Ilizarov treatment of congenital pseudarthroses of the tibia

Sundry mevalonate-derived constituents (isoprenoids) of fruits, vegetables and cereal grains suppress the growth of tumors. This study estimated the concentrations of structurally diverse isoprenoids required to inhibit the increase in a population of murine B16(F10) melanoma cells during a 48-h incubation by 50% (IC50 value). The IC50 values for d-limonene and perillyl alcohol, the monoterpenes in Phase I trials, were 450 and 250 micromol/L, respectively; related cyclic monoterpenes (perillaldehyde, carvacrol and thymol), an acyclic monoterpene (geraniol) and the end ring analog of beta-carotene (beta-ionone) had IC50 values in the range of 120-150 micromol/L. The IC50 value estimated for farnesol, the side-chain analog of the tocotrienols (50 micromol/L) fell midway between that of alpha-tocotrienol (110 micromol/L) and those estimated for gamma- (20 micromol/L) and delta- (10 micromol/L) tocotrienol. A novel tocotrienol lacking methyl groups on the tocol ring proved to be extremely potent (IC50, 0.9 micromol/L). In the first of two diet studies, experimental diets were fed to weanling C57BL female mice for 10 d prior to and 28 d following the implantation of the aggressively growing and highly metastatic B16(F10) melanoma. The isomolar (116 micromol/kg diet) and the Vitamin E-equivalent (928 micromol/kg diet) substitution of d-gamma-tocotrienol for dl-alpha-tocopherol in the AIN-76A diet produced 36 and 50% retardations, respectively, in tumor growth (P < 0.05). In the second study, melanomas were established before mice were fed experimental diets formulated with 2 mmol/kg d-gamma-tocotrienol, beta-ionone individually and in combination. Each treatment increased (P < 0.03) the duration of host survival. Our finding that the effects of individual isoprenoids were additive suggests the possibility that one component of the anticarcinogenic action of plant-based diets is the tumor growth-suppressive action of the diverse isoprenoid constituents of fruits, vegetables and cereal grains.     

Peacetime gunshot wounds

The article describes main principles of treatment of civilian gunshot wounds: rational organization of medical care to wounded at the prehospital stage, combination of diagnostic and medical process in specialized centers, early detection and eradication of menacing to life consequences of the wound, valuable intensive therapy at all stages of medical care and treatment, the shortest in time and full in volume specialized surgical care. Results of treatment of 507 patients with gunshot injuries of different localization in the clinic of military surgery for the last 15 years show that during this period the amount of such patients rose from 6.4% to 12.2% of all patients with different injuries, slight wounds taking place in 30.8%, of mean gravity--in 7.1%, grave--in 46.4%, critically grave--in 14.9%. Lethality made up 17.2%, incidence of complications--31.2%, duration of hospital treatment was 33 +/- 1.8 days.     

Unusual gunshot injuries

Ectopic meningioma outside the skull and spinal column is uncommon. We report a cutaneous meningioma of the scalp in a 77-year-old man. A review of types and their management options are discussed. We also highlight that in certain carefully selected cases, these lesions can be treated conservatively.     

The intra-aortic antibacterial therapy of wounded patients with gunshot meningoencephalitis

The original decision of permanent introduction of antibacterial means to tissues of brain at gunshot meningoencephalitis is offered. For antibacterial therapy the intra-aortal catheter with diameter of 2,5 mm (through a.femoralis) was introduced. After washing the catheter by solution of crystalloid with heparin the various combinations of preparations in 5% solution of glucose were introduced: cephalosporin--8 g/day; hentamicin and brumacilin--240 mg/day accordingly, amicacin--1500 mg/day. Speed of introduction--20-50 mg/h, total volume--500 ml. The catheter was in aorta not more than 10 days, maximum--14 days. A described technique was applied in Burdenko Main Military Clinical Hospital on 34 wounded in head. At computer tomography of brain of all wounded intracranially the splinters and bullets were revealed, clinically--meningoencephalitis. Foreign bodies have been extracted after cupping of clinical and laboratory signs of meningoencephalitis. The authors consider, that the technique is effective not only at wounds of brain, but also at suppurative meningoencephalitis of other etiology.     

Misleading self-inflicted gunshot wound

One deceiving case of suicide with firearm is reported. In the heart area three entrance-wound were seen. At first sight these were the injuries to account for the death. At the autopsy in the mouth another entrancewound was, found. The death occurred due to gunshot into the mouth.     

The choice of surgical methodology in gunshot injury of the colon

To enhance the efficiency of treatment in new cases of infiltrative and disseminated destructive pulmonary tuberculosis, an intermittent (twice daily) regimen of intravenous dropwise administration of three drugs (isoniazid, rifampicin, PASK) was proposed. The immediate results of clinical observations suggest that intermittent 3-drug intravenous chemotherapy supplemented by collapse therapy in some indicated cases, provides a high control over the therapy, sparing drug load, good tolerance, and rather high efficiency: elimination of destructions in 81.4% (mean 4.2 months), cessation of bacterial isolation in 88.9% in the early (2.2 months) period.     

Low-velocity gunshot wounds to extremities

Several therapeutic modalities in the management of low-velocity gunshot wounds to extremities were investigated. Local excision of wound margins, irrigation, and primary or delayed primary closure without the use of the operating room or prophylactic antibiotics produced results which were comparable to those obtained with a more aggressive surgical protocol.     

Prenatal gunshot perforation of the colon

Digitoxin plasma levels were determined in the dog by radioimmunoassy after i.v. infusion of this cardenolide in toxic amounts (388 +/- 13 mug/kg). Plasma values found immediately after the administration of this dose were 588.5 +/- 91 ng/ml and attained very low levels (10 ng/ml) 96 h later. The dominant half-life of digitoxin in the dog was found to be 49.6 +/- 6.5 h, but this value was attained only in the final part of our study. The results found are compared with previous data and controversial aspects are discussed.     

Treatment of pseudarthroses and ununited crural bone fractures with transosseous compression-distraction osteosynthesis

The materials of clinical observations of 103 patients with pseudarthrosis and unhealing crural fractures, in whom 104 operations of compression-distraction osteosynthesis were accomplished, are analysed. The results of the treatment in various groups of patients are described.     

Compression-distraction osteosynthesis of pseudarthroses and ununited fractures of the long tubular bones

Venous blood leucoconcentrate was studied in 48 patients with malignant neoplasms of the genitalia before and after radiotherapy. The decrease in total number of leucocytes on account of the decreased lymphocytes number and young undifferentiated formed elements of blood was observed; a relative neutrophylosis, monocytosis, eosinophilia as well as lymphopenia developed. The study of venous blood leucoconcentrate in oncological patients characterizes more precisely the state of peripheral blood than the routine method of investigation.     

The features of the traumatogenesis and the ballistic characteristics of peacetime gunshot injuries

Features of traumatogenesis and wound ballistics of civilian gunshot wounds are studied on the basis of the International Humanitarian Law and basic principles of wound ballistics. Data of 130 lethal cases and 260 wounded are presented. Types of the weapons used were taken into account. A detailed analysis of gunshot wounds inflicted by TT and PM handguns was made. The main components of traumatogenesis of civilian gunshot wounds were established.     

The role of sigmoidoscopy in the management of gunshot wounds to the buttocks

The charts of all patients (n = 70) admitted over 26 months after sustaining a gunshot wound to the buttocks were reviewed to assess the role of physical examination, routine radiologic studies, and sigmoidoscopy in the evaluation of these patients. There were 68 men and 2 women. Sixteen patients underwent sigmoidoscopy, which demonstrated a rectal injury in 7. Six of these patients had other abnormalities on either physical examination or plain pelvic radiographs that would have otherwise led to operation. There were no missed injuries and no morbidity in the remaining patients that were managed without sigmoidoscopy. Indications for sigmoidoscopy were gross blood on rectal examination in 2, bullet path with proximity to the rectum in 13, and persistent abdominal pain in 1. All patients with gross blood on rectal examination (n = 5) and blood at the urethral meatus (n = 2) had visceral injuries. One patient underwent celiotomy for an injury at 15 cm that was noted on sigmoidoscopy performed because the bullet trajectory was in proximity to the rectum. Sigmoidoscopy can be performed selectively in patients sustaining a gunshot wound to the buttocks when the proximity of the wound to the rectum is in doubt.     

The vermilion myomucosal flap for the treatment of oral commissure gunshot wound deformities

The vermilion myomucosal advancement flap was successfully used to reconstruct the oral commissure for a wide range of deformities in three patients with facial gunshot wounds. In one case, a delayed cross lip flap was later used to restore the philtrum of the upper lip, despite the fact that the cutaneous perforating vessels of the cross lip flap had previously been divided.     

The classification of binary eutectics

Values of the interface roughness parameter (α) have been calculated for the primary phases of the 12 simple binary eutectic systems for which sufficient thermodynamic data are available; namely, Ag?Bi, Ag?Cu, Ag?Pb, Al?Ge, Al?Sn, Bi?Cd, Bi?Sn, Cd?Pb, Cd?Zn, In?Zn, Pb?Sb and Sn?Zn. It is shown that in the presence of solute the values of α can be significantly different from those of the pure component elements. The calculated, values of α are correlated with eutectic morphologies on the basis of the Hunt and Jackson classification. If the broken lamellar structure is also in the faceted/nonfaceted group then the results are in agreement with Hunt and Jackson’s classification. The analysis is discussed in the light of recent interpretations of the theories of solid-liquid interfaces and resultant growth morphologies. It is concluded that thermodynamic calculations are useful in the prediction of eutectic structures even though they may not necessarily resolve arguments concerning the mechanisms of eutectic solidification.     

The classification of cyclooxygenase inhibitors

In summary, precise classification of COX inhibitors has important clinical implications for efficacy and toxicity. However, classification of these agents clinically is difficult because there are insufficient data to predict correlations between biochemical and pharmacologic properties and the clinical effect of a given agent. In any case, specific COX-2 inhibitors are expected to show antiinflammatory and analgesic activities equivalent to those of NSAID, as well as significant reductions in the incidence of the life threatening side effects (i.e., GI bleeding) associated with COX-1 inhibition. The advantages of preferential COX-2 inhibitors may be more subtle and therefore more difficult to verify in clinical trials.