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.     

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     

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.     

Comparing Operative Exposures of the Le Fort I Osteotomy and the Expanded Endoscopic Endonasal Approach to the Clivus

Objectives We compare surgical exposures to the clivus by Le Fort I osteotomy (LFO) and the expanded endoscopic endonasal approach (EEEA). Methods Ten cadaveric specimens were imaged with 1.25-mm computed tomography. After stereotactic navigation, EEEA was performed followed by LFO. Clival measurements included lateral and vertical limits to the midline lower extent of exposure (t test). Results For EEFA and LFO, respectively, maximal lateral exposure in millimeters (mean ± standard deviation) was 24.5 ± 3.7 and 24.5 ±  − 3.8 (p = 0.99) at the opticocarotid recess (OCR) and 25.1 ±  − 4.1 and 24.1 ±  − 3.0 (p = 0.53) at the foramen lacerum level; lateral reach at the hypoglossal canals was 39.0 ±  − 5.88 and 56.1 ±   − 5.3 (p = 0.0004); and vertical extension was 56.0 ±  − 4.1 and 56.3 ±  − 3.4 (p = 0.78). Conclusions For clival exposures, LFO and EEEA were similar craniocaudally and laterally at the levels of the OCR and foramen lacerum. LFO achieved greater exposure at the level of the hypoglossal canal.     

Surgical treatment of complicated ulcers of cardia and sub-cardia

Two hundred and two patients with ulcers of a proximal part of the stomach (17.5% of all patients with gastric ulcer) were treated. In 135 (64.9%) patients these ulcers were complicated: in 28 (20.7%) -- malignant ulcers, in 42 (31.1%) -- bleeding ulcers, in 53 (39.3%) -- penetrating ones. Surgery was performed in 142 (70.3%) patients. A high rate of complications dictates a need to reduce period of conservative treatment of such ulcers to 6 months -- 1 year. Distal and proximal resection of the stomach are main surgeries in elective surgical treatment of patients with benign ulcers of cardia and sub-cardia. In malignant transformation gastrectomy is the most preferable. Suturing is indicated in perforated and bleeding ulcers, and if it is impossible -- distal subtotal resection of the stomach.     

Surgical treatment of diseases of operated stomach

Experience with treatment of 262 patients with late complications after operations for duodenal ulcer was analyzed. Eighty-four (32.1%) patients underwent earlier suturing of perforated duodenal ulcer, 97 (37.0%) -- resection of the stomach and 81 (30.9%) -- various types of vagotomy. In recurrent ulcers after sutured perforation organ-saving operations (62, or 73.8%) have important advantages over resection of the stomach. Combined postgastrectomy syndromes (18, or 18.6%) were most difficult for surgical treatment. Resection of the stomach (70, or 86.4%) patients is the best reconstructive operation for postvagotomy syndromes.