[The diagnosis of Helicobacter infections in patients with gastric and duodenal peptic ulcers]. / Diagnostika khelikobakternoi infektsii u bol'nykh iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

The results of the study of 33 patients having gastroduodenal peptic ulcer, with 9 of them subjected to surgical treatment, are presented. The diagnostics of Helicobacter infection was made with the use of bacteriological and biochemical assays. The study revealed that in the overwhelming majority of cases peptic ulcer was associated with the presence of H.pylori, and the most informative method for the diagnostics of H.pylori infection was the bacteriological study of biopsies from the pyloric antrum characterized by the highest degree of massive contamination. The determination of ammonia concentration by biochemical assay with the use of Aerotest was most suitable for the diagnostics of H.pylori infection in patients with a short history of peptic ulcer.

[Detection of Helicobacter pylori in stomach cancer]. / Vyiavlenie Helicobacter pylori pri rake zheludka.

Helicobacter pylori (HP) infection was detected in different segments of the gastric mucosa in 13 patients with stomach tumors. Twenty five patients suffering from stomach ulcers were used as controls. HP infection was diagnosed by means of urease and microbiological testing. HP was identified in all cases of stomach cancer, the rates of dissemination in the mucosa in such patients being higher than in those with stomach ulcers.

[Lipid peroxidation in the blood and tissues of patients with peptic ulcer]. / Perekisnoe okislenie lipidov v krovi i tkaniakh u bol'nykh iazvennoi bolezn'iu.

Investigation of 67 patients with peptic ulcer revealed a reliable activation of lipid peroxidation processes both in the blood of the patients and in the mucous membrane in the area of the ulcer location immediately. The activation of lipid peroxidation resulted in a decrease in the contents of phospholipids in the biological membranes of the mucosa cells. The alterations revealed occurred in the presence of inhibition of the antioxidant system of the body. The authors proved the efficacy of the use of antioxidant formulations and ultraviolet irradiation of the blood in the treatment of patients which resulted in acceleration of the ulcer cicatrization and the reduction of the inpatient period as well as the improvement of surgical results.

[Blood flow and free radical oxidation of lipids in gastric and duodenal mucosa in complicated duodenal ulcers]. / Krovotok i svobodno-radikal'noe okislenie lipidov v slizistoi zheludka i dvenadtsatiperstnoi kishki pri oslozhnennom techenii duodenal'noi iazvy.

38 patients with complicated duodenal ulcer were examined with polarographic method. The significant decrease of tissue blood flow was revealed in all segments of gastroduodenal zone. The increased level of free-radical oxidation of lipids was determined in duodenal mucosa and ulcer edges. Disorders of blood supply and activation of free-radical lipid oxidation play an important role in the mechanism of ulcer formation. The drugs improving blood supply and antioxidants should be used in combined therapy and preoperative preparation.

[Prognosis of bleeding from duodenal ulcers]. / Prognozirovanie razvitiia krovotechenii iz iazv dvenadtsatipestnoi kishki.

Clinical and pathogenetic findings on 147 patients with duodenal ulcer (DU) and 29 patients with DU complicated by ulcerogenic bleeding were compared. This allowed to single out significant criteria for prediction of development of bleeding in such patients: male sex freguent seasonal exacerbations, hereditary load, location of the ulcer at the back wall of the duodenal bulb, negative atropine test, HLA-phenotype B35, A2 A3, A2 AX. High acidity and large sixe of DU were hot prognostically independent. The importance of complex approach in solution of prognostic problems is emphasized.

[The comparative hemodynamic characteristics in the lower extremities during laparoscopic and traditional interventions on the abdominal cavity organs]. / Sravnitel'naia kharakteristika gemodinamiki v nizhnikh konechnostiakh pri laparoskopicheskikh i traditsionnykh vmeshatel'stvakh na organakh briushnoi polosti.

The plethysmographic methods were used for studying the influence of pneumoperitoneum in hemodynamics in lower extremities. It was proved to cause venous stasis in them and constriction of precapillaries in the venous area predominantly. The degree of such influence depends on the strain of the pneumoperitoneum and its duration. This factor should be taken into consideration for prophylaxis of postoperative complications.

[The immediate results of laparoscopic treatment in perforated gastroduodenal ulcers]. / Neposredstvennye rezul'taty laparoskopicheskogo lecheniia pri perforativnykh gastroduodenal'nykh iazvakh.

The article presents an analysis of immediate results of laparoscopic interventions (suturing, vagotomy) in 40 patients with perforated ulcers in the pylorobulbar zone. Postoperative complications were noted in 7.5% of the patients. There were no lethal outcomes. The authors recommend wider introduction of the laparoscopic technology as a method of optimization of surgical treatment for perforated ulcers.

[The association of HLA antigens with gastric and duodenal peptic ulcer]. / Assotsiatsiia antigenov sistemy HLA s iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

The association of duodenal ulcers with antigens AIO and combinations of antigens B18B40, B35B40, A10B5, A10B40 and others and the association of gastric ulcer with antigens A3B7, A3B40, B14B15 were revealed by an investigation of HLA antigens in 46 patients with ulcer disease of the duodenum and 25 patients with ulcer disease of the stomach. It was concluded that the ulcer disease had a hereditary predisposition characterized by genetic heterogeneity with different etiopathogenetic mechanisms of the development of ulcers of different localizations. The HLA antigens may be used as immunogenic markers of ulcer disease if observing the population method in the investigations.

[A methods of laparoscopic suturing of perforated pyloro-bulbar ulcers]. / Tekhnika laparoskopicheskogo ushivaniia perforativnykh pilorobul'barnykh iazv.

The article describes a method of laparoscopic suturing perforated ulcers of the pylorobulbar zone. The elements of all steps of the operation are analyzed including the places of introducing the trocar, the method of putting the intracorporeal stitches, means of sanitation and drainage of the abdominal cavity. The method was successfully used in operations on 43 patients with perforated ulcers without any complications.

[Use of laparoscopic methods in combined surgery]. / Ispol'zovanie laparoskopicheskikh metodov pri sochetannykh operatsiiakh.

The authors have made a comparative analysis of the effectiveness of isolated and combined laparoscopic cholecystectomies. The control group consisted of 246 patients subjected to isolated cholecystectomies. The group under study included 22 patients in whom combined cholecystectomies were performed. The comparative analysis included the following clinical data: duration of the operation, number of postoperative days in the hospital, amount of postoperative complications. It was concluded that the little-invasive laparoscopic technique used in one of the steps of the combined operation allowed traumatism of the surgery to be decreased which in its turn allowed wider indications to combined operations.

[The pathophysiological basis of vagotomy in perforated duodenal ulcers]. / Patofiziologicheskoe obosnovanie vagotomii pri perforativnykh duodenal'nykh iazvakh.

Fractional intubation, intragastric pH-metry and other methods were used in complex examination of 107 patients who had perforated duodenal ulcers. The influence of surgical vagotomy upon the state of tissue blood flow was determined by means of polarography with a medicamentous vagotomy test. The medicamentous denervation was found to result in decreased blood supply of the acid-producing area and increased blood filling of the duodenum mucose. A conclusion is made that performing vagotomy is expedient after suturing the ulcer defect in patients having no diffuse purulent peritonitis.

[The HLA phenotype and duodenal ulcers in patients following kidney transplantation]. / HLA-fenotip i duodenal'nye iazvy u bol'nykh posle transplantatsii pochki.

The authors have performed an investigation of the association between ulcer disease of the duodenum and bleedings from the ulcers in 204 patients after transplantations of the kidney with the antigen of HLA system histocompatibility. Duodenal ulcers were found in 25 patients (12.9%), in 11 of them the ulcers were complicated by bleedings which was 5.4% of the total number of the patients with the transplanted kidney. The evaluation of the HLA antigen distribution has revealed an association of duodenal ulcers with A2 and B13 antigens which took place significantly more often than in a group of practically healthy people (RR = 1.85 and 1.9 correspondingly). In patients with the transplanted kidney and following ulcerous bleedings this association was more obvious (RR = 2.32 and 3.74 correspondingly). According to the calculated etiological fraction 40% of the patients can be supposed to have the etiological association of the disease with A2 antigen and 20% of the patients with B13 antigen. A typical feature was the presence of possible "protective" A9 antigen which was found in the group under study two times more seldom than in the control group (RR = 0.25). A comparison of the distribution of HLA antigens in the patients in whom there developed bleeding duodenal ulcers with those who had no such complications has also established the association of the disease with HLA A2 and B13 antigens. The probable "protective" A9 antigen was also found. Since the kidney transplantation is preceded by determination of the recipient's HLA phenotype, these data can be used as prognostic criteria as well as the indications to performing preventive antiulcerous therapy in patients with high risk of the development of ulcerous lesions of the gastrointestinal tract.

[Characteristics of Helicobacter infections in gastroduodenal ulcers and their complications]. / Osobennosti gelikobakaterioza pri gastroduodenal'nykh iazvakh i ikh oslozhneniiakh.

The presence of Helicobacter pylori (HP) was studied in 143 patients with ulcer disease of the stomach and duodenum. The urease test, immunoenzyme analysis, "AEROTEST" and culture of HP in laboratory conditions were used for diagnosis of HP. On the grounds of the culture method three degrees of colonization of the gastroduodenal mucosa were established. It was found that 96.3% of the patients were infected with HP, 86.3% of them having massive colonization. All the patients with complicated ulcers of the duodenum were HP-positive. A severe degree of the HP-infection with the predominant involvement of the antral part was characteristic of patients with bleeding ulcers; in patients with perforative ulcers and stenosis of the pyloric part the HP status is notable for considerably greater variability. Among the patients with gastric ulcers there was less amount of cases with HP (88.2%) as compared with those having duodenal ulcers. All patients with complicated disease were infected with HP, but there was nothing specific in colonization depending on.

[Patient Helicobacter pylori infectivity after gastric resection]. / Infitsirovannost' Helicobacter pylori bol'nykh posle rezektsii zheludka.

The article is devoted to investigation of the Helicobacter pylori (HP) infection in 14 patients after resection of the stomach for ulcers of the gastroduodenal zone. Different methods were used for the assessment of the state of the gastric stump and gastroenteric anastomosis in the postoperative period. In most cases different degree of inflammatory alterations of the gastric mucosa were detected. In 2 cases (14.3%) peptic ulcers of the anastomosis developed. Changes to the gastric stump of 11 patients were associated with the HP infection which involved the mucosa of the anastomosed intestine in 8 patients. The data obtained point to possible participation of HP pathogenesis of the alterations detected after the stomach resection. The question of the expediency of a specific antibacterial therapy in the postoperative period and in treatment of certain kinds of postgastroresectional syndromes is raised.