[Tumors and tumor-like diseases of the bones in children].
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Biomedical subjects
Publications and source records attributed to V N Makarov.
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The experience with treatment of 34 children with gynecomastia is summarized. The examination included roentgenography of the Turkish saddle, definition of bone age, investigation of buccal sex chromatin, excretion of 17-ketosteroids, excretory urography against the background of retropneumoperitoneum, ultrasound investigation of the mammary glands. In juvenile gynecomastia, the mammary glands were removed, the expectant tactic being considered unwarranted. The long-term results of the surgical treatment are good.
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The experience with modelling acute pancreatitis (AP) in dogs is summarized. In 15 of them, to reproduce AP, the intraductal administration of a bile with trypsin mixture was used, in 8--intraductal administration of automobile under the pressure, in 15--intraparenchymatous administration of automobile at several points. Depending on the method of modelling, the forms, rate and severity of the AP course were different.
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The authors observed 38 children with umbilical cord hernias. In 27 of them some other defects were noted. Among 25 children there were 14 deaths (56.2%). Conservative therapy was conducted in 13 patients with umbilical cord hernia, 10 children died (76.9%).
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For the treatment of neurogenic dysfunctions of the urinary bladder resulting in residual urine and therefore the lack of adequate urination, the authors proposed the performance of omentovesicopexy due to which the damaged function could be partially compensated by intraperitoneal pressure. The greater omentum should be used for reinnervation and revascularization of the urinary bladder as it meets the requirements for the donor organ enabling the formation of competent indirect innervation due to its adequate mobility and size and the formation of the abdominal enclosure of the bladder when ascending to the abdominal cavity. Being a double layer of the peritoneum the greater omentum avoids transformation into the connective tissue thus contributing to "functional anastomosis" for a long time. The technique developed was successfully used in 12 surgeries for the patients with residual urine. The postoperative period was featured by the manifest equivalent of micturition urge, disappearance or a significant decrease in the amount of residual urine, restoration of spontaneous and controlled urination. The omentovesicopexy is a simple, efficient and available technique for usage by a wide range of urologists.
As a therapeutic management of neurogenic disorders of micturition is an actual problem, the authors analysed the results of electrotherapy in 58 patients suffering from the aforementioned conditions. Out of them 22 patients sustained conservative and 36 combined treatment with the use of electrical stimulation of the urinary bladder. With regard to the clinical manifestations of micturition distress and the pattern of the bladder dysfunction the patients were allocated to three groups: group 1-34 patients with chronic urine retention; group 11-9 patients with enuresis; group 11-15 patients with the combination of all the symptoms mentioned. With regard to the disease etiology and pathogenesis as well as the functional performance of the lower urinary tract, electrotherapy of the bladder sphincter-detrusor system was performed according to certain parameters developed. Group I patients were exposed to impulsive cross currents with following linear electric stimulation of detrusor; group II patients underwent transrectal electrical stimulation of the sphincter, group III patients were simultaneously subjected to the effect of impulsive cross currents and linear electrical stimulation of the detrusor. In 70.7 per cent of the patients the treatment was a success, in 13.9 it led to an insignificant improvement and in 15.4 per cent it was a failure. Thus, selectively used electrotherapy essentially improves the rehabilitation of the patients suffering from neurogenic distress of micturition.
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