[Fibrinolytic activity of duodenal mucosa in elderly and senile patients with the ulcer hemorrhage]. / Fibrynolitychna aktyvnist' slyzovoï obolonky dvanadtsiatypaloï kyshky u khvorykh pokhyloho ta starechoho viku z vyrazkovoho krovotecheiu.

The duodenal mucosa fibrinolytic activity was investigated in elderly and senile patients with chronic ulcer, complicated by hemorrhage. In noncomplicated duodenal ulcer the mucosal fibrinolytic activity of anterior intestinal wall prevailed such an activity of posterior wall. It preserved in the hemorrhage occurrence also. Maximal meaning of indices were noted on the second-fourth day after hemorrhage beginning in anterior duodenal wall and on the first day in posterior one. In term up to 8 days fibrinolytic activity had lowered, but in mucosa of anterior duodenal wall it exceeded by 44% the index in control group and of posterior wall--by 28%. Treating the patients it is necessary to take into account the results obtained, especially in presence of endoscopic signs of unstable hemostasis.

[Clinical sequelae of blood remaining in the intestinal inlet after the hemorrhage]. / Naslidny perebuvannia krovi v prosviti kyshechnyku pislia krovotechi.

In experiment there were revealed significant changes of composition of aerobic and anaerobic microorganisms in the jejunum and ileum mucosa after hemorrhage of middle severity. While application of antibiotics these changes were more pronounced, demanding serious substantiation of its application.

[Surgical treatment of bleeding duodenal ulcer in elderly and senile patients with intraoperative verification of the diagnosis]. / Khirurhichne likuvannia vyrazky dvanadtsiatypaloï kyshky z krovotecheiu u khvorykh pokhyloho ta starechoho viku z intraoperatsiinoiu veryfikatsiieiu diahnozu.

The method of duodenotomy performance for duodenal ulcer with hemorrhage was proposed. Duodenum was dissected longitudinally across the ampulla lower edge going all over medial edge of pars descendens, permitting not only doing the revision but revealing the hemorrhage source, securing homeostasis. The rules of local hemostasis performance were elaborated. Application of the above mentioned access prevents damage of nervi vagi duodenal anterior brunch, guaranteeing the duodenal motor-evacuation function preservation.

[Proteolytic activity of duodenal mucosa in elderly and senile patients in the presence of duodenal hemorrhage from ulcer]. / Proteolitychna aktyvnist' slyzovoï obolonky dvanadtsiatypaloï kyshky u khvorykh pokhyloho ta starechoho viku za naiavnosti vyrazkovoï duodenal'noï krovotechi.

During investigation of proteolisis of duodenum mucosa in patients of elderly and senile age with duodenal ulcer, complicated by hemorrhage, in terms up 8 for days there was revealed considerable increase of proteolytic activity, especially of high-molecular proteins and collagens, maximum--on the first day of hemorrhage. In all terms the revealed activity of anterior wall of duodenum was higher, than posterior.

[The Helicobacter pylori role in origination of hemorrhage in elderly and senile patients with duodenal ulcer disease]. / Rol' Helicobacter pylori u vunyknenni krovotechi pry vyrazkovii khvorobi dvanadtsiatypaloï kyshky u patsiientiv pokhyloho ta starechoho viku.

During examination of 37 patients with duodenal ulcer disease aging more than 60 years it was established that while presence of the ulcer complicated by bleeding the revelation frequency of Helicobacter pylori (HP) in gastric antrum is increasing up to 74% and in cases of noncomplicated ulcer--70%. HP was revealed most frequently in patients with "senile" ulcer. For an "inveterate" ulcer the presence of S-like forms is typical. The absence of HP in 41.6% patients with "senile" ulcer testifies the presence of other mechanisms of occurrence and support of bleeding.

[Surgical treatment of giant posterior ampullar duodenal ulcer with bleeding in the elderly and senile patients]. / Khirurhichne likuvannia hihants'koï zaampul'noï vyrazky dvanadtsiatypaloï kyshny z krovotecheiu u khvorykh pokhyloho ta starchoho viku.

There was experimentally elaborated and introduced to clinical practice the method of surgical treatment of giant retroampullar ulcer of duodenal posterior wall with hemorrhage in elderly and senile patients. Physiological exteriorization of ulcer out of duodenal borders and original method of tamponage using the small intestine wall with complete coverage of duodenal lumen and restoration of intestinal passability performing gastroenteroanastomosis antecolica anterior and Brown anastomosis are the main advantages of this method. The method guarantees the ulcer healing, prophylaxes the recurrency rise due to distribution of the contents motion in two streams.

[The surgical treatment of perforated bleeding duodenal peptic ulcer in middle-aged and elderly patients]. / Khirurhichne likuvannia penetruiuchoï krovotochyvoï vyrazky dvanadtsiatypaloï kyshky u khvorykh pokhyloho ta starechoho viku.

The surgical hemostasis method was elaborated and introduced in the clinic according to the data of morphological investigation of bleeding penetrating ulcer of the duodenal ampulla posterior wall in elderly and senile patients.

[Classification and selection of treatment of chronic gastroduodenal ulcer complicated by hemorrhage in elderly and senile patients]. / Klasyfikatsiia i vybir taktyky likuvannia khronichnoï hastroduodenal'noï byrazky, uskladnenoï krovotecheiu u khvorykh pokhyloho ta starechoho viku.

The classification of chronical bleeding gastroduodenal ulcer in elderly and senile patients, considering the blood loss severity and concurrent pathology, was proposed. The tactics of treatment--conservative, operative, or actively-waiting one--was determined according to the classification adduced. The proposed classification application and the tactics of treatment also have permitted to reduce mortality from 15.7 to 11.2%.

[Performance of organ salvaging intervention for duodenal ulcer with bleeding in elderly and senile patients]. / Vykonannia orhanozberihaiuchykh vtruchan' z pryvodu vyrazky dvanadtsiatypaloï kyshky z krovotecheiu u khvorykh pokhyloho ta starechoho viku.

An experimentally elaborated and introduced in clinical practice organpreserving methods of surgical treatment of the bleeding duodenal ulcer, localized on the ampullar posterior wall in elderly and senile patients, mentioning the ulcer tamponade with complete duodenal inlet overlapping and the gut passability restoration using gastroenteroanastomosis antecolica anterior formation with anastomosis according to Brown, were proposed. The secure stoppage of bleeding is guaranteed by the application of the method, what is simple in application.

[The formation of a small intestine-large intestine anastomosis: the end to the side method]. / Sposib formuvannia tonko-tovstokyshkovoho anastomozu kinets' u bik.

The longitudinal ileotransversostomy forming method according to which the ileum is divided at an angle of 45 degrees to the mesentery edge, forming a single layer anastomosis end to the side at an angle of 45 degrees in isoperistaltic mode, was elaborated. Clinico-experimental investigations were conducted on 45 mongrel dogs. Method was applied in 6 patients with malignant tumor of caecum and colon ascendens.

[The rehabilitation of compensatory changes after right side hemicolectomy]. / Vidnovlennia kompensatornykh zmin pislia pravobichnoï hemikolektomiï.

Macro- and microscopic changes in the anastomosis region, motor-emptying function of the small bowel, and immunological changes also, were experimentally investigated after the right-sided hemicolectomy conduction. Compensatory dilation of colon, transversum for the absorbtion square increase with simultaneous wall thinning was revealed. The stump may reduce or dilate. Lymphoid follicles appear in the small bowel submucosa. The accelerated emptying of the small bowel contents become slower after its circular division up to submucosa on 20 and 40 cm distance from anastomosis. General T-lymphocytes quantity, T-helpers/T-suppressors ratio reduces abruptly on the third day with gradual increase on the 5th, 7th and 30th day. At the same time the IgM, IgG, IgA levels, the index of spontaneous and stimulated NBT-test rises on the third day, stabilizing slowly before the 30th day.