[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.

[A comparative assessment of gastric secretory function using a probe method and intragastric Ph-metry]. / Sravnitel'naia otsenka sekretornoi funktsii zheludka, izuchaemoi zondovym metodom i intragastral'noi Ph-metriei.

To compare informative value of probing and intragastric pH-metry, relevant examination was performed in 130 patients with chronic gastritis, 132 patients with noncomplicated peptic ulcer and 50 healthy subjects. pH values obtained with probing and intragastric pH-metry did not differ significantly in defects of gastric mucosa, superficial gastritis, peptic ulcer. In apparent atrophic gastritis intragastric pH-metry detected minimal secretion of H ions in all the patients, whereas probing failed to show it. Intragastric pH-metry is useful in recognizing duodenogastric reflux and decompensated acid stomach as shown by antral basal pH (below 2.0).