[Influence of ursodeoxycholic acid on the immune status of patients with cholesterosis of gall-bladder depending on cholesterol index in blood].

Application of ursodeoxycholic acid in a standard dosage for 3 months provided a positive effect in relation to the indexes of the immune system for patients with the cholesterosis of gall-bladder. It is shown that medicine assists renewal of T-cell immunity, renders positive influence on B-link and renewal of index of immunoregulation can be seen. Reliable increase of specific receptors to CD25, HLA-DR and high level of CD95 testifies about including of the scray reaction of organism under influence of ursodeoxycholic acid on the remaining high indexes of B-cell of immunity. At the initial indexes of lipid spectrum, corresponding to the norm, the efficiency of normalization of immunological changes is more considerable than at the higher level of general cholesterol of serum of blood.

[Interrelation of morphological changes of a mucous membrane of a duodenum and bowel microflora contents at cholelithiasis].

It is shown that biliary disorders in a combination with chronic duodenitis are accompanied by infringements of bowel microflora. It is revealed that more expressed changes of structure of microflora were observed at chronic duodenitis 2nd and 3rd degree. Strong correlation connection between degree chronic duodenitis and degree bowel dysbiosis (r = +0,55) is established. Microbic settling of a mucous membrane of a duodenum is revealed in 50% of cases. The analysis of the received results has shown dependence between frequency of revealing of microbic settling biopsy a mucous membrane of a duodenum and presence concretion a gallbladder. At half of patients with presence of microbic settling of a mucous membrane of a duodenum it is established chronic duodenitis 2nd and 3 items.

[Point system in diagnostics of the gallbladder cholesterosis].

THE PURPOSE OF THE STUDY: Development of scoring systems of diagnostics of gallbladder cholesterolosis (GBC) on the grounds of clinical and laboratory-instrumental parameters determined in the general clinical practice. MATERIAL AND METHODS: For development of the scoring systems, the methods of the logistic regression (LR) and artificial neuron networks (ANN) were used. The results of specially carried clinical observations of 124 patients, who had cholelithiasis with morphological confirmation of presence of GBC or chronic cholecystitis after planned cholecystectomy, were analysed. THE RESULTS: The scoring systems of diagnostics of GBC have been created: the detailed scring system, subjected to 24 parameters (12 quantitative ones; 12 qualitative ones) and the diminished scring system subjected to 6 the most informative parameters (3 clinical ones, 3 ultrasonic signs). Using the detailed scoring system of diagnostics of GBC allowed to set a correct diagnosis in 83,8% cases, specificity of the method was 91.80%, sensitiveness--92.11%. Diminished scoring system provides the correct diagnostics of GBC in 68% cases, the model specificity--63.41%, sensitiveness--63.77%. THE CONCLUSION: Using LR and ANN allowed to evaluate the influence of individual clinical and laboratory-instrumental parameters on probability of the GBC diagnosis. Developed scoring systems open new possibilities of the early diagnosing of this disease that enables to conduct the identical medication treatment in proper time, cut off clinical presentations and prevent the development of cholelithiasis.

[Biliary calculosis, cholesterosis of the gallbladder, xanthogranulematous cholecystitis: clinical-morphological parallels].

AIM: The retrospective analysis of prevalence, peculiarities of duration of biliary calculosis without gall bladder cholesterosis, biliary calculosis with gall-bladder cholesterosis and xanthogranulematous cholecystitis among persons who underwent cholecystectomy using clinical, instrumental and morphological data. MATERIAL AND METHODS. The data was evaluated obtained from medical cards of 4073 inpatients operated for cholelithiasis in 1999-2005. Preoperative clinical condition, body mass index, the results of abdominal ultrasonography, morphology of removed gall-bladders were evaluated. Statistical processing was made by Student's criterion and correlation analysis. RESULTS: After cholecystectomy the diagnosis of cholelithiasis was confirmed in 4020 patients (98.7%). 1177 patients had concomitant gall-bladder cholesterosis (GBC), 38 patients-- xanthogranulematous cholecystitis (XC). GBC and XC were diagnosed morphologically only in the postoperative stage. The patients were divided into three groups: cholelithiasis without GBC (32 patients), cholelithiasis with GBC (68 patients), XC (38 patients). Diseases of the gall-bladder occur more frequent in women and older patients. XC in males occurred 2 times more frequently, cholelithiasis without cholesterosis and XC ran 2 times less. The above diseases are related with disorders of metabolism and lipid transport. GB dyskinesia has different causes in each of the diseases. CONCLUSION: The analysis determined peculiarities of duration of cholelithiasis without gall-bladder cholesterosis, cholelithiasis with GBC and XC. This necessitate differential therapy.

[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.

[Low blood bilirubin level: possible diagnostic and prognostic importance].

The review deals with the problem of a possible physiological role of bilirubin as an endogenous anti-oxidant. The author considers low blood bilirubin level to be a risk factor of coronary artery disease (CAD) as well as a phenomenon observed in seasonal depression, diseases accompanied by non-hemolytic anemia etc. Mean bilirubin level in blood in such cases is within a narrow interval, between 0 and 10 mcmol/l. Circulating bilirubin is considered to protect human tissues from peroxidation of organic compounds, lipids first of all. Mechanisms that give rise to this phenomenon are probably diverse and not well-studied yet. Processes of the formation of free oxygen and peroxide radicals are known to take place in numerous pathological conditions. Low bilirubin level in blood may prove to be a significant marker for the evaluation of the general anti-oxidant status of the human organism. This parameter may, alone or in combination with other factors, make it possible to distinguish individuals with a risk of CAD as well as to predict the appearance or peculiarities of certain diseases.

[Continuum of Helicobacter pylori infection as the scientific substantiation for taking clinical decisions].

The article describes diseases of the gastroduodenal zone in the continuum of Helicobacter pylori infection. It discloses factors of risk and state of human health that increase the chance of the development of this or that disease and have an effect on its development and its complications that may lead to death. The article also disclosed a possibility of arresting the man's movement along the way of this continuum.

[Effect of preceding acid-reducing therapy on the Helicobacter pylori eradication rate in patients with ulcerous disease]. / O vliianii predvaritel'no provedennoi kislotosnizhaiushchei terapii na chastotu éradikatsii Helicobacter pylori pri iazvennoi bolezni.

32 patients having for the last one or two years an episode of exacerbation of stomach ulcer disease associated with Helicobacter pylory had received 7 days Helicobacter eradicative therapy of the first line according to Maastricht consensus-2, 2002 year. All the patients were divided into 2 groups. 15 persons of the first group have received just after establishing diagnosis antihelicobacter therapy, other 17 patients of the second group preliminarily over the period of 2-3 weeks had been treated with proton pomp's inhibitor. Helicobacter pylori eradication rate in the first and second group was 93,3% and 52,9% respectively. The obtained results enable us to discuss the regimen of rational medical therapy of patients with Helicobacter pylori associated diseases.

[Segmental reflexes after sciatic nerve damage in rats given thyroxine]. / Osobennosti segmentarnykh refleksov posle povrezhdeniia sedalishchnogo nerva u tiroksinizirovannykh krys.

Amplitude of the L5 segmental reflex responses 20 min. before and after intraperitoneal introduction of obsidan, clopheline and finoptine was recorded in experiments on spinalized and thyroxinized rats which 3 weeks before have endured transection of the sciatic nerve. It is demonstrated that obsidan does not change the amplitude of the monosynaptic reflex responses of the ventral root restored under the effect of thyroxine at the operated side, while clopheline and finoptine mainly reduce it.