Biomedical subjects
Publications and source records attributed to N A Brazhnikova.
The data on frequency, location and pronouncement of pericholedochal lymphadenitis in complicated forms of chronic opisthorchiasis requiring surgical correction have been summarized. Pericholedochal lymphadenitis is caused by infection in the bile ducts which is the most frequently noted in cholestasis. The authors recommend to perform external drainage of the bile ducts with the aim of their sanation.
The authors have observed 10 patients with opisthorchiasic cysts of the liver. These cysts are multiple and disposed mainly in the left lobe of the liver. Sonography and laparotomy are expedient methods for diagnosis of the disease. Operations were performed on 7 patients and gave good immediate and long-term results.
The authors observed 24 patients with opisthorchiasis and 14--with nonparasitic cysts of the liver. No essential differences in the tactics of surgical treatment of these cysts were noted. In medium-size and large cysts, the operative treatment--excision of cystic walls with omentoplasty, liver resection--is recommended; in small opisthorchiasis and nonparasitic cysts--dynamic observation with the performance of ultrasound scanning.
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Purulent cholangitis was found in 128 (44.6 per cent) of the 288 patients operated on for complicated forms of opisthorchiasis. Mechanical cholestasis due to sclerotic changes in the bile ducts, major duodenal papilla and pancreas is the most responsible factor in disease prognosis. Esophagogastroduodenoscopy, ultrasound examination, intra-operative cholangiography and fibrocholedochoscopy are used for diagnosis as well as study of bile microflora in the common bile duct. The acute form of purulent cholangitis was attended by acute liver insufficiency in 42.4 per cent of the cases; fatal outcomes took place in 8.2 per cent. Cholecystectomy must be supplemented by the restoration of passage of bile in the duodenum with external drainage of the bile ducts to eliminate bacterial flora and helminths.
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The effect of immunosorption on the state of the membranes of immunocompetent cells playing an important role in numerous links of pathogenesis of disease was studied in 11 patients with bronchial asthma (atopic form). Two biophysical methods were employed: a fluorescent probe (a chlorotetracycline probe) and hemiluminiscence. A preliminary study showed noticeable changes in the state of cell membranes in patients with atopic bronchial asthma and aggravation of pathological changes caused by a specific allergen. Extracorporal immunosorption produced a positive effect on the state of the membranes of immunocompetent cells and a decrease in their sensitivity to a specific allergen in patients with the atopic form of bronchial asthma.
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