Visual evoked potentials and the P300 component in different courses of the posttraumatic vegetative state

The late latency components of visual evoked potentials (VEP) and the component P300 AEP were analyzed to evaluate their informative value in the process of mental function restoration in patient after long-term traumatic coma. VEP components with latencies of 70 to 320 msec were studied in 24 patients. Topographical mapping of the power of the study VEP components and components P300 was made by the peak amplitude. Long-term VEP components and component P300 were examined by the method of three-dimensional localization of equivalent dipole sources. In 16 patients with positive tendencies in the condition there was a stable localization of the maximum VEP power in the parietal, sagittal, and occipital regions, component P300 showed its maximum amplitude in the central and parietal regions in the left hemisphere. Eight patients with negative tendencies in the status had the maximum VEP and component P300 in the frontal and temporal regions, predominantly in the right hemisphere. The paper shows it important to evaluate not only time-amplitude parameters and analyzes the tomographic features of its formation in dynamics.     

Treatment of urinary fistulas with allogenic fibroblasts growth culture

15(2.4%) of 601 patients (392 have undergone transvesical adenomectomy, 111 had gunshot wound of the external genitalia and small pelvis organs, 98 had closed pelvic traumas, injuries of the urinary bladder and posterior urethra) were treated for persistent urinary fistulas with human allogenic fibroblasts growth cultures grown in the artificial medium. Before transplantation into the fistula tracts, the fibroblasts were grown in bioreactor on the microcarriers. Application of allogenic fibroblast growth culture has reduced hospital stay to 7.5 days. This method is simple and effective in inpatients. Use of allogenic fibroblasts allows to create bank of cell transplants for application in clinical practice.     

The lipid profile in patients with obesity who have undergone vertical gastroplasty

The effect of vertical banded gastroplasty (VBG) on the lipid profile in obese patients is considered. The antiatherogenic effect of VBG and of the following weight loss consists in significantly decreased plasma triglycerides, increased content of high-density lipoproteins and decreased atherogenic coefficient. Patients with hypercholesterolemia have significantly lower total plasma cholesterol by the period of the body mass stabilization. The effect of VBG is compared with that of other methods of correction of dyslipidemia. The possibility to improve this effect is also discussed.     

The immediate results of laparoscopic treatment in perforated gastroduodenal ulcers

The article presents an analysis of immediate results of laparoscopic interventions (suturing, vagotomy) in 40 patients with perforated ulcers in the pylorobulbar zone. Postoperative complications were noted in 7.5% of the patients. There were no lethal outcomes. The authors recommend wider introduction of the laparoscopic technology as a method of optimization of surgical treatment for perforated ulcers.     

A methods of laparoscopic suturing of perforated pyloro-bulbar ulcers

The article describes a method of laparoscopic suturing perforated ulcers of the pylorobulbar zone. The elements of all steps of the operation are analyzed including the places of introducing the trocar, the method of putting the intracorporeal stitches, means of sanitation and drainage of the abdominal cavity. The method was successfully used in operations on 43 patients with perforated ulcers without any complications.     

An approach to the right hepatic duct in treating high damage and cicatricial stricture of the bile ducts

There was proposed an operative access to the duct via the lateral end of transverse hepatic fissura, basing on the results of studying of the right hepatic duct anatomy. The method performed includes the right hepatic lobe mobilization, its fibrous capsule transsection along the transverse fissura in the direction toward right posterior sectorial duct, longitudinal transsection of the duct lateral wall along 1-2 cm with subsequent formation of laterolateral hepaticojejunoanastomosis. Method was tested in 9 patients with high damage and cicatricial stricture of biliary ducts, the result was positive.     

The surgical treatment of toxic goiter in middle-aged and elderly patients

Of 128 patients, ageing more than 60 years, polynodular toxic goiter was diagnosed in 84, diffuse toxic goiter--in 34, toxic adenoma--in 10. The nodules in thyroid gland (TG) were revealed in 94 patients, cancer--in 3. There were following indications for the operation: the lack of the thyreostatic therapy efficacy, the malignant-like nodules presence, compression of cervical and mediastinal organs. After the euthyreotic state achievement all the patients were operated on using endotracheal narcosis. Subtotal resection of TG was performed in 91 patients, thyroidectomy--in 27, hemithyroidectomy--in 10. The frequency of specific complications (n. recurrence damage, bleeding, hypoparathyroidism, the wound purulent complication) was 4.7%.