Specifics of diagnosis and treatment of gastroduodenal diseases associated with Helicobacter pylori infection in surgical clinic]

Complex of diagnostic measures in patients with gastroduodenal ulcer disease includes conduction of investigations for revealing of helicobacteriosis, dysbacteriosis, helminthosis; esophagogastroduodenoscopy with optical biopsy and biopsy for histological and cytological investigation; computeric analysis of the blood neutrophils and buccal epithelium. Conservative treatment is conducted under endoscopic control, curative endoscopy and investigation for Helicobacter pylori are done additionally if necessary. In the absence of the conservative treatment efficacy various kinds of organpreserving surgical interventions are applied.     

Diagnosis and treatment of Zollinger-Ellison syndrome

In 1970-2005 yrs. 65 patients with Zollinger-Ellison syndrome were observed and operated on in the clinic. The decisive meaning in diagnosis owes radioimmunological determination of gastrin level in the blood and its changes while conduction of tests with calcium and secretin. Surgical tactics was determined by localization, number and character of gastrinomas. During the first period of work gastrectomy with complete excision of gastrinproducing tumor constituted the operation of choice. Implementation of intraoperative method of ultrasonography have permitted to excise the benign gastrinoma when her localization was favourable with preservation of stomach. Minimal life span after gastrectomy, performed for nonresectable malignant gastrinoma, have constituted 9 years.     

Clinico-endoscopic peculiarities of gastric ulcer of type I and II

A detailed analysis of clinico-endoscopic peculiarities of gastric ulcer type I and II was presented. The peculiarities of a clinical course and the complications character of differently localized gastric ulcers were determined. There was shown the connection between concomitant disorders of esophagogastroduodenal motor-evacuation function and gastric ulcer localization and type. While tactics of treatment and operative procedure choosing it is mandatory to take into account the clinical course peculiarities and the results of endoscopic investigation.     

Analysis of ultrastructural myocardial changes in the pathogenesis of post-resuscitation circulatory insufficiency]

The article deals with the electron-microscopic characteristics of morphofunctional changes in the myocardium of dogs resuscitated by means of donor extracorporeal circulation after 13--15 minutes of clinical death caused by an electrical trauma. Damage to the energy and contractile apparatus of the myocytes and structures of the microcirculatory channel was revealed in different postresuscitation periods (in 1, 4--5, 9 hours and in 3 days). The revealed morphofunctional changes were marked by phases. Previous study of changes in the main parameters of hemodynamics in the same animals showed that the hemodynamic shifts occurred in phases; sharp hemodynamic disorders were determined 4 to 5 hours after life had been restored. The authors conclude that the damage to the intracardiac mechanisms responsible for the pump activity of the heart plays an essential role in the genesis of postresuscitation circulatory insufficiency.