Biomedical subjects
Publications and source records attributed to I D Duzhyĭ.
A rare disease of lungs, leiomyomatosis, is discussed in the article. The author presents pathomorphological changes of lungs, clinical manifestation and course of the disease based on literature data. One interesting clinical observation is given by the author.
Endometriosis is a grave pathological process that comes to be encountered in young women of the reproductive age, and it is not infrequently that it terminates in disability. Apart from genital organs, other organs may be affected by the disease, including those of the thorax. But in proportion of instances the process escapes early diagnosis. In the author's opinion, the reason for the above-said is absence of classification, in view of which fact a classification is suggested that is supposed to advance diagnosis.
Pathogenetical mechanisms of pyopneumothorax formation that cause hypoxia--hypoxemia, decreased cardiovascular function and intoxication have been described. The existing approach leads to the progression of disease, and the majority of patients die within the next 1.5-2 years. The immediate surgery (step-by-step thoracoplasty with modelling of parietal pleura on the terms of pneumoperitoneum) were suggested. Positive statistical data are provided.
The authors submit data from the published literature, showing that endometriosis is a grave disease in young women of reproductive age. The incidence of endometriosis tends to be on the increase. At the same time, cases have come to be seen of polyorgan localization of the process, the thoracal one included. The paper contains a presentation of a case of thoracal endometriosis accompanied by spontaneous pneumothorax diagnosed after her having been ill with the disease for ten years. Arguments are submitted in favour of a pleural investigation to be conducted in patients with spontaneous pneumothorax, which reasoning determines further therapeutic policy in such patients. In the authors' opinion, it is thoracotomy that is to be embarked upon, the volume of intervention being determined by revision of organs of the pleural cavity.
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The causes of spontaneous pneumothorax, methods of its diagnosis are adduced. The results of treatment improvement was promoted by introduction of the proposed algorithm of patient's examination.
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The results of observation of 151 patients with pleural malignant exudate, in 19 of whom the malignant gastric tumors was revealed, were adduced. The peculiarities of the disease diagnosis are depicted.
On the basis of modern ideas of the etiology and pathogenesis of pathologic pneumothorax (PP), its complications and problems arising in this setting, the author presents a critical survey, of existing classifications of pneumothorax. At the same time, proceeding from personal experience (almost 300 patients), the author submits his own classification of pneumothorax that is clear in construction and is easy both to grasp and to use. It is the above classification that helped the author to prevent relapses in PP in all settings except for those where there are contraindications to radical intervention (1.2%).
The described methods for ultraviolet blood radiation were used in 80 patients: 51 had tuberculosis of the bronchopulmonary system and 29 nonspecific pulmonary diseases. A marked clinical effect was confirmed by subjective and objective methods. In all cases blood pressure moderately decreased, there was a tendency to hypercoagulation decline, the erythrocyte count and hemoglobin level increased. The microstructure of blood elements studied by a scanning electron microscope showed formation of the rosette-forming structures in the blood and a significant increase in deformed erythrocytes.
Pulmonary sequestration was observed in 7 patients at the age of from 14 to 46 years. Diagnosis can be suspected in frequently repeated pneumonia without pronounced purulent intoxication and cough with expectoration, which are supposed in patients according to the findings of roentgenologic study. Aberrant vessels deviated from intercostal arteries of the thoracic and abdominal aorta.
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The author submits a clinical observation of a patient who had chronic tuberculous pleurisy complicated by constriction of the root of the lung having resulted in bettolepsy. The paper contains theorization concerning its pathogenesis. An outline of differential diagnosis is given together with surgery indications.
Referring to data from the published literature the authors have given a well-grounded description of the pathogenesis of nontypical neurological symptoms in disorders of the pleura. The presented observations clearly show that there is a possibility for errors to occur in making a differential diagnosis of the medical conditions under consideration.
The author substantiates the difficulty one has in making a differential diagnose of pleural diseases emphasizing the responsibility of the physician since 75% of the above diseases come to be due to tuberculosis and malignant tumors. The use of the proposed 4-stage algorithm-based technology of diagnosis will, the author believes, help in meeting diagnostic challenges, permitting the verification of diagnosis by day 2 to 4 after manifestation of the process.
There is an ever-increasing risk of the pregnant women's developing a specific lesion of the pleura as evidenced by high infection rates (80%) among the adult population. In registering women for pregnancy, taking a history of a contact with a TB person is mandatory as is of a 3-year exposure to those illnesses presenting with paraspecific signs that characterize the pregnant women's having had atypical tuberculous pleuritis (subfebrile condition, the act of breathing-related pain in the chest, unmotivated shortness of breath). In all such cases phthisiological advice is to be applied for with writing it down in the pregnant women's card for adequate (and in some cases preventive) measures to be instituted after labor.
Under conditions of tuberculosis epidemic resective methods come to be used more and more seldom, the causes of which fact being resistance of Koch's bacilli to antibacterial drugs, extension and duration of the process. Collapsosurgical interventions constitute an alternative to resecting methods but such operations are accompanied by complications in 11 to 22 percent of cases. The author suggests that pneumoperitoneum be used to prevent complications developing in thoracoplasty, substantiating his suggestion, validating it by submitting the relevant statistical material.