[Disturbed absorptive function of small intestines in patients with chronic obstructive pulmonary disease].

The study included 93 patients (mean age 56.8+/-7.2) with COPD; 22 presented with grade 1 COPD, 36 and 35 with grade II and 111 COPD respectively. The latter group displayed reduced absorption of fats, proteins, and carbohydrates in the small intestine, the degree of dysfunction increasing with the severity of the disease, degenerative/dystrophic changes in intestinal mucosa, and deterioration of its regenerative potential. The data obtained are interpreted in the context of the relationship between the functional/structural properties of intestinal mucosa and clinical manifestations. The body mass deficit in COPD patients was shown to positively correlate with the reduction of absorption of fats (r=0.55), proteins (r=0. 71), and carbohydrates (r=0.48) in the small intestine.

[The clinical and functional status of the stomach and small intestine in patients with chronic inflammatory bowel diseases concurrent with chronic opisthorchiasis].

To study the impact of Opisthorchis infestation on the upper digestive tract and small bowel in chronic inflammatory bowel diseases, the authors examined 164 patients with inflammatory bowel diseases, including 71 patients with ulcerative colitis and 45 with Crohn's disease without parasitosis and 48 with chronic opisthorchiasis (31 with ulcerative colitis and 17 with Crohn's disease). A control group consisted of 20 healthy individuals and 20 patients with chronic opisthorchiasis. A diagnosis was established by colonofibroscopy and a morphological study of colonic biopsy specimens. Gastric mucosal atrophic changes and motor evacuatory disorders as duodenogastric reflux were significantly more frequently encountered in inflammatory bowel diseases concurrent with chronic opisthorchiasis. The presence of Opisthorchis infestation significantly worsened fat and carbohydrate malabsorption in the small bowel in inflammatory bowel diseases.

[Circulating leptin and the trophological status of patients with chronic obstructive pulmonary disease].

AIM: To study the specific features of the nutritional status of patients with persistent chronic obstructive pulmonary disease (COPD) in relation to the hormone-regulating function of energy exchange in terms of leptin and to concurrently evaluate the functional status of fat and protein digestion and absorption and to measure body fat percentage. To assess the influence of these factors on the regulation of the serum concentration of leptin and its potential role in the development of trophological insufficiency in patients. SUBJECTS AND METHODS: In 93 patients with COPD (Stages I, II, and III in 22, 36, and 35 patients, respectively, the nutritional status was evaluated by somatometric methods. The concentration of leptin was measured by enzyme immunoassay using a test system (DSL, USA). Absorption was estimated by biochemical studies and by using radionuclides. Body fat content was determined, by measuring bioelectric impedance with an OmRon BF-302 apparatus (Japan). RESULTS: Protein and fat absorption was decreased in patients with moderate and mainly severe COPD as compared with that in the control group and correlated with body weight deficit and lower body fat percentage. Decreased leptin levels were detected in Stages II-III COPD and correlated with the degree of the disease and reduced protein (r = 0.68 +/- 0.02) and fat (r = 0.64 +/- 0.18) absorption. CONCLUSION: Protein and fat absorption impairments correlating with body weight deficit in patients with COPD underline the significant role of this mechanism in the development of trophological insufficiency. In COPD patients with trophological insufficiency, the lower circulating leptin levels that correlate with impaired absorption of fatty acids and protein characterize the pathogenetic role of secondary malabsorption syndrome in leptin-mediated impairments of energy exchange mechanisms. Functional insufficiency of the hormone-regulating mechanism responsible for energy exchange in terms of leptin in patients with Stages II-III COPD gives warning of the insufficient stock of adipose tissue and its reduced energy reserve.

[Exocrine function of the pancreas in patients with ulcerative colitis].

Fecal elastase-1 was measured in 38 patients with ulcerative colitis to evaluate the functional state of pancreas by enzyme immunoassay with the use of monoclonal antibodies. It was shown that absolute and relative fecal elastase-1 levels in patients with chronic inflammatory intestinal disorders significantly decreased with increased severity of the disease.

[Trophologic insufficiency and absorptive function of small intestine in patients with chronic obstructive pulmonary disease].

The study included 93 patients with grade 1-3 chronic obstructive pulmonary disease (COPD) in the stable clinical phase. Absorptive function of the small intestine was evaluated by biochemical methods and with the use of radionuclides; plasma tumour necrosis factor-alpha (TNF-alpha) levels were measured by an enzyme immune-assay. Trophologic status in 44% of the patients with COPD was unaltered whereas 14% had an excessive body weight. Trophologic insufficiency (TI) was diagnosed in 42% of the patients. Severe TI or cachexia occurred in 5.4% of the patients and only in severe COPD. Impaired absorptive function of the small intestine documented in moderately-severe and severe phases of COPD correlated with the severity of the disease. There was close relationship between body weight deficit and reduced protein absorption (r = 0.77 +/- 0.09). The presence and progress of TI correlated with the magnitude of increment of plasma TNF-alpha. The level of TNF-alpha in patients with COPD and cachexia was 7.8 times its normal value. Elevated plasma TNF-alpha concentration positively correlated with body weight deficit (r = 0.77 +/- 0.12). Also, significant direct correlation was found between the rise in TNF-alpha concentration in patients with COPD and TI and enhanced excretion of fat measured by the method of Van de Kamer (r = 0.56 +/- 0.12), albumin (r = 0.78 +/- 0.12), and d-xylose (r = 0.46 +/- 0.12). It is concluded that impaired absorption of fats, proteins, and carbohydrates in the small intestine plays an important role in the mechanisms underlying the development of trophologic insufficiency in patients with moderately-severe and severe phases of COPD.

[The diagnostic value of the detection of hepatic fibrosis serum markers in chronic viral hepatitis].

The diagnostic significance of serum markers of fibrosis was investigated in 92 patients with chronic viral hepatitis (CVH) by studying the collagenolythic activity of blood, proteasic inhibitor activity, collagen metabolism products (oxyproline fraction), and fibronectin. At the same time, the patients underwent puncture biopsy of the liver, which made it possible to determine the degree of process activity and the stage of its chronization. As the degree of fibrosis grew, the collagenase serum activity increased significantly, while the alpha1-proteinase inhibitor activity fell, the content of oxyproline (its fractions) increased, and the fibronectin level decreased. Hence, the measurement of the noted parameters allows for noninvasive diagnostics of CVH stages.

[Combined treatment with reaferon and iodantipirin in patients with chronic viral hepatitides B and C].

AIM: To examine clinical efficacy of combined therapy with reaferon and iodantipirin in patients with chronic hepatitis B and C of moderate activity. MATERIAL AND METHODS: 100 patients with confirmed diagnosis of chronic viral hepatitis (CVH) at the stage of replication. All the patients have undergone puncture biopsy of the liver with estimation of index of histological activity Knodell and index of fibrosis Desmeth. RESULTS: Comparative evaluation was made of clinical efficacy of combined therapy reaferon + iodantipirin and monotherapy with reaferon in 100 patients with moderate activity CHB and C. CONCLUSION: Conventional scheme with reaferon turned out less effective than the above combination therapy.

[Metabolic aspects of the prediction of outcome in chronic viral hepatitis].

The researchers evaluated the condition of lipid peroxidation and antioxidant protection system together with biochemical, immunological and morphological values in 117 patients with chronic hepatitis (CH) in virus replication phase (28 patient had CH type B, 66--CH type C and 28--CH type B+C), and estimated the importance of their interrelations to the prediction of disease outcomes.

[The specific features of the course of chronic viral hepatitis concurrent with chronic opisthorchiasis]. / Osobennosti techeniia khronicheskogo virusnogo gepatita pri sochetanii s khronicheskim opistorkhozom.

A hundred and one patients with chronic viral hepatitis (CVH) in the phase of replication were examined. Group 1 comprised 53 patients with CVH in combination with chronic opisthorchiasis. Group 2 (a comparison group) included 48 patients with CVH without opisthorchiasis. According to the etiology of hepatitis, each group was divided into 3 subgroups: subgroups 1a and 2a consisted of patients with CVHB; 1b and 2b included those with CVHC, and 1c and 2c comprised those with CVHB+C. The clinical, functional, and morphological status of the liver was studied and hepatic tissue was qualitatively and quantitatively assessed in all the examinees. The findings suggest that Opisthorchis is an additional factor that aggravates hepatic damage in patients with CVH in the replicative phase of infection.

["Hematological masks" of chronic viral hepatitis]. / "Gematologicheskie maski" khronicheskogo virusnogo gepatita.

AIM: To reveal the structural features of the red blood cell membrane in patients with prolonged persistence of hepatitis B virus (HBV) and hepatitis C virus (HCV). MATERIALS AND METHODS: 61 patients with moderate and mild chronic viral hepatitis B and C were examined. A control group comprised 22 healthy donors. Fluorescence of the red blood cell membrane was performed, by using the following probes: pyrene, phenylnaphthylamine, 1-anilinonaphthalene-8-sulfonate. The activity of the ion-transporting enzyme Na+, K(+)-ATPase was determined. RESULTS: Increases in the microviscosity of the lipid bilayer, periprotein lipid environment, as well as the structural modification of the surface layers of the membrane were found in patients with chronic hepatitis B and C. The activity of the membrane-bound enzyme Na+, K(+)-ATPase was statistically significantly decreased as compared with that in healthy donors. CONCLUSION: In HBV and HCV infection, the impairments of the red blood system are highly diversified: they involve bone marrow compartment of an erythron, as earlier shown, and its peripheral one. Molecular disorganization of the red blood cell membrane fails to present with obvious red blood cell dysfunctions. Despite the multifactorial property of their occurrence, impairments of the red blood system are mediated and corrected by many regulatory mechanisms at different organizational levels and may be compensated.