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Biomedical subjects

V D Fedorov

Publications and source records attributed to V D Fedorov.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Infection in burn patients: the problems of pathogenesis, prevention and treatment].

Urgent issues of pathogenesis, prophylaxis and treatment of infection in patients with thermal injuries are considered. Analysis of the results of multifactorial dynamic examinations of immunological reactivity and nonspecific resistance of 198 burnet patients is presented. For the first time a substantial decrease of B-lymphocytes count in normal or elevated level of immunoglobulins of the main classes is shown as well as a decrease in plasma fibronectin content. Lowering of T-lymphocytes content and polymorphonuclear leucocytes function disturbances, dominant role of St. aureus and P. aeruginosa in etiology of infections in burnt patients and high antibiotic resistance of these microorganisms are demonstrated. Pathogenetic substantiation of combined therapeutic usage of thymus and interferon preparations and when indicated--immunoglobulines is recorded. Positive experience in application of recombinant interleukine-2 (Ronkoleukine) is outlined. The data are provided on advisability of application of new cephalosporines and fluorine-quinolones for antibiotic therapy and prophylaxis in the burnet. In complicated forms of gram-negative infections the combination of aminoglycosides with ureidopenicillines or cyprofloxacine is recommended, in infections provoked by polyresistant strains of S. aureus vancomycin is indicated. With prophylactic aim in case of early surgical treatment it is recommended to apply modern antibacterial preparations with broad spectrum of action. Prophylaxis of hospital infections inpatients of specialised clinics for the burnt is discussed.

Anti-Bacterial Agents↗
PubMed1999

[Leiomyomas of small bowel].

The analysis of our own country and foreign literature, devoted to the problems of clinical aspects, diagnosis and treatment of leiomyomas of the small bowel for the last 48 years has been carried out. The authors present their personal experience in follow-up of 6 cases of the small bowel leiomyomas, the main clinical manifestations of which being recurrent intestinal bleedings and in lesser degree--small bowel obstruction. The results of preoperative examination evidence that besides thorough physical, endoscopical and ultrasound examination the necessity may arise to use for diagnosis angiographic and computed-tomographic methods. The subject of special attention of each clinical physician should be the danger of malignant transformation of benign leiomyomatous neoplasms of the small bowel, which the authors encountered in 2 patients.

Adult↗
PubMed1999

[Recurrent profuse hemorrhage in gastric angiodysplasia].

Dieulafoy's disease--i.e. arteriovenous malformation--is a rare cause of gastric bleedings, which makes up 1.5-3% of all sources of hemorrhage. All the armory of diagnostic modalities may require to reveal arteriovenous malformations. Angiography of the stomach appeared to be the most informative method for diagnosis of this disease in 2 patients. Radical treatment of patients with Dieulafoy's disease implies resection of the proximal part of the stomach or gastrectomy. Endoscopic hemostasis (with the use of coagulation and injections of sclerogenous preparations around the diseased area) results in temporary effect.

Adult↗
PubMed1999

[Place of laparoscopic surgery in the treatment of gastroesophageal reflux].

62 patients (57 females and 5 males, mean age 42.3 years) with gastroesophageal reflux disease were treated and followed up in the A.V. Vishnevsky Institute of Surgery. The diagnosis was established at endoscopic examination, which revealed esophagitis of the 1st degree in 39 patients, of the 2nd--in 20, of the 3d--in 2 and of the 4th--in 1. Roentgenologic examination of the esophagus and the stomach revealed manifestations of the reflux in 43 patients, hernia of the esophageal orifice (of the diaphragm)--in 27. According to esophageal manometry data, basal pressure in the area of the lower esophageal sphincter made up 9.8 +/- 5.7 mm Hg; in 24-hour pH-metry the index of the De Meester exceeded normal 4-5 times and made up 61.1 +/- 33.8. All the patients have undergone a course of conservative antireflux therapy which in the majority of patients resulted in temporary improvement. Laparoscopic operations were carried out in 41 patients (fundoplication by Nissen--in 32, Toupet procedure--in 4 and--by Dor--in 5). In 23 patients cruroraphy and in 32 cholecystectomy have been performed. The patients were followed up from 1 to 36 months. In the majority of them the results were good and favourable.

Adult↗
PubMed1998

[Spiral computer tomography in diagnosis of hepatic diseases].

Spiral computer tomography (SCT) is a new method of computer tomography by which, in contrast to conventional CT, the information about absorptional capacity of tissues is obtained without omission of images which makes it possible to build MPR and 3D of a very high quality. 205 patients with diseases of hepatopancreatoduodenal area were examined, in 189 patients the diagnosis being verified. Optimal technique of intravenous bolus contrasting in SCT was developed. Using various time interval between the start of the scanning and the beginning of infusion of contrast media, it is possible to obtain primary image of the arteries (arterial phase of contrasting, time of delay 18-25 sec.), the picture of veins and the image of saturation of hepatic parenchyma--(venous return phase, time of delay 60-80 sec.), to reveal characteristics of contrasting of the liver masses during delay (8-15 min) phase. The largest quantity of masses are revealed in arterial phase of contrasting. Specific features of contrasting in hemangiomas and malignant tumors of the liver has been revealed. Hemangiomas absorb contrast medium already at the early phase as hypercontrasted lacunas in an outlying areas, at a late phase they are hyperdenced in relation to hepatic parenchyma. Primary and metastatic tumors of the liver accumulate contrast medium in an early phase along the whole area and quickly lose contrast medium during parenchymal phase. The method of contrast intensification enables evaluation of interrelation between tumor and vessels, to determine passage of hepatic arteries and branches of portal and hepatic veins, to visualise choledochal duct, to determine the distance between hepatic and tumor surface, and to produce these data as a view of multiplanar and three-dimensional image (reconstruction). The effectiveness of obtained reconstructions in planning of the extent of surgical intervention is demonstrated.

Contrast Media↗
PubMed1998

[Ultrasonic study in thoracoscopic operations].

Intraoperative ultrasound diagnosis (IOUSD) was made in several thoracoscopic interventions in 15 patients: diagnostic thoracoscopies (3) in patients with lymphogranulomatosis, carcinoid and peripheral lung cancer, enucleation and atypical resection of the lung (4) in patients with hamartochondromas, in excision of lung cyst (1), in removal of foreign body of the lung (1), in removal of celomic cysts (2) and in ablation of neurofibroma of the mediastinum (1), in atypical resection of the lung and enucleation of tuberculomas (2). Video thoracoscopy in combination with intraoperative ultrasound examination provides possibility for precisional diagnosis of focal disease of the lung and mediastinal organs, including local masses of small sizes, and is rather informative method of diagnosis. IOUSD allows to define the diagnosis more exactly and to determine the extent of pathological process, to prevent complications and locate intraparenchymal masses and foreign bodies in lung tissues, and thus enables to complete operation without thoracotomy.

Cysts↗
PubMed1998

[The concept of the clinical use of serotonin adipinate in treating surgical patients].

The influence of serotonin adipinate on the mechanisms of development of tissue hypoxia, disturbances of the microcirculatory bed and smooth muscles before, during and after operative interventions was studied in experiments and clinical practice. The syndrome of serotonin insufficiency is described including smooth muscle insufficiency which can be abolished by serotonin adipinate administered at the early postoperative period irrespective of the cause of surgery, age and sex of the patient. Good results were obtained in treatment of patients after operations on the liver, pancrease, heart, in patients with the diabetic foot and in other diseases. No complications or lethal outcomes resulting from using serotonin adipinate were noted.

Adipates↗
PubMed1998

[Diagnosis and treatment of leiomyosarcomas of inferior vena cava].

3 clinical cases and literature data, illustrate effective diagnostic and surgical policy in patients with uncommon type of tumor. Two patients were previously operated in other clinics, but the operations were diagnostic because the tumors were estimated as being inoperable. In all 3 patients radical operations were carried out with resection of infrarenal segment of inferior cava vein without its prosthetic reconstruction. In did not result in substantial blood flow disturbances, because before the operation it was known about the presence of well functioning collaterals. The significance of ultrasound examination, especially duplex scanning, computer tomography and angiography (cavagraphy) is emphasized. Favourable results of treatment, especially conclusion of the tumor resectability are more common in specialized institutions.

Aged↗
PubMed1997

[Should a doctor be insistence in proposing surgery for cancer?].

On a basis of a large personal experience in treatment of patients with gastro-intestinal cancer the author considers the expediency of convincing patients in surgical treatment of gastro-intestinal cancer, especially in the new social situation in Russia. Positive experience in long-term follow-up (more than 10-20 years) of patients, operated on because of cancer, is one of pro factors for such a convincing. The results of long-term follow-up (exceeding 9 and 25 years) of the patients operated on in gastro-intestinal cancer (including primary-multiple cancer); the clinical case of a patient, who was operated for several times at the period of 13 years-10 malignant tumors were removed from his body; the clinical case of a patient, who was operated in case of 3 sinchronous cancers (cancers of pancteatic head, rectum and ascending colon) illustrate the benefit of the operative intervention.

Episode of Care↗
PubMed1997

[Laparoscopic surgery in gastroenterology].

The present status of gastroenterological laparoscopic surgery in Russia is comprehensively analyzed. Based on the generalized data obtained by 11 leading clinicians of the country, the authors in detail consider the feasibilities of endoscopic techniques of surgical gastroenterology, the proportion of each nosological entity in the total statistics of laparoscopic operations. A description is given of the following endoscopic interventions: cholecystectomy, choledocholithotomy, biliodigestive anastomoses, vagotomy, perforated ulcer suture, antireflux operations, gastrectomy, sigmoidectomy, right-sided hemicolectomy, rectal surgery, appendectomy, Meckel's diverticulum removal. By using the cumulative experience gained at short-term endoscopic surgery in Russia, the authors conclude that the new technique is promising during most surgical interventions in gastroenterology.

Cholecystectomy, Laparoscopic↗