Comorbid for gastroduodenal ulcers in the aspect of calcium imbalance and blockers of slow calcium channels in their treatment.

AIM: Find out the calcium content of the blood reflecting its balance and functional status the calcium regulatory system when it is comorbid for gastroduodenal ulcers (GDU), developed on the background of chronic erosive gastritis (CEG), chronic erosive duodenitis (CED), arterial hypertension (AH) and osteo-articular pathology with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and the impact of his changes on the activity ulzerogennogo process, the state of regional microcirculation and the functions of the stomach. To determine the pathogenetic justification for and effectiveness of blockers of slow calcium channels (BSCaC) in complex treatment. MATERIALS AND METHODS: Examined 132 patients with GDU. All patients were divided into groups: the 1st (n=49) - patients with recurrent of peptic ulcer disease (PUD) and CEG/CED; the 2nd (n=23) - with recurrence of PUD and AH, the 3rd (n=14) - with GDU and osteoarticular pathology, taking NSAIDs. Patients of these three groups for the treatment of erosive ulcerous lesions of gastroduodenal zone (GDZ) has been appointed complex therapy with inclusion of nifedipine. The 4th (control) group consisted of 56 patients with recurrent BU without concomi- tant pathology, applying integrated therapy with nifedipine. RESULTS: The PU relapse, comorbid her over with erosive gastroduodenitis, hypertension, GDU with of osteoarticular pathology and taking NSAIDs is accompanied by a calcium imbalance with increased levels of calcium in the blood, contributing to increase of acid-peptic factor in the formation of hypermotor dyskinesia stomach, disruption of regional microcirculation and repair processes, activa- tion of ulcerogenesis in GDZ. Inclusion in the complex therapy of GDU of nifedipine leads to the recovery of calcium balance, functions of the stomach and regional mi- crocirculation, accelerates the timing and increases the percentage of scarring ulcers. CONCLUSION: GDU accompanied by dysfunction the calcium regulatory system with increasing levels of blood calcium, contributing to the for- mation of the major pathogenetic mechanisms of ulcerogenesis. BSCaC application in complex therapy of GDU is pathogenetically justified and clinically effective, reduces the excessive drug treatment in the treatment.

Circadian time structure of circulating plasma lipid peroxides, antioxidant enzymes and other small molecules in peptic ulcers.

BACKGROUND: The circadian rhythm, as part of a broad time structure (chronome) of lipid peroxides and antioxidant defense mechanisms may relate to prevention, efficacy and management of preventive and curative chronotherapy. METHODS: Fifty newly diagnosed patients with peptic ulcers, 30-45 years of age, and 60 age-matched clinically healthy volunteers were synchronized for one week with diurnal activity from about 06:00 to about 22:00 and nocturnal rest. Breakfast was served around 08:30, lunch around 13:30 and dinner around 20:30. Drugs known to affect the free-radical systems were not taken. Blood samples were collected at 6-hour intervals for 24h under standardized, presumably 24-hour synchronized conditions. Plasma lipid peroxides, in the form of malondialdehyde (MDA), blood superoxide dismutase (SOD), glutathione peroxide (GPx), glutathione reductase (GR), catalase (CAT) activities, and serum total protein, albumin, ascorbic acid, total serum cholesterol, and HDL-cholesterol concentrations were determined. RESULTS: By population-mean cosinor analysis, a marked circadian variation was demonstrated for all variables in healthy subjects and in ulcer patients (p<0.001). As compared to controls, patients had a lower MESOR of MDA, SOD, GPx, GR, ascorbic acid, and HDL-C. They also had smaller circadian amplitude of SOD, CAT, GPx, GR, ascorbic acid, T-C, and HDL-C, but larger circadian amplitude of MDA and albumin. As compared to healthy subjects, the circadian acrophase of ulcer patients occurred later for MDA and GR and earlier for GPx. CONCLUSION: Mapping circadian rhythms, important chronome components that include trends with age and extra-circadian components characterizing antioxidants and pro-oxidants, is needed for exploring their putative role as markers in the treatment and management of peptic ulcers.

[Calcium and phosphorus balance and its significance for the course of recurrent peptic ulcer disease].

AIM: To evaluate calcium and phosphorus balances during recurrent peptic ulcer disease (PUD) and to estimate the impact of found changes on the course of an ulcerative process, secretory and motor functions in the stomach. SUBJECTS AND METHODS: Sixty patients with recurrent PUD were examined. They underwent determinations of blood and urinary calcium and phosphorus levels and gastric secretory and motor functions in addition to clinical and endoscopic examinations. RESULTS: Recurrent PUD was shown to be accompanied by significantly elevated blood calcium and substantially decreased blood phosphorus, insignificant hypercalciuria and hyperphosphaturia. These changes were attended by considerably increased acid- and pepsinogen-forming functions of the stomach, lower gastromucoprotein production, and gastric hypermotor dyskinesis. More pronounced shifts in calcium and phosphorus balance were revealed in the acute phase of a disease recurrence in young men with duodenal ulcers. CONCLUSION: A clear relationship between calcium and phosphorus metabolic disturbances, ulcerative process activity, and gastric functional changes may point to the significance of found shifts in ulcerogenesis and to the pathogenetic substantiation of correction of these disorders in the treatment of a disease recurrence.

[Correlation between long-term proton pump ingibitor use, homocysteine and lipoproteins serum concentrations in patients with comorbidity of ischemic heart disease and acid peptic disease].

Present article is devoted to the study of the correlation between vitamin B12 serum level, hyperhomocysteinaemia and dyslipidemia. During research there were discovered that the lowest vitamin B12 serum level and the highest homocysteine serum level have been registrated in associated pathology (ischemic heart disease and acid peptic disease according to long-term proton pump inhibitor use) patients. It was shown evident correlation between that changes and dyslipidemia. Тhe complex therapy that includes parenteral B12 supplementation leads to more effective correction of hyperhomocysteinaemia and dyslipidemia in patients with comorbidity of ischemic heart disease and acid peptic disease with long-term use of proton pump inhibitors.

[Calcium-phosphorus ratio in relapse of peptic ulcer disease].

AIM: To determine the metabolism of calcium and phosphorus in the period of peptic ulcer recurrence and to compare it with gastric secretion and motility. MATERIALS AND METHODS: 150 patients with peptic ulcer recurrence were examined. Apart from clinical and endoscopic examinations, the presence of calcium and phosphorus in blood and urine was detected, gastric secretion and motility were determined. RESULTS: It was ascertained that recurrence of peptic ulcer was accompanied by essential increasing of calcium and decreasing phosphorus in blood, insignificant hypercalciuria and hyperphosphaturia. These changes were accompanied by considerable increasing of gastric secretional function, decreasing production of gastromucoproteids and gastric hypermotility. The more significant changes of calcium-phosphorus metabolism were determined in the acute phase of the recurrence in duodenal ulcers in young males. CONCLUSION: The evident connection between the impairment of calcium and phosphorus metabolism, the activity of peptic ulcer and changes in the function of stomach can show the importance of these changes in pathogenesis of ulcer and the validity of therapeutic correction of these changes in case of the recurrence.

[The influence of low-intensive laser therapy on the aggregation properties of thrombocytes in patients with peptic ulcer].

The purpose of the study was to evaluate the influence of low-intensive laser therapy (LILT) on the aggregation properties of thrombocytes in patients with exacerbation of peptic ulcer (PU). The subjects, 111 patients aged 18 to 63, were divided into two groups: the main group (n = 81), and the control group (n = 30). In addition there were 15 healthy people who also underwent examination. Patients in the main group received complex treatment with untiulcer drugs and different methods of laser therapy: intravenous laser irradiation of blood, cutaneous irradiation, and a combination of both. The control group was treated with drugs only. The study found various changes in the aggregation properties of thrombocytes in patients with PU exacerbation, which consisted mostly in hyperaggregation. LILT had a normalizing effect on the aggregation properties of thrombocytes in patients of the main group.

Hypothalamic digoxin, hemispheric chemical dominance, and peptic ulcer disease.

The isoprenoid pathway produces three key metabolites--endogenous digoxin-like factor (EDLF) (membrane sodium-potassium ATPase inhibitor and regulator of neurotransmitter transport), ubiquinone (free radical scavenger), and dolichol (regulator of glycoconjugate metabolism). The pathway was assessed in peptic ulcer and acid peptic disease and its relation to hemispheric dominance studied. The activity of HMG CoA reductase, serum levels of EDLF, magnesium, tryptophan catabolites, and tyrosine catabolites were measured in acid peptic disease, right hemispheric dominant, left hemispheric dominant, and bihemispheric dominant individuals. All the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listening test. The pathway was upregulated with increased EDLF synthesis in peptic ulcer disease (PUD). There was increase in tryptophan catabolites and reduction in tyrosine catabolites in these patients. The ubiquinone levels were low and free radical production increased. Dolichol and glycoconjugate levels were increased and lysosomal stability reduced in patients with acid peptic disease (APD). There was increase in cholesterol:phospholipid ratio with decreased glyco conjugate levels in membranes of patients with PUD. Acid peptic disease represents an elevated EDLF state which can modulate gastric acid secretion and the structure of the gastric mucous barrier. It can also lead to persistence of Helicobacter pylori infection. The biochemical pattern obtained in peptic ulcer disease is similar to those obtained in left-handed/right hemispheric chemically dominant individuals. But all the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listen ing test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Peptic ulcer disease occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function.

[Noninvasive transcranial electrostimulation of endorphin structures of the brain as a reparation activator: experimental and clinical parallels]. / Neinvazivnaia transkranial'naia élektrostimuliatsiia éndorfinnykh struktur mozga kak aktivator reparatsii: éksperimental'no-klinicheskie paralleli.

The authors evaluated the capacities of transcranial electrostimulation and the specific features of its impact on reparative regeneration of damaged tissues of different types, such as the dermal and gastroduodenal epithelium, hepatic cells, connective tissue, peripheral nerve fibers, on animal experimental pathological models and compared with the results of treatment of respective pathology in patients.

The influence of commonly prescribed synthetic drugs for peptic ulcer on the pharmacokinetic fate of glycyrrhizin from Shaoyao-Gancao-tang.

The influence of synthetic drugs prescribed for peptic ulcer on the pharmacokinetic fate of glycyrrhizin (GL) from Shaoyao-Gancao-tang (SGT, a traditional Chinese formulation, Shakuyaku-Kanzo-to in Japanese) was investigated in rats. Co-administration of histamine H2-receptor antagonist (cimetidine) and anticholinergic drug (scopolamine butyl bromide) with SGT didn't influence the area under the plasma concentration-time curves (AUC) of glycyrrhetic acid (GA), an active metabolite derived from GL in SGT. The AUC of GA from SGT were significantly reduced by co-administration of synthetic drugs commonly used for peptic ulcer in a triple therapy (OAM), a combination of a proton pump inhibitor (omeprazole) and two antibiotics (amoxicillin and metronidazole). We found that the reduction of AUC in OAM treatment was due to the antibacterial effect of amoxicillin and metronidazole on intestinal bacteria in rat which lead to the decrease of GL-hydrolysis activity. The present study suggests that it may not be a proper way to use triple therapy containing antibiotics simultaneously with SGT for healing of chronic ulcers.

[Changes in alkaline phosphatase activity and blood phosphorus levels in healthy persons and patients with peptic ulcer]. / Kolebaniia aktivnosti shchelochnoi fosfatazy i soderzhaniia fosfora v krovi zdorovykh i bol'nykh iazvennoi bolezn'iu.

Venous blood total phosphatase activity, its thermostable fraction, and inorganic phosphorus levels were measured thrice within 20-64 min in the course of registration of regular motor activity of the gastrointestinal tract in 38 men aged 18 to 57 (9 healthy and 29 with peptic ulcer). These parameters changed within a wide range over the mentioned period; besides, they depended on the individual features of the organism. Using the chi 2 test at the 5% significance level the authors have demonstrated that total blood alkaline phosphatase activity is increased by the end of a regular cycle in the gastroduodenal system. For more accurate assessment of venous blood total alkaline phosphatase and its thermostable fraction activities and inorganic phosphorus level repeated measurements should be carried out within an hour.

An open trial of long-term therapy with lansoprazole in patients with peptic ulceration resistant to extended high-dose ranitidine treatment.

Forty-two patients with peptic ulceration of the duodenum, stomach or oesophagus, who had not responded to 3 or more months of high-dose treatment with ranitidine (450 or 600 mg/day), were treated with oral lansoprazole at 30-60 mg daily. In 40 patients (95.2%) the ulcers healed within 2-12 weeks. In the remaining 2 patients healing took several months but eventually all ulcers healed. After healing, 40 patients underwent long-term maintenance treatment with 30-60 mg lansoprazole daily for 1-3 years (continuing). During maintenance therapy with lansoprazole, no endoscopically verified relapses occurred when the drug was taken regularly. In 1 patient treatment had to be discontinued because of a drug-related colitis that disappeared soon after treatment had been stopped. There were no significant changes in routine laboratory tests in any patient. Basal serum gastrin concentrations, which were already elevated by the previous high-dose ranitidine treatment (125 +/- 25 pg/ml), rose to four times the normal values after 4 weeks of treatment with lansoprazole (255 +/- 65 pg/ml). Thereafter no further increases in basal serum gastrin concentrations were observed, even after 3 years of administration. The volume density of argyrophilic cells in the oxyntic mucosa increased slightly during lansoprazole treatment; until now no dysplasia of the enterochromaffin-like cells has been observed. In conclusion, 30-60 mg lansoprazole daily healed ranitidine-resistant peptic ulcers, and subsequent maintenance therapy with 30-60 mg lansoprazole daily was found to be highly effective and safe over the time observed.

[The effect of microwave resonance therapy and hypnotherapy on the links in the pathogenesis of peptic ulcer]. / Vliianie mikrovolnovoi rezonansnoi terapii i gipnoterapii na nekotorye zven'ia patogeneza iazvennoi bolezni.

Results of a study are reported of a study of the concentration of biologically active substances such as histamine, serotonin, noradrenaline, adrenalin, corticotropin and indices of gastric secretion in ulcer disease patients at the stage of exacerbation receiving microwave resonance therapy and hypnotherapy. The obtained results evidence that hypnotherapy and microwave resonance therapy are pathogenetic methods of treatment of patients with ulcer disease. Combined treatment proved more effective.

Inter-relationship between serum gastrin levels, gastric mucosal histology and gastric endocrine cell growth.

The development of gastric enterochromaffin-like (ECL)-cell hyperplasia in humans may be associated with extreme hypergastrinaemia, as occurs in Zollinger-Ellison syndrome (ZES) and pernicious anaemia (type A gastritis). More recently, endocrine cell hyperplasia has been found in all forms of chronic atrophic gastritis and even in cases of focal atrophy. Serum gastrin levels, non-antral gastric endocrine (argyrophil) cell growth, and the severity and type of concomitant gastritis were monitored in 66 unoperated and 8 antrectomized patients with poorly responsive peptic ulcer or reflux oesophagitis during up to 5 years' treatment with high-dose omeprazole, 40 mg daily. A small subgroup of patients (23%) had serum gastrin concentrations of more than four times the normal upper limit. These patients also had hyperplasia of the gastric argyrophil cells. More importantly, the same subgroup of patients had high-grade (atrophic) gastritis. Micronodular hyperplasia of argyrophil cells was significantly more frequent in biopsies showing atrophic gastritis (48%) than in biopsies showing only superficial gastritis (3.6%). It is concluded that, as previously demonstrated in untreated patients with gastric ulcer, the argyrophil cell hyperplasia observed during high-dose omeprazole therapy is related to the progression of chronic atrophic gastritis rather than to serum gastrin levels.

Significant role of aspirin use in patients with esophagitis.

This study determines objectively the extent of nonsteroidal anti-inflammatory drug (NSAID) use in upper gastrointestinal (GI) mucosal acid-peptic diseases by supplementing the conventional interview with two tests of current aspirin (ASA) use--high-performance liquid chromatography (HPLC) for the presence of salicylates in serum and platelet cyclooxygenase activity, which detects ASA use within 5 days of testing. Of 186 consecutive patients undergoing upper endoscopy, 62% of 55 patients with esophagitis had evidence of current NSAID use, vs. 26% of 42 control patients with normal endoscopy (p less than 0.001), 12% of 17 patients with recently healed peptic ulcer (p less than 0.001), and 36% of 25 patients who had an active peptic ulcer (p less than 0.05), five of whom had concomitant esophagitis. Another 52 patients were ineligible for this analysis. Testing for platelet cyclooxygenase activity uncovered 26% more ASA users than history alone. In considering age, sex, smoking and drinking habits, arthritis, and ASA use by logistic regression, ASA use was the only factor contributing to esophagitis; ASA could not be further associated with severity, stricture or symptoms, however. In these patients, 95% of NSAID use was chronic, and 84% of that was ASA. These data show a previously unreported, strong association of ASA use with esophagitis, which suggests that ASA may be a significant factor in the resistance of esophagitis to current therapies as well as the frequently rapid relapse after therapy is withdrawn.

[Cytogenetic effects of hyperbaric oxygenation]. / Tsitogeneticheskie posledstviia oksigenobaroterapii.

This paper presents cytogenetic data obtained from peripheral blood of patients who were treated with hyperbaric oxygenation (HBO) at 0.15-0.2 MPa for 40 min daily during 10 days. The patients showed a significant increase of chromosome aberrations mainly caused by chromatid and chromosome breaks. The level of induced aberrations showed individual variations. These results suggest that HBO may have an indirect effect on the genetic apparatus of human somatic cells.

[Functional and structural changes in the surface of human erythrocytes following irradiation with ultraviolet rays of various wave lengths. V. Modification of the glycocalyx in autotransfusions of UV-irradiated blood]. / Funktsionalnye i strukturnye izmeneniia poverkhnosti éritrotsitov cheloveka posle oblucheniia UF luchami raznoi dliny volny. V. Mofifikatsiia glikokaliksa pri autotransfuziiakh UF-obluchennoi krovi.

A study was made of the structural and functional state of the erythrocyte surface components of patients with ischemic heart disease, and of patients with ulcer disease during the treatment with UV-irradiated blood autotransfusions. The cytochemical and isoserological methods employed showed some structural disturbances in the state of erythrocyte, glycocalyx and its modification in the course of treatment. The clinical results of treatment correlated with these changes.