[Abnormalities of the pericardium]. / Poroki razvitiia perikarda.

By 2000 there have been at least 187 cases of rare pericardial malformations (of them there were 5 cases of the authors) and 1047 cases of celomic pericardial cysts (CPC) (43 cases of the authors) in the literature. Of them 18 (9.6%) patients were found to have no pericardium, the absence of its left half was in 76 (40.6%). No left pericardium was more common in men (61.04%) than in women (38.96%). The literature reports about the absence of the right pericardium only in one case. Partial pericardial defects were encountered in 30.48% of patients with rare pericardial malformations. In general, malformations in the left pericardium were 10 times more common often than those in the right one. The absence of the pericardium or its half most commonly requires no surgical correction. In partial defects, suturing or plastic closure must be performed due to a risk for strangulation and a possible fatal outcome. CPC are not clinically manifested in more than 50% of the patients with CPC, but in some cases dyspnea, dry cough, palpitation may be caused by other causes. Cystectomy yields good results.

[Clinical features, diagnosis and surgical treatment of solitary air cysts of the lungs]. / Klinika, diagnostika i khirurgicheskoe lechenie solitarnykh vozdushnykh kist legkogo.

86 cases of solitary air cysts of the lung (6.83% of all maldevelopments) were analyzed. This maldevelopment of bronchial tree is found most often in men (10:7) and more often in the right lung than in the left (18:13). There were no clinical symptoms in 33 (38.37%) patients. Uncomplicated course of the disease was in 51 (59.3%) patients, the disease was complicated by infection in 28 (32.56%) patients. Solitary bronchial cysts were complicated by spontaneous pneumothorax in 8.14% cases, by hemoptysis--in 6.98%. Roentgenography of the chest thorax on two projections and tomography (including CT) are enough for diagnosis of solitary air bronchial cysts. Bronchoscopy, bronchography and APG are not much informative in diagnosis of cysts and should be used on special indications. Cystectomy or cystectomy with partial resection of lung tissue were performed in 67.14% patients with good results.

[Surgery of some diaphragm diseases]. / Khirurgiia nekotorykh zabolevanii diafragmy.

The authors analyze 127 rare diaphragm diseases. Among them, the rate of true diaphragmatic hernias does not exceed 1%. The congenital through diaphragm defects were encountered three times more often than false hernias, equally frequently on the left and on the right. The majority of the patients (51.97%) had hernia of Larrey's fissure. The rate of true hernia (Morgagni's) was 3 times less than of false hernia (Larrey's). In Bochdalek's hernia (3.15%) false hernias were found three times more often than true hernias. Relaxation of diaphragm was found in 40.94% of the patients. Right-sided complete diaphragm's relaxation occurred 4 times less often than on the left, partial--10 times more often on the right than on the left. Duplication of diaphragm with inserting kapron net, velours or teflon between it layers remains the dominant way of surgical correction of total relaxation of diaphragm's cupula.

[Spontaneous pneumomediastinum]. / Spontannyi pnevmomediastinum.

The authors present 7 cases with spontaneous pneumomediastinum (SPM), a rare pathological condition. The cause of SPM is rupture of marginal alveoles and spread of air into the mediastinum through perivesical and peribronchial fats. Males are more frequently affected, but females were prevalent in this study (as 4:3). At the stage when air does not spread outside the mediastinum, Hamman's sign, i.e. "crepitation" ("a crunching sound", "a noise of air bursting bubbles") heard at cardiac auscultation is significant in the diagnosis. Dissection of air in all mediastinial structures, which is detectable during X-ray studies both at this stage of SPM, and at the stage of spread of air to the neck, chest, and abdomen is an important diagnostic sign. The evolution of SPM is generally good and conservative therapy leads to recovery in most patients. In 9-16% of patients, the evolution of the process is dramatic and requires cervical mediastinotomy after Tiegel or thoracotomy with wide mediastinotomy.

[Analysis of the activities of pathology departments in Obninsk during the past 20 years (1966-1985)]. / Analiz raboty prozektur Obninska za 20 let (1966-1985).

This review of data from pathology departments in the town of Obninsk has shown that over the last 20 years the most frequent causes of death, among males and females alike, were cardiovascular diseases (44%), with malignant neoplasms ranking second (30%) and causing almost twice as many deaths among males as among females. From 63% to 85% of deaths due to malignancy were from epithelial tumors, particularly of the stomach and lungs. A steady increase in the volume of autopsy material and especially of material from intravital morphologic examinations was apparent, with a tendency to a rise in the proportion of biopsy specimens relative to operative specimens, although the latter still predominate.