Clinical significance of non-fermentative bacteria isolated from the environment of a surgical department

The article deals with the frequency of isolation of non-fermentative gram-negative bacteria, potential causative agents of postoperative infection, from objects found in the environment of various departments of a surgical inpatient clinic. The species composition of the grown culture was determined. The relation of the isolation rate of certain species of nonfermentative bacteria to the object of the examination, the department of the clinic, and the disinfection method applied was revealed. The authors point out that it is necessary to undertake systematically the investigations to determine of the activity of antiseptics and disinfectants in relation to the microorganisms indicated in order to choose the effective methods for the prevention of postoperative infection induced by nonfermentative bacteria.     

Factors determining prognosis in stage T1.2NoMo breast cancer

From study of data on 5- and 10-year survivals of 560 patients who underwent operation for breast cancer in stage T1.2NoMo, the authors determined the most significant prognostic factors. These were the histological form of the tumor and the degree of invasion into the adjoining tissues. The percentage of each studied factor was determined by mathematical analysis, which allowed the individual prognosis for each patient to be made and treatment planned accordingly.     

Correction of immunologic disorders in patients with burns

Addition of immunomodulating therapy with Thymalin, a thymus agent, to the multimodality therapy of burnt patients contributes to a rapid normalization of immunological parameters. The most marked immune response was observed 7-10 days after a therapy course initiated in the early periods of burn disease in patients with severely depressed T-system immunity and a high sensitivity to the drug. Inclusion of a donor blood leukomass transfusion course activates the cellular link of the immune system just after the treatment course, but fails to favour a stable normalization of thymus-dependent lymphocyte ratios.     

Early postoperative rejection crises after transplantation of the kidney from the living related donors

The frequency of the development of rejection crises in the early postoperative period in 32 recipients of allogeneic kidneys from alive related donors was analysed depending on the histocompatibility according to the antigens of the HLA-AB system and the nature of the immunosuppressant therapy. The results of the analysis showed that the frequency of rejection crises was 100% when the donor and recipient were compatible in 1-2 antigens, and 40% in compatibility according to 3-4 antigens. The incidence of rejection crises was 71.4% among patients who received the standard immunosuppressant therapy (corticosteroids + azathioprine) and 36% among those given also sandimmune. Analysis of the frequency of rejection crises according to the ABO blood group system to which the donor-recipient pair occurred, showed that rejection crises occurred most frequently among patients with A (II) blood group.     

Ultrasonic vascular scanning in the diagnosis of acute arterial obstruction

In thrombosis of the aorta and major arteries (52 cases), postthrombotic occlusion (26), arterial embolism (14), the ultrasound vascular scanning++ was performed. The method permits to define the presence and location of arterial occlusion, differentiate thrombosis and embolism, atherosclerotic and autoimmune diseases of the vessels and as well to assess the outcome of restorative and reconstructive operations in acute arterial obstruction.     

The use of laser scalpel in the surgical treatment of cholecystitis

A comparison of the results of 169 cholecystectomies with the use of a laser scalpel and 160--conventional methods was carried out. The CO2-laser was used for exposure of the gallbladder and coagulation of tissue of the liver in the region of its bed. Hemo- and cholestasis in all the cases was reliable, and due to this fact in 27% of the patients, the subhepatic recess was not drained. The incidence of complications after the elective cholecystectomy reduced by 11%, after the emergency one--by 9%, the lethality reduced considerably.     

Surgical treatment of postoperative abdominal hernia

After surgical treatment of 664 patients with postoperative abdominal hernias (PAH) within the period of from 1972 to 1983, the incidence of recurrences was 48.4%. On the basis of studying microcirculation at the area of hernioplasty and its dependence on tissue tension force in the experiment on animals and at operations by means of radiometry, rheometry and fluorimetric analysis, the technique for surgical treatment of PAH with regard to location of a defect, including the method of plasty, system of preoperative preparation and prophylaxis of the postoperative wound complications, has been developed. From 1984, 200 patients with PAH were operated on, the incidence of recurrences decreased to 2.4%.     

Prevalence of hypocitraturia and hypopyrophosphaturia in recurrent calcium stone formers: as isolated defects or associated with other metabolic abnormalities

Several underlying metabolic abnormalities may be present in patients with recurrent calcium calculus disease (RCCD). The aim of this study was to determine the prevalence of deficiencies of 2 well-known potent inhibitors of crystal formation and growth, citrate and pyrophosphate, in the various metabolic subgroups and as single defects. In 107 patients with RCCD, urinary citrate was significantly decreased in all metabolic subgroups with 49% of patients having hypocitraturia (2.53 +/- 1.19 mmol/24 h) versus controls (3.44 +/- 0.96 mmol/24 h; p less than 0.001). Reduced pyrophosphate:creatinine ratios were present in all the patient subgroups, and 48% of all patients had reduced ratios (1.68 +/- 1.68 vs. 3.10 +/- 2.66 in controls; p less than 0.01). There was no correlation between citrate and pyrophosphate concentration. Isolated hypocitraturia was found in 11.2%, reduced pyrophosphate:creatinine ratios as the single defect in 11.2% and a combination of both in 12.1% of patients. Thus inhibitor defects play an important role in patients with RCCD and frequently occur as isolated biochemical defects.