Biomedical subjects
Publications and source records attributed to Ia M Voloshin.
There are adduced the literature data and own observation of rare disease of main thoracic cavity veins-syndrome of disorder passability of vena cava superior (SDPVCS). The most frequent causes of SDPVCS occurrence, informative methods of diagnosis, mane methods of treatment were enlighted.
The during 7 years 258 patients with malignant effusion (ME) of different ethiology were treated in clinic, that composed 13.8% among all patients with pleural effusion. It was discovered the increase of this complication frequence in 1.6 time. The main reasons of ME were lung cancer--in 42.6% of observations, pleural mezothelioma--in 19.3%, mammary glands cancer--in 6.9%, real reason of ME was not found in 13.9%. Aged patients (oldest 60 years) are risk group for discovering of ME, for pleural mezothelioma the next ages are risk 30-40 and oldest 60 years.
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New approach for decision making concerning conduction of surgical treatment of the patients with pleuropulmonary diseases is proposed. This approach especially important in differential diagnosis of dissemination of obscure etiology. He is based on usage of a new screening diagnostic method "Oncotest", which intends setting of photohistochemical reaction in the blood smears, sections and serum for detection of biomolecular markers of cancer. Results of oncotesting of 172 patients with various pleuropulmonary diseases are analyzed. Application of a new approach permits to administer to the patient surgical or endoscopic intervention timely.
There were done histologic, electron-microscopic investigations of the lungs preparations in 47 patients with destructive tuberculosis (DT) and diabetes mellitus, the operations were performed, the signs of the disseminated microangiopathy were revealed. This complication negatively influence the DT course before and after the operation, and the final result of operation also.
Arteriovenous fistula (AVF) is rare congenital pathology of the bronchopulmonary system vessels. The results of treatment of 12 patients with AVF were analyzed. In 2 (16.6%) patients Randu-Veber-Osler syndrome was diagnosed. In 10 observations the diagnosis was confirmed by the angiography data. All the patients were operated on. One (8.4%) patient died.
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Six patients with carcinosarcoma were observed in the clinic. In 4 patients with roentgenological signs of tumor were determined and in 2--the signs of pleuritis. The diagnosis was established after pulmonary resection performance or after thoracoscopy with pleural biopsy conduction.
A total of 75 patients with diabetes mellitus who underwent surgical interventions on the lungs for fibrocavernous tuberculosis were followed up. A complex preparation for surgery being completed, operative interventions under endotracheal narcosis were carried out in all cases. Postoperative complications occurred in 32 percent of cases, four patients (5.33%) died after the operation. The clinical efficiency was recordable in 94.87 percent of patients. During the postoperative 1- to 15-year follow-up the achieved effect was still to be seen in 83.8 percent of those having been operated on. A major proportion of patients showed improvement in the course of diabetes mellitus.
Retrospective analysis of 58 patients history cases, in whom pleural mesothelioma was diagnosed, was conducted. Clinical signs of the disease were: progressive pain in the chest on the affection side, permanent fever, dyspnoea, weakness, rapid accumulation of pleural liquor. The combined application of clinico-roentgenological, laboratory and instrumental methods of examination has great significance in diagnosis. The informativity of transthoracic puncture with pleural biopsy is 36.2%, and of thoracoscopy-84.3%. Diagnostical thoracotomy was performed when indications were present.
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On the basis of examination of 45 patients who had been operated on for tuberculoma, tumors, abscesses, echinococcosis, developmental anomalies of the lungs and bronchiectasis it is concluded that R. F. Klement's tables of the degrees of bronchial patency gradation for phthisiopulmonological patients cannot be used for characterizing bronchial patency in individuals who had undergone operation. The dependence of some indices of the flow-volume loop on the volume of the resected lung is shown. The authors claim that in order to use the above-mentioned tables in characterizing the degree of bronchial patency in patients subjected to operation, a conversion factor must be elaborated.
The results of treatment of 103 patients with tuberculosis and non-specific diseases of the lungs with concomitant diabetes mellitus were analysed. The main principles of preoperative preparation and postoperative management of the patients are presented. The incidence of operative complications was 10.7%, postoperative--17.5%, mortality--2.9%. The clinical effect was achieved in 97.1% of patients. Reactivation of tuberculosis after operation was noted in 7.8% of patients.
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