[Primary pulmonary hypertension in adults]. / Pervichnaia gipertoniia malogo kruga krovoobrashcheniia u vzroslykh.

Primary pulmonary hypertension is a rare disease of unknown etiology which relates to the precapillary form of the hypertension. The review of the literature and authors' data on the changes of pulmonary vessels and the heart weight are presented. So-called plexiform structure characteristics for this pathology are considered by the authors as glomus anastomoses developing as a compensation of pulmonary circulation disturbances.

[The effect of extragastric vagotomy on gastric emptying and motility of the small intestine]. / Vliianie ékstragastral'noi vagotomii na zheludochnuiu évakuatsiiu i motoriku tonkoi kishki.

Selective parasympathetic denervation of small and some large intestine has been performed in dogs. Chronic experiment on these dogs has revealed that this operation: has no effect on frequency and amplitude of intestine contractions during the first phase of the digestive process but it is accompanied by significant relaxation of the motor intestine activity in the second phase, causes a retardation of the rate of evacuation from stomach by 56.0% in dogs subjected to extragastric vagotomy as well as pH of chyme in the duodenum by 1-1.5 units above the norm.

[Neutrophilic leukocyte reaction in the course of diffuse purulent peritonitis]. / Osobennosti reaktsii neitrofil'nykh leikotsitov na étapakh razvitiia razlitogo gnoinogo peritonita.

Peritoneum biopsies from patients with various stages of peritonitis were studied electron microscopically. As distinct from the widespread opinion of a significant phagocytic activity of neutrophil leucocytes in early peritonitis this activity was not found. The authors consider this as a cause of peritonitis progression and fatality of the disease in the absence of surgical treatment. Phagocytic activity is restored after the elimination of the causative factors, i.e. after the sanative operation.

[Principles of the morphofunctional classification of granulocyte deficiencies]. / Printsipy morfofunktsional'noi klassifikatsii granulotsitarnykh defitsitov.

On the basis of qualitative and quantitative indexes of the plasmatic-cellular system of neutrophilic leukocyte /NL/ a classification of granulocytic deficiencies /GD/ is developed, 4 forms of GD are distinguished: agranulocytosis, granulocytasthenia, myeloproliferative conditions and inflammatory leukocytosis. As a clinicomorphological criterium of GD a triad is suggested that includes a tissue necrosis, microbism and inflammatory infiltration. Functional failure typical for every form of GD has it sown features.

[Surgical treatment of chronic pancreatitis associated with duodenal ulcer]. / Khirurgicheskoe lechenie khronicheskogo pankreatita, sochetaiushchegosia s iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

In combination of the ulcer disease and pancreatitis with the aim to achieve simultaneous suppression of gastric hypersecretion and reduction of the secretory pancreatic activity, a method of operation--selective proximal vagotomy added by cutting the celiac branch of the right vagal trunk has been developed. In 42 patients, operated on using the suggested method, the pancreatic secretion, acid production and gastric motility were studied. At observation of up to 7 years, the excellent and good results were noted in 88.09% of patients.

[The reciprocity of gastrin and cholecystokinin effects on the motor and evacuatory functions of the proximal section of the gastrointestinal tract in dogs]. / O retsiproknosti éffektov gastrina i kholetsistokinina na motornuiu i évakuatornuiu funktsii proksimal'nogo otdela zheludochno-kishechnogo trakta u sobak.

In dogs with fistulas in fundal and antral parts of the stomach and in the proximal part of jejunum, subcutaneous and i.v. administration of pentagastrin and i.v. administration of cholecystokinin caused reciprocal reactions in the stomach: pentagastrin suppressed the motility of fundal part and activated the contractions of antral part, whereas cholecystokinin activated the contractions of fundal part and suppressed the motility of antral part of the stomach. Excepting a more complex character of pentagastrin and cholecystokinin effects on the jejunum contractions, the responses were reciprocal as well. Pentagastrin exerts mainly a suppressing effect whereas cholecystokinin--an activating one. Possible biological significance of the hormones interactions while maintaining evacuatory function of the stomach, is discussed.

[Characteristics of the evacuatory function of the stomach when fat is added to the food]. / Osobennosti évakuatornoi funktsii zheludka pri dobavlenii v pishchu zhira.

In dogs with fistulas in fundal and antral parts of the stomach and in the duodenum, the influence of adding fat (margarine) to carbohydrate food (bread) on the stomach evacuation was studied. Progressive increase of fat (25, 50 and 75%) in the food stimuli delayed the stomach evacuation, the delay assuring no stability of caloric transport to the duodenum. Destroying of pyloric sphincter led to an acceleration of the stomach evacuation. The latter finding suggests that the pyloric sphincter plays a major role in the regulation of stomach emptying from the fat food.

[Morphological criteria of the acuity of peritonitis during treatment by staged cleansing irrigations of the abdominal cavity]. / Morfologicheskie kriterii ostroty peritonita pri lechenii ego étapnymi saniruiushchimi promyvaniiami briushnoi polosti.

56 biopsies of the parietal peritoneum from 28 patients with diffuse purulent peritonitis treated with periodical irrigations of the abdominal cavity. The goal of the study was to determine histological criteria of the peritonitis course in order to establish the earliest time for hermetic closure of the abdominal cavity. It is found that the abdominal cavity irrigations--when the cause of the peritonitis is eliminated--improve the microcirculation, facilitate the development of the granulation tissue, result in the shift of cell reactions; in other words, the reparative-resorptive process dominate the destructive-inflammatory ones. The hermetic closure of the abdominal cavity can be performed without waiting for the complete morphological restoration of the peritoneum; the absence of the mesothelium and the presence of the necrotic foci may not be contraindications. It is sufficient to establish the lack of the progression of the disease (absence of the microcirculation disturbances, the cessation of the polynuclear migration beyond the vascular wall, the appearance of numerous macrophages and granulation tissue. The absence of the complications during 1.5 year allows one to suggest the complete morphological restoration of the peritoneum, after the hermetic closure of the cavity.

[The chronic form of the Budd-Chiari syndrome]. / Khronicheskaia forma sindroma Badda-Kiari.

A rare chronic course of Budd-Chiari syndrome associated with thrombosis of the portal vein was observed in a 30-year-old male patient suffering from postmyocarditic cardiosclerosis. At the age of 24 the patient had infectious allergic myocarditis, was hospitalized and rehospitalized for circulatory insufficiency. Upon 3 years since the disease onset the patient was admitted to a hematological department for progressive enlargement of the spleen. The diagnosis on discharge was idiopathic myelofibrosis with portal hypertension. The treatment included prednisolone, blood transfusions, myelosan. In 1987 the patient presented with enlarged liver and spleen, ascites, gastric and esophageal varicosis, augmenting hepatic insufficiency clinically evaluated as hepatic cirrhosis. Postmortem examination revealed macrofocal cardiosclerosis, splenomegaly, ascites, portal varicosis, enlarged nutmeg liver with smooth surface. Microscopically there was phlebosclerosis and phlebothrombosis varying in duration and involving predominantly medial branches of the hepatic and portal veins, liver fibrosis. The findings provided evidence for the final diagnosis of Budd-Chiari syndrome running an uncommon chronic course.

[Structural changes in the lungs induced by different levels of hyperbaric oxygenation]. / Strukturnye izmeneniia v legkikh pri deistvii raznykh rezhimov giperbaricheskoi oksigenatsii.

Morphological and ultrastructural changes in the lungs of 30 rabbits placed into the altitude chamber with 100% O2 and the pressure of 2, 2.5, 3 and 4 ata for 60 min daily during 1, 2 and 3 weeks have been studied. Morphological changes in the lungs were shown to depend on the degree and duration of oxygen pressure. 2 ata for 60 min daily during two weeks or 2.5 ata for 60 min daily during one week were considered to be safe regimens of hyperbaric oxygenation. Microcirculatory disorders and dystrophic changes of the aero-hematogenic barrier (AHB), its increased permeability, the development of intraalveolar and interstitial edema are observed in the lungs at a higher pressure of 3 or 4 ata. The endothelium and type I alveolocytes are more sensible to high doses of hyperbaric oxygenation. Hydropic degeneration and exfoliation of cells from the basilar membrane are gradually increasing. Type II alveolocytes are more stable to the destructive action of hyperbaric oxygenation. Greater dystrophic changes in other AHB elements are associated with the hypertrophy of mitochondria and lamellar bodies. The described AHB changes are more expressed in atelectasis areas.

[Dynamics of emptying of the antral portion of the stomach]. / Dinamika oporozhneniia antral'nogo otdela zheludka.

In 3 dogs with antral and duodenal fistulas, the time of remaining of a portion of chyme in the antrum was constant and did not depend on the rate of gastric emptying. No retropulsion of antral contents into the fundus was observed. The data suggest that: 1) the antrum is only involved in discharge of chyme from the stomach into the duodenum during the period which depends but a little on the amount of food evacuated; 2) the rate of gastric emptying is determined by fundus and corpus of the stomach.

[Mechanisms of compensating the evacuatory function of the stomach after exclusion of the pyloric sphincter]. / Mekhanizmy kompensatsii évakuatornoi funktsii zheludka v usloviiakh vyliucheniia piloricheskogo sfinktera.

The rate of solid food evacuation from the stomach was investigated in chronic experiments on dogs with the stomach and the duodenum (its first part) fistulae. It was found that in exclusion of the pyloric sphincter (operations of pyloroplastics or gastroduodenostomy) the stomach evacuation was mainly compensated. However, judging by the free passage of rubber balls (3 mm in diameter) into the duodenum no structures replacing the pyloric sphincter formed in the stomach. The compensation of the stomach evacuatory function under these conditions was provided by a significant increase of the enterogastric reflex.

[Effect of fat on the evacuatory function of the stomach]. / Issledovanie vliianiia zhira na évakuatornuiu funktsiiu zheludka

In dogs with a postpyloric fistula, the food with relatively large content of fat passed out of the stomach by equal portions although not exponentially. The size of these portions seem to be determined by the ability of small intestine to digest and absorb the portion of fat which has passed the pyloric sphincter. Besides, the fat in the food increases pH of chyme in the duodenum. Similar findings are reported for healthy subjects and patients with the duodenum ulcer. The inhibitory effect of fat on the stomach and duodenum motility depends on the initial background of contractile activity of the digestive tract. The positive role of fat in self-convalescence from the ulcer disease is suggested.