EDITORIALS
While conducting experiment on rats, the author has inquired into deep burn wounds regeneration in the course of transplantation of allogenic and autogenic fibroblast-like mesenchymalbone marrow stem cells and embryonal fibroblasts onto the burn surface. As is shown, the transplantation lessens cellular infiltration of the wound, as well as accelerates granulation tissue generation. Regeneration processes were well-marked, when using fibroblast-like mesenchymal cells, that is determined by their lesser differentiation, as compared with the embryonal fibroblasts.
REVIEWS
The author analyses the potential and shows the results of the liver transplantation in Republic of Singapore. The paper includes two lines of researches: cadaveric hepatic transplantation and liver transplantation from living donor. 102 transplantations have been performed, including 22 ones from living donors. Donor death-rate was 0,3%. Three recipients perished from venous thrombosis and sepsis. The author draws a conclusion that the liver transplantation from living donor is more expedient and worthwhile. Forecasting the increase in the number of analogous surgeries in the nearest future, he believes that researching and improving the transplantation technique is of great significance.
LECTURES
Based on the data of 2000 observations and literature, the authors examine diverse procedures of surgical treatment of obstructive jaundice. They highlight the up-to-date diagnostics of the diseases, which entail biliary tracts obstruction, and show the potentialities of ultrasonic diagnostics, magnetic resonance imaging procedure and computed tomography. The authors draw a conclusion that developing transcutaneous, video-endoscopic methods and procedures with mini-approach could solve many problems of obstructive jaundice treatment.
ORIGINAL RESEARCHES
The authors described the procedure of laparoscopic application of low colo-rectal and colo-anal anastomosises when operating on account of rectal cancer conducting lymphadenectomies. 7 operations had been performed. Later on, the authors marked all the traditional advantages of the laparoscopic approach and good functional results of the treatment. In the course of a year after the interventions there were no recurrent tumors.
The authors introduced a new method of spleen resection having been used during the experiment. It was carried out so as to specify the probabilities to preserve a part of the spleen on the short stomachal vessels when there is no blood supply from splenic artery, as well as to develop the spleen resection technique preserving its upper pole. The work demonstrates the probability of the reduction of indications for splenectomy under closed injury of the organ at children.
The authors have studied chronobiological features of the beats and ciliary arrhythmia of patients who suffer from ischemic cardiac disease, rheumatism and chronic obstructive lungs diseases using original methodical procedures to analyze electrocardiograms. Having detected essential distinctions in parameters under study for both rhythm disturbances, they showed that at patients having ischemic cardiac disease under extrasystolic and ciliary arrhythmia certain time parameters had corresponded to golden section proportion that had not been observed under rheumatism and lungs diseases. A special emphasis was placed on the necessity of further inquiry into the nature of nosologic chronobiological heterogeneity of heart rhythm disturbances.
Based on the sensitivity and specificity analysis, the authors have estimated the diagnostic value of standard methods of examination applied to the patients with mammary glands diseases associated with the galactorrhea syndrome. As is shown according to the results of the examination of 2277 patients, the diagnostic sensitivity of clinical trial has amounted to 66,4%, mammography — 0,49%, ductography 67,1%, and diagnostic specificity 93,4,99,5 and 87,1%, respectively. Allowing for the fact that none of the methods has had optimal diagnostic value while applying separately, so as to improve the quality of diagnosing it is recommended to use the whole arsenal of diagnostic facilities.
In the present paper the authors, based on the computer-based morphometry of the nucleolar zones, make division of nucleolar-nuclear indices of prostate gland biopsy material epithelium of 183 patients having benign and malignant diseases into 6 groups, which are characterized by certain morphometric histotypes being correlated with concrete clinicopathologic forms. Visual analysis of quantity of nucleolar organizers has indicated their regular increase while passing to higher histotype. The findings testify the high self-descriptiveness of the computer-based morphometry of nucleolar-nuclear apparatus in differential diagnostics of the prostate gland diseases.
The authors analyse the causes of formation of chronic cicatricial stenoses of larynx and trachea and provide the results of treatment of 120 patients. One part of them has undergone a traditional treatment, and the others have been treated by using a new enzymatic drug «KK collagenase» so as to cut short the inflammatory process and perform the wound cleansing. The findings allow recommending it for using in regimens of the measures to prevent from deformation of larynx and trachea at patients being in intensive care department.
The paper is dedicated to the analysis of the changes occurred in diagnostics and treatment of the cardiovascular diseases in the USA over the last ten years. In author-s opinion, the increase in number of off-pump operations in cardiosurgery is associated with the increase in number of the aged among the population at large. Discussing the changes in the role of perfusionist in the present-day clinic, the author states that 40% of doctors specialized in this line of activity have mastered new manipulations so as to enhance their professional potential.
Urodynamic monitoring, which implies uroflowmetering at home and clinical estimation of urinary bladder functions of patients suffering from enuresis, makes for carrying out a selection for surgical treatment and distinguishing patients having mixed type of incontinence. In the latter case it is necessary to perform combination therapy associated with both conservative and surgical methods. Construction of nomograms based on machine registration of parameters allows evaluating objectively the treatment efficiency. Noninvasiveness and absence of contraindications for monitoring open up excellent possibilities of selection procedures that thereby tell on the operative intervention results.
METHODS
Since the actual "Instructions to calculate the cost of medical care" have restricted application, the author describes a new procedure to calculate economic efficiency in the health care service, based on existing methods. The difference is that actually the cost of service time unit is required to be calculated. The author focuses a great attention on the fact that developing new procedures to calculate the economic efficiency in the health care service should take place in parallel with introduction of research protocols on nosologies that will allow achieving major results at all stages of medical care provision.
The author describes the technique of transcutaneous endoscopic gastrostomy. Based on the literature, he examines the indications and contra-indications for this operation and shows the low rate of complications and the simplicity of performance that, in a number of cases, makes this procedure a real alternative to the traditional intervention.
The paper provides the clinicopathologic analysis on the efficiency of ozonotherapy carried out for 72 patients aged 11-18, suffering from thyroid gland diseases. Having used an original method being comprised of intravenous introduction of ozonized physiologic saline and pricking around of gland mass with ozone and oxygen compound, the authors have showed the high clinical efficiency of ozonotherapy under the thyroid gland diseases of children and teenagers. Nevertheless, this issuere-quires further developing.
GUIDELINES FOR PRACTITIONERES
The author presents the clinical situation, which in anesthesiology is referred to as «difficult intubation». Providing the classification of the methods to diagnose this state, he describes the clinical procedures and manipulations that allow avoiding the complications of «difficult intubation», and proposes algorithms to handle patients.
DISCUSSION
PUBLIC HEALTH ORGANIZATION
The authors describe the present-day demographic setting in Primorsky region of the Russian Federation, which is characterized as depopulation associated with the reproduction of population being typical for the countries waging a war for a long while. They show both high death rate among the economically active population and low average forthcoming life interval, and draw a conclusion that the stabilization of the natality, diminution of the mortality and increase of the birth rate are possible when improving the social and economic situation and environment, as well as the quality of public medical care.