[Osteal scintigraphy in the evaluation of the course of reparative processes after surgical treatment for tuberculous and nonspecific arthritis, by using constrained bone grafting].

Osteal scintigraphy was used to study the course of reparative processes after surgical treatment in 106 patients with large joint lesions, including 76 patients with tuberculous arthritis and their sequels and 30 with nonspecific and dystrophicones before and 2-3 weeks after operations (those with and without articular tissue revascularization (n = 43 and n = 63); mobilizing (n = 64) and stabilizing (n = 42) operations), of them 22 being performed in late periods (1-3 years (n = 16)). It was established that after mobilizing operations with revascularization, the early postoperative period was marked by a significant increase in radionuclide accumulation (by 1.52 times) and after those without revascularization, there was a less significant rise (by 1.34 times); following stabilizing operations with revascularization, hyperfixation was similar before and after surgery whereas following those without revascularization it significantly reduced (by 1.53% in 70% of patients). The late postoperative period was characterized by reduced hyperfixation, which was more evident after mobilizing operations with revascularization. Osteal scintigraphy quantifies the course of reparative processes and determines the efficiency of different operations.

[Bone tissue metabolic features in tuberculous and nonspecific large joint lesions as evidenced by osteoscintigraphy].

Osteoscintigraphy was employed to study the bone tissue in 405 patients referred for tuberculous arthritis and its sequels or suspected tuberculosis. Tuberculous lesion was identified in 228 patients; there were nonspecific arthritides (n = 69), dystrophic diseases (n = 88), tumors (n = 8), and no bone involvement (n = 12). In active tuberculous ostitis, radiotracer hyperfixation (HF) was found to be marked and it was normal when the disease subsided. In tuberculous arthritis in the arthritic phase (synovitis and in full swing) HF was higher than that in arthrosis; in complicated forms (fistulas and abscesses) HF showed 5-to 15-fold increases in 19.5%. An insignificant HF was observed at the stage of subsidence. In nonspecific arthritis and dystrophic arthrosis, HF depended on the activity and stage of involvement. This procedure could provide an objective assessment of bone tissue changes, by substantially supplementing the basic X-ray study in both the examination of patients and the determination of further treatment policy.

[Current radiotherapy for extrapulmonary tuberculosis].

Radiation studies are prominent in the diagnosis of extrapulmonary tuberculosis. X-ray study preserves its basic value. Its-based concepts of the pathology of osteoarticular, urogenital, lymphabdominal tuberculosis largely allow for analyzing the images obtained by new medical visualization techniques, such as X-ray tomography, computed tomography, magnetic resonance imaging, ultrasonography, and radionuclide studies. Each method has its merits and demerits and is used by a certain algorithm at different sites of extrapulmonary tuberculosis.

[Osseous-perichondral autoplasty in surgery for tuberculosis of the joints]. / Kostno-peikhondrial'naia autoplastika v khirurgii tuberkuleza sustavov.

The results of 68 reconstruction surgeries made in the hip and knee joints in tuberculosis and concomitant diseases were studied. Advantages of operations involving the component plasty of joint ends (osseous autoplasty, as well as auto-perichondral plasty and their variations), including under the conditions of revascularization of the osseous bed, were proven on the basis of the results of a comparative analysis of clinical-and-functional data and X-ray examinations. The use of the method ensuring additional sources for vascularizing the joint tissues improves the conditions of autograft assimilation; the application of perichondral grafting preserves or expands the joint split, which provides an increased mobility amplitude in a damaged joint. The use of perichondral plasty and of its combination with revascularization of the joint osseous joint tissues secured more favorable results as compared to the implementation of osseous-plasty interventions alone.

[Radionuclide diagnosis of capillary pulmonary blood flow in new cases of pulmonary tuberculosis]. / Radionuklidnaia diagnostika narushenii kapilliarnogo legochnogo krovotoka u vpervye vyiavlennykh bol'nykh tuberkulezom legkikh.

The radionuclide technique pulmonary perfusion scintigraphy was used to study 124 new cases of pulmonary tuberculosis before therapy and 25 controls. The data indicated that perfusion impairments were significant and rather noticeable in 84% of new cases of the disease. Evidence was provided for that pulmonary capillary blood flow was associated with the duration of the disease, with the initial type and phase of a tuberculous process, and with clinical manifestations. There was a predominance of significant and drastically marked vascular lesions in patients with infiltrative and disseminated tuberculosis under the present conditions.

[External respiratory function and pulmonary capillary blood flow in patients with postoperative recurrent pulmonary tuberculosis]. / Funktsiia vneshnego dykhaniia i kapilliarnyi legochnyi krovotok u bol'nykh s posleoperatsionnymi retsidivami tuberkuleza legkikh.

To clarify criteria for functional operability, external respiratory function (ERF) and pulmonary capillary blood flow (PCBF) were studied in 116 patients with postoperative recurrent pulmonary tuberculosis who had been admitted to the resurgery unit. Moderate ERF impairments (stages I and II) were identified in 65% of cases, 23% had stage III ventilation disorders (VD), and 11% were found to have stages IV and V VD. In focal recurrences, overall PCBF ranged 19 to 36% of the total pulmonary blood flow with is decrease from 11 to 0.3% in the total number of recurrences. Preoperative preparation improved ERF in 54% of patients. Contraindications for surgery were found in 9% due their low functional reserves. A total of 105 patients were operated on, postoperative mortality was 11.4%. Cardiopulmonary insufficiency was a cause of death in 4 cases, of them 3 patients underwent repeated resection of the lung as pneumonectomy in baseline stage III VD, which allows these patients to refer to as a high surgical risk group.

[Efficiency of plastic surgery for osteoarticular tuberculosis by using revascularization of osseous tissue bed and graft]. / Effektivnost' plasticheskikh operatsii pri kostno-sustavnom tuberkuleze s primeneniem revaskuliarizatsii kostnoi tkani lozha i transplantanta.

The paper provides the results of using original procedures for revascularization of the osseous bed and free bony grafts by transplanting osteovascular complexes in patients with tuberculosis of the hip joint and spine. A total of 20 patients with tuberculous coxitis and 14 with spondylitis were operated on. These interventions were found to have advantages over plastic surgery with bony grafts and mobilizing operations without plasty in similar skeletal lesions, appeared as a great scope of movements in the operated joints is achieved, less time for grafts to adhere with the bed and bony block of vertebrae, and enhanced accumulation of a radioopaque agent in the area to be replaced.

[Radionuclide diagnosis of the ureteral motor function and urodynamics in renal tuberculosis and other diseases of the urinary system]. / Radionuklidnaia diagnostika motornoi funktsii mochetochnikov i urodinamiki pri nefrotuberkuleze i razlichnykh zabolevaniiakh mochevydelitel'noi sistemy.

Radionuclide methods (a new technique of infusion dynamic ureteroscintigraphy and standard techniques of dynamic and static scintigraphy of the kidneys, radionuclide renography) were used to examine 134 patients with nephrophthisis, 61 patients with other urological diseases and 51 controls. It is shown that nephrophthisis brings urodynamic disorders and impairment of ureteral contractility. Three types of the contractile disorders are distinguished. A decline in motor function and urodynamic defects occurred also in other urological affections. Sensitive radionuclide techniques are thought valuable in examination of the urinary system and objective evaluation of urodynamic disorders.

[Evaluation of the contractile capacity of the ureter and kidney pelvis in tuberculosis by the method of infusion dynamic uretero- scintigraphy]. / Otsenka sokratitel'noi sposobnosti mochetochnikov i lokhanok pri urotuberkuleze metodom infuzionnoi dinamicheskoi uretero- stsintigrafii.

The radionuclide method--infusion dynamic ureteroscintigraphy--was used to examine 123 patients with tuberculosis of the urinary organs and 51 patients of the control group. Contractility parameters of various portions of the ureters and pelves in varying urinary tuberculosis were established. The contractility of the pelves and ureters was proved to be impaired even prior to the appearance of visible X-ray changes in the ureters. A specific increase in contractility in the area from the pelvis to the middle third of the ureter and further reduction in the lower third were seen.

[Tuberculosis and pneumonia]. / Tuberkulez i pnevmonia.

Analysis of the clinical course of acute pneumonia in pulmonary tuberculosis patients is presented. The lowest rate of acute pneumonia morbidity was found in patients with active tuberculosis during antituberculosis therapy. As soon as the specific process subsides and its activity diminishes acute pneumonia morbidity grows. Specific features of the course of acute pneumonia in patients with different phases of tuberculosis development are shown. Data on the study of liquid-crystal thermography are presented as well as the assessment of the capillary blood flow and the results of immunologic study in the presence of combined pathology. The terms of alleviation of acute pneumonia in tuberculosis patients are delayed, especially in inflammation development in the zones of post-tuberculosis changes.

[Infusion dynamic uretero-scintigraphy in the evaluation of the functional status of the ureter and pelvis]. / Infuzionnaia dinamicheskaia ureterostsintigrafiia v otsenke funktsional'nogo sostoianiia mochetochnika i lokhanki.

A proposed new method of infusion dynamic ureteroscintigraphy was used for investigation of 51 controls and 27 patients with unilateral tuberculous ureterohydronephrosis. Values of the contractility of different parts of the ureters and pelvis were obtained. The statistic law of distribution of these values is logarithmically normal. A high sensitivity of the method in the assessment of ureteral and pelvic function was shown.