[Disorders of Vasoregulative Endothelial Function, Echocardiographic Assessment of Myocardial Dysfunction and Hemodynamics of Pulmonary Circulation in Cirrhosis of the Liver].

AIM: to study relationship between parameters of intracardiac hemodynamics assessed by Doppler echocardiography and functional activity of endothelium, hepatic blood flow and severity of portal hypertension in patients with cirrhosis of the liver (CL) of different etiology. RESULTS: We found that changes of structural and functional parameters of the heart in LC depended on the stage of compensation of portal hypertension and were accompanied by rearrangement of parameters of intracardiac hemodynamics. Pulmonary arterial hypertension (PAH) was found in 11.1% of patients with LC. PAH was moderate and was more frequent in patients with end-stage disease (Child-Pugh class C) compared with those with initial stage of LC (21.4% and 6.3%, p<0.05, respectively). CONCLUSION: Disorders of vasoregulating endothelial function in patients with CL were related to parameters of cardiopulmonary hemodynamics and functional state of the right ventricle and were more pronounced in patients with PAH.

[ANALYSIS OF THE RESULTS OF ENDOSCOPIC AND MORPHOLOGICAL STUDIES OF THE STOMACH MUCOSA WITH REDUCED PEPSINOGEN-I IN PATIENTS WITH H. PYLORI (H.P.)--ASSOCIATED GASTRITIS IN TOMSK AND TOMSK REGION].

AIM OF INVESTIGATION: To explore and describe the endoscopic picture of HP--associated atrophic gastritis and to analyze the specificity of endoscopic markers indicating the presence of atrophic gastritis, intestinal metaplasia and dysplasia using high-tech methods of endoscopy in comparison with morphological characteristics of atrophic gastritis defining the degree of activity and stage of atrophic gastritis according to the system OLGA. MATERIALS AND METHODS: 40 people: males and females aged 40 to 70 years with a reduced level of pepsinogen I and a positive titre of antibodies to H. pylori in serum--were included into the study. THE RESULTS: Risk groups with atrophic gastritis based on indicators of pepsinogen 1 were formed. Endoscopic picture of H. Pylori--associated atrophic gastritis in patients with reduced level of pepsinogen I in serum is studied and described. Analysis of the specificity of endoscopic markers indicating the presence of AG, intestinal metaplasia and dysplasia using high-tech methods of endoscopy (endoscopy with high resolution, magnifying endoscopy, chromoendoscopy and narrow band imaging endoscopy (NBI) is made. Analysis of their sensitivity in comparison with the results of morphological studies of biopsy material is made. CONCLUSION: Thus, these studies show that high-resolution endoscopy in combination with magnification and chromoendoscopy allows accurately identify areas of atrophy, intestinal.Narrow band imaging endoscopy (NBI) provides a detailed picture of the vascular pattern of tissues, pattern changes typical for pathological areas of inflammatory genesis, as well as for precancers and early cancers. All these methods have high sensitivity and specificity in the diagnosis of HP-associated atrophic gastritis in comparison with the results of morphological studies of biopsy materials of stomach mucosa.

[IMMUNOGENETICS AND PROGRESSION OF CHRONIC VIRAL HEPATITES].

AIM OF INVESTIGATION: To estimate the role of polymorphic variants of genes IL4 (C-590T), IL4RA (I50V), TNF (G-308A) and SLC1IAI (D543N) in chronic viral hepatitis progression. MATERIAL AND METHODS: Overall 121 patients with chronic viral hepatitis C and B. RESULTS: Study results have demonstrated, that of all investigated polymorphic variants of genes IL4 (C-590T), IL4RA (150V), TNF (G-308A) and SLC11A1 (D543N) in patients with chronic liver diseases of various etiology the <> IL4RA gene variant (II50Val) is associated with HBV-infection chronization. The allele <> gene TNF-α (G-308A) is protective for chronic viral hepatitis and is associated with a low level of production by mononuclear cells of TNF-α and IL-12, high secretion of IL-4 and low degree of collagenopathy in the liver. Genotype <> of IL4 (C-590T) gene is an adverse marker for progression of chronic viral hepatitis B. There was significant correlation of polymorphic variants TNF (G-308A) and IL4 (C-590T) genes with production of the key interleukins, that determine type of immune response (Th-1, Th-2) and products of collagen metabolism that testifies genetic determination of system immune response and collagen formation processes in the liver at chronic viral hepatitis.

Serotonin metabolism parameters in patients with chronic hepatitis and liver cirrhosis.

We studied disorders in serotonin metabolism in patients with chronic hepatitis and cirrhosis of the liver with and without inflammatory process (cytolysis syndrome) and their impact for the formation of depressive disorders. Blood serotonin content decreased in patients with cirrhosis of the liver with pronounced depressive disorders. Serum serotonin level was elevated in all patients with the cytolysis syndrome.