[Severe and complicated forms of chronic pancreatitis]. / Tiazhelye i oslozhnennye formy khronicheskogo pankreatita.

A total of 437 patients with chronic pancreatitis (CP) were examined. The authors detected interstitial or acute, parenchymal or recurrent, hyperplastic or pseudotumorous, and cystic variants in 91 (20.8%), 218 (49.9%), 78 (17.8%), 22 (5.1%), and 28 (6.4%) patients, respectively, Severe types due to the permanent pain syndrome, substantial weight loss and overall intoxication phenomena were seen in 21.5%. Complications of chronic pancreatitis were revealed in 32.3%. Pyoseptic complications (11.2%), anicteric cholestasis (8.5%), subhepatic portal hypertension (8.0%), cholestatic jaundice (7.8%) were most common. Immunodeficiency states developed with long-term treatment of CP. A small portion (0.9%) of patients with CP developed pancreatic carcinoma. 3% of patients had deaths directly due to the active course of the disease whose causes were pyoseptic processes, pancreatic carcinoma and profuse hemorrhages from exulcerations of the duodenal postbulbar part.

[The clinical picture and diagnosis of pancreatic carcinoma]. / K klinike i raspoznavaniiu kartsinomy podzheludochnoi zhelezy.

A total of 97 patients with pancreatic carcinoma were examined with sonography, computed tomography of the pancreas and endoscopy of the stomach and duodenum. The tumor involved mainly the head of the pancreas in 69 (71.1%), the body in 21 (21.7%) and the tail in 7 (7.2%) patients. Two basic types of the disease were identified: disseminated in 83 patients and rare in 14 patients. The disseminated type included a central (45 patients) and a peripheral (38 patients) variant. The latter is classed as peripheral (n = 30) and paraduodenal (n = 8). The rare types included masked variants (n = 6), miniblastomas (n = 3), megablastomas (n = 2) of the pancreas, as well as thrombotic variants of the disease (n = 3). The highest diagnostic value of sonography and computed tomography was observed in intrinsic peripheral variants of carcinoma. Gastroduodenal endoscopy along with biopsy of suspected segments is highly diagnostic in paraduodenal variants of the disease.

[The clinico-pathogenetic variants of cholestasis in different liver diseases]. / Kliniko-patogeneticheskie varianty kholestaza pri razlichnykh zabolevaniiakh pecheni.

To base the clinico-pathogenetic nonuniformity of cholestasis in different liver diseases, 135 patients distributed into groups were examined. Group I was made up of 48 patients with chronic persistent hepatitis, group II of 34 patients with chronic active hepatitis, group III of 29 patients with liver cirrhosis, and group IV of 24 patients with primary and metastatic liver carcinoma. The data obtained suggest the existence of different forms of cholestasis: multicomponent cholestasis, partial bilirubin cholestasis, partial choleacid cholestasis. In the group I patients, the incidence of cholestasis was 8.3%, in group II 2.9%, in group III 3.4%. The incidence of partial choleacid cholestasis was 4.2% in group I, 2.9% in group II, and 6.9% in group III. The presence of partial cholestasis may be caused by the impairment of the assumed "personal" carrier for different bile components.

[Hepatitis B virus markers in the internist's practice]. / Markery virusa gepatita B v praktike terapevta.

Three various forms of contact or its consequences are recognized for hepatitis B virus and human body; acquired immunity to HBV, HBV persistence, HBV replication. Two forms of seroconversion (transfer of HBeAg into anti-HBe serum) are demonstrated. One of them occurs commonly and has a good prognosis, the other emerges rarely and runs a severe course likely to end in life-threatening complications.

[The classification of chronic pancreatitis]. / O klassifikatsii khronicheskogo pankreatita.

To make the II Marseilles Classification of Pancreatitis more applicable to everyday clinical practice, a new systemic approach is suggested basing on clinical, laboratory, CT and ultrasound evidence. Upon examination of 182 chronic sufferers with pancreatitis, interstitial--edematous, parenchymatous, fibrous--sclerotic (indurative), hyperplastic (pseudotumorous) and cystic variants of the disease were established in 34.6%, 30%, 21.1%, 4.4% and 9.9%, respectively. Clinical features typical for each variant of the disease and most common complications are reviewed.