The modern demand for effective treatment options in dermatology was successfully addressed by the invention of cryogenic method. By 2009, Dr. V.I. Kochenov had devel oped and patented cryogenic set of instruments based on 30 years of his personal clinical experience. The set includes a number of instruments, which could be used indepen dently. It allows implementing a wide range of therapeutic and surgical procedures and has no commercially available alternatives. The main applications of the set include cryogenic revitalization, and treatment for such common dermatological ailments as pso riasis, warts, acne, hypertrophic scars, purulent diseases of the skin and subcutaneous fat, epithelial cysts, skin hemangiomas, precancerous skin lesions, and even malignant melanoma of the skin. A brief overview of etiology, classification and pathogenesis of these maladies is presented alongside with the step-by-step guidelines to cryo-exposure procedures. Not only guidelines but also comprehensive theoretical and practical train ing is provided to physicians at the center which was established at Nizhny Novgorod State Medical Academy. Physicians at Scientific Clinical Center of Medical Cryology "OnKolor" have been using the set, which proved to be effective even in the most dif ficult and otherwise costly cases. The procedures that have pronounced cosmetic effect, leaves no scars and dark spots.
The aim of the study was to evaluate the efficacy of circular cryo-excision in the surgical treatment of skin melanomas. Materials and Methods. The study involved 126 patients with histologically verified malignant skin melanomas. The treatment efficacy was assessed by measuring the levels of antibodies to the CD3, CD16, CD4, and CD8 lymphocytes followed by calculating the CD4/CD8 ratio (immune regulation index, IRI) as an index of the immune health. For deep freezing of skin melanoma, a continuously cooled applicator with a ring-shaped tip attached to a vertical tube was used. Cryosurgical intervention-an excision of tumor tissues-was carried out in three stages. Results. The CD4/CD8 ratio (IRI) before the cryosurgery was 0.6±0.1; after the treatment, the IRI increased 2-fold. In 6 months, the level of IRI reached 1.5±0.2. The 5-year survival rates after the circular cryo-excision were 80.0±8.9%, even for melanomas with the Clark index of IV-V. Conclusion. Cryosurgical treatment of melanoma has a stimulating effect on the immune system and causes therapeutic consolidation that lasts for about 48 months, depending on the reactivity of the immune system. The results demonstrate the efficacy of this novel approach and rationalize its further use in oncosurgery.
There have been presented the results of lung cancer cryosurgery simulation using numerical solutions of enthalpy equation according to Godunov method. For the cryodestruction improvement purposes we successfully calculated the effective freezing time taking into account the evolution of an ice ball covering the tumor area. Geometrical transformation parameters of an ice ball have been measured by calculating the temperature distribution and the interface position in biological tissue. Mathematical cryosurgical procedures are described by heat transfer equations in solid and liquid phases. Numerical results for one-dimensional case were verified by comparing with exact solutions. In twodimensional modeling an effective cryotherapy time, which corresponds to freezing time of all tumor parts, was calculated as the area of forming ice balls covering all tumor region. The findings enable to set the effective time of a cryosurgical procedure in lung cancer. The knowledge of temperature distribution and interface position in biological tissue offers an opportunity to a cryosurgeon to finish the procedure within a certain time period to minimize the healthy tissue damage and destroy tumor cells to the maximum. Simulation application enables to schedule cryotherapy in lung cancer more effectively and to a good quality.
The currently used iodilators do not provide a stable position of the diluted tissues of the vestibule of the nose and require constant support by the doctor's hand during work. The position of the jaws of the retractor inevitably changes during manipulation and surgical interventions. Often during the operation, when the next surgical instrument is readied, which requires both hands, the doctor has to release the nasal dilator and remove it from the nose. At this time, control over the operating field is lost, the direction of the vestibule of the nose changes, which often affects the quality of the operation or manipulation.
K., 58 years old, was admitted to the clinical department of otorhinolaryngology of the Gorky regional hospital named after N. A. Semashko 2 / III 1980 with suspected laryngeal neoplasm
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