[Cancer of the thyroglossal duct]. / Rak shchitoiazychnogo protoka.

The authors present the clinical observation of the cancer of the tongue-lingual duct together with the concise overview of the relevant literature and the discussion of etiology and pathogenesis of this condition.

[The application of the YamIk nasal catheter in the outpatient practice]. / Nazal'nyi kateter IaMIK v ambulatornoi praktike.

The objective of the present study was the enhancement of the effectiveness of the treatment of acute inflammatory diseases of the paranasal sinuses with the unilateral application of a medication mixture containing the vasoconstricting antiseptic agents, antibiotics, and other medications introduced into all paranasal sinuses by means of the procedure performed with the use of the Yamik nasal catheter.

[The cross-plastic correction of the soft tissue defect on the neck with the use of a pectoral flap harvested from the opposite side]. / Perekrestnaya plastika defekta myagkikh tkanei shei pektoral'nym loskutom s protivopolozhnoi storony.

The authors describe a patient presenting with initially multiple metachronous cancer spreading over the right-handed side of the mouth floor and the right-handed part of the lower jaw. The patient who underwent cross-plastic surgery for the correction of the extensive soft tissue defect on the neck with the use of the musculocutaneous pectoral flap with the axial blood supply is described. The observation during the 14 year follow-up period confirmed the good functional outcome of the treatment.

[The application of biopolymer-based antiseptic drugs for the surgical treatment of intranasal and paranasal tumours].

The authors report their experience with the application of the local antiseptic preparation Ambipor for the treatment of operative wound infection in the patients presenting with malignant neoplasms. Ambipor was used in 23 patients receiving surgical treatment of locally advanced intranasal and paranasal tumours. It was shown that the application of ambipor allows decreasing the risk of development of wound infection in the postoperative period.

A hominid tooth from Bulgaria: the last pre-human hominid of continental Europe.

A hominid upper premolar was discovered in the Azmaka quarry, near Chirpan (Bulgaria). The associated fauna, especially the co-occurrence of Choerolophodon and Anancus among the proboscideans, and Cremohipparion matthewi and Hippotherium brachypus among the hipparions, constrains the age of the locality to the second half of the middle Turolian (ca. 7 Ma), making it the latest pre-human hominid of continental Europe and Asia Minor. The available morphological and metric data are more similar to those of Ouranopithecus from the Vallesian of Greece than to those of the early to middle Turolian hominids of Turkey and Georgia, but the time gap speaks against a direct phyletic link, and Turolian migration from the east cannot be rejected.

[Diagnosis and treatment of Wegener's granulomatosis].

The author emphasizes the importance of early diagnosis of Wegener's granulomatosis based on clinical manifestations of the disease with the participation of an otorhinolaringologist. An algorithm of its treatment is proposed that allowed life expectancy to be increased from 8 to 25 years in 10 of the eleven patients.

[Laryngectomy: clinical aspects of preceding tracheostomy].

The objective of this study was to compare results of combined and surgical treatment in 114 patients with stage III-IV T3-4N0M0 laryngeal cancer. Fifty eight patients were treated by laryngectomy without preceding tracheostomy; in the remaining 56 laryngectomy followed tracheostomy (control group). The two groups were matched for all major characteristics, such as age and sex of the patients, histological structure of the tumour, its growth rate and localization, dose and schedule of radiotherapy, extent of surgical intervention. The data obtained were used to evaluate oncological and functional outcomes of the treatment.

[Clinical aspects of tracheostomy as a stage of anterolateral laryngeal resection].

We analysed medical histories of 68 patients with T2-3N0M0 laryngeal cancer who had received combined or surgical treatment. All the patients given the organ preservation treatment were divided into two groups one of which included 36 patients after laryngeal resection without tracheostomy, the other consisted of 32 patients who had undergone laryngectomy with tracheostomy (control). The two groups were matched for age and sex of the patients, the degree of advancement and histological structure of the tumour, its growth rate and localization, dose and schedule of radiotherapy, extent of surgical intervention. The data obtained were used to analyse oncological and functional outcomes of the treatment. Oncological result was estimated based on the survival rate expressed in percentage terms.

[Functional methods for nasal cavity examination in the work of outpatient health facilities].

Three methods for conducting objective functional studies in the ENT cabinet of an outpatient health facility are proposed. The methods may be helpful in the diagnose of acute and chronic disturbances of nasal mucosa.

[Surgical hygroscopic bandages for amputations, secreting wounds and diabetes foot].

The authors adopt in clinical practice using of sterile hygroscopic wound dressings 'pampers type'. They use these dressings in 113 patients. The appropriate patients are these with limbs amputations, diabetic foot, suppurative and plenty secreting deep wounds, atonite and decubital wounds. The dressings are sterilised using paraformaldehyde sterilization which do not injure the synthetic materials. The hygroscopic dressings are non- allergic and are well tolerated by the patients. Using these dressings facilitate the medical team work and help to reduce the contamination of the hospital linen and the patients coverlet. They help for accelerating the wound healing process. They are also economic effective by reducing the amount of used dressing material.

[Fistula-in-ano treatment a modo Jonesko using brace].

References to fistula-in-ano date to antiquity. Hippocrates made reference to surgical therapy for fistulous disease. The English surgeon John Arderne described fistulotomy and seton use in 1376. Despite 2500 years of experience, fistula-in-ano remains a perplexing surgical disease. Over the last 30 years, many authors have presented new techniques and case series in an effort to minimize recurrence rates and incontinence complication. We offer a new technique for seton placement using a brace.

[Peritonitis in cases of complicated diverticulosis of the gastrointestinal tract].

Within the period 2002 - 2007, a total of 29 patients with diverticulosis of the gastrointestinal tract have been treated at the surgery clinic: 26 (89,66%) male and 3 (10,34%) female patients. Their average age amounted to 65,7 years (22 y. - 81 y.). A total of 25 (86,21%) patients have had a complicated form of disease and 6 (24%) of them have had peritonitis. The operative interventions included: resection of small-intestine diverticulitis and primary anastomosis with 2 patients, Hartmann's type resection of the sigmoid colon with 2 patients, suture of sigmoid colon perforation with protective colostomy with 1 patient and resection of the sigmoid colon with primary anastomosis with 1 patient. No mortality in the postoperative period. 2 complications have been observed - suppuration and dehiscence of the operative wound.

[Surgical approach to combined and repeated complications of stomach and duodenal ulcer].

The combined and serious repeated complications of the peptic disease are rarely met in the clinical practice. They put a lot of problems for solving and the decision is usually taken in conditions of emergency. The authors present their experience in treating this type of pathology. They divide the complications into groups and make analysis of the behavior, the surgical methods used and the results of the treatment.

[Surgical tactics in gunshot injuries of the rectum].

Gunshot rectal injuries, although uncommon, are a source of significant morbidity and mortality. These injuries are associated with a significant potential for life-threatening septic complications if they are not recognized and treated promptly. The gold standard has been intestinal diversion, primary rectal repair, distal rectal washout and presacral drainage. The management of these injuries has evolved, and controversy now exists as to the need for each of these maneuvers. An approach based on mechanism and degree of tissue destruction, location of injury, and associated organ involvement is now advocated.

[Antibacterial therapy of patients with complicated diabetic foot].

The main reason for hospitalization and lethality of patients with diabetes mellitus are the infectious complications of the lower limbs. In the period 2000-2005, 147 were treated for complications with the diabetic foot in the Surgical Clinic at the Ministry of Interior Medical Institute. 105 of them were men and 42 - women. The average age of the patients was 67 +/- 8.2. Different number of microorganisms, from 2 to 8, was identified in testing the material from the wound secret. Mixed (anaerobic-aerobic) infection was found in 135 patients (91.8%), and only aerobic infection - in 12 patients (8.2%). Staphylococcus aureus (61%) and Staphylococcus epidermidis (21%) were the most often found ones from the facultative-anaerobic microorganisms in the associations. Bacteroides fragilis (23%), Peptococcus spp. (19%) and Fusobacterium spp. (11%) were the most often found ones from the sporogenic anaerobic microorganisms. The empirical and etiotropic antibacterial therapy, the different combinations of antibacterial preparations and the results of their application were discussed.

[Abdominal compartment syndrome].

Abdominal compartment syndrome is a potentially lethal condition caused by any event that produces intra-abdominal hypertension; the most common cause is blunt abdominal trauma Increasing intra-abdominal pressure causes progressive hypoperfusion and ischemia of the intestines and other peritoneal and retroperitoneal structures. Pathophysiological processes may lead to translocation of bacteria from the gut and intestinal edema, predisposing patients to multiorgan dysfunction syndrome. The consequences of abdominal compartment syndrome are profound and affect many vital body systems. Hemodynamic, respiratory, renal, and neurological abnormalities are hallmarks of abdominal compartment syndrome. Medical management consists of urgent decompressive laparotomy.