RESUMO
In coincidence of chronic phthisic pleuritis in a rigid stage with pulmonary tuberculosis operative intervention is indicated of a pleuropulmonectomy type, what is a complex situation for performance and preservation of the patient's functional state. Pleuropulmonectomy in some patients is complicated by empyema and pathological processes in bronchi. Possibilities of operative interventions application, alternative to pleuropulmonectomy, were studied. Of 48 patients, to whom pleuropulmonectomy is indicated in accordance to data of clinic-roentgenological investigations, in 7--simultant operative treatment were conducted with positive results.
Assuntos
Pleurisia/cirurgia , Pneumonectomia/métodos , Toracoplastia/métodos , Tuberculose Pulmonar/cirurgia , Adulto , Antituberculosos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/patogenicidade , Mycobacterium tuberculosis/fisiologia , Pleurisia/tratamento farmacológico , Pleurisia/microbiologia , Pleurisia/patologia , Pneumoperitônio Artificial/métodos , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologiaRESUMO
The authors are analyzing the epidemic situation in Ukraine and the epidemiology of chronic tuberculous pleuritis (CTP). They are suggesting 206 pleurectomy results of operated patiens. Restrictive type of venting disorders before surgery occurred are in 26.4% cases, 36.2% and 100%, respectively at 1; 2 and 3 stages of CTP. Reducing the number of patients with this type of violations occurred if 6.9 times, 11.7 times and 3.3 times respectively to operated in case of 1, 2 and 3 stages of CTP. Improvements and other positive functional parameters are submitted. The authors conclusion: pleurectomy is the method of functional rehabilitation at CTP cases.
Assuntos
Pleura/cirurgia , Cavidade Pleural/cirurgia , Pneumonólise/métodos , Tuberculose Pleural/cirurgia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Cavidade Pleural/patologia , Recuperação de Função Fisiológica , Tuberculose Pleural/patologia , Tuberculose Pleural/reabilitação , UcrâniaRESUMO
Expression of alpha-receptors of estrogen (RE) in accordance to immunohistochemical (IHC) labeling in gastroduodenal mucosa cells was studied up in patients, suffering the ulcer disease and without it. In 4 patients (group I) a gastroduodenal mucosa affection was revealed, they were operated on for hemorrhage from gastroduodenal ulcers; in 3 patients (group II) gastroduodenal mucosa affection was not observed; in 4 patients (group III, control), a mammary gland cancer was diagnosed, a positive reaction on alpha-RE was noted. In groups I and II the biopsies were studied, obtained from pylorus and gastric fundus, as well as from duodenal ampula, and in a group III--obtained from the tumor. In a control group a positive labeling of nuclei was revealed in biopsies. In patients of groups I and II the alpha-RE expression by cellular nuclei was not revealed, but, the lots of positive IHC labeling of cytoplasm in glandular and stromal mucosal cells of the investigated gut were noted. Positive IHC labeling of cytoplasm for alpha-RE witnesses about sensitivity to them in norma and pathological processes. But, a trustworthy difference of alpha-RE expression by cellular nuclei was not noted. For confirmation or denial of this hypothesis further clinical and IHC investigations are needed.
Assuntos
Neoplasias da Mama/metabolismo , Úlcera Duodenal/metabolismo , Receptor alfa de Estrogênio/metabolismo , Estrogênios/metabolismo , Úlcera Péptica Hemorrágica/metabolismo , Úlcera Gástrica/metabolismo , Adulto , Idoso , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Núcleo Celular/efeitos dos fármacos , Núcleo Celular/metabolismo , Núcleo Celular/patologia , Úlcera Duodenal/complicações , Úlcera Duodenal/patologia , Duodeno/efeitos dos fármacos , Duodeno/metabolismo , Duodeno/patologia , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Receptor alfa de Estrogênio/genética , Estrogênios/farmacologia , Feminino , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patologia , Expressão Gênica , Humanos , Imuno-Histoquímica , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/complicações , Úlcera Péptica Hemorrágica/patologia , Estômago/efeitos dos fármacos , Estômago/patologia , Úlcera Gástrica/complicações , Úlcera Gástrica/patologiaRESUMO
Genetic-hormonal regulation plays a key pathophysiologic role in a blood loss on background of complicated gastroduodenal ulcer disease, but a clinical significance of some genes of compensatory steroidogenesis remains unrevealed. Examination of 63 patients, using a chain reaction with polymerase (CRP); analysis of length of restriction fragments (CRP-RFLP) and immunohistochemical investigation of gastroduodenal mucosa were performed on the base of a Sumsky Rural Clinical Hospital. Trustworthy difference of distribution of polymorphic genes ESR1 and VKORC1 in patients of both gender in presence of the ulcer hemorrhage was not revealed, excluding genotype A/A VKORC1, what trustworthy more frequently was revealed in women (p < 0.05). There was established, that intact zone of gastric fundus owes immunoreactivity towards alpha-receptors of estrogen in nuclei of epitheliocytes and stromocytes. Diagnosis of polymorphic gene VKORC1 and expression of the estrogen receptors may serve the base for pathogenetic therapy in patients with hemorrhage occurrence.