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Short-term intragastric pH-metry was carried out on atsidogastrometre AGM-05K in the modification "Gastroskan-5. Prolonged (24 hour) pH-metry was performed using a daily notebook atsidogastromonitora AGM-24 MF (Gastroskan-24).

Thread of a nickel-titanium - is the intermetallic brand viagra online compound titanium and nickel (TiNi), the homogeneity of which varies from 2 to 5%. The structure of TiNi identified as ordered by the type Cs CL (B2) with a degree of order of 0,8-0,9. The lattice parameter varies depending on the composition and heat treatment from 0.3005 to 0.3040 nm. Melting point is 1240 ° C. Thread is manufactured in the Institute of Medical materials and implants with shape memory in Siberian Physico-Technical Institute and the Tomsk State University (Director - Doctor. Tekhn., Professor, Honoured Scientist of Russia Vladimir E. Gunther).

In an experiment designed [3] and introduced in clinic modeling method INPS hyperfine (80 mm) and superelastic filament of nickel-titanium alloy (RF Patent № 2003106069 on June 21, 2004).

Method is generic viagra as follows: after the introduction into the peritoneal cavity 5 trocars produce mobilization of the proximal part of the lesser curvature of the stomach on the technology of selective proximal vagotomy (SPV), 4-5 cm distal esophagus, fundus of the stomach. Next, form the INPS by applying continuous suture thread of nickel-titanium alloy. Start in seam subkardialnom department at the lesser curvature of the stomach, extending to the right wall of the esophageal-gastric junction and continue on the rear wall of the esophagus spiral coil of 3.2 along the circular muscle fibers of the esophagus in an upward direction. In total, form an overall height of 3.2 helix turns up to 3 cm then continue to stitch in reverse descending spiral to the left side of the esophageal-gastric junction and the small curvature of the stomach to the top of the seam, where the knot tied intrakorporalno. Upon application of a continuous suture dosed pull the thread until a certain pressure generated in the INPS. Intraoperative measurement of pressure in the INPS produced by the method of V. Oskretkova [8]. Method completed by imposing ezofagofundografiey 3.2 stitches to the right and left wall of the esophagus to form a corner-branch block and valve in the cardiac notch (Fig. 1).

In each patient a combination of these symptoms were different. Organic failure of esophageal-gastric junction was detected in 48 (36.3%) patients with GERD. All 132 patients were diagnosed with reflux esophagitis (RE) to varying degrees. RE I degree was detected in 32 (24.5%) patients, II degree - in 71 (53,7%), III degree - in 17 (12,8%), IV degree - in 12 patients (9%) patients (classification Savary - Miller). To complete the confirmation or cialis without prescription exclusion of the organic nature of insolvency PZHP traditional EFGDS complement EUS. Structural changes in the walls of esophageal-gastric junction with GERD according to EUS we described previously (Russian patent number 2,257,149 on June 27, 2005) [2].

Analysis of data obtained with a gauge study of NPC was held in three areas: setting boundaries sphincter assessment of its solvency and ability to relax during swallowing. In this case, the following results.

Shortening the overall length of NPCs from 1 to 2 cm was noted in 32% of patients. Shortening of the abdominal part of the NPC - is more common phenomenon. Relative shortening of 1 to 2 cm was noted in 57%, to 1 cm - in 16% of patients. In 46.2% of patients the average pressure in the respiratory area LES was less than 14 mm Hg. Art. In 12% of patients were below the relaxation of the rules and were equal to 66 ± 8,5%.

On the basis of manometric studies NPS developed classification of the failure LDC (application for the invention "Method for diagnosis of insufficiency of the lower esophageal sphincter" № 2005108149 on March 22, 2005). Process is carried out as follows: spend oesophageal manometry, in which the original record and stimulated srednerespiratornoe pressure pumping station. In the case where the initial pressure below 14 mm Hg. Art., conduct stimulation tone NPS 2 ml intramuscular metoclopramide record the reaction of NPC. According to the results of research define the degree of insufficiency of NPCs.

IV power failure NPC - with no increase in pressure from 2-5 to 14-34 mm Hg. Art. (N = 15) (Fig. 4).

Lack of increase in pressure in this sample noted in 36 (27.2%) patients and was considered a sign of organic disease NPCs.

Increasing pressure to normal values was regarded as an indication of functional insufficiency of NPC, and noted in 25 (18.9%) patients. High blood pressure, less than 14 mm Hg. Art., regarded as a sign of organic disease and NPC noted in 8 patients (22%) patients.

1. The amplitude of contractions. Hypotensive contraction (below 30 mmHg. Cent.) Distal esophagus were found in 6% of patients. In 14% the amplitude ranged from 30 to 60 mm Hg. Art., 62% - from 70 to 110 mm Hg. Art., 18% - from 120 to 180 mm Hg. Art. (Hypertensive).

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