[Ultrasonographic diapeutics of the hepatic abscess. Possibilities and achievements].

Transcutaneous interventions (TI) under ultrasonographic control were applied in 163 patients (the main group) for primary pyogenic hepatic abscess (PPHA). For comparative group 31 patients were included, in whom an operative intervention was done (disclosure, sanation and external drainage of the focal lesions). While treating PPHA in 91 patients the TI punctures under ultrasonographic control were made and in 72--transcutaneous drainage was performed. The puncture treatment appeared effective in 88 (96.7%) patients, drainage--in 70 (97.2%), summarized efficacy of TI had constituted 96.9%. The morbidity ratio after miniinvasive treatment of PPHA was lesser than after routine operative treatment. The TI application for PPHA is an effective method of the patients treatment, not dependent on their foci size and the patient general state, it permit to lower morbidity, lethality and period of hospitalization significantly, and to improve the results meaningfully. TI under ultrasonographic control constitutes the method of choice in PPHA treatment, excluding posttraumatic abscesses, chronic hepatic abscesses and intracavitary sequesteres presence.

[Diagnosis and treatment of esophageal leyomyoma].

Radical operations for benign esophageal leyomyoma were performed in 50 patients in 1976-2006 in the clinic. Highly informative roentgenologic, endoscopic and ultrasonographic (including intraesophageal) methods were applied in the disease diagnosis, permitting to establish the diagnosis, as a rule, accurately before the operation. The diagnosis was verified definitely, basing on intraoperative revision data and the results of express-histologic investigation of the tumor excised. Extramucosal enucleation of benign leyomyoma with plastic closure of esophageal muscle defect or its suturing was done in 33 (66%) patients. Subtotal esophageal resection was performed in 11 (22%) patients, reconstructive operations--in 10 (20%), including in 5 (10%)--retrosternal esophagocolonoplasty, in 2 (4%)--intrathoracic esophagogastroplasty and in 1 (2%)--retrosternal esophagojejunoplasty. In 2 (4%) patients with small benign leyomyoma the esophageal wall portion resection was performed using suturing apparatus and in 1 (2%)--gastrostomy. Postoperative mortality had constituted 2%. Results of treatment were studied in 46 (92%) patients in 1-18 yrs, 4.8 at average. There were no recurrences. The result was estimated as good in 39 (78%) patients and fair--in 7 (14%).

[The information value of the left ventricular end-systolic volume-pressure ratio for the noninvasive assessment of human cardiac contractile function]. / Doslidzhennia informatyvnosti kintsevosystolichnoï zalezhnosti ob'iem--tysk livoho shlunochka dlia neinvazyvnoï otsinky skorochuval'noï funktsiï sertsia u liudyny.

To create a noninvasive method of myocardial contractility assessment and to evaluate its diagnostical significance, 84 patients with ischemic cardiac disease and 17 healthy persons were clinically investigated including real-time ultrasound sectoral scanning, bicycle ergometry, selective coronaroarteriography and blood pressure measurement. Using noninvasive approximations of end-systolic and maximal isovolumic pressures and left ventricular volume values at the end of systole and diastole, we constructed end-systolic pressure-volume relations (ESPVR) which were compared with relations obtained by traditional methods. Results of this work show that a slope of ESPVR obtained from the study of data of one cardiac cycle is a reliable contractility index more sensitive to small alterations in the contractile state of the heart than traditionally used ejection fraction and circumferential fiber shortening velocity. We suggest that the ESPVR obtained in such a manner has some advantages because it takes into account influences of the afterload changes reflex consequences. The results also support application of this method to early diagnosis of ischemic cardiac disease.