Acute biliary pancreatitis. Diagnosis and course of treatment

The results of surgical treatment of 320 patients with an acute biliary pancreatitis are analysed. The therapeutic-tactical algorythm, using miniinvasive endoscopical interventions, is elaborated. Mortality for pancreatitis in systemic-toxical phase have constituted 10.1%, and in septical one--33.3%.     

Analysis of the relationship between chimerism and the allgeneic humoral response

BACKGROUND: Persistence of antigens has been suggested to play a role in two opposing immunological phenomena: tolerance and memory. Therefore, we studied the impact of chimerism on alloreactive antibody (allo-Ab) production in kidney transplant patients. METHODS: Thirty-five female renal transplant recipients of male donor organs were classified into the following groups: group 1, 13 sensitized uremic patients on dialysis; group 2, 5 nonsensitized uremic patients on dialysis; group 3, six sensitized patients experiencing graft rejection (3 acute vascular, 1 acute cellular, and 2 chronic); and group 4, 11 nonsensitized with functioning allografts (9 with good function, 1 with acute cellular rejection, and 1 with chronic rejection). Mean duration of dialysis after graft failure was similar in groups 1 (56+/-29.7 months) and 2 (41.8+/-42.4 months), as was dialysis efficiency. Chimerism was measured indirectly in the peripheral blood lymphocytes by polymerase chain reaction amplification of a specific Y chromosome DNA gene sequence with a detection sensitivity limit of 1 male cell per 1 million female cells. Allo-Ab production was measured by the PRA-STAT enzyme-linked immunosorbent assay (Sangstat) method. RESULTS: Chimerism was observed in 60% of groups 1 and 2, 83% of group 3, and 82% of group 4. Among all groups, graft existence, irrespective of its function, positively predicted chimerism in 92% with a sensitivity of 88% and a specificity of 78%. In group 3, all three patients with acute vascular rejection had chimerism and donor-specific allo-Abs. In group 4, eight of the nine patients with no rejection had chimerism. CONCLUSION: Chimerism relates to persistence of allogeneic stimulus irrespective of its function. Chimerism did not confer protection against allo-Ab production or vascular rejection, and its existence was not crucial for sustenance of allo-Ab production.     

Alexithymia in personal characteristics of patients with coronary heart diseases]

Psychological status was assessed in 120 patients with coronary heart disease (CHD) according to MMPI, Toronto alexithymic scale. Alexithymia was diagnosed in 49.1% of the examinees. They were characterized by difficulties in definition of their feelings, absence of dreams and fantasies, introversion, inclination to depressive response to stress, hypochondria eventuating in senesthopathy. The above psychological and pathopsychological traits in CHD patients require psychotherapeutic and chemotherapeutic correction in order to enhance efficacy of the treatment.     

Localised carcinoma of the prostate: a paradigm of uncertainty

The incidence and prevalence of prostate cancer is increasing. A number of aetiological factors including age, race, family history and diet have been implicated. The majority of patients present with disease which is amenable only to palliation. Digital rectal examination, serum prostate-specific antigen and transrectal ultrasound can lead to a prostatic biopsy. Transrectal ultrasound, magnetic resonance imaging, bone scan and a chest X-ray are used for staging. The management of localised cancer is shrouded in uncertainty. Three options exist, watchful waiting, radiotherapy, and radical total prostatectomy. The published data are inadequate for a valid comparison of these, and none has been shown to offer an advantage. Surgery, and to a lesser degree radiotherapy, have a significant morbidity. It is hoped that through better understanding our management of this disease will improve.     

Microbiological and chemical changes in high-pressure-treated milk during refrigerated storage

The microbiological and biochemical changes during storage of high-pressure-treated (400 MPa at 25 degrees C, for 30 min) whole (3.5% fat) and skim (0.3% fat) milk at refrigeration temperatures (7 degrees C) were studied. From a microbiological point of view, high-pressure treatment of milk led to an increase in the shelf life because, after 45 days of refrigerated storage, the psychotrophic and pseudomonad counts of the pressurized milk were lower than those of the unpressurized milk after 15 days. Capillary electrophoresis of the case in fraction showed that proteolysis by bacterial proteinases was not relevant in high-pressure-treated milk, as evidenced by a negligible degradation of kappa-casein. However, since the pressure conditions assayed did not lead to plasmin inactivation, considerable beta-, alpha-s1-casein hydrolysis took place during refrigerated storage, which can be responsible for flavor defects. No significant differences were found between skim and whole high-pressure-treated-milks.     

Bacteriological analysis of various environmental sources in a rural hospital

The prognosis of patients with end-stage cardiac disease has dramatically changed with transplantation. The incidence of complications remains relatively high and needs a very careful follow-up to have good long term results.     

Effect of genotype on the hormonal activity of the Leydig cells during stress in inbred strains of mice

Paraffin sections from various organs of sheep fetuses following transplacental infection with non-cytopathogenic (ncp) bovine viral diarrhoea virus (BVDV) or cytopathogenic (cp) BVDV were stained immunohistochemically with BVDV-specific monoclonal antibodies. Comparison of the distribution of viral antigen in sections from fetuses of experiment A revealed that in organs such as parotid, thyroid, thymus, lung, spleen, kidney, liver and skin from 20 days post inoculation (p.i.) onwards numerous antigen-containing cells were present. In organs of fetuses infected with cp BVDV, however, antigen-positive cells were only detectable until days 10 and 14 p.i. These findings suggest that the ncp BVDV used in experiment A replicated considerably faster and more efficient than the cp BVDV used in experiment B and that the two virus biotypes differ considerably concerning their tropism for fetal ovine organs.     

The role of persisting opportunistic intestinal microflora in dysbiosis in the occurrence of hepatobiliary system diseases

The state of microbiocenosis in the intestine of 89 patients with surgical pathology of biliary ducts was determined. Dysbiotic disturbances of different severity were detected in 96.6% of the examined persons. High occurrence of dysbiosis of the large intestine and the presence of the capacity for inactivating natural host resistance factors in different representatives of intestinal microflora were regarded as the cause of the development and maintenance of the inflammatory processes of the biliary ducts.