Method for diagnosing destructive ulcerating complications in duodenum ulcer cases
SUBSTANCE: method involves detecting duodenum wall integrity disorders in performing endoscopic examination of duodenal ulcer after removing necrotic detritus from ulcer bottom. Available wall defect is subjected to endoscopic probing with catheter introducing water-soluble radiopaque solution through the probe and followed with fistulographic examination. The radiopaque solution being observed outside of duodenum, duodenal fistula or perforated ulcer are diagnosed.
EFFECT: high reliability of early stage diagnosis.
The present invention relates to medicine, namely to gastroenterology, endoscopy, radiology and surgery. The problem of diagnostics and treatment of peptic ulcer of the duodenum (YAB KDP) remains in recent years one of the most acute. Despite the progress made in the study of etiology and pathogenesis, review of medical algorithms, it retains its relevance. Thus, according to the Ministry of health of Russia for the period 1999-2001, the number of scheduled operations at YAB WPC decreased in 2 times. While the number of emergency operations associated with urgent complications of this disease, for the same period increased by 2-3 times, the operative mortality rate has increased by 20-25%. [Nmin, Wtihin et al. Treatment of peptic ulcer disease: the views of the physician and surgeon. The "round table". // Russian journal of gastroenterology, Hepatology, Coloproctology. - 2001 - No. 2. - P.9-16].
This situation is due to insufficient position of medical diagnosticians and surgeons in timely detection and treatment of these patients, because the risk of surgical intervention increases significantly when it is in the later stages of the development of complications of duodenal ulcer [Resolution all-Russian conference of surgeons, Saratov, 2003].
High diagnostic value of endoscopic who Yoda in the study YAB KDP has made it a priority for this pathology. The main requirement to the study of the gastroduodenal area these patients is increased attention to duodenal ulcer - substrate life-threatening destructive complications YAB duodenum. The advent of endoscopic video system broadband, next generation equipment allows to perform a broad range of instrumental manipulation in the area of pathological changes in the gastrointestinal tract, including in the field of duodenal ulcers. This strengthening method improves the quality of research in early detection of complications YAB duodenum. Application to patients with duodenal ulcer x-ray endoscopic diagnostic complex increases the informativeness of these methods in the study of the gastroduodenal region.
There is a method of x-ray fistulografii [Ludlinderhof, Lbowman. Methods x-ray examinations of organs and systems of man. - Publishing House "Medicine". - 1976. - S]. Fistulography is applied in the presence of abdominal wall fistulous openings. Its objectives: to determine the source of the fistula, to clarify the position, size, branching fistulous course, to detect possible foreign body (bullet injuries and postoperative fistula). To fistulografii necessarily produce an overview radiograph of the abdomen in the nternet and lateral projections, and, if necessary, additional images. These radiographs often shed light on the origin of the fistula (of subdiaphragmatic or other intraperitoneal ulcer, one of the organs of the abdominal cavity, retroperitoneal space). It is advisable to introduce into the fistulous channel contrast mass through the catheter. As water-soluble roentgenocontrast use 50% solution "Hipac". Due to the complexity of the relationship of the fistula and abdominal organs, it is especially important to combine radiography - fluoroscopy and radiography. Remove the clip (a sticker) and let the contrast agent is not necessary until analyzed received fistulogram. In many cases, it is necessary to conduct additional research - artificial contrast study of the stomach, intestines, urography, to determine the ratio between the fistula, abscess and neighbouring authorities.
This method offers a diagnosis only those fistulous formations that appear on the anterior abdominal wall, fistulas, communicating with the KDP - internal fistulas, in this study remain inaccessible to the review.
A significant drawback of this method is that it does not reveal the internal fistula resulting from acute or chronic inflammatory reactions between the bodies of the gastroduodenal and HepB is Mobiliare areas.
As the closest analogue is adopted a method of endoscopic prediction of bleeding from ulcers of the stomach and duodenum, described in 1974 J.A.N Forrest et al. [Vincotto, Tchubinsky, Ari. Endoscopic treatment of bleeding from the upper gastrointestinal tract. (Tutorial). Russian medical Academy of postgraduate education. M, - 2000. - 24 S.]. Scientists have described and systematized pathological changes in the area of the bottom of the ulcer is diagnosed endoscopically in patients with peptic ulcer disease. Assessed the presence of stigma active, held or likely bleeding in the bottom of the ulcer in the form of a pulsating jet or stream, visible vessel, thrombus or black spots in the bottom of the investigated ulcers. Thus, in accordance with the proposed classification is performed endoscopic visualization of the bottom of the ulcer and the prediction of the risk of complications YAB bleeding.
Classification of ulcer bleeding by Forrest:
Type I is active bleeding:
Ia - pulsating stream
Ib - flow
Type II - signs of recent bleeding:
IIa - visible vessel
IIb - fixed thrombus-clot
IIc - flat black spot (black bottom ulcers)
Type III ulcers with a clean (white) bottom
Currently, this classification has been recognized worldwide as a basis for the distribution tactics of conducting the patient with peptic ulcer disease, complicated by bleeding [ibid, Vinsonneau et al., 2000]. When you clean the bottom of ulcer type sores - Forrest III) the likelihood of recurrence is less than 5%, when the type Forrest IIc - 10%. The highest risk of recurrent bleeding - up to 40% of patients with visible in the bottom of the ulcer necroticism vessel - type Forrest IIa or type Forrest IIb. However, many gastroenterologists note that the type of ulcers Forrest III (ulcer with a clean white bottom)observed in patients after an episode of gastrointestinal bleeding is the most unpredictable. It is assumed that a thick layer of detritus can hide stigma bleeding (vessel, thrombus, black spot) in the bottom of the ulcer.
The disadvantage of this method is:
1) passive endoscopic visualization of the bottom of the ulcer can lead to erroneous prediction of re-bleeding - destructive complications of peptic ulcer disease;
2) in the present method is not the focus of all possible and important pathological changes of the bottom of the ulcer of the duodenum. The diagnostic potential of endoscopic method in the study ulcer-destructive complications YAB WPC used in full.
improving the diagnostic accuracy of endoscopic method in the detection of hidden complications of peptic ulcer of the duodenum.
The technical result of the proposed method is the use of endosco the systematic manipulation in the area duodenal ulcer, allowing in combination with x-ray method to diagnose more accurately ulcerative-destructive complications YAB duodenum. In addition, the application of the method allows to expose the pathological zone duodenal ulcers, concealment, which distorts the results of the study. Execution of radiographic contrast defect found in the duodenal wall allows to differentiate complications of duodenal ulcer is perforated ulcers from duodenal fistula.
The method provides:
- determination of optimal timing of surgical treatment YAB duodenum complicated by perforation of the ulcer or the formation of duodenal fistula;
- improving clinical and economic effectiveness of treatment YAB duodenum, by eliminating unsuccessful conservative treatment and determine the indications for surgical treatment by endoscopic criteria;
acceleration of functional recovery of the upper gastrointestinal tract in the postoperative period by timely identification of indications for surgical treatment.
The essential novelty of the proposed method is the endoscopic examination of the bottom of the ulcer by prior removal of necrotic debris and revealing the hidden violating the integrity of the walls of the duodenum. Filling patologica the zone through which the catheter is water-soluble radiopaque solution and execution prepositional by fistulography can detect and differentiate such complications YAB KDP, as the perforation duodenal ulcer and duodenal fistula.
The method is tested on 129 patients within 3 years (2002-2005). All patients were referred to the clinic of the FGI "RZQHG University" in a planned manner. The method is as follows. Patients with YAB KDP esophagogastroduodenoscopy performed using videoconferencing system with digital image quality firm Olympus Evis Exera CV-160 GIF TYPE × P160 (Japan) in the Cabinet, equipped relentlessing install - Baccara with electro-optical Converter of the firm "Apelet" (France).
40 minutes before the study, patients perform sedation in the composition of the Sol. Athropini 0,1% - 1 ml, Sol. Sibazoni 2% 2 ml. Pay special attention to the study of the proximal DICK. Subject to the discovery of duodenal ulcers (figure 1-a; 2-a; 3-a) endoscopically remove necrotic detritus from the bottom of the ulcer by leaching through the catheter aseptic aqueous solution (0.9% NaCl, furatsilina 1:3000 and others) and/or scarification fixed fragments of detritus biopsy forceps (Fig 2-b; 3-b). In case of detection in the bottom of ulcer disorders of the integrity of the duodenum (figure 1-b; 2-b; 3-b) carry out endoscopic intubation of the defect catheter (figure 1-b; 2-d; 3-b), followed by the introduction through the catheter with water-soluble radiopaque solution "omnipak", "Ultravi is -370", and others) and perform prepositional fistulografii. Provided x-ray determination of unidirectional fill the contrast of adjacent organ (1-g) or destructive cavity (2-d) state the complication YAB KDP education duodenal fistula, while the multidirectional flow of contrast into the peritoneal cavity determine the perforation ulcers (3-in).
Example 1. Patient D., 49 years old, was admitted to the surgical Department of the FGI "RZQHG University" 9.10.03, with a diagnosis of peptic ulcer disease duodenal ulcer, constantly relapsing course. Upon receipt of a complaint on a constant aching pain in the epigastrium and right hypochondrium, worse in the evening, calmed down after taking antisecretory drugs, heartburn, nausea, bitter taste in the mouth. Ulcer history 10 years, exacerbation were seasonal. Took various antisecretory agents. In 2000, after determining the cytological method in gastrobioptates HP-contamination, high contamination, the patient was assigned several schemes antihelicobacter therapy, in accordance with the provisions of the 2nd Maastricht conference 2000 as a result was achieved full erradicate HP-bacteria. In spite of this the last 2-3 years the patient had noted a deterioration of General health with the changing nature of the pain syndrome, proyavlyayuschego is his constant presence, the average intensity and a more extensive localization (in the epigastrium and right hypochondrium). On this occasion, the patient was forced to take a daily antisecretory drugs (omez - 40 mg/day). Endoscopic examination of the bulb of the duodenum revealed in its middle third on the back of ulcerative defect (Fig 1-a). After laundering necrotic detritus in the bottom of the ulcer was detected violation of the integrity of the duodenal wall (figure 1-b). Endoscopic intubation of the defect catheter and subsequent fistulography (figure 1-C) 10 ml of the solution "omnipak" revealed the message of the duodenum with an expanded and deformed choledochal. After administration of 20 ml of the solution "omnipak" radiographically determined contrasting the common bile, gallbladder and hepatic ducts (figure 1-g). Based on the results of clinical and diagnostic examination the patient was recommended to perform routinely organ-preserving surgical treatment is radical duodenoplasty.
14.10.03. According to intraoperative studies of KDP in the middle - third of the bulb of the duodenum on the back of the semicircle revealed duodenal ulcer, fixed robovie spikes from serosa of the duodenum to choledocho. The proximal half of the duodenum expanded to 35 mm. Identified commissural fixation with external compression of Obodo the Noah and the small intestine. Completed bridge duodenoplasty with the formation choledocho-duodenal fistula on the back of the duodenum, supplemented by the removal of the duodenum from under the root of the mesentery by the method developed in the clinic Veenapani [Vignobles et al. The complicated forms of peptic ulcer of the duodenum. A guide for physicians, surgeons gastroenterologists. Russian center of functional surgical gastroenterology health Ministry. - Krasnodar, 2002. - 655 S.]. The patient locally excised sore back wall of the duodenum in healthy tissues, adhesive bands and granulation tissue forming the wall of the fistula in choledocho created choledocho-duodenal fistula on the back of the duodenum. Defect of the duodenum was restored by shifting two of the lateral and anterior duodenal wall. External compression of the small intestine was removed by removal of the adhesive fixation and mobilization duodenojejunal transition of the gastrointestinal tract. The postoperative period was uneventful. On the 3rd day removed the nasogastric tube. On the 5th day are allowed to eat. Discharged from hospital on the 10th day. The patient is examined after 2 months. Had no complaints, dieted (table No. 1 by Pevsner). Endoscopy of the proximal duodenum: the gatekeeper rounded functioning properly. The bulb of the duodenum is shortened in the longitudinal dimension, her question is no barrel-shaped with a diameter of up to 3.5 cm, mucosa with mild diffuse hyperemia. Postbulbar departments without signs of pathology. 6 months after surgery, the patient felt well, antisecretory drugs is not accepted, quit Smoking, currently adheres to the recommended diet, works in the specialty.
Example 2. Patient S., 46 years old, was admitted to the surgical Department of the FGI "RZQHG University" 14.04.03, with a diagnosis of peptic ulcer disease duodenal ulcer, constantly relapsing course. Upon receipt complained of constant pain in the epigastrium and right hypochondrium weak and medium intensity, heartburn, belching air. Ulcer history 15 years. Exacerbations were seasonal. Took various schemes antiulcer therapy with varying degrees of success. The last 3 months, the patient noted the ineffectiveness of conservative anti-ulcer treatment, manifested by deterioration of General health and permanent nature of the pain syndrome. Endoscopic examination of the duodenum was found in postbulbar Department of the ulcer (figure 2-a). After removal of necrotic detritus from the bottom of the ulcer (figure 2-b) was detected violation of the integrity of the duodenal wall (figure 2). Endoscopic intubation of the defect catheter (figure 2-d) and the subsequent water-soluble contrast fistulography showed unidirectional shall ispolnenie fistulous destructive cavity (figure 2-d).
The patient was performed routinely bridges radical duodenoplasty. The patient locally excised sore back wall of the duodenum in healthy tissues, extrauterine commissural fibers and granulation tissue forming the wall of the fistula and destructive cavity. The postoperative period was uneventful. On the 3rd day removed the nasogastric tube, on the 5th day are allowed to eat. Discharged from hospital on the 10th day. The patient is examined after 2 months. Had no complaints, complied with the recommended diet. Endoscopy of the proximal duodenum: the pylorus is closed, the bulb of the duodenum is shortened in the longitudinal size of its lumen had a cylindrical shape and a diameter up to 4 cm, slimy pink. Postbulbar departments without signs of pathology. 6 months after surgery, the patient felt well, antisecretory drugs is not accepted, started to work in the specialty.
Example 3. Patient A., 68 years. Did 23.04.2004, with complaints of persistent epigastric pain, radiating to the left hypochondrium, heartburn, vomiting, bringing relief.
Suffered from peptic ulcer of the duodenum about 13 years. Noted seasonal exacerbations (spring, autumn) with an average duration of about 10-14 days. Has taken various schemes antiulcer treatment in inpatient and outpatient is again order by place of residence, with a follow fibrogastroduodenoscopy study. The present deterioration of health came within 5 days of emergency admission to the surgical Department RZQHG, manifested severe pain in the epigastric region, intractable analgesics and antagonists, proton pump.
Endoscopic examination of the duodenum revealed on the front wall of the middle third of the bulb duodenum ulcer (figure 3-a: A; b: (A) polygonal shapes with high sides and bottom covered with necrotic debris. Endoscopic examination of the bottom of the ulcer with the removal of detritus by laundering with 0.9% NaCl and scarification biopsy forceps revealed the violation of the integrity of the duodenal wall (figure 3-b: B).
Performing a sensing catheter pathological region, followed by the introduction of water-soluble contrast medium and holding prepositional fistulografii showed multidirectional flow of contrast into the peritoneal cavity (Fig 3-C). The obtained diagnostic data suggest a complication flow YAB duodenum the patient perforated duodenal ulcer. The patient was performed emergency radical duodenoplasty method Vieodrive (1995).
Intraoperative study revealed in all departments of the abdomen moderate quantity the STV fibrinous-purulent discharge. The right half of the greater omentum, lesser omentum, hepatoduodenal ligament, infiltrated, with fibrin, involved in the subhepatic space, which is determined by a moderate amount of duodenal contents. The gall bladder is deformed, a solid elastic consistence, wall infiltrated and swollen. The gastric antrum and expanded in size, wall thickened, infiltrated. In the duodenal bulb ulcer has front wall, closer to the greater curvature with perforating a hole in the bottom to 0.5 see the edges of the ulcer swollen. WPC due to widespread ulcerative-destructive process that has become complicated, shifted inwards and downwards towards the retroperitoneal tissue. Thin, thick intestines and other parenchymatous organs without features.
The complex of preventive manipulations aimed at the prevention of acute pancreatitis, including the introduction enzymeinhibitor solutions on the basis of a 0.25% solution of novocaine in retroduodenal space, parapancreatic fiber and periduodenal. According to the clinic technique the edges of the ulcer of the duodenum is consistently excised to a healthy, well krovosnabjaemah tissues. Through the window in a small gland and during the manual control of the gastrocolic ligament pancreas dissected the back wall of the duodenum. When Beeman the social study clearly reveals the preservation of biostructure gatekeeper. Large duodenal papilla is located 1.5 cm from duodenotomy holes. Clearly defines the difference between the diameter of the matched ends of the duodenum. After applying bonding orienting seams-taped imposed first map, and then closing the seams. Formed anastomosis.
The nasogastric tube torrigiano and fixed. In the subhepatic space and pelvis installed Winternitz drainage tube. Layered seams on the wound. In the subcutaneous tissue is installed drain pipe with however. Aseptic bandage.
The postoperative period was uneventful. On the 5th day removed the nasogastric tube, allowed to eat. Drainage tube removed within 8-12 days. Discharged from the hospital on the 15th day, with the recommendations of the receiving antisecretory drug (lanzap from 60 to 30 mg/day) on the proposed scheme within 2 months.
The patient is examined after 2 months. Had no complaints. When the control endoscopy of the duodenum was observed shape recovery gatekeeper with some slow contractile function. Proximal division of the duodenum is shortened in the longitudinal size of its lumen is cylindrical, with a diameter of 4 cm, the mucosa with mild diffuse hyperemia. At follow-up at 1 year after surgery, the functional indicators with the situation of the gastroduodenal junction normalized.
Method for the diagnosis of latent destructive complications of peptic ulcer of the duodenum, including endoscopic examination of the bottom of duodenal ulcers, characterized in that after removal of necrotic detritus from the bottom of the ulcer, if the integrity of the walls of the duodenum, perform endoscopic intubation catheter detected defect wall with the probe through a water-soluble radiopaque solution and then fistulography, when the contrast beyond the duodenum determine the presence of duodenal fistula or perforation of an ulcer.
SUBSTANCE: method involves giving magnesium-sodium-hydrocarbonate mineral water of moderate mineralization degree at room temperature in the amount of 150-200 ml. 20-30 min later alternating electromagnetic field operating in low frequency bandwidth of 0.022 Hz-270 kHz is administered in scanning mode of 43 produced by Rematherp apparatus. The total treatment course is 8-10 procedures long.
EFFECT: enhanced effectiveness of treatment; stimulated reparative processes in esophageal mucous membrane.
SUBSTANCE: method involves introducing Omeprasol at a dose of 20 mg twice a day before taking meals 10 days long, Amoxycillin at a dose of 1000 mg twice a day after breakfast and supper 7 days long, Clarithromycin at a dose of 500 mg twice a day before taking meals and Imudon as local immunomodulating factor at a dose of 8 pills a day making 2-3 h long pauses for resolving drug in oral cavity within 10 days.
EFFECT: enhanced effectiveness of treatment; reduced reinfection risk.
FIELD: medicine, gastroenterology, pediatrics.
SUBSTANCE: method involves using drugs directed on eradication of microorganism Helicobacter pylori that comprises the preparation "Vetoron" additionally. The preparation "Vetoron" is prescribed in the dose 6-8 drops to children of age 7-12 years and in the dose 8-10 drops to children of age 13-17 years for 7-10 days. Invention provides decreasing the mutagenic effect in carrying out the anti-helicobacter therapy in children. Invention can be used in treatment of children suffering from diseases of upper regions of digestive tract associated with infection with Helicobacter pylori.
EFFECT: improved method of treatment.
3 tbl, 2 ex
FIELD: medicine, pharmaceutical.
SUBSTANCE: invention relates to solid composition for treatment of reflux esophagitis, gastritis, or ulcers, method for production thereof and uses in therapy. Claimed composition contains alginate, bicarbonate and/or carbonate, and poly(C1-C5-alkylene glycol) hawing molecular mass of at least 6000 in amount of 1-50 %.
EFFECT: composition of decreased foam-forming properties and improved organoleptic characteristics.
12 cl, 18 ex
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to using compounds of (R,S)-2-arylpropionic acids of the formula (Ia) , and their (R)- and (S)-isomers as inhibitors of neutrophile (PMN leukocytes) chemotaxis induced by IL-8. These compounds elicit unexpected ability to inhibit effectively IL-8-induced chemotaxis and degranulation of neutrophiles being without significant effect on activity of cyclooxygenases. These compounds can be used in treatment of such diseases as psoriasis, ulcerated colitis, melanoma, chronic obstructive pulmonary disease, bulla pemphigus, rheumatic arthritis, idiopathic fibrosis, glomerulonephritis, and for prophylaxis and treatment of damages induced by ischemia and reperfusion.
EFFECT: valuable medicinal properties of compounds and pharmaceutical compositions.
9 cl, 3 tbl, 43 ex
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to novel derivatives of carboxylic acid represented by the general formula (I): , their pharmaceutically acceptable salts or esters wherein values Y, L, X, T, Z, M, R1, W and are given in the invention claim. Proposed compounds possess insulin-sensitizing effect and they are double agonists with respect to PPARα and γ, and triple agonists with respect to PPARα, β(δ) and γ. Except for, the invention relates to a medicinal agent and pharmaceutical compositions based on the claimed derivatives of carboxylic acid, to methods for prophylaxis or treatment of diseases, and to using derivatives carboxylic acid for preparing a medicinal agent.
EFFECT: valuable medicinal properties of compounds and pharmaceutical compositions.
56 cl, 2 tbl, 609 ex
FIELD: medicine, gastroenterology, surgery.
SUBSTANCE: starting since the 2nd d after operation it is necessary to have a daily twice peroral intake of 200-300 ml ozonized distilled water at ozone concentration being 4-6 mg/l and intragastric injection of ozone-oxygen mixture (OOM). On the 5-6th d after operation in case of fibrogastroduodenoscopy (FGDS) it is important to inject per 4-5 ml ozonized physiological solution (OPS) at ozone concentration of 2-4 mg/l submucosally along the perimeter of the sutured ulcer, at about 4-5 mm against its edges, from 4 equidistant points. Then it is necessary to carry out ulcer's application with "Ozonide" oil. After that OOM should be injected at ozone concentration ranged 20-25 mg/l till the appearance of bulging out feeling in area of a patient's epigastrium. The above-mentioned procedures should be repeated every 3-4 d till complete ulcer's healing. The innovation shortens the terms of lysis of necrotic masses, improves reparative processes in the sutured wound and decreases inoculation degree with Helicobacter pylori in gastric and duodenal mucosa.
EFFECT: higher efficiency of therapy.
FIELD: medicine, gastroenterology, pharmacy.
SUBSTANCE: invention relates to a pharmaceutical composition used in treatment of diseases of digestive tract accompanying with disturbance of acid formation in stomach and/or ulceration of stomach and/or duodenum mucosa. The composition comprises sucralfate in a single dose from 0.25 g to 1.0 g or aluminum phosphate in a single dose from 3.8 g to 16.0 g, and prebiotic - fructooligosaccharide in a single dose from 2.5 g to 16.0 g and this composition is taken 1-3 times per 24 h. Also, invention relates to a method for preparing and using this composition. Proposed pharmaceutical composition promotes to acceleration of ulcer defect epithelization being independently on areas of ulcer defect and acidity of the stomach content.
EFFECT: improved and valuable medicinal properties of pharmaceutical composition.
8 cl, 8 tbl, 8 ex
FIELD: microbiology, biotechnology, biochemistry.
SUBSTANCE: invention relates to the Bifidobacterium bifidum NCIMB 41171 strain that elicits capacity for producing enzyme possessing galactosidase activity that converts lactose to a mixture of galactooligosaccharides comprising disaccharide, trisaccharide, tetrasaccharide and pentasaccharide. Galactooligosaccharide composition is designated for stimulation of bifidobacteria growth. Synbiotic composition based on B. bifidum NCIMB 41171 strain and galactooligosaccharide composition provides improvement in the bowel state. Compositions can be added to multiple foodstuffs and fodders for animals for improving bowel state by stimulation of bifidobacteria growth in large intestine and for inhibition of pathogenic microflora.
EFFECT: improved and valuable properties of strain.
20 cl, 2 dwg, 7 tbl, 7 ex
FIELD: medicine, pharmacy.
SUBSTANCE: invention describes a stable inclusion complex comprising pure S-omeprazole and cyclodextrin wherein the mole ratio of S-omeprazole to cyclodextrin = from 1:1.5 to 1:5.Method for preparing this complex involves addition of cyclodextrin to S-omeprazole or its pharmacologically acceptable salt an aqueous-alkaline solution, dilution of mixture containing this complex and regulation of pH to value between 8 and 10 using boric acid aqueous solution or other equivalent agents at temperature of a solution/mixture maintaining at the level 300C or above followed by cooling a mixture to 50C or below and isolation of the prepared inclusion complex from a solution. The inclusion complex prepared by this method can be extracted easily as a stable white powder and this powder, in turn, shows advantage involving convenience handling.
EFFECT: improved preparing method, improved and valuable properties of complex.
7 cl, 4 ex
SUBSTANCE: method involves adding 52-523 mg/l guanosine disodium triphosphate and 3.5-4.7 g/l of sodium chloride to radiopaque preparation before introducing it.
EFFECT: prevented cardiac function disorder; high safety of coronography without worsening radiopaque preparation quality.
FIELD: medicine, surgery.
SUBSTANCE: one should insert a gastroscope into fistular foramen in the wall of a hollow organ to fulfill sanitation followed by cavitary nasodrainage. The innovation enables to decrease traumatism and drain distant small-sized sites of congestion.
EFFECT: higher efficiency.
FIELD: medicine; biology.
SUBSTANCE: method involves selectively filling coronary blood vessels with radiopaque substance like red lead suspension in melted butter containing at least 70% of fat taken in 3:1 proportion. Suspension temperature is 55-65°C. The coronary blood vessels are filled by separate left and right coronary artery outlet cannulation or coronary sinus outlet cannulation with peripheral venous catheter. Tourniquets are placed under coronary blood vessels or coronary sinus outlets. The tourniquets are tightened after having introduced the radiopaque substance for creating sealing conditions. Radiopaque substance introduction is finished after having filled small subepicardial arteries or veins visible with naked eye. Then required X-ray examinations are carried out.
EFFECT: improved coronary blood vessel bed visualization; enabled postponed X-ray examinations.
SUBSTANCE: composition is based on gadolinium (Gd3+) complex aqueous solutions comprising gadolinium (Gd3+) complex with disodium salt of diethylenetriaminopentacetic acid or of dimethylamide diethylenetriaminopentacetic acid and additional metal-to-chrome indicator having stability constant of 12-16 units at pH equal to 6-8 in concentration of 0.0001-0.5% by gadolinium mass.
EFFECT: increased diagnostic data volume; simplified quality control; improved falsification protection.
SUBSTANCE: method involves filtering sterile 1:5 barium sulfate suspension through a needle of 0.3 mm large diameter. 5 ml of filtered suspension is introduced into the biliary ducts via drain or catheter members. X-ray imaging or radioscopy examination is carried out. The produced images are used for diagnosing pathological changes in biliary tract or endosurgical intervention is carried out under X-ray control.
EFFECT: reduced radiation exposure and risk of traumatic complications; enhanced effectiveness of treatment.
FIELD: medicine, radiology, pharmacy.
SUBSTANCE: invention relates to roentgenology and designated for X-ray study of different organs. The proposed agent for contrasting in X-ray diagnosis comprises tantalate of at lest one element chosen from group comprising yttrium, lanthanum, cerium, praseodymium, neodymium, samarium, europium, gadolinium, terbium, dysprosium, holmium, erbium, thulium, ytterbium, lutetium or bismuth, polysaccharide and water. Also, agent can comprise pectin, xanthane resin, carragheenan as polysaccharide and, additionally, it can comprise methylparaben and propylparaben as a preserving agent. Also, invention proposes an agent for contrasting in X-ray diagnosis that comprises tantalate of at least one element chosen from group including yttrium, lanthanum, cerium, praseodymium, neodymium, samarium, europium, gadolinium, terbium, dysprosium, holmium, erbium, thulium, ytterbium, lutetium or bismuth, polysaccharide and water that comprises additionally barium sulfate. Invention provides effective carrying out X-ray analysis of some organs in the sparing regimen using region of low energy of X-radiation (about 35-45 keV), and to obtain the distinct image of organ to be contrasted in diagnosis of patients with big weight and, therefore, significant adipose layer.
EFFECT: valuable properties of agent.
6 cl, 15 ex
FIELD: medicine, laser surgery.
SUBSTANCE: the present innovation deals with treating neuroorthopedic vertebral diseases: it is necessary to apply a puncture needle into an affected disk, introduce a needle of laser light guide, form the canals in the disk under laser action and fulfill direct retrograde vaporization of disk's hernia under the control of visualization means. Moreover, hernial vaporization should be carried out under roentgenocontrast control - discography, or myelography, or disko-myelography at introducing a contrast substance into the disk or a dural sac, or into the disk and the dural sac, correspondingly. Application of the present method enables to obtain specifying significant information in the course of operation on localization of hernial formations at different degree of disk's lesion at decreasing radiation loading upon a patient and, also, enables to simplify the process of operation and shorten the time for fulfilling it without any detriment to its quality.
EFFECT: higher efficiency.
SUBSTANCE: method involves carrying out polyphase scintigraphy with osteotropic radiopharmaceutical preparation RPP and comparing RPP accumulation in tibia to a reference value. RPP accumulation level in tibia is determined from local bone fraction of RPP accumulation using formula LBFARPP = A*K/((Spre- Spost)*5), where LBFARPP is the local bone fraction of RPP accumulation, A is the scintillation count in region under study within 5 min, K is the initial 99mTc radionuclide activity change coefficient beginning from the RPP introduction moment, Spre is the preinjection scintillation count of RPP syringe within 1 min, Spost is the postinjection scintillation count of RPP syringe within 1 min, 5 is adjustment coefficient for determining scintillation count time. LBFARPP being >0.50-0.67% in upper tibia one-third, LBFARPP being >0.25-0.31% in middle tibia one-third, LBFARPP being >0.23-0.35% in lower tibia one-third, increased reparative osteogenesis process intensity is to be determined.
EFFECT: high accuracy of estimates.
4 dwg, 4 tbl
FIELD: medicine, roentgenodiagnostics.
SUBSTANCE: it is necessary to introduce the suspension of barium sulfate followed by roentgenoscopy, moreover, additionally, it is necessary to introduce a roentgenocontrast preparation designed as a sphere out of barium sulfate and gelatin, its diameter being correspondent to the lumen of normally functioning pyloric sphincter about 10-12 mm and in case of the delay of its evacuation one should diagnose pylorostenosis despite the fact that the passage of barium sulfate suspension occurs without any obstacles. Moreover, this preparation has been fulfilled at the following ratio of components, g/dragee: barium sulfate up to 1.5; gelatin 0.5.
EFFECT: higher accuracy and efficiency of diagnostics.
1 cl, 2 ex
SUBSTANCE: invention elates to methods for radionuclide diagnosis of inflammation foci. Agent and method provide high precision of diagnosis based on using the preparation "Tekhnofit, 99mTc" as an agent for carrying out the scintigraphy method and labeled autologous leukocytes in diagnosis of suppurative-inflammatory processes. Diagnosis is carried out using the scintigraphy method and leukocytes labeled with a radiopharmaceutical preparation and the following localization of inflammatory infiltration by topical accumulation of a radiopharmaceutical preparation. Leukocytes are labeled with the preparation "Tekhnofit, 99mTc" in the dose 740 MBq and in case of topical accumulation of the preparation in 45-90 min after its administration in a patient the suppurative-inflammatory process is diagnosed.
EFFECT: improved method of diagnosis.
2 cl, 2 dwg, 2 ex
SUBSTANCE: method involves producing X-ray picture with step attenuator being applied, building graduation curve matching optical density of X-ray picture and specific calcium hydroxyapatite content in volume in g/cm2. The step attenuator is manufactured from copper alloy.
EFFECT: high accuracy of estimation.