[CLINICAL CASE OF COMBINATION OF PRIMARY SCLEROSING CHOLANGITIS WITH NONSPECIFIC ULCERATIVE COLITIS IN TWINS MONOZYGOTIC].

The article presents discussion of basic hypotheses of pathogenesis of primary sclerosing cholangitis (PSC): genetically conditioned pathology, autoimmune pathology, result of inflammatory reaction in bile ducts, cholangiopathy. The authors presents a clinical case of monozygotic twins with association of PSC and nonspecific ulcerative colitis (NUC). The first twin had a severe course of PSC and mild course of NUC; he died due to bacterial complications of cholangitis. The second twin--patient B--had an opposite situation: severe course of NUC, while PSC was suspected only after determination of cholestasis biochemical markers. As soon as cholestasis was revealed, patients B was treated with Ursofalk and Budenofalk (2001). He received Salofalk as a remedy of basic therapy for NUC. Repeated liver biopsy (2005) showed no progression of PSC, but there were present minimal biochemical signs of cholestasis. So, it is necessary to investigate the first degree relatives of patients with PSC. The timely administered treatment in some cases gives the possibility of the control of the disease course.

[Cholestasis and pancreatic insufficiency: how to start treatment?].

The article presents a detailed analysis of pathogenesis and clinical manifestation of secondary pancreatic excretory insufficiency due to disorders of bile production and choleresis. Pathogenesis of hepatogenic (chologenic) pancreatic insufficiency considered in view of impairment of bile acids' different functions in cholestasis. Authors review pathology of liver and bile ducts resulted in steatorrhea. It was conducted pathogenetic substantiation treatment tactics of patients, which have a combination of cholestasis and secondary pancreatic insufficiency.

[Pancreatitis in intestinal diseases].

In article review of the literature and own data about pathogenesis of pancreatitis and secondary pancreatic insufficiency in various diseases of small and large intestines is presented. The special attention is given to pancreatic insufficiency in celiac disease and in inflammatory bowel disease. The main directions of pancreatitis and exocrine pancreatic insufficiency therapy are grounded.

[Antibiotics in pancreatology: pros and contras].

The problems of antibioticotherapy in patients with pancreatic diseases and pancreonecrosis in the first place, are discussed in the article in detail. The paper covers the indications and contraindications, as well as the most preferable classes of antibiotics according to bacterial flora present. The authors have developed a classification of medications as possible agents provoking pancreatitis.

[Clinical and pathogenetic significance of the euphylline-calcium test for direct analysis of the exocrine secretory function of the pancreas in chronic relapsing pancreatitis]. / Kliniko-patogeneticheskoe znachenie éufillin-kal'tsievogo testa dlia priamogo issledovaniia vneshnesekretornoi funktsii podzheludochnoi zhelezy pri khronicheskom retsidiviruiushchem pankreatite.

The authors improved the probe assay of the pancreas: an original euphylline-calcium test was developed. The examination is informative and safe in the diagnostics of the chronic relapsing pancreatitis. A number of advantages of the optimized method of diagnostics before the traditional ones, including the secretin-pancreazimin test, were proven.