[Tuberculous coronaritis as a cause of myocardial infarct].
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Biomedical subjects
Publications and source records attributed to E L Kazachkov.
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AIM: Comparison of the levels of lipid peroxidation (LPO) products in condensate of the exhaled air (CEA) and in the biopsy samples from the inflammation focus. MATERIALS AND METHODS: Extraction spectrophotometry was used to measure LPO products in CEA and biopsies from 30 males aged 30-60 years suffering from chronic bronchitis and 30 healthy controls of the same age. RESULTS: There was activation of local accumulation of isopropanol-soluble LPO products in the bronchopulmonary system accompanied by lowered content of lipoperoxides and high antioxidant activity in CEA. CONCLUSION: Chronic bronchitis is characterized by multidirectional shifts in LPO in the inflammation focus and CEA.
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Clinico-pathoanatomic features and thanatogenetic aspects in tuberculosis in young subjects have been studied by retrospective analysis of medical documentation and postmortem findings. Among the 43 young subjects who died within 10 years (1979-1988) in 37, tuberculosis was the underlying illness and 18 had two severe diseases. The clinico-pathological features of tuberculosis in young age are now characterized by therapeutic pathomorphism of its most forms, association with other diseases and imposition of iatrogenic complications. These factors should be taken into consideration in the pathogenetic and thanatogenetic assessment of the disease and in the final clinical and pathoanatomic diagnosis.
Clinicoanatomical analysis of 6 cases of pathological processes in the lungs and pleura caused by gauze cloths left carelessly during operative treatment of pulmonary diseases was carried out. It was found that the character of these accidentally induced sufferings depended on the volume of the surgical intervention and the time during which the foreign bodies remained in the pleural cavity or the operative wound. The complications caused by the presence of gauze cloths accidentally left in the pleural cavity or lung follow a course separately from the initial pulmonary pathological process, have no pathogenetic relations to it, and possess a characteristic clinicoanatomical picture which allows them to be evaluated as surgical iatrogenesis, an equivalent of a nosological unit.
Autopsy findings (160 deceased patients) were assessed clinically and anatomically. Lethal outcomes occurred after surgical treatment of the lungs and heart. Postoperative complications in the absence of a pathological relation to the primary pathology or its adverse effects were considered in diagnosis documents as an equivalent of a nosological unit, i. e. iatrogenic "secondary" diseases. These conditions resulted either from adequate surgical interventions (78.1% of cases) or were attributed to technical and strategical errors (21.9% of cases). Unification of the complications associated with pulmonary and cardiac surgery implies use of the fundamentals of the "secondary" diseases theory and International Classification of Diseases (the 9th revision).
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Modification of the method of heart dissection in patients who died after valve replacement is suggested. After standard atrial cutting dissection of the ventricles is made from the apex along the interatrial fissure without cutting the proximal regions of the coronary arteries. The method allows good inspection of the ventricular cavities and elucidation of the relationships between anatomical structures and artificial valves.
Postsurgical myocardial infarction in a 68-year-old female was observed after occasional compression of the coronary artery by a teflon gasket when P-like suture was applied on the anterior wall of the right ventricle in the course of surgical intervention for closure of the aortic-right-ventricular fistula. The latter had formed after the rupture of Valsalva's sinus aneurysm into the right ventricle this being the cause of the surgery. The authors propose how to document the diagnosis and medical death certificate in similar cases.
A total of 145 women with chronic inflammatory diseases of uterus and appendages (IDUA) were examined. Bacterioscopy of smears and culture of vaginal, cervical canal and uterine cavity contents were performed in all patients. Direct immunofluorescence and PCR were used for detection of chlamydiae in scrapes and smears and in biopsy specimens taken from endometrium. The number of T lymphocytes and their subpopulations, B lymphocytes as well as the level of plasmatic cells synthesizing IgA, IgM and IgG and secretory IgA (sIgA), immune complexes and C3 component of the complement were determined in biopsy specimens of the endometrium. Pathomorphological examination revealed structural changes characteristic of the immunocomplex disease (secondary deficiency of sIgA, pronounced suppression of IgA production by plasmocytes along with an essential increase in the number of IgG synthesizing cells and immune complexes fixed to the venule endothelium) were detected. Lectin-histochemical study revealed considerable changes in secretory activity of endometrial epitheliocytes manifested by severe suppression of bactericidal activity of the uterine mucus. The detected disturbances of local protective reactions in the endometrium of women IDUA gave grounds for including immunomodulators into the traditional treatment scheme. The latter made it possible to increase essentially the therapeutic effect.
The paper presents a sectional case of primary cardiac Echinococcus infection in a patient with fibrocavernous pulmonary tuberculosis. A whitish thin-wall round-oval cyst, 2 cm across, was detected in the thickness of the lateral left ventricular wall at autopsy. The tinctorial properties of the cyst sheath suggested that the parasite might be viable. The internal germinal layer of its sheath showed minor filial vesicles provided with scolexes. An extensive area of tissue detritis was perifocally detectable near the cystic wall, then peripherally there was a fibrous capsule with developed plethoric vessels and polymorphically cellular inflammatory infiltrate with a predominance of lymphocytes, macrophages, eosinophilic leukocytes, and fibroblasts. Parasitic cardiac damage along with tuberculous infection of respiratory organs had played an important role in the decompensation of performance of the hypertrophic heart and referred to the unified category of the second malaise in the mixed underlying disease.
A local case of dirofilariasis was first reported in a 70-year-old female in Magnitogorsk, Chelyabinsk Region, in November 2002. The primary diagnosis is atheroma of the skin of the forehead. A round mass having a smooth surface and slightly solid gray-whitish walls was surgically excised, which yielded a mobile rolled nematode measuring 7 cm in length and 0.8 mm in width. The parasitological diagnosis is an immature Dirofilaria repense female. It has been found that the female has neither dogs nor cats in her flat and she had not been left Mangitogorsk for approximately 18 years. A histological examination of the fibrotic capsule around the parasite revealed inflammation in the inner layer of the capsule, which was regarded as proliferative and having no signs of a granulomatous process. Fragments of cuticles of a round helminth having a well-defined alimentary tube was found. To encode the case, the authors have used Category B74.8 "Other types of filarisis (dirofilariasis)" of the first class, ICD-10.
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A case of iatrogenic granulomatous pleurisy in a 36-year-old female developed after cosmetic correction of the mammary gland shape with polyacrylamide gel (an interfall injection). Symptoms of spontaneous left-side pneumothorax developed one month after the manipulation. Histological examination of the parietal and visceral pleura biopsy revealed multiple non-immune corpuscular mature macrophagal granulomas around gel particles resulting in the pleura damage and pneumothorax. A complete recovery. This is the first publication of pneumothorax of such genesis.