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Pacific Medical Journal

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No 3 (2004)

EDITORIALS

5-9 258
Abstract

This paper provides retrospective analysis of maternal mortality in Primorsky Region over the years 1997-2001. The authors have ascertained prevailing mortality among the pregnant women in twenty-eight weeks of pregnancy and more, as well as among parturient and puerperant women. Maternal mortality among the pregnant women in the period of less than 28 weeks was registered five times more, as compared with the all-Russian level, and took up the second place. Death rate due to abortions was lower than all-Russian rate, whereas the number of criminal abortions was larger. The most frequent causes of maternal death were bleedings, septic complications, and gestosis. According to the findings, adverse social and economic circumstances, ecological crisis resulted in increasing maternal mortality, as well. Based on the aforementioned data, the authors come to a conclusion that maternity consulting centers and therapeutics units of the outpatient departments belonging to the public health service are the most important elements responsible for prevention of the maternal mortality in the region. Furthermore, they propose some measures aimed at decreasing maternal mortality rate.

REVIEWS

10-13 187
Abstract

A leiomyoma uterus is a prevailing gynecological pathology. When conservative therapy does not yield results, it is an indication for surgical treatment in the form of myomectomy or hysterectomy. More then twenty years uterine arterial embolization has been successfully used in obstetrics and gynecology to stop post-natal and postoperative bleedings. The paper describes the possibility to apply the embolization of uterine arteries as an independent method in leiomyoma treatment. Literature analysis allows drawing a conclusion that this procedure is very effective, low-invasive and relatively safe alternative to hysterectomy.

LECTURES

14-17 274
Abstract

The author presents a survey dedicated to the research activities of the chair of hospital therapeutics of Vladivostok State Medical University. Among the outstanding achievements made in science are discovery of new form of parasitic invasion (larval paragonimiasis), researches into compensatory adaptive responses, and practical application of adaptogens to workers of industrial enterprises. Over the last years the computerized dermography and electrocardiotopographic examination of heart have been developed and introduced into the practice.

ORIGINAL RESEARCHES

18-20 420
Abstract

Increased content of the lipid peroxidation products and reduced integral antiradical activity in liver tissue were found in experimental mice and rats with induced stress hypodynamia as well as in pilot rats with modeled acute carbon tetrachloride-induced hepatitis or liver fibrosis which were caused by combined administration of carbon tetrachloride and ethanol for one month. Preventive administration of an ethanol extract of stichopus to rats exerted antistress and antioxidant effects similar to the preparation of comparison silibinine.

21-23 259
Abstract

Using general morphologic methods, electron microscopy, and morphometry, the author has studied ten eyes of human foetuses (a 10-12 weeks' intrauterine development material received in the course of therapeutic abortions), detected some changes confirming ganglionary neurons death in ontogenesis by means of apoptosis, and described stages in the course of apoptosis bodies' generation.

24-27 268
Abstract

In earlier researches based on computer morphometry of the specimens stained to find out nucleolar organizers using multivariate and discriminant analyses the author succeeded to within 95.7% in discerning the stratified flat epithelium of unaltered gingival mucous membrane under chronic catarrhal, hypertrophic and atrophic gingivitis. This notwithstanding, the following analysis showed some shortcomings of this classification and necessitated drawing up a new one. Based on the visual analysis and computer classification of measuring data base of 23 patients, the author proposes morphometric classification that includes three groups of the stratified flat epithelium: normoplastic, hyperplastic, and hypoplastic ones. Coefficient of correctness of this classification, using discriminant analysis, amounts to 100%.

27-29 238
Abstract

The authors impart an experience gained in the course of medical treatment of 43 children suffering from funnel-shaped deformation of chest. In most cases this deformation was asymmetrical. In order to provide chest modeling of regular shape for the patients with this pathology, the authors used external device of their own design. Using distraction compression attachment of the external device, mobilized breast bone and ribs were fixed to achieve regular spatial posture. By doing this, in all cases the authors have succeeded in achieving positive aesthetic effect due to distraction compression modeling of symmetrical ellipsoid chest and improvement of bearing in the sagittal plane.

30-33 277
Abstract

This paper provides experience of surgical treatment administered to 244 patients suffering from arterial hypertension of suprarenal origin. Good and satisfactory results were observed at 96.3% of cases. The most effective were the operations performed on account of pheochromocytoma, benign corticosteroma, primary hyperaldosteronism, and Cushing's syndrome. Unacceptable results of the surgical treatment were stated in cases of malignant corticosteroma. The authors emphasize the importance of early diagnostics and opportune surgical treatment under hormone-producing suprarenal gland tumors before the irreversible changes in the cardiovascular system and in kidneys may appear.

33-34 908
Abstract

Medical specialists of the Regional Clinical Center of the Maternity and Childhood Protection (Vladivostok) since 2000 to 2004 detected 57 retroareolar cysts that were found, predominantly, at patients under twenty. The diagnostics was based on examination data, ultrasound study, cyst puncture results, cytologic analysis of cyst contents, and pneumocystography. Choice of therapeutic approach depended on whether there was inflammation or not. When detecting retroareolar cysts, the authors proposed active therapeutic management in order to prevent non-lactational mastitis.

35-38 218
Abstract

Case histories of 47 patients with thoracic and lumbar vertebral injuries aging from 18 to 77 years old have been analyzed. Indications for transpedicular fixation were based on combination of some radiological signs: decrease of vertebra's body more than 1/3, kyphotic angle more than 10°, stenosis of the vertebral canal within 25% of the injury with destruction of 3 «rods post», neurological signs. Systems of Roy-Camille, Medbiotech, Osteosynthes, USS were used for operative fixation. Transpedicular vertebroplasty with bone allograft taken from iliac bone crest has been performed in 13 patients. Postoperarive patients could stand up on the 3-5th day. 29 postoperative patients were followed for distant outcomes. 4 patients had no stable construction in late postoperative period. 17 patients showed complete recovery of the height and form of the broken vertebra. So, transpedicular fixation may be success-fully used in patients with thoracic and lumbar fractures (A and B type). Anterior technologies are rational for patients with fractures of B type with destruction of a disc and C type of fracture.

39-42 233
Abstract

The authors have kept 182 patients aged 5-17 suffering from tumors and tumor-like masses in the ovaries under observation. They most often diagnosed retention cysts which had tendency towards regression without any surgical procedures. Among the true tumors, germinogenous ones and serous cystadenoma were predominant. Malignant tumors were detected at three observations. If there was a necessity to remove tumors, both lowtraumatic laparoscopic operations aimed at tumor enucleating and cyst punctures were preferable even in cases of emergency. Thus, in authors' opinion, as to young patients all ovary operations must be only performed by strict indications to a maximum sparing extent, as any resection of ovary results in ovarian reserve loss and reduction of generative function in the future.

42-45 251
Abstract

The authors have examined 128 patients aged 20-64, suffering from somatoform vegetative dysfunction. The disease arose from psychic trauma. Vegetative abnormalities manifested themselves as both paroxysmal and permanent disorders. In 38 cases the authors observed predominant cardiovascular system involvement, while in 49 cases it was respiratory system involvement, and in 41 cases — gastrointestinal tract involvement. Predominant involvement of different systems determined peculiarities of clinical presentations of somatoform dysfunction.

46-49 220
Abstract

The paper provides analysis of oncological morbidity among the inhabitants of the Primorsky Region of the Russian Federation which testifies the overall unfavourable situation. The authors point out that an obvious increase in the sickness rate results from man-made atmospheric air, water and soil pollution, as well as from increased harmful effect of motor transport on the environment of the large inhabited localities. Specific character of the oncological pathology arises from the ecosystem stress which depends on whether there are any large-scale plant facilities in the territory or not.

49-51 228
Abstract

The paper provides etiological description of community-acquired pneumonia at young people in closed groups (armed forces personnel), as well as analysis of pathogenicity, virulence and persistence factors of the aforementioned microbe strains. The authors have studied serotype parameters of pneumococcus strains among patients suffering from community-acquired pneumonia and healthy young people during group formation and in the course of military service, making estimate of their differences in the virulence and persistence factors activity. According to the findings, increase in pneumococcus strains of 14, 6B, 23 serotypes was observed among the suffering patients, while 1, 14, 23, 18N and 19F serotypes were detected among the healthy people during the first year of the service, and their replacement by 23, 9, 14, 15, 19F and 6 A serotypes occurred in the course of the second year.

52-54 275
Abstract

Duplex scanning — informative and non-invasive method in diagnosis of pathology of brachiocephalic arteries in the presence of hypertonic disease. By the method of the ultrasound duplex scanning was estimated condition of the extracranial level of the carotid and vertebral arteries. There were observed 80 patients suffered from arterial hypertension. There was revealed the complex of structure and hemodynamic alterations of the brain vascular system with estimation of cerebrovascular reactivity.

55-58 226
Abstract

The authors share their experience in application of surgical stapling instruments during resections of large intestine and pay special attention to the advantages of the machine stitch. They also lay bare some errors associated with wrong mobilization of the bowels, wrong choice of surgical stapling instruments, as well as technical mistakes and mistakes in choosing surgical appliances. Furthermore, the authors point out the difficulties that are likely to arise due to inadequate development of medical care both in Primorye and in Russia, but they come to a conclusion about good prospects when using surgical stapling instruments in surgery.

58-61 256
Abstract

The paper provides experience of surgical treatment administered in Clinic of Children Surgical Diseases of the Vladivostok State Medical University to 127 children and adolescents aged 1-14 suffering from portal hypertension. Under such conditions application of splenorenal anastomosis is considered to be a preferable procedure. In author's opinion, splenectomy does not apply to children. Under splenomegaly and hypersplenism the operation of choice is resection of spleen. Application of the mesentericoportal shunting in the Clinic is very promising, especially in cases of anhepatic portal hypertension.

61-63 212
Abstract

The authors have examined 75 patients aged 37-79 suffering from acute coronary syndrome, including 22 cases of instable angina pectoris, 29 cases of large-focal myocardial infarction, and 24 cases of microinfarction. Control group was comprised of 20 healthy persons of the same age and sex. The vasomotor function of endothelium was estimated by using noninvasive ultrasonic method depending on how brachial artery responded to reactive hyperemia and nitrate intake, while the nitric oxide-producing function of endothelium was determined by nitric oxide metabolite content in blood serum. The patients suffering from the acute coronary syndrome had the nitric oxide-producing endothelial function disturbed. At the same time the state of the vasomotor and nitric oxide-producing endothelial functions did not detect any abnormalities of the parameters under examination at patients with unfavorable outcomes of the acute coronary syndrome.

METHODS

64-65 249
Abstract

The most radical surgery as to patients suffering from liver cirrhosis associated with portal hypertension is transplant operation. When there is no possibility to perform this procedure it is recommended to carry out partial resection of spleen that may result in reduction of portal hypertension, prevention of esophageal bleedings, and relief of secondary hypersplenism effects. Collateral circulation allows maintaining the decompression effect for a long time. The authors who have been earlier performed four such surgical procedures with good follow-ups describe this surgical technique in this paper.

PRACTICE OBSERVATIONS

65-67 247
Abstract

The paper describes two cases of human stomachic anisakiasis. The infection was got by eating low-salted fish. The authors point out high infectiousness of the fish and squid living in the Far-Eastern seas by nematodes of the Anisakidae family and give recommendations how to diagnose and cure this human disease.

PUBLIC HEALTH ORGANIZATION

68-71 280
Abstract

Maternity and childhood protection is nowadays one of the priority directions in the development of the public health system. Genetic consultation is one of the units being a part of the maternity and childhood protection system whose development is defined as a priority line in most countries of the world. The authors analyze the activities of the genetic consultation in Primorye and point out the increasing number of families coming to consult a geneticist over the last five years. This situation may be explained by two reasons: doctors and population's awareness of genetic consultation activities and its accessibility. The authors also emphasize the increasing number of pregnant women seeking genetic care including invasive prenatal diagnostics (placentocentesis, chorion biopsy, chordocentesis, and amniocentesis) that is the second level of the examination. On the whole, by authors' estimate, Primorsky genetic consultation is available, all-inclusive, very promising unit in the maternity and childhood protection system which can render aid required by patients in most visits to the doctors.

71-73 195
Abstract

The paper provides generalized results of the activities of the Family Planning Center that is a part of the Regional Clinical Center of the Maternity and Childhood Protection (Vladivostok). In the course of examination of 2537 infertile married couples the authors very often diagnose male sterility that is all-important problem having direct impact upon demographic setting in Primorye. According to the authors' data, effectiveness of artificial insemination and other procedures aimed at sterility healing amounts to 13%. The authors bring to the forefront the necessity both to improve available techniques and to develop new methods to deal with this socially significant pathology.

73-76 290
Abstract

The authors have studied 300 cases of atopic dermatitis at children being at the age of 3 — 18. Based on the medical documentation analysis and questioning, they ascertained high cost of the disease both for the family and the state. Structure and amount of costs depended on duration and severity of the disease. On the whole, the authors point out that atopic dermatitis has negative impact upon life quality of the patients and their families, nevertheless there is a need to carry out further pharmacoeconomic researches.

PEDAGOGY

76-79 199
Abstract

The paper provides experimental data on researching into the peculiarities of thinking in the changed consciousness states. On mastering the "self-immersion" method, the experiment participants — students — give written answers about their physiological parameters relating to the functioning of the organism. The author adduces generalized parameters of the peculiarities of thinking in the changed consciousness states and shows very promising prospects when using this method in the course of education in the institutions of higher education and during self-instruction.

79-82 210
Abstract

Effective activity of the medical college teaching staff depends both on the level of educational potential and professional pedagogical skills. Excellent qualification of the teaching staff may be attained by implementing professional development system at three levels: inside the sub-faculty, within the institute, and between different institutes. Pedagogical training of the teaching staff in the context of modernization of higher medical school is characterized by continuity and andrological principles. Among the criteria that may testify the effectiveness of the professional development are professional competence, reflective activity, pedagogical consciousness and thinking, personal and professional development.

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ISSN 1609-1175 (Print)