Vol 44, No 3 (1963)

For a number of years, we have studied the combination of peptic ulcer disease with various diseases (pulmonary tuberculosis, closed craniocerebral trauma, hypertension, atherosclerosis, angina pectoris, myocardial infarction, etc.). We believe that the study of the relationship between diseases can be a method to clarify various issues of pathogenesis.

In domestic and foreign literature there are isolated reports on multiple ulcers of the stomach and duodenum (V.M. Podleshchuk, T.K. Novitskaya, A.G. Serebryakova, Katz, Masyon, etc.). Sometimes they write about multiple ulcers as casuistic observations (D.N.Sheid, L.I.Kovarsky, Yu.E. Berezov, N.V. Gladkov, etc.). T.K. Novitskaya indicates that multiple stomach ulcers occur in 4.8% of ulcerative patients, V.N. Promtov - in 3.5%, A.A. Busalov - 6.6%, I.M. Flekel - from 5 to 20%, Mayo - 12%, Moinigen - 25%.

In a previous work (1962), we showed that transillumination research can be important as a method for diagnosing gastric cancer during laparotomy. This message highlights the capabilities of this method in identifying normal and pathological structures of the stomach wall during surgery.

Development of preventive measures is impossible without knowledge of the etiological factors and pathogenesis of chronic liver damage. There is still no clarity regarding the etiology of liver cirrhosis, which is the outcome of unfavorable chronic hepatitis. It can be considered undoubtedly proven that Botkin's disease prevails among these reasons. After the huge pandemic of the last world war and the subsequent ones, the percentage of liver cirrhosis associated with Botkin's disease is constantly growing. Based on our material (Tajikistan), a study of the anamnesis of patients with liver cirrhosis showed that over 5 years the percentage of patients with cirrhosis who had suffered Botkin's disease in the past increased from 18 to 33, with a significantly lower percentage in the control groups (0-6%, respectively). In some statistics, this percentage is even higher. However, in the data of the authors of the beginning of the century, as well as the 30s. on a considerable number of patients with cirrhosis, Botkin's disease does not even find a place for itself in the list of diseases suffered in the past by patients (S. V. Chapman, A. M. Snell a. G. Rowntreçh, 1931 - 112 patients; N. Evans A. R. A. Gray, 1938 - 217 patients, etc.). In the 40s, during and after the war, Botkin's disease in the history of patients with cirrhosis of the liver already reaches 1.5-13% (JD Fagin A. R. Thompson - 1944; B. Rosenacka.oth., 1949, etc.) ... K. Howard a. S. J. Watson (1947) has already found among patients with cirrhosis of the liver 17% of those who have had infectious hepatitis in the past, compared with 3% who have had this disease among people with other diseases.

The issues of tactics in acute pancreatitis have not yet been resolved, and judgments about the indications for surgical treatment are contradictory. As for the fundamentals of surgical tactics in acute cholecystopancreatitis, they have not yet been fully developed. All this makes the problem of tactics in these diseases very urgent.

Portal hypertension can be caused by causes that lie within the liver (mainly cirrhosis), as well as outside the liver: thrombosis, compression by scarring or tumor of the portal vein or its main branches.

The prevalence of paraproctitis diseases and the variety of proposed treatment methods require great attention from surgeons to this group of patients. The complexity of topographic and anatomical conditions, a variety of etiological and pathogenetic factors require a differentiated approach in determining the clinical picture of the disease and, in particular, to the surgical treatment of patients with paraproctitis. In this case, there can be no standard of operational procedures.

Since 1957, we have been using a differentiated method of treating patients with typhoid fever with antibiotics, which has some advantages over other methods (Pediatriya, 1958, 5). We would like to draw the readers' attention to the results of treatment with this method of adults and children with typhoid fever.

The question of restoring the tone of the intestinal muscles after operations in the abdominal cavity and with inflammatory phenomena in it still remains unresolved. Discussing the mechanism of development of intestinal paresis in peritonitis, the authors usually pay attention to the state of the nervous system, especially its vegetative part, as directly responsible for the regulation of the tone of smooth muscle organs. Recognizing the violation of the tone of the autonomic nervous system in peritonitis, researchers often come, however, to contradictory judgments about the degree of damage to its parts. So, M. K. Avdeev and D. I. Vyropaev (1936), L. V. Lepeshinsky (1940), S. S. Girgolav and V. S. Levit (1946), N. L. Gurevich (1951), V. Ya. Shlapobersky (1958), Ya. Nelyubovich (1961) and others attribute the occurrence of intestinal paresis due to damage, mainly, of the parasympathetic division of the autonomic nervous system. A whole number of authors associate the occurrence of intestinal paresis with changes in the sympathetic section of the autonomic nervous system (B. G. Rubinstein, 1936; S. M. Muromtsev, 1938; G. M. Shpolyansky, 1939, 1945; I. F. Pantsevich, 1948 ; and etc.). Such inconsistency of data in understanding the mechanism of intestinal paresis during the development of an inflammatory process in the abdominal cavity significantly limits the scope of rational therapeutic treatment of this formidable complication.

In the pathogenesis and clinical course of many diseases, a significant place is given to autosensitization. Autoantibodies are found in burn disease, purulent-septic infection, leukemia, agranulocytosis, various anemias, Verlhof's disease, rheumatism, nephritis, encephalomyelitis, Shenlein-Henoch disease and other diseases.

One of the common complications after curettage of the uterine cavity during abortion and in the postpartum period is cervical atresia, sometimes combined with atresia of the uterine cavity.

Ectopic pregnancy is the most common pathology that an obstetrician-gynecologist has to deal with.

Until recently, treatment of ovarian cancer in the late stages of development gives unsatisfactory results. According to most authors (A. T. Abbasov, R. N. Shimanovsky, E. M. Vermel, A. N. Kosarev and others), even with 1 tbsp. ovarian cancer cure by an operative method ranges from 50-53%, and the average cure rates for all its stages do not exceed 25%.

Complication in the treatment of ulcerative patients with silver nitrate is quite rare. In the blood, lapis with organic substances is reduced to metallic insoluble silver, which cannot be excreted from the body and is deposited in the form of a dark pigment of the connective tissue of various organs. A very small dose of it is removed back from the body by urine and bile (in dissolved form).

Currently, data are provided on the clinical effectiveness of gangleron in the treatment of patients with peptic ulcer disease.

Surgical intervention at the height of bleeding in diseases of the gastrointestinal tract is performed by most surgeons more often in middle-aged and elderly patients and very rarely in old age, especially with pronounced age-related changes in the cardiovascular and nervous system. The fear of “losing the patient” makes some surgeons refuse surgery and use conservative therapy. Of course, there may be contraindications for the operation of such patients, when the operation may be either useless or harmful. In these cases, conservative therapy will be the only treatment. With direct indications and the absence of special contraindications, surgical intervention is a necessary treatment even in extreme old age. By careful, active action, the surgeon can prolong the life of elderly people.

Almost all surgeons agree that in case of perforation of gastric and duodenal ulcers, an emergency operation is necessary, and either suturing of the perforated opening or primary resection of the stomach is performed.

Lesions of the gastrointestinal tract with lymphadenosis, although rare, are encountered.

When, with Werlhof's disease, it is not possible to stop the bleeding conservatively, one has to resort to splenectomy as the only way to save the patient.

As you know, determining the nature of gastro-duodenal bleeding is very difficult.

Damage to the common bile duct during resection of the stomach occurs in 0.2-1.8% of operations with anomalies in the location of the duct, when the duct is seized together with a vessel (stopping bleeding), with cicatricial adhesions in the hepato-duodenal ligament and displacement of the duct.

In the period from 1955 to 1959, 172 patients were admitted to the surgical department of the Republican Hospital with a diagnosis of intestinal obstruction.

In a district hospital, spleen removal is still rarely performed, so we consider it possible to share our observations.

In the practice of an ophthalmologist, a rather significant place is occupied by diseases of the lacrimal ducts and especially the lacrimal sac. Inflammation of the latter - dacryocystitis is accompanied by very unpleasant phenomena: lacrimation and suppuration. For a long time, they tried to artificially restore the outflow of tear fluid into the nasal cavity with this disease. The most effective should be considered dacryocystorhinostomy modified by prof. V.N. Arkhangelsky.

G., born in 1930, turned to a psychiatrist in connection with the need to recommend a transfer to another area of ​​work (noise intolerance). Developed correctly in childhood. Since 1953 he is engaged in boxing, first-class athlete; until 1957 did not know a single defeat. From 1957 to 1959 received three knockdowns (with blows to the head). In December 1959 he was knocked out with a blow to the head. For five days he was treated inpatiently, then outpatiently. After that, he noted a sharp deterioration in his condition: constant headaches, sleep disorders (at first - drowsiness, followed after a few months by insomnia). Fatigue, decreased performance, and memory worsened gradually. In 1960, due to traumatic cerebrosthenia with reactive layers, he was demobilized from the army.

A., 2 years 8 months, was admitted 2/IX-58, the Child from the second pregnancy. The birth proceeded normally. Birth weight - 3,200 g, height - 50 cm. Sits from 6 months, walks from 14 months. Teething from 6 months. The child was fed with breast milk alone for up to 1 year. Complementary feeding from the first year. Didn't hurt. Heredity is healthy. Father is 26 years old, mother is 27 years old. The first child died at three days of age, the cause is unknown. The third child is healthy at the age of 5 months. Material conditions are satisfactory.

P., 21, was admitted at 14 hours 20/X 1959 with complaints of nausea, vomiting, burning and dry mouth, abdominal pain, dizziness, general weakness.

The most common criteria for the functional state of the secretory apparatus of the stomach are the determination of acid-forming function, secretory (determination of the amount of gastric contents) function - on an empty stomach and in response to certain stimuli; less often pepsin-forming and other functions are studied. However, doctors often exaggerate the importance of these criteria both in assessing the functional state of the stomach and in the development of the pathological process. In this regard, it is advisable to cite some facts that help in the correct assessment of the results of the study of these functions.

Manganese is widely used in domestic industry. The results of studying the incidence of people in contact with manganese and numerous experiments on animals clearly indicate pathological changes caused by manganese dust.

The use of atomic energy is so wide that it does not fit into the framework of any one science or division of the national economy.

The meeting, convened on the initiative of the USSR Academy of Sciences, was attended by 243 delegates and about 100 guests. All union republics (except for the Latvian one) were represented.

The symposium was organized by the Board of the Society of Surgeons of the Ukrainian SSR.

June 13, 1963 marks 2 years since the death of the director of the Kazan Research Institute of Epidemiology, Microbiology and Hygiene, Candidate of Medical Sciences, Honored Doctor of the RSFSR Nina Aleksandrovna Nemshilova.