[The stage of portal blood flow in patients with hemoblastosis combined with chronic hepatitis].

109 patients with hemoblastosis (HB) were examined. Average age was 31.8 +/- 1.4 years in group of lymphogranulomatosis patients, and 44 +/- 5.3 years in group of acute leukemia patients. Group of 46 patients with clinical laboratory signs of hepatic lesion was marked out. Since features of portal blood flow (PBF) revealed at dopplerography did not depend on hepatitis aetiology, all patients with chronic hepatitis were analyzed in one group. These patients were examined clinicobiochemically: functional hepatic tests, markers of viral hepatitis B and C, ultrasonic abdominal scanning, PBF dopplerography, puncture biopsy of hepar. All patients had PBF disturbances such as decrease of portal vein blood flow, increase of venous drainage of hepar and spleen. The degree of disturbances intensity increased depending on degree of chronic hepatitis activity (the index of histological activity) and hepatic fibrosis stage. Thus, presence of chronic hepatitis in HB patients regardless of aetiology, is the factor aggravating patients' stage and corrupting PBF. PBF disturbances (decrease of arterial and venous inflow and increase of venous outflow) and development of fibrous changes apparently related with compression of vessels by connective tissue around central veins, inside of lobules and among of hepatic cells. Consequence of it is including anastomosises in blood flow which leads to redistribution of PBF and portal hypertension forming.

[Features of heart function and morphology in chronic organic solvents intoxication]. / Osobennosti strukturno-funktsional'nogo sostoianiia serdtsa u bol'nykh khronicheskoi intoksikatsiei ogranicheskimi rastvoriteliami.

Patients with chronic organic solvents intoxication are characterized by left ventricle hyperfunction mostly isometric type, with left ventricle diastole disordered due to impaired both passive filling and active relaxation, given the chamber geometry is normal and hypokinetictype hemodynamics is prevalent. Phase analysis of left heart mechanic activity in patients with chronic organic solvents intoxication demonstrated I degree hypodinamia syndrome and left ventricle outlet stenosis.

[Monitoring arterial hypertension in workers in professions exposed to vibration hazards (results of a 15-year study)]. / Monitoring arterial'noi gipertonii u rabochikh vibroopasnykh professii (rezul'taty 15-letnego nabliudeniia).

AIM: To follow up for 15 years prevalence of arterial hypertension (AH) in workers exposed to vibration, to study AH course and possible correction in long-term vibration exposure. MATERIAL AND METHODS: The survey covered 1232 males aged 25-59 years exposed to vibration at their working places for 1 to 30 years (test group) and 1163 males matched for age but not exposed to vibration (control group). Active primary and secondary prevention of AH and annual population control for 10 years were performed in the test group. The control group was followed up outpatiently without active intervention. Final screening was conducted 5 years after completion of the program of AH prophylaxis. RESULTS: Among workers exposed to vibration AH prevalence was similar to that in the controls and tended to reduction in the process of preventive treatment. However, after the end of prophylactic measures AH incidence rate returned to the baseline level. In workers at risk of vibration aftereffects conversion of normal arterial pressure to hypertension was observed more frequently than in unexposed patients. This requires active prophylactic intervention. CONCLUSION: Long-term exposure to moderate and high frequency vibration is an AH risk factor. Incidence rate of AH increases with longer exposure to vibration. Compared to controls, aged workers exposed to vibration have AH much more frequently.

[Angiotensin converting enzyme inhibitor enalapril in the treatment of endomyocardial fibrosis in patients with lymphogranulomatosis subjected to radio- and chemotherapy]. / Ingibitor angiotenzinprevrashchaiushchego fermenta énalapril v lechenii postluchevogo i lekarstvenno-indutsirovannogo éndomiokardial'nogo fibroza pri limfogranulematoze.

Echocardiography was used in the study of 40 patients with stage IIA-IVB lymphogranulomatosis. In 2-6 years before the study all patients had been treated with combination radio- (36-44 Gy) and chemotherapy. Echocardiography revealed endomyocardial fibrosis and signs of cardiac remodeling (reduced left ventricular dimensions and volumes, decreased myocardial mass and impaired diastolic function). The patients were divided into 2 groups. Patients of group 1 were given enalapril (5-10 mg/day), of group 2 - potassium and magnesium aspartate and inosine. In 2 months 68% of patients in group 1 demonstrated improvement of structural and functional state of the heart, no such changes occurred in group 2.

[Dynamics of rates of fatal and nonfatal complications of hypertension in a population of workers subjected to occupational vibration (15-year follow-up)]. / Dinamika chastoty fatal'nykh i nefatal'nykh oslozhnenii arterial'noi gipertonii v populiatsii rabochikh vibroopasnykh professii pri 15-letnem nabliudenii.

Prospective monitoring of fatal and nonfatal myocardial infarctions and strokes was carried out in a population of workers with professional exposure to vibration. Duration of monitoring was 15 years. In the end of this period implementation of a program of preventive intervention was associated with lowering of rates of cerebral and coronary events (3.0 vs. 5.2% among nonparticipants in this program). In 5 years after cessation of the program an increase of risk of cardiovascular complications especially that of strokes occurred. Changes of rates of events in a group of workers not subjected to special intervention were less pronounced. Negative dynamics of event rates in the group of active prevention could be attributed to continuing action of unfavorable occupational factor.

[Clinical and functional cardiac characteristics in iron-deficiency anemia]. / Kliniko-funktsional'naia kharakteristika serdtsa pri zhelezodefitsitnoi anemii.

AIM: To characterize clinically and electrocardiographically the condition of the heart in chronic iron deficient anemia (IDA), to study hemodynamic mechanisms of heart impairment for early detection of diastolic myocardial dysfunction in long-term course of sideropenia. MATERIAL AND METHODS: Clinical and ECG examinations were made in 400 IDA patients. Echocardiography and dopplerechocardiography were made in 95 and 27 patients, respectively. Patients with non-anemic myocardiodystrophy were withdrawn. Mean age of the patients was 35.4 +/- 3.8 years, mean Hb level--79.5 +/- 6.5 g/l, mean anemia duration 6.9 +/- 4.2 years. RESULTS: The severity of cardiac symptoms directly correlated with severity and duration of anemic sideropenic syndrome. 100% had heart complaints, 91.3% had mild chronic cardiac failure, 86.2% patients showed changes on the electrocardiogram. Diastolic insufficiency of both right and left ventricular myocardium was registered in almost all the examinees. CONCLUSION: Long-term anemia due to iron deficiency promotes metabolic and dystrophic alterations in the myocardium manifesting with diastolic dysfunction of both the ventricles prior to systolic failure. The study of cardiac diastolic function in IDA allows detection of early symptoms of cardiac failure which requires pharmacological correction.

[Dynamics of vegetative indicators induced by low-frequency magnetotherapy and EHF-puncture in hypertensive workers exposed to vibration]. / Dinamika vegetativnykh pokazatelei u rabochikh vibroopasnykh professiii s arterial'noi gipertoniei pod vliianiem nizkochastotnoi magnitoterapii i KVCh-punktury.

Low-frequency magnetic fields and EHF-therapy have been used in correction of autonomic homeostasis in workers exposed to vibration for different periods of time. The workers suffered from early arterial hypertension. Vegetative status and central hemodynamics improved best in workers exposed to vibration for less than 5 years. If the exposure was 6-15 years, a positive trend occurred in the tension of regulatory mechanisms. Workers with long exposure to vibration suffering from vagotonia showed an inadequate response of the autonomic parameters to treatment. This necessitates enhancement of therapeutic measures with medicines.

[Hormonal regulation disorders in vibration disease pathogenesis]. / Narushenie gormonal'noi reguliatsii v patogeneze vibratsionnoi bolezni.

The authors studied humoral regulation state in vibration disease patients. Correlation analysis proved role of hormonal disturbances in pathogenesis of angiopathies and visceropathies characteristic for vibration disease.

[Influence of low-frequency magnetotherapy and HF-puncture on the heart rhythm in hypertensive workers exposed to vibration]. / Vliianie nizkochastotnoi magnitoterapii i KVCH-punktury na serdechnyi ritm rabochikh vibroopasnykh professii s arterial'noi gipertoniei.

The authors present results concerning use of low-frequency magnetic fields and HF-therapy for correction of vegetative homeostasis in workers with variable length of service, exposed to vibration, having early forms of arterial hypertension. The most positive changes of vegetative status and central hemodynamics are seen in workers with low length of service.

[The use of low-frequency magnetotherapy and EHF puncture in the combined treatment of arterial hypertension in vibration-induced disease]. / Primenenie nizkochastotnoi magnitoterapii i KVCh-punktury v kompleksnom lechenii arterial'noi gipertenzii pri vibratsionnoi bolezni.

Combination of EHF therapy + magnetotherapy + drugs results in faster and persistent hypotensive and analgetic effect compared to standard drug therapy, potentiates action of vascular drugs on cerebral and peripheral circulation, reduces dose of hypotensive drugs in patients with arterial hypertension and vibration disease.

[Multiple organ failure in patients with hemoblastosis during long-term follow-up of treatment]. / Poliorgannaia patologiia u bol'nykh gemoblastozami v otdalennom periode lecheniia.

AIM: Investigation of the condition of the liver, gastrointestinal tract, heart in patients at the stage of clinicohematological remission after treatment for hemoblastosis (acute leukemia, Hodgkin's disease, non-Hodgkin's lymphoma). RESULTS: Marked functional-morphological changes were found: endomyocardial fibrosis, cardiopathy, pulmonary hypertension, chronic atrophic gastritis, colon lesions, dysbacteriosis, viral or drug-induced hepatitis. CONCLUSION: The above affections have developed because of the treatment: chemotherapy, radiotherapy, hemotransfusions, antibacterial drugs. They deteriorate life quality and require a special system of rehabilitation measures.

[The characteristics of cardiac diastolic function in myocardiodystrophy in persons subjected to aromatic hydrocarbon exposure]. / Osobennosti diastolicheskoi funktsii serdtsa pri miokardiodistrofii u lits, podvergaiushchikhsia vozdeistviiu aromaticheskikh uglevodorodov.

Left and right ventricular diastolic function was investigated at doppler echocardiography in patients with myocardiodystrophy exposed to organic aromatic solvents (30 female house painters). The control group consisted of healthy females and females with autonomic-dyshormonal myocardiodystrophy. The study group exhibited diastolic dysfunction characterized by disturbed active relaxation assessed by duration of isometric left and right ventricular relaxation.

[Prevalence of serological markers for viral hepatitis B and C in patients and medical personnel in the hematologic ward of Novosibirsk city hospital No. 2]. / Vstrechaemost' serologicheskikh markerov virusnykh gepatitov B i C patsientov i meditsinskogo personala gematologicheskogo otdeleniia gorodskoi bol'nitsy No. 2 Novosibirska.

Blood samples of 60 patients and 19 staff members were tested for serological markers of hepatitides B (HBV) and C (HBC) using the Vector-Best JSC enzyme immunoassay kits. HBV and HBC markers were found in 25 in 30% of patients and in 15.8 and 5.3% of staff members, respectively. Part of the sera with HBV and HBC markers were tested for the HBV and HBC RNAs by polymerase chain reaction. The findings confirm that donors should be more thoroughly tested for hepatitis markers, as well as the patients and staff of hematology departments.

[Optimization of the diagnosis and treatment of anemias under exposure to aromatic-type organic solvents]. / Optimizatsiia diagnostiki i lecheniia anemii v usloviiakh vozdeistviia organicheskikh rastvoritelei aromaticheskogo riada.

171 iron-deficient painters and 20 subjects with chronic intoxication with aromatic hydrocarbons were studied in a large aircraft construction factory. After correlative analysis of iron metabolism, ferritin, erythrocytes, diameter and perimeter of reticulocytes, length of service three types of iron-deficiency were identified: typical, with evident toxicity, with a high risk of toxic damage. An important role of lipid peroxidation activity and toxic erythrocyto-membranopathy for pathomorphosis of iron deficiency anemia and progress of toxic anemia is demonstrated. A differential approach to treatment of different anemia variants was used. The treatment included membranoprotectors (alpha-tocopherol, essential, lypostabil) and unspecific detoxication (SUMS-enterosorbent, unitiol).

[Erythrocyte structure and function in iron-deficiency states in painters]. / Struktura i funktsiia éritrotsitov pri zhelezodefitsitnykh sostoianiiakh u maliarov.

The studies of lipid peroxidation, antioxidant defence, structure and functions of erythrocytes in iron deficiency of painters revealed severe changes in the cells' chemiluminescence, sulfhydryl and catalase activities, levels of free cholesterol, lipoproteins, hystidine and glucose-6-phosphate dehydrogenase, saponin resistance and viscosity of erythrocytes. The changes appeared to depend on duration of exposure to the toxic chemicals. The data presents additional markers of toxic influence on erythrocytes in developing iron deficiency of painters.

[Ultrastructural changes in the liver cells in severe iron-deficiency anemia]. / Ul'trastrukturnye izmeneniia v kletkakh pecheni pri zhelezodefitsitnoi anemii tiazheloi stepeni.

Ultrastructural changes in hepatocytes, sinusoidal endothelial and Kupffer cells and their phagocytic activities were studied in rabbits with grave posthemorrhagic iron deficiency anemia. Morphologic characteristics of depressed mitochondrial function and cellular plastic processes were observed in all liver cells. Necrobiotic changes in endothelial and Kupffer cells were discovered. Kupffer cells phagocytic capacity was decreased, this being shown by latex particles phagocytosis. The share of secondary lysosomes with more labile membranes increased 2-3-fold, this being a risk factor in the treatment of iron deficiency anemia with lysosomotropic agents, including iron-containing ones.

[Quantitative and functional characteristics of T-lymphocytes and monocytes in lymphosarcoma patients at various stages of the neoplastic process]. / Kolichestvennaia i funktsional'naia kharakteristika T-limfotsitov i monotsitov u bol'nykh limfosarkomoi na raznykh stadiiakh opukholevogo protsessa.

IKO monoclonal antibodies were used to study peripheral blood mononuclear types in 92 patients with various histomorphological types of diffuse lymphosarcoma at various stages of tumorous process. Absolute counts of CD7 and CD5 cells (T cells) were found reducing as was CD4 cell (T helpers) level as the disease progressed. CD8 cell (T suppressors) count reliably increased only in the phase of lymphoblastic lymphosarcoma leukemic degeneration. A group of patients with stage IV lymphoblastic lymphosarcoma was detected with drastically increased counts of mononuclears carrying mature T cell markers. Clinical course of the disease in these patients was characterized by the highest malignancy degree and metastatic involvement of the central nervous system. Examination of peripheral blood monocyte/macrophage ratio in the same patient population (n = 26) revealed reduced Fc receptor expression, EA phagocytosis, and increased levels of circulating immune complexes, these shifts augmenting with the tumor progress. The results may be valuable for prediction of lymphosarcoma course and for immunocorrection.

[Somatosensory evoked potentials in patients with disordered thermoregulation of central origin]. / Somatosensornye vyzvannye potentsialy u bol'nykh s narusheniem termoreguliatsii tsentral'nogo geneza.

Clinical, neurological, neurophysiological examinations including registration of somatosensory evoked potentials (SEP) were performed in 25 patients with impaired thermoregulation of the central origin. It was found that amplitude of all the SEP components in patients had become significantly reduced compared to normal subjects. Most prominent shifts occurred in hyperthermia patients with neuroendocrine and metabolic abnormality which acquired monotonic and stable patterns. SEP impairment was more severe in the right hemisphere.