[Early changes in the kidney microcirculatory bed in the generalized Sanarelli-Shwartzman reaction]. / Rannie izmeneniia mikrotsirkuliatornogo rusla pochek pri generalizovannoi reaktsii Sanarelli-Shvartsmanna.

Investigations of early changes of renal microcirculation in generalized Sanarelli-Schwartzmann's reaction revealed markedly manifest alterations in endotheliocytes, podocytes, basal membrane of the glomeruli accompanied by disorders in the permeability of their capillaries and disseminated microthrombosis.

[Isolation and purification of urokinase]. / Vydelenie i ochistka urokinazy.

An improved procedure is developed for isolation of urokinase from human urine by means of ion exchange on cyrboxyl cationite SMT at pH 4.7. with subsequent stepwice elution by phosphate buffer, rH7.0. Depigmentation of the urine was achieved by pretreatment with an anionite FAF. Chromatographically pure preparation of urokinase was obtained as shown by gel filtration through Sephadex G-100 and G-150.

[The effect of specific transfusion therapy on the level of circulating immune complexes in hemophilia patients]. / Vliianie transfuzionnoi spetsificheskoi terapii na uroven' tsirkuliruiushchikh immunnykh kompleksov u bol'nykh gemofiliei.

The level of circulating immune complexes (CIC) was measured in 108 hemophilic patients registered at the Republican Center for Hemophilia Treatment. High levels of CIC were detected in hemophilic patients of different age. The concentrations of CIC were higher in adult patients than in children. Formation of immune complexes in the test groups did not go beyond the framework of the physiological process, for the signs of vasculitis, which is an indispensable component of immunocomplex pathology, could not be identified. Higher levels of CIC in adults were related to a greater number of transfusions made throughout the life, particularly if the annual dose of the preparations infused exceeded 10,000 Units of factor VIII or IX. No significant correlation was established between the rise of CIC levels in the patients' serum and the biochemical alterations in liver function, detected in these patients. Therefore, CIC detected by the authors are not specific and lesions of the liver parenchyma in hemophilic patients are not determined by their presence.

[Coagulopathic hemorrhage in operations on the lungs]. / Koagulopaticheskie krovotecheniia pri operatsiiakh na legkikh.

The authors observed 38 patients with intrapleural hemorrhages arising during operations on the lungs. In 34 patients different disturbances of blood coagulation were diagnosed. Due to the developed methods of urgent coagulodiagnosis and purposeful treatment hemostasis was obtained in all the patients. A relationship between the size of blood loss and outcome of the disease has been established. The timely diagnosis and correction of disturbed hemostasis are shown to be necessary.

[Rheologic properties of the erythrocytes and hemostatic system in patients with polycythemia vera]. / Reologicheskie svoistva éritrotsitov i sistema gemostaza u bol'nykh istinnoi politsitemiei.

Rheologic properties of red blood cells and hemostasis were investigated in 25 patients with polycythemia vera (PV). Manifest hemorheologic and hemocoagulation disorders attended by thrombohemorrhagic complications were revealed in this group of patients. It has been shown that hemorheologic disorders play an important role in the mechanisms of thrombohemorrhagic complications in PV, therefore they should be corrected with antiaggregation agents. In some cases disorders in the rheologic phenomena of red blood cells are a triggering mechanism in the development of disseminated intravascular coagulation (DIC) syndrome. A correlation has been revealed between the parameters of red blood cell rheologic properties and hemostasis and the disease severity. It is suggested that rheologic properties of red blood cells should be studied for the diagnosis of DIC syndrome.

[A new method for evaluating the rheological properties of the erythrocytes in surgical patients with endogenous intoxication]. / Novyi sposob otsenki reologicheskikh svoistv éritrotstitov u khirurgicheskikh bol'nykh s éndogennoi intoksikatsiei.

An examination of 30 patients against the background of using both the operative and conservative methods of treatment was performed in order to study the rheological properties of blood and selection of the most informative tests for diagnosis of microcirculatory disturbances in diseases of the gastrointestinal tract and gastroduodenal area. The authors propose methods of investigation of deformability and viscosity of erythrocytes in patients with the surgical diseases in question. The methods are simple, quite handy for any surgical hospital and polyclinic laboratories. In addition to being used in investigations of the aggregative ability of erythrocytes and viscosity of the whole blood, these methods can be of use in express diagnosis of rheological disorders. The endogenous intoxication in patients with the diseases in question was found to be accompanied by deep rheological disturbances. The deformability of erythrocytes and their viscosity index which can pass ahead of the shifts in other parameters characterizing the hemocoagulative and rheological properties of blood are changed. A conclusion is drawn that the parameters of the erythrocyte deformability and viscosity can be an additional criteria of the adequacy of therapy used for patients with the diseases in question.

[Rheological properties of erythrocytes and hemostasis in patients with acquired autoimmune hemolytic anemia treated with anti- lymphocyte globulin]. / Reologicheskie svoistva éritrotsitov i gemostaz u bol'nykh priobretennoi autoimmunnoi gemoliticheskoi anemiei, polu- chavshikh antilimfotsitarnyi globulin.

Rheologic properties of red blood cells and hemostasis were studied in patients with acquired autoimmune hemolytic anemia who received antilymphocytic globulin (ALG). Hypocoagulation changes attended by elevation of red blood cell aggregation activity were detected in the patients already at their admission to the hospital. After administration of ALG, growth of these shifts, characteristic of disseminated intravascular blood coagulation (DIC) syndrome, was noted. It was shown that erythrocytic thromboplastin and antiheparin factor action on blood coagulation, mainly at the expense of the young cell fraction, was responsible for disorders in hemostasis. Nevertheless, despite the presence of DIC syndrome, in the group of patients, who received ALG, no clinical signs of this state were recorded, that could be explained by the protective effect of red blood cell intensified capacity for aggregation leading to the improvement of blood coagulation parameters.

[Rheologic properties of erythrocytes of the hemostatic system in patients with acute lymphoblastic leukemia]. / Issledovanie reologicheskikh svoistv éritrotsitov i sistemy gemostaza u bol'nykh ostrym limfoblastnym leikozom.

Disturbed erythrocytic rheology revealed in ALL patients with hypocoagulative shifts is suggested to trigger DIC syndrome. Combined treatment enhanced erythrocytic aggregation, viscosity and reduced deformability. Nevertheless, the patients improved, hemorrhagic complications attenuated, hemostasis underwent positive changes. The shifts are thought a defense reaction. A correlation exists between rheologic abnormalities and ALL severity.

[Rheologic and coagulational disorders and their correction with heparin in patients with autoimmune thrombocytopenic purpura treated with antilymphocytic globulin]. / Reologicheskie i gemokoaguliatsionnye narusheniia u bol'nykh autoimmunoi trombotsitopenicheskoi purpuroi, poluchavshikh antilimfotsitarnyi globulin, i korresktsiia ikh geparinom.

Rheologic and hemocoagulation parameters were studied in 26 patients with autoimmune thrombocytopenic purpura (AITP). It has been shown that disorders in red blood cell rheologic properties detected in these patients aggravate the hemostasis disturbances and promote the development of disseminated intravascular blood coagulation (DIVBC). After infusion of antilymphocytic globulin (ALG) to 20 AITP patients improvement of general condition, as well as positive changes in the rheologic and hemocoagulation parameters were recorded in 15 of them. However, progressing DIVBC syndrome was observed in 5 patients, rheologic shifts being in the basis of its mechanism. To prevent or correct arising disorders, besides ALG infusions, heparin administration was used in a dose of 2000 IU/day. Rheologic and coagulation parameters significantly improved, hemorrhagic symptoms disappeared. Heparin administered in time to AITP patients who received ALG will permit conduction of a full course of treatment with this preparation.

[Use of fibrinogen in hemorrhages in surgical practice]. / Primenenie fibrinogena pri krovotecheniiakh v khirurgicheskoi praktike.

Fibrinogen was used in 62 out of 380 patients with chronic hemorrhages. A conclusion is made that when choosing the dosage of fibrinogen it is necessary to take into account its content in other injected hemostatic drugs. The authors emphasize the danger of thromboses resulting from the unjustified use of fibrinogen.

[Study of thrombus resistance of materials using the prothrombin consumption test]. / Issledovanie tromborezistentnosti materialov testom potrebleniia protrombina.

The work presents a simple and informative method of the assessment of thromboresistivity of opaque materials by the test of determination of prothrombin consumption in vitro. The average time of prothrombin consumption in the blood after its contact with a glass was 136 +/- 13,3 sec., after the contact with a siliconized glass it was 62 +/- 3,45 sec. which suggests higher thromboresistivity of silicon. The difference of the indices is highly significant (P less than 0,001). A conclusion is made that the method concerned is a reliable one.

[Clinico-roentgenological characteristics of renal hemorrhage in hemophilia]. / Kliniko-rentgenologicheskie osobennosti pochechnykh krovotechenii u bol'nykh gemofiliei.

The observation over 20 cases of hemophilia with severe renal bleedings proved the possibility of rendering an effective surgical aid to these patients. Besides, on the grounds of the observations the authors concluded that in all the cases of hematuria and microhematuria constitute indications for x-ray examination of the kidneys and the urinary tract.

[Hemorrhagic syndrome after transfusion of incompatible blood]. / Gemorragicheskii sindrom pri perelivanii nesovmestimoi krovi.

The patients were observed by a reanimation-hematological team of the Leningrad emergency service. It has been established that the hemorrhagic syndrome is the main one deterimining the unity of pathogenesis and clinical picture of the hemotransfusional complication. Phase character of the changes in the homeostasis system during the transfusion of incompatible blood was noted. The express diagnosis of the disorders and a scheme of the sequence of administration of hemostatic drugs are proposed. Mortality among such patients was reduced.

[Hemorrhagic complications caused by heparin therapy]. / Gemorragicheskie oslozhneniia, obuslovlennye geparinoterapiei.

The article deals with complications resulting from the application of heparin. An analysis of 92 case histories is given where hemorrhages made their appearance due to noncorrect administration of heparin. Recommendations are given for purposeful therapy of these complications and their prophylactics.

[Changes in the rheologic properties of erythrocytes in various hematologic diseases]. / Izmeneniia nekotorykh reologicheskikh svoistv eritrotsitov pri riade zabolevanii sistemy krovi.

Some rheological properties of red blood cells were investigated in certain hematological diseases, considering the factors inducing disorders in red blood cell aggregation, deformability and viscosity. It has been shown that these disorders are responsible for increased blood viscosity and microcirculatory disorders in some blood diseases. The changes in red blood cell rheological properties play a significant role in the pathogenesis of thrombohemorrhagic complications in certain hematological diseases. The study of rheological mechanisms regulating blood circulation is necessary for successful development of optimal programs for combined treatment of hematological patients.

[Characteristics of the arrest of hemorrhages occurring after tooth extraction in patients with congenital coagulopathies]. / Osobennosti ostanovki krovotechenii, voznikaiushchikh posle udaleniia zubov, u bol'nykh s vrozhdennymi koagulopatiiami.

Prompt and durable hemostasis was achieved in 56 hemophilic patients and 62 patients with von Willebrand disease in 131 and 62 teeth extractions, respectively. The antihemophilic globulin-containing drug was infused as only a single dose in 61 of the 146 cases. Kaprofer, hemostatic sponge with kanamycin and tamponade were locally applied. No bleedings were observed.

[Hemodilution coagulopathy and infusion-transfusion therapy of massive hemorrhage in obstetric practice]. / Gemodiliutsionnaia koagulopatiia i osobennosti infuzionno-transfuzionnoi terapii massivnoi krovopoteri v akusherskoi praktike.

The paper presents the experience gained by a critical hematological care team in diagnosis and treatment of hemodilution coagulopathy. The investigations were performed in Leningrad obstetric hospitals in 1985-1990 and included 38 patients. Basic principles of the therapy and its control are described. The policy of infusion-transfusion treatment indicated in the paper secured successful management of puerpera with massive blood loss.