Pub Date : 2022-12-13DOI: 10.25298/2616-5546-2022-6-2-105-109
A. Kanatbekova
Background. Chronic hepatitis B (CHB) remains one of the most urgent problems in modern medicine. There are about 296 million people with CHB worldwide, 820 thousand dying annually of liver cirrhosis and hepatocellular carcinoma. Objective. To study the immunodeficiency syndrome peculiarities in acute hepatitis B (AHB) convalescents. Material and methods. We have studied immunodeficiency syndrome (IDS) in 104 AHB convalescents, the control group comprised 78 apparently healthy donors. All examined were between the ages 18-45. IDSs were studied according to the IDS Map developed by Acad. R.V. Petrov (1987). Results. In 17.3% of AHB convalescent patients IDSs were absent, while in 82.7% - at least one of the three IDSs (infectious, atopic and autoimmune) was detected. In 44.2% of cases, clinical variants of one IDS were noted, in 34.9% - those of two syndromes, in 20.9% - those of three syndromes simultaneously in various combinations. Convalescence from AHB with IDS either had a non-smooth course or the disease transformed into a chronic process in 24.4%, while in the control group - in 12.3% of cases. Conclusions. AHB with IDS should be included in the progredient form, i.e. as a high-risk pathology of liver cirrhosis and hepatocarcinoma development, thus determining its appropriate therapeutic strategy.
{"title":"IMMUNODEFICIENCY SYNDROMES IN ACUTE HEPATITIS B CONVALESCENTS","authors":"A. Kanatbekova","doi":"10.25298/2616-5546-2022-6-2-105-109","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-105-109","url":null,"abstract":"Background. Chronic hepatitis B (CHB) remains one of the most urgent problems in modern medicine. There are about 296 million people with CHB worldwide, 820 thousand dying annually of liver cirrhosis and hepatocellular carcinoma. Objective. To study the immunodeficiency syndrome peculiarities in acute hepatitis B (AHB) convalescents. Material and methods. We have studied immunodeficiency syndrome (IDS) in 104 AHB convalescents, the control group comprised 78 apparently healthy donors. All examined were between the ages 18-45. IDSs were studied according to the IDS Map developed by Acad. R.V. Petrov (1987). Results. In 17.3% of AHB convalescent patients IDSs were absent, while in 82.7% - at least one of the three IDSs (infectious, atopic and autoimmune) was detected. In 44.2% of cases, clinical variants of one IDS were noted, in 34.9% - those of two syndromes, in 20.9% - those of three syndromes simultaneously in various combinations. Convalescence from AHB with IDS either had a non-smooth course or the disease transformed into a chronic process in 24.4%, while in the control group - in 12.3% of cases. Conclusions. AHB with IDS should be included in the progredient form, i.e. as a high-risk pathology of liver cirrhosis and hepatocarcinoma development, thus determining its appropriate therapeutic strategy.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47755356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-13DOI: 10.25298/2616-5546-2022-6-2-128-133
A. Ihnatsiuk
Background. When treating the dehiscence of the esophagus and its anastomoses, it is necessary to fulfil the following tasks: drainage and sanitation of the mediastinum and pleural cavity, replenishment of protein losses and energy costs, dehiscence closure and treatment of present purulent complications. Objective. To improve the treatment outcomes of esophageal and its anastomoses dehiscence using modern minimally invasive video-assisted thoracoscopic techniques. Material and methods. 20 patients (15 (75%) men and 5 women (25%)) with esophageal and its anastomoses dehiscence underwent treatment. The mean age of patients was M±SD = 55 ± 10 (CI (95%) = 50-60; min−35; max−76). Body mass index averaged M±SD = 20.98 kg/m2 (CI (95%) = 18.61-22.45; min−15,82; max−38,27). Results. The reasons for the surgical interventions resulting in dehiscence were as follows: esophageal cancer - 6 (30.0%); esophageal diverticula - 4 (20.0%); cardia achalasia − 2 (10.0%); esophageal chemical burn − 4 (20.0%); benign formations - 4 (20.0%). The development of clinical manifestations of dehiscence occurred at M±SD = 170 ± 61 hours, (CI (95%) = 141 - 198). Conclusions. The dehiscence management of the esophagus, esophagogastroanastomosis or esophagoenteroanastomosis either by installation of a T-shaped drainage system or fixation of transpleural tube to the thoracic wall at a place of dehiscence enables to preserve the esophagus or a created conduit, to reduce surgical stress as well as the duration of intervention and is regarded as an adequate surgical option.
{"title":"DEHISCENCE MANAGEMENT OF THORACIC ESOPHAGUS AND ITS ANASTOMOSES","authors":"A. Ihnatsiuk","doi":"10.25298/2616-5546-2022-6-2-128-133","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-2-128-133","url":null,"abstract":"Background. When treating the dehiscence of the esophagus and its anastomoses, it is necessary to fulfil the following tasks: drainage and sanitation of the mediastinum and pleural cavity, replenishment of protein losses and energy costs, dehiscence closure and treatment of present purulent complications. Objective. To improve the treatment outcomes of esophageal and its anastomoses dehiscence using modern minimally invasive video-assisted thoracoscopic techniques. Material and methods. 20 patients (15 (75%) men and 5 women (25%)) with esophageal and its anastomoses dehiscence underwent treatment. The mean age of patients was M±SD = 55 ± 10 (CI (95%) = 50-60; min−35; max−76). Body mass index averaged M±SD = 20.98 kg/m2 (CI (95%) = 18.61-22.45; min−15,82; max−38,27). Results. The reasons for the surgical interventions resulting in dehiscence were as follows: esophageal cancer - 6 (30.0%); esophageal diverticula - 4 (20.0%); cardia achalasia − 2 (10.0%); esophageal chemical burn − 4 (20.0%); benign formations - 4 (20.0%). The development of clinical manifestations of dehiscence occurred at M±SD = 170 ± 61 hours, (CI (95%) = 141 - 198). Conclusions. The dehiscence management of the esophagus, esophagogastroanastomosis or esophagoenteroanastomosis either by installation of a T-shaped drainage system or fixation of transpleural tube to the thoracic wall at a place of dehiscence enables to preserve the esophagus or a created conduit, to reduce surgical stress as well as the duration of intervention and is regarded as an adequate surgical option.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-15DOI: 10.25298/2616-5546-2022-6-1-20-24
Ya. I. Bik-Mukhametova, T. N. Zakharenkova, N. M. Golubykh
Background. Intrahepatic cholestasis of pregnancy (COP) is the most common complication of pregnancy that occurs during the 2nd-3rd trimester and is accompanied by liver damage manifested as cholestasis and cytolysis. Objective. To establish the role of cytokine response in the pathogenesis of COP as well as its obstetric and perinatal complications. Material and methods. 87 pregnant women were examined: 57 with intrahepatic cholestasis of pregnancy and 30 patients of the comparison group. The levels of pro-inflammatory (interleukin 6) and anti-inflammatory (interleukin 4) cytokines were determined by enzyme-linked immunosorbent assay, and their prognostic significance as predictors of obstetric and perinatal complications in women with COP was estimated. Results. The course of COP is accompanied by a decrease in the concentrations of IL-6 and IL-4 cytokines and a lower ratio of IL-4/IL-6 (P(U)IL-6=0.041; P(U)IL-4=0.0007 and P(U)IL4/IL-6=0.008). The concentration of IL-6 in blood serum that is > 2.53 pg/ml (Se=83.3 %, Sp=73.9 %; AUC=0.822; 95 % CI 0.636–0.938; p=0.004) and IL-4 concentration that is > 41.99 pg/ml in symptomatic COP (Se=100.0 %, Sp=78.6 %; AUC=0.839; 95 % CI 0.593–0.965; p=0.011) are regarded as a risk factor for preterm labor (PL) in women with COP. The concentration of IL-6 > 3.07 pg/ml in women with COP and negative vaginal discharge culture can be considered as a predictor of meconium staining of amniotic fluid (MSAF) (Se=100.0 %, Sp=62.9 %; AUC=0.770; 95 % CI 0.597–0.895; p=0.024). Conclusions. COP is accompanied by a lower level of IL-6; an atypical immune deviation with no shift towards the Th2 immune response that is characteristic of a normal pregnancy; as well as an imbalance in the cytokine response with a decrease in the anti-inflammatory link. Preterm birth in patients with COP is associated with higher levels of IL-6 during pregnancy. The release of meconium into amniotic fluid in women with COP (in the absence of significant pathogenic and opportunistic microflora according to the results of vaginal discharge culture) correlates with higher concentrations of IL-6 in the blood.
{"title":"PECULIARITIES OF THE CYTOKINE STATUS IN OBSTETRIC AND PERINATAL COMPLICATIONS IN WOMEN WITH INTRAHEPATIC CHOLESTASIS OF PREGNANCY","authors":"Ya. I. Bik-Mukhametova, T. N. Zakharenkova, N. M. Golubykh","doi":"10.25298/2616-5546-2022-6-1-20-24","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-1-20-24","url":null,"abstract":"Background. Intrahepatic cholestasis of pregnancy (COP) is the most common complication of pregnancy that occurs during the 2nd-3rd trimester and is accompanied by liver damage manifested as cholestasis and cytolysis. Objective. To establish the role of cytokine response in the pathogenesis of COP as well as its obstetric and perinatal complications. Material and methods. 87 pregnant women were examined: 57 with intrahepatic cholestasis of pregnancy and 30 patients of the comparison group. The levels of pro-inflammatory (interleukin 6) and anti-inflammatory (interleukin 4) cytokines were determined by enzyme-linked immunosorbent assay, and their prognostic significance as predictors of obstetric and perinatal complications in women with COP was estimated. Results. The course of COP is accompanied by a decrease in the concentrations of IL-6 and IL-4 cytokines and a lower ratio of IL-4/IL-6 (P(U)IL-6=0.041; P(U)IL-4=0.0007 and P(U)IL4/IL-6=0.008). The concentration of IL-6 in blood serum that is > 2.53 pg/ml (Se=83.3 %, Sp=73.9 %; AUC=0.822; 95 % CI 0.636–0.938; p=0.004) and IL-4 concentration that is > 41.99 pg/ml in symptomatic COP (Se=100.0 %, Sp=78.6 %; AUC=0.839; 95 % CI 0.593–0.965; p=0.011) are regarded as a risk factor for preterm labor (PL) in women with COP. The concentration of IL-6 > 3.07 pg/ml in women with COP and negative vaginal discharge culture can be considered as a predictor of meconium staining of amniotic fluid (MSAF) (Se=100.0 %, Sp=62.9 %; AUC=0.770; 95 % CI 0.597–0.895; p=0.024). Conclusions. COP is accompanied by a lower level of IL-6; an atypical immune deviation with no shift towards the Th2 immune response that is characteristic of a normal pregnancy; as well as an imbalance in the cytokine response with a decrease in the anti-inflammatory link. Preterm birth in patients with COP is associated with higher levels of IL-6 during pregnancy. The release of meconium into amniotic fluid in women with COP (in the absence of significant pathogenic and opportunistic microflora according to the results of vaginal discharge culture) correlates with higher concentrations of IL-6 in the blood.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43908997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-15DOI: 10.25298/2616-5546-2022-6-1-11-19
V. Davydov, S. Zhavoronok, A. Babenka, D. S. Borisovets, T. Rogacheva, I. Zadora, L. V. Novak, E. Gasich, N. Bayur, S. Marchuk
Background. The incidence of hepatitis E (HEV) in Belarus differs from the frequency of occurrence of anamnestic antibodies in the population. Objective. To study the epidemic trends of HEV in Belarus. Material and methods. The study included 5745 samples of blood serum obtained from: residents of Belarus (Brest and Brest region, Minsk and Minsk region) – 2784; foreign citizens - 1457; +ALT and -ALT blood donors – 378; domestic pigs - 1126. All samples were tested for anti-HEV IgG and IgM and 130 samples - for HEV RNA, 9 samples were genotyped by Sanger sequencing. Results. Seroprevalence of anti-HEV IgG in the population amounts to 7.3% (95 CI 5.8-9.0), and in patients with liver damage – to 11.2% (95% CI 9.6-12.9). For foreign citizens it equals 5.22% (95% CI 4.11-6.53), for domestic pigs – 33.75% (95% CI 30.44-37.32). The incidence of anti-HEI IgM in the population amounts to 1.35% (95% CI 0.75-2.22), and in patients with liver damage – to 4.25% (95% CI 3.32-5.37). For foreign citizens it equals 1.03% (95% CI 0.58–1.7), for +AlAT donors – 2.89% (95% CI 1.25–5.69). All HEV RNA sequences isolated in Belarus are caused by genotype 3. Conclusions. Epidemiological characteristics of HEV in Belarus are presented. The anti-HEV immunostructure of various population cohorts was studied. There have been established cases of imported HEV. Autochthonous cases of HEV have been identified as well.
背景。白俄罗斯戊型肝炎(HEV)的发病率与人群中出现无记忆抗体的频率不同。目标。目的研究白俄罗斯HEV流行趋势。材料和方法。该研究包括来自以下人群的5745份血清样本:白俄罗斯居民(布列斯特和布列斯特地区、明斯克和明斯克地区)- 2784份;外国公民1457人;+ALT和-ALT献血者- 378;家猪- 1126头。对所有样本进行抗HEV IgG和IgM检测，并对130份样本进行HEV RNA检测，其中9份样本通过Sanger测序进行基因分型。结果。人群中抗hev IgG血清阳性率为7.3% (95 CI 5.8-9.0)，肝损伤患者血清阳性率为11.2% (95% CI 9.6-12.9)。对于外国公民，这一比例为5.22% (95% CI 4.11-6.53)，对于家猪，这一比例为33.75% (95% CI 30.44-37.32)。人群中抗hei IgM的发生率为1.35% (95% CI为0.75-2.22)，肝损害患者为4.25% (95% CI为3.32-5.37)。对于外国公民，它等于1.03% (95% CI 0.58-1.7)，对于+AlAT捐赠者- 2.89% (95% CI 1.25-5.69)。在白俄罗斯分离的所有HEV RNA序列都是由基因3型引起的。结论。介绍了白俄罗斯HEV的流行病学特征。研究了不同人群的抗hev免疫结构。已有确诊的输入性HEV病例。也发现了本地HEV病例。
{"title":"EPIDEMIOLOGICAL CHARACTERISTICS OF HEPATITIS E IN THE REPUBLIC OF BELARUS","authors":"V. Davydov, S. Zhavoronok, A. Babenka, D. S. Borisovets, T. Rogacheva, I. Zadora, L. V. Novak, E. Gasich, N. Bayur, S. Marchuk","doi":"10.25298/2616-5546-2022-6-1-11-19","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-1-11-19","url":null,"abstract":"Background. The incidence of hepatitis E (HEV) in Belarus differs from the frequency of occurrence of anamnestic antibodies in the population. Objective. To study the epidemic trends of HEV in Belarus. Material and methods. The study included 5745 samples of blood serum obtained from: residents of Belarus (Brest and Brest region, Minsk and Minsk region) – 2784; foreign citizens - 1457; +ALT and -ALT blood donors – 378; domestic pigs - 1126. All samples were tested for anti-HEV IgG and IgM and 130 samples - for HEV RNA, 9 samples were genotyped by Sanger sequencing. Results. Seroprevalence of anti-HEV IgG in the population amounts to 7.3% (95 CI 5.8-9.0), and in patients with liver damage – to 11.2% (95% CI 9.6-12.9). For foreign citizens it equals 5.22% (95% CI 4.11-6.53), for domestic pigs – 33.75% (95% CI 30.44-37.32). The incidence of anti-HEI IgM in the population amounts to 1.35% (95% CI 0.75-2.22), and in patients with liver damage – to 4.25% (95% CI 3.32-5.37). For foreign citizens it equals 1.03% (95% CI 0.58–1.7), for +AlAT donors – 2.89% (95% CI 1.25–5.69). All HEV RNA sequences isolated in Belarus are caused by genotype 3. Conclusions. Epidemiological characteristics of HEV in Belarus are presented. The anti-HEV immunostructure of various population cohorts was studied. There have been established cases of imported HEV. Autochthonous cases of HEV have been identified as well.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47123077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-03DOI: 10.25298/2616-5546-2022-6-1-66-70
A. Sushko, S. Kul, E. V. Mahiliavets, J. Kropa
Background. The article is devoted to the description and outcomes of conservative and surgical treatment of observed cases of achalasia cardia (AC). A brief literary review of the peculiarities of pathogenesis, clinical features as well as differential diagnosis of AС is presented. Objective. To analyze the treatment outcomes and evaluate the choice of the АС surgical treatment method. Material and methods. The analysis of treatment outcomes in 31 patients with AK confirmed by clinical, radiological and endoscopic findings was carried out. Results. 3 (10%) patients were opted for drug therapy only. Endoscopic balloon dilatation of the esophagus in combination with drug therapy was performed in 15 (48%) patients, mainly with stage II AC. The extent of surgical intervention in 16 (52%) operated patients was represented by laparoscopic Heller cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller cardiomyotomy with Dor fundoplication for the prevention of gastroesophageal reflux was defined as the most effective surgical treatment of stage II-III AС. Endoscopic balloon dilatation of the esophagus combined with drug therapy is an effective treatment option for stage II AС, and can be used in stages II-III if there are contraindications for surgical treatment.
{"title":"MINIMALLY INVASIVE SURGICAL TREATMENT OF ESOPHAGEAL ACHALASIA","authors":"A. Sushko, S. Kul, E. V. Mahiliavets, J. Kropa","doi":"10.25298/2616-5546-2022-6-1-66-70","DOIUrl":"https://doi.org/10.25298/2616-5546-2022-6-1-66-70","url":null,"abstract":"Background. The article is devoted to the description and outcomes of conservative and surgical treatment of observed cases of achalasia cardia (AC). A brief literary review of the peculiarities of pathogenesis, clinical features as well as differential diagnosis of AС is presented. Objective. To analyze the treatment outcomes and evaluate the choice of the АС surgical treatment method. Material and methods. The analysis of treatment outcomes in 31 patients with AK confirmed by clinical, radiological and endoscopic findings was carried out. Results. 3 (10%) patients were opted for drug therapy only. Endoscopic balloon dilatation of the esophagus in combination with drug therapy was performed in 15 (48%) patients, mainly with stage II AC. The extent of surgical intervention in 16 (52%) operated patients was represented by laparoscopic Heller cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller cardiomyotomy with Dor fundoplication for the prevention of gastroesophageal reflux was defined as the most effective surgical treatment of stage II-III AС. Endoscopic balloon dilatation of the esophagus combined with drug therapy is an effective treatment option for stage II AС, and can be used in stages II-III if there are contraindications for surgical treatment.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45269972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-132-137
I. P. Sutsko, I. Semenenya, A. Shlyahtun
Background. Three metabolic pathways that can function simultaneously are known to be involved in ethanol oxidation in the liver: alcohol dehydrogenase pathway, microsomal ethanol-oxidizing system, and catalase pathway. Though the cytochrome P450-dependent microsomal ethanol-oxidizing system plays an insignificant role in metabolism of small amounts of ethanol, it is induced in case of ethanol excess and becomes essential when ethanol is abused. The main components of this system are cytochrome P450 (CYP) isoforms of smooth endoplasmic reticulum. Objective. To characterize the role of the key isoforms of cytochrome P450 in ethanol oxidation. Material and methods. We carried out an analysis of modern literature data on the role of the main isoforms of cytochrome P450 in liver metabolism of ethanol. Results. Data on the primary role of cytochrome CYP2E1 in ethanol metabolism, as well as on the contribution of isoforms CYP1A2, CYP2B1/2, CYP2C, CYP3A4, CYP4B1 to ethanol oxidation are presented. Conclusions. Ethanol is metabolized by many CYPs of endoplasmic reticulum of hepatocytes. The importance of CYP in biotransformation processes in the liver necessitates the study of the role of individual CYP isoforms in ethanol metabolism for predicting changes in the pharmacokinetics of drugs and metabolism of endogenous compounds under the influence of ethanol.
{"title":"THE ROLE OF CYTOCHROME P450 ISOFORMS OF HEPATOCYTE ENDOPLASMIC RETICULUM IN ETHANOL METABOLISM","authors":"I. P. Sutsko, I. Semenenya, A. Shlyahtun","doi":"10.25298/2616-5546-2021-5-2-132-137","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-132-137","url":null,"abstract":"Background. Three metabolic pathways that can function simultaneously are known to be involved in ethanol oxidation in the liver: alcohol dehydrogenase pathway, microsomal ethanol-oxidizing system, and catalase pathway. Though the cytochrome P450-dependent microsomal ethanol-oxidizing system plays an insignificant role in metabolism of small amounts of ethanol, it is induced in case of ethanol excess and becomes essential when ethanol is abused. The main components of this system are cytochrome P450 (CYP) isoforms of smooth endoplasmic reticulum. Objective. To characterize the role of the key isoforms of cytochrome P450 in ethanol oxidation. Material and methods. We carried out an analysis of modern literature data on the role of the main isoforms of cytochrome P450 in liver metabolism of ethanol. Results. Data on the primary role of cytochrome CYP2E1 in ethanol metabolism, as well as on the contribution of isoforms CYP1A2, CYP2B1/2, CYP2C, CYP3A4, CYP4B1 to ethanol oxidation are presented. Conclusions. Ethanol is metabolized by many CYPs of endoplasmic reticulum of hepatocytes. The importance of CYP in biotransformation processes in the liver necessitates the study of the role of individual CYP isoforms in ethanol metabolism for predicting changes in the pharmacokinetics of drugs and metabolism of endogenous compounds under the influence of ethanol.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49591830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-99-110
V. Tsyrkunov, N. Prokopchik, V. Andreev
The review presents literature data and original findings of light and electron microscopy of pathomorphological changes in the bile ducts in primary sclerosing cholangitis (PSC), immunoglobulin G4 (IgG4)-associated autoimmune sclerosing cholangitis and overlap syndromes: PSC + chronic autoimmune hepatitis (AIH); PSC + primary biliary cirrhosis (PBC).
{"title":"AUTOIMMUNE CHOLESTATIC LESIONS OF BILIARY DUCTS","authors":"V. Tsyrkunov, N. Prokopchik, V. Andreev","doi":"10.25298/2616-5546-2021-5-2-99-110","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-99-110","url":null,"abstract":"The review presents literature data and original findings of light and electron microscopy of pathomorphological changes in the bile ducts in primary sclerosing cholangitis (PSC), immunoglobulin G4 (IgG4)-associated autoimmune sclerosing cholangitis and overlap syndromes: PSC + chronic autoimmune hepatitis (AIH); PSC + primary biliary cirrhosis (PBC).","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47097681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-191-196
N. Prokopchik, R. Yakubtsevich, S. S. Kerimova, A. A. Balla, E. L. Cherevan, N. V. Belyavsky, S. N. Drutko, E. T. Volkova, N. Gavina
Background. An upper and lower gastrointestinal (GI) series is an available and informative diagnostic test. Side effects are extremely rare. Objective. To present a case description of portal vein and liver barium embolism with a fatal outcome and explain the mechanism of its occurrence. Material and methods. The clinical manifestations, laboratory and instrumental findings, as well as autopsy of a female patient who died after lower GI radiography were analyzed. Results. To exclude intestinal obstruction, the patient underwent a barium follow through. Three days later, during X-ray computed tomography, barium and gas were detected in the inferior mesenteric vein, portal vein and its intrahepatic branches. During colonoscopy, diverticula of the sigmoid colon were detected, but the localization of the intestinalvenous fistula wasn’t determined. Conservative surgery failed and the death occurred 15 days after radiography. Conclusions. The autopsy revealed that the site of entry for the development of barium embolism as well as for gas, were diabrotic veins in peridiverticular abscesses localized in pericolic tissue.
{"title":"PORTAL VEIN AND LIVER BARIUM EMBOLISM","authors":"N. Prokopchik, R. Yakubtsevich, S. S. Kerimova, A. A. Balla, E. L. Cherevan, N. V. Belyavsky, S. N. Drutko, E. T. Volkova, N. Gavina","doi":"10.25298/2616-5546-2021-5-2-191-196","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-191-196","url":null,"abstract":"Background. An upper and lower gastrointestinal (GI) series is an available and informative diagnostic test. Side effects are extremely rare. Objective. To present a case description of portal vein and liver barium embolism with a fatal outcome and explain the mechanism of its occurrence. Material and methods. The clinical manifestations, laboratory and instrumental findings, as well as autopsy of a female patient who died after lower GI radiography were analyzed. Results. To exclude intestinal obstruction, the patient underwent a barium follow through. Three days later, during X-ray computed tomography, barium and gas were detected in the inferior mesenteric vein, portal vein and its intrahepatic branches. During colonoscopy, diverticula of the sigmoid colon were detected, but the localization of the intestinalvenous fistula wasn’t determined. Conservative surgery failed and the death occurred 15 days after radiography. Conclusions. The autopsy revealed that the site of entry for the development of barium embolism as well as for gas, were diabrotic veins in peridiverticular abscesses localized in pericolic tissue.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47954589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-197-204
Ya. A. Kolodzeyskiy, V. I. Shishko, А. A. Karpovich, Yu. Ya. Shelkovich, T. N. Yakubchik
Background. Gastroesophageal reflux disease (GERD) is an urgent problem of modern gastroenterology as well as the most common pathology of the upper gastrointestinal tract; it is a chronic disease that significantly reduces the patient's quality of life, increases the risk of developing Barrett's esophagus and esophageal adenocarcinoma. Objective. To assess the potentials of multichannel intraluminal pH impedance monitoring in the diagnosis of esophageal diseases. Material and methods. In 3 patients with clinical and endoscopic signs of GERD esophageal multichannel intraluminal pH-impedance monitoring was performed using the diagnostic equipment Digitrapper pH-Z from Given Imaging (USA). Results. 24-hour esophageal pH monitoring enabled to verify the diagnosis of GERD, to reveal a hypersensitive esophagus and manifestations of nocturnal acid breakthrough. Conclusions. Multichannel intraluminal pH-impedance monitoring is the "gold standard" for the diagnosis of esophageal diseases; it significantly expands opportunities of gastroenterologists in the treatment of GERD.
{"title":"СУТОЧНАЯ МНОГОКАНАЛЬНАЯ РН-ИМПЕДАНСОМЕТРИЯ ПИЩЕВОДА В ДИАГНОСТИКЕ ГАСТРОЭЗОФАГЕАЛЬНОЙ РЕФЛЮКСНОЙ БОЛЕЗНИ (КЛИНИЧЕСКИЕ СЛУЧАИ)","authors":"Ya. A. Kolodzeyskiy, V. I. Shishko, А. A. Karpovich, Yu. Ya. Shelkovich, T. N. Yakubchik","doi":"10.25298/2616-5546-2021-5-2-197-204","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-197-204","url":null,"abstract":"Background. Gastroesophageal reflux disease (GERD) is an urgent problem of modern gastroenterology as well as the most common pathology of the upper gastrointestinal tract; it is a chronic disease that significantly reduces the patient's quality of life, increases the risk of developing Barrett's esophagus and esophageal adenocarcinoma. Objective. To assess the potentials of multichannel intraluminal pH impedance monitoring in the diagnosis of esophageal diseases. Material and methods. In 3 patients with clinical and endoscopic signs of GERD esophageal multichannel intraluminal pH-impedance monitoring was performed using the diagnostic equipment Digitrapper pH-Z from Given Imaging (USA). Results. 24-hour esophageal pH monitoring enabled to verify the diagnosis of GERD, to reveal a hypersensitive esophagus and manifestations of nocturnal acid breakthrough. Conclusions. Multichannel intraluminal pH-impedance monitoring is the \"gold standard\" for the diagnosis of esophageal diseases; it significantly expands opportunities of gastroenterologists in the treatment of GERD.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42079413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-25DOI: 10.25298/2616-5546-2021-5-2-184-190
N. N. Kostenevich, I. P. Chernikevich, V. V. Baum, V. A. Malashenko
Background. The probability of undergoing surgery always predetermines the state of stress in a person; therefore, it is advisable to search for ways to optimize and (or) reduce this unfavourable effect. Objective. To find out the mechanism of vitamin B1 antistress activity during surgery. Material and methods. Metabolism intensity was investigated on donors’ blood lysates (n = 19) and those of patients with stage III stomach cancer (n = 64), referred to an elective surgery, aged 51-70. The blood was taken from the cubital vein three days before the operation, after premedication, during the most traumatic moment of the operation, after extubation, as well as on the first and third days of the postoperative period. The surgery was performed under combined multicomponent anesthesia using nitric oxide, sodium hydroxybutyrate, and epidural block. Thiamine and thiamine diphosphate kinase activities were assessed by the concentration of the formed thiamine di- and triphosphates of the vitamin. The activities of thiamine mono-, di- and triphosphatases were determined by the release of inorganic phosphate. The concentration of inorganic phosphate was recorded colorimetrically. The content of B1 and its derivatives in the blood was determined by the method of ion-pair reversed-phase HPLC. Results. There has been observed an increased content of thiamine monophosphate and that of free thiamine in the blood of donors and patients with stomach cancer. The registered rate of the hydrolytic thiamine monophosphatase reaction is not high. At the stages of premedication and maximum trauma of surgical exposure, the concentration of monophosphoric ester rapidly decreases alongside with monophosphatase activation. Therefore, the thiamine monophosphate hydrolysis is the rate-limiting link of vitamin B1 metabolism. The level of free thiamine remains persistently increased at all stages of surgical treatment. Thiamine monophosphatase activity is manifested at two pH optima – of 6.0 and 9.0. Thiamine monophosphate hydrolysis at pH of 9.0 is catalyzed by alkaline phosphatase. At pH of 6.0, in addition to thiamine monophosphoric ester, the enzyme hydrolyzes only p-nitrophenyl phosphate, flavin mononucleotide and phosphotyrosine, that allows it to be classified as hepatic acid phosphatase. The noted changes in B1 metabolism under stress concern mainly non-coenzyme forms - thiamine mono-, triphosphate, and free thiamine, which are used at the stages of thiol reduction as important components of insulin synthesis. Conclusions. The use of vitamin B1 allows to optimize the development of the stress response at all stages of surgical treatment. Its protective effect is achieved through the activation of the insulin-synthetic function of the pancreas, which increases the level of immunoreactive insulin in the blood. The formation of the most favorable physiological conditions for insulin synthesis provides an increased background of free thiamine, which is created due to the hy
{"title":"VITAMIN B1 BIOLOGICAL FUNCTION IMPLEMENTATION IN THE BLOOD OF PATIENTS WITH STOMACH CANCER UNDER SURGICAL INTERVENTION","authors":"N. N. Kostenevich, I. P. Chernikevich, V. V. Baum, V. A. Malashenko","doi":"10.25298/2616-5546-2021-5-2-184-190","DOIUrl":"https://doi.org/10.25298/2616-5546-2021-5-2-184-190","url":null,"abstract":"Background. The probability of undergoing surgery always predetermines the state of stress in a person; therefore, it is advisable to search for ways to optimize and (or) reduce this unfavourable effect. Objective. To find out the mechanism of vitamin B1 antistress activity during surgery. Material and methods. Metabolism intensity was investigated on donors’ blood lysates (n = 19) and those of patients with stage III stomach cancer (n = 64), referred to an elective surgery, aged 51-70. The blood was taken from the cubital vein three days before the operation, after premedication, during the most traumatic moment of the operation, after extubation, as well as on the first and third days of the postoperative period. The surgery was performed under combined multicomponent anesthesia using nitric oxide, sodium hydroxybutyrate, and epidural block. Thiamine and thiamine diphosphate kinase activities were assessed by the concentration of the formed thiamine di- and triphosphates of the vitamin. The activities of thiamine mono-, di- and triphosphatases were determined by the release of inorganic phosphate. The concentration of inorganic phosphate was recorded colorimetrically. The content of B1 and its derivatives in the blood was determined by the method of ion-pair reversed-phase HPLC. Results. There has been observed an increased content of thiamine monophosphate and that of free thiamine in the blood of donors and patients with stomach cancer. The registered rate of the hydrolytic thiamine monophosphatase reaction is not high. At the stages of premedication and maximum trauma of surgical exposure, the concentration of monophosphoric ester rapidly decreases alongside with monophosphatase activation. Therefore, the thiamine monophosphate hydrolysis is the rate-limiting link of vitamin B1 metabolism. The level of free thiamine remains persistently increased at all stages of surgical treatment. Thiamine monophosphatase activity is manifested at two pH optima – of 6.0 and 9.0. Thiamine monophosphate hydrolysis at pH of 9.0 is catalyzed by alkaline phosphatase. At pH of 6.0, in addition to thiamine monophosphoric ester, the enzyme hydrolyzes only p-nitrophenyl phosphate, flavin mononucleotide and phosphotyrosine, that allows it to be classified as hepatic acid phosphatase. The noted changes in B1 metabolism under stress concern mainly non-coenzyme forms - thiamine mono-, triphosphate, and free thiamine, which are used at the stages of thiol reduction as important components of insulin synthesis. Conclusions. The use of vitamin B1 allows to optimize the development of the stress response at all stages of surgical treatment. Its protective effect is achieved through the activation of the insulin-synthetic function of the pancreas, which increases the level of immunoreactive insulin in the blood. The formation of the most favorable physiological conditions for insulin synthesis provides an increased background of free thiamine, which is created due to the hy","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49550596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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