Results of the treatment of patients with torsion of the sigmoid

The results of treatment of 204 patients with torsion of the sigmoid colon are analysed. Total postoperative mortality was 14.2%. Sixty-eight patients were subjected to palliative operations of the type of ++de-torsion or ++de-torsion in combination with mesosigmoplication and sigmopexy. In this group of patients, 20.5% underwent a second operation for a recurrence of the disease in different periods after the first operation. The mortality rate after palliative operations was 13.2%. Resection of the sigmoid colon with an end-to-end anastomosis was carried out in 87 patients. The postoperative mortality was 13.7%. There were no fatal outcomes among patients who were treated by radical operation carried out in a planned order of preliminary detorsion. In 11.7% of cases, sigmoid torsion was complicated by gangrene. Seven patients (29.1%) died in the postoperative period.     

Argon laser pretreatment in Nd: YAG iridotomy

Argon laser pretreatment prior to Nd:YAG laser iridotomy may decrease the incidence of operative hemorrhage. In a prospective, randomized clinical trial involving 12 patients (24 eyes), one eye was randomly assigned treatment with the Nd:YAG laser alone, while the other eye was pretreated with argon laser photocoagulation immediately prior to Nd:YAG laser. Eight of the 12 eyes (67%) treated with Nd:YAG laser alone had operative hemorrhages; only 2 of the 12 (17%) pretreated eyes did. Thus, argon laser pretreatment significantly reduced the incidence of hemorrhage during Nd:YAG iridotomy (P = .012).     

Reconstructive and restorative operations in iatrogenic injuries of the extrahepatic bile ducts

The results of diagnosis and treatment of iatrogenic injuries of the extrahepatic biliary tract in 47 patients are analysed. The injury was detected during the operation only in 6 cases, in 41 cases it was revealed on the 1st-6th postoperative day. Intensive conservative therapy was applied in the preoperative period to correct the values of homeostasis and metabolism. Special attention was attached to antibacterial therapy aimed at suppression of ++non-clostridial anaerobic infection. Sixty-three surgical interventions were conducted on 47 patients; 47 of them were restorative or reconstructive, 15 were undertaken for emergency indications, one, for developed postoperative complication. One patient died. Particular importance was attached to adequate draining both in emergency and in reconstructive and restorative operations.     

Hepatectomy in repeated operations on patients with parasitic diseases of the liver]

The results of resection of the liver in repeated operations on patients with parasitic disease of the liver are discussed. Operations were conducted on 22 patients with alveococcosis and 7 patients with echinococcosis. By means of the method of atypical liver resection radical operations were performed on 20 patients (69%) and palliative resections of the liver in 9 patients (31%). The palliative resections were combined with cryodestruction of the remaining parasitic tissue, which improved the therapeutic effect significantly and prolonged the patients' survival. The volume of the resection ranged from a segment to one half of the liver. The fatality rate was 6.8%.     

Changes in the levels of neuropeptide Y-LI in the external jugular vein in connection with vasoconstriction following subarachnoid haemorrhage in man

Summary NPY is a putative neurotransmitter mainly co-localized with noradrenaline in sympathetic fibers which innervate the cerebral vasculature. The origin of most of the perivascular NPY fibers seems to be in the superior cervical ganglion. To investigate involvement of Neuropeptide Y (NPY) mechanisms in subarachnoid haemorrhage (SAH), twenty patients with SAH were investigated. NPY-LI (-like immunoreactivity) levels in the external jugular vein were assessed using radioimmunoassay in blood samples collected postoperatively (or after SAH in non-surgical patients) on days 1, 2, 3, 5, 7 and 9. These levels were compared with the clinical course and blood flow velocity changes monitored with ultrasonic Doppler equipment from both middle cerebral arteries (MCA) and both internal carotid arteries (ICA).Compared to NPY-LI levels in 14 controls (mean 116±3 pmol/ l), increased levels (up to 253 pmol/l) and a close relationship between velocities and NPY-LI levels were found in a subpopulation of the SAH patients. When comparing the mean haemodynamic index (V MCA/ipsilateral V ICA) and mean NPY-LI levels in each of the 20 patients, a correlation of r=0.75, p=0.0001 was found. Increased NPY-LI were found (131±8 pmol/l) when simultaneous Doppler velocity recordings showed vasoconstriction (Haemodynamic index >5) compared with samples taken when the haemodynamic index was <5, p<0.05. When MCA velocity exceeded 120 cm/sec, increased levels were found (129±9 pmol/l) compared with the conditions when MCA velocity was less than 120 cm/sec (113±5 pmol/ l), p=0.06. The results indicate a possible NPY involvement in cerebral vasoconstriction after SAH.     

Comparison of antigen expression on normal urothelial cells in tissue section and tissue culture

Antigenic characterization of urothelial cells cultured from normal adult ureter was performed. These cells were cultured using a simplified isolation and culture technique and a commercially available serum-free medium. The cells growing in these cultures had epithelioid morphology and normal quantities of DNA. The antigen expression on these cultured normal urothelial cells was evaluated using a panel of monoclonal antibodies: 5G6.4, AN43, URO-5, anti-keratin and anti-blood group antibodies, and 425 (anti-epidermal growth factor receptor). Lower levels of anti-A and AN43 binding on cultured cells were observed than are seen on urothelial cells in sections of normal ureter, while the binding of anti-blood group H, 5G6.4, and URO-5 was unchanged. Binding of anti-epidermal growth factor receptor antibody 425 was improved if the cells were grown in medium lacking epidermal growth factor. These results confirm the urothelial origin of these cultured urothelial cells but indicate that some antigenic differences between cultured normal urothelial cells and urothelial cells in situ in the normal ureter exist.