Cutaneo-fascial flaps in restorative and reconstructive surgery of burns

On the basis of experience with the treatment of more than 1,500 patients with post-burn defects, deformities, and trophic ulcers, the authors distinguished types of affection in which the traditional methods are ineffective. These 133 patients were subjected to plasty with ++cutaneo-fascial grafts; the zones of donor areas from which the grafts are taken are determined. Plasty with ++cutaneo-fascial grafts is indicated in defects of the face, deformity of the neck, total adduction contracture of the arm, defect of the breast, and affections of the hand, leg, and foot. Concrete grafts and the site from which they are taken for restoration of certain regions of the body are suggested. ++Cutaneo-fascial grafts make it possible to restore the shape, function, and the skin of the involved region.     

Sentinel Bleeding After Pancreaticoduodenectomy: A Disregarded Sign

Introduction Delayed massive hemorrhage induced by pancreatic fistula after pancreaticoduodenectomy is a rare but life-threatening complication. The purpose of this study was to analyze the clinical course of patients with late hemorrhage, with or without sentinel bleeding, to better define treatment options in the future. Material and Methods From April 1998 to December 2006, 189 pancreaticoduodenectomies were performed. Eleven patients, including two patients referred from other hospitals, were treated with delayed massive hemorrhage occurring 5 days or more after pancreaticoduodenectomy. Sentinel bleeding was defined as minor blood loss via surgical drains or the gastrointestinal tract with an asymptomatic interval until development of hemorrhagic shock. The clinical data of patients with bleeding episodes were analyzed retrospectively. Results Eight of the 11 patients had sentinel bleeding, and seven of them had it at least 6 h before acute deterioration. Seven out of 11 patients died, five out of eight with sentinel bleeding. No differences could be detected between patients with or without sentinel bleeding before delayed massive hemorrhage. The only difference found was that non-surviving patients were significantly older than surviving patients. Delayed massive hemorrhage is a common cause of death after pancreaticoduodenostomy complicated by pancreatic fistula formation. The observation of sentinel bleeding should lead to emergency angiography and dependent from the result to emergency relaparotomy to increase the likelihood of survival.     

Early bronchoscopic and morphological diagnostics and prognosis in thermal inhalation trauma

Thermal injury is diagnosed by fibrobronchoscopy within the first 5 days after inhalation burn trauma in 73 patients (34% of the total number of patients hospitalized during the last 2 years). Pathological changes of the mucosa with predominant multiple ulceration at different levels of the tracheobronchial tree are detected in 44% patients and in more than 70% patients with acute respiratory deficiency. These changes determine variation and severity of thermal inhalation injury in the patients, and, together with morphofunctional characteristics, provide objective basis for the early diagnostics and prognosis. Translated fromByullelen' Eksperimental'noi Biologii i Meditsiny, Vol. 124, No. 8, pp. 221–225, August, 1997     

Homozygous microdeletion of chromosome 4q11-q12 causes severe limb-girdle muscular dystrophy type 2E with joint hyperlaxity and contractures

Microdeletion syndromes are commonly transmitted as dominant traits and are frequently associated with variably expressed pleiotropic phenotypes. Nonlethal homozygous microdeletions, on the other hand, are very rare. Here, we delineate the fifth and so far largest homozygous microdeletion in nonmalignancies of approximately 400 kb on chromosome 4q11-q12 in a large consanguineous East-Anatolian family with six affected patients. The deleted region contains the beta-sarcoglycan gene (SGCB), the predicted gene SPATA18 (spermatogenesis associated 18 homolog) and several expressed sequence tags. Patients presented with a severe and progressive Duchenne-like muscular dystrophy phenotype, a combination of hyperlaxity and joint contractures, chest pain, palpitations, and dyspnea.     

Enzyme spectrum of the pancreas in chronic stress

The enzyme spectrum of pancreatic homogenate was studied in acute experiments on male albino rats during adaptation for 30 days to muscular exertion (forced swimming in water at a temperature of 32±1°C), heat (hyperthermia to 40–41°C), and cold (cooling to 3–4°C) for 3 h. The initial periods of adaptation to these factors (second-twelfth day) were shown to be characterized by a considerable decrease in activity of all the enzymes studied, but later, with adaptation of the animals to these factors, enzyme activity was restored to its original level (18th–24th day), and remained more or less constant until the end of the experiment (30th day). It is suggested that changes in the enzyme spectrum of the pancreas are brought about through the participation of the hypothalamo-hypophyseo-adrenal system in accordance with the principle of the general adaptation syndrome.Laboratory of the Physiology of Digestion and Laboratory of General Physiology, Institute of Physiology, Academy of Sciences of the Uzbek SSR, Tashkent. (Presented by Academician of the Academy of Sciences of the USSR O. G. Gazenko.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 87, No. 5, pp. 412–414, May, 1979.     

Hormonal and immunological status of children with thymus hyperplasia

The state of the adrenocortical system, cellular and humoral immunity was studied in 152 infants, suffering from thymomegaly, associated with virus-bacterial pneumonia. The results obtained allow one of to consider the hormonal and immunological state of the patients with thymomegaly to be inhibited and the adrenocortical hypofunction to be secondary. Therefore, the infants with thymomegaly should be separated into a special "risk" group, according to their immunodeficient states, respiratory allergies, acute and chronic adrenocortical deficiency.     

Selective proximal vagotomy in combination with drainage operations in duodenal ulcers

From 1989 to May 1999 selective proximal vagotomy (SPV) was performed in 400 patients with duodenal ulcer, 190 (47.5%) of them had pyloric stenosis. Various drainage operations were performed in 180 patients with stenosis, in 10 patients compensated pyloric stenosis was eliminated by excision of the scars around the ulcer. Out of 210 patients without pyloric stenosis drainage operations were performed in 23 (11.0%) patients with large penetrating duodenal ulcers, which at healing could cause stenosis. The best results were received after SPV in combination with drainage operations, which save the pyloric mechanism of gastric evacuation--transverse duodenojejunostomy (5) and duodenoplasty (15); the results after them do not differ from results after SPV without drainage operations.