Publications by authors named "Korot'ko G"

Aim Of Review: Statement of modern traditional and original view on essence and mechanisms of postprandial adaptation of pancreatic enzymes secretion is presented.

Main Points: The exosecretion of synthesized de novo and recreted pancreatic enzymes is adapted to nutrient content of the meal by means of duodenal-pancreatic stimulated and inhibition peptidergic mechanisms, generalized and selected-induced enzyme-substrate complexes of duodenal chyme. The managed module secreted-transported pancreatic system is important as a normal criterion in urgent adaptation.

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During the breast feeding the hydrolysis of breast milk nutrients in natural conditions provides by milk enzymes, digestive gland secrets and intestinal epitheliocyte as autolytic induced digestion with following including and development of auto-digestion in hydrolysis of milk lipids and proteins. Milk lactose is hydrolyzed as a type of auto-intestinal digestion. Breast glands release enzymes according to a year lactation dynamics.

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During the breast feeding the hydrolysis of breast milk nutrients in natural conditions provides by milk enzymes, digestive gland secrets and intestinal epitheliocyte as autolytic induced digestion with following including and development of auto-digestion in hydrolysis of milk lipids and proteins. Milk lactose hydrolyses as a type of auto-intestinal digestion. Breast glands release enzymes according to a year lactation dynamics.

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The review presented the results of the author, his co-workers and investigators of other laboratories about types of feeding (histotropic, hemotropic, amniotropic, lactotropic, definitive) and digestion (autolytic, native) of a fetus and an infant. The study was based on analysis of enzymes that provided hydrolysis of amniotic fluid and breast milk. The data about probable technology of abovementioned types of digestion in earlier stages of individual human advance and opportunity of hydrolase recretor origin in amniotic fluid and breast milk are shown.

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The transport processes take place on the all stages of pancreatic secretion. The article highlighted the multi-parametric regulated exosecret transport through the duct system of the pancreas. The system has valves and micro-reservoirs of secret.

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The results of own study and literature review about digestive glands enzymes transport into the bloodstream, simultaneous controlling exosecretion of two enzyme pools - poliglandular, recreting from blood, and new synthesized, gematoglandular recirculation of hydrolytic enzymes are presented.

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Signal enzymes with direct and indirect hormone releasing action are formed by means of proteolysis from exogenic and endogenic proteins. The proteolysis is the basis of hormone processing. The limited proteolysis forms hormones from pro-hormones, ligand proteolysis excludes or reduces their stimulated or inhibited effects.

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Literature data and the results of own examinations of speed and differentiation of stomach evacuation of test breakfasts consisted of different nutrients were presented. The relation of evacuation speed, antegrade and retrograde gastro-duodenal passage to digestive fermentative potential of gastro-duodenal complex was shown. It was concluded about the possibility of it's system characterizing by the ultrasonographical examination of speed and character of test breakfast's evacuation from the stomach.

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Enzymes, exosecreted by the digestive glands plays not only a role of the hydrolases, but also an informational and modulating role in the urgent adaptation of the enzyme secretion to the structure and properties of the luminal content of the gastrointestinal tract. Endosecreted enzymes in the blood not only inform about enzymatic condition of the hydrolase-producing glands and duct system, but also plays an informational and modulating role by the inhibition of the secretion of the same enzymes, and by the stimulation of the secretion of the heteronymic enzyme, defines a parity of their secretion and recretion, integrates enzyme secretion of the pancreas and gastric glands.

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In original research are compared results of treatment of irritable bowel syndrome (IBS) by standard technique and treatment with to additional application of the control of a biofeedback. The analysis was carried out on dynamics of clinical symptoms in 1 and 6 months after course of treatment. Research showed improvement of results of treatment IBS in the group with additional treatment of a biofeedback.

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The review contains the materials on scientific literature, research results of the author and his colleagues about organization of pancreatic exosecretion activity. Peptidegric regulatory mechanisms and pancreatic exosecretion of the hydrolytic enzymes, their participation in adaptation of the pancreatic enzymatic discharge to the nutrient composition of duodenal chyme are underlined.

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The problem of treatment optimization of patients with urgent cholangiogen pancreatitis after papillotomy is considered Dynamics of laboratory parameters is resulted. High efficiency with use delayed papillotomy, decrease in pancreatic secretion using oktreated in pre- and the postoperative period, and also introductions tripsin in the duodenum in a combination to it decompression, or the main pancreatic channel a probe pf an original design is established.

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Dynamics of cholecystokinin-like, secretin and somatostatin immunoreactivity of blood plasma and extracts of duodenal mucosa, frequency of acute pancreatitis (AP) after the resection of the duodenum was studied on not purebred dogs. Rising of a secretin concentration in blood plasma after the clinoid resection of the duodenum, accompanied by decreasing of its concentration in duodenal mucosa, was revealed. Decreasing of cholecystokinin concentration in a neutral extract was revealed.

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Such salivation parameters as saliva volume, total protein saliva concentration and amylolytic enzyme activity as well as their discharge levels were compared to the level of H. pylori contamination of the stomach mucous coat in clinically healthy people (30 people) and patients with complicated duodenum ulcer (142 patients) within various terms after the duodenoplasty eradication and within long-term periods after the selective proximal vagotomy (50 patients). The amylolytic enzyme activity and ptyalin discharge was higher in clinically healthy but HP-contaminated subjects than HP-negative people.

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It is offered to allocate three basic contours of regulation and self-regulation of pancreatic secretion: duodeno-pancreatoglandulary, hemato-pancreatoglandulary and ductulo-pancreatoglandulary, at which participation the correction of enzymatic structure of a secret of pancreas concerning permanent properties of duodenal chyme and variation of enzymatic spectrum of a secret in the postprandial period of secretion is carried out. In all three contours in quality of the regulatory factor acts actually a pancreatic secret and its components, and also condition of ductal hydrokinetics of a pancreatic secret. Is established, that the pancreatic secretion is provided with the large number of the functionally nonequipotential secretory-transport modules having certain determinants of their morpho-functional organization.

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Based on the rheographic studies of the postprandial transformation of the splanchnic blood flow and morphological study of the resected parts of the pancreas in patients with chronic fibrosing pancreatitis, the authors revealed functional and morphological attributes of local arterial hypertension and, at the stage of exacerbation of disease--manifestations of a vascular crisis. Local arterial hypertension with vascular crises originating on its basis is an important pathogenetic factor of the progression of chronic pancreatitis. It is assumed that local arterial hypertension develops against the background of depression of cholinergic effects and domination of sympathetic effects.

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In clinical healthy volunteers (20) the rapid of gastric evacuation of three types of test meals: the gruel with egg protein or butter are investigated by sonography. There are investigated (117): the half-time of evacuation, the area of a diameter of the antrum in the systole and diastole, the amplitude of the contraction and the frequency of it. In healthy volunteers the differentiative evacuation of the three types of the test meals are established.

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Samples of the stomach, duodenum and pancreas removed from 76 patients obtained during organ-preserving operations for ulcer and chronic pancreatitis were examined morphologically. It is found that the most frequent type of changes in the intraorgan arteries is their wall hypertrophy in combination with hyperelastosis and elastotic fibrosis. This characterizes chronic local arterial hypertension.

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Transformations of parameters of pancreatic exocrine secretion after the direct operations on the pancreas of a dog were studied during the experiment. It was determined that the early post-operative period proceeds in the conditions of the expressed pancreatic hypersecretion, hyperenzymemia and ductal hypertension. Their intensity reduces as the destructive process in pancreas develops.

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This is a review of physiological, morphological and clinical studies of pancreas secretion with the emphasis placed on pancreatic enzymes. It was established that different parts of the duodenal mucous coat have different chemosensory thresholds to the stimulators and inhibitors of pancreatic secretion. Secretory regions of the pancreas having a modular organization are also functionally different.

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