[Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism].

The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.

[Metabolic structures of the blood serum--markers of acute pancreatitis].

The goal of the study was to reveal the meaning of metabolic structures of the blood serum (BS) in the diagnostics of acute pancreatitis (AP). Along with standard methods of examination, cystalloscopical examination of the BS was conducted for 46 patients with AP. The BS of 22 healthy people was used as control. In this group, the structure of BS had a form of threadlike bipalmate crystals. Metabolic structures of BS in patients with AP were characterized by signs of enzymatic dysfunctions: hyperamylasemia was presented in the form of subparallel lamellae, hypertrypsinaemia - in the form of a dendritic grid, hyperlipasaemia--in the form of bubble chambers with branches. Hyperhistaminemia was characterized by the presence of optically active feathered spherolithes, hyperserotonemia--by plateau dendritic aggregates, and markers of hyperelastasaemia were aggregates of rectangular and prismatic crystals. Hyperimmunoglobulinaemia M was characterized by skeleton cruciform crystals, and hyperimmunoglobulinaemia G--by skeleton crystals branching from the main axis at an acute angle. The optically active dendrite-like crystals were revealed at hypercreatinemia, and selective structures of BS were found at dysproteinaemia, hypersyalaemia, hyperdophaminaemia, hyper-beta-endorphinaemia, hyperacetylcholinaemia and hypertryglyceridaemia. The revealed microtypes can be used for the visual diagnostics of metabolic disorders at AP and for control over the treatment efficacy.

[Polarization microscopy in diagnosis of metabolic disorders]. / Poliarizatsionnaia mikroskopiiia v diagnostike obmennykh narushenii.

An early diagnostics of metabolism disorders by using different methods is still acute. In this respect, the crytstal-optic examination of the metabolism structures of blood serum, implemented in a polarized light (microscope MIN-8) is in the focus of attention. We studied the structure of blood serum of 160 patients with various metabolic disorders. The examinations were made through drying up, under control, the blood serum drops between two isotropic plates, the mentioned preparations were subsequently kept in the open air and examined under the microscope in polarized light. Simultaneously, the below substances were identified in the blood serum: oxalic acid, creatinines, total calcium, glycine, uric acid and cholesterol. In accordance with metabolic disorders, crystals were isolated, which characterize a type of a metabolic disorder. Thus, the fan-type dendrites are indicative of hyperoxaluria, druses and dendrite-like spherulites--hypercreatinemia; oolite spherulities are indicative of hypercalcemia, fine-grained particles are typical for hyperglycinemia, feather-like rays are typical for hyperuricemia and cross-like spherulites are typical of hypercholesterolemia. The suggested method improves the control over a type of metabolic disorder, and it can be used in the express diagnostics of a pre-pathology and pathology of metabolism.

[Crystallo-optic structures of bile in chronic acalculous cholecystitis]. / Kristalloopticheskie struktury zhelchi pri khronicheskom beskamennom kholetsistite.

A crystal optical study of the cystic bile under the conditions of compulsory dehydration in patients with acalculous cholecystitis made it possible to determine selective markers of lithogenic dyscholia according to the bile oversaturation with cholesterol, bilirubin and calcium. Chronic acalculous cholecystitis (CAC) is a chronic polyetiologic inflammatory disease of the gall-bladder (GB) combined with motor-tonic impairments of the bile-excreting tract function and with changes of physical and chemical properties and biochemical bile structure (dyscholia). CAC contributes to cholestasia, metabolic disorders and formation of calculi. The identification of lithogenic bile properties and early, pre-clinical diagnostics of cholelithiasis remain as urgent as before. Complicated physical and chemical methods are used for diagnostics of cholelithiasis: nuclear magnetic resonance spectroscopy, laser quasielastic scattering, electron microscope studies, gel-distribution chromatography. At present these methods are inaccessible for wide practical application due to their high cost. At the same time it is known that the diagnostics of cholelithiasis at early stages can be based on the detection of liquid crystalline structures in the bile. The object of this study was an early crystal optical diagnostics of dyscholia in patients with CAC and detection of bile lithogenicity markers.

[Effects of the long-term treatment with losartan and captopril and of the abrupt cessation on circadian blood pressure profile]. / Kharakteristiki sutochnogo profilia arterial'nogo davleniia pri dlitel'noi terapii lozartanom i kaptoprilom i posle ee otmeny.

The influence of a long-term treatment with losartan (50-100 mg o.d.) and captopril (25-50 mg b.i.d.) followed by the abrupt therapy cessation was studied in an open randomized placebo-controlled parallel group trial. The study was performed on a group of 22 essential (soft to moderate) hypertensive male patients, which entered the trial when a mean daytime diastolic blood pressure was BP > or = 90 Torr. The antihypertensive effect of losartan was more pronounced and homogeneous than the effect of an equivalent dose of captopril. The group-average trough/peak ratios upon the losartan treatment were 61.5 and 61.3% for the systolic and diastolic BP (against 21.2 and 26.9% for captopril), respectively. At the same time, the smoothness index values of the patients treated with losartan and captopril showed no significant difference. Neither treatment with any of the two drugs nor the therapy cessation affected the circadian BP profile or the BP variability. The abrupt termination of the drug administration did not cause a withdrawal syndrome: on the contrary, a significant effect of the captopril and losartan treatment (statistically reliable against the placebo control) persisted for at least four days after the therapy cessation. Taking into account poor homogeneity of the antihypertensive effect of captopril in patients with a stable moderate hypertension treated b.i.d., the drug administration is recommended according to the t.i.d. schedule. In this group of patients, losartan and captopril are probably more expediently administered in combination with other hypertensive drugs.

[Evaluation of the evenness of the antihypertensive effect of losartan and captopril by using a 24-hour monitoring of arterial pressure]. / Otsenka ravnomernosti antigipertenzivnogo éffekta lozartana i kaptoprila s pomoshch'iu 24-chasovogo monitorirovaniia arterial'nogo davleniia.

AIM: To investigate 24-h evenness of an antihypertensive effect of angiotensin II receptor blocker losartan vs captopril by four parameters of arterial pressure (AP) monitoring. MATERIAL AND METHODS: An open, cross-over, placebo-controlled trial was made in 22 patients with mild/moderate arterial hypertension (AH). Four parameters of AP monitoring were assessed: TPR, SI, rate of AP morning rise, index of AP morning rise. RESULTS: In losartan treatment TPR for systolic and diastolic AP were 61.5 and 61.3%, respectively, IS made up 0.74 +/- 0.13 and 0.64 +/- 0.09, respectively. For captopril these values reached 21.2 and 26.9%, 0.51 +/- 0.14 and 0.47 +/- 0.10, respectively. Differences by SI between the two drugs were statistically insignificant. Both drugs did not raise the rate and index of AP morning rise significantly. CONCLUSION: When administered in a single daily dose 100 mg, losartan produced a regular antihypertensive effect throughout 24 hours. Captopril (twice a day in a dose 50 mg) effect was not regular enough. This means that some patients need a three-times-a day regimen of captopril. Of the four parameters, SI is most informative for evaluation of antihypertensive effect evenness.

[Diagnostic significance of investigation of morphological structures forming during a vacuum drying of blood serum from patients with immune pathology]. / Diagnosticheskaia znachimost' issledovaniia morfologicheskikh struktur, obrazuiushchikhsia pri vakuumnoi sushke syvorotki krovi, pri zabolevaniiakh s immunoi patologiei.

In vitro models of vacuum-dried serum of patients with immune diseases are presented for the first time. These structures allow visual evaluation of transfer of many-step metabolic reactions into certain morphological types. Variety and depth of uncontrolled antibody production leave their "structural trace" in various diseases. The detected serum morphotype markers can be used for early diagnosis of immune conflicts.

[Serum crystalloscopic study in the diagnosis of chronic pancreatitis concurrent with biliary diseases]. / Kristalloskopicheskoe issledovanie syvorotki krovi v diagnostike khronicheskogo pankreatita v sochetanii s zabolevaniiami zhelchevyvodiashchikh putei.

The sera from 20 patients with chronic pancreatitis concurrent with diseases of biliary tract and gallbladder were first crystalloscopically studied. Hypertrypsinemia was followed by the appearance of a specific structure appeared as crystals made by a continuum dendritic large-porous lattice. The test proposed is easy-to-use and may be useful in diagnosing chronic pancreatitis.

[Left ventricular myocardial hypertrophy in patients with arterial hypertension: the clinical characteristics and prognostic significance]. / Gipertrofiia miokarda levogo zheludochka u bol'nykh s arterial'noi gipertenziei: klinicheskie osobennosti i prognosticheskoe znachenie.

Blood pressures in the out- and inpatient settings, ECG findings and 24-hour Holter monitoring data, hemodynamic parameters, exercise test results, carbohydrate tolerance, blood lipid levels, and renal function were studied in 21 males with arterial hypertension and left ventricular hypertrophy as evidenced by echocardiography and 20 patients of the same age who had the same disease length. The patients with left ventricular hypertrophy generally showed a more severe course of arterial hypertension: more elevated and stable blood pressure, more renal affliction than those without left ventricular hypertrophy. ECG monitoring indicated that they had ventricular premature contraction and atypical episodes of ST-segment depression. These patients displayed lower heart rate and its lower increment, but higher diastolic blood pressure at the peak of exercise. A five-year follow-up suggests that the patients with left ventricular hypertrophy (38.1%) have higher incidence rate of cardiovascular events than those without this abnormality (5%) (p < 0.01).

[Plasmapheresis in the therapy of insulin-dependent diabetes mellitus detected for the first time]. / Plamaferez v terapii vpervye vyiavlennogo insulinzavisimogo sakharnogo diabeta.

Heterogeneity of the metabolic syndrome in diabetes mellitus serves as an indication for plasmapheresis in therapy of disease. The effect of plasmapheresis on the indices of carbohydrate, lipid metabolism and immune homeostasis was studied in 30 patients with primary diabetes mellitus. Microstructure of the surface of dried blood serum drops was investigated in parallel with it. The control group included 20 patients who were not given plasmapheresis and 20 healthy subjects. A positive effect of plasmapheresis on the above indices was observed. Its approximate effect on the patients blood serum composition was shown.

[Structural characteristics of dry blood serum of patients with arteriosclerosis after plasmapheresis]. / Strukturnye osobennosti sukhoi syvorotki krovi bol'nykh aterosklerozompri primeneni plazmofereza.

The surface of dried drops of blood serum (BS) from 86 plasmapheresis patients with atherosclerosis has been studied for its structural peculiarities. The content of lipids (total cholesterol, cholesterol of lipoproteins of high density, triglycerides), sialic acids and immunoglobulins was determined in all the examinees. BS from 20 practically healthy people was taken as a control. Optically inactive filamentous dichotomically branching crystals were typical of its microstructure. Optically active spherolites were found in patients with high content of cholesterol, optically active dendrite aggregation--in patients with high content of triglycerides, optically active fibrils appeared in case of hypersialemia, optically inactive aggregates--in case of hyperimmunoglobulemia. The plasmapheresis course carried out in patients was followed by appearance of filamentous dichotomically branching crystals, and disappearance of optically active inclusions, that testified to ordering of the BS structure. The results obtained were confirmed by normalization of the content of lipids, sialic acids, immunoglobulins.

[Evaluation of the risk of exposure to unfavorable environmental based on the results of sanitary, microbiological and clinical studies]. / Otsenka riska vozdeistviia neblagopriiatnykh faktorov okruzhaiushcheisredy po rezul'tatam sanitarno-mikrobiologicheskikh i klinicheskikh issledovanii.

It has been established as result of studies with the use of complex sanitary-hygienic, microbiological, clinical and statistical methods, that the increasing antropogenic stress causes changes in microbiocenosis of water objects of the environment and of blood serum, which may produce unfavourable human health effects. The necessity to use integral complex indexes of the state of man and water medium for the assessment of the degree of risk of ++eco-technogenic effects has been found out.

[Morphotypes of serum crystallograms and various indices of glycoprotein metabolism in patients with toxic goiter]. / Morfotipy kristallogramm syvorotki krovi i nekotorye pokazateli glikoproteidonogo obmena u bol'nykh toksicheskim zobom.

Crystallographic investigation of the blood serum of 65 patients and 20 healthy persons aged 20 to 45 was conducted to observe the content of carbohydrate components of glycoproteins in toxic goiter over time and to study the content of seromucoid and sialic acids. Crystallograms were obtained by placing a drop of blood serum between two isotropic plates and dried under controlled conditions for 12 h. The obtained specimen was investigated microscopically in transmitted and polarized light. N-acetylneuraminic acid was used. The data obtained indicated the heterogeneity of micromorphotypes of crystallograms of patients with toxic goiter which formed individual macromorphotypes according to the gravity of disease. Crystallography of the blood serum can be used as an adjuvant method to control glycoprotein metabolic derangements and as a diagnostic method for toxic goiter.

[Xeroproteinography of the blood serum system in patients with diabetes mellitus]. / Kseroproteinografiia syvorotochnoi sistemy krovi bol'nykh sakharnym diabetom.

A study of the structure of a dry gel of proteins of the blood serum system (BSS) in diabetes mellitus patients brings to light, to a certain degree, the problem of possible conformation conversions in its proteins. A study was made of networks of xeroproteinograms (XPG) in patients with average and severe forms of insulin dependent type of diabetes mellitus. A study of the XPG structure has a diagnostic and prognostic value for obtaining data on the conformation stability of BSS globular proteins in diabetes mellitus.