RU2333493C1 - Method of express diagnostics of structural changes in pancreas during diabetes - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, gastroenterology, endocrinology, pathophysiology, biology and can be used for diagnostics of structural changes in a pancreas during diabetes. Bbiological test system (BTS) is prepared. The BTS in the form of a strip is put on a glass plate, and place in area of a projection of a pancreas - in Mayo-Robson zone of the left costovertebral angle. It is mantained throughout 1-2 minutes, dried at T=+18-20°C. Further, it is investigated in polarised light with the quartz jack. At presence in a preparation of spherolith crystals of motley colouring: polygonal in a capsule with grains on periphery and in the centre and/or ovoloidal - in a capsule with grains on periphery and in the centre, roundish units from grains, ovoloidal without a capsule with grains in the centre and on the periphery, degraded, relic are diagnosed structural changes in a pancreas.

EFFECT: increase of diagnostics informativeness of structural changes in a pancreas at a diabetes, maintenance of the operative control over efficiency of treatment.

5 ex, 8 dwg, 2 cl

Description

The present invention relates to medicine, gastroenterology, endocrinology, pathophysiology and can be used to diagnose structural changes in the pancreas in patients with diabetes mellitus.

DM is a disease caused by absolute or relative insulin deficiency, causing a violation of carbohydrate and other types of metabolism (Dedov II, Shestakova MV Diabetes mellitus. - M., 2003).

In diabetes mellitus, the islet apparatus of the pancreas is primarily affected. In the future, pathological changes occur in the parenchyma of the organ, vessels, ducts, which is accompanied by structural restructuring of the pancreas with impaired function of its exocrine part.

In a morphological study of the pancreas in patients with diabetes, the following changes in the islet apparatus are observed: the number of islets of Langerhans decreases due to insulin, atrophy, followed by the development of hyalinosis, lipomatosis, necrobiosis, calcification, and sclerosis.

For severe and rapidly progressive forms of diabetes, beta-cell necrobiosis, as well as lymphoid cell infiltration, are characteristic. In the pancreatic parenchyma (pancreas), sclerotic atrophy, the development of lipomatosis are detected; periductal fibrosis, hyalinosis, duct calcification, sclerotic changes in blood vessels (Breslavsky A.S., Gordienko V.M. Pathological anatomy of the endocrine glands. - Kiev .: Zdorove'e, 1974; Guide to pathological anatomy. Pathology of circulatory diseases Book 2. Edited by A.I. Abrikosov. - M., 1957. - P.458-464 .; Finger M.A., Anichkov N.M. Pathological anatomy. - M., 2001. - T. 2. Part I.).

The activity of the islet apparatus and acinar cells forming the pancreatic parenchyma is closely related. Insulin deficiency of any genesis is considered as the main reason for the development of fibrosis, fatty degeneration and atrophy of acinar cells (Morozova N.N. Exocrine pancreatic function in the initial forms of diabetes mellitus. // Clin. Honey. - 1980. - No. 1. - P. 69 -72.).

Among the methods for diagnosing structural changes in the pancreas, computed tomography and ultrasound are most known (Gabunia RI, Kolesnikova EK Computed tomography in clinical diagnosis. - M., 1995. - P.160-170 .; Clinical guide to ultrasound diagnostics (Edited by V.V. Mitkov, M.V. Medvedev) - M .: VIDAR, 1996. - T.1. - P.140-160, 166-173 .; Ultrasound diagnosis in abdominal and vascular surgery ( Under the editorship of G.I. Kuntsevich) - Cavalier Publishers, 1999 .-- P.42-57).

An analogue is computed tomography. The basis of the method is the ability to obtain an image of the organ and pathological foci in the plane of the investigated section, to obtain accurate quantitative information about the size and density of the organ. Diagnosis is based on direct radiological symptoms (Gabunia R.I., Kolesnikova E.K. Computed tomography in clinical diagnosis. - M., 1995. - S.160-170).

The main steps of the method:

1. Before the study, for 15-20 minutes, the patient takes 100 ml of 70% verographin solution for contrasting the small intestine, immediately before scanning another 50 ml for contrasting the stomach.

2. Then the patient is placed on the table of the tomograph in a horizontal position to scan the organ.

3. The patient is moved during scanning from the control panel in automatic mode.

4. After scanning receive a series of tomograms that are studied.

The disadvantages of the method:

- the presence of an expensive computer device (scanning system, x-ray system, control panel, computer);

- the presence of a highly qualified specialist;

- radiation to which the patient and the doctor are exposed;

- duration of execution.

The closest analogue is an ultrasound examination (ultrasound) of the pancreas using a sensor with a frequency of 3.5-5 MHz (Clinical Guide to Ultrasound Diagnostics / Edited by V.V. Mitkov, M.V. Medvedev /. - M .: VVDAR, 1996.- T.1. - C.140-160, 166-173).

The essence of the method is based on the study of the ECHO structure of the pancreas using an ultrasound scanner.

Research Stages:

1. The patient is placed on his back.

2. The sensor is installed under the xiphoid process and is gradually displaced in the caudal direction.

3. The structure of the pancreas is assessed by the state of its contour, size, echogenicity and uniformity.

The disadvantages of the method:

- the use of an ultrasound scanner that affects the physiological state of the subject;

- mutual influence on the image of the pancreas of the surrounding organs and tissues (stomach, small and large intestines, spleen, left kidney);

- occurrence of artifacts during scanning;

- interference from the contents of the digestive tract;

- stimulation of certain processes in the pancreas (cyst, tumor).

The objectives of the invention:

1. Safety for the patient in the diagnosis of structural pathological rearrangement in the pancreas with diabetes.

2. Increasing information content by express visualization of changes in the structure of the organ.

3. Providing operational control over the effectiveness of treatment.

4. Express registration of pancreatic energy radiation.

5. Reducing the cost of diagnosis.

The technical result of the proposal is the rapid registration of pancreatic energy radiation in the form of certain morphological structures of the biological test system, which allows you to quickly register the dynamics of the structural pathological organ reorganization depending on the severity of the disease. By differentiating these disorders, it is possible to timely achieve compensation of endo- and exocrine pancreatic functions. The method is safe for the patient, economical, profitable, informative.

A significant novelty of the proposal is the registration of natural radiation of the pancreas with the help of BTS, for which, unlike the ultrasound method, BTS is preliminarily prepared (a mixture of a 0.1% aqueous solution of amino acids - aspartic, glycine, tryptophan, leucine, valine, series, phenylalanine, threonine in equal proportions ; 0.5% aqueous solution of dopamine neurotransmitter, 12% aqueous solution of magnesium sulfate in a ratio of 3: 1: 6), apply it in an amount of 0.01-0.02 ml in the form of a track on a glass plate, which is placed in the Mayo zone Robson's left rib vertebral angle Hold it for 1-2 minutes, dry at T = + 18-20 ° C, examine in polarized light with a quartz compensator, and if the preparation contains spherulite crystals of motley color: polygonal in a capsule with grains at the periphery and in the center and / or ovoid in a capsule with grains on the periphery and in the center, round aggregates of grains, ovoid in a capsule with grains in the center and on the periphery, degraded, relict, diagnose structural changes in the pancreas.

The method is as follows:

1. Prepare a biological test system - an energy-information model for detecting radiation from the pancreas, for which a mixture consisting of a 0.1% aqueous solution of 8 vital amino acids (aspartic, glycine, tryptophan, leucine, valine, serine, phenylalanine, threonine) is used , A 0.5% aqueous solution of the dopamine neurotransmitter, 12% aqueous solution of magnesia sulfate. The ratio of amino acids, neurotransmitter and magnesium sulfate 3: 1: 6.

2. A BTS pipette pipette with a volume of 0.01-0.02 ml is applied to a slide in the form of a track.

3. A slide (glass plate) with a BTS deposited on it is placed in the area of the pancreatic projection (Mayo-Robson zone, left rib-vertebral angle), incubated for 1-2 minutes, dried in an oven at T = + 18-20 ° C for 2-3 minutes

4. The resulting preparation is examined in polarized light with a quartz compensator and in the presence of motley-colored spherulite crystals in the preparation: polygonal in a capsule with grains at the periphery and in the center and / or ovoid in a capsule with grains at the periphery and in the center, round aggregates of grains , ovoloid without a capsule with grains in the center and on the periphery, degraded, relict, diagnosed with structural changes in the pancreas.

The method was tested on 270 patients and compared with known methods for diagnosing structural changes in the pancreas with diabetes. When assessing the statistical significance of the data obtained, it was found that p <0.05.

We present data on BPS (energy-information model of biological object radiation) - a variant of a biological liquid crystal that responds to radiation by the appearance of a specific structure.

Information radiation from various objects (living, biocosal, inert) is one of the general principles of energy-informational interaction in nature.

Information influence is understood as a specific reaction of systems to a weak material-energy stimulus, which is perceived as a signal in the form of a code (Raimes NF System approach to solving the problem of interaction of a medium with a biological object. In: Electromagnetic fields in the biosphere. - M., 1984. - T.1. - S.294-300).

Structure - a snapshot of the internal energy interactions in the biological system (A. Malinovsky, Theory of structures and its place in the systematic approach. In the book: System Studies. Yearbook. - M.: 1970. - P.10-31).

We have developed BTS - a variant of a liquid crystal, an energy-information matrix. The proposed model is a complex biological system with self-organization and high spatial orientation. The amino acids in its composition form the cell nucleus (DNA and RNA), they themselves are sources of information, have the ability to perceive information about electronic-information interactions occurring in other substances, and transmit information in the form of structures. Liquid crystals are used as biosensor devices.

Liquid crystalline DNA and amino acids - analogues of cell associations - “read” the information-energy code of energetic biological radiation, which results in the appearance of a certain structure (Evdokimov Yu.M. Liquid-crystalline forms of nucleic acids. // Bulletin of the Russian Academy of Sciences. - 2003. - № 8. - P.712-721; Varfolomeev SD, Evdokimov Yu.M., Ostrovsky MA Sensory biology, sensory technologies and the creation of new human senses // Bulletin of the Russian Academy of Sciences. - 2000. - No. 2 .-- S.99-108).

We used BTS to register biological radiation of the pancreas on the basis of data that modulated bioelectromagnetic radiation is emitted from a person (his organs) in all directions. Complex information-coded multi-frequency oscillation patterns arise, wave radiation forming individual information-energy codes (Vvedensky VL, Ozhogin V.I.Super-sensitive magnetometry and biomagnetism. - M., 1986; Kogan Sh.M. Physical nature of human biofield. В book: Abnormal phenomena. Facts, studies, hypotheses. - M., 1991. - Issue 1. - P.24-37).

Figure 1 shows the morphological microstructure of the pancreas, the histological structure of the islet of Langerhans (OL) is normal (Dedov II, Shestakova MV Diabetes mellitus. - M., 2003. - P.24). Parenchyma of the pancreas includes exo- and endocrine components, comprising 97% and 3% by weight of the gland, respectively. The exocrine pancreas is composed of acini and duct system. The endocrine part is represented by OL lying between the acini. OL usually have a round or oval shape.

Figure 2 shows the original structure of the BPS, represented by polygonal structural elements.

Figure 3 shows the structure of the BPS obtained by placing a glass plate with the BTS deposited on it in the area of the projection of the pancreas of a healthy person (Mayo-Robson zone). The plate was kept in the zone for 2 minutes, dried in a thermostat at T = + 18 ° C for 3 minutes, and examined in polarized light. There is a crystal - a rounded spherulite of mottled color with a pronounced radial beam orientation, small spherulites with druses in the center are visible along its periphery.

The study conducted 350 experiments. The proposed method is compared with known methods for diagnosing structural changes in the pancreas with diabetes.

When assessing the statistical significance of the data obtained, it was found that p <0.05.

Example 1, Fig. 4 a, b. B. K. Diagnosis (DZ): DM, moderate severity. Medical history (IB) No. 349.

Figures 4a and b show the most informative sections of the BTS structure obtained by placing a glass plate with a BTS deposited on it in the Mayo-Robson zone; crystals are present: polygonal spherulites in a capsule with grains at the periphery and in the center (a), ovoid spherulites a capsule with grains on the periphery and in the center (b) of motley color.

Technology. 0.01 ml of BTS was applied to the glass plate and placed in the pancreatic projection zone - in the Mayo-Robson zone, held for 1 min, then dried in a thermostat for 3 min and examined in polarized light with a quartz compensator. There are crystals of spherulites of motley color: polygonal spherulites in a capsule with grains at the periphery and in the center, ovoid spherulites in a capsule with grains at the periphery and in the center. An ultrasound of the pancreas was performed simultaneously: the dimensions were not enlarged, the head - 23 mm, the body - 16 mm, the tail - 24 mm; the contours are clear, uneven; echogenicity is increased, the structure is diffusely heterogeneous.

Structural adjustment of the pancreas was confirmed.

Example 2, Fig. 5 a, b. B-th D. DZ: diabetes, moderate severity. IS No. 485.

On figa, b shows the structure of the BPS obtained by placing a glass plate with a BI applied on it in the Mayo-Robson zone. Ovoloid spherulites are visible in a mottled capsule with grains in the center and on the periphery (a), rounded aggregates of grains (b).

Technology. 0.01 ml of BTS was applied to the glass plate and placed in the pancreatic projection zone (Mayo-Robson zone), held for 2 minutes, then dried in a thermostat for 2 minutes at T = + 20 ° C and examined in polarized light with a quartz compensator. There are ovoid shaped spherulites of motley color in a capsule with grains in the center and on the periphery, rounded aggregates of grains. An ultrasound of the pancreas was performed simultaneously: the dimensions were not increased, the head was 20 mm, the body was 16 mm, the tail was 20 mm; the contours are clear, uneven; echogenicity is mixed, the structure is diffusely heterogeneous with multiple small, up to 2-4 mm, hyperechoic zones.

Structural adjustment of the pancreas was confirmed.

Example 3, Fig.6 a, b. B-th A. DZ: SD, severe course. IS No. 795.

On figa, b there is a mottled color ovoid spherulite without capsule with grains in the center and on the periphery (a) and degraded spherulite of variegated color (b).

Technology. 0.02 ml of BTS was applied to the glass plate and placed in the Mayo-Robson zone of B.A., kept for 2 minutes and studied in polarized light with a quartz compensator. Visible: ovoid spherulite of motley color without capsule with grains in the center and on the periphery and degraded spherulite of motley color. Did an ultrasound of the pancreas; head - 15 mm, body - 9 mm, tail - 16 mm; the contours are clear, uneven; echogenicity is increased, the structure is diffusely heterogeneous, the main pancreatic duct is expanded to 4 mm, the lumen is homogeneous, the walls are hyperechoic.

The diagnosis of pancreatic structural adjustment was confirmed.

Example 4, Fig. 7 a, b. B-I. I. DZ: diabetes, moderate severity. IS No. 499.

On figa, b there are spherulites of motley color ovoid without capsule with grains on the periphery and in the center.

Technology. 0.01 ml of BTS was applied to the glass plate and placed in the Mayo-Robson zone of B.I., held for 2 minutes, dried in an oven at T = + 19 ° C for 2 minutes, and studied in polarized light with a quartz compensator. The preparation contains ovoid spherulites of variegated color without capsule with grains on the periphery and in the center. An ultrasound of the pancreas was performed simultaneously: the dimensions were not increased, the head was 24 mm, the body was 19 mm, the tail was 22 mm; the contours are clear, uneven; echogenicity is increased, the structure is diffusely heterogeneous.

The diagnosis of pancreatic structural adjustment was confirmed.

Example 5, Fig. 8 a, b. B. S. DZ: DM, severe course. IS No. 129.

On figa, b shows relic spherulites variegated.

Technology. On the glass plate, 0.02 ml of BTS was applied, placed in the projection area of the pancreas (Mayo-Robson) of C. S., dried in a thermostat at T = + 20 ° C, studied in polarized light with a quartz compensator, mottled relic spherulites are visible . At the same time made an ultrasound of the pancreas; head - 16 mm, body - 12 mm, tail - 15 mm; the contours are clear, uneven; echogenicity mixed with multiple zones of increased echogenicity up to 2-5 mm, linear hyperechoic inclusions without acoustic shadow.

Structural adjustment of the pancreas was confirmed.

The advantages of the proposed method:

1. The use of a highly sensitive biological test system - a marker of the damaged structure of the pancreas.

2. High information content and efficiency of the method.

3. Nativeness and physiology.

The technical essence of the invention is to increase the information content of reliability.

Biomedical and social effect of the application of the method lies in its accessibility and the possibility of screening studies.

Claims (2)

1. A method for the rapid diagnosis of structural changes in the pancreas in diabetes mellitus, including the registration of radiation of the pancreas, characterized in that a biological test system is prepared in advance, consisting of a 0.1% aqueous solution of a mixture of amino acids - aspartic, glycine, tryptophan, leucine , valine, serine, phenylalanine, threonine, a 0.5% aqueous solution of dopamine neurotransmitter, a 12% aqueous solution of sulfuric acid magnesia in a ratio of 3: 1: 6, which is applied as a track to a glass plate, placed in a cloud the projection of the pancreas into the Mayo-Robson zone of the left rib-vertebral angle, maintain it for 1-2 minutes, dry at T = + 18-20 ° C, examine in polarized light with a quartz compensator, and if crystals are present in the preparation -spherulites of motley color: polygonal in a capsule with grains on the periphery and in the center and / or ovoloid - in a capsule with grains on the periphery and in the center, rounded aggregates of grains, ovoid without grains in the center and on the periphery, degraded, relict structural changes in n the pancreas. 2. The method according to claim 5, characterized in that the biological test system is applied to a glass plate in a volume of 0.01-0.02 ml.

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