Biomedical subjects
Publications and source records attributed to I P Kudrevatykh.
The method of endoscopic intraduct cleavage of calculi was used in 78 patients from 19 to 88 years of age. History of operations on bile ducts had 35 of them, laparoscopic cholecystectomy was performed in 43 patients after the endoscopic sanitation of the bile ducts. Three cases are described as illustration.
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.
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 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.
Silver plating of nucleoli was used to study the activity of nucleolar organizers (NO) in the cells of one-layer prismatic epithelium of the gastric and duodenal mucosae. The activity of NO was established to be lowered in patients suffering from ulcer disease and in patients with compression stenosis of the celiac trunk, which may point to the impairment of protein synthetic processes in the cells. Factor of ischemia as the most probable cause of the enumerated changes is under discussion.
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The authors report 5 patients who developed acute peptic ulcers following transplantation of a cadaveric kidney and 4 patients who developed erosive gastritis or gastroduodenitis. The diagnosis and treatment of these complications are described.
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Based on an analysis of treatment of 216 patients with postcholecystectomy syndrome the authors have found its occurrence to be 15.5%. It may be true and false. Patients with the true postcholecystectomy syndrome should be reoperated. The methods of the reoperations must be individual.
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.