[A case of pancreatic glucagonoma].

Neuroendocrine tumor consisting of pancreatic alpha-cells -- glucagonoma -- is a very rare finding (one case per two million people a year). This functionally active, usually malignant tumor has typical clinical manifestations. Glucagonoma syndrome is a disease that has an original clinical picture that includes necrolytic migrating erythema with secondary bullous dermatitis, glucose tolerance disorder or diabetes mellitus, weight loss, anemia, hypoaminoacidemia, venous thrombosis, and alimentary and mental disturbances. By the time diagnosis is made, 60 to 70% of glucagonomas already give metastases, and even small glucagonomas should be considered tumors with unknown malignant potential or malignant tumors. Glucagonomas grow slowly, and patients live long (the survival median is approximately 15 years). The authors describe their own observation.

[Connective tissue dysplasias (hereditary collagenopathies)].

Connective tissue dysplasia (hereditary collagenopathy) presents a group of genetically heterogenous and clinically polymorphic pathological conditions, associated with disturbances in the forming of connective tissue during the embryonal and postnatal periods. Differentiated dysplasias include monofactor diseases with an established genetic defect and clear clinical symptoms, such as Marfan's syndrome, Ehlers-Danlo's syndrome, and osteogenesis imperfecta. The variants of non-differentiated hereditary dysplasias include primary mitral valve prolapse and other minor heart anomalies, tracheobronchial dyskinesia, visceroptosis, join hypermobility, congenital chest deformations, "weakness" of the ligamentous apparatus of the foot and the spine, and a range of other prevalent pathological changes. The author adduces his own observation of a patient with Marfan's syndrome.

[A rare case of large-cell gastric lymphoma in a patient with chronic lympholeucosis].

Chronic lympholeucosis (CLL) is a B-cell lymphoproliferative disease, the morphological substrate of which is a clone of lymphocytes similar in size and morphology to normal mature lymphocyte and similar in immunophenotype to B lymphocytes at late stages of differentiation. The occurrence of large-cell lymphoma against the background of B-CLL is called Richter syndrome. A new tumor may occur in lymph nodes, the spleen, the liver, and the gastrointestinal tract (GIT). GIT involvement in Richter syndrome is a very rare case; the authors found only six descriptions of such cases in available literature, and no such description in Russian literature. The authors adduce their own observation.

[Surgical tactics in thyroid nodular neoplasms associated with chronic autoimmune thyroiditis]. / Khirurgicheskaia taktika pri uzlovykh obrazovaniiakh shchitovidnoi zhelezy v sochetanii s khronicheskim autoimmunnym tireoiditom.

There were analyzed the results of surgical treatment of 628 patients with different thyroid nodular neoplasms combined with autoimmune thyroiditis, who were operated in the surgical department of the Mandryka Central Military Clinical Hospital in 1989-2001. The use of organ-preserving operations is substantiated by the necessity of maximal decrease of the post-operative complication level and preservation of thyroid hormonogenic function. Resection with node removal within the limits of healthy tissues is substantiated by the results of analysis of morphologic structure of nodular neoplasm and adjacent thyroid tissue. The analysis of repeated operations has shown that the etiology and morphologic structure of nodular neoplasm (but not the volume of operation) play the main role in the pathogenesis of relapse development.

[Function of the liver and gallbladder after subtotal gastric resection and gastrectomy with the creation of an artificial stomach]. / Funktsional'noe sostoianie pecheni i zhelchnogo puzyria posle subtotal'noi rezektsii zheludka i gastréktomii s formirovaniem iskusstvennogo zheludka.

A comparative ultrasound and radiological investigation of gallbladder and hepatic tree function was made in patients after operation with creation of artificial stomach, Billroth I and Roux operations. The control group consisted of 30 unoperated patients. Scintigraphy discovered gallbladder dyskinesia in 12 (18.7%) patients of the study group and in 6 (20%) controls. Ultrasonography--in 15 (33.3%) patients of the study group, 5 (25%) patients after distal resection of the stomach with pyloriform gastroduodenoanastomosis, 18 (51.47%) patients operated by Roux and 5 (16.6%) controls, respectively. It is shown that normal transduodenal passage of food has a positive effect on gallbladder and liver functions.

[New variants of intestinal plastic repair of the urinary bladder in experiment]. / Novye varianty intestinal'noi plastiki mochevogo puzyria v éksperimente.

Two operative techniques of urinary reservoir creation are described. The techniques preserves urethral urination and urinary reservoir for supravesical urine passage with establishment of "dry" enterostoma. Ureteral implantation is made with establishment of invagination-valvular ureterocystoanastomosis. The above operations were tried on 13 mongrel dogs. The experiments have shown that urinary reservoir, serous-muscular constrictor, invagination valve of the urinary reservoir and invagination-valvular ureterocystoanastomosis retain their shape, structure and functional capacity in different postoperative terms and can be practiced in inpatients after radical cystectomy for muscular-invasive cancer of the bladder or in urinary bladder diseases urging greater capacity of the bladder.

[Correction of immunological status of patients with cholelithiasis for the prevention of postoperative complications]. / Korrektsiia immunologicheskogo statusa u bol'nykh s zhelchno- kamennoi bolezn'iu s tsel'iu preduprezhdeniia posleoperatsionnykh oslozhnenii.

An investigation of immune status of patients with chronic calculous cholecystitis prior to operation and in the postoperative period has proved the development of a pronounced secondary immune deficiency involving T and B-systems of the immune control as well as factors of nonspecific resistance. These changes may be considered as risk factors of the development of infectious complications in the postoperative period. Prophylactics of the secondary immune deficiency by administration of Contrical is indicated which permitted the amount of postoperative complications and the period of stay at the hospital to be decreased.