[The clinical and pathogenic significance of the chronic specific infection in the gastroenterology].

As a result of the integrative evaluation of clinical and laboratory results of 610 patients with pathology of the digestive system, which was accompanied with the chronic specific infection (CSI) such as VHA, VHE, VHB, VHC, VHD, GB, F, TTV, SEN; types I and II herpes virus, cytomegalovirus, toxoplasmosis. The conception of the systemic polyglandulopathy was formulated. The authors have analyzed some pathogenic mechanisms and clinical pecularities of the chronic specific infection in patients with the diseases of the digestive system and the principles of the diagnosis and complex treatment were proposed.

[The ultrasonic diagnosis of the phasic interdigestive activity of the pancreas and the main pancreatic duct in healthy subjects and chronic pancreatitis patients]. / Ul'trazvukovaia diagnostika faznoi mezhpishchevaritel'noi aktivnosti podzheludochnoi zhelezy i glavnogo pankreaticheskogo protoka u zdorovykh i bol'nykh khronicheskim pankreatitom.

Sixteen healthy subjects and 113 patients with chronic pancreatitis were studied for ultrasonic dynamics of phase interdigestive activity of pancreas and calibre of the main pancreatic duct (MPD). Both in healthy individuals and patients, the gland sizes and MPD calibre change with phases of interdigestive motility of duodenum. The largest sizes in healthy subjects are found in phase 2 irregular contractions of duodenum, the least ones--in patients with grave disease course. This is an important differential and diagnostic criterion between chronic pancreatitis and normal functional state of pancreas corresponding to a certain phase of interdigestive motility of duodenum. Phase-dependent sizes of pancreas and MPD calibre are to be taken into account in conducting ultrasonography of pancreas and interpretation of the results obtained.

[The ultrasonic diagnosis of the interdigestive phase motility of the gallbladder in healthy subjects and duodenal peptic ulcer patients]. / Ul'trazvukovaia diagnostika faznoi mezhpishchevaritel'noi motoriki zhelchnogo puzyria u zdorovykh i bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

The contractile function and tone of the gallbladder were studied under basal conditions with regard to phases of interdigestive motility of duodenum in 100 patients with duodenal ulcer and 20 healthy controls. It has been ascertained that in healthy subjects and patients with ulcer disease, the gallbladder tends to function in a manner consistent with phases of interdigestive motility of duodenum. Patients with ulcer disease show hypermotoric dyskinesia of the gallbladder and biliary tract evidenced by diminution of its capacity as well as by hypertonicity. It is necessary that ultrasonics to study the gallbladder be used with regard to phases of the interdigestive motility of duodenum, the latter consideration being important in studying the gallbladder's motor function. The most significant results are obtainable during the second phase of duodenal irregular contractions (2 phases).

[The interdigestive motility of the gallbladder in patients with gastric and duodenal peptic ulcer]. / Mezhpishchevaritel'naia motorika zhelchnogo puzyria u bol'nykh iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

As many as 30 patients with uncomplicated ulcer disease and 8 essentially healthy individuals were studied for the tone and contractile function of the gallbladder under basal conditions with regard to the phases of duodenal interdigestive motility. In normals, the gallbladder functions according to phases of duodenal interdigestive motility while the clinical picture in those patients with ulcer disease is distinguished by predominance of hypermotor dyskinesia of the gallbladder and bile tract, which fact is manifested by reduction of its capacity as well as hypertone and discordant work of Lütken's--and Oddi sphincters leading to untimely and incomplete outgo of the bladder bile. Ultrasonic investigation of the gallbladder is to be carried out with due regard to its phase-associated interdigestive motility.

[The clinical significance of phasic duodenal intubation and ultrasonic monitoring of the gallbladder in healthy subjects]. / Klinicheskoe znachenie pofaznogo duodenal'nogo zondirovaniia i ul'trazvukovogo monitoringa zhelchnogo puzyria u zdorovykh lits.

Overall twelve essentially healthy subjects were evaluated for the tone and contractile function of the gallbladder according to phases of interdigestive motility of duodenum as were for effects on these functions of phase-by-phase administration of 30 ml of 33% solution of magnesium sulphate. The gallbladder in healthy individuals was found out to function according to phases of duodenal interdigestive motility and be ready to evacuate bile during phase II. Prior diagnostic techniques did not take advantage of interdigestive phase of duodenal and gallbladder motility during which phase a standard stimulating agent was routinely employed. This can lead to wrong diagnosis of the functional state of the biliary tract, gallbladder and their sphincters in the interdigestive period: incomplete gallbladder emptying from bile in case the stimulating agent is being introduced during phase I or III; hyperdiagnosis of cholecystitis; heterodirectivity of the same patient's notion about type of dyskinesias of the gallbladder and biliary tract.

[The interdigestive phasic motility of the gallbladder and bile excretion in healthy subjects and in patients with duodenal peptic ulcer]. / Mezhpishchevaritel'naia faznaia motorika zhelchnogo puzyria i ékskretsiia zhelchi u zdorovykh i bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

Interdigestive phasic motility of the gallbladder and bile excretion into the duodenum were studied in 100 patients with duodenal ulcer (DU) and 20 healthy subjects. Gall bladder motility and bile excretion in both healthy and DU subjects directly depended on interdigestive phasic activity of the duodenum and gastric antrum. In health, gallbladder volume reached its maximum within termination of phase II, minimum in the end of phase III-beginning of phase I. Maximal bile production occurred at phase II-III and coincided with pH decline in the stomach. The mixture of the vesicular and duct bile flowed out in the end phase III-beginning of phase I. The range of volumetric bladder contraction made up 33% of its capacity. In DU patients this reached 35%, the bladder capacity was reduced, the maximum bile production occurred at phase II, bile flowed out intermittently, its color changed from achromatic to dark yellow. The latter fact suggests hypertensive and hypermotor dyskinesia of the gallbladder as well as its sphincter system and bile duct functional impairment. This requires adequate therapeutic correction with consideration of relevant motor and secretory disturbances.

[Determining the level of the tumor marker--neuron-specific enolase in patients with neoplastic and non-neoplastic diseases]. / Opredelenie opukholevogo markera--neirospetsificheskoi enolazy u bol'nykh s opukholevymi i neopukholevymi zabolevaniiami.

Radioimmunoassay was employed to measure serum levels of neuron-specific enolase (NSE) in 38 lung cancer patients, 20 patients with noncancer pulmonary lesions and 10 healthy donors. An average NSE level (92.8 +/- 18.7 micrograms/l) in small cell carcinoma (10 patients) was significantly higher (p less than 0.01) than in control, nonmalignant pulmonary diseases, squamous cell and adenocarcinoma. Sensitivity and specificity of the tumor marker to small cell carcinoma reached 80 and 95%, respectively. NSE serum test may serve an additional tool in differential diagnosis of small cell carcinoma of the lung.

[The combined radionuclide diagnosis of rectal cancer recurrences]. / Kompleksnaia radionuklidnaia diagnostika raka priamoi kishki.

Of 153 patients with confirmed rectal cancer CEA was recorded in 139 (90.8%); erroneous results were noted in 14 (9.2%) patients; in scintigraphy with 67Ga-citrate and 111In-bleomycin diagnoses coincided in 147 (96.1%) patients, and false-negative results were noted in 6 (3.9%) patients. During the investigation 16 patients who had undergone radical operation with any signs of recurrence and 36 patients with suspected tumor recurrence, scintigraphic false-positive results were observed in 12.5 and 30.6% patients, and a false-positive increase in the CEA titer was observed in 12.5 and 11.1%. Of 11 patients with false-positive scintigraphic results a rise of the CEA level was noted in 2 cases making it possible to rule out with a great degree of assurance the presence of a recurrent tumor. The results obtained suggest the appropriateness of the combination of these methods to improve the diagnosis of rectal cancer recurrences.

[Radioimmunological determination of tumor markers in the diagnosis of recurrences of rectal cancer]. / Radioimmunologicheskoe opredelenie opukholevykh markerov v diagnostike retsidivov raka priamoi kishki.

The levels of tumor markers were determined in 173 patients with rectal cancer recurrences by radioimmunoassay. An increase in a CEA level was observed most frequently (92.5%). An increase in the levels of alpha-fetoprotein, ferritin and beta 2-microglobulin was observed in 61.7, 56.6 and 46.3%, respectively. CA-19-9, a carbohydrate antigen, was of no importance for the detection of cancer of this site, and an increase in its titer was observed in 15.5% only. Thus the most specific and effective diagnostic test for the diagnosis of rectal cancer recurrences is the determination of a CEA level.

[Characteristics of hormonal homeostasis in children with thymus enlargement syndrome]. / Osobennosti gormonal'nogo gomeostaza u detei s sindromom uvelicheniia vilochkovoi zhelezy.

Hormonal homeostasis was examined in 104 children aged 1 to 14 years with thymus enlargement. There was a significant growth of somatotropic hormone in children of the first 3 years of life, characterized by thyroid dysfunction and hypofunction increase with age, by a tendency towards ACTH and hydrocortisone lowering under 6 years of age, and a significant decrease of those parameters in children over 6 years. The children with thymus enlargement also showed other disorders of hormonal homeostasis.

[Carcinoembryonic antigen in the evaluation of the effectiveness of surgical treatment in cancer of the rectum]. / Kartsino-émbrional'nyi antigen v otsenke éffektivnosti khirurgicheskogo lecheniia raka priamoi kishki.

The carcinoembryonic antigen content (CEA) was studied in 163 patients who had been subjected to surgical treatment. The content of antigen in blood plasma was determined by the radioassay. It is shown that a high pre- and postoperative CEA level may be indicative of the spread of the neoplastic process, nonradical character of the treatment, and an unfavourable prognosis.

[Carcinoembryonic antigen in multiple primary cancer of the colon]. / Rakovo-émbrional'nyi antigen pri pervichno-mnozhestvennom rake tolstoi kishki.

The paper is concerned with analysis of CEA indices in 43 patients with multifocal colon cancer (22 with synchronous and 21 with metachronous colon cancer). The level of CEA was elevated in the group of patients with metachronous cancer in 85.7%, in the group of patients with synchronous cancer in 90.9%, and in the entire group of colon cancer patients in 88.4%. No correlation between the level of CEA and the presence of the second (third of more) tumor simultaneously was not revealed. CEA can be used as a test for diagnosis of recurrences and metachronous colon cancer during a follow-up of patients subjected to radical treatment for a primary colon tumor.

[Determination of carcinoembryonic and carbohydrate antigens in the diagnosis of recurrences and metastases of rectal cancer]. / Opredelenie rakovo-émbrional'nogo i uglevodnogo antigenov v diagnostike retsidivov i metastazov raka priamoi kishki.

A study was made of the results of measuring the carcinoembryonic and carbohydrate antigens using a kit of reagents in 75 patients with rectal cancer recurrences and metastases. The concentration of these antigens in healthy persons was for CEA 6.4 +/- 0.71 micrograms/l, the carbohydrate antigen--19.6 +/- 2.51 units/ml. In this group of patients rectal cancer local recurrence was found in 52, metastases to the liver in 19 and metastatic involvement of the liver and lungs in 4. An elevated level of the CEA was detected in 92.8% of the patients with cancer recurrence (the mean concentration was 99.9 +/- 9.29 micrograms/l), and in 100% of the patients with metastases (the mean concentration was 193.4 +/- 30.42 micrograms/l). The content of the carbohydrate antigen in cancer recurrences was raised in 21.3% of the cases only, in metastases to the liver in 31.6% and in 2 patients with metastatic liver and lung involvement. Thus, measuring the CEA content turned out to be the most specific and sensitive test for the diagnosis of rectal cancer recurrences and metastases. The use of the carbohydrate antigen for this purpose was found ineffective.

[Radioimmunologic determination of beta 2-microglobulin and carcinoembryonic antigen in the diagnosis of recurrences of rectal cancer]. / Radioimmunologicheskoe opredelenie beta 2-mikroglobulina i rakovo-émbrional'nogo antigena pri diagnostike retsidivov raka priamoi kishki.

The paper is concerned with the results of the determination of beta 2-microglobulin (beta 2-MG) and CEA concentrations in rectal cancer patients to improve diagnosis of recurrences. The CEA content was shown to be the most specific indicator reflecting the course of a recurring tumor process whereas the beta 2-MG test was found inappropriate for the purpose though it might be used in suspected involvement of the urinary organs in a tumor process.

[Disorder of thyroid function in patients with cancer of the gastrointestinal tract]. / Narushenie tireoidnogo statusa u bol'nykh rakom organov zheludochno-kishechnogo trakta.

A quantitative assessment of T3 pool was performed in patients with malignant tumors of the esophagus, stomach, pancreatic head, rectum and colon as well as in patients with chronic gastritis, peptic ulcer and benign stomach tumors. A high T3 pool deficiency was noted in patients with malignant GIT tumors. It was assumed that such a deficiency was indicative of profound disorder of hormone supply of tissues which could be regarded as an endogenous factor of predisposition to the development of malignant neoplasms.

[Tumor markers in rectal cancer]. / Opukholevye markery pri rake priamoi kishki.

The paper is concerned with an assay of tumor markers in rectal cancer patients. The carcinoembryonic antigen has been shown to be the most specific marker characterizing the degree of tumor dissemination, particularly in metastatic liver lesion. Preliminary results suggest a possibility of the use of the determination of the ferritin level for this purpose whereas the use of the marker like alpha-fetoprotein in this group of patients is not desirable.