[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.

[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.

[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.

[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.

[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.

[Structure and function of erythrocytes in lymphomas]. / Struktura i funktsiia éritrotsitov pri limfomakh.

Significant changes have been recorded in the concentration of sulfhydryl groups, histidine, lipoproteins, catalase activity, saponin resistance, and kinetics of chemiluminescent responses of red blood cells in lymphoma patients. Lymphosarcoma is characterized by changes in the structure and function of red blood cells at the early stage of the process, whereas in lymphogranulomatosis changes are observed with the disease progressing, when pronounced signs of tumor intoxication are noted and anemia is present. In lymphosarcoma patients an increase of peripheral blood mononuclears is recorded which expresses the erythroid differentiating antigens with the use of monoclonal antibodies against glycophorin A (ZAE-3) and human erythroblast antigen AG-EB (HAE-9). In lymphogranulomatosis patients it was not detected.

[Expression of erythroid differentiation antigens on mononuclear cells of peripheral blood in neoplastic progression of non-Hodgkin's malignant lymphoma]. / Ekspressiia éritroidnykh differentsirovochnykh antigenov na mono- nuklearakh perifericheskoi krovi pri opukholevoi progressii nekhodzhkinskikh zlokachestvennykh limfom.

High level expression of erythroid differentiation antigens on peripheral blood mononuclear cells associated with increased BFUe number has been identified in a malignant lymphoma patient. A possible pathogenetic role of such disturbance in leukemogenesis has been considered.

[The expression of lymphopoietic differentiation antigens on the membrane of the peripheral blood mononuclear cells in lymphosarcoma tumor progression]. / Izuchenie ékspressii differentsirovochnykh antigenov limfopoéza na membrane mononuklearov perifericheskoi krovi pri opukholevoi progressii limfosarkom.

Monoclonal antibodies were used in the indirect immunofluorescence test to assay the antigenic features of lymphoid cells in patients with lymphosarcoma. Some patients with progression of lymphoblastic lymphoma showed an increased content of T lymphocyte expressing early activation antigens, antigens of early hemopoietic progenitors, and CALLA-antigens.

[Prognostic significance of nucleolar markers in chronic lymphocytic leukemia]. / Prognosticheskaia znachimost' nukleoliarnykh markerov pri khronicheskom limfoleikoze.

The morphological criteria have been identified permitting the prognosis of the course character of chronic lymphoid leukemia (CLL). Slow progressing of CLL is attended by the accumulation in the peripheral blood of lymphocytes in the transient stage G0----G1 with ring-like nucleoli surrounded by the perinuclear area. In rapid progressing of the disease, lymphoid cells in stages G1 and S with homogenous nucleoli containing the nucleolar lipid component, are observed in the blood of CLL patients.

[The nucleolar apparatus of the lymphoid cells in AKR mice at different stages of leukemogenesis]. / Nukleoliarnyi apparat limfoidnykh kletok myshei linii AKR na razlichnykh étapakh leikozogeneza.

Morphological features of nuclear apparatus in mice leukemic cells of the peripheral blood, lymph nodes, thymus, bone marrow and spleen were studied. These cells were taken from 12-months-old AKR mice. Enlarged percentage of cells with nucleolar lipid component in thymus characterizes preleukemic state for 6-months-old AKR line mice.

[The spatial reorganization of the perinucleolar area of hematopoietic cells in human leukemias]. / Prostranstvennaia reorganizatsiia perinukleoliarnoi zony gemopoéticheskikh kletok pri leikozakh u cheloveka.

The structure of perinucleolar zone in nuclei of peripheral blood hemopoietic cells has been studied. The cells of human patient with chronic lympholeukemia, chronic myeloleukemia, various forms of acute leucosis have been investigated. The phenomenon of radial strings and border structures has been found in these cells. The features have been revealed by visualization of ribonucleoproteides and lipoproteins. The same process takes place in human lymphocytes after 6-24 h of 3-phosphoglyceric aldehyde stimulation in vitro. A comparative study of morphologic peculiarities of hemopoietic cell nucleolar apparatus depending on cell cycle phase has been performed. The action of cytostatics upon the structure of nucleus perinucleolar zone has been investigated.

[Characteristics of erythrocyte metabolism in iron deficiency of varying degrees of severity]. / Osobennosti metabolizma éritrotsitov pri defitsite zheleza razlichnoi stepeni tiazhesti.

The content of free cholesterol, sulfhydryl groups, histidine, lipoproteins, as well as saponin resistance and catalase activity were studied in red blood cells of peripheral blood in patients with latent iron deficiency and in those with iron deficiency anemia. Significant functional disorders were detected in the red blood cells. A relationship was recorded between the changes in the red blood cell metabolism and the pattern and severity of iron deficiency.

[A method for the early detection and treatment of patients with iron deficiency states]. / Metodika rannego vyiavleniia i lecheniia patsientov s zhelezodefitsitnymi sostoianiiami.

In order to optimize the identification of persons with iron deficiency during mass prophylactic screenings, a diagnostic algorithm using a unified questionnaire was proposed and introduced into medical practice. During 1985-1987, a total of 3655 women aged 18 to 54 years belonging to different occupational groups filled in questionnaires at an industrial enterprise of Novosibirsk. The women were distributed into several groups: group I was made up of normal persons, group II of persons at risk, group III of persons with latent iron deficiency, group IV of persons with iron deficiency anemia, and group V of patients with continuously relapsing iron deficiency anemia refractory to therapy. Taking into account the groups indicated, the diagnostic and the treatment and prophylactic measures have been elaborated.

[The socioeconomic aspects of the therapeutic measures in lymphogranulomatosis]. / Sotsial'no-ékonomicheskie aspekty lechebnykh meropriiatii pri limfogranulematoze.

The socioeconomic impact of procedures used in the treatment for Hodgkin's disease was studied on the basis of follow-up data. The first-year costs appeared maximal, viz. approximately 3904.78 rubles per patient. The cost effectiveness of the first-, first two- and first three-year treatment was 8.2, 4.8 and 3.5 higher than the overall costs, respectively. Comparison of costs of treatment and maintenance of the whole of patients with the expected cost effectiveness assuring that at least one-third of rehabilitated patients resume working showed the latter parameter to exceed the overall costs by 1.4 times.