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Biomedical subjects

Z Krŭstev

Publications and source records attributed to Z Krŭstev.

15 recordsLinked to original sources
PubMed1991

[A modified Sugiura operation].

This is the first report in Bulgaria of the application of the modified method of Sugiura. The operation is less traumatic than the original one, the postoperative mortality is essentially reduced, patient survival to 7 years is increased and there is no encephalopathy. This operation is technically easier to perform than splenorectal anastomoses and may be performed both as planned and emergency intervention. Two personal observations on two patients operated by the modified technique of Sugiura are reported. The results were very good.

Adult↗
PubMed1991

[A modified Sugiura operation].

The modified method of Sugiura is reported for the first time in Bulgaria. The operation is less traumatic than the original one, the postoperative case fatality rate is lower, patient survival rate up to 7 years is high and there is no encephalopathy. This operative technique is more practicable than splenorenal anastomosis and may be applied both for planned and for emergency operations. Two patients have been operated by the authors, using the modified technique of Sugiura, with very good results.

Adult↗
PubMed1991

[The extracorporeal lithotripsy of gallstones in Bulgaria].

Extracorporal lithotripsy is a new, modern method of treatment of gallstone disease. The effect of the treatment was evaluated as follows: full--fragments up to 2 mm in size (in 60.5% of the patients), partial--fragments between 2 and 5 mm in size (in 30.1% of the patients) and no effect--fragments larger than 5 mm or lack of fragmentation (in 9.4% of the patients). Complications during the manipulation and after it were very rare--allergic in 1.7% and obstructive in 6.7% of the patients. In only 3 patients on operation had to be done. 84 patients were followed up for 270 or more days. In 10.4% of the patients a full clearance of the fragments was found, and in 28.2% of the patients there was only a reduction of their number. Extracorporal lithotripsy followed by litholytic therapy is a perspective method for gallstone disease treatment. It has wide indications, few contraindications, is well tolerated and is with a low complication rate.

Bulgaria↗
PubMed1988

[A case of somatostatinoma of the pancreas].

A case of a 36-year-old man with pancreatic somatostatinoma is reported. Such cases are very rare. The following signs were found; quick ESR, increased alpha 2- and beta-globulins, shortened Weltmann's coagulation band, increased serum bilirubin level, especially of the conjugated fraction, enzyme constellation of cholestasis and moderate liver cytolysis. Ultrasound examination of the abdomen, retrograde cholangiopancreatography and percutaneous liver cholangiography were performed in order to prove the diagnosis. They demonstrated an obstruction in Vater's papilla region and a bulky process in the head of the pancreas. The patient was operated. The microscopic, electron microscopic and immunohistochemical examinations proved a somatostatinoma of the pancreas. The positive immunohistochemical tests for somatostatin and carcinoembryonal antigen in the tumor cels are especially indicative.

Adenoma, Islet Cell↗
PubMed1987

[Potentials and limits of ultrasonic diagnosis in gastroenterology].

The great diagnostic value of ultrasonic tomography in the diagnosis of liver, biliary, pancreatic, gastric, intestinal, abdominal and retroperitoneal disease is reviewed and proved. Best results can be achieved in the indications for its application and the potentialities of the method are well known. The sonographic results should always be assessed with the clinical, laboratory and other instrumental data. The faulty diagnoses are due not to the method itself but to the incompetent interpretation of the sonographic images and to the lack of knowledge for the scope and limitations of sonography.

Gallbladder Diseases↗
PubMed1987

[A case of spontaneous pneumoperitoneum in a female patient with pneumatosis cystoides intestinalis].

A case of a woman with spontaneous pneumoperitoneum as result of pneumatosis cystoides intestinalis is reported. A brief review of this rare disease and its pathogenetic mechanisms is presented. The clinical course of the pneumatosis cystoides intestinalis was characterized by abdominal pain and distention, vomiting. The disease was proved by contrast X-ray examination. The pneumoperitoneum was the result of subserous cyst rupture and had a benign course. It was treated successfully with chemotherapeutics. The participation of extensive bacterial growth in the pathogenesis of the pneumoperitoneum is discussed.

Diagnosis, Differential↗
PubMed1987

[Case report of Gaucher's disease].

The case of a 42 years old man suffering from Gaucher's disease is reported. The primary diagnosis was liver cirrhosis based on echographic and scintigraphic examinations. The following signs were found: thrombocytopenia, slight hemolysis, shortened life of the erythrocytes with considerable sequestration in the spleen, abnormal flocculation tests, increased acid phosphatase. The X-ray examination revealed irregularly oval light spots with different size and form and well cut outlines in the skull and a zone of bone resorption in the right shoulder joint. The liver needle biopsy showed parenchymal infiltration with Gaucher's cells. The above mentioned deviations and the family heredity of the patients suggested the diagnosis of an adult form of Gaucher's disease. The fibroplastic changes in the liver including formation of septa led to the suggestion of a link between Gaucher's disease and liver cirrhosis.

Adult↗
PubMed1986

[Hepatocellular carcinoma--its echographic characteristics and diagnostic potentials].

Echography is an approved method for establishing focal processes in liver. Forty five patients, from Bulgaria and Kuwait, with confirmed hepatocellular cancer (HCC) were studied by echographies aiming at the elucidation of the possibilities of ultrasound examination in making the diagnosis of HCC in patients with and without cirrhosis of the liver. Five types of images have been established--hyperechogenic (29%), hypoechogenic (27%), mosaic (24%) mixed (11%) and type "bovine eye" (9%). The echographic characteristics that could suggest the character of the lesion are low-echogenic zone in the periphery and non-homogenous (mosaic) tissue structure. HCC, in 55.6 per cent of the patients, proved to be with multiple localization in liver. The comparison of the patients from Kuwait and Bulgaria revealed no differences in the mean age, carriership of HBsAg, but in the latter--the HCC was significantly more often combined with cirrhosis of the liver. Serum alpha-fetoprotein was increased in 15 out of 20 patients with HCC. The establishment of the tumour in part of the patients by ultrasound initially, suggests that echography is a useful method for the early diagnosis of HCC and for a systematic follow up of the patients with cirrhosis of the liver. Guided fine-needle biopsy was performed in 15 patients, and in 86.7 per cent of the cases--accurate cytologic diagnosis was obtained. Echography, combined with guided biopsy and determination of alpha-fetoprotein, guarantee in a considerable part of the cases, also the correct diagnosis of HCC in patients with and without cirrhosis of the liver.

Aged↗
PubMed1983

[Serum gastrin levels before and after short-term treatment of duodenal ulcer with cimetidine and pirenzepin].

Serum gastrin was studied before meals in 71 patients with duodenal ulcer, treated with various doses of simetidin and pyrensepin. Gastrin level was elevated after a treatment with 1 g simetidin daily and 125 mg pyrensepin, and remained unchanged with pyrensepin treatment (50 and 100 mg daily). A tendency to decreased gastrin level was observed after the treatment with simetidin 400 mg daily. Under those circumstances the attempt at duodenal ulcer treatment with lower simetidin doses, than the usual, is justified.

Adult↗
PubMed1981

[Gastric acidity in a double ulcer (of the stomach and duodenum)].

Gastric salt-acid secretion was studied in three comparative patient groups with gastric ulcer, endoscopically confirmed, combination of gastric and duodenal ulcers. In the patients with double localization of the ulcer (stomach and duodenum) - hyperacidity was determined after pentagastrin stimulation. Acid-salt secretion was higher than that of the patients with gastric ulcer and was close to the secretion of those with duodenal ulcer, being but with a high standard deviation, necessitates consideration to be given to each concrete case of treatment. No discrepancy in the volume of gastric secretion before meals was established, thus impugning the role of pylor stasis in the genesis of secondary gastric ulceration. The incidence of atrophic gastritis in case of gastric and double ulcer is almost identical, hence attention is paid to the duodeno-gastric reflux as an eventual cause for damaging gastric mucosa with its successive ulceration in the patients with duodenal ulcer of many years. That is the reason, drugs enhancing the resistance of gastric mucosa as well as methoclopramid intake are proposed additionally to the drugs, neutralizing or blocking the gastric acid-salt secretion.

Adult↗