[Disturbed absorptive function of small intestines in patients with chronic obstructive pulmonary disease].

The study included 93 patients (mean age 56.8+/-7.2) with COPD; 22 presented with grade 1 COPD, 36 and 35 with grade II and 111 COPD respectively. The latter group displayed reduced absorption of fats, proteins, and carbohydrates in the small intestine, the degree of dysfunction increasing with the severity of the disease, degenerative/dystrophic changes in intestinal mucosa, and deterioration of its regenerative potential. The data obtained are interpreted in the context of the relationship between the functional/structural properties of intestinal mucosa and clinical manifestations. The body mass deficit in COPD patients was shown to positively correlate with the reduction of absorption of fats (r=0.55), proteins (r=0. 71), and carbohydrates (r=0.48) in the small intestine.

[Circulating leptin and the trophological status of patients with chronic obstructive pulmonary disease].

AIM: To study the specific features of the nutritional status of patients with persistent chronic obstructive pulmonary disease (COPD) in relation to the hormone-regulating function of energy exchange in terms of leptin and to concurrently evaluate the functional status of fat and protein digestion and absorption and to measure body fat percentage. To assess the influence of these factors on the regulation of the serum concentration of leptin and its potential role in the development of trophological insufficiency in patients. SUBJECTS AND METHODS: In 93 patients with COPD (Stages I, II, and III in 22, 36, and 35 patients, respectively, the nutritional status was evaluated by somatometric methods. The concentration of leptin was measured by enzyme immunoassay using a test system (DSL, USA). Absorption was estimated by biochemical studies and by using radionuclides. Body fat content was determined, by measuring bioelectric impedance with an OmRon BF-302 apparatus (Japan). RESULTS: Protein and fat absorption was decreased in patients with moderate and mainly severe COPD as compared with that in the control group and correlated with body weight deficit and lower body fat percentage. Decreased leptin levels were detected in Stages II-III COPD and correlated with the degree of the disease and reduced protein (r = 0.68 +/- 0.02) and fat (r = 0.64 +/- 0.18) absorption. CONCLUSION: Protein and fat absorption impairments correlating with body weight deficit in patients with COPD underline the significant role of this mechanism in the development of trophological insufficiency. In COPD patients with trophological insufficiency, the lower circulating leptin levels that correlate with impaired absorption of fatty acids and protein characterize the pathogenetic role of secondary malabsorption syndrome in leptin-mediated impairments of energy exchange mechanisms. Functional insufficiency of the hormone-regulating mechanism responsible for energy exchange in terms of leptin in patients with Stages II-III COPD gives warning of the insufficient stock of adipose tissue and its reduced energy reserve.

[Genetic and clinical and pathological characteristics of breast cancer in premenopausal and postmenopausal women].

This study involved 525 breast cancer (BC) patients of T2-4N0-2M0 stages at the age of 35 years and older. Significant differences in clinical and pathological characteristics between premenopausal and postmenopausal BC patients were found. Mostly marked differences were shown for positive lymph node correlation with distant metastasis, multicentric growth and local recurrence depending on menopause status. The prevalence of various morphological structures in primary tumors was appeared to be associated with different forms of tumor progression in pre- and postmenopausal women. We have studied polymorphisms in 15 genes involved in major cancer related pathways (apoptosis, interleukins, folate metabolism enzymes genes). We found that variant genotypes of MTHFR and DHFR genes were associated with an increased BC risk among premenopausal women while polymorphism in IL-18, p53 genes were associated with BC among postmenopausal women. These results demonstrate novel biological information, which points the different mechanisms contributed to breast cancer progression in premenopausal and postmenopausal women.

[Morphofunctional changes in the bronchial epithelium in combined therapy for lung cancer].

Morphofunctional changes in the bronchial mucosa were studied in 33 patients with stage 3 lung cancer. The patients underwent intraoperative radiation therapy (IORT) in a dose of 15 Gy, using cisplatine as a radiosensitizer. No degenerative changes in the bronchial epithelium were found 2 weeks after IORT. Basal cell proliferation was observed, goblet cells were reduced in size and the basement membrane was thickened and twisted. Epithelial reparation due to pronounced local basal cell proliferation was observed 3 months later. A year later, the mucosa was covered with the multinuclear cylindrical epithelium and the cover of ciliated cells was preserved. The functional activity of goblet cells was in the normal range and scanty lymphoplasmocytic infiltration was found in the stroma. With IORT without radiosensitization, the damaged epithelium was regenerated due to the reserved cells coming from the damaged margins with the formation of an epidermoid regenerative layer and subsequent cell differentiation. Moderate sclerosis occurred in the stroma. A year later the bronchial epithelium was characterized by moderate goblet cell hyperplasia with preserved functional activity. Thus, IORT caused mucosal damage as alteration, dystrophy, and desquamation of the epithelium. Subsequently, the bronchial epithelium recovered through reparative regeneration.

[The course of Helicobacter pylori-associated duodenal ulcer concurrent with chronic opisthorchiasis].

The purpose of the investigation was to study the specific features and the course of Helicobacter pylori-associated duodenal ulcer (DU) concurrent with chronic opisthorchiasis (CO) A hundred and twenty-seven patients with H. pylori-associated DU were examined. Of them 78 patients were found to have H. pylori-associated DU concurrent with CO. In mixed pathology, asthenovegetative disorders were observed in most patients, one third had eosinophilia. With an over 10-year history of CO, acid production and pepsin secretion substantially decreased in both phases of gastric secretion. Mucosal atrophic changes were found mainly in the antral portion of the stomach, which frequency correlated with the duration of Opisthorchis invasion. The incidence of atrophic duodenitis tripled. All the patients received eradication therapy by the classical first-line treatment regimen including omeprazole and the antibiotics clarithromycin and amoxicillin. In the mixed pathology group, the time of ulcerative defect scarring increased by an average of 5 days. Fifty-eight with pathology continuously receiving the antisecretoty agent underwent dehelminthization with the anthelminthic bilthricide in 33 patients and with the plant anthelminthic dry aspen bark extract in 25. Evaluation of the efficiency of eradication therapy indicated that the best results of H. pylori eradication had been achieved in the patients dehelminthized with bilthricide. Assessment of long-term results showed that after multimodality therapy (eradication followed by bilthricide dehelminthization), there were no relapses for 2 years and there was a drop in the number of patients resorting to on-request therapy in patients with H. pylori-associated DU concurrent with CO.

[Clinico-morphological assessment of early and late results of laser therapy of the anastomosis area after radical surgeries for stomach cancer]. / Kliniko-morfologicheskaia otsenka blizhaishikh i otdalennykh rezul'tatov lazernoi terapii zony anastomoza posle radikal'nykh operatsii po povody raka zheludka.

The study included 52 patients after gastrectomy for carcinoma of the proximal part of the stomach. Endoscopic laser therapy was made in 32 patients to reduce inflammation in the anastomosis zone 2-3 weeks after surgery. Drug therapy was made in 20 patients within the same time period. Histochemical study of the biopsy material of esophageal and intestinal part of the anastomosis was carried out. It is revealed that application of copper vapor laser early after surgery reduces edema and inflammation in the anastomosis zone for 2 weeks as well as accelerates the growth of granulation tissue forming a delicate scar thus preventing formation of scar stenosis.

[Morphologic changes of bronchial epithelium after intraoperative radiotherapy of lung cancer]. / Morfologicheskie izmeneniia bronkhial'nogo épiteliia posle provedeniia intraoperatsionnoi luchevoi terapii.

Integration of intraoperative radiotherapy (IORT) with combined treatment of non-small cell carcinoma of the lung seems to be promising. Of particular interest are studies of morphological changes in the bronchial epithelium under the influence of large single dose of radiation (15 Gy). Our clinical investigation included patients with non-small cell carcinoma stage III who had received different schedules of treatment at the Center's clinics. Examination was carried out of biopsy material sampled from the bronchus stump as well as from the contralateral segment of the bronchial tree following combined therapy. Exacerbation of the chronic process in the bronchus stump after IORT was reported. One month after bronchial resection, 80% of patients suffered from catarrhal sclerosing bronchitis. Its progression triggered on bronchial sclerosis in 20%. Catarrhal sclerosing bronchitis in the contralateral segment of the bronchial tree occurred in 60%; there was no significant correlation between catarrhal sclerosis, on the one hand, and the initial condition of the bronchus, on the other. In the control group, there were also signs of chronic bronchitis exacerbation on the site of operation. On the whole, the distribution of patients by bronchitis patterns remained unchanged.

[Morphofunctional alterations of the small intestine in patients with psoriasis and concomitant chronic opisthorchiasis]. / Morfofunktsional'nye izmeneniia tonkoi kishki u bol'nykh psoriazom v sochetanii s khronicheskim opistorkhozom.

To characterize the small intestine clinically and functionally in psoriasis combination with chronic opisthorhiasis, 60 patients were examined with this combination, 45 with psoriasis but no helminthosis, 30 patients with chronic opisthorchiasis and 15 healthy subjects. Small intestinal absorption was studied by fat and carbohydrates absorption; bioelectric small intestinal activity--by electroenterography. Absorption in the small intestine of patients with mixed pathology was impaired. Pathogenetic mechanisms of such impairment were the following: low amplitude of bioelectrical activity of the small intestine, subnormal concentration of bile acids in the vesical bile, defects in microbial biocenosis of the intestine, structural disorders of the upper small intestine. Abnormal absorption in the small intestine correlated with psoriasis clinical picture (stages, duration, size of the lesion, disease severity).

[Morphological validation of peloidobalneotherapy intensification in patients with duodenal ulcer]. / Morfologicheskie obosnovanie intensifikatsii peloidobal'neoterapii u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

AIM: To study effectiveness of short courses of intensive peloidobalneotherapy in duodenal ulcer (DU). MATERIAL AND METHODS: Esophagogastroduodenoscopy and biopsy before and after the treatment course were made in 124 DU patients. Depending on timing of moor applications, pine and pearl baths, the patients were divided into 2 groups. Patients of group 1 received procedures daily with interval 4-5 hours (intensive course), patients of group 2 were treated each other day. RESULTS: 3-4 weeks of the treatment produced a response in both groups but in group 2 there were no signs of active inflammation in gastric and duodenum mucosa. 2 years later, patients of group 1 had histological evidence of chronic inflammation exacerbation. The latter was absent in group 2. CONCLUSION: An intensive course of peloidobalneotherapy results in attenuation of chronic gastroduodenal inflammation in DU patients.

[Effectiveness of an intensive pelobalneotherapy course in the treatment of patients with duodenal ulcer]. / Effektivnost' kursa intensivnoi peloidobal'neoterapii v lechenii bol'nykh iazvennoi bolezn'iu s lokalizatsiei iazvy v dvenadtsatiperstnoi kishke.

Intensification of peloidobalneation pattern results in cicatrization of ulcer in many patients with duodenal ulcer at the stage of partial clinical remission and attenuated exacerbation during 18 days promoting alleviation in chronic inflammation in gastroduodenal zone.

[The characteristics of the mechanism of action in the joint use of solutions of brine and mud extracts with galvanization and ultrasonic exposure. 2]. / Osobennosti mekhanizma deistviia sochetannogo primeneniia rastvorov ékstraktov rapy i griazi s gal'vanizatsiei i ul'trazvukovym vozdeistviem. Soobshchenie 2.

Radionuclide tracing has demonstrated that intraperitoneal introduction of natural brine and mud solutions to intact rats followed by ultrasound versus galvanization provides more intensive delivery of chemical elements to the target organs and tissues. These differences should be taken into account when planning rehabilitation schemes with various physiotherapeutic modalities.

[Gastric and duodenal mucosal function in peptic ulcer patients exposed to endoscopic laser therapy and sanatorium-health resort factors]. / Sostoianie slizistoi obolochki zheludka i dvenadtsatiperstnoi kishki u bol'nykh iazvennoi bolezn'iu pri vozdeistvii éndoskopicheskoi lazeroterapii i sanatorno-kurortnykh faktorov.

A comparative study of gastric and duodenal bulb mucosa has been performed in 138 patients with ulcer before and after treatment. The patients were treated with either He-Ne laser or copper steam laser alone vs combination of laser therapy with spa treatment. The most favourable was the complex including green spectrum laser in combination with administration of Shira Lake mineral water and electrophoresis of this water.

[The characteristics of the mechanism of action in the electro- and ultraphonophoresis of brine and mud preparations]. / Osobennosti mekhanizma deistviia élektro- i ul'trafonoforeza preparatov rapy i griazi.

Rat experiments with short-life radionuclides revealed a marked differences in the action of dry mud extract and dry brine in spite of the fact that their composition was almost similar. Galvanization and ultrasound induce effects acting differently on accumulation of chemical elements from brine and mud in the body and skin of both healthy animals and those with induced diseases. These differences in the action of the above natural compounds of the same type should be considered when planning physiobalneotherapeutic rehabilitation complexes.

[The possibility of using the inhalations of some types of Kamchatka mineral waters in bronchopulmonary pathology]. / Vozmozhnost' ispol'zovaniia ingaliatsii nekotorykh tipov mineral'nykh vod Kamchatki pri bronkholegochnoi patologii.

Kamchatka spring mineral water (wells 6.9 and 32 of Ketkinskoye, Malkinskoye and Verkhne-Paratunskoye deposits, respectively) was used in inhalations in 54 patients with chronic bronchitis. Clinical and experimental findings evidenced irritating effect of the water from well 9 which activated inflammation and reduced bronchial patency. Water from well 6 can be used in nonobstructive processes, whereas that from well 32 is effective in inflammation-induced bronchial obstructions and is fit to stimulate respiratory reserves.

[The phonophoresis of solutions of a "dry" mud extract in the therapy of patients with chronic gastritis]. / Fonoforez rastvorov "sukhogo" ékstrakta griazi v terapii bol'nykh khronicheskim gastritom.

The study of stomach morphology and function in chronic gastritis treated with phonophoresis of dry mud extract solutions demonstrates a stimulating effect of the treatment on acid production. A positive response was also registered on the part of the structure of gastric mucous lining and functional activity of this epithelium.