Vol 68, No 3 (1987)

Diphyllobothriosis is a chronic intestinal helminthiasis in which all parts of the gastrointestinal tract are involved in the pathological process. Experimental diphyllobotriose observed violation of digestion of food substances in the small intestine, in clinical studies - disorders of absorption.

The works of several researchers found that acid formation and motility of the stomach, the absorptive function of the small intestine are not restored immediately after deworming. This requires a period longer than the two-month observation accepted in polyclinics. An important task is to determine the optimal timing of the follow-up.

Many researchers point to frequent lesion of the sphincter apparatus of the terminal choledochal region in biliary tract diseases. Thus, spastic state of Oddi sphincter occurs in 4.2-21.9% of cases that depends on a contingent of patients and type of biliary tract pathology.

Diagnostics of spastic state of Oddi sphincter is based on dynamics of contrast substance accumulation, and also on reaction to spasmolytic drugs: nitroglycerin, amylnitrite etc. Nitroglycerin and amyl nitrite are antispasmodics, indirectly acting on smooth muscles of biliary tracts and having unstable effect.

Based on observation of O.S. Kochnev and V.N. Biryaltsev about the influence of ß-adrenoblocker anapriline on the contractile function of Oddi sphincter (author's certificate No 1082404), we used this drug in the process of infusion cholangiography in 80 patients with biliary system pathology.

Significant attention to immunological disorders in extrahepatic cholestasis is closely related to the search for criteria of severity of patients with mechanical jaundice. Existing clinical, laboratory and biochemical methods of control do not reflect the whole depth of pathophysiological disorders in this disease. It has been experimentally established that under the influence of cholemic intoxication factors the thymus-dependent part of immunity is damaged to the greatest extent. Clinical studies have revealed a decrease in blast-transformation of lymphocytes with phytohemagglutinin, which may be due to either a change in the functional characteristics of T-lymphocytes or a decrease in their number.

Currently, the attention of researchers is attracted by fibronectin protein, which is present in all human organs, tissues and biological fluids, performing adhesive and opsonic functions. Fibronectin is most closely related to the liver: firstly, liver cells - hepatocytes - are the main site of blood fibronectin synthesis; secondly, numerous experimental and clinical studies have revealed a direct functional relationship between fibronectin levels and the uptake capacity of RES, in particular the relationship with the function of endothelial kupffer cells.

Surgical treatment of external colonic fistulas, a serious complication of abdominal injuries and diseases, is a complex problem. The success of its solution to a great extent depends on the completeness of modern diagnostic methods and methods of surgical intervention.

Transverse flatfoot accounts for 55.2% of all static deformities in women and 38.1% in men. Valgus deviation of the I toe is the most frequent secondary component of transverse plantar foot deformity (in 96.2%). The disappointing results of conservative treatment of transverse-plastic foot deformity with valgus deviation of the I toe encourage many doctors to seek new surgical interventions, but even the latter are not always effective.

The problem of non-pharmacological treatment of arterial hypertension is receiving more and more attention, but many of its aspects and, moreover, specific recommendations for targeted prescription of certain therapeutic agents remain poorly studied. Sauna and balneo-procedures play a certain role among different variants of nonmedicamental treatment. The positive influence of sauna on the state of central hemodynamics in arterial hypertension is marked by a number of authors, but only single reports contain references (without detailed factual data) about the positive effect of simultaneous use of the swimming pool and sauna.

The aim of the work was to study the influence of the courses of the swimming pool and sauna on the parameters of central hemodynamics in hypertensive patients in the recreation center of an industrial enterprise, that is without discontinuing daily labor activity.

Among the manifold manifestations of occupational pathology from antibiotic exposure a significant place belongs to chronic enterocolitis and colitis and neurological disorders. There are reports in the literature about the importance of intestinal pathology in the formation of neurological symptoms in patients suffering from gastrointestinal tract diseases. Nervous system disorders are mainly reducible to neurasthenic, radicular and polyneuritic syndromes. However, the question about the influence of intestinal pathology on the development of neurological disorders in occupational diseases from exposure to antibiotics has not yet been developed, which prompted us to conduct the present study.

The data on the role of disseminated intravascular coagulation in the occurrence of ischemic lesions in severe forms of this pathology are attracting increasing attention in the study of the pathogenesis of pregnant gestosis. V. P. Skipetrov suggests that coagulopathy developing in pregnant gestosis is the result of increased thromboplastic activity of the blood in response to damaging agents. Direct evidence has been obtained that severe forms of pregnancy gestosis are accompanied by a chronic form of disseminated intravascular coagulation syndrome (DIC). Thromboplastinemia acts as one of the initial moments of hemostasis system activation, which underlies thrombotic complications.

The postwar years were marked by a true revolution in the field of antibiotic therapy. Thanks to the widespread use of antibiotics, the mortality rate of a wide variety of human diseases decreased considerably. However, the total, not always reasonable, and sometimes even illiterate self-treatment, and failure to comply with the sequence of taking antibiotics has turned the sick person's body into a kind of microbiological laboratory for the production of new (antibiotic-resistant) strains of saprophytic microflora, many of which have acquired new pathogenic properties. That's why the main etiological factor of inflammatory processes in organs and various complications of infectious genesis are nowadays not Gram-positive bacteria, but opportunistic Gram-negative microorganisms.

Early complications after Bilroth-II gastric resection for peptic ulcer disease are duodenal stump failure, anastomosis, postoperative pancreatitis, anastomosis stitch failure, etc. First of all duodenostasis underlies these complications, and it appears as a result of duodenum atony and accumulation of bile, pancreatic juice and gastrointestinal contents in it. The resultant increase in hydrostatic pressure in the duodenal cavity can lead to residual limb failure. In addition, increased hydrostatic pressure contributes to inflammatory phenomena in the area of the junction, supports intestinal paresis and, preventing further secretion of pancreatic juice, leads to pancreatitis. Lack of enteral nutrition in the postoperative period disturbs metabolism and reduces plastic capabilities of the body. Stagnation of intestinal contents also has a toxic effect.

75 patients with acute dysentery Flexner's disease without concomitant and past diseases of the digestive organs were examined. The clinical diagnosis was confirmed bacteriologically.
The aim of the work was to study the total proteolytic activity of the gastric juice by Ensky and Mirsky method, which allows to evaluate proteolysis in a wide pH range at its values from 1.5 to 7.0, including optimums of pepsin, gastrixin and, probably, other gastric proteases. Studies were performed before histamine administration (0.1 mg per 10 kg weight) and thereafter.

Chloroform, ether, heparin, mono-octanoin, taurocholate, etc. were used by different authors to dissolve concrements. Direct contact of a chemical compound with gallstones is necessary for lysis of concrements. It is noted that chemicals, especially organic solvents, should be used with caution since they are toxic themselves and can cause aggravation of hepatitis, limited liver necrosis, formation of acute duodenal ulcers with bleeding, etc. Therefore, before deciding on the use of chloroform for lysis of residual choledochal concrements it is necessary to exclude liver functional changes by laboratory tests.

Meckel's diverticulum, which is a congenital intestinal anomaly, often causes various pathological conditions. There are numerous testimonies about it in the literature, but all pathological variants associated with it are of some interest up to now.
We had to observe a patient with acute strangulation intestinal obstruction caused by Meckel's diverticulum in the department of burn surgery. We could not find any description of such a combination in the available literature.

To determine the prognostic significance of the level and nature of lymphoid infiltration, we undertook a study of 210 cancerous tumors of different localizations (stomach, lung, breast, intestine) obtained at the operation and partially at the section. Gender, age of patients, localization of the process, histological type, degree of differentiation, stage of the disease, presence of metastases to lymph nodes and distant organs were taken into account. For a comparative study of lymphoid infiltration of benign and malignant tumors we analyzed infiltrate cells of 30 fibroadenomas (breast, prostate).

We studied the types of hyperlipoproteidemia and the effect of normalization of carbohydrate metabolism on lipidogram in diabetic patients. Fractional separation of blood serum lipids was performed by electrophoretic method.
We observed 80 patients aged 15 to 70 years. The control group included 33 healthy people aged 22 to 26. Body weight was normal in the majority of patients (75). The following diseases were revealed in the examined patients: diabetic retinal angiopathy (in 73), limb neuropathy (in 21), limb angiopathy (in 29), Stage I nephropathy (in 22), diabetic hepatosis (in 37), ketoacidosis (in 22). On admission to the hospital all patients had decompensation of diabetes mellitus. Patients were divided into two groups according to their age: 38 fell under 40 years old and 42 fell over 40 years old. Among the patients under 40 years old there were 31 patients with severe form of the disease, 7 patients with medium severity; among the patients older than 40 years old there were 19 and 23 of them, respectively. Depending on indications, patients received various antidiabetic drugs, B-group vitamins, anabolic agents, angioprotectors, lipotropic agents.

A socio-hygienic study of the actual state of field camps in the farms of 16 districts of Penza Oblast has shown that the field camp is built separately for each brigade. Of the 404 mills, 395 were permanent and represented capital structures, but none of them was built according to any standard design. More than a half of them (215) have an area of 0,3-0,5 ha. The areas of 187 camps were planted with trees or bushes, and 207 of them were fenced. The territory of the majority of field camps is not clearly zoned, let alone fenced and landscaped between the economic and household zones. Therefore, the planning structure does not maintain a sanitary gap between the various objects of industrial purpose and recreation room, catering facility. For example, grounds and sheds for parking agricultural machinery in 77 field camps and warehouses for storing fuel and lubricants in 13 remote from the rest room for only 25-50 m. The location of these production facilities does not take into account the possibility of their harmful effects on the human body in the rest room, red corner or canteen. Various smells, and less often noise, emanating from the nearby parking area for agricultural machinery, interfere with the rest of mechanics.

In recent years, lasers have been actively introduced into various fields of surgery, certain experience has been accumulated in the treatment of a number of surgical diseases, indications for surgical interventions using lasers are expanding. The ability of the laser beam to sterilize the surgical field, preventing access of microorganisms to the wound surface (which is especially important in conditions of contaminated wounds), allows its effective use in surgical treatment of proctologic diseases.

Treatment of children with biliary system lesions has been developed by many pediatricians. However, in recent years, it has become apparent that lesions of the biliary system in children are often combined with diseases of the gastroduodenal zone. This causes the need to make appropriate adjustments to the set of previously developed therapeutic regimens.

During 1985 we conducted a study of living conditions, state of health, organization of medical care in elderly and old people living alone in rural areas. In our opinion, improving the organization of medical care for the elderly should begin with improving medical workers' knowledge of gerontology and geriatrics. With the help of special questionnaires distributed to doctors and nurses engaged in self-reception, we studied opinions on the level of their knowledge on gerontology and geriatrics and the organization of care for the elderly in rural areas, and in our letter we would like to share the results of this questionnaire.