[Insulin resistance in patients with metabolic syndrome and cholelithiasis].

The aim of the study was to determine serum insulin level in patients with metabolic syndrome (MS), pronounced manifestation of cholelithiasis (CL), and abdominal obesity. The measurements were compared with hyperlipidemia and glycemia levels in these patients. The subjects were 55 women with MS, divided into two groups according to 1991 Kh. Kh. Mansurov's classification of CL stages. Insulin level was measured by immune-enzyme assay; carbohydrate and lipid metabolism (lipid levels, lipoprotein and fatty acid spectrums, malonic dialdehyde and catalase levels)--by conventional methods. The study revealed a correlation between high insulin level in patients with hyperglycemia, disorder of tolerance to glucose, and type II diabetes, on the one hand, and lipid peroxidation level and dislipidemia, on the other. The study also found high insulin level at various stages of CL, especially during the period of concrement formation. Insulin is a CL risk factor, i.e. it elevates the risk of nucleation.

[Some parameters of carbohydrate and lipid metabolism in patients with non-alcoholic steatohepatitis].

The pathogenesis of non-alcoholic steatohepatitis (NASH) has not been fully studied yet. At the same time, some key points of its forming are already clear. In this regard, the authors studied disturbances of carbohydrate and lipid metabolism in patients with NASH. This included evaluation of fatty acid (FA) and lipoprotein (LP) spectrum, as well as measurement of triglyceride (TG), malonic aldehyde and glucose blood concentrations. The study found that an important role in the pathogenesis of NASH is played by carbohydrate and lipid dysmetabolism, manifested by hyperglycemia, glucose tolerance disorder, and type II diabetes. Other manifestations include hyperlipoperoxidcholia, high concentrations of chylomicrons, low density lipoproteins, and triglycerides, as well as low concentration of high-density lipoproteins. The spectrum of higher fatty acids is characterized by high concentration of saturated fatty acids and deficit of polyunsaturated fatty acids.

[Clinical and morphological features of alcoholic steatohepatitis].

48 patients with alcoholic steatohepatitis (ASH) were examined and divided into 3 groups according to the degree of fatty liver infiltration. It was minimal in 8 (16. 6%) patients, moderate in 10 (20.8%) and severe in 30 (62.5%) patients. The higher the degree of the fatty infiltration, the more pronounced dystrophic alterations and the more often necrosis, fibrosis and cell infiltration focuses were found in liver biopsy material. Morphologic changes in biopsy samples from ASH patients were much more pronounced in comparison with those in non-alcoholic steatohepatitis (NASH). The latter is characterized mostly by lymphocyte infiltration, while leukocyte infiltration is more typical of ASH. The study found prominent alterations in serum lipoprotein spectrum, triglyceride (TG) and saturated fatty acid concentrations in patients with ASH. High concentrations of chylomicrons, low-density lipoproteins and TG were registered together with low levels of high-density lipoproteins and albumin complex.

[Differential diagnosis of congenital fibrosis of the liver and hepatoportal sclerosis]. / Differentsial'no-diagnosticheskie kriterii vrozhdennogo fibroza pecheni i gepatoportal'nogo skleroza.

The article deals with differential-diagnostic criteria of inborn liver fibrosis and hepatoportal sclerosis. Congenital liver fibrosis is inherited and manifests at young age. It is characterized by marked hepatomegaly with stony dense liver, moderate splenomegaly with hypersplenism and portal hypertension in high activity of alkaline phosphatase and 5-HT, renal affection. Fibrosis locates around the biliary ducts. Hepatoportal sclerosis manifests more frequently in the adults with moderate hepatomegaly, marked splenomegaly with hypersplenism and predominance of anemia, high portal hypertension. Fibrosis is moderate and locates around portal vein branches in which thrombi are found.

[Role of lipoproteins and triglycerides in cholesterol lithogenesis]. / O roli lipoproteidov i triglitseridov v kholesterinovom litogeneze.

Serum lipoprotein spectrum was evaluated in 63 patients with cholelithiasis at various stages versus 10 healthy subjects as control. The patients were found to develop lipoprotein shifts as early as a physicochemical stage of the disease. Abnormal proportions of lipoproteins and triglycerides, changes in the formation of free radical products justify correction of dyslipoproteinemia early in cholelithiasis course.

[Role of porphyrins in the development of alcohol-induced liver lesions]. / Rol' porfirinov v razvitii alkogol'nykh porazhenii pecheni.

To specify the role porphyrins play in the development of diffuse liver injuries, 53 patients with alcohol-induced liver injuries were examined. Of these, 17 patients manifested marked derangement of porphyrin metabolism. As a result of clinico-biochemical, immunological and morphological research methods, it is established that marked derangement of porphyrin metabolism manifesting itself in porphyrin deposition in hepatocytes and in the high level of uro and coproporphyrinuria is associated with the development of autoimmune reactions towards liver-specific lipoprotein, which determines the development of the grave forms of liver injury in patients who abuse alcohol.

[Effects of helium-neon laser on physico-chemical properties of the bile]. / Vliianie gelii-neonogo lazera na fiziko-khimicheskie svoistva zhelchi.

The influence of helium-neon laser radiation on bile physico-chemical characteristics in healthy subjects and in patients with the physico-chemical stage of gallstone disease was studied in vitro. This type of laser was found to induce positive therapeutic effects, such as: correction of hydrogen ion concentrations, surface tension and viscosity decrease and prolonged bile nucleation in patients with gallstone disease.

[Various new approaches to the treatment of patients with uncomplicated peptic ulcer]. / Nekotorye podkhody k lecheniiu bol'nykh neoslozhnennoi iazvennoi bolezn'iu.

Basing on literature and his own experience, the author suggests the standard therapy of ulcer with spare diet to be revised. In noncomplicated duodenal ulcer soft diet is not obligatory for it has no advantages over unmeasured diet. The same is true for hospital treatment of duodenal ulcer, as the patients demonstrated the same mean duration of the ulcer healing in outpatient conditions. Healing of duodenal ulcer, compared in duration for monotherapy (histamine H2 blockers) and polychemotherapy (peritol plus antacids or cymetidine plus antacides) showed that neither therapy is preferable.

[A mass study of hepatobiliary system function in workers and collective farmers in southern Tadzhikistan]. / Massovoe issledovanie sostoianiia gepatobiliarnoi sistemy u rabochikh i kolkhoznikov iuga Tadzhikistana.

A total of 4085 persons living in the Parkhar District of Kulyab Province of the Tadzhik SSR underwent examination for the cholelithiasis incidence among 3 large groups (Koreans, Tadzhiks and Uzbeks) populating that territory. It has been established that as compared with Tadzhiks and Uzbeks, cholelithiasis turned out to occur rarely in Korean women. This is likely to be due to the metabolism of bile acids in the liver, the lack of genetic predisposition, noticeable disorders in the kinetics of the gallbladder as well as to the presence in the diet of the Korean community of a large amount of food plant fiber and soybean products which ameliorate to a certain degree the chemical composition of the bile and enhance the kinetics of the gallbladder.

[Effect of furosemide on the renal prostaglandin system in liver cirrhosis with ascites]. / Osobennosti vliianiia furosemida na sistemu prostaglandinov pochek pri tsirroze pecheni s astsitom.

Daily urine levels of PGE2 and PGF2 alpha as well as water-electrolyte exchange were measured in 72 patients with chronic active hepatitis (CAH) and hepatic cirrhosis (HC) in comparison with healthy controls. Furosemide treatment was performed in 26 HC patients. It was established that in CAH and compensated HC daily excretion of PGE2 and PGF2 alpha as well as 22Na elimination were within the range registered in the control. In association of HC with nonrefractory ascites the above excretion was elevated, with refractory one daily excretion of PGE2 was low, the urine ratio PGF2 alpha/PGE2 rose. Daily urine excretion of prostaglandins and PGF2 alpha/PGE2 value may be of prognostic significance in evaluating efficacy of diuretic therapy in HC patients with ascites.

[Markers of the hepatitis B virus in the blood serum and liver tissue in chronic diffuse diseases]. / Izuchenie markerov virusa gepatitia B v syvorotke krovi i tkani pecheni pri khronicheskikh diffuznykh zabolevaniiakh.

It is shown that the activity of the disease depends on the localisation of HBsAg and HBcAg in the hepatocyte and on the reaction of the delayed hypersensitivity (RDH) to HBsAg and liver-specific lipoprotein (LSL). RDH to HBsAg, LSL and a diffuse localisation of HBsAg in the hepatocyte cytoplasm are observed in the non-active chronic diffuse liver disease while the marginal or membraneous localisation of HBsAg which is frequently combined with HBcAg in nuclei and RDH to HBsAg and LSL are found in the active forms of chronic liver diseases.

[Cardinal problems of alcoholic diseases of the liver]. / Kardinal'nye voprosy alkogol'noi bolezni pecheni.

Proceeding from a clinicofunctional and morphological analysis of the liver state in 367 patients with different variants of alcoholic liver disease (ALD), the authors presented obligatory and optional morphological features of alcoholic hepatitis (AH); possible diagnostic difficulties of AH were considered. Two types-stages of alcoholic fibrosis--perivenous and pericellular fibrosis and chronic centrolobular sclerosis were proposed. Chronic active hepatitis of alcoholic etiology was considered as a nosological entity, different interrelationships of alcohol and hepatitis B virus were shown in ALD genesis.