Effectiveness of present-day therapy of purulent lesions of the cornea

The treatment of 313 patients (317 eyes) with purulent injuries of the cornea was studied. The medication therapy was found to be effective in 173 patients (176 eyes), which made up 56.2%. The purulent process in the cornea was arrested after the therapeutic penetrating and lamellar keratoplasty in 62 patients (63 eyes or 20.1%). 74 patients (74 eyes or 23.7%) were cured through the loss of an organ: enucleation was made for 63 patients, evisceroenucleation--for 8 patients and evisceration--for 3 persons. Before the onset of purulent pathology, all removed eyes were blind due to different diseases and traumas. Pathomorphological examinations of 63 enucleated eyes showed, in 76.2% of cases, purulent-and-inflammatory changes only in anterior eye segment, and in 23.8% of cases they showed that the purulent process extended into the posterior segment structures of the eyeball; it is noteworthy that the signs of developing endophthalmitis were found only in 6.3% of cases. The obtained morphological data are indicative of that not all therapeutic possibilities were used to preserve the injured but unpromising (in the optic sense) eyes. We conclude that the absolute indication for removing an eye with purulent pathology of the cornea is the generalizing process, i.e. endophthalmitis or panophthalmitis.     

Excision of a recurrent mediastinal cyst through mid sternotomy with high thoracic epidural anesthesia as the sole anesthetic—A case report

Conclusion Our case report highlights the possibility of tackling mediastinal, pericardial and pleural problems with regional anesthesia alone even if the surgery requires opening of the pleura.     

Change in anatomo-functional state of the parenchyma in early unilateral renal cell carcinoma before and after surgical treatment

The aim of the trial was to study compensatory potential of renal parenchyma in the presence of renal cell carcinoma (RCC) and after organ-saving and radical surgical treatment as shown by one-photon emission computed tomography (OPECT). OPECT before the treatment and 6 and 12 months after it evidences that in unilateral RCC, irrespective of the focus location, both kidneys as a single organ respond to tumor growth with compensatory hypertrophy. Compensatory reserve is limited. In tumor size more than 6 cm the affected kidney starts losing the volume of the functional tissue while infiltrative growth is most likely. Assessment of the compensatory potential of the kidneys provides additional information. If the volumes of the kidneys differ by more than 30%, RCC growth is infiltrative. In this case only radical nephrectomy is recommended. If the size of the kidneys is by 60% more than normal one and parenchymas of the affected and contralateral kidney reach their compensatory limit but are equal, indications to organ-saving surgery extend as greater hypertrophy of the remaining kidney is excluded. After organ-saving surgery, a compensatory increase was observed in the contralateral kidney. This is explained by effective distribution of protein material and separate processes of proliferation (healing) and hypertrophy (compensation). Assessment of anatomo-functional condition of renal parenchyma helps better selection of patients for organ-saving surgery.     

Acute scrotum: clinical picture, diagnosis, treatment

The purpose of this study was to evaluate the potentialities of ultrasonic dopplerography and radioisotope scanning of the scrotal organs for the diagnosis of acute scrotal diseases and defining the indications to surgery in patients with acute epididymoorchitis. A total of 128 subjects were examined (23 healthy controls and 105 patients with scrotal diseases). 139 ultrasonic and 76 radioisotope scannings of the scrotum were carried out. Ultrasonic scanning plays the key role in the diagnosis of traumatic and inflammatory epididymoorchitis. Radioisotope study is more informative in the diagnosis of torsion of the testicle. The data indicate high informative value of ultrasonic and radioisotope studies in differential diagnosis of acute scrotal diseases and diseases simulating an acute process in the testicle and appendage. A positive feature of both methods is the possibility of their repeated use for evaluating the treatment efficiency. Analysis of 241 cases with acute epididymoorchitis showed that early surgical treatment of patients with pyodestructive inflammation promotes rapid recovery. Ultrasonic monitoring helps timely detect the complications and correct the treatment strategy. Wide use of ultrasonic and radioisotope methods of examination in patients with acute scrotal diseases promote timely detection of pathological changes and better results of treatment.     

Detection of TT DNA virus (TTV) in blood donors and patients with hepatitis of unclear etiology]

A new human infective agent: TT virus (TTV) has been recently identified. The polymerase chain reaction detected TTV DNA in the sera of 5 (31.3%) out of 16 children with acute hepatitis, 5 (17.2%) out of 29 children and 3 (14.3%) out of 21 adults with liver diseases of unknown etiology, and 18 (13.2%) out of 136 free-of-charge blood donors. These results indicate a high prevalence of TTV infection in Russia and absence of an obvious correlation between this infection and nonA, nonB, nonC hepatitis in examined patients. Phylogenetic analysis of amplified fragments of viral DNA from 3 patients selected at random showed that the isolated strains belong to subtype 1a, most prevalent in the world.     

Activity of monoamine oxidase in the medial preoptic area and median eminence of female rats of different ages

Total monoamine oxidase activity in the medial preoptic area and median eminence (with surrounding tissue) has been studied in female rats of three age groups, viz., those aged 1.5–2 months (peripubertal), 4–5 months (mature), and over 12 months (aging). Monoamine oxidase activity was measured using kynuramine as a substrate and changes in the concentration of product (4-hydroxyquinoline) were recorded at 327 nm. In the medial preoptic area, the lowest activity (nmole kynuramine/min/mg protein, M ± m) was found during the peripubertal period (1.55 ± 0.11), while in mature and aging rats the activities were similar (1.93 ± 0.12 and 2.01 ± 0.15, respectively). In the median eminence, the greatest activity of monoamine oxidase was found in the aging rats (6.61± 0.56), whereas in the rats of peripubertal and mature age the activities were similar (4.79 ± 0.57 and 4.36 ± 0.25, respectively). In animals aged 4–5 months, we found a tendency toward a negative correlation between the activity of monoamine oxidase in the medial preoptic area and the activity in the median eminence. Our results suggest that opposing changes in enzyme activity are necessary for the coordinated work of the monoaminergic systems in the areas studied.