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Biomedical subjects

S A Kondrashin

Publications and source records attributed to S A Kondrashin.

At least 19 recordsLinked to original sources
PubMed2005

[Mini-invasive technologies in diagnosis and treatment of major vessels diseases].

Experience with 150 endovascular stents and endoprostheses including ones of vertebral and carotid arteries (first experience in Russia) is analyzed. Mini-invasive surgery is indicated for patients with isolated arterial lesions (segmental stenosis, short occlusions), changed and hard for surgery parts of vascular system (renal, visceral arteries, branches of aortic arch), restenosis after traditional surgeries and also for patients with severe concomitant diseases. Rate of complications of carotid endovascular stenting was 4,3%. The follow-up ranged from 2 months to 5,5 years. There were no restenoses in the stented zone. Complete absence of complains and regress of neurological symptoms were seen in 89% patients.

Blood Vessel Prosthesis↗
PubMed2003

[Hemangioendothelioma of the nasal cavity complicated by polypous sinusitis].

Three patients were observed who had small angioma in the region of the middle nasal passage. Angioma was the cause of recurrent nasal bleeding. In one of the patients the vascular tumor was covered with massive edemous polyps for which the patient was referred for polypotomy. Introduction of computed tomography, endoscopic methods of examination allows detection and assessment of the tumor spread, selective angiography followed by embolization enables operations with minimal blood loss.

Female↗
PubMed2002

[Diagnosis and treatment of gastrin-producing pancreatic tumors].

Current literature data on the clinical course, diagnosis and treatment of gastrinoma, one of the most frequent neuroendocrine tumors of the thyroid, as well as 23 cases with Zollinger-Ellison syndrome treated by the authors are analysed in detail. Peculiarities of the clinical course, difficulties of syndrome diagnosis, principles of updated topical diagnosis of gastrinoma, conservative and surgical treatments including treatment of multiple endocrine neoplasia syndrome are described.

Female↗
PubMed2000

[Treatment of malignant pancreatic islet cell tumors].

Among 142 patients with islet cell tumor who were admitted to hospital between 1982 and 1999, 15 patients (10.6%) had malignant tumours. The mean age was 45.3 +/- 5.8 years. Islet cell tumors were located in the head and corpus of the pancreas in 26.6% and 26.6% of the patients, respectively, in the tail of the pancreas in 46.8% of the patients. The mean size of the tumor was 2.9 +/- 0.7 cm, in 6 patients (40%) liver metastases were found. US, CT and angiography which sensitivity were 72.7, 100 and 85.7%, respectively, were used for topical diagnosis of the islet cell tumors. 12 patients were operated on (15 operations) and 3 patients were treated conservatively by streptozocin. Surgical procedures included distal pancreatic resection (n = 11), enucleation of the tumor (n = 2), hepatic resection (n = 1), abdominal exploration (n = 1). In 2 patients palliative pancreatic resections were combined with transarterial embolization and devascularisation of the liver metastases and 2 patients were treated by systemic chemotherapy. To reveal malignancy before and during the operation was possible only by evaluation of distant metastases and the adjacent organs infiltration. In other cases to determine the diagnosis was possible only after planned histological identification of the resected specimens. 5-year survival rates after conservative and surgical treatment were 33% and 62.5%, respectively. In patients without distant metastases 5-year survival rate was 100%.

Adult↗
PubMed1999

[Adrenal tumors found by chance. Surgical treatment or follow-up?].

206 case records of the patients treated from 1985 to 1998 for various diseases of the adrenal glands were analyzed. In 39 (18.9%) patients tumors were chance finding at ultrasound examination or computer tomography of the abdominal cavity and retroabdominal space. 25 patients from this group were operated on, 14 patients were not operated and were followed up from 1 month to 7 years. All the patients underwent complex examination including analysis of the complaints, anamnesis and physical examination data, hormonal status examination (ACTH, hydrocortisone, 11-oxycorticosteroids, 17-ketosteroids, aldosterone, renin, adrenalin, noradrenalin, vanillyl-mandelic acid), device methods of examination USE, CT, MRT, superselective phlebography with separate catheterization of adrenal veins and blood intake per floor, fine needle aspiration biopsy under ultrasound control. Comparison of the results of complex clinical examination with morphological data of removed adrenal glands was carried out retrospectively. Arteriography and superselective phlebography with separate catheterization of adrenal veins and per floor taking of blood samples, performed in 36 patients, enabled not only to supplement and define more exactly the other methods of topical diagnosis, but also to asses objectively functional actively of the affected and contralateral adrenal. Despite the fact that during the study of hormonal level in peripheral blood of patients it was normal analysis of the data obtained by superselective phlebography of adrenal veins and per floor taking of blood samples showed significant increase in hormones level in blood of all operated patients. Comparison of the data of superselective phlebography with separate catheterization of adrenal veins and per floor taking of blood samples and clinical picture of the disease made it possible to suggest the presence of preclinical (subclinical) Cushing or Conn syndrome. Operative treatment was not indicated in the absence of hormonal activity of the tumor (i.e. preclinical syndromes by Icenko-Cushing, Conn, pheochromocytoma, the virilizing and feminizing tumors), tumors of small size (less than 3 cm), in absence of malignant growth features confirmed by complex instrumental examination (USE, CT, MRT, fine-needle aspiration biopsy under US control, superselective phlebography with per floor taking of blood samples). Such patients were reexamined in 6 months. During the follow up period no changes of tumor size, homogeneity, hormonal status were revealed.

Adrenal Cortex Hormones↗
PubMed1999

[Long-term results of balloon dilatation in the treatment of esophageal achalasia].

25 patients (aged from 32 to 58 years) with achalasia of the esophagus during 1985-1997 years underwent balloon dilatation of the esophagus. 18 patients had stage IV, 5--stage III and 2--stage II of the disease. Mean diameter of the stricture's area in the esophagus made up. 7.2 +/- 2.0 mm. Balloon dilatation was performed in 4 patients by 2-4 balloons d = 10 mm in one stage, and in the test patients by balloon "Rigiflex" d = 40 mm. 2-3 procedures were carried out with the interval 7-10 days. In all cases balloon dilatation was successful. Mean diameter of the esophageal lumen after dilatation has increased to 16.0 +/- 2.5 mm. In 2 patients with IV stage of the disease relapse was detected within 6-8 months. 5 year follow-up results were satisfactory in 4 patients, from 5 to 10 years--in 14 patients, and over 10 years--in 5 patients. Prolonged clinical follow-up (for 7.5 years) demonstrated complete absence of dysphagia and normal regime of nutrition. Balloon dilatation is safe, available and effective method of nonoperative treatment for achalasia of the esophagus.

Adult↗
PubMed1999

[Diagnosis and surgical treatment of organic hyperinsulinism].

From 1982 to 1998 144 patients (males 31.7%, females 68.3%) with organic hyperinsulinism underwent surgery. Mean age of the patients was 44.2 +/- 4.6 years. The causes of the development of this disease were benign insulinoma (82.6%), malignant insulinoma (6.9%), beta-cells hyperplasia and microadenomatosis (4.2%). In 6.3% of the patients the origin of the disease was not established. The location of the insulinoma in the pancreatic head was detected in 33.8%, in the body--in 35.2%, in the tail--31%. The sensitivity of the used methods of topical diagnosis was the following: US--40.3%, CT--28.6%, angiography (selective celiacography and upper mesentericography)--76.9%, blood samples from the right hepatic vein after intraarterial stimulation of different parts of the pancreas by Ca with measurement of immunoreactive insulin level--87.2%, intraoperative palpation--86.5%, intraoperative US examination--100%. Preoperatively, the authors used combined angiographic examination, the sensitivity of which made up 94.9%, this study being a single one which allows to reveal the region of the lesion of the pancreas in beta-cells hyperplasy. Tumor enucleation (59 patients), distal resection of the pancreas (50), the excision of the insulinoma (25), duodenopancreatic resection (1), explorative laparotomy (9) were made. Postoperative complications rate arose in 43.6% of the patients, mortality rate--7.7%. The best results were achieved in enucleation of insulinoma and distal resection of the pancreas. The authors suggest that in preoperative diagnosis of insulinomas the preferable methods should be US-examination and combined angiographic examination. Intraoperative revision should be made with use of US examination. Depending on the intraoperative findings the preference should be given either to enucleation of insulinoma or to distal resection of the pancreas.

Adolescent↗
PubMed1998

Preoperative and intraoperative topographic diagnosis of insulinomas.

Altogether 120 patients with organic hyperinsulinism underwent clinical examination and treatment (38 male, 82 female, mean age 44.2 +/- 4.6 years). The cause of hyperinsulinism was benign insulinomas in 96 (80.0%), malignant tumors in 9 (7.5%), and hyperplasia of beta cells in 6 (5.0%). In 9 (7.5%) patients the origin of hyperinsulinism was not diagnosed. The tumor was localized in the head, body, and tail of the pancreas in 31.8%, 36.4%, and 31.8% of cases, respectively. Intraoperative ultrasonography (IOUS) was undertaken in 37 patients, and in 83 cases only intraoperative palpation was done. Arterial stimulated venous sampling (ASVS) was performed in 17 patients (blood was sampled from the right hepatic vein for determination of the insulin level after arterial stimulation by calcium gluconate in different parts of the pancreas). The sensitivity of ultrasonography (US) was 29.5%, computed tomography (CT) 24.2%, angiography 55.9%, superselective angiography (branches of the celiac trunk) 72.2%, and intraoperative palpation 90.0%. ASVS showed an accuracy of 90.0%. Combining angiography with ASVS gave an exact diagnosis of hyperinsulinism in 100% of cases, and IOUS revealed tumors in 100% of cases. Hyperplasia of beta-cells was diagnosed only by means of ASVS. A total of 117 patients underwent surgery, including distal resection of pancreas (n = 39), enucleation of tumor (n = 70), and laparotomy (n = 8). The postoperative mortality associated with insulinomas was 7.7%. The frequency of postoperative complications was 43.6%. Benign insulinomas recurred at a rate of 5.4%. Patients with malignant insulinomas had a 5-year survival of 66.0%. The diagnosis of insulinomas was achieved by a combination of selective angiography, ASVS, and IOUS.

Adult↗
PubMed1998

[Catheterization translumbar angiography of the aorta and its branches].

Method of complex angiographic examination and treatment from translumbar approach (CTLA) in patients with diffuse occlusive lesions of arterial bed was developed. 529 patients (516 males and 13 females) aged from 20 to 80 years (53.1 +/- 1.6 years) were examined and operated with the use of translumbar approach: they underwent various angiographic examinations of peripheral, visceral and coronary arteries as well as interventions on arteries. The quality of contrasting of arterial bed in CTLA was higher in comparison with results of punction translumbar aortography and intravenous digital angiography, complications rate being minimal. Application of CTLA in practice made it possible to perform practically all kinds of angiography and many invasive procedures in patients with occlusions of peripheral arteries and after reconstructive operations on vessels.

Adult↗
PubMed1997

[The potentials of computed tomography in the diagnosis of salivary gland diseases].

Computer-aided tomography (CAT) was carried out in 68 patients with tumors of the salivary glands and 45 with sialolithiasis. CAT detected the tumors and located them, showed the type of the tumor (benign or malignant) and the tumor invasion. Sensitivity of CAT in tumors of the salivary glands was 97%, specificity 81.8%, accuracy 94.9%. In sialolithiasis CAT not only detected the concrements, but helped assess the status of the gland and the adjacent structures; its sensitively, specificity and accuracy were 95.5, 100 and 98.0%, respectively.

Adolescent↗
PubMed1996

[Diagnostic and curative procedures with ultrasound guidance in patients with mechanic jaundice].

Transcutaneous procedures have been performed under ultrasound control in 404 patients with mechanical jaundice, caused by tumor of the pancreas, primary liver tumor or its metastatic lesion. Cholecystostomy was performed in 40 patients, in other cases external or external-internal draining of bile with subsequent implantation of endoprosthesis for the life-long biliary duct decompression (108 endoprostheses in 98 patients) has been done. Complication have been observed in 3 (0.7%) patients. The mortality rate was 2.1%. The authors recommend this method for wide use in patients with mechanical jaundice and consider it to be a method of choice in inoperable cancer of hepato-pancreatico-duodenal zone.

Cholestasis↗
PubMed1996

[Choice of treatment of destructive pancreatitis and its complications].

Choice of a proper method of treatment of complicated acute pancreatitis remains indefinite. The results of treatment of 130 patients with acute destructive pancreatitis complicated with pancreatic pseudocysts have been analysed. The authors formulate individual indications to minor surgery under the ultrasound control. The classical type of surgery was used only in patients with calculous pancreatitis complicated with pseudocysts (14). In other patients various types of transcutaneous ultrasound controlled procedures were used. Pilot experience of placing cystoduodenoanastomosis under ultrasound endoscopic control is described. Letal outcomes were absent. The rate of recurrence in external drainage was 10, 5%; there were no cases of recurrence in internal drainage of pseudocysts. The period of long-term follow-up was 58 months.

Acute Disease↗
PubMed1991

[Postmanipulation hemostasis in angiography from different approaches].

The paper is concerned with some data on the quality of hemostasis after various types of angiography in 629 patients: manual hemostasis in transfemoral catheterization was used in 130 patients, mechanical fixing rubber pellets were used in 108 patients. Postmanipulation tamponade in the area of catheterization was used in 163 of 321 patients after catheterization translumbar angiography. In mechanical hemostasis, hematomas were found in 1.8%, in manual hemostasis--in 4.6%; CT and USI findings showed no hematomas after catheterizations translumbar angiography, in PTLA hematomas over 200 ml were found in 3.7%.

Angiography↗