2011, volume 7

The research goal is to develop a universal method of monitoring of intragastric medium dynamics. It allows diagnosing of bleeding recurrences and monitoring the effectiveness of gastric secretion suppression. In Saratov clinic of General Surgery use of probe-detector, dynamic endoscopy, laser Doppler flowmetry and methods of endoscopic hemostasis has reduced mortality: postoperative mortality has been decreased from 7,4 to 1,6%, while the general mortality — from 3,5 to 1,5%. The proposed devices can be used separately, and do not allow parallel assessment of pH of gastric juice, the microcirculation in the stomach wall and bleeding recurrences. 47 patients have been under the study. The changes in electroconductivity of intragastric medium have been proved in the suppression of intragastric secretion and the appearance of blood in gastric lumen. The received data have considered impedancemetry as the method of monitoring of intragastric medium in gastroduodenal bleedings

Objective of the research is to improve the results of surgical treatment in patients with postoperative acute bleeding erosions and ulcers of stomach and duodenum by their prediction and validation of methods for prevention and treatment. Materials and methods. A retrospective analysis of 3746 case histories of patients has been made. Acute erosive and ulcerative lesions, complicated by gastroduodenal bleeding, have been diagnosed in 220 cases (5, 9%) in the postoperative period. Older patients have been accounted 62, 8%. Results. Acute erosive and ulcerative lesions have been developed in 5.6% of all operated patients of older age, and 0,3% in patients of middle age. Mortality rate in older patients with bleeding acute erosive and ulcerative lesions has accounted 35,8. Conclusion. The development of gastroduodenal acute erosive and ulcerative lesions is considered to be a risk factor degenerating condition of older patients in the postoperative period. The main areas of acute erosive and ulcerative lesions treatment are antisecretory therapy and endoscopic hemostasis. Endoscopic hemostasis should be accompanied by good antisecretory treatment with antacid effect in the stomach. The use of injections of H2-blockers does not prevent bleeding recurrences

Aim of investigation — to analyze the results of treatment of patients with atherosclerotic gangrene of a limb, to identify the causes of adverse outcomes amputation. Materials and methods: We analyzed the results of examination and treatment of 218 patients with atherosclerotic gangrene of the limb. Good outcome of amputation was considered the primary surgical wound healing of the stump. Suppuration, secondary healing, re-amputation and death we attributed to the adverse results of amputation. Results: The adverse outcomes of amputation due to technical errors in surgery, properly chosen level, inadequate drainage of the wound stump, an unsuccessful operation on the arteries of a limb, inadequate empirical antibiotic therapy, patient's age, functional capabilities of myocardium, the duration of critical ischemia, as well as the lack of psychological adaptation of patients before amputation. Conclusion: To decide the need for amputation in patients with atherosclerotic gangrene follows the assessment of possible vascular reconstructive surgery. In determining the level of amputation is necessary to objectively assess the degree of disruption of regional blood flow using multilevel manometry and laser Dopplerflowmetry. In preparation for amputation should be paid special attention to the correction of rheological and coagulation properties of blood, normalization of the functional state of the myocardium, as well as specialized psychotherapeutic training for timely and adequate psychological adaptation of the patient

The purpose of the article is to identify the most characteristic and significant changes in indicators in patients with bladder cancer during diffusion-weighted whole-body imaging (DWIBS). Materials: From September 2009 till 2011 98 patients have been examined (61 (62,24%) with morphologically verified bladder cancer and 37 (37,76%) with cystitis. Results: The study has revealed that the sensitivity of DWIBS-study in detecting bladder cancer is 98,36%, specificity of 10,81 %, the efficacy of 65,38%. Conclusions: DWIBS is an informative noninvasive method for screening diagnostics of bladder cancer, to identify suspicious areas on regional, and distant metastases

The research goal is to study morphological changes after direct electropulse effect (DEPE) on the wall of urinary tract. Materials and methods: Materials of renal pelvis (25 fragments, n), ureter (n=33) and urinary bladder (n=20) from open surgeries were used. During the surgical intervention a few small fragments were resected to study the organ, immersed on a Petri-dish with solution of 0.9% NaCI. Mucosa was subjected to 1-20 single nanosecond electric impulses of intensity 0.8-1.0 J using probe of electropulse lithotriptor «Urolith-105M». The fragments were fixed in formalin, and then tissue sections were made. Results: Wall of renal pelvis was the most resistant to DEPE. Epithelial desquama-tion, basal disorganization, capillary dilatation and edema were observed within submucosal layer on application up to 10 impulses of intensity 1.0 J in the same point of mucosa. Walls of ureter and urinary bladder were less resistant to the DEPE, where just 5 impulses of intensity 1.0 J caused similar disorders, and 10 impulses of intensity 1.0 J caused damage to the entire thickness of the muscular layer up to adventitia. Conclusion: DEPE of urinary tract mucosa with a number of electric impulses from 1 to 20 with intensity of 0.8 to 1.0 J is a safe method. It causes morphological disorders within the muscular layer but it does not lead to wall perforation

Objective is to detect bone mineral density along the shin according to «Esperanto» levels by Hounsfield's scale. Materials and methods. The analysis of density modification in 25 patients with pseudoarthrosis of tibia with predominant localization in a lower one-third of bone has been carried out. Results. By means of computed tomography it has been revealed that the bone tissue density of the tibia in the process of false joint union when using the compressive variant of combined transosseous osteosynthesis has changed according to the regularity reproducing phase character of the accumulation of mineral substances in the bone. Conclution. The growth of mineral density of the bone tissue during treatment spreads in the directions from proximal and distal metaepiphyses to the zone of pseudoarthrosis knitting

The purpose of work: to study the medical and social status of learning youth of different types of educational institutions and scientifically to prove the differentiated approach to the organization of the prophylactic aid. Methods. Sociological research of 1039 respondents (students of universities) is lead; learning average special educational institutions and technical training colleges under specially developed questionnaire. Results. Features of a social accessory (belonging), a standard of living and well-being of learning universities, special educational institutions and technical training college are determined. The student's cohort of universities under many characteristics was a cohort of safe people from full (70%) intelligent (78%), малодетных (100%) families with an average level of well-being (70%). Pupils of technical training college — are more often natives from incomplete (57%) and quite often having many children (27%) than families working (37%) and peasants (39%) — differed the most unsuccessful characteristics. Pupils special educational institutions took an intermediate place on all investigated parameters. The conclusion. Essential distinctions of the social status of students and learning different types of educational institutions from which the most unsuccessful appeared pupils of technical training college are revealed. It serves as argument for a substantiation of the differentiated approach by development of programs of improvement and the preventive help of learning youth of different types of educational institutions

The analysis of elderly people attitude to alternative practices of health maintenance in the context of activity prolongation is presented. By the example of conducted sociological research it is demonstrated that besides medication, health resources maintenance includes the following relevant methods: physical exercises and fitness; quit pernicious habits; rational nutrition; sexual activity

The research goal is to determine the clinical and pathogenetic efficacy of Cycloferon liniment in the combined therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis. Materials and methods: Medical examination and treatment of 60 patients have been carried out. The marker of endogenous intoxication, infectious severity and immunity has been investigated. Results. It has been established that use of Cycloferon liniment in the combined therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis has allowed to decrease infectious severity in par-odontal recess and evidence of local inflammation, to normalize immunity indices and reduce the level of endogenous intoxication that has been liable for acceleration of recuperation processes and lowering of frequency of stomatitis recurrences. Conclusion. The clinical efficacy of Cycloferon liniment in the therapy in patients with herpetic stomatitis accompanied by chronic tonsillitis conditioned by the decreasing of activity of local inflammatory process according to the reducing of level pro-inflammatory cytokines, infectious burden of the mouth cavity, endogenous intoxication

Diagnosis of occlusion in combination with the musculo-articular dysfunction is based on data from medical history, results of clinical and special methods of research: analysis of diagnostic models of jaws in the articulator, the results of radiological methods of investigation: orthopantomography, teleroentgenography, tomography of temporomandibular joints, magnetic resonance imaging, electromyography of masticatory muscles; functionography and other methods of investigation