Ter Arkh

[New cases of helicobacter pylori associated duodenal ulcer]

Year 1998
Minushkin ON. Vasil'eva NIu. Kudriavtseva LV.
No information.
AIM: Generalization of the results obtained through analysis of examinations of new cases of duodenal ulcer (DU) with patients suffering from DU of different duration, made in two main aspects: the patients' Helicobacter pylori (HP) status determined by histological, bacteriological, immunological studies and rapid urease test and their clinical manifestations, including analysis of risk factors predisposing to peptic ulcer. MATERIALS AND METHODS: Two groups of patients with DU: 1) 23 new cases; 2) (a group of comparison) 43 patients with DU of different duration were examined. Family history, risk factors (smoking, alcohol consumption, use of nonsteroidal antiinflammatory agents), concurrent diseases were analyzed. Esophagogastroduodenoscopy (EGDS), ph metry, histological, bacteriological studies, rapid urease test and IgG antiHP determination were made. RESULTS: More than 95% of patients with DU were found to have HP just at the moment of diagnosis. New cases of DU have less HP colonization in the mucosa. The best diagnostic results were obtained with a combination of a histological study and a rapid urease test. 74% of new DU cases have scarring-ulcerative deformity of the duodenal bulk and, therefore, the onset of peptic ulcer was asymptomatic or mild. DU accompanied by hemorrhage averaged 4.5%. A third of new cases have simultaneously 2 ulcer defects in the duodenal bulb. The pains and symptoms of gastric dyspepsia are typical of the two groups of patients; however, of particular significance for their formation are functional disorders in new cases and organic changes in other patients. CONCLUSION: The comparison of the diagnostic techniques for HP allows the authors to recommend a combination of a histological study and a rapid urease test as the most informative tool.

[The characteristics of peptic ulcer in subjects with concomitant ischemic heart disease]

Year 1998
Loginov AS. Zvenigorodskaia LA. Potapova VB. Arbuzova VG. Korzhikov VV. Nilova TV.
No information.
AIM: The study of clinical running of gastric or duodenal ulcer in associated coronary heart disease (CHD). MATERIALS AND METHODS: 209 CHD patients with gastric ulcer (GU) or duodenal ulcer (DU) were examined clinically plus histological examination of gastric or duodenal mucosa biopsies was made. RESULTS: In CHD patients GU occurred more frequently (56%) than DU. The lesions involved more frequently lesser curvature of the stomach and pyloric part of the stomach. Males developed ulcers 3.5 times more frequently than females. Ulcers tended to a painless course without season exacerbations. The disease manifested first with gastric bleeding in 52% of the patients. GU and DU ran with frequent recurrences and long-term exacerbations (76% of patients) which coincided in time with CHD exacerbations. 68% of patients developed exacerbations within 10 days after myocardial infarction or aortocoronary bypass operation. Helicobacter pylori was present as a resolving factor in arising ulcer in 26% of patients. Microcirculatory disorders, reduced blood flow speed in gastric or duodenal mucosa, hypocoagulation syndrome, dyslipidemia provoked exacerbations in 62% of patients. Examinations of biopsies from gastric and duodenal mucosa showed marked dystrophic changes in the mucosa, its connective tissue basis in the vessels in the presence of mild inflammation at ulcer site. CONCLUSION: The onset of ulcers and erosions in the mucosa of the gastrointestinal tract in CHD may be due to circulatory disorders in gastric mucosa. The main factors of aggression are hypoxia, hypoxia-induced trophic defects in gastric and duodenal mucosa, circulatory disorders.

[The effect of combined treatment using bicycle exercise with a free choice of the load parameters on the hemodynamics in peptic ulcer patients]

Year 1998
Efremushkin GG. Titova ZA. Molchanov AV. Nedoseko OV. Burgsdorf OE.
No information.
AIM: To study the role of bicycle exercise in combined treatment of gastric and duodenal ulcer, its effect on central hemodynamics and microcirculation. MATERIALS AND METHODS: 94 patients with gastric and duodenal ulcer. 64 patients received conventional antiulcer treatment plus exercised on bicycle ergometer in free regimen of training. 30 patients on the routine treatment only served as control. RESULTS: Doppler echocardiography demonstrated that ulcer patients have eukinetic hemodynamic type more frequently. After combined treatment with bicycle exercise hyper- and hypokinetic hemodynamic types transformed into the eukinetic one, while the eukinetic type remained unchanged. Bicycle exercise contributed to normalization of microcirculation (as shown by conjunctival biomicroscopy), especially in location of ulcer in the duodenum. CONCLUSION: Introduction of bicycle exercise in the treatment of ulcer promoted acceleration of ulcer defects healing, especially in patients with hyperkinetic hemodynamics and duodenal ulcer.

[The clinical and morphofunctional characteristics of different types of stomach ulcer]

Year 1998
Reshetnikov OV. Usov SA. Kurilovich SA. Gerasimov NV. Usova LE. Barabanov IE. Danilov AS.
No information.
AIM: The study of a complex of anamnestic, clinicoendoscopic and functional-morphological characteristics in type I and II (according to Johnson) gastric ulcer. MATERIALS AND METHODS: Esophagogastroduodenoscopy, gastric secretion tests, determination of blood group and Rh factor were performed in 91 patients (52 patients with ulcer type I and 39 with ulcer type II). RESULTS: Ulcers type I have arisen in the presence of long-term chronic gastritis. They were associated with marked changes in the mucosa of gastric body, its atrophy and intestinal metaplasia, persistent recurrences in the same gastric zone. Ulcers type II are characterized by hereditary loading, 0(I) blood group, combination with gastroduodenal erosions, season occurrence, trend to migration and recurrence in different gastric or duodenal zones, HCl hypersecretion, high occurrence of Helicobacter pylori infection. CONCLUSION: It is thought valid to include types of gastric ulcer in current classification of ulcer.

[The diagnosis of chronic duodenal obstruction combined with duodenal peptic ulcer]

Year 1998
Dzhumabaev KhD.
No information.
AIM: The study of clinical manifestations of chronic duodenal ileus (CDI) and potential of specific methods of CDI diagnosis in its combination with duodenal ulcer (DU). MATERIALS AND METHODS: Assessment of acid-producing gastric function, duodenogastric reflux, manometry of the upper gastrointestinal tract, fibrogastroduodenoscopy, ultrasonic and x-ray investigations were made in 1140 patients with chronic DU. RESULTS: 29.2% of the examinees were found to have CDI. Specific features of CDI course are described. The diagnostic criteria are defined. Higher informative value of the diagnostic methods can be achieved. CONCLUSION: The findings can be used in the choice of DU treatment, for formulation of indications to duodenocorrective interventions.

[The prognostic criteria of the course in newly detected duodenal peptic ulcer]

Year 1998
Minushkin ON. Zverkov IV.
No information.
AIM: Elucidation of the significance of various factors in prognosis of duodenal ulcer (DU) severity. MATERIALS AND METHODS: The observational study entered 18 new cases of DU and 13 healthy controls. All the patients were followed up for 7 years with annual esophagogastroduodenoscopy. RESULTS: 10 patients (group 1) had annual exacerbations of DU, 8 patients had rare exacerbations (group 2). Group 1 was characterized by basal acid hyperproduction, hyperpepsinogenemia, hypergastrinemia, marked contamination with Helicobacter pylori. Patients of group 2 had normal basal and pentagastrin-stimulated acid production, normopepsinogenemia, normogastrinemia, mild Helicobacter pylori infection. CONCLUSION: The 7-year follow-up of new DU cases allowed demonstration of functional-morphological prognostic criteria for frequently and rarely recurrent DU courses.

[Gastroesophageal reflux combined with Helicobacter pylori infection]

Year 1998
Masevich TsG. Loseva IA.
No information.
AIM: Investigation of the role of Helicobacter pylori infection of the low esophagus in patients with duodenal ulcer (DU). MATERIALS AND METHODS: Endoscopic examination was performed in 40 DU patients. All the biopsies were examined for Helicobacter pylori and degree of relevant contamination. RESULTS: Helicobacter pylori was present in all the patients' antral stomachs. It contaminated the low part of the esophagus in 17 of 40 patients. Endoscopic changes were more severe in those patients who had the infection both in the stomach and in the esophagus. CONCLUSION: The presence of Helicobacter pylori in the lower esophagus and antral stomach in DU patients may entail negative changes in the stomach and esophagus.

[Bicarbonate deficiency and duodenal peptic ulcer]

Year 1998
Malov IuS. Kulikov AN.
No information.
AIM: The study of alkaline gastric secretion in health and disease and its changes in response to blockers of H2-histamine receptors. MATERIALS AND METHODS: The trial enrolled 74 patients with duodenal ulcer (DU), 28 patients with chronic gastric (CG) and 16 healthy controls. The secretion was studied initially, in administration of ranitidine, in stimulation with hydrochloric acid. RESULTS: DU patients demonstrated a significant reduction of gastric secretion of bicarbonates in the basal and stimulated phases and a 3-fold decrease in the proportion alkaline/acid secretion. There was also a trend to acidosis. Administration of H2-histamine receptors provided recovery of acid-alkaline balance. CONCLUSION: Bicarbonate deficiency is an important element of duodenal ulcer pathogenesis.

[The characteristics of the lipid peroxidation and antioxidant activity of the duodenal mucosa in peptic ulcer patients]

Year 1998
Esedov EM. Mamaev SN.
No information.
AIM: Lipid peroxidation (LPO) and antioxidant defense (AOD) in ulcer and periulcer zones of duodenal mucosa were studied at different phases of ulcer. MATERIALS AND METHODS: 111 patients with duodenal ulcer exacerbation before treatment and in the course of the treatment were studied versus 23 healthy volunteers. RESULTS: In active ulcer there was high activity of LPO and depressed AOD. LPO may be initiated by Helicobacter pylori. Pathogenetic measures including anti-Helicobacter ones decreased LPO hyperactivity and promoted AOD normalization. CONCLUSION: In ulcer, optimal treatment is supposed to combine antisecretory and antibacterial drugs adjusted to the activity of ulcer and imbalance between LPO and AOD systems in gastric and duodenal mucosa.

[The results of a morphological study of the gastric and duodenal mucosae in patients with vibration-induced disease]

Year 1998
Liubchenko PN. Novikova AV. Karpov VN. Gorenkov RV. Tereshchenko SG. Dement'eva OIu.
No information.
AIM: Morphological study of gastric and duodenal mucosa in patients with vibration disease. MATERIALS AND METHODS: 64 patients with vibration disease stage I and II were examined endoscopically, histologically, bacterioscopically and morphometrically irrespective of the presence or absence of gastrointestinal complaints. RESULTS: Erosive gastroduodenitis, non-erosive gastroduodenitis and gastritis, polyps in the stomach and gastric ulcer were diagnosed in 19(29.7%), 40(62.5%), 2(3.2%) and 1(1.6%) patients, respectively. Small intestinal metaplasia occurred in 22% of patients. Helicobacter pylori occurred most frequently in the antral part of the stomach (90.24%). Advanced dissemination often combined with metaplasia of the small bowel. Morphometrically, there were slight differences from relevant values in patients with chronic gastroduodenitis who were not exposed to occupational hazards. Vibration disease patients exhibited impairment of duodenal vessels (large endothelial nuclei, thick arteriolar walls) 2 times more frequently than controls. CONCLUSION: In vibration disease, gastric and duodenal mucosa, as a rule, shows signs of chronic gastroduodenitis.

[Chronic viral infection in patients with alcoholic liver involvement]

Year 1998
Nikitin IG. Storozhakov GI. Volynkina VM. Uskov IuI. Kisliakov VA. Shilo VIu.
No information.
AIM: Detection of viral hepatitides markers in patients with alcoholic damage to the liver. MATERIALS AND METHODS: Virological, immunological and histochemical tests were performed in 36 chronic alcoholics who had enlarged liver and/or abnormal hepatic characteristics. RESULTS: 60% of the examinees carried chronic HBV, HCV, HDV infection. The activity of chronic inflammation of hepatic parenchyma was associated with biological phase of the viral infection development. The degree of hepatic parenchyma morphological changes was unrelated to the virus type. (HBV, HCV, HDV). CONCLUSION: Alcoholic hepatic damages often combine with viral hepatitis.

[The bile acid and bile lipid spectrum of the migrant population of the Asian North with biliary tract diseases]

Year 1998
Tsukanov VV. Tonkikh IuL.
No information.
AIM: The study of biochemical bile composition in Asian North migrants with biliary diseases (BD). MATERIALS AND METHODS: The diagnosis of BD was made upon clinical examination, ultrasound scanning, duodenal intubation in 329 examinees. The bile was examined for total bile acids, total cholesterol, total phospholipids and bile acid spectrum. RESULTS: Cholelithiasis patients were found to have high index of bile cholesterol saturation, high level of deoxycholic acid and low ratio primary/secondary bile acids. CONCLUSION: Changes in bile lipid spectrum are the leading cause of forming bile concrements in migrant population of the high altitudes.

[The indices of lipid metabolism in the blood plasma of patients with chronic calculous cholecystitis]

Year 1998
Selevich MI. Rusin IV. Lelevich VV. Garelik PV.
No information.
AIM: The study of lipid fraction spectrum in plasma of patients with chronic calculous cholecystitis (CCC) before and after the operative intervention. MATERIALS AND METHODS: 28 female patients with CCC. Plasma lipids were measured before the operation, 1 and 5 days after it, at the discharge from hospital and in healthy donors. RESULTS: Before the operation blood concentrations of total lipids, triacylglycerins, phosphatidylcholine and phosphatidylethanolamine were elevated. Cholesterol, lisophosphatidylcholine and sphingomyelin, cholesterol/phospholipids ratio were subnormal. The same changes of the lipids persisted 1 and 5 days after the surgery and at discharge. CONCLUSION: Plasma lipids in CCC patients are not corrected early after the surgery and require drug correction.

[Current medical technologies in the treatment of cholelithiasis]

Year 1998
Preobrazhenskii VN. Taianovskii VIu.
No information.
AIM: Assessment of different approaches to treatment of cholelithiasis (CL). MATERIALS AND METHODS: 245 CL patients were given a long-term treatment with ursosan, laser lithotripsy and combined modalities. RESULTS: Ursosan promoted dissolving of the stones in 56% of the patients. Laser lithotripsy destroyed the stones in 74 from 91 patients. Ursosan and laser lithotripsy eliminated the concrements in 59 of 67 patients. CONCLUSION: Efficacy of laser lithotripsy in CL depends on valid selection of the patients. The combined therapy of CL is preferable in patients who reject operative intervention and in those with severe somatic complications.

[Effectiveness of differential diagnosis of benign and malignant ulcers at endoscopy]

Year 1998
Gurin NN. Logunov KV.
No information.
AIM: Assessment of efficacy of differential diagnosis between benign and malignant lesions in gastric mucosa by means of endoscopy. MATERIALS AND METHODS: Morphological verdicts upon investigation of operative specimens were compared to findings at preoperative duodenofibrogastroscopy with spot biopsy in 326 patients operated for gastric ulcer. The number of discrepancies between the endoscopic and morphological diagnoses enabled estimation of endoscopy + biopsy efficiency in identification of the ulcer malignancy. RESULTS: The number of diagnostic errors made on malignant or benign nature of ulcer at endoscopic and biopsy investigations is rather big, i.e. at least 12% for both false negative and false positive hypophyses. The overall diagnostic efficacy of endoscopy in detection of the disease lies within 65-80%. CONCLUSION: Reliability of endoscopic identification including biopsy of malignant nature of gastric ulcers is not very high. Real sensitivity of this method in detection of ulcers undergoing malignant transformation reaches 76-78%.

[Cholestasis assessment by activity of antioxidant enzymes and composition of plasma lipoproteins in patients with liver diseases]

Year 1998
Loginov AS. Matiushin BN. Chebanov SM. Reshetniak VI.
No information.
AIM: Investigation of activity of copper-containing enzymes in plasma superoxide dismutase (SOD) and ceruloplasmin (CP) in comparison with concentrations of lipoproteins (LP) of the main classes in patients with chronic hepatic diseases (CHD). MATERIALS AND METHODS: SOD activity, CP and LP in plasma were measured in 90 patients with CHD. RESULTS: An inverse relationship was found between SOD activity and CP content in CHD. SOD/CP ratio proved informative in cholestasis assessment. An increased ratio beta-LP/alpha-LP was noticed in patients with primary biliary cirrhosis. This value and the disease severity correlated. CONCLUSION: Patients with cholestatic hepatic lesions exhibited inhibition of enzyme utilization of superoxide radicals in plasma in line with enhancement of CP secretion.