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Biomedical subjects

A E Dmitriev

Publications and source records attributed to A E Dmitriev.

At least 19 recordsLinked to original sources

[Invasive interventions with computerized tomography guidance].

Invasive interventions (diagnostic and therapeutic) were conducted on 125 patients. Fifty-six has diseases of the lungs, 16 of the mediastinum, 4 of the pleura, 17 of the liver, 2 of the pancreas, one of the spleen, 15 of the kidneys, 7 of the retroperineal space, two of the soft tissues, and 5 patients had diseases of the skeletal bones. Biopsy was combined with aspiration of the renal cyst content in 7 cases. The diagnostic value of biopsy under control of CT was 86% (106 cases); negative and pseudonegative results were recorded in 18 (14%) patients. The efficacy of biopsy is determined by such factors as the size of the lesion and the depth of its localization in the involved organ, the character of the pathological process and the region of its localization, the site from which the material is collected, and the needles used. Among 7 patients with therapeutic interventions, 5 had good and 2 had satisfactory immediate results. Complications were revealed in 4 (3.3%) patients, pneumothorax was encountered most frequently.

Adult

[Errors and complications in computed tomography-guided biopsies].

The article analyses the results of 104 biopsies which were carried out in 84 patients with different diseases of the organs of thoracic (50) or abdominal (16) cavities, postperitoneal space (32), bones and soft tissues (6). Positive results were obtained in 67 cases, negative--in 26, false-negative--in 11. The specificity was 70.3%, sensitivity--100%, authenticity--64.4%. The authors make a conclusion that the results and authenticity of biopsies depend on such factors as the proper organ to be punctured, character and structure of the affection, its location, volume and spreading, as well as the type of needles to be used.

Adult

[The potentials of computed tomography in the treatment of cysts and inflammatory diseases of the internal organs].

Computed tomography (CT) is used more and more often recently in the treatment of some surgical diseases of the internal organs. The subject of discussion in this work are the results of treatment of cysts and pyoinflammatory diseases of the internal organs. The work was conducted on CT IV generation "QUAD 1" of the CMS firm (England). Needles measuring 14-18d in diameter (Charrière scale) were used for aspiration. A total of 23 therapeutic interventions were performed in 19 patients with exudative pleurisy (1 patient), pleuritis (4), pulmonary abscesses (1), abscesses of the liver (1), abscesses of the subhepatic and subdiaphragmatic spaces (2), cysts of the liver (1) and kidneys (1 patient). Among the interventions 21 were aspirations and 2 drainage of the abscess. A mechanical syringe is used lately for more effective evacuation of the contents. The removed contents, ranging in volume from 10.0 to 600.0 ml, was subjected to cytological, biochemical, and bacteriological analysis. A single puncture is sufficient, as a rule, for aspiration of the cyst contents, one-stage aspiration from cysts of both kidneys may be conducted (as was the case in two of our patients). 96% alcohol was used as the sclerosing agent. In cases of small abscesses aspiration may be repeated for removal of the contents, irrigation of the cavity, and administration of antibiotics. In abscesses measuring more than 10 cm drainage is advisable. Control CT examination is conducted once a week. The condition of the cavity is appraised by combining CT with its contrast study. The immediate results were good and satisfactory in 17 (94.7%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess

[Role of cholestanol in the pathogenesis of cholesterol cholelithiasis].

The proportion of cholestanol/cholesterol in hepatic and cystic bile was evaluated using capillary gas-chromatography in subjects with disturbances in the biliary system (biliary dyskinesia, chronic acalculous cholecystitis, chronic calculous cholecystitis). The proportion was also measured in bile "paste" and cholesterol choleliths. With progression of cholesterol cholelithiasis, the proportion cholestanol/cholesterol increases, reaching its maximum in the stone the center of which accumulates crystals of cholestanol-cholesterol dihydrate. An original conception is proposed on pathogenesis of cholesterol cholelithiasis in man. It considers cholestanol as factor-reason underlying various pathological processes running in cholesterol cholelithiasis. Cholestanol is suggested to mark cholesterol cholelithiasis.

Bile

[The physicochemical evaluation of the bile using infrared spectroscopy].

Native bile, inspissated bile, and cholesterol choleliths were examined by infrared spectroscopy. Model compounds spectra were compared with native bile spectra. The spectra were divided into 3 groups: with acid fragments or cholesterol groups predominating and intermediate group. The peak of 3620 cm-1, absent in normal human bile and liable to augment if acid fragment level reduced was detected. The authors suggest a technique of infrared spectroscopy permitting early detection of disordered physicochemical characteristics of the bile in the course of cholesterol cholelithiasis development.

Bile

[Characteristics of blood flow in the vertebral arteries in scalenus anticus syndrome].

The authors studied hemodynamics in the vertebral arteries in 62 patients with the scalenus-anticus syndrome by means of radioconstrast angiography and ultrasonic angiography which produced a colour image of the vessels with calculation of the diameter and the linear and volume blood flow rate. The results of the study showed that in constriction of the subclavian artery to 60% of its diameter in the typical place, the volume blood flow rate in the vertebral arteries remained normal (184 +/- 6.9 ml/min) but reduced 1.5-2 times during the functional test. Adequate surgical correction restored normal hemodynamics, control ultrasonic angiography recorded increase of the volume blood flow rate in the vertebral values to normal values. Ultrasonic angiography provides authentic information on the character of affection of the subclavian artery in the scalenus-anticus syndrome and makes it possible to appraise the hemodynamic significance of affection of the vertebral arteries. Besides, the method allows objective evaluation of the efficacy of treatment and quantitative characteristics of hemodynamics.

Adult

[Diagnosis of cancer of the thyroid gland].

The clinical diagnosis of carcinoma of the thyroid gland (CTG) is a difficult and responsible problem. The importance of cytologic and histologic methods of examination has grown, they determine the therapeutic tactics and the volume of the operative intervention. Clinical examination and operations were carried out on 484 patients with various diseases of the thyroid. The examination included inspection of the thyroid gland, radioisotope scanning, radiological examination of the neck, mediastinum and lungs, ultrasonic study, and aspiration biopsy with further cytologic study of the material. Among the patients treated by surgery 58 (11.9%), 39 females and 19 males (2:1), were found to have CTG. Intraoperative emergency cytologic and histologic study was conducted in 30 patients. Differentiated CTG was revealed in all cases. Among the patients who were operated on 5 died from CTG in a 10-year follow-up period. The importance of aspiration biopsy, under conditions of an outpatient clinic in particular, is emphasized. The results of operative treatment of differentiated CTG show that early diagnosis and appropriate surgical intervention are conducive to a favourable prognosis in relation to the patients survival period.

Adenocarcinoma

[Evaluation of the results of the treatment of pseudarthroses of the forearm bones based on the analysis of the data of radionuclide studies].

The work is based on the analysis of the results of radionuclide examination and treatment of 14 patients with ununited tractures and pseudoarthroses of the forearm bones. Treatment was accomplished by means of external fixation apparatuses which in comparison with intramedullary and epiosseous osteosynthesis provide a better stability of the site of bone injury and create ortimal biomechanical conditions for consolidation of ununited fractures and pseudoarthroses of the forearm bones. Radionuclide examination was conducted before the treatment to determine the initial activity of reparative regeneration in the zone of the pseudoarthrosis and the adjacent healthy regions, 2-3 weeks after perosseous osteosynthesis when the bone fragments were reduced and the compression or distraction regimen was established, and before removal of the apparatus when consolidation of the pseudoarthrosis was demonstrated radiologically. This made it possible to control the activity of reparative regeneration during treatment and to introduce corrections, if necessary. The radionuclide method is preferable to the radiological method in the intermediate stages of treatment not only because of the lesser exposure of the patient to radiation but because of the higner informativeness.

Adolescent

[Primary controlled endolymphatic antibiotic therapy in traumatology and orthopedics].

The work analyses 55 cases of traumatic osteomyelitis of the leg bones, open fractures of the leg bones, and medial fractures of the femoral neck. Patients with medial fractures of the neck of the femur were treated by endoprosthesis after Mur-Kaplan. Endolymphatic antibiotic therapy was included in the complex of therapeutic measures in each group of patients. This method allowed suppuration of the postoperative wounds to be avoided and promoted in this manner rehabilitation of the patients.

Gentamicins

[Spinal osteomyelitis].

The paper covers questions of etiology, pathogenesis, clinical and radiographic appearance and diagnosis of spinal osteomyelitis. Principles of conservative and surgical treatment are outlined. It is noted that pain in the spine associated with elevated body temperature and alterations in blood count may be suggestive of setting up inflammation (with occasional destruction) in the vertebra and adjacent structures.

Adult

[Tietze's syndrome].

The results of treatment of 14 patients (11 males and 3 females) with Tietze's syndrome are discussed. The patient's ages ranged from 22 to 56 years. Most of them were engaged in heavy physical work. The correct diagnosis was established before admission only in 9 patients. The complaints and clinical symptomatology were of the same type almost in all of the patients: pain and swelling in the region of the II-IV costal cartilages at the sternum or along the whole cartilaginous part of the ribs, in some cases pain was referred to the upper part of the shoulder girdle. Clinical and X-ray methods of examination failed to make recognition of the disease easier. The diagnosis was established on basis of scrupulous investigation of the complaints, the history of the disease, and the local clinical manifestations. Most patients were subjected to nonoperative treatment, 2 patients were treated by operation--resection of the hypertrophied cartilage. Local application of hydrocortisone and kenalog produced good results. Pain disappeared completely in 7, was relieved significantly in 5, and was not relieved at all in 2 patients.

Adult

[Computerized tomography in the diagnosis of degenerative-dystrophic lesions of the spine and herniated intervertebral disk].

Computed tomography (CT) examination was performed in 711 patients with various degenerative and dystrophic processes in the spine. The most numerous group (485 patients) included those with a posterior discal hernia associated in 54.3% of cases with other degenerative and dystrophic alterations in the vertebral column. The hernias were paramedial in 336 and central in 147 patients. In 98.4% of cases the lumbosacral portion was involved. The CT diagnosis was verified at surgery in 103 patients (21.3%) providing evidence for setting up the principal CT criteria of the hernia: deformity of the disk posterior margin in the form of its local prolapse, deformity of the epidural fat, presence of a soft tissue component, dislocation and deformity of the dural sac. It is established that CT is a safe and highly informative diagnostic procedure in discal hernias.

Adolescent

[Clinico-radiographic evaluation of the state of the spine in stomach and duodenal diseases].

Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine.

Adult

[Effect of intravascular laser irradiation of the blood on blood cells in pancreatitis].

Inpatient examinations included 17 patients with necrosis of the pancreas (4 patients had hemorrhagic and 14 fat necrosis): synthetic lymphocyte activity was studied by the luminescent method and the erythrocyte content of adenyl nucleotides by thin-layer chromatography in the toxic phase of pancreatitis. Synthetic lymphocyte activity was found to be decreased and the ATP pool of erythrocytes exhausted in the toxic phase of pancreatitis. Intravascular laser irradiation of the blood caused recovery of lymphocyte activity and increase in the ATP content in erythrocytes.

Adult