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Generalized leiomyomatosis of the esophagus and stomach is a rare disease. According to literature data, age of the patients ranges from 9 to 84 years, in men this disease is diagnosed 2 times more often than in women. It is necessary to differentiate this disease with cancer, esophageal diverticulum, achalasia of the cardia, hiatal hernia. In our case a woman of 32 years was ill from 5 years of age. Correct diagnosis was not made before surgery. Endoscopic examination suspected leiomyoma. Only repeated urgent histological tests during surgery resulted in accurate diagnosis (subtotal leiomyomatosis of the esophagus and proximal stomach) and in adequate surgical policy--subtotal resection of the esophagus and proximal resection of the stomach with Toprover gastrostoma creation. Then, retrosternal esophagocoloplasty was performed. 2 years after the first surgery the state of the patients is satisfactory, there are no symptoms of recurrence of the disease.

Plasma-membrane-enriched particles isolated from the tissues of malignant tumors of different sites are shown to accumulate ATP under the influence of polypeptide growth factors and cytokines whose receptors have a tyrosine kinase activity. Polypeptide growth factors, such as EGF, FGF, NGF, TNF, insulin, and the cytokine IL-2, were studied on the accumulation of adenosine-5'-triphosphate (ATP) by the preparations of plasma-membrane-enriched particles isolated from the target tissues of human malignant tumors. The tumor (transformed) cell plasma membranes of the lung, bowel, stomach, pancreas, as well as the cells of neurinoma and a retroperitoneal extra-organ malignant tumor (leiomyosarcoma) are demonstrated to be able to synthesize ATP from inorganic phosphate and ADP under aerobic conditions human with the participation of the cyanide-insensitive proton phoric NADH-bound transversely oriented chain. Signal-stimulated accumulation of plasma membranous ATP was found to increase in the tissues in malignant transformation as compared to that in normal tissues. Experiments using selective inhibitors of tyrosine kinases (tyrphostin-25, quercetin) indicated the involvement of plasma membranous signal-transducing ATP in the activation of receptor tyrosine kinase growth factors.

Ceftriaxone was administered intravenously in a single dose of 1.0 g 15 minutes prior to surgical intervention for peptic ulcer and gastric or duodenum tumor in 31 patients at the age of 33 to 74 years. In all the patients primary adhesion of the surgical wound was recorded. No signs of local or general infection were observed. The indices of the total blood count, urinalysis and blood biochemical analysis came to normal by the 5th or the 7th day of the postoperative period. The levels of ceftriaxone in the blood, urine, stomach wall, small intestine tissues and subcutaneous fat were evaluated. The indices of the cellular and humoral immunity in the pre- and postoperative periods in the patients prophylactically treated with ceftriaxone were analyzed.

The results of treatment of 24 patients with benign nonepithelial tumors of the stomach (BNTS) are presented. The majority of the tumors were leiomyomas (42%). The preoperative diagnostic algorithm included x-ray examination of upper gastrointestinal tract, endoscopic examination with histologic study (biopsy), ultrasound examination and CT. The best results were obtained in CT. The operation of choice in BNTS are wedge-resection of the stomach and enucleation (78.3% of patients).

The authors analysed the immediate and late results of selective proximal or truncal vagotomy with excision of the ulcer from the gastric lumen or wedge resection of the stomach in patients with various localization of the gastric ulcers. The best results were produced (Visick I-II) in patients after selective proximal vagotomy with excision of the ulcer from the gastric lumen (in 93%), the results were poorer in selective proximal vagotomy with wedge resection of the stomach and in truncal vagotomy with excision of the ulcer or wedge resection of the stomach (only in 20%, 38%, and 30% of patients, respectively). The results were unsatisfactory (Visick IV) mainly after vagotomy with wedge resection of the stomach due to recurrences and postvagotomy functional disorders. The authors claim only limited use of organ-preserving operations to be admissible.

A female patient of 18 with Peutz-Jeghers syndrome and gastric cancer was found to have in macroscopically intact areas of gastric mucosa cysts of the body of the gastric mucosa glands (the first observation in the national literature) which were characterized by glandular structures of various sizes lined with clear columnar epithelium with basally located nucleus and with production of the PAS-positive substance. Some of the cysts extend into the gastric lumen, some form polyps. They should be regarded as hamartomas. When the cystic epithelium undergoes malignant transformation, the trend for mucus formation is not lost.