[Tactics of management of patients with stomach deformities]. / Taktika vedeniia bol'nykh s deformatsiiami zheludka.

Analysis of gastroscopy in 8781 patients revealed the deformities of the stomach in 1249 (14.2%) patients. Patients younger than 30 had a kink of the stomach and exogastric deformity in 75.5 and 17.7%, respectively. In patients who were older than 70 the respective values were 52.2 and 46.4%. The cause of gastric deformities was stated in 65% of cases (the diseases and specific forms of the adjacent organs). Computed tomography helped to reveal the cause of the deformity in 54% of the cases and ultrasonic investigation in 26% of the cases. The informative value of the used combination of computed tomography and esophagogastroduodenoscopy comprised 75%.

[The diagnosis of cancer of the stomach and large intestine under active dispensary observation]. / Diagnostika raka zheludka i tolstoi kishki v usloviiakh aktivnogo dispansernogo nabliudeniia.

Among patients placed under permanent medical observation carried out for 6-8 years, gastric carcinoma (GC) was revealed in 288 and colonic carcinoma (CC) in 377 cases. In 67 and 60% of the patients, respectively, the diagnosis was established as a result of systematic dispensary examinations. The first and second stage disease was identified in 50 and 43% of the cases, including 67% of GC and 62% of CC patients undergoing active examinations. In 40% of the cases on the average, the disease may run an asymptomatic course, including the late stages of the disease. In half the patients, the clinical manifestations did not last more than 3 months, with their duration being independent of the disease stage. It is assumed that at the initial stage the tumor may, during a short period of time, reach the size corresponding to both early and late stages of the disease, after which the rate of tumor growth is likely to be slower. The authors document the necessity of a comprehensive approach to the diagnosis of GC and CC, using the whole armamentarium of classical and up-to-date methods.

[The dynamics of the focal changes in the gastric mucosa of patients with chronic gastritis based on the data from a multiyear endoscopic observation in a polyclinic]. / Dinamika ochagovykh izmenenii slizistoi obolochki zheludka u bol'nykh khronicheskim gastritom po dannym mnogoletnego éndoskopicheskogo nabliudeniia v poliklinike.

Out of 1700 patients suffering from chronic gastritis, a group of 221 patients followed up for 6 to 14 years at an outpatient clinic was distinguished. Endoscopy and biopsy of gastric mucosa areas with focal lesions were carried out annually. 140 patients were discovered to have atrophic hyperplastic gastritis, 81 "complete" erosions". The lesions were of solitary or multiple character and were coupled with the other manifestations of chronic gastritis. Histology revealed different manifestations of chronic atrophic gastritis. 7.2% of the patients showed moderate dysplasia of the epithelium. The follow-up of focal hyperplasias established invariability of those formations or occurrence of the new ones in 89% of cases. In patients with "complete" erosions, such a course was recorded in 47% of cases whereas in the remainder, there was a decrease or complete disappearance of the sign. Dynamics of the histological appearance available in 28% of the patients, lay in atrophy enhancement and in the appearance of foci of intestinal metaplasia. In an equal number of cases, dysplasia of the epithelium was invariable; in some cases, it disappeared or else its intensity changed (within the framework of mild and medium degree).

[Gastroscopy in follow-up studies of patients with chronic atrophic gastritis and diagnosis of early gastric cancer]. / Gastroskopiia v dispansernom nabliudenii za bol'nymi khronicheskim atroficheskim gastritom i diagnostike rannego raka zheludka.

Visual assessment of gastric mucosa and histological findings in biopsies from the lesions were compared for 1806 patients with chronic atrophic gastritis. The spectrum of the focal lesions appeared wide. Morphological examinations determined basic comparable structural elements typical for atrophic gastritis. 85 patients were diagnosed to have early gastric cancer. All the cancer patients suffered from chronic atrophic gastritis and developed in 88% of cases intestinal metaplasia, in 32% severe epithelial dysplasia. Focal changes in the mucosa characteristic for early gastric cancer in 64% of cases could be considered as variants of chronic atrophic gastritis. In 52 patients cancer was identified during the follow-up, new-onset macroscopic alterations emerging in the last year in 62% cancer subjects. The rest of them had long-lasting macroscopic lesions, among them severe dysplasia of the epithelium in 65% of cases, believed to be histological variants of atrophic gastritis. Early cancer is suggested to develop in the presence of previous lesions rapidly and discretely.