[The role of different factors affecting the duodenum in chronic viral hepatitis B].

The aim of the present study was to determine the frequency and the character of duodenal lesions in patients with chronic viral hepatitis B (CVH-B), to elucidate the dependence of these parameters on the activity and duration of hepatitis, virulence, and portal blood flow. A total of 206 patients with CVH-B were examined. It was found that CVH-B was associated with the development of chronic duodenitis in 23.

[Prevalence of the lactase deficiency among the population of the northwestern region of Russia].

The article presents the authors' and literature data on the prevalence of the lactase deficiency among the nations of the Finn-Ugric language group (Finns, Karelians, Vepses, Izhors, Estonians), Eastern Slavs (Russians, Ukrainians, Belorussians) living in the northwestern region of Russia. The lactase deficiency has been established: among Russians--16%, Belorussians--15%, Ukrainians--13%, Finns--22%, Karelians--20%, Vepses--20%, Izhors--20%, Estonians--23%. Confirmations of the cultural and historical hypothesis of the lactase deficiency prevalence have been found.

[Carbohydrate hydrolysis and absorption in the human small intestine in aging].

In old age, a significant increase of the starch hydrolysis and a decrease in the maltose hydrolysis occur, as well as lactose, glucose absorption, fructose and galactose. The starch hydrolysis decreases with further ageing, too, whereas saccharose hydrolysis and pure galactose absorption maintain their levels in old age. In ageing, the enzyme systems maintaining the membrane digestion undergo alterations earlier than the transport systems.

[Use of enzyme substitutes in hypolactasia].

The paper presents the results of clinical and laboratory studies of lactrase, a drug containing lactase. This agent is recommended for splitting lactic sugar in subjects with appreciably decreased production of endogenous lactase (hypolactasia). Twenty-eight patients with this condition were examined.

[The clinico-immunological characteristics of chronic lobular hepatitis].

A total of 156 patients with chronic hepatitis were examined, among whom 55 had chronic persistant hepatitis, 42 chronic active and 59 lobular hepatitis. It is for the first time that clinicoimmunologic characteristics of chronic lobular hepatitis are fully detailed. The latter was found to take intermidiate place between chronic persistant and chronic active hepatitis in respect of its clinical picture as well as markedness of biochemical and immunological changes.

[The problems of collagen formation in chronic liver diseases].

With employment of radioimmunoassay, the level of procollagen-III-peptide was measured in the blood of 71 patients with chronic hepatic diseases versus 20 healthy controls. This level was examined for correlation with characteristics of the etiological factor, the degree of hepatic-cellular inflammation and immune reactions. Procollagen-III-peptide concentrations were directly correlated with transaminases and reversely with activity of antibody formation.

[The functional-morphological changes in the duodenum in chronic pancreatitis].

A study of the cavitary and membrane digestion of lipids, carbohydrates, proteins and data of the histological structure of the bioptate of the duodenal mucosa in 34 patients with chronic pancreatitis revealed the morphological picture of chronic duodenitis. This resulted in a reduction of the sorption properties of the intestinal epithelium that was manifested in a reduction of the rate of membranous digestion, mainly of lipids and lactose. Lesser degrees of protein, starch and saccharose hydrolysis were observed.

[The role of immune complexes in chronic liver diseases and their dynamics during treatment].

Chronic liver diseases are marked by a well-defined relationship between the intensity of the cytolytic syndrome and the level of circulating immune complexes (CIC). The highest damaging action on hepatocytes is produced by medium-sized CIC because of their penetrating and complement fixing effects. The level of thrombocytopenia and, to a less measure, of leukopenia also depends on the concentration and size of CIC in CAH and liver cirrhosis (LC), which may provide indirect evidence of the lytic action of CIC on hepatocytes, leading in turn to the impairment of microcirculation and aggravation of hepatocyte hypoxia.

[Methods of teaching efficient therapy of internal diseases].

An original method of teaching students efficient therapy has been developed basing on the psychological decision theory, conception of stage-by-stage formation of mental actions, method of key signals. The instructor uses the scheme repeatedly when observing the students' clinical activities, at doctor's rounds and conferences.

[The characteristics of the clinical course of hereditary hemochromatosis].

The authors describe 32 patients with hemochromatosis observed from 1965 through 1990 (28 men and 4 women). The diagnostic role of serum iron determination and liver biopsy is emphasized. The therapeutic results of bloodletting (500 ml weekly for several years) dyspheral (1-1.

[Hormonal mechanisms of carbohydrate metabolism disorders in chronic pancreatitis].

The mechanisms of carbohydrate metabolism abnormality were studied in 128 patients suffering from chronic pancreatitis by means of simultaneous measurement in the blood of glucose, insulin, C-peptide and glucagon concentrations both on an empty stomach and after the glucose tolerance test (50 g glucose). Five types of the hormonal mechanisms of hyperglycemia were revealed, caused by derangement of beta-cells for the most part, more rarely by alpha-cells of the pancreas and impairment of interregulation of those cells in chronic pancreatitis. The rate of the hormonal mechanisms of carbohydrate metabolism abnormality was shown to depend on the gravity and duration of chronic pancreatitis whereas blood sugar and insulin response to intravenous injection of glucose in patients with chronic pancreatitis to have characteristic features in common to type I and II diabetes.

[The treatment with hepatoprotectors of patients with chronic liver diseases].

Hepatoprotectors were used in 89 patients with chronic liver diseases from 1 to 6 months. A positive clinico-biochemical and immunological effect, namely, increase of the T-lymphocyte count, normalization of the ratio of immunoregulator cells, reduction of the antibody-dependent cellular toxicity, level of circulating immune complexes, immunoglobulins. Patients with chronic persisting hepatitis showed a stable remission from 6 to 12 months.

[The clinical significance of immunoglobulin E in chronic liver diseases].

The rise of the IgE content was found in 78.5% of patients suffering from chronic liver diseases. In patients with chronic active hepatitis, it was identified to a greater rate, whereas in patients with chronic persistent hepatitis to a lesser degree.