[Gastroesophageal reflux disease in children].

The last decade is characterized by increasing of the pathology of the gastrointestinal (GI) tract in both adults and children. Among this diseases the first place according to frequency and variety of diseased organs and systems is at the acid developed diseases as gastroesophageal reflux disease (GERD). In this article provided comments to existing classifications of GERD in children, questions about diagnosis, treatment and rehabilitation of children with gastroesophageal reflux disease according to our large clinical experience.

[Diagnosis and treatment of gastroesophageal reflux in children]. / Diagnostika i lechenie gastroézofageal'nogo refliuksa u detei.

The work is based on an analysis of results of treatment of 643 children with gastroesophageal reflux (operations were performed on 69 of them). Methods of anesthesia are described. Conservative treatment was used in correlation with the degree of reflux-esophagitis. Indications to operations were considered to be as follows: hiatal hernias, reflux-esophagitis in children with cerebral paralysis, failure of conservative treatment in the group of children having no anatomical causes of the reflux. A method of surgical treatment is proposed including a combination of fundoplication with the posterior gastropexy and fixation of the esophagus to the diaphragm at a distance of 3 cm from the gastric cuff (43 cases, no recurrences). In patients with a combination of gastroesophageal reflux with the esophagus stenosis resection of the altered portion was made followed by plasty with a colonic transplant or local tissues (10 patients with the diagnosed Barrett esophagus).

[Characteristics of enzymatic function of the stomach in gastroduodenal diseases in children with regard to gastric carcinogenesis]. / Osobennosti fermentativnoi funktsii zheludka pri gastroduodenal'noi patologii u detei v aspekte gastrokantserogeneza.

The paper deals with a description of the biochemical properties of the isoforms of pepsinogen pepsin of gastric mucosa and blood serum in children suffering from duodenal ulcerative disease as well as in atrophic and subtrophic lesions of gastric mucosa. Atrophic gastritis was found to involve an inhibited biosynthesis of the Ist fraction of pepsinogen while ulcerative-erosive lesions of the gastro-duodenal area--an increased level of the 3rd isoform of pepsinogen.

[Lactate dehydrogenase isozyme profile in gastric mucosa as an early marker of possible neoplastic pathology in children with chronic gastroduodenal diseases]. / Izofermentnyi spektr laktatdegidrogenazy slizistoi obolochki zheludka kak rannii marker vozmozhnoi onkopatologii u detei s khronicheskimi gastroduodenal'nymi zabolevaniiami.

The lactate dehydrogenase (LDH) isoenzyme profile was studied in bioptic samples of gastric mucosa taken from 57 infantile patients suffering from chronic gastroduodenal pathology and 7 children with gastric functional disorders. The investigation showed LDH1 level to decrease and that of LDH5 to increase, the LDH5/LDH1 ratio increasing accordingly, in cases of erosive gastro-like gastroduodenitis and duodenal ulcers. The degree of said changes was found to correlate with the extent of morphological lesions of gastric mucosa and the most pronounced changes were recorded in cases of gastric mucosa gland atrophy. Similar changes in LDH isoenzyme profile had been identified in patients with gastric tumors. Said findings may be used in identification of groups at high risk for gastric carcinoma.

[The pepsinogen-pepsin system in gastroduodenal pathology in children]. / Sistema pepsinogen-pepsin pri gastroduodenal'noi patologii u detei.

The changes in the pepsinogen pepsin system reflect the degree of morphological alterations in the gastric mucosa. Based on the results of examining 98 children suffering from gastroduodenal diseases, the possibility is shown of distinguishing genetic and biochemical markers of duodenal ulcer. The characteristic features of the isoenzymic spectrum of pepsinogen-pepsin in different gastroduodenal diseases are demonstrated.

[Clinico-genetic problems of peptic ulcer in children]. / Kliniko-geneticheskie problemy iazvennoi bolezni u detei.

Based on the results of 11200 endoscopies of the stomach and duodenum, the incidence of peptic ulcer in children was established with regard to the sex and site of ulcer. The authors view peptic ulcer as a heterogeneous disease in terms of the genealogical data and differences in proteolytic activity of gastric proteases in biological media.