[Blood insulin levels in surgical treatment of peptic ulcer]. / Soderzhanie insulina v krovi pri khirurgicheskom lechenii iazvennoi bolezni.

Blood plasma insulin has been studied in 74 patients with gastroduodenal peptic ulcer (GDU) with the aid of the radioimmunological method before the operation, in the early and remote postoperative periods. Prior to surgery, the level of insulin gets increased on an empty stomach and after stimulation both in gastric and in duodenal peptic ulcer. The hormone content has been found to be reduced postoperatively, both in the immediate and remote periods but pyloroplasty in selective proximal vagotomy and especially in selective vagotomy resulted in a greater increase in insulin following its stimulation with test breakfast. Rehabilitative measures before and after surgery have been shown to be associated with augmentation of the blood level of the hormone, which fact promotes increase of the trophic effect of insulin on the gastrointestinal system.

[Surgical treatment of patients with duodenal ulcer]. / Khirurgicheskoe lechenie bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

Ulcer incidence in the Crimeahas increased during the last 9 years from 118.4 to 185.7 cases per 10,000 of adult population, being higher in South Coast and in mountains. From 125 patients with duodenal ulcer after conservative treatment only 12.8% have recovered (follow up for 8-10 years). 29.6% of patients underwent surgery; 1.6%--died without operations of ulcer, 35.2%--needed elective treatment. From 97 patients who died during 4 years of ulcer in Simferopol, 25 (25.8%) were not operated. They were aged and very old patients with long history of the disease. Among 9412 operations for ulcer there were 4.17% of lethal outcomes in perforated ulcer and 11.5%--in bleeding (22.18% being at the peak of hemorrhage); 1.45%--after elective resection of the stomach, 0.79%--after organ-saving operations with vagotomy, in SPV--0.56%. According to general hospital surgery data, there were no lethal outcomes after SPV and SPV with pyloroplasty (295 patients). As a conclusion it is stated, that surgery in ulcer should be made earlier, before complications.

[The late results of combined surgical treatment in peptic ulcer patients]. / Otdalennye rezul'taty kompleksnogo khirurgicheskogo lecheniia bol'nykh s iazvennoi bolezn'iu.

Long-term results (for 10 and more years) were analyzed in 661 of 693 patients operated upon for ulcer disease of the stomach and duodenum. The complex antiulcerous treatment before operation, immediately after it, at the nearest and remote periods, the sanatorium and resort treatment were given to 377 patients while 316 patients were treated by the generally accepted methods only, without a sanatorium rehabilitation. The best results were obtained after all kinds of operations (resection of the stomach, vagotomy with resection of the stomach, truncal and selective vagotomy with drainage operations, selective proximal vagotomy) in patients treated by complex methods with the sanatorium rehabilitation. The effect was most pronounced in patients after organ-saving operations and in those having a short ulcer history.

[Proteolytic enzyme inhibitor and the kinin system in thyrotoxicosis]. / Sostoianie sistemy ingibitorov fermentov proteoliza i kininov pri tireotoksikoze.

Free bradykinin, kininogen, kininase, protease inhibitors of alpha 1-antitrypsin, alpha 1-antichymotrypsin, alpha 2-macroglobulin, and antitryptic volume of the blood serum were examined in 25 patients suffering from goiter with thyrotoxicosis symptoms. Activation of the kinin system and reduction in the antitryptic volume were revealed before the operation. The level of the rest inhibitors was elevated. After operative intervention these changes became more expressed. alpha 2-Macroglobulin content increased. By the moment of discharge the above parameters tended to normalization. The content of the majority of inhibitors, however, did not reach normal. This should be taken into consideration during rehabilitation of patients with thyrotoxicosis.

[Blood kinins in diseases of the abdominal organs]. / Kininy krovi pri zabolevaniiakh organov briushnoi polosti.

Under investigation were 151 patients with peptic ulcer (68), postresective disorders (8), non-incarcerated hernias (20), chronic gastritis (11), appendicitis (7), cholecystitis (5) and healthy people (32). The ulcerous disease, especially when complicated, is accompanied by increased activity of the kallikrein-kinin system. Certain deviations are observed in postresective disorders. These disorders were found to increase within the first day after operations on the stomach and in less degree after other interventions. Later these symptoms tended to normalize. The kinin activity was influenced by the severity of the operation trauma and anesthesia. Sufficient preoperative preparation and use of kontrikal resulted in less disturbance in the kinin system.