechoic tumor, and also foci without a trustworthy contour. On the basis of the analysis of our own errors we have essentially added the technique, having used multiplane pancreas scanning and biplane tumor scanning. Important points in EUS algorithm are also the following items: detecting tumor relationship to pancreatic surface, distance from the tumor to the ducts, gastrointestinal wall and vessels--for definition of possibility of the tumor enucleation; careful scanning of pancreas even after detecting one tumor--for an exception of multiple tumors, especially at MEN-I; careful scanning of a contour of the gland for an exception of parapancreatic insulinomas; estimation of vascularization not only of the detected tumor and suspicious foci, but also of all the gland--for detection of hypervascularized isoechoic tumors; revealing and the description of focal changes, especially more homoechogeneous in comparison with surrounding parenchyma-- for selection patients for examination by other methods; scanning of zones of possible metastasis. Examination of patients with organic hyperinsulinism demands combined application of two or more techniques. Use of all modern possibilities of endosonography can put this technique on one of the first places in the diagnosis of insulinomas.
Asunto(s)
Endosonografía/métodos , Insulinoma/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Humanos , Hiperinsulinismo/diagnóstico por imagen , Hiperinsulinismo/metabolismo , Hiperinsulinismo/patología , Hiperinsulinismo/cirugía , Insulinoma/metabolismo , Insulinoma/patología , Insulinoma/cirugía , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugíaRESUMEN
A partially protected phosphatidylinositol with a free hydroxyl group in the cyclitol moiety was synthesized by phosphorylation of a tetrasubstituted myo-inositol using the H-phosphonate and phosphoamidite methods. The H-phosphonate method was advantageous for the synthesis of selectively protected monophosphoinositide due to a lesser number of stages. Two schemes for the conjugation of 2',3'-didehydro-3'-dehydroxythymidine with phosphatidylinositol using succinic acid as a linker were tested in the synthesis of the target nucleoside phospholipid.
Asunto(s)
Fármacos Anti-VIH/síntesis química , Química Orgánica/métodos , Inositol/análogos & derivados , Inositol/química , Fosfatidilinositoles/química , Fosfatidilinositoles/síntesis química , Timidina/química , Timidina/síntesis química , Fármacos Anti-VIH/farmacología , Espectroscopía de Resonancia Magnética , Estructura Molecular , Fosfatidilinositoles/farmacología , Fosfolípidos/química , Fosforilación , Ácido Succínico/química , Timidina/análogos & derivados , Timidina/farmacologíaRESUMEN
Operations on periodontal tissues and accessory operations, such as frenulo- or vestibuloplasty, have always been difficult for beginning practitioners. Analysis of 8-year practical work of a periodontologist--296 operations (57 accessory operations and 239 operations on periodontal tissues) disclosed the regularities in such interventions, related to patient's age and sex and the percent ratio of each operation, determined the rational order of operations, and demonstrated the prophylactic efficacy of accessory operations (frenuloplasty or vestibuloplasty).
Asunto(s)
Planificación de Atención al Paciente , Periodoncio/cirugía , Adulto , Femenino , Humanos , Frenillo Labial/cirugía , Masculino , Persona de Mediana Edad , Planificación de Atención al Paciente/estadística & datos numéricos , Enfermedades Periodontales/cirugía , Estudios Retrospectivos , Vestibuloplastia/estadística & datos numéricosRESUMEN
Periodontal pockets deeper than 4-5 mm require surgical treatment. Records of surgical journals of a periodontology room over 6 years are reviewed and 2183 operations performed by six periodontologists are analyzed. The results of surgery are determined by patient's status, site of anesthesia, type of secondary adentia, convenience of surgical access, terms between operations. Individual features of surgical technique of each of the six surgeons are shown.
Asunto(s)
Periodoncia/métodos , Periodoncio/cirugía , Gingivectomía/estadística & datos numéricos , Gingivoplastia/estadística & datos numéricos , Humanos , Bolsa Periodontal/cirugía , Periodoncia/estadística & datos numéricos , Colgajos Quirúrgicos/estadística & datos numéricosRESUMEN
The current state and prospects of using the liposomal forms of anthracyclinic antibiotics, fluoroucil agents, and platinum compounds are discussed as potential drugs for chemotherapy of tumors. Comparative studies of standard and liposomal forms of the above groups of compounds were made to determine their therapeutical effects.
Asunto(s)
Antibióticos Antineoplásicos/administración & dosificación , Antimetabolitos Antineoplásicos/administración & dosificación , Fluorouracilo/administración & dosificación , Neoplasias/tratamiento farmacológico , Compuestos de Platino/administración & dosificación , Animales , Portadores de Fármacos , Humanos , Liposomas , Neoplasias Experimentales/tratamiento farmacológico , Resultado del TratamientoRESUMEN
A surgical intervention is needed in patients with periodontal pouches deeper than 4-5 mm. The results of 239 operations in 182 patients are analyzed. Optimal variants of the operations are described, depending on the patient's status, analgesia, types of secondary adentia, surgical access, and intervals between the operations.
Asunto(s)
Planificación de Atención al Paciente , Periodoncio/cirugía , Adulto , Femenino , Humanos , Masculino , Planificación de Atención al Paciente/estadística & datos numéricos , Bolsa Periodontal/cirugíaRESUMEN
The results and problems of synthetic studies of natural inositol containing glycophospholipids as well as their biologically active fragments and structural analogs are reviewed.
Asunto(s)
Glicosilfosfatidilinositoles/síntesis química , Inositol/análisis , Secuencia de Carbohidratos , Glicosilfosfatidilinositoles/química , Datos de Secuencia MolecularRESUMEN
The paper summarizes own results of studies on phospholipids and glycolipids from natural biological sources. New approaches for synthesis of inositol-containing sphingophospholipids, glycophosphatidylinositols, semisynthetic synthesis of phosphoglycerols have been introduced. New industrial method of phosphjatidylcholine isolation and production of number of lipid preparations were developed. Incorporation of DOPA into liposomes increases efficacy of its action in the medication of MPTP-induced parkinsonism in mice.
Asunto(s)
Biotecnología/métodos , Lípidos/síntesis química , Lípidos/aislamiento & purificación , Preparaciones Farmacéuticas/síntesis química , Preparaciones Farmacéuticas/aislamiento & purificación , Animales , Productos Biológicos/aislamiento & purificación , Productos Biológicos/uso terapéutico , Usos Diagnósticos de Compuestos Químicos , Portadores de Fármacos , Quimioterapia , Humanos , Liposomas , Preparaciones Farmacéuticas/administración & dosificaciónRESUMEN
The main problems and results of synthetic studies of biologically important myo-inositol phosphates were discussed. The development of the methods of synthesis was shown, and current trends in the methodology of obtaining myo-inositol phosphates by chemical methods were considered.
Asunto(s)
Fosfatos de Inositol , Animales , Fosfatos de Inositol/síntesis química , Fosfatos de Inositol/química , Fosfatos de Inositol/metabolismoRESUMEN
The total synthesis of 1(3)-O-(rac-1,2-dipalmitoylglycerophospho)-4(6)-O- beta-D-glucopyranosyl-sn-myo-inositol was performed. The major stages of the synthetic route are glycosylation of the substituted myo-inositol derivative by the glycosyl fluoride method and creation of the phosphorus moiety of the target glycolipid by means of the H-phosphonate technique.
Asunto(s)
Glicósidos/síntesis química , Inositol/química , Fosfatidilinositoles/química , Espectrofotometría InfrarrojaRESUMEN
The problem of prophylactics of postoperative infectious complications in the surgery of digestive tract is discussed. A comparative analysis of efficiency of two methods of antibacterial prophylactics during operations of closing the formed intestinal fistulas in children is given. High efficiency of the method of preoperative subtotal decontamination of the intestine according to individually selected schemes is shown.
Asunto(s)
Antibacterianos/administración & dosificación , Infecciones Bacterianas/prevención & control , Fístula Intestinal/cirugía , Intestinos/microbiología , Infección de la Herida Quirúrgica/prevención & control , Administración Oral , Niño , Humanos , Fístula Intestinal/microbiología , Intestinos/efectos de los fármacos , Intestinos/cirugía , Cuidados Posoperatorios , Cuidados PreoperatoriosRESUMEN
The results of the resection of the ileocecal angle and creation of the different types of small-to-large intestinal anastomoses in 52 children at the age of from 5 mos to 14 yrs were analysed. The authors have developed in the experiment and employed in 9 children the modification of the invagination anastomosis according to Ya. D. Vitebsky with the use of a silicone tube. This permitted to reduce the incidence of postoperative complications.
Asunto(s)
Ciego/cirugía , Íleon/cirugía , Adolescente , Anastomosis Quirúrgica , Niño , Preescolar , Humanos , LactanteRESUMEN
Diphosphatidylglycerol (cardiolipin) with different fatty acid residues has been synthesised by condensation of 1,2-diacyl-sn-glycero-3-phosphoric acid (obtained, e.g., by the cabbage phospholipase D cleavage of 1,2-dioleyl-sn-glycero-3-phosphocholine or egg phosphatidylcholine) with 2-O-tert-butyldimethylsilylglycerol in the presence of 2,4,6-triisopropylbenzenesulphonylchloride. The synthetic cardiolipins as unsonicated aqueous calcium-free dispersions were shown, by means of 31P NMR spectroscopy, to form aggregates of the bilayer structure.