Abstracts
Kazan Medical Journal
2000 N5.
CONTENTS
STRUCTURAL STUDIES OF FIBRINOLYSIS: HOW TO DISASSEMBLE THE CLOTFibrin is degraded by the fibrinolytic system wich a plasminogen activator converts plasminogen to plasmin, a serine protease that cleaves specific bonds in fibrin leading to solubilization. To elucidate thå biophysical processes involved in conversion of insoluble fibers to soluble fragments, fibrin was treared with either plasmin or the combination of plasminogen and its activator, and morphologiñ changes werå observed using scanning electron microscopy. Initial changes in the fibrin matrix included creation of many free fiber ends and gaps in the continuity of fibers. With more extensive digestion, free fiber segments associated laterally, resulting in formation of thick fiber handles. Supernatants of digesting clots, containing soluble derivatives, were negatively contrasted and examined by transmission electron microscopy large complex fragments containing portions of multiple fibers were observed, as were piaces of individual fibers and smaller fragments. Some large fragments had sharply defined ends, indicating that they had been cleaved perpendicularly to the fiber direction. Other fibers showed splayed ends or a lacy meshwork of surrounding protofibrils. Fibrinolysis was also followed by confocal microscopy of plasma clots labeled with colloidal gold, so that changes at the lysis front of hydrated clots could be examined in real time. Clots made up of thin fibers were cleaved more slowly than clots made up of thick fibers, even though individual thin fibers were cleaved more rapidly. These results indicate that fibrinolytic degradation results in larger pieces than previously identified, and that plasmin digestion proceeds locally by transverse cutting across fibers rather than by progressive cleavage uniformly around the fiber. A model is proposed for the crawling of plasmin across fibrin fibers. POLYSYNAPTIC REFLEX COMPLEXES IN CLINICAL NEUROLOGYThe results of the study of spinobulbospinal reflex during 25 years in healthy people and in various nervous system diseases with affection of afferent and efferent systems, subcortical formations of brain and muscles (facial muscle contracture, miofascial pain syndrome) are given. It is shown that the inconstancy of many reflex characteristics (latency, amplitude, response duration, manifestation) is its basic property in normal conditions. In central nervous system pathology the stabilization of the mentioned parameters comes showing disorder of the program of formation and performance of motion. SOME MORPHOMETRIC PATTERNS OF LIQUOR CIRCULATION DISORDER IN PATIENTS WITH SYRINGOMYELIAThe results of morphometric examination of 98 patients with syringomyelia are given. The combination of syringomyelia with various degree of cerebellar tonsil falling is established. The comparative analysis of subarachnoid space sizes on the level of the posterior cranial fossa and craniovertebral passage in patients with syringomyelia and cerebellar ectopia of various degree as well as in patients without tonsil ectopia and control group is performed. The morphometric patterns of liquor circulation disorders are established. DYNAMICS OF PSYCHOVEGETATIVE DISTURBANCES IN MODERN WAR PARTICIPANTSTwenty modern war participants who have had a mild brain trauma in Afganistan war were engaged in 7,00±0,30 year follow-up study. The basic vegetative state, regulatory brain system function, emotional state (MMPY, Scmiscek-Litman test, Spilberger ques-tionnaire) were investigated in the follow-up study. The increase of nonspecific brain structure dysfunction clinical characteristics: suchas vegetative dysfunction with elevation of sympathetic activity and emotional shift to depressive and hypochondric disturbances was found. LEÅVEL OF ANTIBODIES TO CÍLAMYDIA PNEUMONIAE AND MYCOPLASMA PNEUMONIAE AMONG PATIENTS WITH BRONCHIAL ASTHMAThe level of antibodies to chlamydia pneumoniae (Cp) and Micoplasma pneumoniae (Mp) in 65 patients with bronchial asthma in the clinical remission phase is studied. To reveal antibodies to Cp the indirect immunofluorescence reaction was used, to reveal antibodies to Mp the indirect immunoenzymic analysis method was used. In diagnostic titer the antibodies to Cp were found in 23 patients and antibodies to Mp were found in 25 patients (38%) of 65. In 6 (9,2%) of them the antibodies to Cp were also determined. In patients of seropositive and seronegative groups the differences on some anamnestic and laboratory data, accompanying somatic pathology in medical complex were revealed. ROLE OF BRACHYTHERAPY IN THE TREATMENT OF TUMORS OF TRACHEA AND BRONCHIThe original methods of the radical and palliative endobronchial and combined radiation treatment of patients with primary and relapsing cancer of trachea and bronchi and the approaches to the calculation of dosimetric radiation plans are developed and suggested. The possibility of combining endobronchial radiation therapy, distance radiation therapy and laser destructionof the tumor. is studied. The indications to endobronchial radiation therapy are formulated. The suggested method of the endobronchial and combined radiation treatment significantly extended the possibilities of organsàving treatment of patients with primarily multiple metachronous and synchronous cancer and made it possible to formulate the new approaches to the radical treatment of patients with locally spread cancer of trachea. TEMPORAL ELECTROCARDIOSTIMULATION AFTER HEART CURGERY UNDER ARTIFICIAL CIRCULATIONOn the basis of 93 observations the conclusions on the indications to the temporal postoperative electrocardiostimulation are made. It is established that it should be carried out in bradyarrhythmia. In cardiasthenia not connected with conduction disorders, electrocardiostimulation is not effective. Temporal epicardial electrodes should be sutured both in the stable and in transitional transversal heart block as well as for prevention in traumatic manipulations in the conduction tract zone because of danger of the "late" block occurrence. Duration of the temporal electrocardiostimulation should not exceed nine days. It is necessary to implant the constant electro-cardiostimulator in the traunsversal heart block being retained more than nine days. CLINICAL CHARACTERISTIC OF STAPHYLOCOCCIC INTESTINE DYSBACTERIOSIS IN CHILDRENThe variants of the course of staphylococcic intestine dysbacteriosis in 264 children aged one month to 7 years are studied. In babies with decreased colonizational resistance the pathogenic staphylococcus contamination in 79 - 92,3% of the cases is accompanied by the clinical infection symptomatology of gastroenteric tract and various extraenteric manifestations. In children over one year the given microbiocenosis disorder variant in 45 - 59,5% of the cases takes the course of asymptomatic bacteria carrier Saureus in intestine. Subcompensated forms are characterized by moderately pronounced clinical symptomatology. The infants infected by pathogenic staphylococcus in the first months of life are subjected to the development of allergodermatoses, staphylococcic infection, hypotrophy and anemia. CLINICAL VARIANTS OF THE NONERYTHEMATOUS FORM OF IÕODE ÂITE BORRELIOSESThe patients with the nonerythematous form of borreliosis (83 persons) were observed in the epidemic seasons of 1997-1999. The organ pathology often develops on the background of the general infections syndrome. The clinical variants of the early period are described: arthromyalgic, similar to influenza, regional lymphadenitis, neurologic, cardiovascular, hepatitis, mixed. SURGICAL TACTICS IN CLOSED INTESTINE INJURIESThe results of surgical treatment of 64 patients with closed intestine injuries: duodenum traumas (17), small intestine traumas (39) and closed large intestine traumas (8) are presented. During operative interventions in patients with duodenum injuries after the defect suture it is obligatory to carry out the prolonged nasoduodenal intubation and decompression, wide drainage of the retroperitoneal space, abdominal cavity. In the cases of injuring more than 1/3 of the circumference it is necessary to form duodenojejunoanastomosis or to take duodenum out of the passage. In large intestine injuries the operative intervention is carried out in two stages. NEW EVISCERATION PROCEDURE WITH THE ONE-MOMENT PLASTY OF PELVIC ORGANSThe evisceration procedure of pelvic organs with the one-moment recovery of continuity of the urinary tract and intestine is developed. The work is based on the experience of surgical treatment of 56 patients with locally widespread forms of the pelvic organ cancer after evisceration. The complications after the operation were found in 19 (36,5%) patients, of which 8 (15,3%) patients died. The remote results are studied in 42 patients. The two-year survival rate index was 76,8±1,7%, three-year - 64,1±1,5%, five-year - 49,5±1,5%. In surgical treatment of the pelvic organ cancer the evisceration is an adequate and oncolo-gically justified operative intervention. With the one-moment reconstructive intervention the evisceration makes it possible to reach the optimal results and to improve the life quality of the radically operated patients. CRITERIA OF THE FUNCTIONAL STATE OF INTESTINE AND ENDOTOXICOSIS IN THE TOTAL INTESTINAL INTUBATIONIt is established that intestinal debitomanometry reflects the state of motor and evacuational function of the intestine and can be used as a criterion of the intestinal intubation duration. The ultrasound examination of the abdominal cavity makes it possible to estimate the morphologic and functional state of the intestinal wall in patients with diffuse peritonitis. In this case the intoxication index makes it possible to control and correct the detoxication therapy. The study was carried out in 38 patients aged 42-64 operated for the diffuse peritonitis. The control group consisted of 30 patients operated for the pancreatobiliar zone pathology. NEURAL NOVOCAINE BLOCKADES IN COMBINED TREATMENT OF PATIENTS WITH THE SHIN FRACTUREIn experiments on rats and in examination of two groups of 31 patients the use of novocaine blockades of lumbar sympathetic nodes in the combined treatment of patients with shin fractures on so-called unfavourable levels - on the boundary of the middle and lower third - is well-grounded. Their use normalizes the drainage function of veins and lymphatic vessels decreases the pulse blood flow deficit on the fracture side, improves microcirculation. SUPPURATIVE-INFLAMMATORY COMPLICATIONS AFTER SURGICAL OPERATIONS FOR URINARY BLADDER CANCERIncidence of suppurative-inflammatory comlica-tions after surgical treatment in 618 patients with invasive urinary bladder cancer is studied. The urinary bladder resection is carried out in 306 of them, the cystectomy with various methods of urine removal - in 312 of them. The basic suppurative-inflammatory complications in the postoperative period are acute pyelonephritis and peritonitis. After the urinary bladder resection without ureterocystoneostomy the seirous pyelonephritis is found in 8% of the patients, with ureterocysto-neostomy - in 37,8% of the patients, the purulent pyelonephritis in 10,1% of the patients. The pyelonephritis and peritonitis complicated the course of cystectomy in 19,3% and 22,7% of the cases, respectively. THERAPY STAGES OF NEWBORNS IN WOMEN WITH MICOPLASMA INFECTIONThe state of newborns in women with micoplasma infection is studied to develop the tactics of their management from the first days of life. It is shown that the current antenatal diagnosis, prevention of the perinatal fetus pathology, and adequate therapy in postnatal period promote the significant decrease of residual forms of the micoplasma infection and the prevention of infant disability. EFFECT OF ECOLOGICAL FACTORS ON THE IMMUNE STATUSThe effect of some enviromental factors on the immune status and population health indices is estimated. The study of the immune status can be used as a method to reveal the effect of unfavourable environmental factors on the population health state in order to substantiate and to develop the system of organizational, hygienic and epidemiologic measures. © 1995-2008 Kazan State University |