[Lactose digestion and absorption in the jejunum of man: studies using the regional perfusion method].

Continuous jejunal perfusion with 0.1, 1 and 10% lactose solutions was made in 9 patients with good milk tolerance and 25 patients with secondary hypolactasia. In normal tolerance lactose is assimilated in amounts of 30-60% along the 30 cm of the jejunal length.

[Gluten enteropathy].

The authors relate the results of 10 years of observations of 113 patients suffering from gluten enteropathy (GE) of the adults. In all the patients, the diagnosis was supported by the presence of hyper-regenerative atrophy of the small intestinal mucosa (total in 70% and subtotal in 30%). Metabolic disorders and cellular immunity were investigated.

[Treatment of chronic diseases of the small intestine].

Multimodality and differentiated treatment of small-intestinal diseases is to combine methods of etiological action with pathogenetic treatment of the main clinical syndromes: chronic diarrhea, malabsorption syndrome, hypercatabolic exudative enteropathy. Each nosological form should be treated specifically. Pathogenetic treatment involves diet therapy, chemotherapeutic correction of metabolic processes (vitamin administration, recovery of normal protein and lipid metabolism, water and electrolyte balance, anemia), management of chronic diarrhea.

[Mechanisms of the development of the chronic phase of diseases of the small intestine].

The results of studying mechanisms underlying chronicity of functional (chronic enteritis ) and severe organic (celiac disease) lesions of the small intestine have been analyzed. Mechanisms causing the diseases take a chronic course appeared very similar. They involve bacterial proliferation in the intestine with consequent impairment of the digestion, absorption and motility resultant in derangement of metabolism.

[Current problems in the diagnosis and treatment of small intestinal diseases].

Based on the data obtained during clinical examination of 1,026 patients with small intestinal diseases the authors provide the portion of laboratory and instrumental methods employed in the diagnosis of different disease entities. The clinical picture of small intestinal diseases is mainly determined by the gravity of malabsorption. Histological examination of the small intestinal mucosa is a method of choice in the diagnosis of gluten enteropathy, Whipple's disease, primary lymphangiectasis and amyloidosis.

[Disorders of lipid metabolism in patients with chronic diseases of the small intestine].

Lipid metabolism was evaluated in patients with chronic enteritis, celiac disease, general variable immunodeficiency (GVI), short-bowel syndrome. In chronic enteritis with malabsorption syndrome degree I and II changes in metabolism were characterized by hyperlipidemia due to high lipid fractions, mainly triglycerides; in malabsorption syndrome degree III (celiac disease, general variable immunodeficiency, short-bowel syndrome) by a drop of serum total lipids, phospholipids, cholesterol, beta-lipoproteins, free fatty acids, elevated concentrations of triglycerides. Changes in fatty acid composition of blood serum in patients with malabsorption syndrome degree III manifested by derangement of polyunsaturated fatty acids ratio.

[General variable immunologic deficiency with malabsorption syndrome].

Twenty-two patients with general variable immunodeficiency (GVI) and malabsorption syndrome (MS) were followed up for 2-12 years. III degree MS was found in 17 cases. Serum immunoglobulins concentration and T-lymphocyte count were reduced, the latter at the expense of theophylline-resistant and active E-RFC.

[Diagnosis and treatment of psychogenic intestinal dyskinesia].

Intestinal dysfunction resulting from psychological factors associated with vegetative disorders were found in 79% of relevant patients. It is stated that comprehensive program of screening persons suffering from psychosomatic intestinal diseases should involve diagnosis of psychopathologic syndromes, analysis of personal traits, factors of psychic trauma, internal pattern of the disease. The treatment technique affecting all the levels of the disease (central, vegetative and somatic) provides good therapeutic effect and normal psychological profile in the majority of patients.

[Gastrointestinal biorhythms in chronic intestinal diseases].

Gastric and intestinal bio-electrical activity (BEA) was assessed from body surface by means of a modified electrogastrograph, EGS-4M, in 387 patients with various intestinal conditions and 39 normal subjects. The method is simple, atraumatic and rather inexpensive. It revealed qualitative and quantitative BEA changes (uncoordination in half the cases, and increased amplitudes of waveforms I, IV and V) in patients with mild disorders, which were chiefly functional and involved no organic gastro-intestinal lesions (i.

[The effect of an agluten diet on cellular immunity in adult patients with celiac disease].

A total of 45 patients with Gee's disease of adults were followed up in the time course of 6 months to 3 years. In untreated patients the number of T-lymphocytes was decreased both at the expense of T-helpers and, especially, of T-suppressors. Lymphokine-producing activity of T-lymphocytes, according to the production degree of the mediator, inhibiting monocyte adherence, increases after gliadin-treatment of the immuno-competent cells, that leads to monocyte adhesion decrease.

[Importance of amino acid mixtures in the supplementary nutrition of patients with chronic diseases of the small intestine].

The clinical effectiveness of alvesin, a mixture of pure amino acids, balanced by the amino acid composition, was studied in the treatment of patients with chronic diseases of the small intestine. The drug was well tolerated by the patients after its parenteral administration. A high clinical effect of alvesin was recorded in 98 patients suffering from chronic enteritis, celiac disease, general variable immunodeficiency.

[Pathogenesis of steatorrhea in chronic diseases of the small intestine].

Altogether 150 patients with chronic enteritis and celiac disease with a history of resection of a part of the ileum were examined. It was established that in patients with chronic enteritis, of importance for the pathogenesis of steatorrhea was the deficiency of bile acids during digestion because of hypokinesia of the gallbladder and partial deconjugation of bile acids in the presence of bacterial dissemination of the small intestine. During celiac disease, steatorrhea was caused by the decreased enzymatic function of the pancreas, asynchronism of the food and bile supply to the intestinal lumen, disorders of absorption of lipolysis products.

[State of regenerative processes in the mucosa of the small intestine in celiac disease in adults (gluten enteropathy)].

Biopsies of the small intestine mucosa were studied in 60 patients among which celiac disease was diagnosed in 35 after clinico-morphological examinations and chronic enteritis in 25. Apart from histological and histochemical methods, autoradiography of biopsies with 3H-thymidine was used. The study showed that atrophy of the small intestine mucosa in celiac disease in adults was of hyperregeneratory nature which was manifested by deepening of the crypts and increased number of DNA-synthesizing enterocytes.