Suppurative Process Research Articles

Splenic Abscesses in the Pediatric Population: A Literature Review of an Uncommon Entity.

Splenic abscess in the pediatric population is a rare but serious condition. Its incidence is reported to be between 0.05% and 0.7%. Splenic abscess is an infectious suppurative process with a discernible macroscopic filling defect in the subcapsular space or spleen parenchyma. Causes include bacterial infection through the hematogenous route or from locoregional spread such as the gastrointestinal tract, septic emboli, trauma, sickle cell anemia, and malarial infestation. Diagnosis is often delayed due to non-specific signs and symptoms. Symptoms include fever, abdominal pain, and palpable left upper abdominal swelling. Ultrasound and cross-sectional imaging such as CT scans are useful for the diagnosis of splenic abscess but contrast-enhanced CT scans are considered the gold standard because of their high sensitivity and specificity. Treatment options range from antimicrobial therapy, percutaneous drainage, and aspiration to surgical interventions such as splenectomy. As it has a high mortality rate, prompt diagnosis and appropriate treatment are essential for optimal outcomes.

Domestic researchers who have made important contributions to the study of digestive system diseases: images in art. Georgiy Yosypovych Burchynsky

Georgiy Yosypovych Burchynsky (1908 — 1993) — Doctor of Medical Sciences, Professor, Honored Scientist of Ukraine, and laureate of the State Prize of Ukraine. G. Y. Burchynsky, throughout his life, was brought up on the traditions of the Kyiv therapeutic school. A close relationship with the Kyiv therapeutic school largely determined his personality as a doctor, teacher, scientist, and head of the department. In the years 1954 — 1962, Georgiy Yosypovych was the head of the Department of Therapy at the School of Dentistry. Since 1962, he had been the head of the Department of Faculty Therapy at the Kyiv Medical Institute for 24 years. G. Y. Burchynsky paid much attention to the study of pulmonary pathology. Based on the research materials, the monograph «Suppurative processes in the lungs» was issued in 1950. In particular, G. Y. Burchynsky developed a pathogenetic classification of pulmonary suppurations. One of the first in Ukraine, he applied the technique of endobronchial administration of antibiotics, He developed and introduced into practice the technique of zonal, or local, instillation using a bronchoscope. Gastrointestinal diseases have always been in the focus of Kyiv therapeutic school. G. Y. Burchynsky paid special attention attention to the problems of peptic ulcers. As a result, new data were obtained about this disease, which is outwardly clear but inwardly mysterious. G. Y. Burchynsky and his colleagues did a detailed study on the course of peptic ulcers, even during wartime. They looked at the etiology, pathogenesis, changes in the ultrastructure of the gastric mucosa, general changes, and questions about pathogenetic therapy for this disease. Experimental studies on the model of reproduction of a hypothalamic ulcer, as well as the results of studying the ultrastructure of gastroduodenal mucosa, confirmed the importance of the disturbances of nervous trophism. An experimental study on the pharmacodynamics of anticholinergics, which suppress cholinergic stimulation of the stomach and duodenum, showed that they can be used in clinical practice as a way to treat peptic ulcer disease. Under the supervision of G. Y. Burchynsky, two doctoral dissertations on the problem of peptic ulcers were defended at the department. Observations and results of the studies, performed by Georgiy Yosypovych and his colleagues, are reflected in the papers and monographs, such as “Peptic Ulcer,” “Clinical Gastroenterology,” and the relevant chapters of multi­volume guidelines and the Big Medical Encyclopedia.

Experience Of Using Internal Fixation In The Treatment Of Patients With Inflammatory Complications Of Mandibular Fractures: A Retrospective Study

Study goal — To evaluate the efficacy of plate osteosynthesis in the treatment of patients with inflammatory complications of mandibular fractures on a large sample. Material and Methods — We conducted a retrospective analysis of medical records collected over 15 years in a group of patients with inflammatory complications of mandibular fractures. The analysis included medical records of patients who underwent plate osteosynthesis operations performed according to the surgical algorithm adopted in the clinic, in combination with a simultaneous directed antibacterial effect on the microflora of the pathological focus and osteoplastic replacement of defects. We identified 164 medical records meeting the search criteria distributed among two study groups. Group A included hospitalized patients with developed abscesses and phlegmons of soft tissues surrounding the fracture area. For them, two-stage surgical intervention was performed. Group B consisted of patients who had no suppurative process in soft tissues, which allowed them undergoing one-stage surgical treatment. Results — Good, satisfactory, and unsatisfactory surgical outcomes were obtained in 82.6%, 14.9%, and 2.4% of the patients, respectively. The differences between the comparison groups were not statistically significant. Conclusion — The clinical effectiveness of an integrated approach to the surgical treatment of patients with inflammatory complications of mandibular fractures, based on providing stable fixation of connected fragments as a critical factor in bone wound healing via osteosynthesis, was confirmed on large samples in both comparison groups.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula.

MODERN PRINCIPLES FOR LOCAL MANAGEMENT OF PURULENT WOUNDS

At present, surgical infection is one of the most thorny, difficult and urgent issues in clinical practice and is a great social and ecological importance globally. Growing number of suppurative and necrotizing lesions, postoperative suppurative complications, cases of generalized infection and various toxic and allergic reactions are among the challenges the surgeons have to encounter in daily practice. Patients with suppurative inflammatory lesions, which occurrence rate is reaching out 35 – 40% of soft tissue inflammatory cases, constitute a considerable share of all surgical patients. And sometimes the treatment outcomes of such conditions are unsatisfactory. Under the body immune response, the number of postoperative suppurative complications is demonstrates a tendency toward the growth. The clinical course of such suppurative processes is usually acute and often causes systemic infection, sepsis, and even lethal outcomes. In the total number of the lethal cases in surgical inpatient departments, the number of acute surgical infection ranges from 40 to 60%. Moreover, there has been an increase in a number of chronic cases resulted from acute ones that require more time and expenses to manage them. Long hospital staying, insufficient treatment efficacy of existing techniques, considerable economic losses for rehabilitation evidence the range of questions unsolved. The literary review has shown that early detection and proper management of purulent foci is among the leading factors of successful management of surgical wounds. Despite the active implementation of new approaches and techniques for the treatment of purulent wounds, so called "under the bandage" wound management is of considerable clinical importance, therefore the right selection of wound dressing materials, different by their chemical nature, dressings techniques, medications is one of the most promising ways on local treatment of suppurative wounds that can significantly increase the effectiveness of the treatment outcomes.

Complications after lung resections due to chronic nonspecific suppurative processes

Recently, so-called partial, or economical, lung resections have been increasingly introduced into surgical practice. Various kinds of combined resections, mono-, bi- and trisegmentectomies have replaced the previously inevitable pulmonitis lobectomies.

Some aspects in the treatment of patients with a suppurative process after joint implanting

Attention is concentrated on the basically varying nature of early and late suppurative complications after implanting and hence on different approaches to treating deep suppurative processes. In early deep suppurations, timely intensive care permitted the authors to eliminate suppurative complications in 67.8%, by preserving the implant. In late suppurations associated with metallosis, the implant cannot be preserved, it is necessary to treat not only a deep suppuration, but also metallosis.

Damage to the connective tissue system in patients with post-traumatic osteomyelitis

In 63 patients with suppurative bone process the activity of N-acetyl-fi-D-glucosaminidaze lysosomal enzyme in urine as well as oxyproline and hexuronic acids excretion were evaluated. Significant changes in metabolism of collagen and proteoglycans of osseous organic matrix were detected and it was confirmed by high excretion of their structural components. The more active and vaster the suppurative process was the more quantitative excretion of collagen and glu- cosaminoglycans and higher enzyme activity were. The suggestion was formulated that high excretion of N-acetyl-fl-D-glucosaminidaze in urine noted in the patients with suppurative inflammatory complications was the indicator of pathologic changes in tubular apparatus of kidney. The detection of excretion of the connective tissue metabolites (oxyproline and hexuronic acids) could be used for the diagnostic and prognostic evaluation of the disease severity and for the choice of method for the treatment of suppurative process.

Why was the surgeon V.F. Voyno-Yasenetsky canonized?

Surely everyone has heard of Saint Luke the Blessed Surgeon, whose name is given to many scientific and medical institutions, medical universities and colleges, treatment and diagnostic centers. The Institute of Pediatric and Adult Neurology and Epilepsy in Moscow, the Diagnostic and Treatment Center in Kamensk-Shakhtinsky, and the International Educational Center for Medical Institutions bear his name. Do you know that the famous surgeon Valentin Feliksovich Voyno-Yasenetsky and Saint Luke the Blessed Surgeon are one and the same person, and that he lived and worked not in ancient times, but under the Soviet Union? An outstanding scientist, PhD in Medicine, professor, laureate of the Stalin Prize V.F. Voyno-Yasenetsky made a huge contribution to the development of surgery, including purulent surgery. He wrote about 60 scientific papers, and many of the works were accompanied by his own drawings. He was awarded the Stalin Prize of the first degree for Essays on Purulent Surgery and Late Resections for Gunshot Wounds of the Joints. These monographs were a necessary and timely scientific and practical guide in all base and field hospitals during the Great Patriotic War. In this work, the anatomical and topographic principle of the study of suppurative processes, first put forward by N.I. Pirogov, was consistently highlighted. Over the years, the monograph has not lost its relevance; it remains of interest to neurosurgeons, ophthalmologists, dentists, urologists, and doctors of other specialties. The author of these books was PhD in Medicine, a scientist, surgeon, teacher and artist, who took holy orders in the most terrible years of persecution of the church, in 1921. For the courageous confession of Orthodoxy, he was repeatedly arrested. He spent many years in prisons and camps, but he always remembered the high calling of a doctor. While healing the body, he also healed spiritual wounds, and he never betrayed any of his callings.

MODERN PHYSICAL METHODS IN MANAGING SUPPURATIVE WOUNDS

Suppurative and inflammatory processes in soft tissues make up a considerable share, 35 – 40%, in the structure of surgical problems in inpatients. Suppurative and inflammatory processes are often characterized as acute, resulting in systemic infection, sepsis, and even fatal outcomes. In the total structure of lethal outcomes in surgical inpatient departments the mortality rate due to acute surgical infection makes up 40 – 60%. Long hospital treatment, insufficient effectiveness of existing treatment methods, additional expenses for recovery and rehabilitation put this issue in the forefront of the most challenging healthcare tasks. This review states out that management of suppurative wounds is still remaining the most pressing for surgeons nowadays. Despite the rich experience and ever-increasing techniques and approaches in treating suppurative wounds, the elaboration of more effective physical methods to stimulate the healing of the wounds seems to be promising. The physical methods can include vacuum treatment, laser and ultrasound wound treatment, ozon therapy, hyperbaric oxygenation, phototherapy, hydropress sanation. The above methods can considerably contribute to the wound treatment thus promote its rapid healing. However, each of the techniques listed has its own disadvantages (technical, biological, economical), and can be applied only at a particular stage of wound healing. In-depth analysis of all advantages and shortcomings, contraindications to each method, enables to improve the treatment outcomes for patients with suppurative wounds thus reducing the time of hospital staying and expenses.

Analysis of 93 Brain Abscess Cases to Review the Effect of Intervention to Determine the Feasibility of the Management Protocol: A Tertiary Care Perspective.

Context:Brain abscess is a suppurative process within the brain parenchyma, which remains a challenge for clinicians. Surgical excision or aspiration combined with prolonged antibiotics (usually 4–8 weeks) or only conservative management remains the treatment of choice.Aims:The purpose of this study is to analyze the epidemiology of brain abscess and to determine the potential factors leading to better outcomes.Settings and Design:This was a retrospective analysis of 93 patients undergoing various treatment options for brain abscess in a tertiary care center.Materials and Methods:Their preoperative status, etiology, and microbiological and clinical outcomes were analyzed.Statistical Analysis Used:Statistical analysis was done by Chi-square, one-way analysis of variance, and post hoc Newman–Keuls multiple comparison test wherever applicable using SPSS software.Results:Among 93 brain abscess cases, only 21 cases had a diameter <2.5 cm. Among them, conservative treatment was done for 38% of patients (8/21), aspiration for 47.6% (10/21) of patients, and excision for only 3 (14.2%) of cases. About 37.5% (3/8) persons among these conservatively managed patients had recurrence. None of the patients of <2.5 cm abscess having surgical management had recurrence or any new neurological deficits postsurgery during the 6-month follow-up.Conclusions:There was a significantly high recurrence among the nonsurgically treated patients with lesions <2.5 cm and there was no recurrence or neurological deficit after aspiration among these patients. Probably, aspiration has better results among these patients contrary to previous recommendations of antibiotic therapy alone.

Foreign body aspiration.

The clinical manifestations of foreign body (FB) aspiration can range from an asymptomatic presentation to a life-threatening emergency. Patients may present with acute onset cough, chest pain, breathlessness or sub-acutely with unexplained hemoptysis, non-resolving pneumonia and at times, as an incidental finding on imaging. Patients with iatrogenic FB such as an aspirated broken tooth during difficult intubation or a broken instrument are more common scenarios in the intensive care unit (ICU). Patients with post-obstructive pneumonia with or without sepsis, or variable degree of hemoptysis often require ICU level of care and bronchoscopic interventions. Rigid bronchoscopy has traditionally been the modality of choice; however, with the innovation in instrumentation and wider availability of flexible bronchoscopes, most of the FB removal is now successfully performed using flexible bronchoscopy. Proceduralists choose instruments in accordance with their training and expertise. We describe the use of most common instruments including forceps, balloon catheters, and baskets. Role of cryoprobe and LASER in FB removal is reviewed as well. In general, larger working channel bronchoscopes are preferred; however, smaller working channel bronchoscopes may be used in situations when the patients are intubated with a smaller diameter endotracheal or tracheostomy tubes. Large size FB are removed en bloc with the grasping tool, bronchoscope, and endotracheal or tracheostomy tube, requiring preparation to safely re-establish the airway. After FB removal, bronchoscopy is re-performed to identify any residual FB, assess any injury to the airway, suction post-obstructive secretions or pus, control any active bleeding and remove granulation tissue that may be obstructing the airway. Additional interventions like balloon dilatation may be required to dislodge an impacted FB or to maintain patency of bronchial lumen. If bronchoscopic methods fail, surgery may be required for retrieval of FB in symptomatic patients or to resect suppurative or necrotizing lung process. Multidisciplinary approach involving intensivists, surgeons, and anesthesiologists is the key to optimal patient outcomes.

ОЦЕНКА РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ ОСЛОЖНЕНИЙ МОЧЕКАМЕННОЙ БОЛЕЗНИ У БОЛЬНЫХ С COVID-19

Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19. Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%). Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second - 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group - 8 (1-56) days. Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approachesto achieve success in patientswith complications of urolithiasis duringCOVID-19outbreak. What this paper adds The peculiarities of diagnostics and treatment of urinary tract stone disease complications among patients with new coronavirus infection COVID-19 have been studied. It is shown that the typical differences of patients with complicated urolithiasis and new coronavirus infection COVID-19 are elderly and old age, being a female, prevalence of pyelonephritis and paranephritis in clinical presentations, and presence of several combined complications of the urolithiasis. Mortality rate upon complicated urolithiasis and new coronavirus infection COVID-19 since the pandemic onset has reached 30% that demands optimization of treatment approaches in patients of this group.

Homeopathic Treatment of Trauma, Abscess and Papillomatosis in Trachemys dorbigni

Background Mechanical trauma, bacterial and viral infections are common in Trachemys dorbigni when in captivity. Aims Report the evolution of homeopathic treatment in a patient of Trachemys dorbigni species. Methodology Homeopathic treatment was chosen, based on the principle of similitude, using Arnica montana due to its anti-inflammatory action, Avena sativa for the physical fatigue; Silicea to act in suppurative processes and Thuya occidentalis in papillomatosis. Results On 22/11/2018, with 1 month old, 6g, it presented lethargy, hyporexia, locomotor difficulty due to edema and necrotic process in the right anterior limb, presenting bad prognosis and possible limb loss. The protocol was 2 globules of Arnica montana 6CH, diluted in the contact water, every 8 hours, for 7 days and 2 globules of Avena sativa 6CH, every 12 hours, for 5 days. After 7 days, it was observed that the patient was active, normoretic, with weight gain and decreased edema and necrotic process of the right anterior limb, ruling out the amputation. On 29/12/2018, the patient presented a rigid abscess in the right cervical region, that adopted protocol with a single dose of 2 globules of Silicea 6CH and 2 globules of Arnica montana 6CH, diluted in the contact water, every 24 hours, for 4 days, until the return on 02/01/2019, with the complete regression. On 13/01/2019, it presented papillomas and plastron infection, which the proposed treatment was constituted with administration of 2 globules of Thuya occidentalis 12CH, diluted in the contact water, every 24 hours for 3 days, with total remission of the lesions occurring in 3 days. Conclusion Mechanical trauma, bacterial and viral infections can be controlled by homeopathic medicaments without the administration of antibiotic or surgeries, being fast, less harmful and with an affordable economic value.

ИСПОЛЬЗОВАНИЕ МЕТОДА NPWT В ЛЕЧЕНИИ ОБШИРНОЙ НАГНОИВШЕЙСЯ ПОДШЛЕМНОЙ ГЕМАТОМЫ У ВЗРОСЛОГО

Negative pressure wound therapy (NPWT) has been proven to be one of the most effective techniques in the treatment of severely infected wounds of various origins and localizations. At the same time, the prospects for its application are constantly expanding. This clinical observation demonstrates the use of NPWT in the treatment of an adult patient hospitalized in severe condition with a picture of extensive post-traumatic infected subgaleal hematoma. The development of a generalized suppurative purulent process was contributed both by the patient’s late request for medical help (18&lt;sup&gt;th&lt;/sup&gt; day after the injury) and, as a consequence, the lack of primary surgical treatment of the scalp soft tissue injury, as well as the anatomical features of this area. The magnetic resonance tomography as instrumental examination methods played a significant role in the diagnosis of complications in addition to clinical data. Medical tactics was based on the surgical treatment of the infected focus, the application of antibacterial therapy, taking into consideration the isolated microbial flora (Streptococcus pyogenes). To eliminate severe inflammatory changes in the tissues and to reduce the size of the vast subaponeurotic cavity, NPWT technique was applied, which made it possible in short time to prepare a postoperative wound for surgical closure. The early secondary suturing at the final stage of treatment allowed obtaining a good result.

A Case Report of an Invasive Scalp Actinomycosis

Background: Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as Actinomycosis israelii. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. Case: A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. Conclusion: Involvement of scalp by actinomycosis could be mistaken for different pathologies, such as tuberculosis or carcinoma. This emphasizes the importance of biopsy for histological confirmation of the disease.

The Use of Mucolytic Agent in Percutaneous Drainage of Liver Abscess: A Case-Series Analysis.

Background: Liver abscess is a scarce but potentially fatal suppurative process. There is a general tendency for minimally invasive treatment, such as broad-spectrum antibiotherapy and percutaneous drainage. Multiloculated, multiple or incompletely liquefied abscesses often limit the efficacy of percutaneous drainage. This study aims to assess the effectiveness of percutaneous drainage and intracavitary instillation of a mucolytic agent for liver abscesses. Material and method: From our department database, we have identified patients with liver abscess admitted during the period 2015 - 2020, treated by ultrasound-guided percutaneous drainage and intracavitary instillation of mucolytic agent. Data regarding imaging appearance, drainage technique, inflammatory markers and clinical course were assessed. Results: Twenty-one patients with multiloculated liver abscesses, sized 8 to 17 cm, were percutaneously drained, with local anaesthesia, under ultrasound guidance. The bacteriological exam of the aspirate showed bacterial infection in 19 cases, mostly Klebsiella pneumoniae, and 2 fungal infections. Acetylcysteine in dilution 1: 1 with saline was instilled daily on the 12F or 14 F drainage catheter. Clinical and radiological resolution was achieved within 14 to 29 days. Two cases required supplementary drainage of a non-communicating residual cavity. There were no complications, periprocedural deaths or relapse at 3 months follow-up. Conclusions: Percutaneous drainage is effective even in the management of multiloculated liver abscesses, facilitated by the use of intracavitary mucolytic agent.

Случай хирургической реабилитации пациента с аномальным строением зуба

The article presents the results of a clinical observation of patient M. with an abnormal tooth structure and shape in the frontal maxilla. Teething was accompanied by an atypical suppurative process similar to a follicular cyst. Congenital pathologies of the maxillofacial area often include abnormalities in the shape and number of teeth. The main types of abnormal tooth shape are: spiky teeth, the crowns of which are tenon-shaped or conical in shape; Fournier teeth, when the permanent teeth, namely the lower and upper molars, have the shape of a cone; Pfluger teeth — underdeveloped teeth, the size of the neck of which is larger than the size of the gums. Taurodontism («bovine» teeth) is a violation of the teeth shape, which is more often observed in permanent molars, when the tooth body and pulp cavity increase vertically at the expense of the roots. As a result, the pulp cavity and the furcation of the tooth move apically down the root. Patient M. underwent surgical tooth extraction with further replacement of a bone defect with a PRP technique. A differentiated approach is recommended in the treatment of anomalies of difficult teething, taking into account the further restoration of defects by orthopedic methods.

Surgeon-innovator and physician-humanist ahead of his time (to the 145th anniversary of the birth of academician A.V. Vishnevsky)

The main scientific and practical activities of A.V. Vishnevsky took place in Kazan and Moscow. This paper presents little-known facts from the creative life of A.V. Vishnevsky, with a focus on his contribution to the development of local anesthesia and novocaine blockade in our country. Vishnevsky graduated from the Astrakhan gymnasium in 1894 and from the Kazan University in 1899. From 1899 to 1912, he was an assistant dissector at the departments of normal anatomy, topographic anatomy, and operative surgery of Kazan University. During the First World War, he mostly performed surgery to wounded individuals with gunshot injuries that involved peripheral nerves, producing neurolysis or suturing of the nerves. To treat brain abscesses, he used oil-balsamic drainage, which gave better results than other therapeutic methods. From 1914 to 1934, he managed first the hospital and then the faculty surgical clinics in Kazan. With the emerging problems in surgery, he paid much attention to neurosurgery, local analgesia, suppurative processes, nervous tropism, and gunshot wounds. His original theoretical works were devoted to neural trophy. His proposed methods of nerve block, in particular, pericardial novocainic and vago-sympathetic blockages, were widely accepted. As regards his contribution to the field of military surgery, he promoted proper surgical treatment of wounds, justified secondary treatment of wounds, and suggested methods to combat traumatic shock, secondary bleeding, etc. In 1947, A.V. Vishnevsky was appointed as the Director of the Institute of Surgery of the USSR Academy of Medical Sciences in Moscow. He was the founder of the great national school of surgeons.

Alexander Nikolaevich BAKULEV - Soviet surgeon-scientist, the founder of cardiovascular surgery in the USSR (to the 130th of birthday)

Alexander Bakulev was born in the village Nebankovskaya Vyatka province. He studied first at the parish school, and then at the Vyatka theological Seminary. In 1911 he entered the medical faculty of Saratov University. In 1918, he passed the exams for a doctor's degree ahead of schedule and remained in the hospital surgery clinic of the University. In 1926 A. N. Bakulev entered the residency at the Department of surgery of the 2nd Moscow medical Institute. In 1928 he successfully defended his thesis and was sent for a one-year internship in Germany. For the first time in the domestic practice, he proposed the introduction of radiopaque substances in the brain tissue, a method of ureteral transplantation, improved methods of x-ray examination of vessels, kidneys and ureters, developed methods of plastic esophagus (1935), surgery on the biliary tract, methods of surgical treatment of peptic ulcer, for the first time in the world surgically eliminated the fixation of the heart muscle to the heart bag with pericarditis, developed new methods of treatment of brain abscesses. A. N. Bakulev is considered a pioneer of intubation anesthesia in the USSR, the founder of thoracic and radical pulmonary surgery. He performed a successful lobectomy for chronic abscess (1938) and lung actinomycosis (1939). In 1943 A. N. Bakulev became head of the Department. During the great Patriotic war A. N. Bakulev - front, and then chief surgeon of the evacuation hospitals of Moscow, head of the surgical Department of the hospital medical and sanitary Department of the Kremlin. He successfully removed a lung from a patient with chronic suppurative process (1945), for the first time carried out a successful operation in nezaradene known to inhibit the Bayou (1948), have developed a method comissurotomy. In 1949, A. N. Bakulev was awarded the Stalin prize (1949). He was the first to impose an anastomosis between the superior Vena cava and pulmonary artery, performed surgery for aneurysm of the thoracic aorta, created a technology of heart operations in hypothermia, for the first time in the world he began to operate on children suffering from congenital heart defects. In 1955 on the initiative of A. N. Bakuleva was established Institute of thoracic surgery (now the Institute of cardiovascular surgery. A. N. Bakuleva), the first Director of which he became. Among his developments can be noted the method of electrocardio-stimulation, intended for the treatment of heart rhythm disorders, a method of plasty of coronary vessels in acute myocardial infarction. In the mid-fifties A. N. Bakulev lays the foundations of shunting operations on the vessels of the heart. In 1957 he was awarded the Lenin prize. In 1959 A. N. Bakulev performed a successful operation for valvular stenosis of the pulmonary artery. In 1958, the scientist was elected a full member of the USSR Academy of Sciences. From 1953 to 1960 President of the USSR Academy of Sciences. A. N. Bakulev was awarded three orders of Lenin, the order of the red banner of Labor and the red Star, was awarded the highest international award of surgeons the award "Golden scalpel". On March 31, 1967, Alexander Bakulev died suddenly from cardiac arrest and was buried at Novodevichy cemetery. In memory of Alexander Nikolaevich in 2005, a documentary film "the Key to the heart" was shot in front of the Institute of cardiovascular surgery named after A. N. Bakulev monument to the scientist, and the building a plaque.