[Peculiarities of occupational esophagogastroduodenal pathology in personnel serving at CW disposal and storage facilities].

In a process of medical care and supervision on staff and military personnel, eliminating the chemical weapons, it was revealed that they are more susceptible to esophagogastroduodenal pathology in comparison with the control group. Moreover, the given pathology has an asymptomatic disease course but associated with high contamination of Helicobacter pylori. Marked inflammation changes, atrophic and fibrosis manifestation and microcirculation dysfunction have been confirmed by histological analysis of gastric mucosa. We supposed that the complex of occupational health risk factors, including possible subliminal toxic influence of eliminated CW components determines this pathological dysfunction. Negative influence of shift work and irregular nutrition rhythm are not excluded. The findings of this research are dictating the necessary of revision of military medical expertise principles and the development of the more effective treatment and prophylactic methods.

[Risk factors for myocardial infarction recurrence in young and middle-aged males].

AIM: To assess a set of risk factors (RF) for coronary heart disease in myocardial reinfarction patients aged less than 60 years. SUBJECTS AND METHODS: A multitude of probable RFs that might predispose to the development of MI or provoke its occurrence were studied in 526 male patients aged less than 60 years, who had primary (n = 281) and repeated (n = 245) myocardial infarction (MI) from the results of hospital treatment. RESULTS: Lipid metabolic disturbances, smoking, arterial hypertension (AH), foci of chronic infection, and overweight were ascertained to be the most common RFs in patients less than 60 years. There was a history of dyslipidemia (100%), AH, heart failure, and cardiac arrhythmias in the complicated course of repeated MI. When these RFs are combined, the likelihood of disease complications and death increases. CONCLUSION: According to the results of estimation of the spread of RFs for myocardial reinfarction, it is proposed to enhance the monitoring of lipidogram readings, blood pressure value, magnitude of the symptoms of heart failure, and serum glucose levels, and infection foci sanitization and to improve patients' awareness about a risk from smoking and lower physical activity.

[Specific features of myocardial infarction in young and middle-aged subjects].

The aim of the study was to obtain an insight into the origin and specific features of myocardial infarction (MI) in 322 subjects below 60 yr of age. Most patients had anginous complaints. The incidence of non-anginous forms of MI in patients aged below 45 and 46-60 years was estimated with reference to the occurrence of complications. The structure of these complications and causes of their fatal outcome were elucidated. The prevalence of risk factors of MI in the survivors and patients who died was obtained.

[Chronic atrophic gastritis: morphological features and pepsin formation function].

The paper discusses a modern approach to chronic atrophic gastritis as a precancerous gastric condition. It deals with the role of Helicobacter pylori infection, development of disease, morphological changes taking place in gastric mucosa associated with chronic atrophic gastritis, and their importance for gastrocarcinogenesis. Recommendations are given on the strategies of management of precancerous gastric changes in mucosa as well as early prophylaxis of stomach cancer development from chronic atrophic gastritis associated with Helicobacter pylori infection.

[The clinical physiology of the digestive system. The difficulties in its determination and the first results]. / Klinicheskaia fiziologiia sistemy pishchevareniia. Trudnosti stanovleniia i pervye rezul'taty.

The paper shows it necessary to define clinical physiology of the digestive system as a nosological entity due to the natural evolution of physiology and to the increasing clinical practical requirements. It considers its purpose, tasks, and areas under study and gives the results of some original studies of the gastroduodenal and hepatobiliary systems and the small intestine. Special emphasis is laid on new guidelines to examining the functional and morphological states of the alimentary tract.

[Modified technic of the lysosomal-cationic test for the quantitative and qualitative assessment of leukocytic infiltration of the mucosa of the stomach and duodenum]. / Adaptirovannaia metodika lizosomal'no-kationnogo testa dlia kolichestvennoi i kachestvennoi otsenki leikotsitarnoi infil'tratsii slizistoi obolochki zheludka i dvenadtsatiperstnoi kishki.

Modification of the lysosomalkationic test by V. E. Pigarevsky (1978) is suggested. The method implies usage of 10% neutral formalin (according to Lilly) for the material fixation, optimal staining of histological preparations from gastric and duodenal mucosa with fast green, usage of hematoxyline Carazzi for the additional staining of cellular nuclei. The technique is readily available, it is easily interpreted, is highly informative for studying the inflammatory changes in gastric and duodenal mucosa in gastroduodenal diseases and in the experiments.

[Method of histochemical identification of endocrine cells of the gastric and duodenal mucosa]. / K metodike gistokhimicheskoi identifikatsii éndokrinnykh kletok slizistoi obolochki zheludka i dvenadtsatiperstnoi kishki.

A scheme of histochemical identification and morphometry of G-, Ecl- and Ec-cells of the gastric and duodenal mucosa has been developed, tested, and is recommended. It includes the use of silver staining by the methods of Grimelius (1968), Masson-Hamperl, Sevier-Munger, and of diazonium reaction with diazol pink "O". The methods are described with additions and modifications of the authors which increase the effectiveness and validity of the most important stages of their performance.

[The role of polymorphonuclear leukocytes in the mechanisms of ulcerogenesis]. / Rol' polimorfnoiadernykh leikotsitov v mekhanizmakh ul'tserogeneza.

The functional activity displayed by polymorphonuclear leukocytes (PL) of the peripheral blood and gastric mucosa, including ulcer margins, was studied in 50 rabbits with ulcer experimentally induced by the Okabe method and in 25 intact animals. The peripheral blood PLs were found to show substantially increased lysosomal cation proteins (LCP), enhanced alkaline phosphatase and decreased peroxidase activity. The changes in the gastric mucosa, particularly in its damaged area, were characterized by a marked microcirculatory bed response and formation of lymphocytic and, later on, pronounced neutrophilic infiltrates. The tissue PL therewith contained abundance of glycogen and LCP and intensively secreted granules. The maximum of these manifestations as viewed from PL coincided with the ulcer formation period (on days 2-3 of the experiment). When the ulcer had developed, the levels of LCP and glycogen in PL became lower. It was concluded that PL made an important contribution to ulcerogenesis.

[Functiono-morphologic substantiation of the diagnostic value of the atropine test in patients with duodenal ulcer]. / Funktsional'no-morfologicheskoe obosnovanie diagnosticheskoi tsennosti atropinovogo testa u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

The basal production of hydrochloric acid, pepsin, the level of immunoreactive gastrin-17 in the blood serum and gastric juice, endocrine G-, EcI- and Ec-cells of the gastric mucosa were studied in 42 patients with duodenal peptic ulcer. Patients with a negative atropine test were characterized by a high production of hydrochloric acid, hypergastrinemia, an elevated secretion of gastrin with gastric juice, hyperplasia of G- and EcI-cells. In a positive atropine test these indices were lower with the exception of a great amount of Ec-cells in the antral mucosa. Thus the atropine test reflected the functional-morphological arrangement of the secretory apparatus of the gastric mucosa and was of diagnostic value.

[Clinical significance and diagnosis of transpyloric prolapse]. / Klinicheskoe znachenie i diagnostika transpiloricheskogo prolapsa.

Data of complex clinico-instrumental and morpho-functional examination of 168 patients with transpyloric prolapse are presented. The authors suggest its great significance in the development and progress of the inflammatory-destructive changes of the stomach and duodenum. The detected features of the clinical course show the importance of a dynamic observation and rational treatment of patients with transpyloric prolapse.

[Morphologic characteristics of the mucous membrane of the stomach and duodenum in patients with acute complications of gastroduodenal ulcers after surgical procedures]. / Morfologicheskaia kharakteristika slizistykh obolochek zheludka i dvenadtsatiperstnoi kishki u bol'nykh s ostrymi oslozhneniiami gastroduodenal'nykh iazv posle khirurgicheskikh vmeshatel'stv.

Patients with acute complications of gastroduodenal ulcers are characterized by common morphological alterations in mucous membranes of the stomach and duodenum which consisted in higher or normal content of parietal, main and EcI-cells, substantial deficiency of Ec-cells as well as in progressively decreased mucin formation from proximal portions of the stomach to distal ones with its lowest level in the duodenum.

[The prenatal manifestations of peptic gastroduodenal diseases]. / Prenatal'nye proiavleniia pepticheskikh gastroduodenal'nykh zabolevanii.

Proteolytic activity of uropepsinogen as a marker of gastroduodenal diseases of peptic character was studied in 92 children aged 7-9 years and it was analyzed in parallel with specific features of their mothers' pregnancy. The findings obtained and literature data show that the genotypical features of the fetus can play a certain role in genesis of the specific course of the mothers' pregnancy and manifest themselves phenotypically via the elevated level of uropepsinogen proteolytic activity in the children at the age of 7-9 years with possible formation of gastroduodenal diseases in them.

[The prognosis of the late results of vagotomy and dispensary care in patients with duodenal peptic ulcer]. / Prognozirovanie otdalennykh rezul'tatov vagotomii i dispanserizatsii bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

The article studies the remote results of vagotomy in treatment of 212 servicemen with ulcer of duodenum. Laboratory, endoscopic, roentgenological, pH-metric, manometric, radioimmunological and morphological researches were used before and after operations. From the point of view of prognostication 30 important criteria were selected to forecast the results of vagometry, and also to determine the groups for control examination. These data made it possible to prognosticate the right outcomes of treatment in 84.7% of cases, and thus individualize the treatment and prophylaxis of the prior disease and postvagotomy syndromes reducing their frequency. In the results of these measures the cases of invalidity and disability retirement of servicemen were diminished.

[Age characteristics of the bile duct system functioning in the norm and in the gastrointestinal system pathology]. / Vozrastnye osobennosti funktsionirovaniia zhelchevyvodiashchei sistemy v norme i pri patologii zheludochno-kishechnogo trakta.

At the present the age-specific particularities of many organs and systems used in diagnostics are determined. The function--morphological state of the biliary system in different age groups is poorly studied. The age-specific particularities of biligenesis in norm (control group--90 persons) and in pathology were studied by the following traditional methods: multifractional chromatic duodenal catheterization, dynamic scintigraphy of gallbladder, dynamic ultrasonic cholecystography. There were 167 patients with gastroduodenal diseases (chronic gastritis, gastric, duodenal and intestinal ulcers) and 115 patients with calculous cholecystites and chronic hepatites. The gastroduodenal affections reinforced the appearnce and the course of typical age alterations of biliary system. Patients sufferin from hepatobiliary pathology over 5 years biliation ability has remained in normal values.