[A prognostic criterion for the course of chronic recurrent pancreatitis]. / Ob odnom kriterii prognoza techeniia khronicheskogo retsidiviruiushchego pankreatita.

Disorders in the blood kallikrein-kinin system presenting mainly with kallikrein elevation and accelerated rate of bradykinin release from kininogen, hyperhistaminemia and hyperserotoninemia may be considered natural for chronic recurrent pancreatitis at the height of its exacerbation. Despite attenuation of the aggravation some patients continue to exhibit the above changes. Upon the analysis of the prospective follow-up data, such patients develop more progressive deficiency of pancreatic enzymes as shown by repeated pancreozymin tests. This fact is under consideration in the discussion on the prognostic role of kallikrein-kinin system dysfunction, hyperhistaminemia and hyperserotoninemia persistent registration when advancing the remission of the disease.

[A prospective multiyear study of the course of chronic recurrent pancreatitis]. / Prospektivnoe mnogoletnee issledovanie techeniia khronicheskogo retsidiviruiushchego pankreatita.

It was established during observation over time (within the period from 10 to 12 years) that the overwhelming majority of patients with chronic cholecystopancreatitis and primary chronic pancreatitis progressed to a different degree to enzyme-secreting pancreatic failure according to the pancreozymine tests. At the same time in 2/5 of all the cases, enzyme-secreting failure turned out substantial by the end of the indicated period. During the years of prospective studies, every tenth patient with chronic pancreatitis developed secondary diabetes mellitus. The degree of pancreatic enzyme secretion and carbohydrate metabolism abnormalities depended on the number of disease exacerbations suffered by the patient. Secondary gastroduodenal ulcers occurred in 27 out of 647 patients observed over time, and all the cases were associated with a considerable reduction of pancreatic bicarbonate secretion (according to the secretin test). Pancreatogenous pleural exudate was recorded in 1.4% of all the cases of chronic pancreatitis. During the observation period, 16 out of the 647 patients died from chronic pancreatitis associated with progressive exocrine pancreatic failure and malabsorption.

[Clinical significance of various metabolic disorders in patients with chronic pancreatitis]. / Klinicheskoe znachenie nekotorykh metabolicheskikh narushenii u bol'nykh khronicheskim pankreatitom.

The degree of hyperlipidemia, hyperthyrosinemia, hyperserotoninemia and enhanced release of bradykinin from kininogen in patients with chronic recurrent pancreatitis was found to be decreased upon the attainment of a clinical remission. In patients with more considerable and more stable metabolic disorders, the incidence of exacerbations and the rate of progression of pancreatic, enzyme-secretory deficiency appeared, according to the data of a 8-year follow up, greater than in those with lesser degree and resistance of metabolic shifts.

[Insulin activity of the blood, the action on it of various loads and the effect of blood serum on the effect of insulin relative to fatty tissue in chronic pancreatitis]. / Insulinovaia aktivnost' krovi, deistvie na nee razlichnykh nagruzok i vliianie syvorotki krovi na éffekt insulina primenitel'no k zhirovoi tkani pri khronicheskom pankreatite

In patients with chronic pancreatitis a decrease in insulin activity of blood was observed. The activity was tested using preparations of diaphragm and epididymal fat of rats. Reaction of the insulin activity of blood, after loading with glucose, secretine and pancreosimine, was also decreased. The phenomenon was probably important for development of decreased tolerance to carbohydrates, which was observed in patients with chronic pancreatitis. In blood serum of the patients no effect of inhibition of the insulin activity could be observed by means of influence of insulin on lipolysis in epididymal rat adipose tissue. The data obtained suggest that in chronic pancreatitis the leading role in development of carbohydrate metabolism impairements belonged to the quantitative insufficiency of insulin, but not to the qualitative alterations in blood serum, where the ability to inhibite the insulin activity appeared.