[A new view on the problem of nonneoplastic stenosis of the major duodenal papilla. Results of a prospective investigation].

The article contains results of a continuous prospective investigation of the normal course of the major duodenal papilla stenosis in 167 patients. It was revealed that the course of the disease was benign, pain syndrome became inconsiderable in the course of time, the degree of changes in biochemical analysis of blood was not significant. The development of complications (choledocholithiasis, acute pancreatitis, jaundice) was noted in 6-14% of the patients, depending on the presence or absence of GID. The data obtained allow suggestion of an algorithm of managing the patients.

[Gastric carcinoid--modern approaches to diagnosis and treatment].

Gastric carcinoid tumors are rare, but are increasing in incidence. This article reviews what is known about the classification, epidemiology, tumor pathogenesis and management of patients. Additionally we present the results of our own 10-years observation after endoscopic and surgery treatment of this tumors.

[Barrett's esophagus: endoscopic and immunomorphological parallels].

Barrett esophagus is the most serious sequela of the gastroesophageal reflux disease being an obligate precancer with a high index of the neoplastic transformation as to an adenocarcinoma esophagus. THE PURPOSE OF THE PAPER: To reveal the extent of the susceptibility to oncogenesis of the Barrett esophagus-patients and to determine high-risk groups. MATERIALS AND METHODS: Our paper has shown the examination results of the 55 Barrett esophagus-patients (29 women and 26 men at the age of 39 to 62 years old), including 40 intestinal metaplasia-patients and 15 patients of the intestinal metaplasia + dysplasia of long clinical course given corresponding correcting cure. In our investigation a DNA-flow cytometry was a method of determining the adenocarcinoma esophagus risk secondary to the Barrett esophagus as well as an index of the proliferation and an index of the aneuploidy were the factors analyzed. THE RESULTS: 1) As the pathosis histology-progresses from metaplasia to dysplasia and adenocarcinoma esophagus the increase in the aneuploidy rate, the proliferation index, and S-cycling state cells portion is observed; 2) the proliferation index is a rather stable factor of the human body susceptibility to oncogenesis and varies only slightly in the course of the cure. The index of the aneuploidy is a labile factor that can be subject to decrease down to normal figures given corresponding cure (p > 0.05); 3) the increased aneuploidy index in the presence of the intestinal metaplasia free of esophagus dysplasia can serve as an objective factor for neoplastic progression.

[Analysis of efficacy of extensive systematic transperineal TRUS-guided cor biopsy of the prostate].

The paper presents the technique of extensive systemic transperineal TRUS-guided cor biopsy of the prostate. Some aspects of the patients' safety and quality of biopsy cores are considered. The analysis of TNM stages of the detected cancers (55 cases out of 142 patients who have undergone systemic biopsy) showed 65.4% of local cancer (T1-2). The quality of cores was adequate for histological examination in 92.8% cases. None serious complications was reported. Only in two of ten patients subjected to radical prostatectomy stage T2 was changed to stage T3 in the absence of metastases to regional lymph nodes and distant metastases.

[The sympathetic innervation of the myocardium and its damage in acute massive pulmonary embolism]. / Simpaticheskaia innervatsiia miokarda i ego povrezhdenie pri ostroi massivnoi legochnoi émbolii.

The state of the adrenergic heart innervation and injuries of right (RV) and left (LV) ventricles in experimental massive embolism of pulmonary arteries (MEPA) were studied in 62 dogs under conditions of the intact thorax and natural respiration. The degree of focal myocardial injuries depended upon the density of the sympathetic innervation: when the density of adrenergic nerves (AN) was high the number of injuries decreased. Hypercatecholaminemia developing at the early period of MEPA has a cardiotoxic effect, more pronounced in dogs with decompensation. A decrease of the AN density and increase of injuries in RV and LV were observed in long-term experiments. The results allow explaining the possibility of the adaptation processes breakdown by the development of heart failure in acute MEPA.

[Morphologic criteria of the adaptation of the vascular bed of the myocardial ventricles in acute massive embolism of the pulmonary arteries in an experiment]. / Morfologicheskie kriterii adaptatsii sosudistogo rusla miokarda zheludochkov pri ostroi massivnoi émbolii legochnykh arterii v éksperimente.

Acute massive pulmonary embolism was induced in 94 random-bred dogs. There were 3 groups of the time control (0, 1 and 6 hrs) and 4 experimental groups (1- and 6-hrs compensated, 1- and 6-hrs decompensated). Favorable signs of the vascular adaptation: moderate arterial plasmorrhagia; lack of blood stasis, heterogeneity of metabolic profiles of arteries; prevalence of anaerobic glycolysis; some prevalence of catabolic reactions over anabolic reactions. Non-favorable signs: considerable plasmorrhagia; perivascular edema; multiple stases and hemorrhages; venous thrombosis; a dramatic decrease of the enzymatic activity in the arterial wall.

[The sympathetic-adrenal system in experimental massive pulmonary embolism]. / Sostoianie simpatiko-adrenalovoi sistemy pri éksperimental'noi massivnoi legochnoi émbolii.

The density of adrenergic nervous plexus in ventricular myocardium, the concentration of catecholamines in blood and in adrenal medulla were studied on 24 dogs with acute massive pulmonary embolism (MPE) and also on 13 control dogs. Moderate and shortterm activation of adrenal system took place in control group. During the first hour of MPE the activation of both adrenal and mediator systems was revealed. To the six hour of MPE the enlarged activity of adrenal chromaffin cells was maintained, but the density of adrenergic nervous plexus in ventricular myocardium decreased. In cases, when MPE was followed by heart failure, a quick and significant decrease of mediator concentration in myocardium and increase of adrenal medullary cells activity took place. Thus, the velocity of revealed changes may be the reason of transition processes exit to compensative or decompensative state.