[The role of local factors in the development of acute and chronic rhinosinusitis].
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Biomedical subjects
Publications and source records attributed to V I Egorov.
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AIM: To devise the technique and evaluate the efficacy of videothoracoscopic collagen pleurodesis (VCP) in malignant pleural exudates (MPE). MATERIAL AND METHODS: VCP was performed in 24 patients with recurrent MPE. 20 patients were diagnosed to have non-small-cell cancer of the lung, 4 patients--breast cancer. The operation included videothoracoscopic revision of the pleural cavity under endobronchial anesthesia, pleural biopsy, liquid evacuation, dispersion of powder collagen (1 g) and drainage of the pleural cavity. RESULTS: Videothoracoscopy macroscopically diagnoses pleural carcinomatosis in 100% patients. Pathomorphological examination of the biopsies defined a histological type of the tumor in all 24 patients. A positive clinicoroentgenological effect with a compete disappearance of pleural exudates was achieved in all the cases. The recurrence was absent in 18 of 24 patients. Short- and long-term results, survival and quality of life are outlined. CONCLUSION: VCP is a simple and effective method of palliative treatment improving quality of life in patients with malignant pleural exudates.
Sixty acute appendicitis suspects with unclear clinical picture were examined with high-frequency ultrasound and native CT. The results of the examinations were compared with clinical data, surgical findings and histological evidence. Acute appendicitis was in 39 patients, other diseases of abdominal cavity and small pelvis--in 21. Sensitivity of CT was 95%, specificity--91.3%, accuracy--96.6%. Sensitivity of US was 92.3%, specificity--100%, accuracy--95%. The above parameters for non-invasive diagnostic methods were similar to ones for laparoscopy. Native CT and US are highly precise methods for diagnosis of acute appendicitis. They are preferable in unclear clinical situations, atypical location of the appendix, in children, elderly and aged patients, and in patients with mental disorders.
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The examination of 120 patients with verified labyrinthine fistulas (LFs) has demonstrated that perilymphatic LFs most often are caused by rupture of the cochlear window's membrane (54%). Among other reasons were broken base of the stapes (6%), the defect in the area of both windows (17%), rupture of the annular ligament of the stapes (15%), defects in the area of semicircular canals. Incompetence of the stapedial piston prosthesis is documented.
Basic diagnostic criteria for perilymphatic fistulas of the labyrinth (PFL) comprise previous trauma or psychoemotional stress, unilateral acute affection of the acoustic and vestibular functions, severe noise in the ears, mixed hypoacusis, lower hearing thresholds in change of the head position, alteration of stabilogram parameters in rising pressure in the external acoustic meatus.
One-row continuous suture (OCS) was used in 3605 patients while placing anastomoses in different parts of the digestive tract, extrahepatic bile ducts and pancreas as well as suturing after gastrostomy and choledochotomy. Two techniques of OCS were used. In 526 patients OCS was used for biliary tract surgery with complications rate 1.3%. In surgery of the stomach and small intestine OCS was used in 2606 patients; the insufficiency rate of stomach and small intestine anastomoses was equal (0.04%). In surgery of colon and rectum OCS was used in 405 patients; insufficiency rate was 1.5%. In surgery of the pancreas this suture was used in 70 patients without complications after surgery. Analysis of the data shows high reliability of OCS for anastomoses in abdominal surgery and allows to recommend its wider use in clinical practice.
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Quite often a sudden surdity can appear after baro or mechanical traumas, it happens because of rupture of the round window membrane which leads to the formation of the perilymphatic fistula. The article deals with the syndrome of the round window membrane rupture. The authors describe two successful cases of treatment of patients with vestibular disorders caused by posttraumatic perilymphatic fistula. Practical recommendations are given for providing a tertiary medical care in emergency situations.
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The work deals with the results of comparative evaluation of different variants of intraoperative aerostasis by means of glue and bioplastic materials in experiments on 75 animals. The authors give in detail a clinicomorphological characteristics of each method for rendering the lung wound airtight. It is concluded from the obtained data that aerostasis by means of fibrin glue and collagenous film is highly effective.
Based on their experience with the treatment of 65 patients the authors consider that choice of the method of treatment depends on the bronchus calibre and the fistula size. Good results were obtained when using different variants of bronchus obturation with the application of glue.
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