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Biomedical subjects

M I Kuzin

Publications and source records attributed to M I Kuzin.

At least 19 recordsLinked to original sources
PubMed2001

[Pressing problems of gastric and duodenal ulcer surgery].

Main types of surgical operations for the treatment of ulcer disease were elaborated towards the end of XIX century and improved constantly for the better by surgeons. Vagotomy is the outstanding achievement of the XX century. It enabled lowering of mortality, and frequency of postresection syndromes and improved patients' quality of life. The discovery of Helicobacter pylori (Hp) has changed our knowledge about ulcer disease pathophysiology. Eradication of Hp with omeprasol and antibiotics sharply improved the treatment, decreased the relapses. In this connection number of elective surgical operations decreased, but number of emergency increased. Importance of Hp in pathophysiology of ulcer disease is overestimated. Chronic Hp gastritis, destroying protective mucosal barrier clear the way for destructive action ofacidopeptic component of gastric juice and ulcer formation. The comparative evaluation of different surgical operations is given and optimal methods for the treatment of complicated and uncomplicated duodenal and gastric ulcers are recommended.

Digestive System Surgical Procedures↗
PubMed2000

[Estimation of stomach surgery results].

Operations on the stomach make up about 2-5% of all operations performed in clinics of general surgery. In evaluation of the efficacy and quality of treatment the quantitative indices are used: intraoperative and postoperative complications, frequency of relapses of the basic disease, frequency and degree of severity of developing functional manifestations of the diseases of postoperative stomach and metabolic disturbances. However, contemporary trends to standardization of surgical technique and to high rank of technological equipment of the operation unit predetermine related or identical results after various operations on the stomach. Differences in outcomes of surgical treatment are best of all revealed in the study of qualitative results. The qualitative evaluation of various operative procedures with the use of integrale scales of Johnston and Visick has some substantial disadvantages. WHO recommends to use "adequacy of treatment", i.e. achievement of the adequate quality of life for each patient as a criteria for evaluation of the efficacy of treatment. The authors suggest that, until the influence of particular operation on the level of the quality of life of patients in postoperative period (in comparison with the initial ones before the operation and in healthy people) is not studied, it is impossible to judge about its advantages and shortcomings. The quality of surgical operation--the choice of the procedure and its technical realisation--predetermines quality of life of patients in postoperative period.

Digestive System Surgical Procedures↗
PubMed2000

[Plastic surgery in patients with obesity late after horizontal banded gastroplasty].

The results of 361 plastic operations in 296 patients with morbid obesity late after horizontal gastroplasty were analyzed. Plastic and corrective operations aimed at removal of redundant lipocutaneous "aprons" at the anterior abdominal wall, thighs, thoracic wall, gluteal region and the arms, represent a final stage of surgical treatment of patients with morbid obesity. The indications, technique and the results of plastic operations performed from 1985 to 1998, are thoroughly elucidated. The analysis of early postoperative complications has established, that it a reasonable to perform such operations 1-3 years after gastroplasty when body weight stabilizes and there are no vitamin deficiency, iron deficient anemia, hypoproteinemia, hydroionic disturbances or other complications of the later period. Complex prophylactic measures for prevention of pyoseptic and thromboembolic complications in patients with obesity late after gastroplasty permits to avoid severe complications and lethal outcomes in patients after plastic operations.

Adolescent↗
PubMed2000

[Spectro-fluorescence analysis of ALA-induced protoporphyrin IX in differential diagnosis of stomach disease].

The results of examination of 47 patients with confirmed diagnosis of cancer of the stomach (21 patients) or 26 suspects were analyzed. 2-4 hours after oral taking of Alasence in the dose 5-10 mg/kg, gastroscopy with spectrofluorescence analysis of ALA-induced protoporphyrin IX was performed. There were no toxic complications due to Alasence taking. The standard spectrodetector LESA-7 was used for fluorescence record registration. The fluorescence spectra were recorded in the range of 650-850 nm. The specific for protoporphyrin IX peak at 700 nm wavelength was analyzed. Fluorescent endoscopic diagnosis allowed to confirm stomach cancer in 21 patients, and to detect cancer in 7 patients, including 2 cases of cancer in situ. The contrast of protoporphyrin IX accumulation (tumor/norm ratio) ranged from 2.5 to 18, that was enough for differential diagnosis in the majority of cases. In analysis of spectrograms for correct contrast calculation it is necessary to take into account the own fluorescence, with was high in some cases.

Diagnosis, Differential↗
PubMed1996

[Intraoperative instrumental examination in stomach cancer].

Ultrasound examination and laser autofluorescent spectroscopy were used intraoperatively for evaluation of gastric cancer dissemination. These methods were efficient in differentiation of cancer and benign tumors, estimation of cancer dissemination, revealing of metastases in the liver and lymph nodes. The use of these methods made it possible to increase sensitivity and specificity of estimation of cancer infiltration to 100% and of revealing lymph nodes metastases to 90% and 76%, respectively.

Diagnosis, Differential↗
PubMed1996

[Laser fluorescence spectroscopy in intraoperative diagnosis and staging of lung cancer].

67 patients with different kind of lung diseases have been evaluated by intraoperative laser spectroscopy. 49 of them had lung cancer and 18 patients had nonmalignant tumors, tuberculomas and chronic abscess. Helium-neon laser has been used to study spectral parameters of a normal lung tissue and lungs with malignant and benign tumors intraoperatively. It was found that intensity of autofluorescence will increase in cancer tissue. This phenomenon may be used for differential diagnosis of a lung cancer with benign tumors and chronic pulmonary diseases. It was also shown that autofluorescence of metastatic lymph nodes is higher compared to their hyperplasia. That may be used for rapid diagnosis of metastases in mediastinal lymph nodes and intraoperative staging of lung cancer.

Diagnosis, Differential↗
PubMed1996

[Topical problems in classification and treatment of disseminated purulent peritonitis].

A critical analysis of modern classifications of peritonitis has been done. The article is based on the analyses of 347 patients with peritonitis in the phase of subcompensation and decompensation (polyorganic failure). The author suggests to differentiate peritonitis according to the character of inflammation and rate of dissemination: diffuse peritonitis (local, disseminated and general) and localized (abscesses and infiltrates). The term "general peritonitis" should not be used because it combines the definition of "diffuse" and "disseminated" peritonitis. The programmed staged peritoneal lavage (cleaning and revision of peritoneum) is advocated as a method of choice in the treatment of residual infection. Nasointestinal drainage of small intestine should be used in treatment of paralytic ileus.

Bacterial Infections↗
PubMed1995

[Spectroscopic diagnosis of stomach diseases based on laser-induced fluorescence of endogenous porphyrins].

For higher efficacy of early gastric carcinoma diagnosis by endoscopy, the authors suggest a method of autofluorescent diagnostics. It is d=based on the property of endogenous porphyrins contained in the tumor to emit light under the effect of laser. The suggested method was used in examination of 54 patients. The experimental group was composed of 35 patients with gastric carcinoma, the control group was formed of 21 patients with benign diseases gastric ulcer, polyps, chronic gastritis). The sensitivity of the method was 94%, th specificity 90.5%. It is shown that the method of autofluorescent diagnostics may be applied in cases which are difficult for diagnosis.

Adult↗
PubMed1994

[Significance of spectral-fluorescence analysis in the diagnosis of surgical lung diseases].

The work analyses the results of spectroscopy conducted at the Faculty Surgical Clinic of the Moscow Medical Academy in 105 patients with various pulmonary diseases. Sixty-four patients had carcinoma of the lung, 9 had benign tumors, and the rest had inflammatory diseases and tuberculosis of the lungs. He-Ne laser (wave length 633 nm) was employed. The radiation was recorded with a multichannel spectrum analyzer with the use of a specially designed fiber-optical catheter. The system provided for normalization of the spectra according to the intensity of the laser component scattering. The spectroluminescence characteristics of normal and inflammatory pulmonary tissue and of lung tumors were studied during bronchoscopy, during and after the operation. Analysis of the results showed the high specificity and sensitivity of the spectra of malignant pulmonary tumors. Essential differences between the spectral characteristics of normal pulmonary tissue and those of carcinoma were noted. The dependence of reduced intensity of tissue fluorescence on the distance from the visible tumor border was studied, maximum fluorescence was encountered not on the surface of the tumor or inside it, but at a distance of 1-3 cm from the border of the tumor. Increased tissue fluorescence in suppurative diseases and benign tumors of the lungs was not recorded. Laser fluorescence spectroscopy may be recommended in bronchoscopy for widening its diagnostic possibilities and in intraoperative differential diagnosis of lung carcinoma, benign tumors, tuberculomas, and chronic abscesses during diagnostic thoracotomy.

Adult↗
PubMed1994

[Treatment of peritonitis complicated by multiple organ insufficiency].

Comparison evaluation of the methods of treatment was based on the analysis of the results of management of 347 patients with general purulent decompensated peritonitis with polyorganic insufficiency. The efficacy of closed drainage in 98 patients, continuous flow irrigation (dialysis) in 126, stage programmed irrigation and inspection of the abdominal cavity in 99, and open drainage in 24 patients was compared. The causes of peritonitis were: complications after acute surgical diseases (in 156 cases), in planned operations (59), and in obstetrical and gynecological diseases (132). Most of the patients were brought to the clinic from other hospitals because of unsuccessful treatment of peritonitis and absence of means for performing hemodialysis and management of polyorganic insufficiency. The incidence of the last-named reached 71.0 to 91.0% in the different groups of patients. In monotypic complex treatment, stage programmed irrigation was marked by a much lesser number of abscesses and other complications and a lower mortality (20.2%) as compared to flow irrigation (30.0%, closed drainage (27.5%), and open (laparostomy) treatment (37.5%). Despite the very serious contingent of patients, total mortality (27.0%) in the application of the indicated methods was quite low.

Anti-Bacterial Agents↗
PubMed1993

[Diagnosis, surgical treatment and prognosis in patients with generalized myasthenia].

The work deals with the clinical analysis of the richest experience in the surgical treatment of patients with generalized myasthenia in the country. The efficacy of various methods for the diagnosis of affection of the thymus is studied comparatively. It is shown that for more effective diagnosis of neoplastic lesions of the thymus wider use of computerized and magneto-resonance tomography is expedient and that they must replace the insufficiently informative and invasive examination methods used today (pneumonodiastinography, phlebography, scintigraphy, etc.) which still form the basis for the system of diagnostic research in patients with myasthenia. The authors determined the indications and contraindications for, the optimum terms for undertaking the surgical intervention and its volume in neoplastic and nonneoplastic diseases of the thymus in adults and children. Comparative evaluation of various means of preoperative management was conducted. It is shown that to improve the patient's condition and stabilize the myasthenic status on the possibly minimal doses of anticholesteremic agents glucocorticoid hormones should be included in the complex of preoperative management. The indications for hormonotherapy were determined. The efficacy of plasmapheresis, radiotherapy, and glomectomy with denervation of the sinocarotid zone was evaluated and their place in the complex treatment of patients was determined. From study of the late-term results of treatment of a large group of patients (children, adults with a thymus) the main causes of unsuccessful surgical treatment of generalized myasthenia were identified and the concrete means of improving the results of treatment were planned. Two types of changes in the clinico-immuno-morphological values were revealed in patients with generalized myasthenia, differing evidently in pathogenesis. New clinico-immuno-morphological correlations and prognostic factors were discovered, and a method for prognosticating the effect of thymectomy was suggested. It is shown that splenectomy has a favorable effect in the most severe category of patients in unsuccessful operative and nonoperative treatment. The tactics of management of patients accepted in the clinic led to a uncomplicated course of the postoperative period in the majority of patients in the last years.

Adult↗
PubMed1993

[Comparative evaluation of diagnostic methods in thymus disease].

From analysis of the case records of 2,000 patients with the generalized form of myasthenia, who underwent operation at the surgical faculty clinic of the Moscow Medical Academy, the authors discuss in detail the results of using a wide spectrum of methods for examination of the thymus, including: pneumomediastinography (PMG), scintigraphy, phlebography, computed and magnetoresonance tomography (CT and MRT). Taking into account the sensitivity and specificity of each of these methods, the indications and contraindications, and the degree of invasiveness, the authors concluded that MR tomography is the method of choice for examination of the thymus. It yields the rechest information and is most simple and safe for the patient. They also noted that CT made it possible to locate the pathological process more exactly, and provided additional information on the degree of the invasion, the presence of implants, and the condition of the other mediastinal organs. The indications for phlebography of the thymus and PMG are limited because of their invasiveness, difficult techniques, high risk of complications, and relatively low informativeness. Scintigraphy of the thymus is the least informative examination method. In view of the high percentage of pseudopositive and pseudonegative results, it may be concluded that its use for detecting lesions of the thymus in patients with myasthenia is hardly expedient.

Humans↗
PubMed1993

[Effect of fragmin, a low-molecular heparin, on hemostasis in patients with alimentary-constitutional obesity].

The authors conducted comparative study of the hemostasis indices before and in the immediate period after operation for formation of a small stomach in 31 patients with stage III-IV alimentary-constitutional obesity, in 50 patients without obesity who underwent operation on the stomach, and in 15 volunteers. Nonspecific prevention of thrombogenesis was performed in all patients with normal weight and those with obesity. Patients with obesity were given in addition specific thrombogenesis prevention with nonfractionated heparin (group I) and fractionated low-molecular heparin-fragmin produced by KABI (groups II and III). Study of the parameters of the hemostasis system in the postoperative period showed nonspecific prevention of thrombogenesis to be sufficient to reduce the risk of pulmonary artery phlebothrombosis and embolism in most patients without obesity. In patients with obesity the probability of phlebothrombosis and thromboembolism is much higher, in view of which they must be given heparin in addition to nonspecific prevention. Fragmin, as an agent for thrombosis prevention, has certain advantages over nonfractionated heparin and should be used more frequently in clinical practice in patients of the risk group, e. g. with pathological obesity, in a dose no less than 100 U/kg. With the use of fragmin laboratory control before each injection is not needed. Administration of nonfractionated and fractionated heparins must be combined with bandaging of the lower limbs and other measures of nonspecific prevention of thrombogenesis.

Adult↗
PubMed1991

[Magnetic resonance tomography in the diagnosis of surgical diseases].

The authors analyse the first experience in the use of magnetic resonance tomography (MP-tomography) in the diagnosis of some surgical diseases. MR-tomography of the mammary gland (257 patients), thymus (55 patients), adrenals (41 patients), and hypophysis (18 patients) was conducted. The results of the examination were compared with the findings of other diagnostic methods and verified intraoperatively and histologically. The authors claim that the high informativeness of MR-tomography, its noninvasiveness, the absence of a radiation load, and the possibility of repeating the examination many times in three mutually-perpendicular planes distinguish the method favorably and dictate the necessity of its further study in clinical medicine.

Adrenal Gland Diseases↗