Biomedical subjects
Publications and source records attributed to V D Fedorov.
The authors present an original experience of using an ultrasonography and a computer scan for a preoperative diagnosis of VP mucocele. The laparoscopy has been used as a method for the final diagnosis as for an appendectomy. The authors also describe their understanding of VP mucocele pathogenesis and their opinion about diagnosis and treatment of such kind of a case.
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The paper gives evidence for the fact that serotonin and serotonin receptors are responsible for the occurrence of primary contractions of smooth muscles, primary cardiac contractions and primary brain electric activity (EEG genesis). It is concluded that the function of the smooth muscle, brain and heart cannot take place without serotonin and its receptors. This suggests that the serotonin receptors are life ones.
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The previously unknown properties of ferroproteins (hemoglobin and myoglobin) to cause smooth muscle spasm and to accelerate platelet degradation are described in the paper. Ferroproteins are shown to interact with some serotonin receptors. Some serotonin receptors of smooth muscles and platelets which hemoglobin and myoglobin interact with are termed serotonin-ferroprotein receptors (S-Fe-pr-receptors). The found properties of ferroproteins provide a deep insight into the understanding of physiological and pathophysiological processes with the participation of hemoglobin, myoglobin, platelets, smooth muscles, serotonin, and serotonin receptors.
The paper outlines the previously unknown smooth muscle insufficiency in terms of its etiology, pathogenesis, diagnosis and treatment. It has been shown that drug administration leads to smooth muscle insufficiency which is eliminated by serotonin both in vitro and in vivo. The clinical manifestations of smooth muscle (SM) insufficiency are eliminated by serotonin, irrespective of whether it has been caused by the use of drugs or impaired smooth muscle innervation. The mechanism of vascular rhythmic oscillations in the microcirculatory bed, the so-called endogenous vasomotility (EV) has been decoded. The mechanism of EV regulation is due to the fact that platelets constantly (continuously) adsorb serotonin from the enterochromaffin cells of the gastrointestinal tract and constantly (continuously) release it into the microcirculatory bed, thereby providing the continuum of entry of the stimulant to the SM fibers which are able to contract at this time. The summation of these contractions of smooth muscle contractions in the microcirculatory bed maintains their vascular tone and yields the pattern of EV. The paper also describes the earlier unknown properties of hemoglobin and myoglobin to cause smooth muscle spasm and to accelerate platelet destruction. A correlation between the EV and vascular platelet hemostasis is described in terms of these properties. The continuous mechanism of EV is impaired and it transforms to intermittent (final) vascular platelet hemostasis.
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Combination of severe purulent processes (peritonitis, phlegmons, and extensive wounds of the abdominal wall), eventration, and complete high unformed intestinal fistulas leads to rapid hemostasis disorders and emaciation. In nonoperative treatment lethality reaches 70%. Complete bilateral disconnection of the fistula bearing intestinal loop is the operation of choice in such situations. In this case the length of the disconnected intestinal segments may be two thirds of the length of the jejunum and the greater part of the colon. The results of morphofunctional study of an intestinal segment disconnected for a long period are analysed. The tactics of active surgical treatment is illustrated by clinical cases.
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Compensation of the functional condition of the liver after its resection is determined by the volume and structural changes of the remaining part of the organ and the injuriousness of the intervention rather than by the character of the affection; adequate and stable restoration of the function of the organ occurs in 12-18 months after extensive resections of the liver and in 2-4 months after economical resections. The parts of the liver remaining after extensive resection become sharply enlarged (by 100% and more) in the early postoperative period (up to 3 weeks) and then reduce gradually in 6-12 months to the size of the uninvolved parenchyma. In concurrent cirrhosis of the liver, complete restoration of the volume of the organ does not occur, the dynamics of the restoration of hepatic function is slowed down, and the terms of rehabilitation of the patients increase. Resection of the liver in humans is attended by marked activation of the processes of regeneration, which is manifested by hypertrophy of the cells and their nuclei, hyperplasia of the intracellular structures, providing for compensation of the disturbed functions of the organ. Removal of the pathological focus leads to abatement and disappearance of the inflammatory infiltration.
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Catheterized balloon mitral valvuloplasty was carried out in two females with rheumatic mitral stenosis on the 28th and 24th weeks of pregnancy. The operation on the first patient was performed at the beginning of the development of pulmonary edema. Treatment produced good results in both cases. The surface of the mitral orifice increased from 1.5 and 1.6 to 3.2 and 3.5 cm2, the pressure gradient between the left atrium and left ventricle reduced from 40 and 30 to 6 and 4 mm Hg. There was attended by disappearance of the diastolic murmur and the clinical manifestations of congestion in pulmonary circulation in both patients. Mitral regurgitation did not occur after the operation. Radioscopy lasted 20 and 33 minutes. Protective screens were used to protect the fetus from direct exposure to X-ray. Pregnancy terminated at full term by spontaneous delivery in both patients. The babies, both girls, are healthy. Catheterized balloon mitral valvuloplasty does not yield to closed mitral commissurotomy in efficacy. The mild character of injury inflicted during the operation and no need for general anesthesia make this intervention most preferable in female patients with mitral stenosis during pregnancy.
The article analyses the efficacy of extracorporeal lithotripsy by a LT-01 piezoelectric lithotriptor (EDAP, France). A total of 72 lithotripsy sessions were performed on 37 patients, in 2 of them who suffered from chronic calculous cholecystitis the procedure was conducted on the day before the operation. As a method for treatment, extracorporeal lithotripsy was applied in 35 patients for the following indications: solitary and multiple stones measuring in sum no more than 3 cm in the satisfactory functioning of the gallbladder and patency of the bile ducts. In 35 patients the stones were crushed to fragments of various size. In 29 patients extracorporeal lithotripsy produced a marked effect and was the final method of treatment. Six patients were operated on (cholecystectomy) due to exacerbation of chronic cholecystitis in 4 patients, pancreatitis in one patient; total destruction of calcinated large stone fragments could not be achieved after 6 sessions in one patient.
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The work is based on the analysis of the results of surgical treatment of inguinal hernias in 198 patients in the period from 1983 to 1988. Most of the patients were over 60 years of age, a lesser number were under 35 (11.1%). Hernias of a complicated and transitional form were found in 174 patients and mild forms only in 24 patients. The hernias were recurrent in 45 and sliding in 59 patients. Proceeding from the specific features of the surgical anatomy of the inguinal space, all patients, irrespective of their age and the form and type of the hernia, were treated by operation with plastics of the opening of the hernial sac to the back of the elements of the spermatic cord. The only exception were patients under 35 years of age with a mild form of oblique inguinal hernia, in which case variants of operations with enforcement of the anterior wall of the inguinal canal were carried out. The Schouldies and McVay methods were preferred, in recurrent and all complicated forms of inguinal hernias they were combined with operations of the Endrews and Postempsky types; the last named was mostly used in individuals over 60 years of age and in repeatedly recurring hernias. The late-term results were studied in follow-up periods of 2 to 7 years in 176 patients in the group of 198 individuals who were operated on. In 77.7% of them 3-6 years have passed since the operation. Almost all patients of mature age have resumed their occupation, there are complaints neither of pain at the site of the operation nor of changes in sexual potency. Recurrent hernias were not detected.