[The extraintestinal manifestations of nonspecific ulcerative colitis].
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Biomedical subjects
Publications and source records attributed to A A Krylov.
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The author describes and classifies the most frequently occurring combinations of peptic ulcer and pathology of other organs and systems on the basis of examining more than 2,000 patients. Diseases and syndromes associated with peptic ulcer are distributed into 2 groups: within the gastrointestinal tract and outside it. The former ones include cardia insufficiency, deranged bowel function, rectal syndrome, diseases of the gallbladder, pathology of the liver and pancreas; among the latter ones are essential hypertension, atherosclerosis, coronary heart disease, chronic nonspecific pulmonary diseases, and diabetes mellitus. Different pathogenetic relations and clinical load are shown to exist between the underlying disease and concomitant illnesses. Evidence is provided for the concept of enlarged spasms (phenomenon of the spastic dominant) common to peptic ulcer. Efficient methods of the individualized treatment of patients with concomitant pathology are described.
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The paper describes a palpable symptom of a marked pit of the stomach in hiatal hernia. The symptom was registered in 67.9% of patients with such hernia and in 20% of gastroenterological patients without it. The sign is suggested to arise in advanced muscular and connective tissue debility.
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Analysis is made of the diagnostic and therapeutic problems related to Addison-Biermer anemia based on studying disease histories of 15 patients afflicted with the disease and placed under the author's observation. Under the outpatient conditions, the disease, in many cases, is not diagnosed accurately whereas the treatment is carried out without any control. The diagnostic role of examining the bone marrow puncture biopsy, reticulocyte and erythrocyte sedimentation crisis, gastric secretion, and the neurological status is outlined. Among rare complications of the treatment with vitamin B12, abacterial feverish reactions, hypertonic crises and cerebral circulatory disorders are recorded. Emphasis is laid on the necessity of oncological apprehension both in the period of the patients' entry into the stage of remission and in long-term dynamic observation.
2130 inpatients with peptic ulcer have been examined for clinical, diagnostic and therapeutic aspects with reference to ulcer site. Differential diagnosis and therapeutic policy are discussed for cardial, middle-gastric , pyloric, extra-bulbar and multiple ulcers.
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Accelerated erythrocyte sedimentation rate detected in 59 patients was a cause of their hospitalization and close examination. It revealed tumors, soft tissue and vessel inflammation, hematologic disorders with M-gradient found at blood protein electrophoresis, disseminated atheromatosis. The cause of the syndrome was not identified in 3 cases.
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Clinical and echocardiographic studies were carried out in 100 young men (mean age 18.0 +/- 3.0 years) with "harmless" murmur (HM). 20 young men (mean age 17.0 +/- 2.0 years) were examined as control. In these men, murmur could not be detected both at rest and after 15 squattings and the hyperventilation test. No relationship was discovered between the murmur intensity and gravity of heart hyperdynamia, although in persons with HM, the predominance of hyperdynamia could be observed. It is believed that the intensity of HM is due to the morphofunctional features of the cardiac structures. The chordal apparatus of the heart is viewed as one of them. In 37% of persons with HM, echocardiography revealed a phenomenon of the "fluttering" chorda, which lies in diastolic-systolic hypermobility of one of the commonly attached chordae of the mitral valve because of its excessive length and weak tonic tension. That phenomenon is usually associated with so-called Steele's murmur. It is concluded that via the phenomenon of the "fluttering" of the chorda of the mitral valve there may occur labile and, in some cases, of "musical" non-regurgitation systolic murmur in local dysfunction of the papillary muscles.
Clinical, epidemiological and serological data as well as literature reviews were used to formulate and substantiate a concept on the presence of cause-sequel (etiological) relation between chronic persistent (slow) infection caused by the Epstein-Barr herpes virus (chronic infectious mononucleosis) and atherosclerosis. Detailed findings of the etiologic agent of atherosclerosis makes it possible to plan principally new ways of its diagnosis, treatment and prophylaxis.
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While analyzing the data available in the literature and their own findings, the authors propose a classification of functional diseases and disturbances of the stomach by origin, nature of functional disorders, and clinical symptoms. They consider the features of gastric functional disturbances in chronic diseases of the gastrointestinal tract, abnormalities of other organs and systems, diseases of the nervous system, intoxications, arrhythmias, nitriture, etc. Among the patients admitted to the Clinic of Neuroses and Psychotherapy, individuals suffering from neurotic disorders or neurotic continuous mild abnormalities of the stomach, neurosis-like disorders complicating the course of chronic gastroenterologic diseases have been identified. Principles and patterns of management of patients with gastric functional diseases and disturbances have been developed.