[Morphological characteristic of tissues, surrounding prosthesis in patients, suffering cutaneo-prosthetic fistulas and paraprosthetic hernias].

While application of the net prostheses in surgery of anterior abdominal wall hernias (AAWH) the complications are noted, such as the prosthesis cyst development, the net wrinkling, migration and separation with the hernia recurrence. Morphological investigation of tissues were conducted in regions of cutaneo-prosthetic fistulas and hernial gates, formatted by the prosthesis edge, in 22 patients, operated for AAWH, in 6 of them cutaneo-prosthetic fistulas were observed. Morphological changes in region of prosthesis, taking part in the hernial defect development, as well as in the wrinkled part of the prosthesis, were characterized by pronounced inflammation, development of rude cicatrices and infiltration of tissues. While durable existence of cutaneo-prosthetic fistulas the prosthesis degradation and destruction occurs as well as the breaks and cracks; on sites of the tissue, surrounding the prosthesis, the microorganisms and fungi vegetations may evolve, trusting its secondary infectioning.

[Surgical treatment of the combined gastric and duodenal ulcers].

Results of the surgical treatment of 354 patients with the combined gastric and duodenal ulcers were analyzed. Hard to be resected ulcers (giant, multiple, <>) were found in 32,8% of cases. Thus, amount of <> ulcers and stenotic deformations of the duodenum (67,2%) defined the necessity of radical operative treatment - gastric resection, as a rule, atypical.

[On the nature of secondary ulcers of the stomach].

The authors have studied two main groups of causes of the arising of secondary ulcers of the stomach: ulcerous aetiology due to stenosing duodenal ulcers (238 patients--81.1%) and non-ulcerous aetiology (53 patients--18.2%). It was found that both variants of secondary ulcers were characterized by a considerable part of so called "difficult" ulcers of the stomach and high bias towards bleedings. Operation of choice for secondary ulcers of the stomach must be resection of the stomach preferably by the Billroth-I method or application of termino-lateral anastomosis.

[Typological peculiarities of giant gastric ulcer]. / Tipologicheskie osobennosti gigantskoi iazvy zheludka.

Of 1441 patients operated on, the giant gastric ulcer was revealed in 16.6%. It is characterized by polymorphism: several ulcers were revealed in 7.6%, coexistent gastric and duodenal ulcer--in 19.8% and, in contradistinction to genuine gastric ulcer (I type--according to Johnson), by high frequency of such complications as hemorrhage (in 44.1% of observations), penetration (in 74.1%), malignancy (in 14.3%).

[Re-operations after formerly performed suturing of the "silent" perforative duodenal ulcer]. / Povtornye operatsii posle ranee proizvedennogo zashivaniia "nemoi" perforativnoi iazvy dvenadtsatiperstnoi kishki.

After the "silent" perforative duodenal ulcer closure the gap till the complications would occur, which need reoperation, by two times more than such period of time in patients with typical ulcer anamnesis, preceding the perforation. The reoperation causes are the recurrence (in 50.6% of observations), newly occurred ulcer (in 26.9%) or nonhealing of already existing (in 22.5%) duodenal ulcer. The reoperation method of choice is gastric resection according to Billroth-I in combination with truncal vagotomy in case of hypersecretory syndrome.

[Morphologic features of mucosa and secretory activity of the stomach in patients with duodenal ulcers in obesity]. / Osobennosti morfologii slizisto i obolochki i sekretornaia aktivnost' zheludka u bol'nykh s duodenal'nymi iazvami pri ozhirenii.

Gastric mucosa of obese patients with duodenal ulcer was investigated by means of light and electron microscopy and morphometrically. The comparison of the morphological findings and data on gastric secretion shows that overall volume of functional structures of the parietal and peptic cells providing secretion is smaller in duodenal ulcer patients with obesity than in non-obese patients. Elevated gastric secretion in these patients is maintained by hyperfunction of the corresponding structures.

[The role of lipids in the metabolic response to intrajejunal administration of hypertonic glucose solution]. / Rol' lipidov v mekhanizme metabolicheskogo otveta na intraeiunal'noe vvedenie gipertonicheskogo rastvora gliukozy.

Importance of impairments in lipid metabolism for development of dumping reactions was studied in experimental animals. Alterations in content of free fatty acids, triglycerides and phospholipids before and at the peak of the provoked dumping reaction depended on the type of the dumping reaction. Lipid metabolites were involved in development of the provoked dumping reaction.