Device for treatment of wounds and abdominal cavity

An original device for the wound and abdominal cavity pretreatment has been proposed. It has the following advantages: high rate of effectiveness in wound pretreatment, simplicity in usage, economical use of a washing solution. The device may be used in clinical practice for the wound and abdominal cavity cleansing.     

Emergency treatment of wounds of the colon

Colonic wounds vary greatly in their severity and the number of concomitantly injured organs. Relatively few colonic wounds are single; these can usually be treated by primary repair. The approach to colonic wounds generally must be selective and take into account the degree of associated shock,contamination, and surrounding tissue damage. Judicious application of the wide variety of technical approaches available today has increased the incidence of primary repair to over 50% and has reduced mortality to 10% to 15%.     

The diagnosis and treatment of neck wounds

The largest in Russia experience of diagnostics and treatment victims with side-arms' wounds of the neck (492 patients) is represented. The authors subdivide allo wounds into superficial (170 cases without mortal outcomes) and profound ones (322 cases with total mortality rate as 6.8%). Classification of the injuries, their features, depending of the causes and the king of the weapon, are represented. Complex of diagnostic methods, which application depends on severity of the patients condition, is substantiated. The standard surgical approach in profound injuries of the neck is considered to be an anterior colotomy.     

Diagnosis and treatment of penetrating thoraco-abdominal peace-time wounds

A formula describing weight losses in the first approximation during space mission was derived assuming that humans may adapt to space flight effects. The process depended on two parameters one of which characterized maximum body losses and another--time of adaptation. Weight estimates of Skylab crewmembers obtained with the aid of the formula were in good agreement with actual results. The typical time of adaptation was two days. Possible ways of constructing a more precise model of weight changes and its use to diagnose the status of crewmembers are discussed.     

Bandages with proteolytic enzymes in the treatment of purulent wounds

The studies conducted in Krasnouralsk (Sverdlovsk region) proved that environmental pollution with lead in the area subjected to releases by copper-melting enterprise creates significant risk of lead accumulation in preschoolers especially prone to unfavorable factors. Considering various environmental lead sources, biokinetic analog formation reliably forecasts serum lead levels. Soil polluted with lead, as the analog considers, is the most important environmental lead source. The authors suggest a system of prophylactic measures based on analysis of children's health risk caused by environmental pollution with lead.     

Effectiveness of collagen-gentamicin implant for treatment of "dirty" abdominal wounds

The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.     

Atrioverter: an implantable device for the treatment of atrial fibrillation

BACKGROUND: During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows prompt restoration of sinus rhythm by a low-energy shock. The safety and efficacy of this system, called the Atrioverter, were evaluated in a prospective, multicenter study. METHODS AND RESULTS: The study included 51 patients with recurrent atrial fibrillation who had not responded to antiarrhythmic drugs, were in New York Heart Association Heart failure class I or II, and were at low risk for ventricular arrhythmias. The atrial defibrillation threshold had to be 相似文献   

Atypical way of treatment of cardiac stab wounds

The paper presents a case of thoracic wall stab wound with profound bleeding masking simultaneous cardiac wound successfully sutured through unusual approach.     

连退机组二次断带预警模型及治理技术

针对连退机组出现的二次断带问题,充分考虑机组设备及生产工艺特点,对二次断带现象和其出现的原因进行了分析,进而提出二次断带预警模型。在此基础上提出二次断带治理技术,通过此技术可以在机组清洗段发生一次断带后防止后续带钢出现二次断带并逃逸至连退炉内,大大减少了故障处理时间。将其应用到生产实践,取得了良好的使用效果,二次断带次数减少为原来的1/4,具有进一步推广应用的价值。     

Operative videothoracoscopy in the surgical treatment of penetrating firearms wounds of the chest

We prospectively analyzed our experience with operative videothoracoscopy (OVT) performed in a field military hospital in cases of penetrating firearms wounds of the thorax (PFAWT) sustained in Chechnya. From February to April 1996, we treated 206 wounded patients, of whom 37 (18.0%) had sustained chest injuries. PFAWT were present in 23 soldiers, accounting for 62.2% of all chest injuries. Twelve injuries were confined to the thorax, eight patients had associated injuries, and three soldiers had thoracoabdominal injuries. Nineteen patients had pleural drainage performed during medical evacuation. The thoracic injuries were right-sided (17), involved bullets or shell splinters (23); were through and through (16), represented solitary wounds (19), and were associated with internal organ injuries (21). Fifteen patients had indications for OVT when they were delivered from the battle-field 1.5 to 22 hours after injury. All patients manifested signs of hemorrhagic shock and hemodynamic instability. Indications for OVT were ongoing intrapleural bleeding (6), clotted hemothorax (6), or marked air leakage (3) preventing lung inflation with the OP-02 apparatus (field modification). OVT revealed 12 lung wounds, nine of which were multiple wounds, pleural bleeding in 6 patients, clotted hemothorax in 11 patients, and foreign bodies in 5 patients. Two patients underwent thoracotomy, one for suspicion of heart injury and the second because we could not adequately visualize and control bleeding revealed at OVT to be from the intercostal artery in the left costovertebral angle. Eight of 23 patients had no indication for operative videothoracoscopy and were managed with continued pleural aspiration and drug therapy. Wedge resection of the lung using an Endo-GIA-30 stapler was necessary in two patients because of parenchymal destruction and bleeding. Evacuation of clotted blood by fragmentation and aspiration was satisfactory in all cases. Satisfactory manual suturing of selected lung injuries was obtained largely with intracorporeal knot tying. The duration of the procedures ranged from 40 to 90 minutes. No morbidity nor mortality was encountered in patients undergoing OVT. Postoperative pain was minimized by using OVT placement of catheters in the chest wall soft tissue with local administration of 2% Trimecain. Patients were able to stand in 10 to 12 hours and to walk by the end of the first postoperative day. All patients who underwent OVT were evacuated without drains by the third or fourth postoperative day, all tolerating sitting and standing positions. We conclude that early OVT in the military field hospital for continued bleeding, clotted hemothorax, and continued major air leakage has several advantages in military patients with PFAWT: early definition and management of organ injury; identification and control of bleeding in most instances; earlier and more accurate assessment for thoracotomy; vigorous lavage and removal of projectiles such as bone fragments and evacuation of clotted hemothorax; early debridement with suture closure of the thoracic wall canal; and minimal postoperative pain with dramatically reduced suppurative sequelae and bronchopleural fistulae.     

Secondarily infected wounds and dermatoses: a diagnosis and treatment guide

In golden hamsters, seasonal changes in day length act via a pineal-dependent mechanism to regulate feedback and behavioral effects of androgen. Endogenous opiates participate in photoperiodically regulated neuroendocrine functions, but the effects of androgen on expression of the gene encoding POMC, the precursor of beta-endorphin, have been controversial. We used quantitative in situ hybridization to examine regulation of POMC messenger RNA (mRNA) by testosterone and to test the hypothesis that short day lengths act through the pineal gland to amplify POMC mRNA expression. We studied intact hamsters and castrates with or without androgen treatment held in long (14 h of light, 10 h of darkness) or short (5 h of light, 19 h of darkness) days for 10 weeks. POMC gene expression differed with rostral-caudal plane, photoperiod, and surgical treatment (castration and testosterone administration). Testosterone increased the number of silver grains in labeled cells throughout the arcuate nucleus, and short day castrates given androgen consistently had more silver grains per labeled cell than did their long day counterparts. Testosterone exerted an inhibitory effect, however, on the number of POMC mRNA-positive cells, and more POMC mRNA-labeled cells were found in the arcuate nucleus of long than short day castrates treated with testosterone. Photoperiod had no significant influence in castrates not receiving androgen. Testosterone treatment had generally similar effects whether it was begun at the time of castration or 5 weeks later. Pinealectomy blocked the influence of photoperiod on both the mean number of silver grains per labeled cell and the number of labeled cells. The results indicate that day length regulates POMC gene expression when androgen levels are held constant, but that androgen is necessary for photoperiod effects to be expressed.     

Gunshot wounds to the mandible and midface: evaluation, treatment, and avoidance of complications

As American society becomes progressively violent, an ever-increasing number of gunshot wounds are being seen across the United States. Particularly challenging are injuries that involve the mandible and midface, not only because of problems with reconstructing bone and soft-tissue defects but also because of emergent problems with airway obstruction and neurovascular compromise. We present 40 cases of gunshot wounds to the mouth, mandible, and maxilla treated at Wake Forest University Medical Center during the past 7 years. The focus of this retrospective analysis is on emergency evaluation and treatment, complications encountered, and operative techniques used for reconstruction. Special emphasis is placed on recognizing and avoiding the complications of these injuries.     

Recent developments in the synthesis and discovery of oligosaccharides and glycoconjugates for the treatment of disease

The development of the first automated oligosaccharide synthesizer, along with new methods for screening carbohydrate ligand arrays is likely to lead to a rapid acceleration in both our ability to synthesize these molecules, and understand the roles of oligosaccharides and glycoconjugates in biology. Consequently we may uncover new avenues for therapeutic intervention more rapidly. These recent developments are very important since our understanding of the role of glycoconjugates in nature has traditionally fallen far behind that of the other biopolymers such as proteins and nucleic acids as the formation of, for example, glycosylated proteins is not template driven. The chemical synthesis of oligosaccharides and glycoconjugates has provided us with new potential cancer vaccines, antibiotics and new biotechnological tools. Glycobiologists have employed many such tools to uncover new signalling roles for oligosaccharides and glycoconjugates. In this review we aim to highlight some emerging methods for glycoconjugate assembly and screening, and discuss innovative approaches to glycoconjugate based drug design and delivery, all of which are, and will continue to be, fruitful avenues for medicinal chemistry research.