[Tumor markers p53, sFAS, FASL, CEA and CA 19-9 in evaluating the effectiveness of surgical and pharmaco nutritional treatment of patients with gastric cancer].

UNLABELLED: The objective of this study is to develop a marker panel of abnormalities of immune regulatory systems and cell genome in patients with gastric cancer for assessment of efficacy of surgical treatment in combination with pharmaco-nutritional therapy in early postoperative period. MATERIALS AND METHODS: Expression of p53, sFAS, FASL, CEA, and CA 19-9, nutritial status, as well as incidence of purulent-septic complications in early postoperative period were determined in 40 patients with gastric cancer (21 patients--the test group and 19 patients--the comparative group) prior to a curative surgical intervention, postoperative days 1 and 7, while the pharmaco-nutritional therapy (the test group) or partial parenteral nutrition (the comparative group) has been performed. RESULTS: The pharmaco-nutritional therapy significantly decreases in activity of tumor suppressing genome, lymphocyte apoptosis, expression of oncology-associated markers, incidence of purulent-septic complications, as well as exacerbation risk for hypotrophy in patients with gastric cancer in early postoperative period. CONCLUSION: To assess the efficacy of the surgical intervention performed in patients with gastric cancer, an expression of mutant p53 and markers of lymphocyte apoptosis (sFAS/FASL) is reasonable to be evaluated together with determination of oncomarkers (CEA and CA 19-9).

[Urological and nephrological diseases in HIV-infected patients and drug addicts].

The article analyses literature on nephrological and urological pathology in HIV-infected and drug-addicted patients, compares original results of the treatment of nephrological and urological diseases in such patients, analyses clinical evidence, surgical interventions, causes of complications and lethal outcomes, indicates markers of renal insufficiency, proposes treatment policy which can improve treatment results of the above grave pathology.

[Clinical features of surgical diseases at the patients with HIV/AIDS].

Results of treatment of HIV-infected patients with surgical diseases are analyzed. These results are compared with ones at non-infected patients. The standards of surgical operations at HIV-infected patients are that permits to optimize surgical tactics at HIV/AIDS patients and to improve treatment results.

[Means for the prognosis and prevention of suppurative complications in intra-abdominal operations]. / Puti prognozirovaniia i profilaktiki gnoinykh oslozhnenii vnutribriushnykh operatsii.

The authors describe the method of assessment of the immune and alimentary status by means of determination of the level of blood albumins and amount of lymphocytes. Preoperative detection of patients requiring immunocorrection and normalization of protein metabolism allows to carry out the corresponding therapy and to reduce the amount of postoperative complications.

[Psychological aspects of relaparotomy]. / Psikhologicheskie aspekty relaparotomii.

The authors analyse the importance of the psychological barrier in the choice of the method of treatment in performing relaparotomy. Proceeding from the fact that the surgeon's psychological barrier is an objective factor aggravating the results of management of postoperative complications, the authors suggest that the indications for relaparotomy should be considered collectively. They believe that the second operation should be carried out by another, more experienced surgeon of the department. The surgeon who performed the first operation acts as an assistant during the relaparotomy.

[Relaparotomy after emergency surgical interventions]. / Relaparotomiia posle ékstrennykh khirurgicheskikh vmeshatel'stv.

Relaparotomy was conducted 251 times on 210 emergency surgical patients. Diffuse and localized circumscribed peritonitis were the main causes of relaparotomy (70.5%). The level of serum cortisol was tested by the radioisotope method in a group of patients before and after relaparotomy. Operations conducted for the second time 6-7 days after the first operation were undertaken in adrenal insufficiency. Radical relaparotomy produced the best results.

[Relaparotomy after operations on the rectum and colon]. / Relaparotomiia posle operatsii na priamoi i obodochnoi kishke.

During 15 years 1663 intraabdominal operations on the rectum and colon were performed, relaparotomy resulting from the complications was fulfilled in 134 patients (8%). The main indication for relaparotomy was peritonitis (57 patients). Its sources were: incompetence of the colonic anastomosis suture, technical errors during the first operation, opening of the abscess into the abdominal cavity. Five types of the course of postoperative peritonitis were established: primary, atypical, artificial, perforative and necrotic types.

[Repeat operations after surgical interventions in perforated gastroduodenal ulcers]. / Povtornye operatsii posle khirurgicheskikh vmeshatel'stv po povodu perforativnykh gastroduodenal'nykh iazv.

Indications to reoperations and conditions of performing them are analyzed on the basis of an experience with 188 reoperations. Principles of choice of the method of reoperations are given which depend on the defects of the primary operations.

[Surgical treatment of complications after operations on the biliary tract]. / Khirurgicheskoe lecnenie oslozhnenii posle operatsii na zhelchnykh putiakh.

Causes of relaparotomies after operations for cholelithiasis are analyzed. The frequency of relaparotomies after cholecystectomies was 2.1%. Technical defects in performing operations were the cause of postoperative complications in 52.4% of the cases. Of 63 patients subjected to relaparotomy 23 patients died (36.5%). Prophylactics of complications after operations on bile ducts should be directed first of all to careful observation of the cholecystectomy technique.