[Biliary pathology in patients with type 2 diabetes mellitus and methods for its correction with the use of health resort and spa factors].

Diagnostics and treatment of hepatobiliary pathologies are known to be the indispensable prerequisites for the successful compensation of diabetes mellitus (DM). The present study revealed disturbances of bile-producing and bile-secreting functions of the liver in all the examined patients with DM. Moreover, the biochemical composition of bile and the ratio of its major components proved to be pathologically altered. The treatment program based at the Metallurg health resort including consumption of the local mineral water resulted in the significant improvement of the hepatic secretory function and normalization of motor-tonic activity of the bile-secreting system in patients presenting with type 2 diabetes mellitus at the stage of noncalculous cholecystitis.

[Optimization of therapy in patients with hepatic cirrhosis and encephalopathy].

With the aim of optimization of therapy of hepatic cirrhosis with manifestations of system encephalopathy 45 patients were examined. The patients were divided into 2 groups: control group (20 patients who received traditional therapy) and observing group (25 patients who in addition to traditional therapy received cryoapheresis). Clinical symptoms, results of neuropsychological and paraclinical examination, and indices of dynamic hepatobiliscintigraphy against the background of various methods of therapy were studied. It was established that with the use of pathogenetic therapy of hepatic encephalopathy--cryoapheresis--processes of hepatic encephalopathy progressing significantly decelerated, which made possible to approach to the choice of therapy individually, and, thereby, to optimize treatment.

[Clinical significance of assessment of the metabolism of connective-tissue biopolymers in patients with type 1 diabetes mellitus and with diabetic nephropathy]. / Klinicheskoe znachenie otsenki obmena biopolimerov soedinitel'noi tkani u bol'nykh sakharnym diabetom tipa 1 s diabeticheskoi nefropatiei.

The purpose of the case study was to define a degree of destructive changes in the connective tissue at different stages of diabetic nephropathy (DN) progression. One hundred and twenty eight DN patients with type 1 diabetes mellitus, disease duration-5 to 20 years (classification according C. Mogensen, 1983) were examined. Special biochemical tools were used to evaluate the connective-tissue condition. The parameters of metabolism of the connective-tissue biopolymers were investigated in blood, urea and saliva, i.e. general and sulphated glucosamine glycine (GAG), sialic acid (SA) and oxyproline fractions. The results showed an increasing value of total and sulphated GAG and SA with a worsening DN severity, which is indicative of a destruction degree of glycoprotein-complexes in the microvascular basal membranes. A high level of bound oxyproline fractions denotes the fibril-genesis processes, which start to activate yet at the preclinical DN stage. The changes detected previously in the parameters of metabolism of the connective-tissue biopolymers, as observed in DN patients, ensure a timely choice of a therapy and a proper monitoring of its efficiency.

[The joint use of hemosorption and plasmapheresis in the combined treatment of rheumatoid arthritis patients]. / Sochetannoe primenenie gemosorbtsii i plazmafereza pri kompleksnom lechenii bol'nykh revmatoidnym artritom.

AIM: Assessment of hemopheresis effects on calcium-regulating and immune systems, clinical and laboratory activity of rheumatoid arthritis (RA). MATERIALS AND METHODS: Hemosorption and plasmapheresis were included in combined treatment of 86 RA patients. Plasmapheresis was performed 3-5 days after hemosorption (a total of 4-6 procedures per course). The activity of RA, immune and calcium-regulating system were assessed clinically, with laboratory tests, enzyme immunoassay. RESULTS: Hemosorption plus plasmapheresis produced positive effects on the disease course, activity. Laboratory indices improved. Percentage of T-helpers and T-suppressors, calcitonin loading rate, levels of parathormone, calcidiol normalized. CONCLUSION: Combined hemopheresis therapy promotes correction of disorders in immune and calcium-regulating systems.

[The characteristics of disorders in carbohydrate metabolism and insulin and C-peptide secretion in patients with chronic glomerulonephritis in developing chronic kidney failure]. / Osobennosti narushenii uglevodnogo obmena, sekretsii insulina i C-peptida u bol'nykh khronicheskim glomerulonefritom pri formirovanii khronicheskoi pochechnoi nedostatochnosti.

The authors studied hormonal regulation of carbohydrate metabolism by secretion of insulin, C-peptide in 86 patients with chronic glomerulonephritis with different functional condition of the kidneys. There was a decrease in glucose tolerance, basal and reactive hyperinsulinemia, elevated level of C-peptide (relative insulin insufficiency). Mechanism of arising changes in the carbohydrate and insulin metabolism is complex and multicomponent. This includes renal lesion and consequent inhibition of hormone metabolism. Intensification of glomerular filtration is associated with inhibition of filtration of insulin and C-peptide derivants. Accumulation of nitrogen metabolism products results in changed response of pancreatic beta-cells to glucose. General disturbances of metabolism are accompanied by increasing levels of hormonal and nonhormonal contrainsular substances.

[A method for determining the formal boundary of the hematocellular interaction zone]. / Sposob opredeleniia formal'nykh granits zony hematotselliuliarnogo vzaimodeistviia.

A method of standard marking of the boundaries of hematocellular interaction zone is proposed. It is intended for identification of most effective transport zone of hematocellular conjugation. The main point of the method is to find minimal zone of the investigated hematocellular interface, the expansion of which will be accompanied by an increment of the perimicrovascular interstitium mean thickness. To verify the method applicability, a stereometric study is carried out on hematocellular barrier formed by thyroid C-cells and perifollicular hemocapillaries. The proposed method has a negligible error and provides accurate ultrastructurometry of blood-cell barriers.

[The effect of hemosorption and plasmapheresis on fibrinogen-125I kinetics in patients with rheumatoid arthritis]. / Vliianie gemosorbtsii i plazmafereza na kinetiku fibrinogena-125I u bol'nykh revmatoidnym artritom.

125I-labelled fibrinogen kinetics has been studied in 73 patients with rheumatoid arthritis (RA). Of them, 53 subjects underwent hemosorptions or hemosorptions combined with plasmapheresis. Fibrinogen metabolism in RA patients appeared enhanced versus healthy controls. It was observed that hemosorption treatment or its combination with plasmapheresis produce positive changes in clinical and laboratory RA parameters, improve fibrinogen metabolism. The study of fibrinogen kinetics is useful in assessing efficacy of on-going treatment.

[Thyroid morphofunctional changes in various types of experimental chronic stress]. / Morfofunktsional'nye izmeneniia shchitovidnoi zhelezy pri razlichnykh variantakh khronicheskogo éksperimental'nogo stressa.

Structural and functional parameters of the thyroid were studied in mature rabbits, inducing stress by stimulating the ventromedial nucleus of the hypothalamus or by exposing the animals to electrocutaneous irritations. Morphometric and radioimmunoassay results have revealed thyroid activation during the adaptation syndrome. Prolonged intensive stress was shown to cause a decrease in thyroid secretory activity, reflecting change of a stage of stable resistance by a phase of depletion of compensatory resources. However the nature of changes in the blood levels of thyroid and thyrotropic hormones in experimental animals have some characteristic features. A conclusion was made of the correlation between pathogenesis of the general adaptation syndrome and a methodological approach to simulation of a body tension reaction.

[Effects of hemosorption on the regulation of calcium metabolism in patients with rheumatoid arthritis]. / Vliianie gemosorbtsii na reguliatsiiu obmena kal'tsiia u bol'nykh revmatoidnym artritom.

A clinical response to hemosorption and the alterations in the calcium regulatory systems associated with the treatment mentioned were studied in 42 patients with rheumatoid arthritis. The use of hemosorption in the multiple modality treatment resulted in a manifest clinical and laboratory positive effect featured by the improvement of the general condition of the patient, a decrease in the values of the joint syndrome and the activity of the inflammatory processes as it was evidenced by routine laboratory tests and the time-course of the contents of beta 2-microglobulin in the blood and synovial fluid. Hemosorption helped the correction of the performance of the systems of calcium regulation: a decrease in parathyrin contents, an increase in the contents of calcidiol, osteocalcin, and ionized calcium.

[Anti-reflux biliary-digestive anastomosis including the gallbladder in the light of long-term results]. / Arefliuksnye biliodigestivnye anastomozy s zhelchnym puzyrem v svete otdalennykh rezul'tatov.

The authors provide the long-term results of cholecysto-digestive + anastomoses in 59 patients operated on for nontumorous diseases. The gallbladder anastomosed with the upper parts of the alimentary tract preserved reservoir and concentration functions, ability for visualization during cholecystocholangiography. The discrete pulse mechanism of bile secretion via the bile diverting anastomoses and their antireflux function eliminated the risk of chronic pancreatitis and terminal cholangitis. The recovery of deranged liver functions and excretory functions of the pancreas were traced during the postoperative period within 2 to 21 years.

[The effect of plasmapheresis on the function of the calcium-regulating systems in patients with rheumatoid arthritis]. / Vliianie plazmafereza na sostoianie kal'tsiireguliruiushchikh sistem u bol'nykh revmatoidnym artritom.

As many as 87 patients with rheumatoid arthritis were examined for changes in the status of the calcium-regulating systems under the influence of therapy. The multimodality treatment of 57 of the patients included discrete plasmapheresis, which allowed the attainment of an earlier and more marked beneficial clinicolaboratory effect. Plasmapheresis contributed to the correction of the status of the calcium-regulating systems: to a decrease of the level of parathyrin, an increase of the concentration of calcitonin, calcidiol, total and ionized calcium.

[Possibilities of hemosorption in the compensation of cardiac dysfunction in patients with ischemic heart disease associated with diabetes mellitus]. / Vozmozhnosti gemosorptsii pri kompensatsii serdechnoi disfunktsii u bol'nykh ishemicheskoi bolezn'iu serdtsa v sochetanii s sakharnym diabetom.

A total of 36 patients with unstable angina and type II diabetes mellitus were studied in the dynamic. All the patients underwent extracorporeal hemocarboperfusion. Marked improvement in the inotropic function of the myocardium was noted with the increase in the rate of relaxation and contraction of the posterior wall of the myocardium. A decrease in the pressure in the lesser circulation and specific peripheral resistance were registered. Using radiometry technique a corresponding decrease in the volume of extravascular fluid in the lungs was observed.