[THE CONTROL OF BLEEDING FROM THE LUMEN OF THE ISOLATED INFERIOR VENA CAVA SEGMENT WHEN REMOVING THE TUMOR THROMBUS].

The paper analyzes surgical methods of bleeding control from the lumen of the isolated inferior vena cava (IVC) segment during thrombectomy. The study included 13 patients with IVC tumor thrombus. The sources of bleeding were divided into variant lumbar veins and lumbar veins of the infrarenal IVC segment. Variant lumbar veins were classified as vessels entering IVC at its posterior surface at suprarenal level. The volume of blood loss from the lumen of the isolated IVC segment during thrombectomy ranged from 100 to 3500 ml with an average of 507.3 ml. The main sources of bleeding were lumbar veins of the infrarenal IVC segment, located at a distance of less than 10 mm from the mouth of the right renal vein (85.7%). Variant veins were found much rarer--in 35.7% of cases. Their orifice diameter and, consequently, the blood loss volume was significantly smaller than those in the group of bleeding from infrarenal lumbar vessels. In 2 (15.4%) cases, the mouths of the venous tributaries were stitched inside the vena cava. In 6 (46.2%) patients the bleeding was stopped by applying a clamp to lumbar veins following the blood clot removal. This maneuver proved successful in 4 (66.7%) of those cases. In the remaining 5 (38.5%) cases, the bleeding was stopped by compression of probable variant or lumbar vein mouth localization with finger or cotton swab. If unable to stop bleeding in the described way, the blood from IVC lumen was evacuated by suction, and cavatomy was closed as quickly as possible. Given the low effectiveness, high complexity and risk of the available methods of IVC lumen bleeding control, visual information about the location and the number of possible sources of bleeding should be obtained preoperatively.

[Neuroimmunoendocrine mechanisms of protective effects of medical rehabilitation in elderly patients].

Physical rehabilitation is the basic method for all programs of medical rehabilitation on different pathologies. Such important diseases as chronic heart failure, diabetes mellitus, chronic pulmonary obstructive disease have the high risk of disability. There is a high motivation to their rehabilitation. These diseases progress in situations associated with immune inflammation. Such signal molecules as tumor necrosis factor (TNF-alpha), interleukins-1,6 (IL-1,6) take part in these processes. The role of medical rehabilitation methods in connection of neuroimmunoendocrinic homeosthasis are described in this article.

[The role of the short-wave therapy in rehabilitation of elderly patents with chronic obstructive pulmonary disease].

The positive clinical effects of using the short-wave therapy in rehabilitation of patients with chronic obstructive pulmonary disease are presented in this article. 49 patients were included in this investigation. The criteria of successful rehabilitation were more expressive in the cases when the short-wave therapy was included in rehabilitative program.

[Long-term observation of E1-Tor cholera vibrions in waste waters from public baths]. / Dlitel'noe obnaruzhenie kholernogo vibriona E1'-Tor v stochnoi vode bani

Prolonged (for a period of one year) isolation of cholera vibrios from the sewage of a bath-house was observed. Sewage proved to serve as a favourable medium for preservation and reproduction of cholera vibrios. The data obtained pointed to the capacity of El Tor cholera vibrio to exist outside the human organism for a long time.