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Biomedical subjects

A Aleksandrova

Publications and source records attributed to A Aleksandrova.

At least 19 recordsLinked to original sources
PubMed2004

[Pancreatitis accompanying inflammatory bowel diseases, and our observations].

According to the literature data the modern concepts of the etiological factors, the pathomorphological features, the diagnosis, the clinical features and the treatment of the drug-induced and the idiopathic pancreatitis, accompanying the IBD are reviewed. The results of a retrospective review of the clinical data of 50 patients, operated on--16 with Crohn's disease and 34 with ulcerative colitis, are shown. Postoperative hyperamylasemia was found in 2 patients with Crohn's disease and in 3 patients with ulcerative colitis. One of them also had primary sclerosing cholangitis. All patients were treated with Metronidazole and Cortizone. Nine years after the operation one of the patients with ulcerative colitis had acute pancreatitis, treated conservatively.

Acute Disease↗
PubMed2004

[Polyposis of the colon and cancer].

Polyposis of the colon is a colon cancer predisposition syndrome. Familial adenomatous polyposis (FAP) accounts for 1% of the cases of inherited colorectal cancer (CRC). The National Register of inherited CRC and polyposis of the intestines keeps track of 18 patients from 14 families with FAP. Eight of them have been operated of CRC, on 6 patients preventive colectomy with ileorectal anastomosis has been done and four patients refused surgery. Colectomy has been done due to the malignant development also on a female patient with difused juvenile polyposis with adenomatosis. Of three patients under surveillance with the Peutz-Jeghers syndrome, surgery has been done on one female patient with ileus and bleeding large polyps.

Adenomatous Polyposis Coli↗
PubMed2004

[Reservoir ileo-anal reconstruction in the surgical treatment of ulcerative colitis].

The authors describe the evolution of the conception and the realisation of the ileo-anal anastomosis (IAA) in the surgical treatment of the ulcerative colitis. Thus, one can get a better idea of the problems of this reconstruction in that disease. On the basis of the review from the available literature, the authors make a summary of the basic factors, responsible for the functional results in the reservoir IAA: physiologic disturbances from the operative destruction; physiologic disturbances from the operative trauma; anatomic reconstruction; the possibilities for a functional adaptation to anatomic reconstruction; postoperative complications.

Anal Canal↗
PubMed2004

[Pros and cons of some conventional groin hernioplasties used for repair of combined hernias].

Using their experience the authors analyze the surgical methods of repair of groin hernias of McVay, Kukudjanov and Shouldice as a method of choice for combined groin hernias. Using their own anatomical researches, the authors prove that it is possible to explore and using Cooper's ligament extrafascially. The combination of duplication of the transversal fascia (as in Shouldice repair) and moderate change of the medial insertion point of the internal oblique abdominal muscle and the transversal abdominal muscle and suturing the Cooper ligament (as in Kukudjanov repair method), but extrafascially, a new repair method evolve, which strengthens the three weak points in the area. This method would meet to the highest extend the requirements for a correct anatomo-physiological strength of the groin area.

Hernia, Inguinal↗
PubMed2004

[Problems in the surgical treatment of Crohn's disease and our experience].

The analysis of the surgical treatment of 16 patients was made according to the modern concept for the role of the surgical treatment of Crohn's disease. The surgical methods for treatment of the perineal disease, Crohn's disease with acute onset and the complications of the chronic disease are discussed. The long-term results at 1 patient with double stricturoplasty is the basis for our opinion, that this procedure should be the alternative of the resection at the most serious forms of the disease--at patients with multiple resections for multifocal intestinal stenoses, which inevitably lead to the development of the short intestine syndrome.

Adult↗
PubMed2004

[Pouchitis, on the basis of a single observation].

The observing of pouchitis at a patient with ulcerative colitis with onset 4 months after the closing of the ileostoma, protecting the reservoir and with good response to metronidazole, was the reason for performing a literature review of the modern problems of this complication. The suspected pre-, intra- and perioperative factors, taking part in its pathogenesis, its clinical features and treatment are reviewed. We share most authors' opinion that this complication probably is connected with the disease.

Adolescent↗
PubMed2004

[A case of a 47 years old hydatid cyst of the liver].

This is a presentation of a clinical observation of a hydatid cyst of the liver, accidentally diagnosed 47 years before the first complains. There were no calcifications on the X-rays before the operation, besides the long duration of its existence. There were no complications before the surgery, and the operation and postoperative period were smooth. The case is presented, mainly because of its extraordinary long period of existence of the parasite in the liver, without any symptoms. This shows, that the processes of aging of the hydatid cyst in the liver, under certain circumstances, can be very slow and asymptomatic. Two of these conditions are intrahepatic (intraparenchymal) localization, and the lack of adjacent large biliary ducts.

Echinococcosis, Hepatic↗
PubMed2001

Presence and activation of nuclear phosphoinositide 3-kinase C2beta during compensatory liver growth.

Highly purified liver nuclei incorporated radiolabeled phosphate into phosphatidylinositol 4-phosphate (PtdIns(4)P), PtdIns(4,5)P(2), and PtdIns(3,4,5)P(3). When nuclei were depleted of their membrane, no radiolabeling of PtdIns(3,4,5)P(3) could be detected showing that within the intranuclear region there are no class I phosphoinositide 3-kinases (PI3K)s. In membrane-depleted nuclei harvested 20 h after partial hepatectomy, the incorporation of radiolabel into PtdIns(3)P was observed together with an increase in immunoprecipitable PI3K-C2beta activity, which is sensitive to wortmannin (10 nm) and shows strong preference for PtdIns over PtdIns(4)P as a substrate. On Western blots PI3K-C2beta revealed a single immunoreactive band of 180 kDa, whereas 20 h after partial hepatectomy gel shift of 18 kDa was noticed, suggesting that observed activation of enzyme is achieved by proteolysis. When intact membrane-depleted nuclei were subjected to short term (20 min) exposure to micro-calpain, similar gel shift together with an increase in PI3K-C2beta activity was observed, when compared with the nuclei harvested 20 h after partial hepatectomy. Moreover, the above-mentioned gel shift and increase in PI3K-C2beta activity could be prevented by the calpain inhibitor calpeptin. The data presented in this report show that, in the membrane-depleted nuclei during the compensatory liver growth, there is an increase in PtdIns(3)P formation as a result of PI3K-C2beta activation, which may be a calpain-mediated event.

Animals↗
PubMed1997

[The physical development of children living in a settlement with a high nitrate content in the drinking water].

The object of the present study is analysis of the physical development of children, living permanently in the village of Karadzhalovo, community of Parvomay, whose drinking water contains abnormal concentration of nitrates. For the period 1983-1994 the nitrate content in the drinking water of the village varies within the limits of 67.0 to 112.6 mg/dm3. Complex evaluation of the physical development of 162 children aged from 3 to 16 years was carried out on the indices level of development of stature and degree of harmony of the body mass. The data were compared with the norms for physical development of the Bulgarian children. 90.4% of the boys and 86.8% of the girls are with good physical development. With satisfactory development are 8.5% of the boys and 13.2% of the girls. Only 1.1% of the boys are with poor physical development, while among the girls there is no poor physical development. No reliable correlative dependency was established between the nitrate content of the drinking water and the stature and weight of the examined children.

Adolescent↗
PubMed1997

[Pancreatic cancer. The experience with its surgical treatment].

Experience had with the surgical management of 483 patients, operated for cancer of the pancreatic gland in the Clinic of Abdominal Surgery over the period 1971 through 1994, is presented. Distribution of the patients by gender and age shows noteworthy consistency. Preoperatively, exact diagnosis in the clinic is made in 91.1 per cent, but usually the patients are admitted in advanced stage of the disease (91.6 per cent). Merely 42 cases (7.6 per cent) are free of metastases in regional lymph nodes or carcinomatous infiltration. The neoplasm is located in the head of the gland in 350 patients (66.5 per cent) with resectability attained in 10.1 per cent, in the body and tail--in 96 patients (19 per cent) with resectability 6.5 per cent; the neoplasm involves the total gland in 55 cases (10.2 per cent), and derives from the papilla in 25 (5.2 per cent) with operability 44 per cent. Operability for the total group amounts to 9 per cent, morbidity--17 per cent and overall lethality--15 per cent; of the latter following radical interventions 4 per cent, palliative interventions 8 per cent and explorative laparotomy 3 per cent. The details of the operative technique are comprehensively discussed.

Adult↗
PubMed1997

[The indications and choice of the technic for pancreatic resections].

The progress of pancreatic surgery naturally leads to broadening the scope of indications for resection of the gland. Over the period 1970 through 1993, in the Clinic of Abdominal Surgery are performed 99 pancreatic resections for carcinoma of the pancreas (including cancer of papilla Vateri (45), endocrine-active tumor of pancreas (5), benign tumor (1), chronic pancreatitis (4), pseudocysts of the pancreas (4), cancer of an adjacent organ infiltrating the pancreas (36), benign lesions to a neighbouring organ (4). The size of resection depends on a number of factors of which location of the neoplasm and stage of the disease are the leading ones. Operations done: duodenopancreatic resection--47, left side hemipancreatectomy--13, resection of the body region and tail of pancreas--14, and partial resection--19. The choice of operative technique is discussed against the background of the variety of indications for pancreatic resection. Special attention is focused on the operative technique used in pancreatoduodenal resection. The practicability of performing pylorus-preserving intervention, the need of vagotomy and its scope are precisely determined. Also discussed are issues relating to the choice of organ for anastomosis with the pancreas and its protection, as well as the variants of successiveness of anastomoses with the biliary canal, residual pancreas and stomach. Morbidity and mortality rates show a decrease parallel to the surgical experience gained.

Bulgaria↗
PubMed1997

[Reoperations on the biliary system].

Reoperations of the biliary apparatus is a branch of biliary surgery still not well enough clarified and difficult to cope with. A total of 169 patients are subjected to operation and investigation in the clinic of abdominal surgery. In 71 of them reoperation is undertaken over the period 1952-1973, and in 97--in the period 1974 through 1993, representing 8.7 per cent of all biliary operations done for benign diseases of the biliary apparatus. In 95 per cent of cases the primary operation is related to cholelithiasis (ChL). One-hundred fifty-five cases (92.6 per cent) are reoperated once, nine (5.3 per cent)--twice, and four (0.7 per cent)--three, four and five times. What is more, 56 of the patients are operated in the clinic of abdominal surgery, and 112--elsewhere in surgical units and departments throughout the country. The severer clinical picture, prolonged postoperative period, increased operative risk and worsened prognosis in the latter group are underscored. The underlying causes necessitating secondary corrective intervention are analyzed--76 per cent are conditioned by ChL, and 24 per cent--by the primary operation. The indications for reoperation are classified in three groups: a) failure to remove or partially removed gallbladder, b) in case of preexisting primary, or secondary postoperative development of various forms of cholelithiasis, c) in surgery induced morbid conditions. A table is presented illustrating the character of secondary operations, performed in the series of 168 patients under study, namely: in 20 per cent the gallbladder is operated on, and in 80 per cent--the extrahepatic bile ducts. Postoperative morbidity is higher as compared to the one in primary operations and not infrequently it is conditioned by preexisting complications. Postoperative mortality rate amounts to 10 per cent.

Adult↗
PubMed1996

[The gastrointestinal tract as the possibility for a reservoir for the urinary system. A modification of the Mainz pouch technic].

Experience accumulated over the past decade with utilization of the gastrointestinal tract in the formation of a reservoir of the urogenital system shows that the Mainz-pouch technique contributes greatly to obtain a continent reservoir, mainly by Bauhin's valve reconstruction. A procedure is suggested enabling retroperitoneal implantation of the reservoir, formed by the original Mainz-pouch technique, in the lower right quadrant of the posterior abdominal wall, instead of suspending it in the abdominal cavity where it anastomoses with the umbilical anulus and augments the hazard of ileus. The 63-year-old woman with urinary bladder carcinoma, operated according to the modification described, tolerates the intervention free of complications with very good immediate outcome in terms of continence.

Carcinoma↗
PubMed1996

[Endocavitary echography following abdominoperineal extirpation of the rectum].

Transrectal echography using a high-frequency transducer is a well established method for preoperative rectal carcinoma assessment, and for postoperative follow-up of patients with anterior resection for rectal carcinoma. Having in mind the impossibility for follow-up study of patients with abdominal perineal extirpation of the rectum by transrectal echography, a new pattern of application of the transducer employed for endorectal examination is suggested. In five patients (4 women and 1 man) endocavitary echography through the anal canal is done. In women the examination is supplemented by transvaginal echography. A local recurrence in the course, of transvaginal study is recorded in one patient. The technique of examination and the superiorities of the procedure are discussed.

Abdomen↗
PubMed1996

[Postoperative peritonitis].

This is a report on retrospective summed-up analysis of the therapeutic approach to 296 patients presenting postoperative peritonitis (PP). They account for 1.4 per cent of the total number of patients operated on in the clinic. The latter percentage differs in the single groups of patients, distributed by organic localization of the pathological process, as follows: 1.3 per cent in hepatobiliary and pancreatic diseases, and 1.9 per cent in gastroduodenal ones. In colorectal diseases the percentage grows to 8, and after the 80th year of life it falls to and below 4, amounting to 2.2 per cent during the last five years. The overall mortality rate is 69 per cent--57.7 and 72.5 per cent respectively for the three separate groups-mainly at the expense of patients presenting oncological diseases, 73.5 per cent. The underlying causes of PP development comprise: insufficiency of the anastomosis, intraoperative contamination and infection of the abdominal cavity, intraoperative oversights-technical errors, iatrogenic and foreign body, circulation derangement in the organ operated on, suture applied to cancer infiltrated and infected tissue and persisting peritonitis for which the intervention is undertaken. The diagnosis is difficult regardless of the biochemical, instrumental and microbiological examinations performed. Early relaparotomy is the only possible life-salvaging approach to the patient, its immediate goal being sanation of the source, peritoneal lavage, wide drainage and ileostomy. PP remains a problem difficult to handle irrespective of the progress of antibiotic and resuscitation treatment.

Acute Disease↗
PubMed1996

[The choice of the operation and management in cholangitis].

Irrespective of the high rate of bacterial flora (intestinal, respectively) penetration into the biliary apparatus, clinically manifested cholangitis cases are relatively seldom met with. The predisposing factors involved are: penetration of virulent flora (anaerobic inclusive) into the bile ducts, presence of conditions promoting delay or discontinuation of the bile passage (biliary hypertension), and longstanding of the disease. Cholangitis associated with cholangiohepatitis development is one of the severest conditions of cholelithiasis (ChL), being observed as an independent nosological entity also. Over the period 1974 through 1993, in the clinic of abdominal surgery a total of 144 patients presenting cholangitis undergo treatment, of which in 74 (8.7 per cent) it is associated with ChL, in 58 it is discovered during reoperation on the biliary apparatus, and in twelve it is diagnosed as an independent disease, unrelated to calculosis. Acute cholangitis runs a foudroyant course with a poor prognosis, whereas the chronic form is characterized by larvate (masked) development with exacerbation periods. The clinical picture is dominated by Charcot's triad. The disease runs a rather severe course in the contingent liable to reoperation. As a rule, it occurs as the result of stricture of the bile ducts or obliteration of bilidigestive anastomosis. 58 per cent of the patients are older than 50 years. Operative intervention in acute cholangitis should be done on an emergency basis. External drainage insertion is a palliative measure, practicable in heavily damaged patients. The operation in acute and chronic cases is aimed at maximum possible healing of the biliary tract and elimination of the underlying causes of obstructed passage. Lethality is higher than the medium rate, and the prognosis remains serious.

Acute Disease↗
PubMed1996

[The surgical and alternative treatment potentials in biliary tract cancer. I. Surgical treatment].

Biliary apparatus cancer is a rare condition characterized by low operability percentage. This is a comparative study of two series of patients, operated during the periods 1952-1979 and 1980-1994. In the first observation period (28 years) 119 patients are operated, and in the second 13-year period a total of 206 patients are subjected to operative and endoscopic treatment. One-hundred five patients present gallbladder carcinoma. The age, gender and clinical patterns characterizing the contingent being examined do not show noteworthy changes with time. Over the past few years, a variety of palliative operations are used, with the proportion of cases subjected to radical operation showing no increase. Carcinoma of bile ducts is diagnosed in 98 patients. During the second observation period, the number of women and patients in advanced and senile age augment. The diagnosis is delayed; thanks to puncture biopsy with cytological study, histological verification shows a three-fold increase. The number of radical operations is slightly increased while the percentage of explorative laparotomies is noticeably diminished. Carcinoma of papilla Vateri has optimal outlooks for surgical treatment. In the latter case too the number of women and patients above 60 years of age shows an increase. Radical intervention is resorted to in fourteen out of 33 patients.

Adult↗