[Adenoma of the parathyroid gland in a young woman with chronic kidney disease: primary or tertiary hyperparathyroidism?]

Clinical observation of a young woman with chronic kidney disease IV stage and hyperparathyroidism is presented. Ultrasound and99mTc-sestamibi scintigraphy of the anterior surface of the neck visualized a tumor of the left upper parathyroid gland. In a histological examination of distant education was diagnosed a solid parathyroid adenoma. The difficulty of differential diagnosis between primary and secondary/tertiary hyperparathyroidism in chronic kidney disease is discussed.

[Impressionable cytology method in diagnostics of dry eye syndrome.]

Analysis of the cellular composition of the eyeball conjunctival prints and evaluation of the informative of the cytomorphological method of research in the diagnosis of dry eye syndrome (DES). Cytological examination using impression cytology was performed in 72 patients: 60 patients with DES and 12 without eye disease (control group). The main component of cytological sample in patients with DES are (a) squamous epithelium (hyperkeratocytes); (b) groups and clusters of flattened epithelial cells; (c) a small amount (up to five in the preparation) of goblet cells. Impression cytology method improves the accuracy of diagnosis of DES.

[Therapeutic pathomorphosis in the practice of clinical cytologists.]

Pathomorphosis means the changes that occur under the influence of various factors during the course of the disease. Therapeutic pathomorphosis develops during diagnostic and therapeutic procedures. The article considers the types of cellular reactions observed in the process of therapeutic pathomorphosis. The main cytological signs of destructive and proliferative processes for assessing the condition of the pathological focus, regardless of its location, are presented. The clinical significance of the study of cytological signs of therapeutic pathomorphosis is discussed.

[The cytomorphologic characteristics of parathyroid gland under various forms of hyperparathyroidism].

The study was organized to establish criteria of cytological diagnostic of pathology of parathyroid glands under various forms of hyperparathyroidism. The ultrasound examination of pathology of parathyroid glands was applied to 74 patients with hyperparathyroidism aged 24-66 years (20 males and 54 females). The examination was applied to 11 patients with primary hyperparathyroidism (bone visceral form), 51 patients with secondary hyperparathyroidism of severe course and 12 patients with tertiary hyperparathyroidism (post-transplantation). The 109 samples of expanded parathyroid glands were visualized and subjected to fine-needle aspiration biopsy. The cytologic material was colored with azure-eosin according Pappenheim method and analyzed using light microscopy technique. The cytological material was informative in 105 (96%) findings. The elements of tissue of parathyroid glands were detected in 99 (90.8%) samples. The main cytomorphologic indications of adenoma of parathyroid gland were follicle-like and papillary structures of main parathyrocites detected in all patients with primary hyperparathyroidism; main parathyrocites at various stages of secretory cycle - in 64% of patients and macrophages - in 50% of patients. The characteristic cytomorphologic indications of hyperplasia of parathyroid gland turned out to be situated in groups, papillary and branching structures with expressed intercellular contacts, main dark parathyrocytes detected in 88% of patients with secondary hyperparathyroidism, parathyrocytes at various stages of secretory cycle (53% of patients) and small basophilic granules of secretion of parathyrocites in cytoplasm and/or extracellular space (31% of patients). The distinctive cytological indications of tissue of parathyroid gland under tertiary hyperparathyroidism included prevalence of main light parathyrocites situated in small clusters and groups with ill-defined intercellular contacts and presence of large basophilic secretory granules in cytoplasm of parathyrocites, extracellular space and colloid-like substance (92% of patients). The comparative analysis detected similar cytological indications in tissue of parathyroid gland and strictly definite criteria characteristic for primary, secondary and tertiary hyperparathyroidism. The relationship between structural functional condition of tissue of parathyroid gland and development of either form of hyperparathyroidism is discussed. The cytomorphologic characteristics of tissue of parathyroid gland under primary, secondary and tertiary hyperparathyroidism can be included in algorithm of pre-surgery diagnostic.

[The cytomorphologic characteristics of parathyroids under hyperparathyroidism].

The article presents the results of intravital studying of cytomorphologic characteristics of elements of tissue of parathyroids obtained under thin-needle aspiration biopsy in patients with hyperparathyroidism. The analysis was applied to 84 fragments of cell material from node formations in projection of anatomic localization of parathyroids and in projection of lobes and isthmus of thyroid gland. The cytologic preparations colored with Pappenheim azure-eosin staining were analyzed using light microscopy. The results were compared with data of histological study of post-operation material. The following cytomorphologic signs of tissue of parathyroids under hyperparathyroidism: heterogeneity of population of cells of glandular epithelium--presence of main (dark, light) and oxyphilous parathyrocytes with prevalence of main parathyrocytes; occurrence of expressed intracellular contacts in groupings of parathyrocytes with formation of rosette-strand like structures or compact assemblies as well as occurrence of dark polymorphic granules positioned in cytoplasm of epithelium cells and intercellular medium.

[Characteristics of a 24-hour rhythm of blood pressure in patients with chronic renal failure on peritoneal dialysis].

AIM: To analyse 24-h rhythm of blood pressure (BP) and its influence on the rate and severity of left ventricular hypertrophy (LVH) in patients with chronic renal failure (CRF) on replacement therapy (peritoneal dialysis - PD). MATERIAL AND METHODS; 70 CRF patients on PD were studied. Their examination included clinical, biochemical tests, automatic 24-hour blood pressure monitoring, transthoracic echocardiography. RESULTS: Non-dipper and night-peaker disorders of BP 24-hour pattern were registered in 81.4% patients irrespective on hypertension severity. Left ventricular myocardial hypertrophy was 87.7% in patients with disturbed 24-h BP rhythm and 53.8% (p = 0.015) in normal BP rhythm. LV myocardial mass index median was 223 and 129 g/cm2 (p = 0.026), respectively. Concentric and excentric models of LV hypertrophy occurred with the same rate in normal and disturbed 24-h rhythm of BP. CONCLUSION: CRF patients on PD are characterized by disorders of 24-h BP rhythm independent of hypertension severity. Night-peaker pattern of BP is a risk factor of development and/or progression of LV hypertrophy.

[Composition of amino acid in blood and dialysate by patients with in chronic renal insufficiency by peritoneal dialysis].

Examination composition of amino acid in blood and dialysate by patients with in chronic renal insufficiency by peritoneal dialysis. As it turned out by these patients composition of amino acid in blood and dialysate near. Only variation composition and lowering concentration amino acid with branching chain.

[The application of artificial protein premixes for nutritive support of patients with chronic renal insufficiency, being treated by perinateal dialysis].

As a result of a survey of 56 patients with chronic renal insufficiency, who undergone hemodialysis, it was established, that clinical condition of patients, biochemical and hematological blood indices as well as results of anthropometric research improve upon application of artificial balanced high-protein premixes -"Nutrinil" and "Nutrien-Nefro". Irrespective of way of administration - introperitoneal ("Nutrinil" solution) or enteral ("Nutrien-Nefro" mixture) protein-energetic insufficiency diminishes or totally disappears, body weight, fat and muscle content of the body weight, as well as indices of whole protein, albumine, lymphocytes, haemoglobin, pH approache the norm. Intraperitoneal way of administration of artificial protein premixes increase patients adherence to this procedure, though enteral way of their administration is more preferable from economic point of view.

[The hemodynamic status during ultraviolet irradiation of the blood in patients with chronic nonspecific lung diseases]. / Sostoianie gemodinamiki pri ul'trafioletovom obluchenii krovi u bol'nykh khronicheskimi nespetsificheskimi zabolevaniiami legkikh.

Central and organic hemodynamics were studied in extracorporeal UV irradiation of blood (EUVRB) conducted in patients with chronic nonspecific diseases of the lungs. Within the first postexposure day the majority of the hemodynamic parameters showed marked fluctuations. EUVRB brought about a persistent reduction in pulmonary-vascular resistance in bronchial asthma and chronic obstructive bronchitis patients. The latter also achieved a decline in pulmonary hypertension. A positive trend arose after EUVRB in red cell histo- and morphograms. Relevant hemodynamic EUVRB mechanisms are discussed.

[Infectious-inflammatory complications in patients after transplantation of the kidney]. / Infektsionno-vospalitel'nye oslozhneniia u bol'nykh posle peresadki pochki.

The work deals with the results of retrospective analysis of infectious complications (IC) in 323 patients with terminal renal failure (TRF) who underwent 371 operations for allotransplantation of cadaver kidney (ATCK). IC frequency was 41%, their mortality, 42.6%. The structure of the IC was as follows: pulmonary 29.6%, wound 22.4%, urinary 20.4%, sepsis 19.1%, others 8.5%. Gram-negative microorganisms predominated in the etiology of the IC; gram-positive cocci, microbial associations, yeastlike fungi, and cytomegalovirus were encountered less frequently. The development of IC did not depend on the patients' sex, primary disease of the kidneys which led to TRF, or the duration of previous treatment by hemodialysis, but was directly related to the age of the recipients. It was found that the character of the basic and anticrisis immunosuppressive therapy influenced the frequency of IC occurrence. The authors recommend some preventive and therapeutic measures for reducing the risk of the development of IC in patients after ATCK.

[Ultraviolet irradiation of the blood in the treatment of pyo-inflammatory complications in patients with terminal renal failure]. / Ul'trafioletovoe obluchenie krovi v lechenii gnoino-vospalitel'nykh oslozhnenii u bol'nykh terminal'noi pochechnoi nedostatochnost'iu.

The authors describe a technique of extracorporeal UV radiation of blood (EUVRB) in flow closed circulation. Its efficacy was assessed in combined treatment of pyo-inflammatory complications of terminal renal failure. Therapeutic effects of EUVRB are due to reduced endogenic intoxication, correction of leukopoiesis and stimulation of immunity. The changes in laboratory findings correlated with clinical pattern of the inflammation. EUVRB produced a favourable response and improved therapeutic results of pyo-inflammation treatment in patients with terminal renal failure.

[Immunologic criteria of severity of suppurative infections in patients on programmed hemodialysis]. / Immunologicheskie kriterii tiazhesti gnoinoi infektsii u bol'nykh programmnom gemodialize.

Certain parameters of the immune system were studied in patients under programmed hemodialysis with and without pyo-inflammatory complications. It was found that patients without pyo-inflammatory diseases are characterized by the state of immune deficiency while in patients with purulent infection the degree of inhibition of immune response of the organism correlates with spread of the suppurative process.

[Ultrastructural changes in the erythrocytes irradiated with ultraviolet light]. / Ul'trastrukturnye izmeneniia éritrotsitov, obluchennykh ul'trafioletovym svetom.

The ultrastructure of erythrocytes of donor blood and blood of patients suffering from kidney insufficiency was studied with the help of scanning and transmission electron microscopes before and after it was treated with ultraviolet light. It was concluded that after being treated with ultraviolet light, the ultrastructure of donor blood erythrocytes undergoes significant positive changes which are being characterized by normalization of the form of cells, decrease of associative ties between them, the cytoplasm content becomes more homogenous. There was a noticeable increase of a number of discocytes and a decreased number of associative ties between the cells after the patients' own blood was treated with ultraviolet light. The violation of the wholesomeness of erythrocytes membrane was not discovered. The indications are that the observed therapeutical effect after treating blood with ultraviolet light, is explained, to a certain extent, by the ultrastructural modification of erythrocytes membrane.

[Morphofunctional changes in blood cells irradiated with ultraviolet light]. / Morfofunktsional'nye izmeneniia kletok krovi, obluchennoi ul'trafioletovym svetom.

Red cell and leukocyte morphology and function have been examined in donor blood UV irradiated in a flow closed circulation. The studies have revealed that a single UV irradiation enhances red cell resistance to chemical hemolysis, helps them acquire normal shape; besides, it improves leukocytic functional activity, that manifests by enhanced phosphatase activity and augmentation of the granulocyte phagocytic activity.

[The effect of ultraviolet irradiation of patients' blood on the morphofunctional status of erythrocytes]. / Vliianie ul'trafioletovogo oblucheniia krovi bol'nykh na morfofunktsional'noe sostoianie éritrotsitov.

The morphofunctional status of red blood cells was studied in patients with terminal renal failure associated with pyo-inflammatory complications treated by means of ultraviolet radiation of autologous blood. The authors have established that ultraviolet radiation of autologous blood results in the increase of the discocyte count and red blood cell activation, evidenced by the rise of the young red blood cell count, of the red blood cell population with marked activity of glucose 6-phosphate dehydrogenase, of the content of sulfhydryl groups, and by the increase of erythrocytic adhesion.