[Scientific rationale for basic directions of the optimization of the population health in the development of municipal environmental programs].

For the solution of ecological problems in the framework of the preparation of the municipal ecological program in the city of Verkhnyaya Pyshma (Sverdlovskaya Oblast) there was peiformed the assessment of the state of population health, the evaluation of carcinogenic and non-carcinogenic health risk from chemicals that pollute the air and drinking water Atmospheric air was established to be the main environment cause for carcinogenic and non-carcinogenic risks. The obtained results served as the basis for the development of technological, sanitary and hygienical measures of the program aimed at optimizing of the population health.

Comparative analysis of antibacterial properties and chemical composition of Glycyrrhiza glabra L. from Astrakhan region (Russia) and Calabria region (Italy).

We compared antibacterial activity of various extracts of two licorice subspecies against Staphylococcus aureus, Escherichia coli, and Bacillus subtilis. Diethyl carbonate extracts of Glycyrrhiza glabra root from Astrakhan region (Russia) exhibited maximum activity against the test microbial strains; activity of Astrakhan licorice was superior among 50% ethanol extracts from Astrakhan (Russia) and Calabria (Italy). Antibacterial activity is directly proportional to the content of glycyrrhizin and 18ß-glycyrrhetinic acid in the extracts. According to preliminary data, the content of these chemical components in Glycyrrhiza glabra root from Astrakhan region is higher than in licorice growing in Italy, which is presumably related to climate and geographic characteristics of Astrakhan region.

[Application of Mesim Forte 10000 at chronic pancreatitis]. / Primenenie preparata Mesim Forte 10000 pri khronicheskom pankreatite.

There was a study of 30 patients with chronic pancreatitis (CP) to study the efficiency of action of Mesim Forte 10000 on the functional state of the pancreas and liver at chronic pancreatitis. Patients were given two pills of the drug three times a day during three weeks. The pancreatic elastase and contents of short chain fatty acids in excrements as well as blood concentration of individual fractions of bile acids were investigated before and after the treatment. According to this research, such clinical presentations of CP as pain syndrome, meteorism and stool frequency were greatly reduced as a result of the therapy with the enzymatic drug Mesim Forte 10000. The increase of the level of the pancreatic elastase depending on the severity of exocrine pancreatic deficiency was determined. At the same time, it was possible to observe the correction of a number of biochemical processes in the gastrointestinal tract related to the exocrine deficiency. In particular, the treatment of the greater part of steatorrhea patients with Mesim Forte 10000 led to apparent changes in the metabolic activity of bacterial microflora resulting in the improvement of the quantity and quality of fatty acids.

[Change of the endocrine function of the pancreas in patients with chronic pancreatitis]. / Izmenenie éndokrinnoi funktsii podzheludochnoi zhelezy u bol'nykh khronicheskim pankreatitom.

There was a study of 19 chronic pancreatitis patients (10 male and 9 female), 11 chronic pancreatitis and pancreatogenic diabetes mellitus patients (8 male and 3 female) and 12 type 2 diabetes mellitus patients (4 male and 8 female) at the age of 30-60 as well as 15 control group subjects at the same age range. The content of the C-peptide and such peptides as INCINE, PAMG-cine and PAMG-tin in the blood serum was subjected to the immunoradiometric assay. It was discovered that there is a trend to the increased C-peptide level in CP patients while the C-peptide level in CP patients with diabetes mellitus was smaller than that in the control group; the C-peptide level in CP patients with type 2 diabetes mellitus was higher as compared to that in the control group. It was shown that erythrocytes of CP patients are less sensitive to insulin action and do not respond to the presence of insulinomimetic peptides under examination during the glucose uptake test. CP patients with diabetes mellitus and type 2 diabetes mellitus patients are more sensitive to the action of insulin and peptides applied. Synthetic insulinomimetic peptides can serve as a means for discovering the functional cell deficiency under the glucose uptake test.

[Changes in indicators of external and internal secretion of the pancreas during treatment of chronic pancreatitis of alcoholic etiology with somatostatin analogs]. / Izmenenie pokazatelei vneshnei i vnutrennei sekretsii podzheludochnoi zhelezy pri lechenii khronicheskogo pankreatita alkogol'noi étiologii analogom somatostatina.

AIM: To study somatostatin (SS) content in patients with chronic pancreatitis (CP) and effects of sandostatin (a synthetic analogue of SS) on endo- and exocrine pancreatic functions in CP patients. MATERIAL AND METHODS: SS plasma levels were measured by radioimmunoassay in basal conditions in 32 CP patients. Sandostatin treatment was given to 20 patients with CP of alcohol etiology (twice a day subcutaneously for 5 days). In the course of the treatment the following indices were measured: serum trypsin, amilase, lipase, alpha 2-macroglobulin, general antitryptic activity, blood immunoreactive insulin in basal conditions and after intravenous injection of glucose. RESULTS: SS levels in peripheral blood were elevated in patients with complicated alcoholic CP. Sandostatin in CP used for 5 days had no significant impact on insulin secretion, levels of pancreatic enzymes, inhibiting system of blood. 90% patients with alcoholic CP experienced relief of pain which may relate to suppression of stimulated secretion of gastrointestinal hormones as well as to a favourable action of sandostatin on stabilization of membranes of acinar cells. CONCLUSION: Sandostatin administration in CP patients is justified and is especially recommended in the complicated course.

[Interrelations of the pancreas exocrine and endocrine functions in chronic alcohol pancreatitis]. / Vzaimosviaz' ékzokrinnoi i éndokrinnoi funktsii podzheludochnoi zhelezy pri khronicheskom alkogol'nom pankreatite.

In order to achieve a positive therapeutic effect in case of secondary pancreatic diabetes in patients with chronic pancreatitis, it is necessary to conduct conservative therapy aimed at parallel correction of the excretory and incretory functions of the pancreas.

[Hormonal regulation of calcium metabolism in chronic alcoholic pancreatitis]. / Gormonal'naia reguliatsiia obmena kal'tsiia pri khronicheskom alkogol'nom pancreatite.

The purpose of this investigation is to study the state of Ca regulation mechanism at chronic alcohol pancreatitis and to compare with the activity changes of pancreatic lipase and its inhibitor at this disease. Content of Ca and regulating hormones (parathormone and calcitonin), activity of pancreas lipase and inhibitory blood ability in connection with it were determined in 30 patients with chronic alcohol pancreatitis without complications and in 20 persons with complicated disease course. Ca blood content fluctuates within normal level. But the median Ca contents in the group of patients with complications were significantly higher than in the control group. No changes in the level of pathormones and the increased Ca content were observed in the blood of the patients. The direct correlation between Ca and calcitonin and inverse correlation between Ca and parathormone were kept. According to correlation analysis of definite indexes the regulatory mechanisms of Ca metabolism in patients were intact. The increased calcitonin blood content in patients with chronic alcohol pancreatitis has apparently a compensatory character. This fact is confirmed by direct correlation with inhibitory ability of blood with respect to lipase.

[Role of stress in the etiopathogenesis of duodenal ulcer in young patients]. / Rol' stressa v étiopatogeneze iazvennoi bolezni dvenadtsatiperstnoi kishki u bol'nykh molodogo vozrasta.

The analysis of the acid-forming function of the stomach, both basal and stimulated with insulin, atropine test, tests for the content of the adrenocorticotropic hormone, somatotropic hormone, thyrotropic hormone, triiodothyronine, thyroxin, cortisol in the blood and the content of gastrin in the blood and gastric juice, activity of the processes of lipid peroxidation, content of ceruloplasmin in the blood, content of Helicobacter pylori (Hp) in the gastric mucosa were conducted in 68 men and 64 women at the age from 18 to 40 years suffering from gastroduodenal ulcer in order to examine the role of stress in ulcer formation. 38 patients with duodenal ulcer took proton pump blockers and antioxidants for 3 years whenever they were in a stress situation. The research revealed that young patients with duodenal ulcer show enhanced sensitivity of parietal cells and sympathoadrenal system to stressful situations, and stimulation of the acid-forming stomach function takes place under the effect of both catecholamines and gastrin. Men can have both Hp-dependent and Hp-independent duodenal ulcers, while women have mostly Hp-dependent duodenal ulcers. Prescription of proton pump blockers of and antioxidants for patients with duodenal ulcer, who are in a stressful situation, reduces the frequency of duodenal ulcer recurrences.

[Change in hormonal regulation in experimental adrenaline stomach ulcer]. / Izmenenie gormonal'noi reguliatsii pri éksperimental'noi adrenalinovoi iazve zheludka.

The activation or inhibition of the activity of various hormone subsystems depending on the phase of the ulcerative process was shown in experiments on rats with adrenal ulcers. The early (catabolic) phase of the ulcerative process develops against the background of the pituitary-adrenal system pituitary-adrenal with an increase of the outlet of adrenocorticotropic hormone (ACTH) and glucocorticoids. In the early period of ulcer formation a suppression of the gonadotropic system activity was observed with an abrupt decrease of the level of sex hormones, especially estradiol, during the whole period of adrenal ulcers existence. A suppression of the growth hormone system activity was also observed with a further increase of its level in the stomach mucosa in the anabolic phase. The level of gastrin in the stomach mucosa was increased in the anabolic phase of the ulcerative process, which can testify to the participation of the growth hormone and gastrin in the healing of an ulcerative defect.

[Effect of sandostatin on the functional status of the pancreas in patients with chronic pancreatitis]. / Vliianie sandostatina na funktsional'noe sostoianie podzheludochnoi zhelezy u bol'nykh khronicheskim pankreatitom.

Taking into account the ability of somatostatin to exert influence of the endocrine and exocrine functions of the pancreas, the object of this research is to study the somatostatin content in patients with chronic pancreatitis and the impact of treatment with its synthetic analog, sandostatin, on the endocrine and exocrine functions of the pancreas in patients with chronic pancreatitis.

[The role of phospholipase A2 in pathogenesis of acute and chronic pancreatitis, its significance in diagnosis of the disease]. / Rol' fosfolipasy A 2 v patogeneze ostrogo i khronicheskogo pankreatitov, ee znachenie v diagnostike étikh zabolevanii.

The literary data concerning phospholipase A2 (PHL2) significance in pathogenesis of acute and chronic pancreatitis and pancreonecrosis development are presented in this paper. Isoforms of PHL2, that are responsible for morphological changes in the patients with chronic pancreatitis were described. The great significance of PHL2 activity for diagnosis of acute and chronic pancreatitis was demonstrated.

[Nicotinamide in combined treatment of chronic pancreatitis]. / Primenenie nikotinamida v kompleksnom lechenii bol'nykh khronicheskim pankreatitom.

AIM: To evaluate effects of nicotinamide on insulin secretion in glucose tolerance test and on blood clotting in patients with chronic pancreatitis (CP). MATERIALS AND METHODS: 30 patients with CP of alcoholic etiology received combined treatment with enzyme medicines. In addition, some of them were administered nicotinamide as 2.5% solution for 2 weeks (1 ml twice a day). Before the treatment and during its course, measurements were made of fasting and post glucose test values of insulin secretion and thromboelastogram. RESULTS: Both basal and stimulated insulin secretion in CP patients was low compared to control subjects. Nicotinamide significantly increased basal secretion of insulin and insignificantly aroused its glucose-stimulated secretion. Nicotinamide promoted reduction of hypercoagulation and time to remission. CONCLUSION: Nicotinamide administration is thought valid for correction of endocrine pancreatic function and hemocoagulation in patients with alcoholic CP.

[Glucocorticoid deficiency of the adrenal cortex in chronic liver diseases]. / Gliukokortikoidnaia nedostatochnost' kory nadpochechnikov pri khronicheskikh zabolevaniiakh pecheni.

AIM: The study of blood levels of hydrocortisone and ACTH in patients with chronic hepatic lesions. MATERIALS AND METHODS: Blood levels of hydrocortisone and ACTH were measured in 198 patients with chronic liver diseases (CLD) of different etiology and severity and in 39 healthy controls. RESULTS: Blood hydrocortisone was subnormal while ACTH elevated in all the patients except those with chronic hepatitis running a favorable course. Changes in the hydrocortisone and ACTH content were the greatest in CLD of viral and autoimmune etiology, the least--of alcoholic etiology. CONCLUSION: Hydrocortisone deficiency was most prominent in severe hepatic lesions.

[Features of insulin secretion and thromboelastography values in chronic pancreatitis]. / Osobennosti sekretsii insulina i pokazateli tromboélastografii pri khronicheskom pankreatite.

The function of pancreatic beta-cells in patients with chronic pancreatitis is insufficient, which manifests by hyposecretion of basal and stimulated insulin into the blood. Moreover, blood-clotting activity is increased in chronic pancreatitis. A conclusion is made that timely prevention of exacerbations of this disease should include laboratory check-ups of insulin production and assessment of blood coagulation in the patients.

[The hormonal characteristics of the pathogenesis of gastric peptic ulcer and duodenal peptic ulcer]. / Gormonal'nye osobennosti patogeneza iazvennoi bolezni zheludka i iazvennoi bolezni dvenadtsatiperstnoi kishki.

Blood levels of STH, ACTH, somatostatin, bombesin, gastrin, hydrocortisone, aldosterone, testosterone, estradiol, progesterone and gastric juice levels of gastrin and somatostatin were measured in remission and exacerbation of gastric and duodenal ulcer (GU), (DU) using radioimmunoassay. The study included 250 DU, 200 GU and 5O control subjects. As a result, two forms of DU were identified. DU type 1 is characterized by basal and stimulated hypergastrinemia, paradoxical D-cell response to stimulation, high blood concentrations of STH, ACTH, testosterone. Type 2 DU exhibits basal hypogastrinemia, elevated gastrin concentration in response to stimulation, adequate reaction of D-cells, low levels of estradiol and progesterone. In GU there were low concentrations of STH, bombesin, hydrocortisone, estradiol, testosterone, progesterone, somatostatin. D-cell response to loading was adequate. It is concluded that DU and GU pathogeneses are different, that DU is a heterogeneous disease.

[A trial of the use of sandostatin in patients with chronic pancreatitis]. / Opyt primeneniia sandostatina u bol'nykh khronicheskim pankreatition.

Out of 15 patients with chronic pancreatitis (CP) treated with sandostatin, 8 patients demonstrated a complete and 6 partial response. One patient did not respond. Pain relief occurred in all of them. Side effects were registered in 3 patients (doughy stools 4 times a day throughout treatment). Normal blood levels of pancreatic enzymes, insulin secretion, parameters of blood inhibitory system did not change much because of sandostatin administration, whereas hypercoagulation got diminished. Rat experiments have revealed a trend to trypsin lowering in tissues of unaffected pancreas and more intensive inhibition of active trypsin by tissue inhibitors.

[The content of gastrin, bombesin and somatostatin in the blood and gastric juice of patients with duodenal and gastric peptic ulcer]. / Soderzhanie gastrina, bombezina i somatostatina v krovi i zheludochnom soke bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki i zheludka.

Ninety patients suffering from peptic ulcer and 25 healthy subjects were examined for the content of gastrin, bombesin and somatostatin in blood and gastric juice. Among patients with duodenal ulcer, 2 groups were distinguished: group I included patients in whom peptic ulcer occurred before 30 years; the majority of the patients manifested blood hypergastrinemia, a decrease of bombesin concentration and normal somatostatin concentration; gastric juice was characterized by a lowering of somatostatin concentration and unchanged gastrin concentration; group II was made up of patients who developed peptic ulcer after 30: in the majority of the patients, gastrin concentration was reduced under basal conditions, after loading it was unchanged; in part of the patients, blood somatostatin concentration was elevated, in 16 in exacerbation and in 19 in remission; in the remainder, it was unchanged. The concentration of bombesin in blood remained unchanged. In gastric juice, gastrin concentration was increased only after histamine administration, somatostatin concentration was unchanged whatever the disease stage. In patients with gastric ulcer, gastrin concentration in blood was elevated only under basal conditions, being unchanged in gastric juice irrespective of the disease stage. Meanwhile, the concentration of bombesin was lowered both under basal conditions and after insulin administration, the concentration of somatostatin was decreased both in blood and gastric juice whatever the disease stage.

[The level of steroid hormones in patients with primary biliary liver cirrhosis]. / Soderzhanie steroidnykh gormonov u bol'nykh pervichnym biliarnym tsirrozom pecheni.

The authors investigated 5 of steroid hormones in patients with primary biliary cirrhosis of the liver and healthy persons. Only cortisol was reduced in the blood of the patients with primary biliary cirrhosis. The authors consider that this reduction may be connected with the change of the activity of 17-alpha-hydroxylase of progesterone of the adrenal glands.

[Secretion of cortisol and growth hormone in patients with peptic ulcers of the stomach and the duodenal bulb]. / Sekretsiia kortizola i gormona rosta u bol'nykh iazvennoi bolzen'iu zheludka i lukovitsy dvenadtsatiperstnoi kishki.

A total of 42 patients with gastric ulcer and ulcer of the duodenal bulb were investigated. A decrease in the blood concentration of STH and cortisol, high indices of gastric acidifying function in the 2nd hour after insulin administration were noted in the patients with gastric ulcer indicating a decrease in the trophic influence of the hormones of the hypophysis-adrenal system on the GI tract, on the one hand, and raised sensitivity of parietal cells to the effects of this system, on the other hand. In the patients with duodenal ulcer the blood levels of STH and cortisol did not change, indices of gastric acidifying function within the 1st hour after insulin administration were higher than during the 2nd hour indicating an important role of the vagus nerve hypertonicity in the pathogenesis of this disease.