Reverse Transposition - a New Surgical Model for the Study the Role of Ileum in Glucose Metabolism.

We studied the possibility of reverse transposition of the small intestine and its effect on glucose metabolism. The reverse transposition model proposed by us consists in a 180° turn of the small intestine after transection and antiperistaltic transposition of the entire intestinal tube. To this end, outbred white rats underwent reverse transposition of the small intestine, sham-operated rats served as the control. Both groups were monitored for body weight and blood glucose levels at fast and after oral glucose tolerance test. The groups did not differ by the duration of surgery, body weight, and blood glucose levels at fast and after glucose tolerance test. The reverse transposition technique proposed by us is reproducible, the anatomical changes lead to early contact of the chyme with the terminal portion of the small intestine, which can modulate absorption of nutrients and the release of ileal hormones (incretins) affecting glucose metabolism.

[Efficacy of compression hosiery and elastic bandaging after surgical treatment of varicose veins]. / Éffektivnost' kompressionnogo trikotazha i élasticheskogo bintovaniia pri khirurgicheskom lechenii varikoznoi bolezni.

AIM: The purpose of the study was to compare the results of using compression knitwear and elastic bandaging in the postoperative period after endovasal laser coagulation in patients with varicose veins. PATIENTS AND METHODS: A total of forty 20-to-55-year-old women with a body mass index of ≤ 35 kg/m2 and CEAP class C2-C3 lower limb varicose veins were randomized into two numerically equal groups. The Study Group included those receiving postoperative compression on the operated leg with the help an elastic stocking, whereas in the Comparison Group compression was achieved by laying an elastic bandage. Both group women underwent laser coagulation of the great saphenous vein and removal of separate veins with the help of Mueller hooks. Efficacy of compression therapy was comparatively assessed based on the results of interviewing the patients prior to intervention and 1 month thereafter, as well as by the level of pain syndrome according to the visual analogue scale at 24 and 48 postoperative hours, by the time spent by the personnel for bandaging of the limb or putting on the compression stocking intraoperatively and at the first dressing, by the degree of lower limb oedema and dynamics of regression thereof, by the area of postoperative haematoma and its dynamics after 2, 7 days and at 1 month. Besides, we evaluated the findings of ultrasonographic angioscanning of lower limb veins at one month postoperatively. RESULTS: The obtained findings demonstrated that efficacy of using a medical compression stocking after the procedure of endovasal laser coagulation in women with varicose veins was comparable to that of elastic bandaging. By the incidence rate and area of extension of postoperative haematomas, degree of pain syndrome, patient-oriented assessment using the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ), condition of veins according to the findings of ultrasonographic angioscanning no significant differences were revealed between the two methods of elastic compression of the leg. However, using a medical stocking appeared to promote a statistically significant 1.4-1.6-fold reduction in the time spent for formation of elastic compression of the lower limb, as well as a decrease in the incidence rate and degree of local oedema of the lower limb in the postoperative period.

[Nephrotic syndrome in a female patient with Rapunzel syndrome].

The Rapunzel syndrome is a rare complication of gastric trichobezoar, which may be long insidious. Systemic hair eating gradually leads to bezoar growth, gastritis, gastric mucosal ulcerations, and evacuatory disorders. The Rapunzel syndrome may cause acute and chronic bowel obstruction, peritonitis, pancreatitis, appendicitis, anemia, hypoalbuminemia, and allergic manifestations. Neither proteinuria nor nephrotic syndrome is depicted in any of the 38 Rapunzel syndrome cases described in the literature. The authors present the first case of gastric trichobezoar extending to the small bowel (its total length was 118 cm), which gave rise to chronic recurrent partial bowel obstruction, causing intoxication nephrotic syndrome in a 20-year-old women with trichotillomania. The nephrotic syndrome became a reason for her admission to a nephrology department and had specific features: it was unaccompanied by hypercholesterolemia, it rapidly regressed and completely disappeared after surgical removal of the trichobezoar weighing 1980 g.

[Experimental study of the effects of impulse-electric discharge on chemotaxis and cytoadhesion of urinary infection pathogens].

The aim of the experimental study was to evaluate effects of impulse-electric discharge in liquid on chemotaxis and cytoadhesion of urinary infection pathogens. Chemotaxis was determined in respect to the lung, liver, spleen, kidney, ureter, urinary bladder, urethra of white mice by S. Likholetov's modified method. Cytoadhesion was assessed by V. Brilis. The experiments show that the impulse-electric discharge holds promise for urological practice.

[Electrostimulation therapy--a new method of preventing postoperative wound complications in abdominal surgery]. / Elektroimpul'snaia obrabotka tkanei--novyi metod profilaktiki posleoperatsionnykh ranevykh oslozhnenii v abdominan'noi khirurgii.

Experimental investigations have shown that chemotaxic activity of microorganisms in the parietal peritoneum and abdominal organ tissues is inhibited when they are treated with impulse electric discharges preventing the process of infecting the tissues. Results of the experiments underlay the development of a new method of prophylactics of postoperative complications in abdominal surgery based on the electroimpulsive treatment of the operation wound. Clinical approbation of the method showed its effectiveness, simplicity and safety.

[Surgical prevention of postresection reflux-gastritis]. / Khirurgicheskaia profilaktika postrezektsionnogo refliuks-gastrita.

Results of treatment of 331 patients operated in surgical clinic of Karaganda Medical Academy from 1990 to 1998 for complicated form of gastric and duodenal ulcers are presented. For surgical prophylaxis of postresective reflux-gastritis and to reduce the risk of sutures insufficiency two original methods of creation of transverse terminolateral gastroduodenoanastomosis with a reflux mechanism were proposed. These methods were used in 129 (39%) patients. Biochemical, endoscopic, X-ray, ultrasonic, morphological examinations demonstrated advantages of the proposed methods of stomach resection which promote portion-tardive type of evacuation with lower rate of postresective pathological states. It is concluded that these operations may be used as methods of choice in surgical treatment of ulcer.