Vol 19, No 8-2 (2017)

Objective - to study the proteome pattern and the expression of E-cadherin in the esophageal mucosa, depending on the composition of pathological gastroesophageal refluxate in patients with gastroesophageal reflux disease (GERD). Materials and methods. This parallel group prospective study included patients with GERD - 39 patients with acidic and slightly acidic nature of reflux and 25 - with alkaline and slightly alkaline reflux. The diagnosis of GERD is verified in accordance with the standard survey protocol. Proteomic and immunohistochemical studies of biopsy from the distal esophagus were conducted. Mass spectra were obtained using a tandem MALDI-TOF/TOF Ultraflex II (Bruker Daltonics, Germany) mass spectrometer. Identification of proteins and peptides was carried out by searching for relevant candidates in the NCBI (National Center for Biotechnology Information) and Swiss-Prot/UniProt databases. Immunohistochemical study of biopsies was carried out by labeled streptavidin-biotin method using monoclonal mouse antibodies to E-cadherin (Dako, the USA). For statistical data analysis, the Statistis 10.0 for Windows (StatSoft, the USA) program package was used. Results. Nine proteins responsible for the formation of the cytoskeleton and the proliferation of epithelial cells are identified and typed in patients with GERD. These proteins are involved in complicated cascades of inflammatory processes in the esophageal mucosa. In the group of patients with acidic character of refluxate were differentially expressed vinculin, calponin-1, cystatin C; with alkaline character - protein-1, which is stimulated by hypoxia, prihibitin-2, thioredoxin. The tendency to decrease of E-cadherin expression in patients with alkaline character of refluxate was revealed. Conclusion. Differences in the protein profile and E-cadherin expression pathogenetically substantiate the content of GERD therapy, especially taking into account the damaging nature of pathological character of refluxate.

Aim - to analyze the modern view on pathogenesis, clinical symptoms and therapy of functional gastrointestinal diseases (FGID) and overlap syndrome. FGID include a number of separate gastrointestinal disorders, characterized by alterations in motility, visceral sensation, and mucus function, that are not associated with structural alterations. The pathogenesis of FGID seems to imply disturbance in brain-gut interactions. The most common functional disorders are irritable bowel syndrome (IBS) and functional dyspepsia (FD). As defined by Rome IV criteria overlap syndrome is one of the modern problem in therapy of FGID. The estimated prevalence of IBS and FD overlap is 42-87%. Since FGID has a huge impact on patient’s psychological condition and the quality of life it is important to treat symptoms of FGID effectively. Symptomatic treatment (antispasmodics, laxative, prokinetics, herbal extracts) has either short-term effect or low impact on patient's improvement. Thus pathogenetic therapy should be the therapy of choice for FGID and overlap syndrome treatment. The aim of FGID therapy is to reduce symptoms effectively, to avoid the symptom recurrence and overlap syndrome. Kolofort with pathogenetic action is safe and effective in FGID treatment and provide high level of patient’s compliance.

Insulinoma is an insulin-producing pancreatic tumor. Hyperproduction of insulin leads to hypoglycemic syndrome - an extremely life-threatening condition in consequence of the high risk of hypoglycemic coma and death. This article presents a clinical case of verification of the diagnosis of insulinoma. Along with laboratory tests were used visualizing diagnostic methods including S-Fusion. This is the first experience of applying the technology which combine ultrasound and magnetic resonance imaging (Fusion) in topical insulinoma diagnosis. S-Fusion allows us to expand the amount of diagnostic information obtained by combining the information of two diagnostic modalities in one image.

The article discusses the most frequent dermatological manifestations of gluten enteropathy, prompt diagnosis of which plays a significant role for practicing gastroenterologists in disease management. The authors report their own clinical observations and analyze the published literature on clinical relevance of specific skin manifestationsas diagnostic markers for coeliac disease. The article provides simple description of skin manifestations of coeliac disease that will be useful for practicing physicians and gastroenterologists.

Purpose: evaluate the influence of preparation Resalut® on the dynamics of lipid peroxidation, antioxidant status, cytolysis syndrome, cholestasis, cholesterol level in patients with nonalcoholic fatty liver disease (NAFLD). Materials and methods: 70 patients with NAFLD were treated with preparation Resalut® and comparing the drug from a group of essential phospholipids. Levels of lipid peroxidation, antioxidant status, markers of cytolysis and cholestasis were determined before and after therapy course. Results: after the therapy in group of patients, threated by Resalut®, revealed a valuable positive dynamics of all indexes, improvement of the general status of patients after therapy. Conclusion: therapy with preparation Resalut® is an effective method of treatment nonalcoholic fatty liver disease.

Purpose: comparative analysis of clinical efficacy of ursodeoxycholic acid drugs for treatment of cholelithiasis and biliary sludge. Materials and methods. A retrospective multicenter study of 5 thousand patients was conducted, in which the actual occurrence of various stages of cholelithiasis in clinical practice was assessed. The effectiveness of treatment of cholelithiasis and biliary sludge in 210 patients receiving ursodeoxycholic acid therapy was evaluated. Results. Analysis of the patients structure on an outpatient visit revealed a frequency of cholelithiasis morbidity 15.5%. The prevalence of mild forms of cholelithiasis was 9.3%. The greatest effectiveness of reducing the size of gallstones and biliary sludge symptoms according to the results of the study was noted in the group whose participants took Ursosan. Conclusion. Сhoosing a treatment it is necessary to take into account the peculiarities of ursodeoxycholic acid preparations, the quality of production and substance. Ursosan may be a drug of choice for therapy of cholelithiasis.

Non-alcoholic fatty liver disease (NAFLD) is the main cause of morbidity and mortality associated with liver disease. The mortality of patients with NAFLD is due mainly to mortality from cardiovascular diseases, and not to the progression of liver disease with the development of liver failure, complications of portal hypertension and hepatocellular carcinoma. Most studies indicate that NAFLD is associated with an increase in cardiovascular disease, and the risk of their development increases with the progression of liver disease.