EXPERIENCE IN THE TREATMENT OF THE FALSE JOINT OF THE DIAPHYSIS OF THE RADIAL BONE COMBINED WITH A MAJOR DEFECT IN THE ULNAR DIAPHYSIS (CASE FROM PRACTICE)

This article presents the experience of surgical treatment of rare pathology of the upper limb – pseudoarthrosis of the middle third of the diaphysis of the radius, defect pseudoarthrosis of the upper and middle third of the ulnar diaphysis. The definition and compilation of an accurate model and treatment tactics are critical to restoring the anatomy and function of the injured upper limb. The rarity of this case was the size of the ulna defect, which was up to 4.0 cm, the scarring and cicatricial changes in the soft tissues and muscles of the right forearm, due to the severity of the injury and the multitude of surgical interventions on the right forearm. The chosen treatment tactics consisted of several successive stages: resection of the zone of false joint of the right radial bone, combined transosseous osteosynthesis of the right radius bone, resection of the false elbow joint of the right ulna with replacement of the defect with autograft from the lower third of the fibula, combined strained osteosynthesis and transosseous osteosynthesis by external fixation apparatus with rod configuration of the right ulna. The results of surgical treatment of false joints depend on the determination of the correct indications for a certain type of surgical intervention and the competent implementation of the planned treatment plan. The chosen treatment tactics allowed us to successfully restore the anatomy and function of the damaged segment, thus rehabilitating the patient.

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Significance of Perinatal Anamnesis for Determination of Treatment Plan and Subsequent Neurological Prognosis for Children with Anomaly Chiari 1

Journal of New Medical Technologies ◽

10.12737/4998 ◽

2014 ◽

Vol 21 (2) ◽

pp. 54-57

Author(s):

Козлитина ◽

T. Kozlitina ◽

Глаголев ◽

Nikolay Glagolev

Keyword(s):

Cervical Spine ◽

Surgical Treatment ◽

Soft Tissues ◽

Treatment Plan ◽

Neurological Status ◽

Pathological Process ◽

Spine Injury ◽

Normal Birth ◽

And Function ◽

Conservative And Surgical Treatment

The injuries of the cervical spine injury craniovertebral transition, involving in pathological process of vertebral arteries or the spinal cord can cause obstetric benefits as pathological and normal birth. In this article the authors evaluate the effects generic posttraumatic changes soft tissues of the cervical spine in the development of vascular disorders in the field craniovertebral transition. For this study, 112 patients with Chiari anomaly 1, received conservative and surgical treatment, were ex-amined. Children from 2 to 18 years were divided into two groups: the 1st group - children (55 patients) without surgical treatment, and the 2nd group of children after decompressive trepanation about Chiari anomaly 1. Common neurological status, anatomy and function of blood vessels at the level craniovertebral transition were assessed in all children. Perinatal anamnesis, including: cesarean section, rapid delivery, entanglement neck child´s umbilical cord, and use of obstetric benefits in the form of application of forceps and receive «squeezing», was studied. Changes in the normal course of delivery, pointing to birth trauma level craniovertebral transition were noted in 96 patients (85,7%). This fact may have prognostic value in the treatment and follow-up care of children with Chiari anomaly 1.

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Primary Extraosseous Ewing Sarcoma of the Upper Limb: Report of a Rare Case

International Journal of Cancer Management ◽

10.5812/ijcm.113387 ◽

2021 ◽

Vol 14 (9) ◽

Author(s):

Ahmad R Mafi ◽

Hasan Barati ◽

Keyvan Ramezani

Keyword(s):

Surgical Treatment ◽

Upper Limb ◽

Ewing Sarcoma ◽

Soft Tissues ◽

Metastatic Potential ◽

Case Presentation ◽

Patients With Cancer ◽

The Right ◽

Short Time ◽

Extraosseous Ewing Sarcoma

Introduction: Extraosseous Ewing sarcomas (EESs) are rare tumors that originate from soft tissues. Upper extremity EESs account for about 3% of all cases. Here we reported a case of ESS of the upper limb whose management became complicated due to the COVID-19 pandemic. Case Presentation: A 27-year-old female with EES of the right deltoid region presented after 3 months delay when the tumor had reached a huge size. Neoadjuvant therapy was initiated for her with acceptable results, however, her surgical treatment was postponed 3 times due to the cancellation of elective operations in the hospital as well as her involvement with COVID-19 infection. She developed multiple pulmonary metastases shortly after the surgery and passed away within a fortnight due to respiratory complications. Conclusions: Although not “emergent” by definition, surgical treatment of patients with cancer, especially those who suffer from malignancies with high metastatic potential such as Ewing sarcoma (including EES), should not be considered as “elective” since the disease may progress in a short time and become incurable.

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NECROTISING SOFT TISSUE INFECTION OF BILATERAL UPPER LIMB CAUSED BY THE INJECTION OF ORAL BACTERIA: A CASE REPORT

Hand Surgery ◽

10.1142/s021881041372012x ◽

2013 ◽

Vol 18 (02) ◽

pp. 243-246 ◽

Cited By ~ 1

Author(s):

Yuichi Yoshii ◽

Tomoo Ishii ◽

Shinsuke Sakai

Keyword(s):

Soft Tissue ◽

Upper Limb ◽

Soft Tissue Infection ◽

Soft Tissues ◽

Biceps Brachii ◽

Subcutaneous Tissue ◽

Oral Bacteria ◽

Tissue Infection ◽

Left Elbow ◽

The Right

Necrotising soft tissue infection is a rare and rapid process with devastating consequence. We report one case of necrotising soft tissue infection in a bilateral upper limb with uncommon oral bacteria. Radiological imaging revealed the presence of gas in upper limb soft tissues, and an MRI showed the localised signal changes in the biceps muscle of the right upper arm, and the subcutaneous tissue of the left elbow. The patient was treated with surgical resection of the infected muscle and wide debridement of the subcutaneous tissue. Antibiotics were initiated. The patient recovered immediately without functional deficit. The unique features of this patient were possible to observe in the progression of the necrotising soft tissue infection in the bilateral upper limb with intentional injection of oral bacteria, and the effect of biceps brachii resection in a prime age worker.

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CLINICAL AND MORPHOLOGICAL JUSTIFICATION OF THE SURGICAL TREATMENT OF CHRONIC ABDOMINAL SYNDROME IN CHILDREN

Российский педиатрический журнал ◽

10.18821/1560-9561-2017-20-5-270-276 ◽

2019 ◽

Vol 20 (5) ◽

pp. 270-276

Author(s):

Igor N. Khvorostov ◽

A. G. Sinitsyn ◽

G. L. Snigyr

Keyword(s):

Surgical Treatment ◽

Acute Inflammation ◽

Prognostic Significance ◽

Morphological Examination ◽

Moderate Amount ◽

Muscular Layer ◽

Collagen Iii ◽

The Right ◽

Immunohistochemical Studies

The chronic recurrent abdominal syndrome (CRAS) in the right lower fossa in children is believed not to be independent nosological unit and is diagnosed as an exception. We carried out comparative studies of the clinical picture, results of morphological and immunohistochemical studies of remote appendicitis in 55 CRAS children and 35 children with acute destructive appendicitis. The low prognostic significance of appendicular scales for the determination of indications to the surgical treatment of CRAS was established. Morphological examination in most cases revealed signs of chronic inflammation with fibrosis of the mucosa and submucosa of the appendix in CRAS children. Immunohistochemical studies revealed the pronounced expression of protein VEGF, MMP-9 and VCAM-1 predominantly in the submucosal and the muscular layer, moderate expression for Collagen-III-alpha-1. The low number of positively stained cells for the VIP protein located both in the mucosa and in the submucosa. The number of MMP-9-positive cells was the largest, there was seen a moderate amount of VEGF, VIP and Collagen-III-alpha-1-positive cells. The disappearance of the abdominal syndrome after appendectomy was noted in 6% of CRAS patients. Recurrence of pain was observed in girls of pubertal age with the irregular menstrual cycle. The established changes in remote appendicitis, other than acute inflammation, make it possible to consider reasonable appendectomy as a way of treating CRAS in children.

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The Structure and Function of the DNA from Bacteriophage Lambda

The Journal of General Physiology ◽

10.1085/jgp.49.6.29 ◽

1966 ◽

Vol 49 (6) ◽

pp. 29-57 ◽

Cited By ~ 16

Author(s):

David S. Hogness

Keyword(s):

Early Gene ◽

Second Step ◽

Wild Type ◽

Gene Orientation ◽

Variant Gene ◽

Position And Orientation ◽

The Right ◽

And Function ◽

Lambda Dna

The position and orientation of genes in lambda and lambda dg DNA are described. The position of six genes located in the right half of isolated lambda DNA was found to be -(N, iλ)--O-P---Q-R-(right end of DNA), which is their order on the genetic map of the vegetative phage. The order of the three genes of the galactose operon (k, t, and e) located in the left half of lambda dg DNA was found to be (left end of DNA)----k-t-e-, consistent with Campbell's model (5) for the formation of this variant. Gene orientation, defined as the direction of transcription along the DNA, is inferred to be from right to left for the galactose operon in lambda dg DNA. The strand of lambda DNA which functions as template in transcription of N, an "early" gene required for normal replication of lambda DNA, was determined as a first step in ascertaining the orientation of this gene. The method includes isolation of each strand, formation of each of two heteroduplex molecules consisting of one strand from wild-type and one from an N mutant) and comparison of their N activities. The second step, which consists of ascertaining the 5'-to-3' direction of each strand, is discussed, as is a determination of the orientation of gene R.

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Stage Reconstructive and Restorative Surgical Treatment of Gunshot Wounds of the Groin, Scrotum and Penis (Case Report)

Health of Man ◽

10.30841/2307-5090.3.2021.246214 ◽

2021 ◽

pp. 85-90

Author(s):

Serhii Golovko ◽

Oleksandr Savytskiy ◽

Oleksandr Netrebko ◽

Yevhen Bidula ◽

Volodymyr Bondarchuk

Keyword(s):

Surgical Treatment ◽

Gunshot Wound ◽

Foreign Bodies ◽

Soft Tissues ◽

Gunshot Wounds ◽

Soft Tissue Defects ◽

Initial Stage ◽

The Right ◽

Upper Third ◽

Tissue Defects

The frequency of external genital lesions in armed conflicts can reach up to 5%. The complexity of gunshot wounds is the presence of significant soft tissue defects, widespread necrosis around the wound, the possibility of progression in the hours and days after injury, the high probability of infection, and the presence of foreign bodies. The tactics of gunshot wounds are determined by the location, nature and extent of damage to soft tissues, organs, large vessels, nerves, bones and includes several stages. At the initial stage, bleeding is stopped, hematomas and foreign bodies are evacuated, non-viable tissues are removed, drainages are installed and skin defects are closed. The stage of reconstructive surgery can be started when the active wound process is over. In this report, we present a clinical case of a 22-year-old man who received a gunshot wound to the right groin, upper third of the right thigh, perineum and external genitalia in a combat zone of Operation Allied Forces, Ukraine. Bullet wound led to: damage to the skin and subcutaneous tissue in the right buttock, right groin, on the inner surface of the upper third of the thigh, penis (skin defect up to 1/3 of the circumference), scrotum, partial destruction of corpora cavernosa, m. iliopsoas and adductor muscles of the thigh, sphincter of the rectum, crushing of the right testicle. The wound was contaminated with earth and foreign bodies At the initial stage, the patient underwent: primary surgical treatment of a gunshot wound, suturing of cavernous bodies with sutures, fixation of the penis in the groin, removal of the right testicle, tamponade of the wound, sigmostomy (due to sphincter damage). Subsequently, the patient underwent regular surgical treatment of wounds, a vacuum suction system VAC was installed. After 7 months (upon completion of the healing process) suturing of the sigmostoma was performed. After 2 months, the penis and the scrotum were reconstructed. Preoperative examination (ultrasound of the penis with assessment of cavernous hemodynamics, MRI) revealed: post-traumatic scarring of the soft tissues of the right groin, inner surface of the right thigh, buttocks, right inguinal canal of the penis and scrotum, deformation of the cavernous cavity, normal indicators of cavernous blood circulation. In the early postoperative period (2 months after the intervention), the patient indicated satisfaction with the cosmetic and functional results, the preservation of morning erections, moderate discomfort in the penis during erection. Prosthetics of the right testicle are planned. The clinical case once again confirms the need for qualified surgical care during the first “golden” hour and subsequent phased treatment at a specialized level using the VAC therapy system in patients with gunshot wounds and large soft tissue defects. The experience of military medicine demonstrates the importance of involving specialists of various profiles in the treatment of combined gunshot wounds of the pelvis. An important stage of treatment in the wounded is plastic and reconstructive surgery in the long term, which is aimed at improving the functional, cosmetic and psychological results of treatment.

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Early detection of odontoma in patients with clinical features of periodontal disease: a case report

Journal of Case Reports in Dental Medicine ◽

10.20956/jcrdm.v1i1.83 ◽

2019 ◽

Vol 1 (1) ◽

pp. 5

Author(s):

Febri EN Tetelepta ◽

Andi M. Adam

Keyword(s):

Chronic Periodontitis ◽

Soft Tissues ◽

Treatment Plan ◽

Treatment Options ◽

Initial Therapy ◽

Curative Therapy ◽

Probing Depth ◽

Grade 3 ◽

Severity Of The Disease ◽

The Right

Objective: Chronic periodontitis is an infection of the gingiva that causes damage to the soft tissues and tooth-supporting bones. Chronic periodontitis is usually a slowly progressive disease that does not cause the affected individual to feel pain. For most patients, gingival bleeding during oral cleansing procedures is a sign of reported disease. Odontoma is an odontogenic tumor, characterized by slow growth. The tumor consists of enamel, dentin, cementum and sometimes pulp tissue.Methods: A 38-year-old male patient complaints swollen gums on the right upper back region. Clinical examination showed the presence of gingiva swelling, fistula, and grade 3 teeth mobility. In the systemic condition of the patient, malaise, fever and lymphadenopathy were not found. The treatment plan includes subgingival scaling treatment as well as antibiotic therapy as initial therapy. Advanced treatment is then continued with curative therapy with surgical extirpation, periodontal surgery and bone graft.Results: The success of treatment is shown by controlled inflammatory as well as probing depth. The condition of the teeth and the dental-jaw relationship has been restored after treatment.Conclusions: Chronic periodontitis with odontoma indicates treatment options according to the severity of the disease, access to mechanical care, and the patient's systemic condition.Keywords: Bone grafting, Gingival overgrowth, Odontoma, Surgical flap.

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Czy Konstytucja Rzeczypospolitej Polskiej wymusza na ustawodawcy ustawową regulację struktury organizacyjnej i właściwości sądów powszechnych?

Studia Prawa Publicznego ◽

10.14746/spp.2020.3.31.6 ◽

2020 ◽

pp. 119-135

Author(s):

Bogusław Banaszak

Keyword(s):

Public Authorities ◽

The Supreme Court ◽

Constitutional Tribunal ◽

Court Proceedings ◽

The Republic ◽

The Individual ◽

The Right ◽

And Function ◽

Statutory Regulation

The Constitution of the Republic of Poland does not define in a comprehensive manner the matter to be standardized in laws and grants the legislator considerable freedom in determining their content. In view of the subject matter of this opinion, based on views founded on the doctrine of Polish constitutional law and on the jurisprudence of the Constitutional Tribunal and the Supreme Court, it can be concluded that the legislator should regulate by law, among other matters, the following matters reserved for statutory regulation (the principle of exclusivity of the act): regulations concerning citizenship and the rights, freedoms and duties of the individual, as well as the basic competences, principles of how public authorities are organised and function. On the basis of this assumption, it was examined whether there is any indication to the legislator from the constitutional norms relevant to the judicial authority. The following were taken into account: the right to a fair trial (Article 45), the principle of the separateness and independence of the judiciary (Article 173), the principle of bi-instantiality of court proceedings and the principle of statutory determination of the system and jurisdiction of courts (Article 176), the principle of the presumption of competence being assigned to common courts (Article 177), and the principle of the non-removability and non-transferability of judges (Article 180). On the basis of an analysis of these constitutional norms, it was concluded that the Constitution of the Republic of Poland enforces statutory regulation of the organisational structure and the material, local and appeal jurisdiction of common courts, and only allows for entrusting specific matters to be regulated by executive bodies by means of a regulation. In the event of any doubts as to whether a given case should be classified into the category of specific matters, the principle of exclusivity of the Act applies.

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Stage treatment of patient with gunshot shin wound possessing bone and soft tissue defects in conditions of osteomyelitis

Perm Medical Journal ◽

10.17816/pmj36695-101 ◽

2020 ◽

Vol 36 (6) ◽

pp. 95-101

Author(s):

N. M. Belokrylov ◽

A. N. Belokrylov ◽

D. V. Antonov ◽

A. V. Schepalov

Keyword(s):

Surgical Treatment ◽

Soft Tissue ◽

Soft Tissues ◽

Structural Integrity ◽

Skin Flap ◽

Anterior Tibial Artery ◽

Dynamic Correction ◽

Total Period ◽

Ilizarov Apparatus ◽

The Right

The paper presents a case of severe gunshot wound of the shin in a 16-year-old adolescent as a result of gunshot from a small distance. Comminuted fracture of the tibia, damage of the anterior tibial artery, defect of the soft tissue in the injured area were detected. When admitted to the hospital, the patient underwent surgical treatment of the wound and fixation of fragments in carboxylic rod apparatus of external transosseous fixation. Osteomyelitis was developed. Ten days later, reosteosynthesis was performed. The first stage of bilocal osteosynthesis of the right shin was implemented, necrotized soft tissues and bone fragments and detritus were removed, initial purulent process was arrested. There was started distraction of the distal fragment of the tibia obtained as a result of its corticotomy in the lower third into the bone defect measuring 5 cm, which occurred when implementing surgical treatment of the wound. Twenty-eight days after, open alignment of tibial fragments in the upper third and reinstallation of Ilizarov apparatus was performed. The site of fragment junction was closed with unfree skin flap on the pedicle measuring 4 6 cm, the transplant bed was closed with full-layer skin graft using Parins technique. The further consolidation of fragments was reached simultaneously with maturation of the bone regenerate. The total period of fixation in Ilizarov apparatus lasted for 8 months. The bone and soft tissue structural integrity was restored, full function of the lower limb and adjacent joints was reached. Ilizarov apparatus is indispensable in multistage treatment of gunshot fractures and provides dynamic correction in changeable conditions; it permits to preserve the limb and its functionality.

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HIDDEN COMPLICATIONS OF THE POSTOPERATIVE PERIOD: DIAGNOSIS AND TREATMENT

Likarska sprava ◽

10.31640/jvd.3.2019(6) ◽

2019 ◽

pp. 43-47

Author(s):

O. A. Halushko

Keyword(s):

Surgical Treatment ◽

Clinical Improvement ◽

Intravenous Administration ◽

Postoperative Period ◽

Diagnosis And Treatment ◽

Surgical Interventions ◽

Results Of Treatment ◽

Phosphate Exchange ◽

Surgical Operations

One of the hidden complications of the postoperative period is hypophosphatemia (HPE), which often develops imperceptibly, but can worsen the overall results of treatment. The objective of the work: to investigate the frequency of development of disorders of phosphate exchange in the postoperative period and to establish the possibility and effectiveness of correction of such violations. Materials and methods. The determination of phosphate levels was carried out in 328 patients undergoing surgical treatment in surgical operations of various surgical status. Results. The highest rate of HPE was observed in patients with burns (23.08 %), after neurosurgical (17.94 %) and abdominal (17.64 %) surgical interventions. It is established that the correction of severe HPE is advisable by intravenous administration of sodium D-fructose-1,6-diphosphate. Conclusion. In the postoperative period, HPE is common, but is successfully corrected to abstract values, which coincides with the clinical improvement of patients.

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