Biomedical subjects
Publications and source records attributed to T I Kazak.
The material of 97 pulmonary resections for large caseous focuses of tuberculosis was compared to relevant x-ray and morphological evidence. Roentgenologically, caseous-necrotic foci may be stable for a long time (6-12 months) in spite of the absence of the fibrous capsule. In view of these findings, x-ray potentialities in the diagnosis of the process form and phase are considered.
On the basis of guinea pig experiments and clinical findings related to 103 patients of whom 51 were operated on, the authors propose a diagnostic set which allows determination of pulmonary tuberculosis phase. The set informative value is 93.5%.
Among the 367 patients with the pleurisy syndrome examined in a specialized diagnostic department, 167 (45.5%) had tuberculous pleurisy and the active stage of pulmonary tuberculosis was diagnosed in 42 (25.1%); in 125 subjects pleurisy was an independent form of tuberculosis. The possibilities of the clinico-roentgenologic, bioptic and bacteriologic diagnosis of the disease etiology have been studied in different variants of the X-ray picture (unblocked, partially sacculated, sacculated and adhesive pleurisy).
A combined ++clinico-roentgenological+ examination of 367 patients with a pleurisy syndrome was aimed at the study of a potential establishment of the etiologic diagnosis of the disease. Examination comprised the routine tests and findings of various types of biopsy, including pleural biopsy performed within the first two months from disease onset. The etiologic diagnosis of tuberculous pleurisy was most difficult in 96% of the patients who exhibited prolonged and stable maintenance of exudation or, on the contrary, very rapid regression of the pleural exudate without residual changes. Simultaneous morphologic and bacteriological examination of a pleural biopsy specimen contributed to the most efficacious and reliable diagnosis of tuberculous etiology of pleurisy.
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A technique of a dynamic cavernoscopy permitting one to conduct diagnostic and therapeutic manipulations for several months has been suggested. The given procedure was conducted in 36 patients with disseminated fibrous-cavernous pulmonary tuberculosis. An important role in defining management tactics belongs to the direct bacteriological and histological examination of the cavern contents. Local treatment by means of antituberculous drug solution instillation was administered in 29 patients. A positive effect was registered in 26 cases. The above technique can be used for the process prognosis and the treatment modification.
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A rare, badly known diffuse pulmonary lesion--multifocal hyalinizing intravascular "bronchiolo-alveolar" tumour in a woman of 22, is described. The lesion was revealed at fluorography, diagnosed by means of mediastinopleuroscopy, in lung biopsy; there were no clinical manifestations. A hyalinized compact and branching node, poor in cells, intruding at the periphery into the alveolar septa in the form of micropolyps was found histologically.
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Eight observations of diffuse pulmonary leiomyomatosis in women were studied. This disease in a number of cases was combined with leiomyoma of the uterus. The clinical picture depends to a certain extent on which structural part of the pulmonary tissue is the predominant source of tumor growth. Disorders in the lymphatic system causes chylous pneumothorax. Hyperplasia of smooth muscle fibers occurs multicentrically: in interalveolar septae, along the small bronchi and bronchioli, in the walls of small blood and lymph vessels, intrathoracic lymph nodes. Leiomyomatosis of the lungs is of neoplastic nature, most likely of dyshormonal genesis.
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