[The role of gastroesophageal reflux in malignization of post-burn and peptic esophageal strictures].

The subjects of the study were 221 patients with cicatrical esophageal strictures. 62 (28.5%) patients had peptic strictures, and 159 (71.9%)--post-burn strictures. 67 (30.3%) patients underwent esophageal resection with one-stage intrapleural esophagoplasty with the stomach, 152 (68.8%) patients--gullet bougienage in combination with surgical intervention or as an only treatment. The study revealed 8 cases of squamous cell carcinoma in patients with post-burn strictures, and 3 cases of squamous cell carcinoma in patients with peptic strictures. In 2 cases the researchers found early stage of esophageal cancer (verrucose carcinoma)--in 1 patient with post-burn stricture and 1 patient with peptic stricture. The results suggest an important role of chronic gastroesophageal reflux in the oncogenesis of esophageal squamous cell carcinoma in patients with post-burn and peptic strictures.

[To differential diagnosis of esophageal cancer and other diseases with the similar clinical symptoms, by using traditional X-ray study].

The principal purpose of the paper is to assess the role of the X-ray section of current radiation diagnosis in obtaining objective information and interpreting it in esophageal cancer. The study was methodically based on its serial studies, by comparing the data of clinical, radiation, and endoscopic diagnosis with those of morphological studies of the biopsy specimens taken at resection for cancer of the esophagus and the upper stomach, and histologically examined them in diseases running with the similar clinical symptoms. The complex of radiation techniques included traditional X-ray study (compact filling, double contrasting). A specially developed procedure that allowed physicians the opportunity to examine the cardioesophageal area in the fragmentary fashion was used during morphological studies. In cancer of the upper stomach, the lower esophageal segments were also involved in the process in 79.9%. It should be also noted that this number of observations includes some cases that clinical symptomatology and endoscopy strongly suggest cancer of the lower third of the esophagus. The authors have arrived at the conclusion that the present-day X-ray semiotics of esophageal diseases running with the similar clinical symptomatology permits their differential diagnosis just before the use of endoscopy and histology of biopsy specimens and that the unique advantage of radiation diagnosis over endoscopy is to specify the initial site of a tumor, namely, to detect primary gastric damage in cardioesophageal carcinoma.

[Antisecretory therapy for prevention of stenoses of bougienage after-burn of esophageal strictures]. / Antisekretornaia terapiia v profilaktike stenozov posle buzhirovaniia ozhogovykh striktur pishchevoda.

The purpose of the research was to study the efficacy of the bougienage of after-burn esophageal strictures against the background of long-term treatment with proton pump inhibitors of H2-blockers. 100 patients with after-burn esophageal strictures were divided into 3 groups in a random way: 1) only bougienage--53 patients; 2) bougienage and omeprazole, 20 mg per day during 12 months--20 patients; 3) bougienage and ranitidine, 300 mg per day during 12 months--27 patients. Bougienage was efficient in 83 patients (83%). 17 patients underwent esophagoplasty due to inefficiency of bougienage. Repeated bougienage was necessary for 35% of patients who were taking omeprazole (p = 0.04), 48.1%--ranitidine (p = 0.2), and 60.4% of patients who underwent only bougienage. Bougienage of the esophagus is efficient in treatment of after-burn strictures. Twelve-month treatment of these patients with omeprazole reduces the number of repeated bougienage courses significantly.

[The surgical and combined treatments of locally disseminated cardioesophageal cancer]. / Khirurgicheskoe i kombinirovannoe lechenie mestnorasprostranennogo kardioézofageal'nogo raka.

The article deals with the experience in the treatment of more than 1,000 patients with cardioesophageal carcinoma in 1965-1989. The authors note increase of surgical activity and widening of indications for operative treatment at the cost of patients of the old age groups and those with locally-extending forms of the neoplastic process. In distinguishing the term cardioesophageal carcinoma the authors insist on the community of the surgical tactics and operative methods in carcinoma of the cardia extending to the esophagus and in esophageal carcinoma spreading to the stomach. Improvement of the results of tre treatment the authors attribute to the perfection of the methods of lymphodissection and formation of esophageal anastomoses. The authors claim that the development of effective methods of combined treatment underlies the prospects of improving the late-term results. Experience in preoperative hypoxyradiotherapy, adjuvant postoperative chemotherapy, and preoperative regional intraarterial polychemotherapy is analysed.

[Garlock's operation in cancer of the esophagus]. / Operatsiia Garloka pri rake pishchevoda.

Experience in 88 Garlock-type operations carried out in carcinoma of the esophagus allows a certain opinion to be formed on the advantages and shortcomings of this surgical intervention. In esophageal carcinoma with its proximal boundary within the range of the retropericardial segment of the esophagus, a left abdominothoracic approach (Garlock's operation) is adequate in resection of the esophagus in conformity with the oncological principles and allows the formation of the esophagogastric anastomosis at the level of the arch of the aorta without particular technical difficulties. Reduction of the time needed for the operation, determination of the resectability of the esophageal tumor before mobilization of the stomach are obvious advantages of the abdominothoracic approach.

[Antibodies to the human T-cell leukemia virus in the blood serum of the inhabitants of Sakhalin and Iuzhno-Kuril'sk]. / Antitela k virusu T-kletochnogo leikoza cheloveka v syvorotke krovi u zhitelei Sakhalina i Iuzhno-Kuril'ska.

Two immunological tests were used in testing of 808 blood serum samples from inhabitants of Sakhalin and of the city of Yuzhno-Kurilsk for antibodies against HTLV-1 etiologically associated with human T-cell leukemia. Antibodies to HTLV-1 were detected in 4.2% of Nivkhs, 1.2% of Oroks and 1.5% of Russians. The highest level of virus-carriers reaching 6.0% was detected in Nivkhs from the middle part of Sakhalin. The antibodies were detected more often in persons of old age and in women.

[Serological examination of the population of the Far East for the presence of antibodies to human T cell leukemia virus HTLV-1]. / Serologicheskoe obsledovanie zhitelei Dal'nego Vostoka na nalichie antitel k virusu T-kletochnogo leikoza cheloveka HTLV-1.

Antibodies to HTLV-1 were detected in sera from 1298 healthy adult persons living in the Far East. It is shown that virus infectivity of the Nigidalts was 8%, Nivkhs--2%, Udegeits--2.9%, Oroches--2.4%, Russians--0.9%. However, the incidence of acute leukemia in these regions is low. It is suggested that these regions are not endemic areas for HTLV-1-associated haemoblastoses.