[Problems of non-healing stomach ulcers: their classification and treatment].
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Biomedical subjects
Publications and source records attributed to V M Maĭorov.
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The authors believe that gastroduodenal ulcer can be treated efficiently in the outpatient setting and day hospitals. Indications are suggested to treatment under either conditions. Arguments are proposed in favor of correcting standard regimens, diet, chemotherapy, optimal terms of control endoscopy dependent on the ulcer size and depth and of preventive treatment with regard to different ulcer courses, etc.
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Altogether 98 patients with chronic gastric ulcers were followed for many of years. There were more men which marks peptic ulcer including chronic ulcers under consideration. The men were of middle or elderly age, which is linked both with the development of peptic ulcer of the stomach at an older age and with specialized study of the subjects belonging to this age group. In the 48 patients, the ulcers did not heal from several months to 5 years, in 16 from 6 to 10 years, and in 9 over 10 years. Ulcers that do not heal for more than 6 months are regarded chronic. The so-called malignant ulcer is nothing but the existent cancer not recognized in time. Chronic ulcers may heal. The use of reparative agents in patients with such ulcers is ineffective. The healing of these ulcers without a cicatrice or cicatricial lesions is unstable. The surgical treatment of such patients is not a must, and the problem is to be decided with regard to the introduction of new efficacious antiulcerous agents, follow up of patients by a specialist and making gastroscopy with spot biopsy.
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Anomalous DNA synthesis was seen in the stomach mucosa of mice with experimental stomach ulcer during different phases of the ulcerous process, using histoautoradiography. At the early stage of ulcer formation a decrease in the label index (LI) is seen. Formation of the ulcer, morphologically similar to the shronic one, is accompanied by growth of the number of DNA-synthesizing cells in its margins. Over a period of ulcer healing proliferative activity of epithelium decreases approximately to an initial level. Histoautoradiographic studies of bioptates of the stomach mucosa obtained under spot gastroscopy in patients suffering from the ulcerous disease allowed to reveal intensifying proliferative activity of epithelium in the ulcer margins. Similar changes in LI were found in gastritis, followed by the gland affection, and in atrophic gastritis.
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