[The use of L-lysine aescinat in the treatment of microcirculatory disturbances in patients young and middle age with violation of the intracranial venous outflow]. / L-lizina estsinat v lechenii mikrotsirkulyatornykh rasstroistv pri narushenii intrakranial'nogo venoznogo ottoka u patsientov s sindromom vegetativnoi distonii.

AIM: To study the efficacy of L-lysine aescinat in the treatment of vascular and microvascular disorders in patients with cerebral venous dystonia. MATERIAL AND METHODS: Sixty-eight patients, 25 male and 43 female, aged from 25 to 56 years, with disturbances of venous cerebral blood circulation and venous outflow difficulties were examined. The examination included the assessment of cerebral hemodynamics using the algorithm of complex ultrasound examinations and functional status of the microcirculation by the laser Doppler flowmetry (LDF) at baseline and 10 days after treatment with L-lysine aescinat. RESULTS AND CONCLUSION: L-lysine aescinat improves intracranial venous outflow, significantly improves the functioning of microcirculation, while not affecting the normal type of microcirculation or changing it in the direction of improvement of hemodynamic parameters, has a modulating effect on the autonomic response, and can be recommended in the complex treatment of young and middle aged patients with disturbances of cerebral venous blood circulation with the predominance of vagotonia as well as hypersympathicotonia.

[Hemipylorectomy with transverse pyloroplasty and vagotomy in perforating and bleeding ulcers of the pyloric canal]. / Gemipiloréktomiia s poperechnoi piloroplastikoi i vagotomiei pri probodnykh i krovotochashchikh iazvakh piloricheskogo kanala.

Hemipylorectomy with transverse pyloroplasty and vagotomy was made in 922 patients with perforating and bleeding ulcers of pyloric canal. 510 of them had perforation of ulcer, 412--ulcer bleeding. In all the cases ulcer was excised together with anterior semicircle of the pylorus, the defect was sutured transversely. Hemipylorectomy with transverse pyloroplasty was combined with (anterior selective proximal serous-muscular and posterior trunkal) vagotomy. Postoperative lethality in perforation of ulcer was 4.8%, in bleeding--8.2%. From 1 year to 10 years after operation good functional results were achieved in the majority of the patients. This variant of organsaving operation is optimal in complicated ulcers of pyloric canal.

[Comparative results of surgical treatment for perforating and bleeding pyloroduodenal ulcers]. / Sravnitel'nye rezul'taty khirurgicheskogo lecheniia probodnykh i krovotochashchikh piloroduodenal'nykh iazv.

Results of treatment of 1309 patients with perforated and bleeding pyloroduodenal ulcers for 20-years period have been analysed. Resection of the stomach performed in 85 cases resulted in high postoperative lethality which made up in bleeding ulcers 14.8%. Drainage operations of the stomach with excision or suturing of ulcer combined with bilateral truncal vagotomy was performed in 60 patients, postoperative lethality rate being 8.4%. 128 patients underwent selective proximal vagotomy together with pyloro- and duodenoplasty, lethality rate being 1.6%. Combined vagotomy (posterior truncal and anterior sero-muscular) with excision of ulcer, transversal pyloroplasty and duodenoplasty was carried out in 1036 patients (postoperative lethality--2.4%). Excellent and good functional results were achieved in 79.6% of the patients.

[Evaluation of the gastric outlet function of normal and operated stomach using ultrasound]. / Otsenka funktsii vykhodnogo otdela normal'nogo i operirovanogo zheludka s pomoshch'iu ul'trazvuka.

The functional condition of the gastric outlet was studied by ultrasound in 25 individuals (the comparison group) and in 37 patients after organ-preserving operations for complicated pyloroduodenal ulcers. The diameter of the gastric outlet and the pylorus, the length of the pyloric canal were recorded during the examination and the presence or absence of duodenogastric reflux was noted. A duodenogastric reflux was found in 48% of persons of the comparison group, in 25% of patients after Judd's pyloroplasty and all patients after Finney's pyloroplasty. The data obtained provide evidence that the functional results are better in pylorus-preserving and pylorus-saving operations that in pylorus destroying operations which lead to loss of the obturation function of the pylorus.

[Clinico-anatomical basis for using the variants of proximal gastric vagotomy in the treatment of gastroduodenal ulcers]. / Kliniko-anatomicheskoe obosnovanie variantov proksimal'noi selektivnoi vagotomii v lechenii iazvennoi bolezni dvenadtsati- perstnoi kishki i zheludka.

Anatomical examinations (33 cadavers) for studying parasympathetic innervation of the upper abdominal organs formed the basis for developing a new variant of proximal gastric vagotomy--anterior seromyotomy of the body and fundus of the stomach in combination with posterior truncal or posterior selective vagotomy. This variant excludes mobilization of the esophagus and makes it possible to preserve the ligament apparatus of the esophago-gastric junction as well as the parasympathetic innervation of the pancreas, small and large intestine, kidneys, and adrenals, which may be a measure for the prevention of some ++post-vagotomy complications.

[Anterior seromyotomy of the body and the functional part of the stomach combined with posterior truncal vagotomy and ulcer excision in the surgical treatment of complicated stomach ulcer]. / Peredniaia seromiotomiia tela i funktsional'nogo otdela zheludka v sochetanii s zadnei stvolovoi vagotomiei i issecheniem iazvy v khirurgicheskom lechenii oslozhnennoi iazvennoi bolezni zheludka.

Anterior seromyotomy of the body and fundus of the stomach was combined with posterior truncal vagotomy and excision of the ulcer in 23 patients with gastric ulcer complicated by bleeding or perforation. Seventeen patients had chronic ulcers of the body of the stomach (type I), 3 patients had concurrent ulcers (type II), and 3 more patients had acute ulcers of the body of the stomach. Operation was undertaken for active bleeding from the ulcer in 20 patients and for perforating ulcer in 3 patients. One patient died. Mild disorders of evacuation of an aqueous barium sulfate suspension from the stomach were noted in 4 patients.