Vol 10, No 3 (2017)

Original articles

Peculiarities of Diagnostics of Gastrointestinal Bleeding in Patients with Acute Infectious Diseases

Zemlyanoy V.P., Nakhumov M.M., Tretyakov D.V.

Abstract

Relevance. Diagnosis of gastrointestinal bleeding in patients with infectious diseases is difficult and has a number of features.

Aim. To analyze the peculiarities of diagnostic gastrointestinal bleeding in patients with acute infectious diseases to improve diagnostic results.

Materials and methods. The data were used in medical records of 58 patients with confirmed infection, 48 patients with unconfirmed infectious disease brought in infectious hospitals in St. Petersburg from 2002 to 2014 years who have diagnosed gastrointestinal bleeding. Depending on the level of gastrointestinal bleeding (upper or lower gastrointestinal tract divisions), complaints are analyzed, objective clinical data, information of various symptoms, sensitive instrumental and laboratory studies. The results of the study compared with the control group – 49 patients with confirmed gastrointestinal bleeding without infection, surgical wards had been treated in city hospitals.

Conclusions. Due to represented data the following concluded the limited effectiveness of clinical and laboratory methods for diagnosis of gastrointestinal bleeding in patients with infectious diseases and the need for greater use of objective such as rectal digital research and sensing stomach sensitivity comparable with endoscopic techniques.

Journal of Experimental and Clinical Surgery. 2017;10(3):178-186
pages 178-186 views

Efficacy of Endoscopic Intervention in the Prevention of Portal Genesis Bleedings

Nazyrov F.G., Devyatov A.V., Babadjanov A.K., Djumaniyazov D.A., Baybekov R.R.

Abstract

Objective. To analyze the survival of patients with liver cirrhosis and to assess the effectiveness of endoscopic interventions in the prevention of portal genesis bleedings.

Materials and methods. To assess the effectiveness of endoscopic interventions, our study included 449 liver cirrhotic patients with portal hypertension who was admitted with bleeding from varicose veins or the threat of its recurrence for the period from 1996 to 2015. All patients were divided into 2 groups of the study. The main group included 239 patients treated between 2010 and 2015 and the control group consisted of 210 patients in the period from 1996 to 2010.

Results. The analysis showed that the percentage of patients without recurrence of bleeding from varicose veins was 27% (33 patients) in the control group and 54.2% (64) in the main group when performing only endoscopic interventions. With the phased tactics of portosystemic shunt performance after endoscopic interventions this figure amounted to 32.4% (45) and 109 (61.6%). In the structure of mortality of patients without cirrhosis in the long-term period (81 patients) with endoscopic interventions recurrence of bleeding were observed in 40.7% (33) cases in the control group and 68.1% (64 of 94) in the main group. In turn, when combined endoscopy and portosystemic shunting in the structure of the patients, without counting deaths from progressive liver cirrhosis, the proportion of absence of recurrence was 45.9% (in 45 of 98 patients) and 71.2% (in 102 out of 153 tracked in the remote period excluding deaths from cirrhosis). In the group of patients that do not carry out any endoscopic intervention and the patients received only conservative therapy only in 3 (10.7%) cases it was possible to avoid recurrence of bleeding, which determines the therapeutic ineffectiveness isolated attempts to reduce the risk of recurrence of hemorrhagic syndrome.

Conclusion. Modern possibilities of endoscopic technologies have significantly improved the results of treatment and prevention of varicose bleeding or the threat of its recurrence, and the commitment to the phased tactics, with a combination of minimally invasive and traditional decompressive surgery, allowed to increase the survival rates of patients with 80% to 88% - up to 1 year and from 42% to 64% - to 3 years of follow-up.

Journal of Experimental and Clinical Surgery. 2017;10(3):187-194
pages 187-194 views

Characteristics of Microbiocenosis of Wounds in Patients with Skin and Soft Tissue Infections on the Background of Type II Diabetes Mellitus

Plakhotnikova A.M., Vinnik Y.S., Teplyakova O.V., Perianova O.V., Potkina N.K.

Abstract

Relevance. Assessment of microbiocenosis of wounds in patients with infections of the skin and soft tissues is an integral part of the complex of diagnostic measures carried out for patients of this nosological group, which allows predicting the severity of the course of the purulent inflammatory process and monitoring the effectiveness of the selected method of systemic and local treatment.

Objective: To assess the microbiocenosis of wounds in patients with infections of the skin and soft tissues against the background of type II diabetes mellitus and the effectiveness of using a local, directed flow of the ozone-oxygen gas mixture.

Materials and methods. A qualitative and quantitative assessment was made, an analysis of the antibiotic resistance of the microbial composition of wound biopsies in 90 patients in three clinical groups. The first group consisted of patients with background type II diabetes mellitus who underwent local wound sanation with an ozone-oxygen gas mixture as the local treatment, the second and third groups consisted of patients receiving basal therapy as a topical treatment. However, in the second group, type II diabetes mellitus was registered in patients, while in the third group there were patients without it.

Results and discussion. Based on the results of the microbiocenosis assessment, it was found that in patients with background type II diabetes mellitus, in addition to representatives of staphylo-, strepto-, enterococci and enterobacteria, nonfermentative Gram-negative bacteria were significantly more often from the biopsy specimens of the wounds, which were represented by acinotobacteria. Significantly higher in the first two groups methicillin-resistant strains of staphylococci were verified. Along with the difference in the qualitative composition of the pathogens in the study groups at the time of admission, pathogens of the purulent-inflammatory process in patients with background diabetes mellitus type II showed a high primary antibiotic resistance to the main classes of antimicrobial agents.

Also, in the patients of the first group, a significantly lower incidence of secondary surgical interventions resulted from the persistence and superinfection of wounds from the data of the dynamic microbiological evaluation of the causative agents.

Key words: skin and soft tissue infections, type II diabetes, purulent wounds, ozone, local treatment of wounds.

Journal of Experimental and Clinical Surgery. 2017;10(3):195-200
pages 195-200 views

Bilateral Pheochromocytoma and Medullary Thyroid Cancer

Zemlyanoy V.P., Lisitsyn A.A., Nakhumov M.M., Nesvit E.M.

Abstract

Introduction: Pheochromocytoma is one of representative of neuroendocrine tumors. According this fact, pheochromocytoma remains to evaluation for multiply endocrine neoplasia, especially if disease is bilateral. In this case, it is necessary to additionally carry out a genetic screening test.

The aim of the study is to Improve diagnosis and treatment outcomes for patients with MEN syndrome.

Materials and methods: The authors present a clinical case of a 37-year-old man diagnosed and treated for a bilateral pheochromocytoma.

Results: The patient was diagnosed medullary thyroid cancer after successful bilateral adrenalectomy. The patient underwent thyroidectomy. A genetic research showed the T1900 mutation in the codon of 634 RET gene, which confirmed the presence of the patient MEN 2 syndrome. According to the high concordance of the mutated gene, patient's son was carried out to genetic examinations, which confirmed the presence of this mutation. The boy underwent thyroidectomy opportunely.

Discussion: Due to primary oncological observation if the patient has pheochromacytoma, it is necessary to exclude MAN 2 syndrome both in the patient himself and his relatives. The safest and informative method is genetic research.

Conclusion: presently a comprehensive examination of both the patient himself and his relatives is necessary for timely diagnosis and correct management of treatment patients with MEN 2 syndrome.

Journal of Experimental and Clinical Surgery. 2017;10(3):201-206
pages 201-206 views

Own Experience of the Resection Interventions on the Headof the Pancreas in Patients with Chronic Pancreatitis

Pronin N.A., Tarasenko S.V., Natalskiy A.A., Zaitsev O.V., Kadykova O.A., Bogomolov A.Y., Bakunina I.V.

Abstract

The article is devoted to optimization of surgical treatment of chronic pancreatitis with consideration of blood supply variants of the pancreas head.

Aim. Optimize the surgical treatment of chronic pancreatitis, taking into account the variants of the blood supply to the head of the pancreas.

Material and methods. At the morphological stage of the study, extraorganic arteries of the pancreas and duodenum were studied by the preparation of 42 complexes of the upper abdominal organs.

Results. In the course of the retro- and prospective study, a comparative evaluation of the results of surgical treatment was carried out, taking into account the anatomical features of the pancreatic blood supply. It has been established that the anterior pancreatoduodenal artery arc has several variants of location in relation to the pancreatoduodenal complex.

Conclusion. The combination of the preliminary ligation of the elements of the anterior pancreatoduodenal arterial arch with more radical excision of the scar-altered parenchyma of the pancreas allows optimizing the surgical treatment of chronic pancreatitis.

Journal of Experimental and Clinical Surgery. 2017;10(3):207-211
pages 207-211 views

Efficacy and Safety of New Oral Anticoagulants in the Prevention of Venous Thromboembolism after Orthopaedic Surgery

Sukovatykh B.S., Sukovatykh M.B., Perkov S.O.

Abstract

Relevance. Despite of a specific prophylaxis, the thromboembolic complications occur in 20-25% of patients after orthopedic surgeries. In those who do not receive the prophylaxis the complications rate is even higher taking up to 45-70% thereby putting the complications into second place after infection complications.

Objective. To compare the efficacy and safety of dabigatran etaxilate and rivaroxaban in prophylaxis and treatment of the venous thromboembolism after hip and knee arthroplasty.

Materials and methods. An analysis of prophylaxis and treatment of venous thromboembolism in 104 patients who had had hip and knee arthroplasty has been accomplished. All patients were randomized into two groups. 51 patients were enrolled into the first (control) group where 220 mg per day dabigatran etexilat therapy was used. The second (investigated) group included 53 patients who received 10 mg per day rivaroxabane therapy. A year after surgery the quality of life of patients was assessed using CIVIQ-20 and SF-36 questioners.

Results and their discussion. Venous thromboembolic complications had occurred in 18 (17,3%) of patients equally in the first and second group. Isolated common femoral vein thrombosis was found in 8 (7,7%), and in 3 (2,9%) patients it was associated with pulmonary embolism. Popliteal and tibial vein thrombosis was detected in 7 (6,7%) patients. Internal bleeding complications were found in 9 (8,6%) patients with venous thrombosis. The complications were more common in a second group (higher by 1,7%). In 7 (6,7%) cases the complications had no clinical significance. Only in 2 (1,9%) patients (one case in each group) were documented severe hemorrhages, that needed hemostatic therapy. A year after surgery the quality of life of patients was assessed using specifically oriented CIVIQ-20 and SF-36 international questioners for chronic venous insufficiency. The evidence based differences between two groups were not discovered.

Conclusion. Dabigatran etexilate as well as rivaroxaban can be used for prophylaxis of the venous thromboembolism after orthopedic surgeries.

Journal of Experimental and Clinical Surgery. 2017;10(3):212-217
pages 212-217 views

The Germinal Epithelium of the Testis in Children with Cryptorchidism in the Ultrastructural Section

Komarova S.Y., Pichugova S.V.

Abstract

Relevance. Male fertility is largely dependent on the timely testicular descent into the scrotum and the formation of the two major divisions of the testis: interstitial and seminiferous tubules.

The purpose of research - to reveal ultrastructural changes in the germinal epithelium of the testes with cryptorchidism and assess their degree of severity of patients of different age.

Materials and methods. To study the ultrastructure of testis in 30 children with inguinal retention testicular biopsy runtime relegated gonads were done. Before surgery clinically and sonographically determined testicle in the groin area. Children age 1 to 14 years. All the children with unilateral cryptorchidism. In the study of testicular tissue ultrastructural changes in cryptorchidism revealed 3 types of state tubules and germinal epithelium. Changes in type I revealed 4 cases (13%). In type II tubules in the testis revealed mixed cell type: along with light cells therein are determined cells with dark cytoplasm and signs of destruction - 13 boys (46.4%). In 11 (37%) boys identified type III tubules dominated cells with signs of degradation.

Conclusions. The study revealed destructive changes of the germinal epithelium of the seminiferous tubules with cryptorchidism: vacuolization of cytoplasm, cytoplasmic foci of local degradation of the matrix, swelling of mitochondria, cristae destruction and devastation of the mitochondrial matrix, pycnosis cores and peritubular interstitial testicular sclerosis, signs of microcirculation disorders.

Journal of Experimental and Clinical Surgery. 2017;10(3):218-224
pages 218-224 views

Morphological Features of Wound Regeneration in the Local Application of Recombinant Interferon Α2b in the Experiment

Zhmailik R., Bogdan V., Korneva Y., Dorosevich A.

Abstract

Summery. Introduction. The research devoted to the study of pathogenetic, immunological, and biophysical aspects of the tissue regeneration process with wound defects of various etiologies is gaining in popularity in the "world" of medical science, at present this problem remains topical [1, 2, 6, 8, 9]

Purpose of the study. A comparative analysis of the dynamics of morphological manifestations of tissue regeneration occurring when recombinant interferon α2b, is used in the healing of an acute experimental wound is carried out.

Materials and methods. Depending on the nature of the wound treatment, the experimental animals were divided into two groups: 1) a comparison group in which the edges of the wound were struck with a 0.9% NaCl solution; 2) the main group, where a similar edge of the wound defect was cut off with recombinant interferon α2b at a dose of 1000 ME / 1ml diluted with 0.9% NaCl solution. The rats were removed from the experiment on the 4th, 8th and 20th day of the study, while a full-thickness skin flap was taken in the area of the scar (defect), which was examined by light microscopy. At the same time, the intensity of formation of the granulation tissue, its "maturation", and also in the margins and on the bottom of the wound was estimated in the absolute values, the cellular populations realizing the process of inflammation were determined.

As a result of the study, the character of the complex effect of recombinant interferon α2b was established, which included reduction of the negative effect of secondary alteration, differentiation of the intravascular immune response, formation of conditions for natural regeneration with activation of angiogenesis and synthesis of a valuable scar, decrease in propensity to keloidosis.

Conclusions. The obtained results testify to the morphological validity of the use of recombinant leukocyte interferon α2β as a stimulant of the inflammation phase, as against the background of the use of this substance, its ability to enhance phagocytosis was noted.

Journal of Experimental and Clinical Surgery. 2017;10(3):225-230
pages 225-230 views

The Modern View on the Effectiveness of Cradiotherapy of Prostate Cancer

Moshurov I.P., Kamenev D.Y., Kravets B.B., Korotkikh N.V.

Abstract

For many years the main method of treatment of patients with prostate cancer remains surgical treatment, which consists in performing a difficult and traumatic operations, leading to reduced quality of life. Currently, as an equal alternative to radical prostatectomy is radiotherapy, presented with a standard 3D conformal beam radiation, stereotactic radiotherapy and brachytherapy using sources with a low or high dose. Brachytherapy using sources of high power is a safe and effective treatment for localized prostate cancer, providing a summing fatal dose to the tumor with the short period of hospitalization, minimal complications, which may be used in combination with external beam radiotherapy and standalone version. A brief review of the literature on the use of combined radiation therapy in the treatment of prostate cancer. Describes the comparative characteristics of results of treatment of this pathology, complications, early and late toxic reactions when used brachytherapy isotopes of different dose in combination with external beam radiation therapy. The vector of further research in this direction is justified.

Journal of Experimental and Clinical Surgery. 2017;10(3):231-235
pages 231-235 views

Comparative Evaluation of the Quality Of Life Of Patients after the Pressible-Transparent Cholecismostomy аnd "Traditional" Cholecismostomy with Thermal Mucoclasion of the Gold Bubble

Polyansky M.B., Nazarenko D.P., Ishunina T.A., Kolmykov D.I.

Abstract

Relevance. The number of elderly patients with acute cholecystitis is constantly increasing, in spite of the success achieved in the diagnosis and treatment of this pathology. The possibilities for radical treatment of patients with high operational anesthesia risk are substantially limited.

The aim of the study was to conduct comparative analysis of the quality of life of patients after transcutaneous-transhepaticmicrocholecystostomy and traditional cholecystostomy with thermal mucoclasia of the gallbladder.

Materials and methods. The quality of life of 31 patients with high operational anesthesia risk following transcutaneous-transhepaticmicrocholecystostomy (TTMC) and traditional cholecystostomy with thermal mucoclasia of the gallbladder (TCTMG), was studied. All patients were divided into two groups: the first group consisted of 20 (64.5%) patients who underwent TTMC, the second one included 11 (35.5%) patients who underwent TCTMG. Quality of life of patients was studied with the help of the questionnaire using the SF-36 Health Status Survey 4 months after TTMC or TCTMG. Statistical processing of the results was carried out using the program Microsoft Office Excel -2013.

Results and its discussion. The physical component of health (physical functioning, role functioning due to physical condition, pain intensity, general health) was 64.25% higher in patients of Group II than in patients of Group I (p = 0.001), and the psychological Health component (mental health, role functioning due to emotional state, social functioning, vital activity) was also (68.05%) higher in Group II (p = 0.004).

 

Conclusions. The use of the method of thermal mucoclasia of the gallbladder in patients with high operational anesthesia risk allows to achieve higher quality indices compared to patients who underwent TTMC, since after demucotization of the gallbladder cavity it is obliterated due to hyperplasia of the connective tissue of the lamina propria or submucosa, thereby finally solving the problem of acute cholecystitis in this category of patients.

Journal of Experimental and Clinical Surgery. 2017;10(3):236-240
pages 236-240 views

Effect of Different Suturing Methods on Uterus Postsurgical Scar after Cesarean Section

Vukolova V.A., Yenkova Y.V.

Abstract

Rationale: the issue of female reproduction maintenance is of vital medical and social importance. This problem is especially acute for women undergoing operative delivery, since the uterus is the key reproductive organ.

The aim of the research, consequently, was to provide adequate evaluation of the lower uterus segment in the early and long postsurgical period after cesarean transection of this segment followed by using different types of suture.

Materials and methods: the research involved ultrasound diagnostics to estimate the effect of different suturing methods on the uterus scar since the 37th week of pregnancy, as well as the visual assessment of the scar during the cesarean transection, in the early postsurgical period on the 2th, 5th, 7th days and in the long postsurgical period after cesarean transection, 3 and 6 months later. There were used lab tests, functional and radio methods of diagnostics. In the early postsurgical period the characteristics under analysis included: the echo structure of the scar, uterus involution rate, the increase or decrease of tissues edema in the scar area, presence or absence of hematoma.

In the long postsurgical period, the main focus was on the echo structure of the scar, presence or absence of niches, vascularization of the assumed uterus scar, anatomic and morphological competence of the scar, statistics methods.

The results: if the scar is incompetent, the ultrasound diagnostic detects such features as uterus cavity deformation in the suture areas, local retraction, visualization of niche near the postoperative scar. The ultrasound diagnostic of the scar in the early and long postsurgical period revealed the advantageous effect of the interrupted sutures for further formation of a competent uterine scar.

Conclusions: early diagnostics of the scar condition in the early and long postsurgical period after cesarean transection as well as preconceptional preparations enable us to maintain and increase reproductive and generative potential of women, who are planning to bear children in future.

Journal of Experimental and Clinical Surgery. 2017;10(3):241-245
pages 241-245 views

Prognosis, Prophylaxis and Treatment of the Postoperative Complications in Diabеtic Cataract Patients

Kovalevskaya M.A., Filina L.

Abstract

The concept of "metabolic syndrome" in ophthalmology can include the entire set of interrelated metabolic abnormalities predisposing to the development of vitreoretinal complications of type 2 diabetes and coronary heart disease (CHD). Based on the definition, the researches of local changes in markers of metabolic processes, particularly in complicated cataract, are relevant for the prediction of the results of surgical treatment. Such a method for detecting marker proteins in tear was introduced by us in clinical practice for the differential diagnosis of local changes in metabolism in complicated (cataract caused by changes of the lens in response to background disturbances of metabolism) and age-related cataract. The mechanism of development of complicated cataracts is similar to cataractogenesis with age-related cataracts, but in complicated cataract processes of change in the lens is more intensive and faster under the influence of a violation of the immunological balance, oxidative processes and biochemical changes that occur in the body and locally on a background of concomitant diseases and diseases of the eye.

At the present stage it is believed that one of the triggers is cataractogenesis depletion of the antioxidant capacity of the lens and the development of oxidative stress. This manifests itself in the early stages cataractogenesis fluctuations in the level of glutathione in the lens and the accumulation of free radical oxidation products. Following this, a reduction in the number of negative charges on the main protein of lens fiber - crystallin. This fact is interpreted as a violation of protein phosphorylation within the fibers of the lens due to discoordination cascade regulation systems due to their free radical damage. In turn, decrease the water solubility of proteins leads to the adsorption of proteins on the uncharged cell membranes, resulting in increasing lens violation regular stacking membranes. Light scattering by surfaces of folded membranes lens fiber is considered as the main cause of lens opacity with cataract.

We examined 136 patients with cataracts of various origins (272 eyes) aged 62 ± 3,2 years. Among those surveyed were women (74 people). All patients underwent detailed clinical, ophthalmological examination of the complex and as a result were divided into groups with a diagnosis of cataracts of

various origins. We have developed an algorithm for determining the prognosis of outcome of surgical intervention in the oxidative stress on the content of antioxidant enzymes tears justified selective choice of preparations of local and systemic antioxidant action to prevent and stabilize the clouding of the lens.

The greatest number of complications arise in the extraction of complicated cataract, because its development is already associated with the presence of an underlying disease (a disorder of metabolism, endocrine disorders), additional ocular pathology (uveitis syndrome Fuchs, secondary glaucoma), the influence of external factors. This kind of state characterized by the presence of pathological changes in the immune, circulatory system, metabolic disorders, entailing and cause various postoperative complications (hyphema, postoperative iridocyclitis, exudative inflammatory response (EVR), epithelial-endothelial corneal dystrophy, macular edema with the outcome in macular degeneration). It becomes apparent that the creation of methods of forecasting and prevention of post-operative complications, as well as specific algorithm scheme of preoperative preparation, at various kinds of complicated cataract, is an important and urgent problem of modern ophthalmology.

Journal of Experimental and Clinical Surgery. 2017;10(3):246-252
pages 246-252 views

Memorials

STRUCHKOV Viktor Ivanovich (to the 110th of birthday)

Andreev A.A., Ostroushko A.P.

Abstract

Viktor Ivanovich Struchkov was born 30 July (12 August) 1907 year in Ryazhsk Ryazan region. After graduating from the 2nd Moscow medical Institute V. I. Struchkov worked as a resident surgeon, and then head of the surgical Department in Voskresensk Interdistrict hospital in Moscow region (1931-1941). During the great Patriotic war, he was a leading surgeon (1941), the chief inspector and a specialist of the 21st army, the army surgeon of the 13th army in Bryansk and 1st Ukrainian front (1942-1945). In 1946, V. I. Struchkov with the rank of Colonel of medical service was transferred to reserves and became an assistant of the hospital surgical clinic, then became an associate Professor of operative surgery, since 1951 – Professor, and since 1953 – the head of the Department of General surgery of the 1st Moscow medical Institute. I. M. Sechenov, while working as chief surgeon of the Ministry of health of the USSR (1949-1965). In 1946 he defended his thesis, and in 1949 – his doctoral dissertation. In 1961, V. I. Struchkov was awarded the Lenin prize. In 1965, his monograph on "tumors of the lung" is awarded the prize. S. I. Spasokukotskogo of medical Sciences of the USSR, and Viktor Ivanovich became an academician of the USSR AMS. 1966-1976 Struchkov V. I. – academician-Secretary of the Presidium of the USSR AMS. His textbook "General surgery" was awarded the state prize of the USSR in 1975. In 1977 Victor Ivanovich was awarded the Title of hero of Socialist Labor.

Viktor Ivanovich Struchkov died on December 25, 1988. He has created a school of more than 45 doctors and 140 candidates of medical Sciences, he published more than 400 scientific works, including 33 monographs. He was the Deputy Chairman of the all-Union scientific society of surgeons, chief editor of the journal "Thoracic surgery", an honorary member of the Medical society of the name of J. Purkinje (Czechoslovakia), foreign, national and regional societies of surgeons, holder of two orders of Lenin, October Revolution, red banner, Patriotic war 1-St and 2-nd degree, two orders of Labour red banner, Friendship of peoples, the red Star, awarded with numerous medals.

Journal of Experimental and Clinical Surgery. 2017;10(3):253
pages 253 views

BARNARD Christian NetLink (to the 95th of birthday and 50th anniversary of the first in the world successful heart transplant)

Andreev A.A., Ostroushko A.P.

Abstract

Barnard (Barnard) Christian Nettling South African surgeon, performed the first successful heart transplant man, he was born in 1922 in Beaufort West in South Africa. In 1940 he graduated from school in 1946, the medical faculty of the University of Cape town. In 1953 he received the degree of doctor of medicine at the medical school of the University of Cape town. In 1956, he studied cardiac surgery in the US, where in 1958 he received the degree of doctor of medicine. After returning to South Africa K. Barnard was appointed cardiothoracic surgeon, and soon the head of surgical research, Department of cardiothoracic surgery at the clinic of the University of Cape town. In the October 1959 Christian Bernard is the first in Africa performed a successful kidney transplant. In 1962 he held the post of assistant Professor in the Department of surgery of the University of Cape town. December 3, 1967 K. Barnard and his colleagues have performed the first successful orthotopic transplantation of the human heart. In 1972 he was appointed Professor of surgical Sciences at the University of Cape town. In 1974 K. Barnard produced the world's first heterotopic heart transplant man. In 1981 he developed the patronage system of the heart by conducting hypothermic perfusion. In 1983, K. Barnard, resigned. He is the author of the autobiographical book "One life" (1970), published in co-authorship with Z. Stander anti-racist novel "Undesirable elements" (1974). Christian Barnard died on 2 September 2001, Paphos, Cyprus.

Journal of Experimental and Clinical Surgery. 2017;10(3):254
pages 254 views

KASHEVAROVA-RUDNEVA Varvara Alexandrovna - Russia's first woman doctor and a doctor of medicine (to the 175th of birthday)

Andreev A.A., Ostroushko A.P.

Abstract

Kashevarova-Rudneva Varvara Alexandrovna (1842-1899) – Russian scientist, the first woman to receive the title of doctor and doctor of medicine, accepted by the Society of Russian doctors in St. Petersburg.

Rudneva-Kashevarova Varvara Alexandrovna was born in 1842 in Vitebsk. In 1862, she finished training at the Midwifery Institute in St. Petersburg educational house, and then courses on detection and treatment of syphilis in Kalinkinskogo hospital in St. Petersburg. In 1863, she enrolled at the St. Petersburg medical-surgical Academy, becoming the first student-woman to have officially crossed the threshold of the Medico-surgical Academy in St. Petersburg, which she graduated in 1868 with the attribution of a diploma of "doctor" in the specialty of obstetrician-gynecologist, became the first woman to receive a medical degree in Russia. In 1876 she defended her doctoral dissertation on "Materials for pathological anatomy of the uterine vagina", i.e. she became the first woman in Russia to defend her thesis. She was the first woman accepted into the Society of Russian doctors in St. Petersburg. Together with her second husband, Professor Rudnev, Kashevarova was one of the originators of the Russian Oncology. She died on January 30, 1899, in the 58th year of life and are buried in the cemetery of the Staro-Preobrazhensky monastery in Staraya Russa. Major works: "a Chronic inflammation of the decidua membrane of the uterus" (Medical Gazette, 1868; "About free abdominal bodies" (virkhov's Archive, vol. 47); "the doctrine of placental polyps" (Journal for normal and pathological anatomy, 1873); Materials for pathological anatomy of the uterine vagina (1876); "Hygiene of the female body in all phases of life" (1892); the story "Pioneer" and "The history of women's medical education" (autobiography, "news", 1886); "Village notes" ("news", 1888 and others).

Journal of Experimental and Clinical Surgery. 2017;10(3):255
pages 255 views

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