[Search for a sentinel lymph node--way to optimize lymphodissection in neoplasms of various locations].
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Biomedical subjects
Publications and source records attributed to L Z Vel'sher.
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Patients with breast tumors, stage IIb-IIIb, received complex treatment including radiation therapy, radical surgery and polychemotherapy. Some of them were also injected 4-40 doses of leukinferon, im, for immunocorrection. The latter treatment carried out during radiotherapy and preparation for surgery prevented lymphopenia development. Leukinferon administered during 6-8 courses of cytostatic polychemotherapy was followed by a significant rise in lymphocyte concentration. Leukinferon-treated patients, on the whole, revealed higher rates of postoperative rehabilitation, improved tolerance of rigorous treatment and lower frequency of metastatic development. A correlation was established between preoperative lymphocyte level and risk of metastasis development at later stages. No metastasis or recurrence was detected within 15-42 months in 16 patients who received leukinferon throughout the entire period of treatment.
The work deals with the study of the mosaic character of the hemostatic potential, connected with the development of a localized pathological process, taking postmastectomy edema in illustration. It is shown that this condition is an example of the manifestation of the RASK system mosaics in one organism in pathology. It should be pointed out that the degree of the development of the local DVS syndrome changes significantly some of the RASK system parameters at the level of the whole organism. This is evidence that normalization of the microcirculatory processes in the edematous extremity will be an important measure in complex treatment of postmastectomy edema. It will considerably lower the risk of general disorders of the RASK system. Parameters determined in the blood collected from the extremity on the side of the operation will serve as controls of the efficacy of the applied therapeutic measures.
The authors elaborated a new approach to radical mastectomy which, combined with nonoperative measures makes it possible to prevent the development of postmastectomy-induced edema by means of a lympho-venous anastomosis (LVA). The choice of the level of LVA formation and their number is substantiated. With due regard for the conditions named, the cubital fossa and the lower third of the upper arm on the anterointernal surface is the most rational zone. To accelerate lymph drainage through the collaterals and reduce lymph loss, goal-oriented ligation of the lymph vessels which are divided during mastectomy is additionally carried out; this is successfully done when they have been stained. As a result, wound lymphorrhea ceases practically at days 4 to 5.
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At present the problem of bladder injuries and methods of their therapy are very urgent in view of a wide use of radiation therapy of cancer of the uterine body, bladder and rectum. None of the existing methods of therapy of local radiation cystitis is sufficiently effective. To obtain better therapeutic results and immobilized trypsin preparation on a powder-like cellulose matrix was used. Therapy was provided to 34 patients with symptoms of acute radiation cystitis. The therapy in all the cases proved to be effective. It was confirmed by the disappearance of clinical symptoms and cystoscopic findings.
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A new combined photoultrasonic technique is suggested for the treatment of infectious injuries. The experiments were implemented on 70 male chinchilla rabbits (7 groups). The dynamics and nature of injuries' healing were analyzed by clinical pathomorphological and histochemical data as well as by biopsy samplings and capillaroscopy of injuries' edges. The experimental results of animals' models demonstrated a high efficiency of the combined photoultrasonic treatment as applicable to the above injuries.