[Quantitative characteristics and specific features of the echographic pattern of the liver and biliary area in opisthorchiasis of a hyperendemic focus].

One hundred and twenty-three patients from a hyperendemic focus underwent ultrasound study. The anteroposterior size of the liver, the thickness of the wall of the gallbladder and the nature of its contents, the diameter of common bile ducts and portal vein, additional morphological changes in the architectonics of the liver and biliary ducts were determined. Examinations have established that ultrasound study is a technique determining the characteristic signs that are pathognomic to moderate and severe invasions--cholangiectases (predominant localization in the second segment of the liver), a significant increase in the anterioposterior size of the liver and an change in the parenchyma of the organ, the thickening of the wall of the gallbladder, an change in its content (at the expense of sediments, flocculi, waxes, and concretions), and an increase in the size of the intrahepatic and common bile ducts.

[Hepatic cell transformation changes in experimental opisthorchiasis].

Changes in the liver where Opisthorchis felines (Rivolta, 1884) parasitizes were traced by light and transmission electron microscopies on experimental models (gold hamsters) of acute and chronic opisthorchiasis. Regenerative processes, such as hepatic epithelial mitotic indices, binucleated, hypertrophic hepatocytes, were determined; the composition of infiltrates was identified; fibroplastic changes and hepatocytic apoptotic index were traced. The progression/regression (P/R) ratio was used to detect atrophy of a hepatic parenchymatous component (hepatocytes) in different periods (from 3 to 120 days) of invasion. In opisthorchiasis, proliferation of committed hepatocytes was first found on day 10 of invasion. Oval (committed) cells are differentiated mainly to cholangiocytes, followed by the formation of ductular structures; the committed cells of the liver may be simultaneously a source of programmed hepatocellular differentiation; however, the newly formed hepatocytes are solitary amongst them in opisthorchiasis.

[Opisthorchiasis in the Ob-Irtysh river basin: etiology and pathogenesis].

Opisthorchiasis in the hyperendemic focus (Ob-Irtysh river basin) is considered to be a co-member of parasitocenosis: opisthorchiasis + methorchiasis and to have a superinvasive form. The symbiotic flora and O. felines metabolites are an etiopathogenetic flora. Scientific evidence is provided for the recurrent forms ofopisthorchiasis; the authors consider it to be the type of superinvasive opisthorchiasis, in which some portion of parasites in microballs unexposed to antheminthics further mature to maritae.

[Molecular genetic approaches in parasitology (in case of opisthorchiasis)].

Light, electron microscopy, polymerase chain reaction (PCR), and immunohistochemistry were used to reveal the proliferative, alterative processes of hepatic parenchymal cells, P 53, K-ras, B-raf, c-Kit, p 16, APC, immunoreactive proteins Ki-67, cytokeratins 9, 14, 20, EMA, c-erb B-2, CD-117, mutated p 53 and bcl-2 genes. P53, K-ras, B-raf, c-Kit, and p 16 gene mutations were detected in the liver of animals with experimental superinvasive opisthorchiasis (SO) and cholangiocellular carcinoma (CCC). Mutations of these genes were found in the plasma samples taken from SO patients. The CCC tissue from SO patients displayed expression of the following genes: p 53 (100.0%), p 53+B-raf (50.0%), K-ras+c-Kit (33.3%), K-ras+B-rafat more than 5 cm from the tumor in 2 cases. Following 2 years, target therapy (canglait, megamin, immunomodulators) leveled mutations in 91.25% of the patients with SO.

[The clinical features and the structural and functional status of the liver in chronic viral hepatitis B concurrent with superinvasion opisthorchiasis].

Clinical manifestations of chronic viral hepatitis B (CVH-B) in replicative phase in patients with superinvasive opisthorchosis comprise the asthenic-vegetative syndrome, pain syndrome, dyspepsia (53.3% of cases) and hepatomegaly (46.7% of cases). Superinvasive opisthorchosis, when combined with CVH-B, stimulates the cytolysis of hepatocytes and the intensity of inflammation; it also shapes the fibrosis of the liver, which complicates the course of viral infection and its outcome.

[N-nitrosodiethylamine-induced changes in the liver of syrian hamster with superinvasive opistorchiasis]. / Izmeneniia v pecheni khomiachkov, indutsirovannye n-nitrozodiétilaminom pri superinvasionnom opistorkhoze.

Trematoda O. felinius-induced hepatic lesions were investigated in Syrian golden hamsters with superinvasive opistorchiasis. One hundred hamsters were divided into 4 groups: (1)--control; (2) N-nitrosodiethylamine (DENA), i.p., twice a week, 3 weeks, total dose 72 mg/kg; (3) metacercariae O. felinius, with drinking water, 3 injections per day, once in 2 weeks, and (4) metacercariae O. felinius, as in group 3, followed by DENA, as in group 2. Animals were sacrificed 12 months after the beginning of the study. No changes in the liver were found in group 2. Reddish protrusions, up to 4 cm in diameter, appeared on liver surfaces in groups 3 and 4. Group 4 featured the highest relative and absolute weights of liver as well as clusters of oval cells and cholangiocellular tubules and cholangiofibrosis (in group 3, they were less visible). Electron microscopic examination identified hepatocytes with destructive changes to plasmalemma, nucleus and cytoplasmic organelles. Also, perisinusoidal cells (Ito cells) occurred. Tumor-bearing animals showed low hepatic cytochrome P-450. It is suggested that proliferative growth in the liver was stimulated by opistorchis invasion.

[Cardiac syndrome in opisthorchiasis]. / Kardial'nyi sindrom pri opistorkhoze.

According to the intensity and duration of invasion, superinvasion opisthorchiasis in laboratory animals and human beings involves all cardiac layers; the myocardium is mostly damaged. In its early phase, vascular inflammation of the microcirculatory bed, dystrophy, necrosis of striated muscle fibers progressing to diffuse cardiosclerosis result from abnormal immunological processes; due to reflex exposures (Botkin's syndrome), there may be persistent cardialgias that may progress to the clinical manifestations of chronic ischemic heart disease. Unpredictable dissipative clusters of metabolic Opistorchis may predispose to different forms of myocarditis progressing to focal and diffuse cardiosclerosis. In these cases, the death of patients with superinvasion opisthorchiasis results from acute or chronic heart failure. Dehelmintization in these patients fails to eliminate myocardial changes (cardiosclerosis) that further determine the clinical presentation of cardiac pathology.

[The course of trichinosis in patients with superinvasion opisthorchiasis]. / Techenie trikhinelleza u bol'nykh superinvazivnym opistorkhozom.

An analysis of the clinical course of trichinosis in the presence of superinvasion opisthorchiasis is indicative of the prognostic value of the time course of changes in eosinophilia in patients: its gradual amelioration during a complex treatment suggests that there is a positive tendency for recovery from the disease; a drastic fall in the level of eosinophils is constantly accompanied by a more severe course of parasitic cenosis with inflammatory complication and a possible fatal outcome. In trichinosis concurrent with superinvasion opisthorchiasis, myocarditis constantly develops at weeks 3-4 of the onset of nematodosis. Prior myocardial changes (focal and diffuse cardiosclerosis) should be considered to be a complication due to superinvasion opisthorchiasis. Trichinosis accompanied by Opisthorchis invasion substantially deteriorates the course of the underlying disease, chronic alcoholic intoxication exalts the course of parasitic cenosis.

[Duodenogastroesophageal reflux disease as a complication of superinvasion opisthorchiasis]. / Duodenogastroézofageal'naia refliuksnaia bolezn' kak oslozhnenie superinvazionnogo opistorkhoza.

In patients with superinvasion opisthorchiasis of prolonged invasion, 84% develop duodenal hypertension, 94% of the patients are found to have gastric hypertension; duodenogastric reflux with formation of chronic gastritis and reorganization is revealed in 75%. Reflux of gastric contents into the esophagus gives rise to chronic eosophagitis, regurgitation of intestinal contents into the pancreatic duct is a cause of chronic indurative pancreatitis of the head of the gland. In cases of duodenal hypertension, the rates of pancreatic O. felineus invasion are as high as 93.7%.