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Biomedical subjects

A M Khokhlov

Publications and source records attributed to A M Khokhlov.

At least 19 recordsLinked to original sources
PubMed1999

Surgical treatment of diabetic osteoarthropathy, complicated by pyogenic process in the feet.

The data on the results of combined treatment of 540 patients with diabetic osteoarthropathies (DOAP) complicated by pyonecrotic lesions of the feet (PNLF) are presented. The authors classification of these lesions is proposed which considers location and the stage of the disease. Surgical treatment was used in 387 (71.6%) patients. The analysis of the clinical experience in surgical treatment and the results obtained in patients with DOAP and PNLF allouvs to subdivide surgical procedures in the patients in to the following categories: 1) the initial prophylaxis of development of pyonecrotic processes; 2) measures of secondary prophylaxis of the progression of pyonecrotic processes; 3) amputation of the shin and the thigh. As a result of the complex of curative and prophylactic measures, comprizing surgical treatment, the number of favourable results of treatment in patients of the lest group increased by 24%, and the number of unfavourable outcomes decreased by 25%, the mortality rate in the test group lowered 2, 4 times.

Amputation, Surgical↗
PubMed1997

[Cyclophosphane in the treatment of trophic ulcers of lower extremities with allergic and autoimmune components].

In 36 patients with varicose-trophic ulcers of the lower extremities with marked allergic and autoimmune components use of low frequency ultrasound through 0.02% solution of chlorhexidine and 0.2% cyclophosphamide made it possible to diminish allergic dermatitis and eczema after 5 or 7 procedures. The ulcers cleaned in 8-13 days (sometimes, in 14-18 days). In 27 patients surgical correction of venous blood flow was performed after the sanatation and autodermoplasty of the ulcers. There were no recurrences in the long-term period (up to 2 years).

Aged↗
PubMed1993

[Preoperative care and surgical techniques in the varicose disease of the lower extremities complicated by trophic ulcers].

The principles of preoperative management of patients with varicosity complicated by trophic ulcers are discussed. The main type of treatment is surgery including subfascial ligation of the perforating veins of the thigh, leg, and foot+phlebectomy after Troyanov-Trendelenburg-Bebcock-Narath. The author suggests or modifies approaches to the perforating veins. The basis of preoperative management is formed of measures causing a general effect on the organism (lysozymo--and immunoglobulinotherapy, stimulation of regeneration by means of zinc sulphate, transfusion of albumins, etc.), local treatment (cleansing of the ulcer by low-frequency ultrasound, and with immobilized enzymes), and measures for improving microcirculation (magnesium preparations, disaggregants, ultrasound). Complex treatment based on subfascial ligation of perforating veins and removal of varicose superficial veins led to stable healing of ulcers in 98.2% of patients.

Combined Modality Therapy↗
PubMed1991

[Pathogenesis of trophic ulcers in varicose veins of the lower extremities].

The work generalized the results of examination of 418 patients with primary varicosity (V) complicated by trophic ulcers. On the basis of the study conducted by the authors, a conception of pathogenesis is suggested, the main links of which are microcirculatory disorders in the system of perforating veins of a closed structure, and deficient resolution of fibrin due to diminished local fibrinolytic activity of the plasma. Insufficient fibrin splitting leads to the formation of paravasal collagen cuffs preventing normal exchange between the capillaries and tissues. Impaired nutrition facilitates spasm of arteries and arterioles, whose genesis magnesium deficit contributes to. Activation of collagenolytic peptidases-cathepsins, D, A, B occurs in the ischemic tissues, which leads to destruction of the skin and the formation of ulcers. The disease is attended by disorders of immunity (secondary immunodeficiency), which reduces the reparative processes and thus promotes the development of a chronic process. A complex approach to the treatment of V in the presence of trophic ulcers is suggested.

Adult↗
PubMed1990

[Pathogenesis of varicose ulcers of the lower extremities].

The article discusses the biochemical mechanisms of skin destruction and ulcer formation in patients with varicosity of the lower limbs. Cathepsins A, B, C, and D were determined in the skin in various parts of the limb in 57 patients: in the lower third of the leg the activity of cathepsin D was increased by 183.8%, that of cathepsin B by 140.2%, and the activity of cathepsin B by 239%. On basis of the data obtained the authors conclude that cathepsins take part in skin destruction. Increased activity of cathepsin D plays the initiative role in this process. Cathepsin activity reduced after 14-16 day treatment with aescusan; D by 24.1%, B by 17.7%, and A by 15.4%. The authors link the effect of the treatment with the protective effect of the preparation on the lysosomal membranes.

Cathepsins↗
PubMed1989

[Role of electrolytes in the pathogenesis of arterial spasm and muscle cramps in varicose veins of the lower limbs].

The blood magnesium and calcium content and the blood flow in the limbs was studied in 68 patients suffering from varicosity, 42 of whom had trophic ulcers of the legs. It was established that diminished content of magnesium in blood serum contributes to the development of hypercalcemia, spasm of arterioles, and the occurrence of muscular convulsions and trophic disorders and thus plays an essential role in the pathogenesis of changes of the blood flow and trophic disorders. Administration of magnesium preparations in the preoperative period improved circulation in the limb and relieved muscular convulsions completely.

Calcium↗
PubMed1984

[Low-frequency ultrasonics in the treatment of trophic ulcers].

The treatment of trophic ulcers by the low-frequency ultrasound results in destruction of the collagen fibres of the fibro-cicatricial tissue, reduces the bacterial dissemination, stimulates the growth of a new granulation tissue which allows to fulfill autodermoplasty .

Administration, Topical↗
PubMed1984

[Pathogenesis and surgical tactics in varicose ulcers of the lower limbs].

The character and specific features of the venous blood circulation in lower extremities were determined by clinico-angiographic studies in 358 patients with trophic ulcers resulting from varicose disease of lower extremities. Causes of the formation of the ulcer are analyzed, methods of correcting the disturbed venous hemodynamics are proposed in relation to the pathology revealed. Indications for dissection of the ulcer are developed.

Adult↗
PubMed1983

[Changes in the structure and antibiotic sensitivity of the wound microflora in suppurative surgical infection of the soft tissues].

The results of the study on the composition, properties and antibiotic sensitivity of pathogenic microbes isolated from purulent wounds of the soft tissues of patients treated in the Institute clinic in 1977-1980 are presented. The frequency of secondary infection of the purulent wounds was estimated. During this period the percentage of gram-negative bacteria isolated from opened purulent foci increased. In some cases investigation of the time course of the purulent processes revealed new microbial strains, such as pathogenic staphylococci or opportunistic gram-negative bacteria. Sometimes replacement of the causative agent by new organisms was observed. The new strains were high- and multiple-resistant to the antibiotics.

Anti-Bacterial Agents↗