[Clinical course of alcoholic pancreatitis]. / Klinicheskoe techenie alkogol'nogo pankreatita.

AIM: To study a natural course of alcoholic pancreatitis (AP). MATERIAL AND METHODS: Follow-up clinical, laboratory and radiation examinations were made of 170 patients with alcoholic pancreatitis. Exocrine secretion of the pancreas was assessed by secretin-pancreozymin test. Morphological signs of pancreatitis were studied in patients who had died of pancreatic cancer. RESULTS: In 24% of patients AP manifested with acute attack. In 76% it was preceded with weak clinical symptoms. AP ran was complicated with pseudotumorous pancreatitis, calcinosis and pancreatic pseudocysts. Pancreatic secretion was suppressed in 87% patients though clinically it was evident only in 12% cases. Autopsy cases of pancreatic cancer carried morphological markers of chronic pancreatitis. CONCLUSION: Various clinical forms of AP represent stages of its development: early symptoms, recurrences, complications and decompensated failure of the pancreatic function. The presence of pancreatitis in patients with pancreatic cancer causes difficulties in differential diagnosis between these diseases.

[Significance of the operational test parameters in selection of a diagnostic test for Helicobacter infection]. / Znachenie operatsionnykh kharakteristik testa pri vybore metoda diagnostiki infektsii Helicobacter pylori.

The group of 89 patients was examined, 63 of them suffered by a duodenal ulcerative disease, 11--by gastric ulcerative disease and 15--by chronic gastritis. It was conducted the comparison of the following indices: sensitivity, specificity, relationship of probability and diagnostic efficiency of histological, cytological methods, urease and respiratory tests, method of polymerase chain reaction, qualitative and quantitative definition of antibodies of the class IgG in serum blood to H. pylori by a method of enzyme immunoassay and Western-blot for H. pylori infection diagnostics was carried out. The results show that in choice of a diagnostic method of infection H. pylori it is better to use such characteristics as sensitivity and specificity, which more objectively reflect the diagnostic possibilities of each test.

[A trial of the use of sandostatin in patients with chronic pancreatitis]. / Opyt primeneniia sandostatina u bol'nykh khronicheskim pankreatition.

Out of 15 patients with chronic pancreatitis (CP) treated with sandostatin, 8 patients demonstrated a complete and 6 partial response. One patient did not respond. Pain relief occurred in all of them. Side effects were registered in 3 patients (doughy stools 4 times a day throughout treatment). Normal blood levels of pancreatic enzymes, insulin secretion, parameters of blood inhibitory system did not change much because of sandostatin administration, whereas hypercoagulation got diminished. Rat experiments have revealed a trend to trypsin lowering in tissues of unaffected pancreas and more intensive inhibition of active trypsin by tissue inhibitors.

[Diabetes mellitus in patients with chronic alcoholic pancreatitis]. / Sakharnyi diabet u bol'nykh khronicheskim alkogol'nym pankreatitom.

The examination of 170 patients with chronic alcohol pancreatitis revealed diabetes mellitus (DM) in 21% of them. It manifested with polydipsia, polyuria and weight loss along with pancreatitis symptoms. DM complications were rare. Exercise tests were indicative of reduced insulin and glycagon reserves in the majority of the examinees. This condition depended on pancreatitis severity. DM in pancreatitis presents a high risk of hypoglycemia which should be taken into consideration when designing schemes of relevant treatment.

[Clinico-morphological correlations of chronic pseudotumorous pancreatitis and cancer of the pancreas]. / Kliniko-morfologicheskoe sopostavlenie khronicheskogo psevdotumoroznogo pankreatita i raka podzheludochnoi zhelezy.

Examination of 57 pancreatic cancer patients and 40 subjects with chronic pseudotumorous pancreatitis revealed a resemblance in the clinical picture and uniform changes in the blood levels of pancreatic enzymes in both groups. Histological examination of 32 patients who expired from pancreatic cancer revealed total chronic pancreatitis manifested in inflammatory infiltration, focal destruction of the duct epithelium, atrophy, interstitial, periductular and perivascular sclerosis, dilatation of the ducts and pancreolithiasis. The character of the morphological changes in patients with pancreatic cancer corresponds to both primary and secondary origin of pancreatitis. Similarity of clinical manifestations and uniform changes in the blood content of pancreatic enzymes could be explained by the presence of chronic pancreatitis concurrent to pancreatic cancer.

[Duodenal diverticula and organic diseases of the pancreatoduodenal area]. / Divertikuly dvenadtsatiperstnoi kishki i zabolevaniia organov pankreatoduodenal'noi zony.

X-ray examination of 123 patients showed duodenal diverticula seated primarily in the descending part. In 60% of the patients, they were located in the area of the major duodenal papilla. Duodenal diverticula were coupled significantly more often with chronic pancreatitis than with chronic cholecystitis and ulcer disease of the duodenum. Combined choleduodenography is a method of choice for establishing interrelations between a diverticulum and the major duodenal papilla. In addition to parapapillary diverticula, the development of pancreatitis may be promoted by the diverticulum taking root in the pancreatic parenchyma.

[Value of determining the activity of cholesterol esterase in the duodenal contents]. / Znachenie opredeleniia aktivnosti kholesterolésterazy v duodena'lnom soderzhimom.

Cholesterol esterase, a pancreatic enzyme, activity has been measured in the duodenal contents of patients with chronic pancreatitis by fluorometry with the use of o-coumaric acid, a cholesteryl ether substrate, manufactured in this country. The measurements have revealed a significant difference in the values of the enzyme secretion debit after pancreozymin-secretin stimulation of the pancreas in chronic pancreatitis patients and in the controls. Hypo- and hypersecretion of cholesterolesterase have been revealed in the patients. The disease severity had a most marked effect on the hyposecretion degree. These data evidence a high value of cholesterolesterase measurements for the assessment of the pancreatic exosecretion: such tests may help detect the early stages of exosecretory disturbances, assess the disease severity and progress.