[Surgical correction of complicated forms of chronic pancreatitis].

In the clinic in 2009 - 2011 yrs 43 patients were operated for complicated forms of chronic pancreatitis (CHP). Basing on the CT and endoscopic retrograde pancreatocholangiography data, the pancreatic pathology variants, significant for the operative method choice, were delineated. The intraoperative biopsy material estimation have shown, that the main sign of CHP in all the cases was prominent pancreatic fibrosis, and in the degree III fibrose the fibrous tissue have constituted 68.2-76.4% of pancreatic tissue, exocrine--16.2-24.8%, in the degree IV fibrose--79.5-95.5 and 2.3-10.8% accordingly. The indications for organ preserving resectional, resection-draining interventions and isolated, draining pancreatic duct system operations, were formulated. The rate of combined resection-draining interventions with duodenal preserving have constituted 30.2%. Total postoperative stationary mortality was 2.3%. The stationary postoperative patients stay was (9.1 +/- 0.8) days.

[Insulinoma].

The authors review statistical, pathogenic, and clinical aspects of insulinima, a rare pancreatic tumor growing from beta-cells of islets of Langerhans. Its functioning is associated with periodical impulsive ejection of insulin, its precursors, and relative peptides in large quantities, which results in hypoglycemic state. Acute neuropsychic disturbances, which may include depression of consciousness of varios degrees or psychic and motor disturbances, are a clinical of hypoglycemic attacks. When consciousness remains, the leading clinical syndrome is vegetative dysfunction. However, hypoglycemia does not have specific signs. This state should be differentiated from neurological, psychic, cardiovascular problems etc. The article describes diagnostic methods in insulinoma; their informative value is evaluated. Special attention is paid to cases of wrong diagnosis. The authors describe their own observation of insulinoma, which illustrates difficulties in its revealing. At the same time, the authors affirm that sufficient information make it possible for doctors to establish timely diagnosis of this disease.

[Particular features of the relationship of Helicobacter pylori and G cells in patients with duodenal ulcer, with special reference to the Helicobacter pylori strain]. / Osobennosti vzaimosviazi Helicobacter pylori i G-kletok zheludka pri iazvennoi bolezni dvenadtstatiperstnoi kishki s uchetom shtamma Helicobacter pylori.

Helicobacter pylori positive form of duodenal ulcer (CagA+ and CagA-) was studied in 120 patients with duodenal ulcer (DU). CagA+ was found in 78 patients (65%); CagA(-)--in 42 (35%). Diagnostic criteria of symbiosis between Helicobacter pylori and macroorganisms have been established. They describe normal mucous structure, absence of CagA+ and G-cell hyperplasia. It can be important for diagnosis and choice of a suitable mode of treatment to be employed in DU patients.

[Characteristics of brain gastrin/cholecystokinin-binding proteins]. / Kharakteristika gastrin/kholetsistokininsviazyvaiushchikh belkov golovnogo mozga.

Gastrin/cholecystokinin-binding proteins were purified using the column affinity chromatography on immobilized pig tetragastrin and cholecystokinin. Immunoblotting analysis of different human tissue extracts with specific antisera obtained against gastrin-binding proteins was performed. It was found that high molecular weight polypeptide zones of 120 kDa and 35 kDa were characteristic of the brain only. Autoantisera of patients with type A gastric disease reacted with some gastrin/cholecystokinin-binding proteins in human brain and mucosa including human brain polypeptide of 120 kDa. It is supposed that there are neurospecific gastrin-binding proteins (possibly gastrin/cholecystokinin receptors in the brain).

[Vimentin-positive epithelial cells in aggregated lymphoid nodules (Peyer's patches) in rabbits]. / Vimentinpolozhite'lnye épitelia'lnye kletki v kupolakh gruppovykh limfoidnykh uzelkov (peierovykh bliashek) krolika.

Peculiarities of cytoskeleton in membranous cells and disposition of the latter in the cupola epithelium in aggregated lymphoid nodules++ (ALN) have been studied in the ileum of 5 rabbits. The material has been fixed in liquid nitrogen and in the mixture of paraformaldehyde and glutar aldehyde. Methods of immunomorphology, high resolving light and transmissive electron microscopy have been used. Monoclonal antibodies to vimentin are selectively bind with a specific population of the ALN cupola epithelial cells. These cells are regularly arranged in the epithelium of the cupola lateral part and they are absent in the epithelium of the intestinal crypts, villi and apex of the cupolas. In the lateral epithelium of the cupolas surface, nearer to their base vimentin-positive++ epitheliocytes make contacts with single interepitheliocytic lymphocytes, and nearer to the apex they surround compact groups of the interepitheliocytic lymphocytes. The vimentin-positive++ epitheliocytic cells are identified as M-cells.

[Rapid diagnosis of celiac-sprue syndrome]. / Ekspress-diagnostika sindroma tseliakii-spru.

A rapid method was developed to diagnose celiac-sprue disease, which was based on the detection of serum antibodies to gluten and simultaneous assessment of the histological structure of the upper small intestinal mucosa. Examinations of labelled lectin binding in the cryostat sections of the small intestinal mucosa, assessment of the status of the regional T-lymphocyte system, and identification of blood autoantibodies to reticuline or epithelial cells of the small intestine provide additional information on the course of the disease. The diagnosis is made within 2-3 hours.

[Nonulcerogenic gastrinoma of the pancreas]. / Neul'tserogennaia gastrinoma podzheludochnoi zhelezy.

Non-beta-cell adenoma of the islet apparatus in the pancreas was described. The tumor measured 8 X 4 X 4 cm. Histological examination revealed its mixed structure. The tumor was composed of trabecular and solid structures, adenoma-like rosettes, and pericytial muffs. APUD-amyloid was found in its stroma. Application of a specific immunoperoxidase technique and electron microscopy provided good evidence for the fact that the tumor consisted of gastrin-producing cells. In view of clinical features, the tumor was regarded as gastrinoma.

[A study of membrane glycoproteins from the rat brain using D-galactose-specific lectin]. / Izuchenie membrannykh glikoproteinov mozga krysy s ispol'zovaniem D-galaktozospetsificheskogo lektina.

Immobilized D-galactose-specific lectin from Zea mais was used to purify rat brain membrane glycoproteins. The membrane glycoproteins preliminarily washed from soluble proteins were solubilized consecutively by 2% triton X-100 and 1% SDS. PAG-electrophoresis with SDS and 2-mercaptoethanol revealed 10 polypeptide bands (Mm 109, 62, 59, 54, 51, 42, 16, 14, 12.5 and 12 kDa) in the membrane fraction of glycoproteins solubilized with triton X-100. Additional solubilization with SDS revealed 3 bands (Mm 109, 62, and 54 kDa). Only 3 polypeptide bands (Mm 62, 59, 42 kDa) were identified when analogous procedure was used for purification of the rat liver glycoproteins. Horse radish peroxidase labelled D-galactose-specific lectin from Zea mais was found to bind to neuron bodies and neurites in the cerebellum. It is suggested that the identified brain-specific membrane glycoproteins may take part in the cell adhesion between neurons.

[Localization of glycoconjugates in tissues of mammals revealed by means of labeled lectins]. / Lokalizatsiia glikokon''iugatov v tkaniakh mlekopitaiushchikh pri vyiavlenii ikh s ispol'zovaniem mechenykh lektinov.

Histochemical peculiarities on binding of castor-oil plant, soybean and lentil lectins with tissues of the mucous membrane in the stomach, small and large intestine have been studied in the human being, rat, mouse, as well as the lectins mentioned and the maize agglutinin with the nervous tissue of the rat cerebral tissue. The reactions are carried out with nonfixed cryostat and deparaffinized histological slices. Lectins labelled with horseradish peroxidase are used. Certain specific peculiarities and differences concerning the lectin binding with tissues of the organs studied are determined. Predominant binding is noted of the soybean lectin with parietal and mucin-producing cells of the stomach, with epitheliocytes of the duodenal glands, with the brush border of the epithelial cells of the intestinal villi. The lentil and castor-oil plant lectins make contours of the basal membrane epithelium in the stomach and intestine. The lentil lectin also reacts with the germinative centers of the stomach lymphatic nodules and the castor-oil plant agglutinin--with the brush border of the small intestine epitheliocytes. The lectins used are predominantly bound with neurons of the subcortical formations of the rat brain and cerebral cortex. By means of labelled lectins of lentil, soybean, and castor-oil plant it is possible to reveal certain modifications of the rat small intestine glycoconjugates produced by means of the immortelle extract.

[Combined gastrinoma of the duodenum and glucagonoma of the pancreas]. / Sochetanie gastrinomy dvenadtsatiperstnoi kishki i gliukagonomy podzheludochnoi zhelezy.

A female patient, aged 53, with a combined duodenal gastrinoma and pancreatic glucagonoma is reported. Such a combination is an integral part of multiple endocrine neoplasias Type I. In both tumors psammous bodies were found. Gastrinoma was an ulcerogenic tumor resulting in the development of Zollinger-Ellison syndrome. Glucagonoma for a long time was asymptomatic.

[Morphological semeiotics of the celiac-sprue syndrome]. / Morfologicheskaia semiotika sindroma tseliakii-spru.

Sprue is a specific form of the gluten intolerance followed by the atrophy of villous structure and lengthening of crypts of the small intestine crypts. Hereditary factor has been implicated in its development and the immune hypothesis considering the sprue as a manifestation of the hypersensitivity to gluten is the most popular among the existing pathogenetic theories of this disease. The epithelium of atrophied villi reveals the most striking alterations. The content of lymphocytes in the epithelium is increased, high percentage of them being in the state of blast-transformation. The cells of the suppressor-cytotoxic type predominate among intraepithelial lymphocytes, the transfer of lymphocytes into the damaged epithelium is enhanced. Altered epitheliocytes have a smaller surface of the apical plasmalemma and a decreased activity of the associated enzymes. Intercellular epithelial contacts are altered and the basal membrane is damaged. There is an increase in number of T-lymphocytes and plasma cells synthesising IgA, IgM and IgG, in the thickened tunica propria of the small intestine mucous membrane. Lymphocytes-helpers predominate among T-lymphocytes and the ratio lymphocytes-helpers to lymphocytes of the suppressor-cytotoxic type is going down. Restoration of morphological alterations in the small intestine occurs when gluten is excluded from food.

[Electron cytochemical study of choleragen absorption by Peyer's patch epithelium in the guinea pig]. / Elektronno-tsitokhimicheskoe issledovanie absorbtsii kholeragena épiteliem peierovoi bliashki morskoi svinki.

The possibility of cholera toxin uptake by the guinea-pig Peyer's patch epithelium was studied by electron cytochemistry. Use was made on highly purified cholera toxin labeled by horseradish peroxidase with the help of glutaraldehyde. The labeled toxin was introduced into the lumen of a ligated jejunum loop containing Peyer's patch. Sixty minutes following the toxin introduction the product of the cytochemical reaction was detected in the elements of the smooth endoplasmic reticulum of Peyer's patch dome epithelium M-cells. The product was simultaneously found on the apical plasmalemma and in the cisternae of the smooth endoplasmic reticulum of columnar epitheliocytes of Peyer's patch intervening villi.

[Morphology of the liver and duodenum in excluded small intestine]. / Morfologiia pecheni i dvenadtsatiperstnoi kishki pri vykliuchennoi tonkoi kishke.

The results of light microscope and ultrastructural examinations of the liver and duodenum when the small intestine was excluded from the food passage. Along-side with liver steatosis and focal hyperplasia of endocrine cells, an unknown type of cell elements was discovered in duodenal glands most likely related to the humoral regulation of the functional activity of the digestive organs. The leading role of disregeneratory processes in cyst formation in the stomach and duodenum is suggested.