Vol. 3 No. 3 (2010): VESTNIK of KSMA

МОЙ ОТЕЦ - ПРОФЕССОР КОЖОКМАТОВ

ПО ЖИЗНИ - КАК ОТЕЦ, БРАТ И ДРУГ

Кожокматов Сатыидыга

ЧЕЛОВЕК, ХИРУРГ, УЧИТЕЛЬ!

КОЖОКМАТОВ САТЫНДЫНЫ 3CKEPYY

The aim of our research: Study of neuroleptanalgesia course and postnarcosis period for revealing complications. 105 patients with severe thermal lesions were examined, who had 127 operations under neuroleptanalgesia at the burning department of Bishkek scientific research center of traumatology and orthopedy for the period from 2004-2008. Analysis of observations showed, that there were no complications connected with using of the method which lead to the death of the patients during anaesthetization or after it.

Quality of life (QOL) in 37 patients with gastric and duodenal ulcer and influence of localization of the ulcer to QOL was studied using questionnaire SF-36. Results have shown, that parameters of QOL in patients with ulcer severe impaired in relatively of control group. Significant role of localization in QOL was revealed. In duodenal ulcer following indicators such as Bodily Pain and General Health much more impaired than in patients with gastric ulcer and control group. These indicators of QOL such as Vitality, Role Emotional Functioning were impaired more in patient with gastric ulcer. Following indicators such as Physical Functioning and Role Physical F unctioning were impaired evenly in patients with both locations of ulcer in comparison with control group. SF36 is the questionnaire which can be used for assessment of QOL in patient with gastric and duodenal ulcer.

Methods of disturbance of biliferous tracts permeability in choledocholithiasis, strictures of choledoch and tumor of pancreatic gland are presented in this article. There were 736 patients. External, inside and transhepatic drainage were used in treatment of these patients. Complications were in 46 (6,25%) patients.

Different metods of biliary fistula liguidation in patients with hepatic echinococcosis are presented in this article. Fistularraphy, fistulaplasty with the use of parietal peritoneum graft, omental lock, glue "Sancon" have been used in 318 patients. The effectiveness of these metods is presented here. Complication were in 4 patients (1, 3%).

In total fraction of low and very low density lipoproteins (LDL+VLDL) isolated from serum by precipitation at the presence of heparinum-Mn copper-induced lipid peroxidation (LPO) during incubation at 37oC al present of 50 liM CuS04 was accompanied by accumulation of LPO products (TBA-reactive products, TBARP), decrease fluorescence intensity (F) of a probe-anion ANS and increase of probe -cation DSP-6, decrease of intrinsic fluorescence intensity in ultraviolet area of a spectrum (Fuv) and increase - in visible area of a spectrum (Fvis). It was suggested to calculate the Fvis / Fuv and FDSP-6 / FANS ratio in order to determine degree of lipoproteins modification. Good relationship was revealed between these ratio's and degree of LPO on LDL+VLDL isolated from serum of 49 donors and incubated at 37oC at present of 50 uM CuS04 during 0, 3 and 24 hrs. LDL+VLDL isolated from human aorta of 6 persons significantly differ from native LDL+VLDL isolated from serum of 49 donors by Fvis / Fuv, FDSP-6 / FANS ratio and level of TBARP (p<0.001) and correspond by all these parameters to serum lipoproteins oxidated in vitro by incubation at 37oC at present of 50 pM CuS04 during more than 3 and less than 24 hrs.

При определенных условиях гемангиомы нередко могут перейти в ангиосаркому. Учитывая возможность достижения больших размеров гемангиом, вызывающих космети­ческий дефект, кровотечения, возможность малигнизации одним из первостепенных методов лечения остается хирургический с обязательным гистологическим исследованием. Важным аспектом лечения является проведение операций на начальных этапах развития гемангиом.

The results of examination of 66 patients with urinary bladder dysfunction in child's age were analyzed in this work. It was identified that spastic forms with detrusor hyper-tonus occur among 30.3%, incontiencc with overflow secondary to detrusor hypotonia among 21.2% and stress urinary incontinence among 50% of patients with myelodysplasia. Abnormality of base tonus of pelvic diaphragm muscle is a significant element upon urinary
bladder dysfunction. Treatment with Driptane allows 86.3% of patients to reach positive results.

This work shows the results of investigations of morphofunctional state of rabbit's uterus ©n 20th - 30th day after 15 days of intramuscular injection of peptide fractions at the dose of 1 mg/ kg body mass, released by the method of acetic acid extraction from myomatosis tissue of women with uterus myoma. It is shown that detected morphofunctional changes mark uterus insolvency. Because of the absence of mucous membrane it is impossible to implant fertilized ovum.Marked morphofunctional shifts are kept to 45th day of experiment.

Study of patients with cicatricial deformities of the skin by means of questionnaire MOS SF-36 suggests that the pathological scarring have a negative impact not only on physiological parameters (in the form of scar contractures and limitation of movement), but also on the essential functions of the patient - his physical , psychological, emotional and social functioning.

In the structure of congenital heart disease in the infants the combined and complicated heart defects with high level of lethality are prevailed. It is required the increase of the surgery activity among the patients of this age group.

This publication is about the 8th World congress on high altitude medicine and biology, which was held in Arequipa (Peru) in August 2010. The current paper presents major hot topics and most outstanding presentations along with their presenters. It also highlights certain thematic aspects of selected lectures for general audience.

ПРАВО НА ОХРАНУ ЗДОРОВЬЯ.

The analysis of mistakes in treatment of bones extremities fractures of 86 patients is made in this work. The reasons, which gave medical and diagnostic mistakes of internal osteosynthesis have been learnt. The main directions of overcoming of mistakes are defined.

We have produced 49 shoulder, femur and tibia osteosynthesis by bloking internal fixation in 47 patients with multiple and combined trauma. Paraarticular and diaphyseal femur fractures were predominated and found in 18 patients (39%), humerus fractures were detected in 9 (20%) of victims of diaphyseal shin fractures were observed in 22 (47%) patients. Multiple injuries of two or three segments were identified in 6 (13%) patients. We have applied the primary dynamic blocking concerning the stabilization of the transverse and oblique diaphyseal fractures, and we have
performed static blocking fragments with comminuted fractures. Postoperatiye complications were observed in 8 patients (17%) patients. Outcomes were followed up in 39 patients in terms of 8 to 18 months. Favorable anatomical and functional results were stated in 32 (68%) patients.

Burn trauma is exogenic stress factor affecting to different system of organism, including endoecologic system with reply reaction and regional lymphonodus.

Eight-year experience of the operative treatment of 23 patients with fracture of the thighbone/ femoris with using of fixatings with memory of the form (MoF) had been generalised. Patients' ages are from 14 till 78. The developed operation methods which combinate internal fixing with fixatings with memory of the form provide stable internal tense fixing. The results of the treatment had been monitored during one year. 20 (87%) patients showed good results, 3 (13%) - satisfactory.

In this article analyze of treatment results of 175 patients was done. Electrochemical activate liquid of neutral anolit act frank bactericidal necrologic actions, and using of neutral anolit provide festinant liquidation of purulent discharge of wound, retract hyperemia and infiltration round wound. Using of preparation citocin ("Betaleicin") with followrup using ofcatolit liquid greatly stimulate reparative and wound-healthing process in wound: Complex using of neutral anolit, preparation citocin and catolit greatly decrease middle ratio of bed-day.

In the article we represent experience and results of arthroscopic methods of treatment meniscus damages at 138 patients. Clinical data are presented in details; preference of carrying out arthroscopic interventions is shown. Authors achieved god and satisfactory results of treatment in 100 % of cases, there was no complication.

In collective work of authors data on studying application porous nickel-titanium afe cited the at forward interbody fusion at degenerative diseases of lumbosacral department of a backbone in comparison with bonecraft stabilization at 41 patients in branch of a pathology of backbone BSRCTO and neurosurgery OUCH. The received advantages of the given technique allow to recommend it for wide application in vertebrology.

В научной работе отражены результаты хирургического лечения 98 пациентов с дегенеративными поражениями пояснично-крестцового отдела позвоночника в отделениях патологии позвоночника БНИЦТО и нейрохирургии ОМОКБ в период с 2007 по 2010 годы. На основе имеющихся передних стабилизирующих операций с применением аутотрансплан­тата, внедрена новая методика хирургической стабилизации нестабильных дегенеративных поражений передним, стабилизирующим корпородезом пористым никелидом титана. Дана сравнительная оценка результатов стабилизации аутокостью и никелидом титана.

the main causes are later admission of the patients with complicated forms of intestinal obstruction, stomach ulcer and duodenum, cholecystitis, inadequate correction of disturbance functions.

After the relaparotomy death rate consisted of 31,6%, and after re-relaparatomy-80%. After the planned relaporatotny death rate consisted of 14,8%, and after re-relaparotomy-25%.

ОБОСНОВАНИЕ. ОРГАНИЗАЦИЯ И ПРОВЕДЕНИЕ ПОЭТАПНОЙ МЕДИЦИНСКОЙ РЕАБИЛИТАЦИИ БОЛЬНЫХ ПОСТРАДАВШИХ ПРИ ЧРЕЗВЫЧАЙНЫХ СИТУАЦИЯХ (ЧС)

P resented X -ray criteria for a hip replacem ent operation, determ ine the level o f treatm ent by this m ethod as an exam ple o f operations o f the prim ary to tal hip arth ro p lasty p erform ed in 30 pаtients w ith different pathologies.

The clinical experience of total knee arthroplasty has presented under foundation of BN1CITO, on the provided work total initial operations of knee joint replacement, which have done since 2007 year for 61 patients with different pathology.

Research on the awareness of patients with asthma about the reduced price for basic drug provision on the Program of State Guarantees (PSG) vas conducted in November - December 2009 in all 7 oblasts of the Kyrgyz Republic and in the 3 districts of the Osh region, as well as in the capital Bishkek. Interviewed 100 adult patients with asthma on a specially designedluestionnaire. Was developed and published a booklet "Does the state support patients with asthma?". It was fond that 84% of patients with asthma were aware of their rights on the Program of State Guarantees and 78% of paients - for the additional program of Mandatory Health Insurance Fund. 90% of patients received in 2009 a basi drug beclomethasone for treatment of their diseases. 74% of patients received prescriptions for beclometfrsone to PSG, 52% of respondents purchased the drug at the pharmacy.

СУДЕБНО МЕДИЦИНСКАЯ ОЦЕНКА ОСЛОЖНЕННОГО ЗАКРЫТОГО ПЕРЕЛОМА КОСТЕЙ НОСА

Thus, the peculiarities of the age-sex structure of the distribution of patients by type of intestinal obstruction, the nature of concomitant diseases, the duration of their admission to surgery and the types of surgical interventions with acute intestinal obstruction determine the specifics of the presence of this disease among the population.

Aim was to compare the efficacy of lisinopril (diroton, "Gedeon Richter", Hungary) combined with indapamide (PRO.MED.CS, Praha a.s.) in hypertensive patients, II and III stages, with comorbid diabetes mellitus 2nd type. Thirty three hypertensive patients with diabetes mellitus 2nd type were examined. All of them had underwent regular medical check-up at CFM №7 in Bishkek. After 12-week treatment by combination of lisinopril, 40 mg and indapamide 2,5 mg daily there was a decrease of the blood pressure (both systolic and diastolic) according to the ambulatory blood pressure monitoring. The combination of lisinopril, 40 mg, and indapamide, 2,5 mg caused significant decrease of the mean daily diastolic variability. The significant decrease of the serum glucose was revealed in the patients after the 12-week treatment by lisinopril with indapamide.

There was presented the treatment analyse of 124 patients with the acetabulum fracture and also with concomitant injuires of other bones. There was determined the differentiated approach in treatment of these patients depending on general conditions and type of the hip joint injuiry there.

A total of 296 patients with fractures of the femoral neck, which was used in the surgical treatment BSRCTO. Use operations such as: early primary osteosynthesis, primary andoprotesis. In the postoperative period was conducted pharmacological correction of osteoporosis.

Has been made the literary review manual facofragmentation of nucleus crystalline lens at tunnel removing cataracts for definition of an urgency of researches in this direction

In this article presented patomorfological changes in the testis, after vaspresection, results was compared with second testis without vasoresection. Experimental animals dogs males in the age 8 -10 years.

In this article presented data of structural analyses of 97 patients with BPH with different
expression of sexual disorders, research was based on gonade function.

In the given job the estimation of results forward corporodez by way "wedge-tyre" of 105 patients with degenerate diseases of a backbone on index Oswestry and VAS during 2006 - 2009y is spent. In branch of a pathology of backbone BSRCTaO. Forward corporodez in the way "wedge-tyre" gives high indicators of recourse of a painful syndrome and the low interest of infringement of capacity of patients.

Проблема безопасности труда актуальна в стоматологических учреждениях, так как в полости рта человека присутствуют различные виды микроорганизмов, в том числе и пато­генные. Проведение стоматологических манипуляций связаны с травматизацией медицинс­ких работников. Указанные обстоятельства способствуют заражению не только пациентов стоматологических учреждений, но и медицинских работников различными инфекциями, в частности гнойно-септическими, респираторными, гемоконтактными и др.

Проведение метафилактики требует строгого диспансерного наблюдения, соблюдения диеты и приема соответствующих лекарственных препаратов. Для ее проведения предложена схе­ма рекомендаций по коррекции метаболических нарушений в виде алгоритма, который вклю­чает индивидуальное послеоперационное амбулаторное динамическое наблюдение и лече­ние больного МКБ, в том числе и диетотерапию, преследующие цели профилактики обостре­ния хронического пиелонефрита, рецидива камнеобразования, подбора и проведения литоки­нетической и литолитической терапии на фоне воспалительного процесса в почке.

Проведенные исследования по применению лекарственного препарата "Байтач” при консервативном лечении показали, что он является эффективным средством для ускорения процесса отхождения фрагментов разрушенного камня из верхних мочевыводящих путей и мелких камней почки и мочеточника после проведения дистанционной литотрипсии и его можно рекомендовать при консервативном лечении.

ВНУТРИБОЛЬНИЧНЫЕ ИНФЕКЦИИ В ЛПУ ТАДЖИКИСТАНА ПРОБЛЕМЫ И ПУТИ ИХ РЕШЕНИЯ

The problems of postoperative suppurative complications attract increasingly more and more surgeons of every description. Today specialists pay great attention to working up of general questions of origin, development and treatment of suppurative inflammation after cortical bone surgery.

It is necessary to restore the balance of low and morality as the only way of solving the essential contradictions of moral-ethic and methodological charakter in transplantology.

Further development of human being and society requires the appearing in vital sense vector the common component, determined by social and ethical novations caused by the requirment of transplantological practice.

ПОРАЖЕНИЕ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У БОЛЬНЫХ С ГИПЕРТОНИЧЕСКОЙ ФОРМОЙ ХРОНИЧЕСКОГО ГЛОМЕРУЛОНЕФРИТА В ЗАВИСИМОСТИ ОТ СТАДИИ ХРОНИЧЕСКОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТИ

МОРФОФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ ОРГАНОВ ИММУНОГЕНЕЗА ПРИ АДАПТАЦИИ ОРГАНИЗМА К КЛИМАТОГЕОГРАФИЧЕСКИМ ФАКТОРАМ ВЫСОКОГОРЬЯ.

АПАРКУЛЬ ШАРШЕЕВНЕ КУРУМШИЕВОЙ - 60 ЛЕТ.