Biomedical subjects
Publications and source records attributed to M Demischew.
It is told about twenty penetrating wounds of thorax in the last ten years. They deal with twelve stab wounds, five gunshot wounds and three impalement wounds. The organic lesions are dominated by wounds of lung. Drainage of thorax is chosen as therapy in uncomplicated cases. Thoracotomy was necessary in 6 cases, 5 of them were urgent.
Reported are 48 cases of aspergilloma underwent surgical treatment. Cardinal symptom was hemoptysis in 26 patients. Because of massive bleeding one patient had to treat by thoracotomy without delay. Specific metabolic properties of the fungus, the situation of the wall and the content of the cavum as well as the genesis of the development of the cavum are discussed in connection with the tendency to hemoptysis.
In the last 30 years five patients with foreign bodies from tracheobronchial tree were treated. In four cases the foreign body was not discovered. In all patients was necessary to carry out a lobectomy.
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Between 1977-1988 89 patients had an operation on tuberculosis in our thoracic surgical department. It were 11 preoperatively diagnosed and 76 undiagnosed cases of tuberculosis and 2 infections with nontuberculosis mycobacteria. In cases, where tuberculosis was diagnosed, surgical therapy was only used because of uneffective antituberculotic therapy. Surgical operations are always applied as secondary late measures. We have manly employed limited resections saving parenchyma. The frequency of postoperative complications was 11.2%. An adequate postoperative chemotherapy is obligatory.
Ten outdated traumatic ruptures of the diaphragm are reported in this paper. The accidents had been up to 34 year back. Symptoms were rarely characteristic. Long intervals with no complaint were found to be possible. X-ray techniques were helpful in diagnosis in seven cases. All ten patients underwent thoracotomy.
40 patients underwent surgery for aspergilloma at the authors' ward of thoracic surgery. Pulmonary defects or cavities were recorded from 95 per cent of them (13 cases of bronchiectasis, eight with tuberculous caverns, and six cysts). Serological methods, 100 per cent in accuracy, were superior to all other diagnostic approaches. Lobectomy was the most common therapeutic approach, followed by segment resection and atypical resection. Surgery has proved to be the optional therapeutic approach to aspergilloma, though a high rate of postoperative complications has to be expected.
Report on 78 cases of chronic pneumonia which underwent surgical treatment between 1959 and 1985. In 52 cases previous to operation a tumor was diagnosed or suspected (in 20 cases cytologically or histologically, and in 32 cases clinically, by x-ray or by endoscopy). The frequency and correlation of x-ray and endoscopic findings, problems of preoperative diagnostics, surgical methods and postoperative course are described.
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In 1016 pulmonary resections we had 2,6% bronchial fistulae. 447 times we used interrupted suture (2,9% of bronchial stump insufficiency) and 542 times we used the Soviet bronchus stapling machine UKB 25 or 16 with 2,2% of fistulae.
A report on a 43-years old patient who fell ill with a bilateral abscessing coli-pneumonia with secondary aspergillus settlement. After a 10-week treatment with a continuous progression of the lung lesions the patient died of a respiratory insufficiency. At autopsy a multilocular metastasing squamous cell carcinoma has been found in both upper lobes of the lungs as the primary disease.