Surgical treatment of diseases of operated stomach

Experience with treatment of 262 patients with late complications after operations for duodenal ulcer was analyzed. Eighty-four (32.1%) patients underwent earlier suturing of perforated duodenal ulcer, 97 (37.0%) -- resection of the stomach and 81 (30.9%) -- various types of vagotomy. In recurrent ulcers after sutured perforation organ-saving operations (62, or 73.8%) have important advantages over resection of the stomach. Combined postgastrectomy syndromes (18, or 18.6%) were most difficult for surgical treatment. Resection of the stomach (70, or 86.4%) patients is the best reconstructive operation for postvagotomy syndromes.     

Simulation of thymus hypo- and hyperplasia by thymalin in guinea pigs

Potentialities of the modulation of thymus function with thymalin and the hormonal-immunological status in simulated hypo- and hyperplasia of the thymus. The advisability of the use of the drug was shown.     

Resistance of melanoma cells to TRAIL does not result from upregulation of antiapoptotic proteins by NF-kappaB but is related to downregulation of initiator caspases and DR4

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has attracted considerable attention as a novel anticancer agent. However, its efficiency may be diminished by occurring resistance in cancer cells. The mechanisms of TRAIL resistance in melanoma are still unsolved. Here we show for the first time that TRAIL-induced activation of NF-kappaB occurs in apoptosis-sensitive melanoma cell lines through TRAIL receptor 1/death receptor 4 (TRAIL-R1/DR4), whereas TRAIL failed to activate nuclear factor kappa B (NF-kappaB) in melanoma cells positive only for TRAIL receptor 2/death receptor 5 (TRAIL-R2/DR5). However, activation of NF-kappaB by TRAIL was not associated with enhanced expression of antiapoptotic factors: cellular FLICE-inhibitory protein (c-FLIP), Bcl-x(L), X-linked inhibitor of apoptosis protein (XIAP), Survivin, Livin. Rather in one of the cell lines, TRAIL induced the downregulation of DR4. In an established cell culture model for TRAIL resistance and regained TRAIL sensitivity, resistance was neither associated with increased NF-kappaB activity by TRAIL nor by an increased expression of antiapoptotic proteins. However, significant downregulation of caspase-8, caspase-10 and of DR4 was characteristic for TRAIL-resistant, DR4-positive melanoma cells, and regained TRAIL sensitivity coincided with re-expression of these factors. Sensitivity was also largely retained after their exogenous overexpression. Thus, initiator caspases and DR4 rather than NF-kappaB may control melanoma cell sensitivity to TRAIL, and strategies, which result in their upregulation, may be useful for enhancement of TRAIL sensitivity.     

Rehabilitation of orthopedic patients after hip replacement

A comparative analysis of the treatment of 120 patients after endoprosthesis for degenerative-destructive diseases of the hip joint was carried on. All the patients were divided into two groups: the main group included 74 patients who underwent a full course of rehabilitation, the control group consisted of 46 patients without rehabilitation. The results of a comparative assessment of the static-dynamic function in the two groups of patients after operation of endoprosthesis have shown the inclusion of an obligatory program of rehabilitation to be expedient for the restorative treatment in addition to the operation of endoprosthesis.     

Approaches to objective assessment of the individual weight bearing in patients after total endoprosthesis of the hip joint

An algorithm for the detection of weight bearing on the lower extremity after total endoprosthesis of the hip joint was developed, taking into consideration the parameters of the morphometric structure, type of pathology, method of treatment, the resulting extremity functioning and social and every-day conditions. The individual rehabilitation measures after endoprosthesis were performed in three steps and corrected depending on changes in the parameters in question. The amplitude of movements in the joint after using the method of calculation of the weight bearing on the lower extremity became close to normal in 26 patients after completion of the rehabilitation course and the statistic-dynamic indices of the extremity became stable.     

Bleedings from ulcers after resection of stomach and vagotomy

Overall 162 patients with recurrent ulcers after previous operations for ulcer disease were treated. Resection of stomach was performed in 69 (42.6%) of them, vagotomy--in 93 (57.4%). Episodes of bleeding were revealed in anamnesis at 56 (81.2%) patients with peptic ulcers after stomach resection, and at 15 (16.1%)--with ulcers after vagotomy. Bleeding was the cause of urgent hospitalization at 39 (28.1%) patients. One hundred and thirty-six from 162 patients have been operated (including 52 patients after primary resection and 81--after primary vagotomy). Vagotomy at the patients with ulcers after primary resections demonstrates good results. Repeated resection of gastric stump with vagotomy is indicated in great penetrating ulcers. Resection of stomach is the operation of choice in majority cases of recurrent ulcers after primary vagotomy. Stem re-vagotomy demonstrates good result an the patients with ulcers of gastro-intestinal anastomosis after primary selective proximal vagotomy.     

Use of rheogluman in the acute period of myocardial infarction]

The efficacy of rheogluman was evaluated in 55 patients with acute myocardial infarction. ECG mapping recordings in 35 leads showed that an earlier positive dynamics in sigma ST, sigma Q, and sigma R was significantly observed in patients treated with rheogluman than in untreated patients. These data indirectly indicated a reduction in the ++peri-infarct zone in the acute period of myocardial infarction. The serum concentrations of lysosomal enzymes (creatine phosphokinase, lactate dehydrogenase, aspartate aminotransferase, alanine amino-transferase) became normal earlier in the rheogluman-treated patients than in the controls. This fact may be regarded as a protective effect of the drug on the formation of a necrotic focus.     

Genetic polymorphism in IL28B is associated with spontaneous clearance of hepatitis C virus genotype 4 infection in an Egyptian cohort

Single-nucleotide polymorphisms (SNPs) around IL28B are associated with spontaneous hepatitis C virus (HCV) clearance of genotypes 1 and 3 in white and African-American populations. This study investigated whether the IL28B SNP (rs12979860) is associated with spontaneous clearance of HCV, principally genotype 4, in 162 Egyptians (80 with clearance). The protective C allele was more common in those with spontaneous clearance (76.3% vs 57.9%; P = .0006). Individuals with clearance were 3.4 (95% confidence interval, 1.8-6.5) times more likely to have C/C genotype. Thus, IL28B plays a role in spontaneous clearance of HCV genotype 4 in North Africa.     

New evidence on the nature of hypocorticism in thymomegaly

According to the present clinical-experimental investigations, hypocorticism at the thymomegaly (hyperplasia of the thymus) was shown to occur as the secondary phenomenon as a result of the reduction of the corticotrophin function of adenohypophysis due to the activation of dopaminergic and serotoninergic central inhibition systems.