[Specific development and course of portal hypertension complication in patients with hepatic cirrhosis of HBV and HCV etiology].

During 1976-2007 in the Republican Specialized Center of Surgery named after acad. Vakhidov various types of portosystemic shunting were performed in 669 patients with portal hypertension. The aim was to estimate the influence of HBV- and HCV-cirrhosis on the formation of portal hypertension and the results of portosystenic shunting. An analysis of 115 liver cirrhosis patients with portal hypertension was made to find out which of them had variceal bleeding and high risk of its development. Such operations were performed in all these patients by the period of 2004-2007 years. Various types of portosystemic shunting were performed in all cases. The analysis has shown that unlike HCV-cirrhoses, HBV cirrhoses are characterized by more progressive course with a short period of a compensation pause in relation to progression of hepatocellular insufficiency, but a less pronounced risk of hemorrhagic complications.

[Two-stage policy of treatment of cholelithiasis complicated with choledocholithiasis]. / Dvukhetapnaia taktika lecheniia zhelchnokamennoi bolezni, oslozhnennoi kholedokholitiazom.

Results of endo-surgical treatment in 81 patients with choledocholithiasis are analyzed. There were 60 women and 21 men aged from 24 to 77 years. It is demonstrated that inclusion of octreotid and dicetel in combined two-stage treatment of choledocholithiasis decreases the risk of pancreatitis and bleeding after endoscopic papillosphincterotomy, number of postoperative complications, hospital stay, cost of treatment and provides good cosmetic effect.

[Surgical treatment of rectal-vaginal fistulas]. / Khirurgicheskoe lechenie priamokishechno-vaginal'nykh svishchei.

An analysis of results of surgical treatment of rectal-vaginal fistulas (RVF) in 54 patients aged from 20 to 56 has revealed that 22 patients (40.8%) had I degree RVF, 32 (59.2%) had II degree RVF. In 24 patients (44.4%) RVF were complicated by anal incontinence. A transsphincter fistula was found in 35 (64.8%) patients, extra-sphincter one in 2 (3.7%), and intrasphincter--in 17 (31.5%) patients. The operation of choice was dissection of the sphincter passage with the descending of rectum mucosa which was supplemented with anterior sphincterolevator plasty in 32 (59.2%) of 54 patients. Recurrent fistulas were found in 2 (3.7%) patients.

[Radionuclide diagnosis of the degree of structural changes in the testes after herniotomy]. / Radionuklidna diagnostika na stepenta na strukturni promeni v testisite sled kherniotomiia.

Funiculus spermaticus is exposed to invasive surgical intervention during Inguinal hernia reconstruction. Division or mechanical trauma to the spermatic artery account for serious trophic changes in the testis which, in bilateral herniotomy in particular, give rise to azoospermia. Here utilization of gamma camera scintigraphy of testes is indicated insofar as it may establish the degree of structural changes in testes as a result of mechanical injury to the spermatic chord during herniotomy which, in turn, has important prognostic implications on the fertility potential of patients. Twenty-five patients aged 3 to 48 years are covered by the study. In four of them herniotomy is associated with ipsilateral cryptorchidism and because of that orchiopexy is resorted to. In seven cases complete atrophy of testes following herniotomy is established scintigraphically. The imaging of testes fails, and functional parenchyma is lacking. In case of testicular hypoplasia, gamma-camera scintigraphy yields important information on the blood flow and blood supply to testes, as well as on intercurrent changes taking place. The radionuclide indices undergo alterations consistent with the structural changes in the parenchyma of testes. The severer the structural changes, the lower the values of radionuclide indices.

[Various factors of nonspecific resistance in pregnant women with anemia]. / Nekotorye faktory nespetsificheskoi rezistentnosti pri anemii beremennykh.

Eighty-two women whose pregnancy was complicated by anemias of varying severity and twelve healthy pregnant women were examined. Blood plasma immunoglobulins A, G, and M were measured by immunochemical methods, as were the immune complexes of various levels and some parameters of the homeostasis system. The findings evidence a noticeable elevation of the concentrations of all immunoglobulins, of low-disperse immune aggregates in severe anemia of pregnancy, as well as intensive synthesis of immunoglobulin M in the fetus, low level of large immune complexes, and stimulation of some homeostasis components that results in consumption coagulopathy and chronic DIC syndrome. Correlations between some parameters of the blood coagulation and fibrinolysis systems, on the one hand, and humoral immunity characteristics, on the other, may be traced, among these correlations being reverse correlations between IgG level, activated recalcification time, fibrinogen concentration, and activated partial thromboplastin time.

[Peptide endotoxins and disruption of the hemostasis system during a complicated pregnancy]. / Peptidnye éndotoksiny i narushenie sistemy gemostaza pri oslozhnennom techenii beremennosti.

Peptide fractions, affecting the state of the hemostasis system, were isolated from blood plasma of patients with abnormal development of pregnancy. The functional activity of homogeneous peptide preparation was expressed as induction of ADP-dependent thrombocytes aggregation.

[The radionuclide diagnosis of posttraumatic complications in the testes]. / Radionuklidna diagnostika na posttravmatichnite uslozhneniia na testisite.

Testicular trauma is not uncommon. Apart from accidental trauma it may deliberately be inflicted during fight by striking blows in the scrotal area. The most common posttraumatic complications are hematoma, hydrocele and hematocele, orchiepididymitis and occasionally malignant degeneration of the injured testis. Unless diagnosed and treated in time, these complications lead to hypoplasia and atrophy of the testes, the far-reaching result being sterility. Fifteen patients 17 to 40 years of age, undergone testicular trauma, comprise the study group. In 8 patients no changes were recorded. In the other group of 7 patients 1 had hematoma, 4 hydrocele, 1 orchiepididymitis and 1 (six months after the trauma)--tumor of the testis--teratocarcinoma. It is concluded that gamma-camera scintigraphy of the testis is a quick and exact method, which furnishes ample information on the complications following testicular trauma thus tracing a correct approach to treatment.

[Emergency radionuclide diagnosis of subtorsion of the spermatic cord]. / Speshna radionuklidna diagnostika na subtorzioto na spermalnata vruv.

Correct diagnosis of subtorsion of the spermatic cord was established in 9 patients by gamma-camera scintigraphy with 99mTc sodium pertechnate. The tentative out-patient diagnosis in 8 patients was acute orchiepididymitis and 2 were suspected of having torsion of the spermatic cord. The scintigraphic image of spermatic cord subtorsion is very characteristic and allows precise diagnosis. At the site of the testis there is some degree of activity--the smaller the degree of torsion the higher the activity is. Around the testis there is a ring-shaped bank of increased activity. In torsion of the spermatic cord (torsion greater than 360 degrees) a cold zone is visualized at the site of the testis, surrounded by a ring of increased activity. In acute orchiepididymitis the testis is seen enlarged with evidence of increased capillary tissue blood flow; on later scintigrams the activity in the testis is strongly increased. Gamma-camera scintigraphy is a quick, exact and noninvasive method, which contributes much to estbich precise diagnosis in cases of acute scrotum. The scintigraphic image of subtorsion and torsion of the spermatic cord is very characteristic and explicit, allowing to distinguish this disease from acute orchiepididymitis. This in turn is of major importance for successful emergency operation to preserve the testis.

[Gamma-chamber testicular scintigraphy in the combined diagnosis of Morris' syndrome]. / Gamakamerna testikularna stsintigrafiia v kompleksnata diagnoza na sindroma na Morris.

The authors examined 15 patients with the syndrome of Morris by gamacamarated scintigraphy and they succeeded in depicting the gonads, found in the abdomen and their topographic localization. Grave structural changes were established in the testes during the performance of gamacamerated scintigraphy, but in 3 patients only one testis was depicted, which suggested atrophy and lack of functional parenchyma in the gonad, which was not discovered. Conclusive scintigraphic examination of topographic localization as well as of structural disturbances of the parenchyma of the testis replaced testicular biopsy, which requires laparotomy. Gamacamerated scintigraphy could establish malignant growth of the gonad and could help to remove it in time by operation.

[The level of autoantibodies to thrombin in the plasma of healthy subjects detectable using an immunochemical analyzer]. / Soderzhanie autoantitel k trombinu v plazme zdorovykh liudei, vyiavliaemykh immunokhimicheskim analizatorom.

The existence of autoantibodies to the active factors of blood coagulation was confirmed by the usage of immunochemical analyzer. Autoantibodies to thrombin were stated to exist both in IgG and IgM and IgA fractions of immunoglobulins. Dose-effect of thrombin was determined. The greatest binding of autoantibodies by thrombin takes place in antigen of 0.125 mg/ml concentration.

[Gamma-camera scintigraphy and radioimmunological study of the hormones of the hypophyseal-gonadal axis to evaluate testicular function in patients with hypogonadism and infertility]. / Gamakamerna stsintigrafiia i radioimunologichno izsledvane na khormonite ot khipofizo-gonadnata os za otsenka na funktsiiata na testisite pri bolni s khipogonadizum i infetilitet.

Gamma-camera and radioimmunological study of hormones of hypophyseal-gonadal axis were carried out on 34 patients with hypogonadism and infertility after successfully performed orchidopexy. The results from this study showed that gamma-camera scintigraphy was exact and noninvasive method for determining the structure and function of testes after operative intervention. The results of the established hormonal deviations in the secretion of hormones of hypophyseal-gonadal axis are sure and early criterium for diagnosis of infertility in these patients. They could indicate the therapeutic management in these patients.