Biomedical subjects
Publications and source records attributed to V S Zemskov.
Data are presented on the reversibility of pathological changes of the common bile duct, causes and criteria of reversibility. Consideration of four stages of pathomorphogenesis of the common bile duct wall may be of help in the choice of surgical tactics in surgical intervention on the common bile duct.
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The experience with treatment of 33 patients who developed hemorrhage from acute ulcers of the alimentary canal at the early period after cholecystectomy has been analysed. The clinical, biochemical and instrumental criteria of likelihood of the development of such a complication have been established. The methods for its prevention and treatment with the use of the techniques developed by the authors, which permitted to reduce the incidence of this complication from 13.7 to 6.9%, are described.
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The authors present a detailed discussion of indications for and peculiarities of performing surgical interventions for ulcer disease of the duodenum in the light of long-term results of vagotomy and gastric resection. Based on their personal experiences the authors made a conclusion that organ-preserving operations and methods of resection are not thought to be competing. Of special significance is the complex correction of pathology of the hepatopancreatoduodenal zone.
In combination of the ulcer disease and pancreatitis with the aim to achieve simultaneous suppression of gastric hypersecretion and reduction of the secretory pancreatic activity, a method of operation--selective proximal vagotomy added by cutting the celiac branch of the right vagal trunk has been developed. In 42 patients, operated on using the suggested method, the pancreatic secretion, acid production and gastric motility were studied. At observation of up to 7 years, the excellent and good results were noted in 88.09% of patients.
On chronic supply to the body of a mixture of nuclear division products lanthanum-140, barium-140, tellurium-132, neodymium-147, neptunium-239, zirconium-95, niobium-95, iodine-131, cerium-141, -144, cesium-134, -137, and ruthenium-103 are detectable in liver tissue within the first months. In the 2 to 4 years following the disaster, liver tissue primarily accumulates cerium-144, radium-226, thorium-228, -232, ruthenium-106, antimony-125, and europium-154. Within the first periods the liver radionuclide content was 19 to 31% higher than that in the blood, and in the following years it was 24 to 38% higher. The radionuclides indicated were actively excreted with the bile into the gastrointestinal lumen. Within the first months after the chronic internal radiation the functional liver disorders were detectable in 30 to 40% of the patients. Later on diverse acute and chronic diseases of the liver, gallbladder and pancreas were detectable in 20 to 30% of the patients. The radionuclide content in the body was found to be in parallel with functional liver disorders. Acceleration of radionuclide excretion from the body results in liver function improvement.
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From experience with 37 vascular operations performed on 31 patients in a general surgical clinic, the authors claim that the reserve in improving the quality of treatment consists not only in specialization and professional mastering of this narrow field of surgery. It is shown that manipulations of temporary hemostasis must be mastered and general surgeons must be trained specially in the problems of emergency angiosurgery. The authors obtained poorer results when embolic complications in myocardial infarction compelled them to resort to operations.
To give sorbents the bactericidal action, a modification of the carbonic sorbents by the metals is suggested. Modification of the SKN and KAU sorbents by copper and zinc didn't reduce sorption by them of microorganisms and their toxins. Inhibitory effect of a sorbent was provided by the lower concentrations of the copper and zinc than by those which in the solution of metallic salts had only bacteriostatic effect.
The use of SKN P-1 and SKN P-2 carbonic enterosorbents in the complex treatment of the patients contributed to decrease in pronouncement of cholemic intoxication. A method is easy, noninvasive, its use is recommended in patients, the elderly and senile in particular, with obstructive jaundice.
On the basis of examination of 34 patients, it was established that after the operations on the bile ducts in development of pancreonecrosis, peritonitis, purulent cholangitis, subhepatic abscess, suppuration of the postoperative wound, the indices of NBT test exceeded the norm 2 times and more. Significant decrease in the indices of NBT test--is a prognostic sign of the favourable postoperative course and effectiveness of the treatment performed.
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The authors had under observation 318 patients who were subjected to operation and suffered from various inflammatory diseases of the bile tract; perivesical and cholangiogenic abscesses of the liver were found in 33 of them. Bacteriological tests of the contents of the abscesses demonstrated most frequently the presence of Bacteroides fragilis as a monoculture in cholangiogenic abscesses and associations of anaerobic and aerobic bacteria in perivesical abscesses. Early operation with obligatory consideration for the anaerobic component of the microflora is recommended.
On the basis of the analysis of changes in the immunologic and biochemical parameters, the rational conditions of intravascular laser irradiation of the blood in treatment of purulent-septic diseases is suggested.
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