[Morpho-immunological criteria for diagnosis of gastritis associated with Helicobacter pylori].

31 bioptates in the antral mucosa of 24 patients with a chronic gastritis and a body of a stomach for revealing H. pylori were being analysed and for the further studying morpho-immunology communications. The presence of H. pylori in bioptates, gastrits's activity (leukocytic infiltration), gastrits's degree evidence, also eosinophilus's presence and IgE containing plasmocytus had correlated with antibodies titre to H. pylori. After inspection, at the majority of patients serum antibodies to H. pylori correlated with positive respiratory-test. Considering that high sensitivity and specificity of immune-enzyme detection of antibodies to H. pylori in theirs blood serum, this method side by side with respiratory-test can be used at the primary screening H. pylori infections. The Biotates morphological examination is the "golden standard" of H. pylori gastritis' diagnostic by it's informatively and diagnostic's importance.

[H. pylori in development of allergic diseases in patients with gastroduodenal diseases].

AIM: To discover relations between allergic diseases and H. pylori infection in patients with gastroduodenal diseases. MATERIAL AND METHODS: The study was made of 113 patients (age 22-65, 34 males and 79 females) with chronic gastritis and duodenal ulcer. Of them, 60 patients (group 1) had concomitant allergy (urticaria, bronchial asthma, atopic dermatitis, food allergy, pollinosis), while 53 patients (group 2) had no allergy. H. pylori infection was diagnosed with the respiratory and rapid urease test, histological and cytological tests. Enzyme immunoassay determined total antibodies (AB) to H. pylori in IgG, IgA, IgM classes; IgA-AB in the kits Vector Best (Russia), IgG-AB to H. pylori in the kits of ECOLab (Russia) and total IgE in the kits IgE-EIA (Stavropol). RESULTS: In group 1 total AB to H. pylori were positive in 48 (80%), IgG-AB and IgA-AB to H. pylori in 38 (63.3%) and 43 (71.6%) patients, respectively. In elevated concentration of AgG-AB to H. pylori 46 (76.6%) patients had elevated total IgE (mean 364 IU.l). In group 2 total AB to H. pylori were detected in 45 (85.0%) patients, IgG-AB and IgA-AB to H. pylori in 47 (88.6%) and 32 (60.3%), respectively. Among patients with high level of IgG-AB to H. pylori in the serum high total IgE was only in 35.8% patients. Mean IgE was 250 IU/l. CONCLUSION: Patients with gastroduodenal diseases associated with H. pylori and allergy and not associated had similar level of total AB to H.pylori, while higher total IgE and specific IgE-AT to H. pylori occurred in the former. Thus, H. pylori infection is associated with allergic (atopic) immune response.

[Hepatic lesion in patients with hepatocerebral dystrophy].

AIM: To study hepatic affection in hepatocerebral dystrophy (HCD) regarding clinical course and duration of the disease. MATERIAL AND METHODS: The records on 63 HCD patients were studied retrospectively as to early clinical symptoms, onset dynamics, biochemical tests for hepatic function, morphological changes of the liver, immune and cytokine status, markers of hepatotropic viruses. RESULTS: Six variants of HCD course were identified: hepatic (24 patients), endocrine (17 patients), neurological (12 patients), psychoemotional (5 patients), hemolytic (3 patients), renal (1 patient). Early hepatitis and hepatic cirrhosis progress were characteristic for the hepatic variant. The other variants were characterized by hepatic fibrosis, lipofuscinosis, fat dystrophy of the liver. Markers of viral hepatitides B, C, G, TT were detected primarily in patients with a hepatic variant of HCD. A moderate rise of aminotransferases, immunoglobulins, cytokines level indicate weak inflammation in hepatic tissue. Disorders in proteins synthesis, hepatic detoxication function reflect changes in the microsomal system and endoplasmic network. CONCLUSION: Hepatic lesions in HCD are different. Clinical, biochemical, morphological activity and immune status affections were most severe in patients with hepatic and endocrine variants of HCD, being the least severe in neurological, psychoemotional and hemolytic variants. Hepatotropic viruses in some patients deteriorate hepatic lesion caused by copper imbalance.

[Cytokines and cytokine therapy in gastrointestinal diseases]. / Tsitokiny i tsitokinoterapiia pri zabolevaniiakh organov pishchevareniia.

AIM: To compare cytokine status in gastrointestinal diseases (GID) with reference to etiological factor, course, stage, therapy of the disease. MATERIAL AND METHODS: Enzyme immunoassay was used to examine cytokines in the peripheral blood, tissue homogenates of 560 GID patients. GID were represented by ulcer disease (UD), cholelithiasis, chronic hepatitis (CH), glutenic enteropathy (GE), Crohn's disease (CD), nonspecific ulcer colitis (NUC). RESULTS: In chronic recurrent GID (UD, cholelithiasis, GE) early exacerbation was characterized by elevated concentrations of IL-1 beta, IL-6, IL-8. Concentrations of IL-12, Inf alpha, g, TNF alpha reached maximum on the height of the disease. Intensification of regenerative processes raised concentrations of IL-4, IL-10. An overall level of serum cytokines averaged 190-780 pg/ml, reaching in some patients with active disease 1200-3000 pg/ml, in remission 30-110 pg/ml, in the control 40 pg/ml. In chronic progressive GID the levels of IL-1 beta, IL-2, IL-8, IL-6 reached 30-80 pg/ml, IL-12, Inf gamma, TNF alpha--150-370 pg/ml. A rise in cytokines concentrations in inflammatory viral, bacterial, autoimmune GID was higher than in cancer, alcoholism-related diseases, metabolic disturbances. Basic therapy in patients with chronic recurrent GID led to a significant fall in concentration of serum cytokines. Therapy with monoclonal antibodies to TNF alpha was associated with transitory pronounced favourable changes in peripheral blood cytokine status. CONCLUSION: GID provoke elevation of serum and tissue cytokines, impairment of cytokine balance in correlation with the etiological factor, variants of the course, stage of the disease, on-going therapy.

[Therapeutic effect of gastrozolum in stomach ulcers]. / Terapevticheskii éffekt gastrozola pri iazvennoi bolezni.

Gastrozolum is the proprietary name of a drug made in Saint Petersburg. Its international nonproprietary name is Omeprazole. The absorption rate is not related to food. Its pharmacotherapeutic action becomes apparent as an inhibitor of the proton pump leading to the inhibition of H+/K(+)-ATPase of the secretory membrane of parietal cells of the stomach mucous membrane and blocking of the concluding stage of hydrochloric acid secretion. The entire action leads to the decrease of the level of basal and induced secretion regardless of the nature of stimulus. As a result of this, symptoms of stomach ulcer decrease, and gastroduodenal ulcers heal faster. Penetrating into the stomach mucous membrane cells, the drug also has a cytoprotective action. The maximum blood concentration (0.6-1.5 mg/l) is found 2-3 hours after a single intake of 40 mg of the drug. It was determined that after the intake of 20 mg of Gastrozolum its action lasts for 24 hours and provides for the inhibition of both night and day secretion. The ricochet syndrome does not take place when the treatment is over. It was proved that Gastrozolum has a bactericidal action on Helicobacter pylori due to the sharp increase of stomach pH, which contributes to the realization of the effect of used components of the anti-helicobacter therapy. The experiment failed to establish any teratogenic or poisonous action on the embryos. The dosage form is a capsule containing 20 mg of Omeprazole in the form of pellets.

[Treatment of patients with ulcer at an outpatient facility]. / Opyt lecheniia bol'nykh iazvennoi bolezn'iu v ambulatornykh usloviiakh.

The most frequent affection of digestive apparatus is the ulcerative disease. Ulcerative duodenal or gastric affection irrespective of its localization is a chronic cyclic recidivating disease of whole organism. It affects mainly an active able-bodied age and often results in heavy course and physical disability. The complicated forms of ulcerative disease--bleeding, perforation, stenosis--require the surgical intervention.

[Modern diagnosis and treatment methods in hereditary hemochromatosis]. / Sovremennaia diagnostika i sposoby lecheniia nasledstvennogo gemokhromatoza.

The authors followed-up 76 patients with hereditary hemochromatosis whose diagnosis was confirmed by morphological signs of liver, pancreatic, pulmonary, gastric, and myocardial changes. The most informative laboratory indices of iron metabolism were defined (transferrin saturation with iron and the level of ferritin in the serum and erythrocytes). HLA typing of probands and their relatives was recommended to specify the hereditary nature of disease.

[Antioxidant activity of hepatotropic preparations in the treatment of chronic diseases of the liver]. / Antioksidantnaia aktivnost' gepatotropnykh preparatov pri lechenii khronicheskikh boleznei pecheni.

Hepatotropic drugs were shown to decrease blood lipid peroxidation activity (LPO) in patients with chronic diffuse liver diseases. A positive time course of LPO indices was noted in the treatment of chronic active hepatitis and liver cirrhosis of moderate activity. Comparison of antioxidant features of the drugs were suggestive of a noticeable effect of trophopar and essential in patients with chronic active hepatitis, trophopar in patients with liver lipodystrophy, and drugs of a silimarina series in patients with liver cirrhosis. Under clinical conditions the effect of the drugs on LPO processes was less noticeable than in experiments in vitro. It is assumed that the pharmacological effect of the hepatotropic drugs is associated with their antioxidant activity.