[Elimination of late endoleak after endovascular repair of a dissecting thoracoabdominal aortic aneurysm]. / Likvidatsiia pozdnego éndolika posle éndoprotezirovaniia rassloivsheisia torakoabdominal'noi anevrizmy aorty.

Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak. He was subjected to elimination of abdominal aortic dissection and type IIb endoleak with partial prosthetic repair of the descending thoracic portion of the aorta by means of prosthetic repair of the lower thoracic portion of the aorta between the stent graft and linear vascular Dacron prosthesis. The postoperative period was complicated by transient acute renal failure and paraparesis of the lower limbs. The patient was discharged on POD 14, with no endoleaks revealed on control computed tomography 3 months thereafter.

[Disorders of the immune status in patients with acute diffuse peritonitis]. / Narusheniia immunnogo statusa u bol'nykh ostrym razlitym peritonitom.

Analysis of various parameters of the immune system and non-specific resistance in patients with acute generalized peritonitis (AGP) has indicated that in AGP there is immunodeficiency involving all the links of immune defense and non-specific resistance. The T-cell immunity, primarily T helpers, is afflicted in AGP to the greatest extent. A magnitude of decreases in T helper counts may be used as a prognostic indicator in AGP. The severity of immune defense abnormalities correlates with the duration and intensity of intoxication, there is a "paralysis" of this defense in the terminal stage of AGP.

[Detoxication therapy in diffuse suppurative peritonitis]. / Detoksikatsionnaia terapiia pri razlitom gnoinom peritonite.

Results of treatment of 284 patients operated upon for diffuse peritonitis are presented. The assessment is given of the significance of detoxication methods--forced fractionated peritoneal dialysis and washing of the abdominal cavity in treatment of diffuse peritonitis and their influence upon the outcome of the disease.

[Perforation of the small intestine and colon by foreign bodies]. / Perforatsiia tonkoi i obodochnoi kishki inorodnymi telami.

An analysis of diagnostics and treatment of perforations of the small intestine and colon with foreign bodies in 10 patients is presented. Laparoscopy is considered to be of great diagnostic value.

[Peritonitis of appendicular origin]. / O peritonite appendikuliarnogo proiskhozhdeniia

The results of treatment in 2437 patients with peritonitis of the appendicular origin are analysed. The causes of development of this complication, therapeutic aspects and also most frequent tactical and technical errors, made while operating patients with peritonitis, and their influence on issues of the lesion are discussed.

[Ultrastructure of the neuromuscular junction in myasthenia]. / Ul'trastruktura nervno-myshechnogo soedineniia pri miastenii

The ultrastructure of neuromuscular synapses were investigated in bioptic specimens of muscles in 15 patients with myasthenia. Changes were detected in the pre- and postsynaptic structures. As a rule, the process initiates with appearance of destructive changes in the terminals of axones and in the adjacent to them areas of the "sole" of the neuromuscular junction, which may lead to destruction of synaptic contacts. In some part of synapses, together with destructive changes, there were observed also regenerative changes. The most representative group of synapses were those possessing the following characteristics of the ultrastructure: an increased electron density of the axoplasm and a greater number of mitochondria in the terminals of the axones; changes in the organization of the symaptic cleft and folds; impoverishment of the "sole" in organellas; all these signs, according to the literature reports, should be considered as typical of myasthenic lesions of the neuromuscular synapses. Collation of the changes observed with the duration periods of the disease, as well as the fact that these changes can be seen in the same patients, justify the assumption about the existence of different stages of the synaptic defect: destructive, destructive-regenerative and myasthenic. From this point of view, the appearance of "myasthenic" synapses may be considered as a result of the proceding destructive-regenerative process.