Biomedical subjects
Publications and source records attributed to V A Solov'ev.
Positive results of combined surgeries in locally advanced cancer of the colon complicated with gastric fistula (3 patients) and duodenal fistula (1 patient) are presented. Effective treatment of these patients requires complex examination, good preoperative preparation, perfect anesthetic management, adequate operation and intensive postoperative (including antibacterial) therapy.
Results of treatment of 771 patients with external intestinal fistulas were analyzed. Duodenal fistulas were diagnosed in 47 patients, small-intestinal - in 366, large-intestinal - in 329, mixed - in 26, combined - in 3. Patients were divided into 2 groups: group 1 - 341 patients treated from 1983 to 1992, group 2 - 430 patients treated from 1993 to 2002. In group 1 - 294 (86.2%) patients underwent surgery, in group 2 - 405 (94.2%) patients. Differential approach to choice of treatment method, intraaortic therapy before and after surgery, use of developed devices for treatment of non-formed fistulas permitted to improve results of treatment and to reduce lethality from 10.3% in group 1 to 3,3% in group 2.
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Structural reorganizations of red and white muscular fibres and peculiarities of changes in phosphoinositides in conditions of total ischemia of skeletal musculature were studied. On the whole morphological and biochemical changes were of the same type. However, decrease of phosphoinositides was more significant in white fibres than in red ones. In white muscular fibres deformations concerned myofibrillar apparatus while in red fibres mitochondrial apparatus was damaged.
The content of phosphoinositids in biomembranes of slow (m.soleus) and fast (m. extensor digitorum longus) twitch muscular fibres (MF) was studied. Biochemical differences in different MF of fast and slow muscles were detected. The content of phosphotidylinosites in plasma membranes, mitochondrial and sarcoplasmic reticulum membranes of fast twitch MF was on average 1.28 times higher than in slow ones. The predominance of phosphatidylinositol-3,4,5-triphosphates in fast twitch MF over slow twitch MF was noted. The content of phosphatidylinoitol-3,4,5-triphosphates in plasma membranes, mitochondrial and sarcoplasmic reticulum membranes of slow twitch MF was 3, 2.35 and 1.25 times higher than in fast twitch MF. It was found that phosphoinositide content in biomembranes of different type MF was unequal which may be used to improve the expansion of understanding of the role of intracellular mediators in MF phenotype regulation.
Functional and structural changes in the stomach, vegetative tone, microcirculation, histamine metabolism were studied in 136 male alcoholics. The results allowed the authors to distinguish clinico-pathogenetic variants of chronic alcoholic gastritis which can be used for objective evaluation of the disease severity and serve basis for design of adequate therapy at different stages of the disease progression.
Extraperitoneal, transperitoneal and combined peritoneostomy was used in 29 patients with acute pancreonecrosis and predominant damage of retroperitoneal fat. The choice of surgical method depended of the volume of damage of pancreas and retroperitoneal fat. The wide opening of necrotized zones of retroperitoneal fat, removal of necrotized tissues and adequate drainage can stop further spreading of suppuration of the retroperitoneal fat. The mortality rate was 6/29 (20.7%).
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As many as 148 patients were examined to demonstrate that chronic gastritis (CG) runs its course in the presence of marked changes in microcirculation and hemostasis which go into the framework of the chronic recurrent thrombohemorrhagic syndrome. The manifestations of the latter one were more appreciable in a dramatic exacerbation of the disease, erosive gastritis, diffuse atrophy of the mucous membrane and secretory insufficiency of the stomach, and disease standing over 10 years. The disorders indicated are involved into the pathogenesis of CG and promote the development of morphofunctional alterations in the gastric mucosa.
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A new modified method of plasty of practically all sizes of postoperative hernias in different areas of the abdomen has been developed on the basis of N. I. Napalkov's principle which is based on doubling aponeurosis and creating muscular defense of the aponeurotic suture. Clinical experience of the treatment of 125 patients with postoperative ventral hernias shows its use to be promising and expedient for a wide introduction into clinical practice.
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Interstitial electrophoresis of antibiotics included in the complex of curative measures was shown to be highly effective for the treatment of chronic pneumonia. The conclusion was made on the basis of an analysis of results of treatment of 128 patients with chronic pneumonia.
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