[Functional condition of pancreas after stomach resection according to Roux]. / Funktsional'noe sostoianie podzheludochnoi zhelezy posle rezektsii zheludka s anastomozom po Ru.

Available are the results of surgical treatment of 90 patients with stenotic gastroduodenal ulcer in Burdenko Surgical Faculty Hospital of Sechenov Moscow Medical Academy between 1984 and 1985. 30 patients (study group) underwent stomach Roux-type resection. Truncal vagotomy with a stomach Bilroth-I resection was made in 20 control patients, after 20 control patients had a truncal vagotomy with pyloroplasty according to Heineke-Mikulicz, and 20 patients had selective proximal vagotomy with gastroduodenostomy by Joboulay (the third control group). Exocrine function of the pancreas was assessed by serum concentration of immunoreactive trypsin, endocrine function by fasting blood sugar, oral glucose tolerance and serum concentration of immunoreactive insulin. The authors came to the conclusion that exocrine function of the pancreas was equally damaged in patients with a Roux stomach resection, stem vagotomy with a stomach Bilroth-I resection and a stem vagotomy with pyloroplasty Heineke-Mikulicz. After selective proximal vagotomy a level of immunoreactive trypsin was normal. After a Roux stomach resection relative incompetence of basophil cells of the pancreas and long increase of insulin in the blood were observed but without influence on the glucose curve. The changes of glucose curve and level of immunoreactive insulin were similar in the control groups.

[Topical diagnosis of pancreatic insulinomas]. / Topicheskaia diagnostika insulinom podzheludochnoi zhelezy.

Diagnosis of pancreatic insulinomas has been performed. Celiacography appeared to be the most efficient diagnostic method (more than 50% of sensitivity). Intraoperative ultrasound testing, that have been done in 16 patients, managed to make a topical diagnosis with a high accuracy and to evaluate relation of a tumor with portal vessels and pancreatic duct that is very important in choosing a proper surgical technique.

[Characteristics of changes in the thyroid status in severe trauma and massive hemorrhage]. / Osobennosti izmenenii tireoidnogo statusa pri tiazheloi travme i massivnoi krovopotere.

Dynamic measurements of the blood serum concentrations of thyrotropic hormone (TTH), prolactin, total and free triiodothyronine (T3), and thyroxin (T4) were carried out in 56 patients with grave combined mechanical injuries in the early posttraumatic period. Reduced T3 levels, variable changes in T4 content, and a relative increase of TTH and prolactin levels were observed in all the patients. Patients dying on days 1-5 after the trauma were characterized by the development of the "low T3 content" syndrome, reduced concentration of free T4, and the most expressed hyperprolactinemia. A direct correlation was established between reduction of the levels of total and free T4 and life duration. A hypothesis is proposed that incomplete reaction in the hypothalamus-pituitary-thyroid system and the absence of an adequate response of the thyroid to increased secretion of thyrotropin releasing factor and TTH is not only associated with, but determines early death.

[Diabetic glomerulonephritis--the first stage of diabetic glomerulopathy]. / Diabeticheskii glomerulonefrit--pervaia stadiia diabeticheskoi glomerulopatii.

20 puncture renal biopsies and 16 pancreatic biopsies from patients with insulin-dependent diabetes mellitus were studied ultrastructurally. The stages in the development of kidney changes depending on the functional state of Langerhans islands B-cells were established. The 1st stage includes signs of segmentary mesangioproliferative glomerulonephritis- segmentary increase of the mesangium due to the hypercellularity, variability of the basal membrane thickness in the glomeruli capillaries, leucocytes in the lumen, subendothelial deposits. This stage may be due to the persistence of the etiologic factors(virus), formation of circulating immune complexes, antibodies excess and relative preservation of B-cells and their function. Thinning of the capillary basal membrane, decrease of the mesangial matrix surface, cell destruction are characteristic for the 2nd stage- stage of the mesangiolysis. The duration of disease up to 15 years has no influence on the formation of glomerulosclerosis.

[Diabetic glomerulosclerosis--a prolonged stage of diabetic glomerulopathy]. / Diabeticheskii glomeruloskleroz--prolongirovannaia stadiia diabeticheskoi glomerulopatii.

Formation of diabetic glomerulosclerosis was followed by the electron microscopy of 21 puncture renal biopsy and 12 incisive pancreatic biopsies from patients with insulin-dependent diabetes mellitus. The influence of the B-cell destruction and the decrease or absence of their activity (the presence of serum C-peptide) on the degree of renal damage and clinical symptoms of the diabetic nephropathy (proteinuria, hypertension) is noted. Dynamics of the diabetic glomerulosclerosis formation is as follows: 1st group--thickening of capillary basal membrane in the glomeruli, mesangial ectopy, formation of nodules at the periphery of loops; 2nd group--increase of the mesangial matrix, doubling of the glomerular capillary basal membrane, hyalin droplets in the capsule membrane. 4 stages in the development of diabetic glomerulopathy are distinguished: diabetic segmentary mesangioproliferative glomerulonephritis, mesangiolysis, two stages of glomerulosclerosis progression. Duration of the disease more than 15 years predetermines the development of diabetic glomerulosclerosis.

[A comparative study of the pharmacokinetics of oral preparations of theophylline]. / Sravnitel'noe izuchenie farmakokinetiki peroral'nykh preparatov teofillina.

The pharmacokinetics of five preparations of theophylline--euphylline and sustained-release forms (theo-dura, retaphylline, theopac and theobilong) was studied in 50 patients with the broncho-obstructive syndrome. Blood serum theophylline concentration was determined by high performance liquid chromatography. The main differences in the pharmacokinetic parameters manifested themselves in the period of half-absorption--the least one for euphylline and the greatest one for theopac. A close correlation between blood serum theophylline concentration and the profile of theophylline release from theopac tablets was revealed. The equal theophylline concentration in blood serum was determined on the 4th and 7th days of the course treatment with sustained-release preparations administered twice a day, the concentration values ranged within the subtherapeutic level. An increase of the dose by 50-150 mg/day resulted in an increase of blood serum theophylline concentration within the therapeutic range.

[Plasma levels of various gastrointestinal polypeptides in patients with cholelithiasis and different degree of functional disorders of the major duodenal papilla]. / Soderzhanie riada gastrointestinal'nykh polipeptidov v plazme krovi u bol'nykh zhelchekamennoi bolezn'iu s razlichnoi stepen'iu narusheniia funktsii bol'shogo sosochka dvenadtsatiperstno'i kishki.

Findings of dynamic cholangiomanometry with the analysis of the tension curves are overviewed. This technique helped reveal different functional ailments of the bile papilla in major variants of the cholelithiasis course (acute obstructive++ cholecystitis, recurrent pancreatitis, and choledocholythiasis with obstructive jaundice). Parallel radioimmunoassay-based studies of a series of gastrointestinal polypeptides (insulin, glucagon, gastrin, vasoactive peptide, bombesin , and somatostatin) were conducted to determine the importance of these polypeptides in the pathogenesis of cholelithiasis complications. The levels of certain polypeptides were found to be related to the clinical manifestations of the disease. The complex assessment of the bile papilla function and gastrointestinal polypeptide concentrations offers a possibility for elaborating the pathogenetically relevant methods of therapy for this group of diseases.