[Injury of the esophagus in closed trauma of the neck].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to N N Ivanov.
Explore the source record for details and available documents.
A new method of duodenal closure in stomach reconstructive resection in patients with pathologic disturbances after vagotomy with drainage operation is worked up. 6 patients have been operated. No postoperative complications were observed. All the method advantages are evident.
An analysis of results of transgastric selective proximal vagotomy in 90 patients with ulcer disease of the duodenum enabled the authors to conclude that seromyotomy of the lesser curvature of the stomach when performing transgastric selective proximal vagotomy fails to ensure valuable parasympathetic denervation of the zone in question which results in a number of cases in preservation of uninterrupted gastric acid formation of high intensity and in the development of recurrent ulcer.
The influence of transgastric selective proximal vagotomy (TSPV) on the cardia functional state was studied in 120 patients with ulcer disease of the duodenum. It was established that seromyotomy in the zone of cardia and lesser curvature of the stomach when performing TSPV resulted in disturbance of the constrictor-valvar mechanism of the esophago-gastric passage. Fundoesophagography does not allow the insufficient closure of the cardia to be adequately corrected. The significance of fundoplication is stressed in order to restore the mechanism of cardia closure after TSPV.
Explore the source record for details and available documents.
The method of roentgen planimetry was used in 79 patients with pyloroduodenal ulcer at different terms after selective proximal vagotomy (SPV) with/without draining operations in order to study the rate of emptying the stomach. It was shown that the evacuatory function of the stomach in remote periods after isolated SPV was determined by the state of the closing function of the pylorus, after SPV with drainage of the stomach--by a draining operation. Alterations of the duodenal passage not corrected during operation manifested themselves in remote periods after SPV as slower emptying of the stomach.
An analysis of results of the endoscopic examination of 320 patients who had been subjected to various operations for ulcer disease of the stomach and duodenum has shown that sphincter-preserving operations (selective proximal vagotomy without drainage of the stomach and pylorus-preserving resection of the stomach) in treatment of ulcer disease of the stomach and duodenum with correction of disturbances of duodenal passability is the most reliable method for prevention of duodeno-gastric reflux and reflux-gastritis.
A primary culture of cells derived from uninvolved and atherosclerotic intima of human aorta was used to elucidate the role of cyclic nucleotides in atherogenesis. The cells cultured from fatty streaks and atherosclerotic plaques had a 2- to 8-fold lower cyclic AMP level and a 1.5- to 2-fold higher level of cyclic GMP compared with those of a grossly normal intima. Medial cells cultured from nonlesioned and atherosclerotic aortic segments showed no differences in the cyclic nucleotide concentrations. Reduction of the intracellular cyclic AMP with 2'-deoxyadenosine or a cyclic GMP elevation with its dibutyryl derivative, or liposomes containing cyclic GMP stimulated the uptake of [3H]thymidine and protein synthesis in the cells cultured from unaffected intima. On the contrary, a rise of the intracellular cyclic AMP caused by adenylate cyclase activators, a phosphodiesterase inhibitor, dibutyryl cyclic AMP, and liposomes containing cyclic AMP inhibited cell proliferation and protein synthesis. Elevation of the intracellular cyclic AMP stimulated the hydrolysis of lipids which led to reduction of lipid levels in the cells cultured from atherosclerotic lesions. The results of this study corroborate the existence of a relationship between the alterations of intracellular cyclic nucleotide levels and the metabolic disorders occurring in atherosclerosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The model system for the analysis of targeted liposomes is proposed--the layer of protein antigen adsorbed on polystyrene wells. Antibodies were treated with palmitoyl chloride and liposomes were produced by the cholate dialysis method in the presence of the modified protein (7 X 10(-4) mol protein/mol lipid). Affinity of antibody-bearing liposomes to the antigen on the surface of Multiwell plates was studied, and apparent dissociation constant value was estimated: KD was in the range 1.5 to 5 X 10(-9) M liposomes. Sequential transfers of liposomes in antigen-coated plates revealed that the high-affinity fraction of liposomes is adsorbed first. The bound fraction has 1.7-times-higher protein content. For effective in vivo targeting it would be necessary to have high-affinity liposomes and a high concentration of the target antigen.
We have incorporated antibodies against fibronectin or laminin into liposomes and studied their interaction with insoluble forms of these antigens. The antibodies, after modification by palmitoylchloride, were incorporated into the lipid bilayer by the cholate dialysis method. The antibodies in the liposomes recognized their specific antigen with little reaction to the alternative attachment protein or to albumin (less than 2%). The binding of antibody-containing liposomes to insoluble antigen was inhibited by soluble antibodies to the respective antigens but not by antibodies to other antigens. The affinity constant of the liposome-antibody complex with the antigen was estimated at 1-10 X 10(-9) M liposomes. Thus, antibodies in liposomes retain their reactivity and specificity, and the reaction constant is comparable to that observed for immune complexes.
A fast and simple method of 1H-NMR spectroscopic control of liposome membrane integrity is suggested. The method is based on the redistribution of intensities between two singlet 1H-NMR signals--from intraliposomal marker compound (nitrilotriacetic acid sodium salt, 1H-NMR signal at 4 p.p.m.) and from its complex with Eu3+ added to the external medium (NMR signal of the complex at - 1 p.p.m.). The method permits registration of the kinetics of liposome destruction under the action of detergent or serum. It is shown that the presence of cholesterol in the membrane makes it more stable.
Explore the source record for details and available documents.
Remote results within the terms of from 1 to 3 years in 60 patients and the working ability in 73 patients subjected to selective proximal vagotomy (SPV) or SPV with drainage of the stomach were studied. Functional disorders were observed much more rarely after the isolated SPV. The use of benzohexasonium and electrostitmulation of the stomach in the early postoperative period allows preventing the development of functional disorders. The SPV ensures an early recovery of the working ability.
The intramural selective proximal vagotomy in its extended form was performed in 110 patients with polyroduodenal ulcer. The technique is described. Good functional results were obtained. A conclusion is made that when performing the selective proximal vagotomy a wide mobilization of the terminal portion of the esophagus can be substituted by the circular extramucosal cardiotomy.
The author studied the condition of the esophagogastric junction in 376 patients with gastric and duodenal ulcer before and in the late-term periods after selective proximal vagotomy and distal resection of the stomach performed in combination with antireflux interventions on the cardia (fundoesophagorrhaphy, crurorrhaphy+fundoesophagophrenorrhaphy, fundoplication) or without such interventions. It is shown that reliable correction of the obturator mechanism of the cardia in selective proximal vagotomy may be achieved only by fundoplication. In gastric resection fundoplication is advisable in marked reflux esophagitis, distention of the hiatus esophageus of third degree, hernia of the hiatus esophageus, and cardiac ulcer. In all other patients with distal resection of the stomach crurorrhaphy+fundoesophagophrenorrhaphy is justified as a preventive measure.
Under analysis are results of transgastric vagotomy in 211 patients with ulcer disease of the duodenum operated upon at the period from 1979 to 1989. The transgastric selective proximal vagotomy (TSPV) was used in 150 patients, an original authors' extensive TSPV--in 33 patients, combined transgastric vagotomy (CTV)--in 28 patients. Long-term results of TSPV are recognized to be excellent and good in 79.1% of the patients, satisfactory--in 9.8%, unsatisfactory--in 11.1%. An analysis of causes of unsatisfactory results of TSPV is made. Advantages of the method of extensive TSPV were shown. The CTV is thought to be expedient in patients in urgent surgery and in patients with severe coexistent diseases.