Biomedical subjects
Publications and source records attributed to S Ivanov.
Renal agenesia was established by antenatal ultrasound diagnosis in 3 cases. The ultrasound image is characterized by the impossibility to visualize one or both fetal kidneys, oligohydramnios, lung hypoplasia and hypotrophy of the fetus. The possibilities for the earliest diagnosis as well as for interruption of pregnancy on account of the lethal outcome of the disease in the newborn are discussed.
On the occasion of three observations of the extremely rare and malignant Burkitt's lymphoma, the authors record their 7-year experience in the operative treatment of 22 patients with non-Hodgkin's malignant lymphomas. Proceeding also from data available in the current literature, the most frequently encountered syndrome-complex is presented, the knowledge of which is of major importance for the early diagnosis, resp. for the results of combined treatment. The possibilities of the operative treatment are evaluated. In the authors' series it was radical in 31.8 per cent of the cases with 13.6 per cent early postoperative lethal outcome and 5.2 months average postoperative survival rate. Proceeding for the rarity of the disease in everyday surgical practice and that it is poorly known, but has become a nosologic entity of increasing interest, the authors have devoted the first part of their article to a discussion on the basic characteristics of non-Hodgkin's malignant lymphomas and the modern achievements of their treatment.
The modern state of the problem and the indications and contraindications for performing transduodenal papillosphincteroplasty are discussed. Personal experience is recorded with 67 transduodenal papillosphincteroplasties, performed for the period 1983-1989, against the background of 1091 operations on the hepatobiliary system, 171 of them on the extrahepatic bile ducts, performed during the same period. Proceeding from their own experience and from available data in the literature, the authors analyse and evaluate the surgical and nonsurgical methods of treatment of benign diseases of the terminal common bile duct and the duodenal papilla, manifested by stenotic lesions. The most important indications and contraindications for applying the different therapeutic methods are adduced. Remarks are made on the technique, which is of major practical importance and the respective conclusion is substantiated.
Some modern aspects of the postcholecystectomy syndrome and the importance of d. cysticus remnant for its arising are discussed. Analysis is made of 13 patients with postcholecystectomy syndrome surgically treated at the Department of Propedeutics of Surgical Diseases, Research Institute of Surgery, over the period 1983-1989. Results are reported of a study of 180 operated patients (cholecystectomized), in in 7.8 of whom low-grade postcholecystectomy syndrome developed. Accent is laid on the importance of the intraoperative diagnosis and on some characteristics of technical nature, requiring precision in processing d. cysticus. Conclusion is drawn, aimed at reducing to a minimum the percentage of postcholecystectomy syndrome.
The author describes medico-social aspects of the family planning, reproductive health of the woman and some problems of the perinatal period of the newborn. Rational planning of the family leads to favourable conditions and possibilities for protection of the health of the pregnant woman, mother and children, for diminution of abortions, for extending natural feeding of the suckling baby. Effects of some factors in active and right family planning and their impact on the health of the woman and on the level of the basic obstetric parameters: maternal mortality, perinatal mortality, sterility, etc. are analysed.
The current status of the problem of nonanatomical liver resections is presented. Some characteristics of the technique applied in them are recorded and the indications for application of the operative technique are specified. Personal five-year experience (1983-1988) with 21 nonanatomical liver resections, applied in gall bladder cancer (4 patients), metastatic tumors (8 patients), high-grade biliary obstruction (7 patients), hemangioma (1 patient) and multiple echinococcosis (1 patient). The early postoperative results were very good, with early postoperative death of one patient. On the basis of these results, the authors advise extension of the indications for application of nonanatomical liver resections.
Explore the source record for details and available documents.
The authors of the article review the state in various European nations and the possibilities for performance of induced interruption of pregnancy. In connection with this they describe the existing various forms of legislation. There are countries, in which induced abortions are absolutely band (Ireland). Legislation of socialistic countries is far more democratic in this respect. There are many factors, on which depend whether to legalize or not induced interruption of pregnancy. In Roman-catholic countries the religious motives are determinant, but in some other countries--the demographic policy of the government, ect. The practice however prove that induced abortions are widely distributes in Europe. The number of registered abortions is quite large in the socialistic countries. The data show that Bulgaria occupies one the first places (61.9% of women). Furthermore there are a series of problems in connection with the formation of high sexual culture of the population. Attention is paid to family planning all over the world. The question about contraception is an important and pressing problem. Good knowledge of current drugs and methods for prevention of unwanted pregnancy and their correct usage leads to a substantial reduction in the number of induced abortions and their unfavourable consequences.
After a brief review on etiology, pathogenesis, frequency, forms and methods for diagnosis, the authors describe their experience in antenatal diagnosis of fetal bilateral multicystic renal disease. Three cases with this disease are reported, diagnosed before delivery with characteristic differential diagnostic criteria. Possibilities for interruption or reaching full-term pregnancy with the described anomalies of the fetus.
The following study shows a syndrome which is commonly not diagnosed by gynaecologists. It was first described from Herlyn-Werner in 1971. In Bulgaria the same was described by I. Karagjosov in 1983 as a part of Herlyn-Werner-Wunderlich Syndrome.
Explore the source record for details and available documents.
For a two-year period (1987-1988) 14 peritoneal-venous shunts with Le Veen's valve were performed in patients with cirrhosis of the liver and ascites. Immediate effect, manifested by decrease in the abdominal circumference and diminution or even complete disappearance of ascites with increased diuresis, was observed in 12 patients. Two patients died during the early postoperative period. The indications, postoperative preparation, operative technique, complications and postoperative care in this type of operative intervention are discussed. Inference is made that the good postoperative results depend on the need patients with refractory ascites to report early enough for operative treatment.
Results are reported of laparoscopic examination of 78 patients with pancreatic cancer. The methods used were laparoscopic inspection and palpation of the pancreas, laparoscopic biopsy by mono- and bipuncture method, laparoscopic inspection and palpation of the organs of bursa omentalis. As a result of these investigations, dissemination outside the pancreas was established in 57 patients (73.1 per cent) in the outpatient services, before entering hospital. The other 21 patients (26.9 per cent) were subjected to radical or palliative surgical interventions. The importance of laparoscopy for evaluation of the operability and for selection of patients, entering surgical clinics, is emphasized.
Experience is recorded with the two-step treatment of 7 patients with acute cholecystitis. The first step in the acute stage comprised unblocking laparoscopic transhepatic puncture of the gall bladder with instillation of hibitan solution and gentamycin in the bladder cavity and subsequent drainage of the subhepatic space. The second step (after 20 days) was that of the radical surgical intervention in a stage of remission (cholecystectomy in 5 patients and cholecystectomy with choledochotomy and extraction of calculi from the common bile duct in 2). The postoperative period was uneventful and the patients were discharged from hospital in a very good state of well-being without any complication. Unblocking laparoscopic transhepatic puncture of the gall bladder with drainage of the subhepatic space proved to be the method of choice for treatment of acute cholecystitis in the acute stage of the disease. Risk operations in this stage were postponed and were performed during the stage of remission.
Explore the source record for details and available documents.
Explore the source record for details and available documents.