ABSTRACT
The authors present results of the investigation of melatonin receptors expression in lymphocytes in dynamics in 102 patients with acute pancreatitis of mild and severe form and in 50 volunteers. A correlated analysis was made between obtained results of laboratory and instrumental researches and clinical course of acute pancreatitis. The decrease of MT1 receptors expression was noted on 25% in patients with acute pancreatitis. The decline of MT2 receptors expression was observed on 40% of patients with acute severe pancreatitis and in a case of acute mild pancreatitis--on 15.5%, respectively. Values of MT1 and MT2 expression were equal between healthy volunteers. The decline of MT2 expression was a prognostic unfavourable sign. Obtained results of dynamic expression assessment of MT-receptors were presented as MT2/MT1 indices. Given index didn't change during disease, because of this, the index could be used as a prognostic development marker of destructive form of acute pancreatitis at the moment of patient's admission to hospital. Mean values of MT2/MT1 were determined for the purpose of universalization of used method (1.13 +/- 0.09 for mild form and 0.81 +/- 0.09 for severe form of acute pancreatitis, respectively).
Subject(s)
Lymphocytes/metabolism , Melatonin/metabolism , Pancreatitis , Receptor, Melatonin, MT1 , Receptor, Melatonin, MT2 , Acute Disease , Adult , Female , Fluorescent Antibody Technique, Indirect/methods , Humans , Male , Middle Aged , Pancreatitis/blood , Pancreatitis/diagnosis , Pancreatitis/physiopathology , Predictive Value of Tests , Prognosis , Receptor, Melatonin, MT1/analysis , Receptor, Melatonin, MT1/blood , Receptor, Melatonin, MT2/analysis , Receptor, Melatonin, MT2/blood , Reproducibility of Results , Severity of Illness IndexABSTRACT
Long-term results of closure of perforated ulcers were analyzed in 91 patients. Excellent and good results were obtained in 70% of the patients, in 12.1% the results were satisfactory. In 18.6% of the cases the results were considered unsatisfactory. Bad long-term results were due to the absence of dispensary follow-up, the absence of repeated courses of anti-ulcer therapy, and not following the recommendations on the treatment. Excellent and good long-term results observed in 70% of the patients allow recommendation of suturing the perforated opening and anti-ulcer therapy in patients with perforated pyloroduodenal ulcers.
Subject(s)
Duodenal Ulcer/pathology , Duodenal Ulcer/surgery , Peptic Ulcer Perforation/pathology , Peptic Ulcer Perforation/surgery , Pylorus/pathology , Pylorus/surgery , Adult , Aged , Digestive System Surgical Procedures/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Time Factors , Treatment OutcomeABSTRACT
The work presents results of treatment of 375 patients with acute pancreatitis, 93 patients with destructive pancreatitis were operated upon. Minimally invasive and traditional technologies were used. Postoperative lethality was 6.5%. The method of lumboscopic extraperitoneal drainage of the destruction focus under the control of laparoscopy and USI is described. The percutaneous paracenthetic-draining interventions under the control of USI and endovideosurgical technologies were shown to be highly effective in treatment of patients with acute destructive pancreatitis and its complications.
Subject(s)
Decision Making , Digestive System Surgical Procedures/methods , Pancreatitis, Acute Necrotizing/surgery , Female , Humans , Male , Middle Aged , Pancreatitis, Acute Necrotizing/diagnosis , Pancreatitis, Acute Necrotizing/drug therapy , Parasympatholytics/therapeutic use , Postoperative Complications , Video-Assisted Surgery/methodsABSTRACT
The article presents an analysis of immediate results of laparoscopic interventions (suturing, vagotomy) in 40 patients with perforated ulcers in the pylorobulbar zone. Postoperative complications were noted in 7.5% of the patients. There were no lethal outcomes. The authors recommend wider introduction of the laparoscopic technology as a method of optimization of surgical treatment for perforated ulcers.
