[How knowledgeable are Czech physicians regarding risk factors for ischemic heart disease?].

The authors present the results of an enquiry made by means of questionnaires in which 298 physicians participated. The enquiry was focused on risk factors of ischaemic heart disease. 41.8% physicians did not know their cholesterol level, 22.1% admitted that they smoked and another 17.8% were ex-smokers. Only half the physicians indicate dietetic treatment of hypercholesterolaemia when the blood level is 6.2 mmol/l. These and other data in the paper indicate that behaviour and knowledge of physicians as regards prevention of cardiovascular diseases most be substantially improved.


[A case of systemic mastocytosis].

The authors describe a rare case of systemic mastocytosis without skin infiltration. The first symptom were episodes of flushing in the face and upper trunk. From the case-history it was assumed that the condition had a several year's benign course, the diagnosis was established in the stage of malignant acceleration of the disease from bone marrow biopsy and liver biopsy. Atypical mastocytes displayed metachromasia with toluidine blue and positive naphthol-AS-D chloroacetate esterase. Symptomatic treatment with sodium cromoglycate reduced temporarily the frequency of flushing episodes, but it was not possible to arrest the increase of the mastocyte mass by cytostatic treatment.


[Oxalosis in patients on regular dialysis therapy].

The authors draw attention to the case of a 46-year-old man who developed after three years of regular dialyzation treatment three times a week the first manifestations of acquired generalized oxalosis. The oxalosis was most marked on the skin, skeleton, heart, and kidneys. Oxalosis was confirmed after eight years of dialysis after death by post-mortem and histological examination and microscopic detection of oxalate crystals. The authors recommend that as part of regular dialyzation treatment patients should not be given more than 100 mg ascorbic acid per day. Oxalates are also the end product of degradation of ascorbic acid and high doses may lead also to hyperoxalosis. Moreover deposits in some visceral organs, in particular the heart may cause clinical manifestations. In the authors patients they caused attacks of auricular flutter. Although these clinical manifestations develop only rarely, the latent form of acquired oxalosis is probably more frequent.


[Angiodysplasia--a cause of severe hemorrhage in the gastrointestinal tract].

The authors describe a case of relapsing severe haemorrhage from angiodysplasias localized in the small intestine in an eighty-year-old female patient diagnosed only after probatory laparotomy. They discuss the diagnostic possibilities in angiodysplasia of the gastrointestinal tract and how it can be influenced by therapy. Even after resection of the affected portion of the intestine the formation of new angiodysplasias must be foreseen in previously intact areas and those can be the source of further severe haemorrhage.


[Psychosomatic aspects of arterial hypertension].

In patients with labile hypertension aged 18-25 years the authors observed an increased sympathicoadrenal reactivity to mental strain caused by solution of a numerical square, parallel with a rise of diastolic blood pressure. Despite the fact that we do not know so far to what extent prolonged mental strain participates in the genesis and development of essential hypertension, the findings of the influence of some types of short-term strain on an acute rise of the blood pressure in hypertonic subjects should be used to modify the non-medicamentous procedure in treatment of the disease.


[Lipoproteinemia and diabetes mellitus].

The author presents a review on lipoprotein metabolism in diabetes mellitus type I and II. He discusses the position in different lipoprotein classes--in particular LDL, VLDL, HDL and draws attention to the role of apolipoproteins and the association between lipoprotein disorders and complications of atherosclerosis in patients with diabetes of type I and II. The author deals also with the influence of genetic factors in the aetiology of hyperlipoproteinaemias.


[A comparative analysis of the effect of low-intensity physical training on a bicycle ergometer, graded walking and drug therapy on the cardiovascular system of patients with stage-II hypertension].

In contrast to standard bicycle exercise with moderate or submaximal effort, low-effort exercises were employed by the author who studied their effect on cardiovascular system of stage II hypertension patients. They were males (n-126) aged 47.2 +/- 3.6 with the disease history of 8.4 +/- 1-9 years. Associated coronary heart disease was diagnosed in 82% of the patients. The test subjects were divided randomly into three groups: group 1 patients received drugs only, group 2 received drugs and exercised walking, group 3 received drugs and exercised on bicycle ergometer in the nonstrenuous regimen. It was found that exercise tolerance of the patients was different and depended on the hemodynamic type. Hypokinetic circulation patients showed the lowest exercise tolerance. Low-effort bicycle exercise in addition to drugs is indicated for hyper- and eukinetic circulation patients. Walking is inferior to the bicycle exercise and can be recommended as a variety of nonpharmacological treatment of hypertension stage II. The combined effect of walking and chemotherapy produced the rise in cardiac capacity in the absence of the adequate increment in coronary blood flow, whereas bicycle exercise seems to enhance cardiac coronary circulation in hypertensive subjects.


[Clinico-experimental prerequisites for the physiotherapeutic use of laser radiation].

The paper reports clinical and experimental evidence in support of the validity of low-energy laser radiation in the treatment of chronic inflammatory and dystrophic diseases. Laser radiation was capable of improving the results of multimodality treatment.


[The optimization of the sanatorium-health resort treatment of children with cardiovascular diseases].

Functional systemic changes as compared to pretreatment characteristics served criteria of adaptation in children suffering from cardiovascular diseases. A load test with a single balneological procedure was used. Adaptation and compensation response proved useful as individual test loads to make therapy most efficient.


[The immunological and hormonal effects of combined exposure to a bitemporal ultrahigh-frequency electrical field and to decimeter waves at different sites].

Bitemporal UHF electric field is shown to enhance glucocorticoid adrenal function unlike inhibition of the thyroid function suppressing a primary immune response (PIR) in the productive phase. The combined exposure to bitemporal UHF electric field and decimeter waves of the adrenals doubles glucocorticoid synthesis abolishing the inhibitory action of the UHF therapy on thyroid function resultant in much more suppressed PIR. Both modalities inhibit thymic production. Decimeter waves alone are less effective. The exposure of the thyroid to decimeter waves initiated PIR by 2.5-fold activation of medullar lymphocytes and by a 80% increase in the thymic function. No response was achieved in combined action on the thyroid of the electric field and decimeter waves.


[Patient psychological characteristics after transient cerebral ischemia under the influence of physical factors].

Seventy-eight patients with transitory cerebral ischemia (TCI) received a course of physiotherapy (68 subjects) or UHF therapy (10 control subjects). According to the authors' data TCI patients differed from hypertensive subjects as regards psychological status by predominance of psycho-organic and asthenic symptoms. It was found that neurological and mental statuses benefited from physiotherapy. The psychological status underwent less pronounced positive shifts.


[The potentials of manual therapy in the neuromotor correction of the statokinetic disorders in infantile cerebral palsy].

It is shown that manual therapy to abolish functional cervical and lumbar blocks is beneficial in reducing spasticity of the synergic muscles, biomechanic characteristics of the support and kinematic pace phases improve. Manual therapy in multimodality rehabilitation treatment of cerebral paralysis creates a functional base for neuromotor correction of a defective motor stereotype in these patients.


[The valvular effect of the skin in electrophoresis with an alternating polarity of the electrodes].

The effectiveness of iontophoresis by means of changing current direction was investigated on the skin of piglets using labelled potassium iodide (125I and 131I). Permeability without current served control. Percutaneous uptake was measured by blood levels and elimination of the isotopes from the urine. About a 200-fold increase of uptake was found in iontophoresis involving current change every 120 seconds and the concentration of 0.25 g/l of potassium iodide. Anions and cations may be pumped through the horny layer if the a-c frequency is less than 1/15 s-i.


[The dynamics of the indices of myocardial autonomic regulation and contractile function in children with meteoropathic reactions undergoing health resort treatment and physical conditioning].

The paper reports the results of examination of 93 patients with rheumatic fever and 42 healthy children aged 10-13 on treatment at Evpatoria sanatorium under different weather conditions. In unfavourable weather (hypoxic, spastic) vegetative regulation underwent changes dependent on clinical condition of the child and initial vegetative status. Sanatorium treatment and conditioning inhibited sensitivity to meteorological factors in rheumatic children by 60 and in healthy children by 83%.


[The methods and efficacy of motor regimens in chronic nonspecific lung diseases at a family sanatorium].

Conditioning exercises according to a specially designed schedule were performed at family sanatorium by the majority of 1757 patients with chronic nonspecific pulmonary diseases (CNPD). From those who completed the course of the conditioning, a pronounced effect was achieved in 20.7%, improvement in 78.4% of the patients. 0.9% of the test subjects did not respond, the disease progressed in 0.6% of the cases.


[Magnetotherapy in obliterating vascular diseases of the lower extremities].

The investigators have developed a polymagnetic system "Avrora-MK-01" employing running impulse magnetic field to treat diseases of the leg vessels by the action on peripheral capillary bed. At a pregangrene stage a positive effect on peripheral capillaries was achieved in 75-82% of the patients treated.


[The dynamics of glucose homeostasis in non-insulin-dependent diabetics under the influence of mineral water intake].

The paper presents time course changes registered in glycohomeostasis of patients suffering from non-insulin-dependent diabetes mellitus (NIDDM) as a result of a single or course intake of acidulous chloride hydrocarbonate sodium mineral waters. The treatment promoted immediate or delayed improvement in glycemia and insulinemia control, correction of imbalance of hormonal glycohomeostasis regulators (insulin, glucagon), enhancement of gastrinemia. The insulinotrophic effect varied with mineralization of the water, concentrations of bicarbonate and sodium ions. Water regimens were specified for NIDDM patients.


[The assessment of the efficacy of bitemporal inductothermy in the combined treatment of obesity].

To treat obese patients with arterial hypertension, bitemporal inductothermy was proposed. It was to be used in association with diet N 8 and drugs, improving trophism in brain cellular structures. The treatment led to reduction of body mass, normalization of arterial pressure without hypotensive drugs, improvements in lipidogram and physiological reaction of vasopressin-renin-aldosteron system.


[The ultrasonic therapy of hypertensive patients].

The collar zone of 40 subjects with essential hypertension stage II was exposed to continuous low-dose ultrasound (0.2-0.4 W/cm2). The course of 12-18 procedures reduced clinical symptoms. The decline in the maximal and minimal arterial pressure was statistically significant. Cerebral and central hemodynamics, sympathicoadrenal systems improved.


[The analgesic efficacy of sulfur mud baths in treating rheumatic diseases of the soft tissues. A study using the double-blind control method].

Changes in pain thresholds assessed in 16 trigger points were traced in two randomly selected groups of patients subjected to diluted mud baths in the presence or absence of sulfur compounds. Sulfur baths produced a significant lowering of pain sensitivity. The effect was augmenting with the number of procedures, the rise slowing down to the end of the course.


[Medical gymnastics in the rehabilitative treatment of patients with locomotor injuries in combined and multiple trauma].

The follow-up of 70 patients with trauma-related locomotor disorders proved that breathing exercises, vibratory massage, chest heparin electrophoresis, drug inhalations early after the injury can be effective in prevention and treatment of pulmonary complications. Transcutaneous neuroelectrostimulation noticeably enhanced the recovery of the locomotor function.


[The extension of the use of physical methods of treatment to patients with disseminated sclerosis].

The trial of various physiotherapeutic and balneological modalities (radon and turpentine baths, heparin electrophoresis, diadynamic current, acupuncture) in 317 patients with disseminated sclerosis showed their high therapeutical potential in the disease stage II-IV. The techniques and schedules need further investigations.


[The experimental and clinical antianemia efficacy of the chalybeate waters from the Skhodnitsa springs].

Low-mineral waters of Skhodnitsa [correction of Skhodnitsky] springs N 13 and N 15 rich in iron, silicon and manganese were tried for an antianemic effect. The latter was registered clinically and experimentally.


[The coronary and myocardial reserves of patients with ischemic heart disease under the influence of the peloid therapy of concomitant spinal osteochondrosis].

Exercise test in coronary patients with angina of effort class II and III, painless cardiac ischemia reflected their increased coronary and myocardial reserves due to peloid therapy of cervical and thoracic osteochondrosis. As indicated by bicycle ergometry, angina of effort class III complicated by attacks of retrosternal pain at rest, circulatory insufficiency stage IIA, complex arrhythmia present contraindications for peloid application.


[Modulation of lipid peroxidation by biogenic amines in model systems].

Specific effects of serotonin, histamine, noradrenaline and tyramine on the rate of lipid peroxidation were studied in model systems by means of measurement of malonic dialdehyde and Schiff base concentration as well as of kinetics of O2 consumption. Alterations in the lipid peroxidation rate in the presence of biogenic amines occurred dissimilarly depending on localization of oxidation substrates either in bilayer membranes or in micellar solution. The antioxidative effect of serotonin was the most pronounced as a result of its ability to react with lipid peroxidation radicals.


[Change in the opioid peptide level in the heart and blood plasma during acute myocardia ischemia complicated by ventricular fibrillation].

After occlusion of the anterior descending coronary artery content of opioid peptides was increased 2-3-fold in blood plasma of all the rats with and without ventricular fibrillation. Content of Leu-enkephalin was decreased in ischemic and non-ischemic regions of myocardium under conditions of ventricular fibrillation. At the same time, concentration of Met-enkephalin in myocardium was increased in the acute ischemia independently on the effect of fibrillation. Synthetic enzyme-resistant derivative of Leu-enkephalin, administered before acute myocardial ischemia, prevented a decrease in the ventricular fibrillation threshold caused by the occlusion. Alteration of the Leu-enkephalin content in heart tissue appears to be importance in pathogenesis of ventricular fibrillation developed after acute myocardial ischemia.


[Derivatives of 4-phenylpiperidine as substrates of rat brain monoamine oxidase].

A rate of utilization of 4-phenyl piperidine and its 12 derivatives by brain monoamine oxidase (MAO) was studied as compared with typical neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The enzyme was isolated from P2 synaptosomal fraction of brain corpus striatum of Sprague-Dawley rats. 10 drugs were oxidized in the MAO-catalyzed reaction with the rate close or similar to the MPTP oxidation while 6 of them exhibited the neurotoxic effect. Analysis of MAO inhibition, using 1 microM of chlorgyline and/or deprenyl, enabled to evaluate the contribution of MAO-A and MAO-B forms to utilization of 1 mM content of the substances studied. MAO-B was shown to oxidize preferably the drugs radicals of which were substituted at 3rd position of the piperidine ring, while MAO-A preferred the derivatives with radical substitution at 4th position. The rate of substrate oxidation was decreased distinctly after introduction of complete substituents into the 3rd and 4th positions of the nitrogenous heterocycle; at the same time, presence of cyclic fluorine-containing structures increased the rate of utilization, similar to that of MPTP oxidation. Derivatives of 4-phenyl piperidine, which contained in a number of drugs, were oxidized in the MAO-catalyzed reactions and might exhibit direct- or side-neurotoxic effects.


[Effect of biogenic amines on glycogen degradation in isolated rat hepatocytes].

Serotonin and tyramine affected dissimilarly the enzyme activity involved in degradation of glycogen in isolated rat hepatocytes. Serotonin inhibited hydrolytic enzymes acid alpha-glucosidase, alpha-amylase and amylo-1,6-glucosidase but activated phosphorylase inducing a decrease of glycogen content in cells. Tyramine inhibited acid alpha-glucosidase and amylo-1,6-glucosidase, did not affect the alpha-amylase and phosphorylase activities and increased content of glycogen in cells. Tyramine may be used as stimulator of glycogen accumulation in liver cells.


[Deamination reaction of biogenic amines and other nitrogen compounds during the long-term influence of ethylenediamine in an experiment on rats].

Activity and substrate specificity of monoamine oxidase (MAO) were studied in tissues of rats inhaling low concentrations of ethylene diamine for a long time. While the activity of MAO-A (serotonin as a substrate) was decreased in brain, functions of the enzyme were altered: the enzyme acquired the ability to deaminate glucosamine, which is not a substrate of MAO under normal conditions. Ethylene diamine-dependent modification of MAO was responsible for alterations of the enzyme catalytic properties involved in oxidation of substances with specific biochemical functions. A new drug diethon as well as ionol, pyrazidole and ascorbic acid were used in attempts to normalize the MAO properties; ionol proved to be the most effective compound. Detection of alterations in the MAO catalytic properties, developed after influence of the chemical factor at very low concentrations but without symptoms of toxicosis, may be used as a sensitive test for evaluation of early steps of ethylene diamine-produced intoxication. Ionol may be used for pathogenetic prophylaxis of ethylene diamine caused intoxication.


[Specifics of changes in various groups of enzymes in rat cerebral cortex after interstrain transplantation of embryonal nerve tissue].

Embryonal nervous tissue from Wistar rats was transplanted into male rats of Wistar and August strains. Activity of eight enzymes belonging to various systems was estimated in brain cortex of rats recipients within 36 days after the transplantation. Lactate dehydrogenase, alanine aminotransferase, acid phosphatase, 5'-nucleotidase, ATPase and aldolase exhibited the dissimilarly decreased rate of activity in brain cortex of Wistar rats after transplantation as compared with the enzymatic activity in intact animals of this strain, while activity of alkaline phosphatase and esterases hydrolyzing alpha-naphthyl acetate was increased. Activation of almost all the enzymes studied was found within 36 days in Wistar rats after the transplantation. The rate of activity of zonal esterase isoenzymes was higher in brain cortex of August rats after transplantation of embryonal nervous tissue from Wistar strain as compared with that of Wistar to Wistar rats transplantation. The data obtained suggest that tissues of donors affected definitely the enzymatic activity in brain cells of rats-recipients as activity of most enzymes studied was higher in brain cortex of donors as compared with that of recipients.


[Activity of antioxidant protection enzymes and content of lipid peroxidation products in blood serum and cerebrospinal fluid in patients with ischemic brain disease].

Activity of superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase as well as content of diene conjugates and malonic dialdehyde were studied in blood serum and cerebrospinal fluid of patients with transitory ischemia, small ischemic insult, ischemic insult of middle severity and with severe ischemic insult without lethality within 1-2, 7-8 and 14-15 days of diseases. Content of lipid peroxidation products and activity of antioxidant enzymes were decreased in the biological fluids studied in all the forms of brain circulation impairments within early periods of pathology. These patterns tend to normalization within 14-15 days. The rate of biochemical alterations corresponded highly to severity of impairments developed and these patterns may be used for diagnostic and prognostic purposes.


[Natural modulators of the function of the amine oxidase system in the body].

In cerebrospinal fluid (CSF) obtained from patients with chronic alcoholism natural modulators of monoamine oxidase (MAO) activity, containing in human mitochondrial and microsomal fractions or in rat brain mitochondria, have been found. These modulators, which were previously unknown, did not affect the activity of partially purified diamine oxidase from human placenta with 14C-putrescine as a substrate. The MAO modulators from CSF were thermostable (during 3 min at 100 degrees), penetrated through dialysing membrane thus differing from high molecular modulators of MAO previously described. In the system containing membrane bound MAO from human placenta, where the MAO-A is predominating, the modulators studied mostly inhibited deamination of 14C-serotonin. However, in the system containing membrane bound MAO from rat brain with prevalence of the MAO-B, the modulators from human CSF caused either inhibition or stimulation of oxidative deamination of 14C-serotonin or 14C-beta-phenylethylamine used as substrates. The modulators studied were not similar to tribulin (isatin) or quinolinic acid in their effects on catalytic properties of the amine oxidases investigated.


[Alcohol and atherogenesis: effect of low and high doses of ethanol on rat blood cholesterol].

Alterations in content of cholesterol and specific radio-activity of erythrocyte lipoproteins were studied in rats after administration of labelled sterol under conditions of acute and chronic influence of low 0.6 g/kg and high 4.0 g/kg doses of ethanol. Both these doses caused a decrease in content of high density lipoproteins (HDL) after single ethanol administration, while content of apoB containing lipoproteins as well as binding of labelled sterol with erythrocytes were elevated after long-term ethanol treatment. Atherogenicity index was increased after single and chronic administration of either low or high doses of ethanol. In chronic administration of low doses of ethanol specific radioactivity of HDL was decreased, thus suggesting that cholesterol acceptor function of these particles was lowered.


[Metabolism of neuronal and neuroglial phospholipids in seizures].

Metabolism of individual phospholipids was studied in neurones and neuroglia under conditions of convulsions caused by picrotoxin administration. Metabolic activity of all the phospholipids studied was increased in neuronal membranes under extreme conditions of convulsive attacks. The rate of metabolism of phosphatidylcholine, phosphatidylethanolamine and sphingomyelin was increased 2-2.5-fold approximately. The most distinct alterations of metabolic activity were observed in the fraction of minor phospholipids: specific radioactivity of phosphatidylserine was increased 10-fold and phosphatidylinositol--16-fold. Metabolism of phosphatidic acid and lysophosphatidylcholine was elevated more than 15-fold. Convulsions exhibited the most distinct effect on metabolism of phosphatidylinositol and phosphatidylserine in neuroglia cells. As distinct from neurones, metabolism of phosphatidyl choline and sphingomyelin was not markedly altered in neuroglia. Similar metabolism and universal cell response, carried out via phospholipids, appear to occur in the system neurone-neuroglia.


[Antioxidant effect of dimethyl sulfoxide in acute liver injury by carbon tetrachloride].

After subcutaneous administration of dimethyl sulfoxide into rats with toxic, tetrachloromethane-produced impairment of liver tissue, lipid peroxidation was effectively inhibited in hepatocytes and the state of anti-oxidation system was improved. Antioxidative properties of dimethyl sulfoxide were shown also in vitro.


[Prostacyclin-thromboxane system in children and adolescents with a high risk of developing ischemic heart disease].

Studies of the prostacyclin-thromboxane system in children and juveniles of 7-18 years old with hereditary ischemic heart disease demonstrated that the hereditary factor proved to be of importance for the system state. Alterations of prostanoids in these children and juveniles were related to atherogenesis development, particularly to hyperproduction of thromboxane A2, whereas patterns of the system studied varied depending on sex and family history.


[Determination of cholesterol esterase activity using micro-thin layer chromatography].

A procedure is developed for estimation of the cholinesterase activity in biological materials immediately on the plates for micro-thin-layer chromatography using a chamber of original construction. The procedure involved incubation of cholesterol esters, used as substrates and biological materials containing the enzyme, directly on the chromatographic plates in the chamber and the subsequent chromatography of the hydrolysis products. The enzymatic activity was calculated on the basis of the decrease in the substrate content per min per mg of protein. The procedure is simple, convenient; it allows to vary the incubation time and to estimate the enzymatic activity in minimal samples of the biological material using only small amounts of reagents.


[Determination of procollagen type III aminopropeptide by a solid phase method using antibodies conjugated with peroxidase or protein A labelled with radioactive iodine].

A solid-phase assay was developed for estimation of procollagen III aminopropeptide which involved both immunoenzymatic and radioimmune procedures. The assay did not require the iodine-labelled aminopropeptide, while content of the antigen was estimated using the conjugate of secondary antibodies and peroxidase or iodine-labelled protein A. Substitution of the protein A for the antibodies conjugate and peroxidase enabled to abolish the radioactive materials use.


[Changes in phosphatidylinositol content in patients with myocardial infarct].

The changes of phosphatidylinositol content in blood of patients with myocardial infarction was studied. A procedure is developed for multiple estimation of phosphatidylinositol content within short-time intervals which enabled one to obtain additional data on the functional state of biomembranes. In the clinical practice the data obtained may be used for diagnosis and evaluation of efficiency of ischemic heart disease treatment.


[Systemic and regional hemodynamic in rats after use of 5-methoxytryptamine: mechanisms of "pharmacological adaptation" to hypoxia].

Effects of 5-methoxytryptamine (5-MOT) on parameters of systemic and regional hemodynamics were studied in awake Wistar rats. Arterial pressure and pulse were measured using a direct procedure. Content of systolic blood and volume rate of blood flow in 12 vascular zones were estimated by means of the radioactive microsphere technique. The microspheres were inoculated in left heart ventricle under free conditions before, within 30 min and after termination of the "pharmacological training". Single intraperitoneal administration of 5-MOT, 25 mg/kg, led to increase in total peripheral resistance by 67% and in cardiac index by 34%. The rate of blood flow was decreased in skin, spleen, kidney and testicular tissues, while it was increased in heart and adrenal glands. "Pharmacological training", carried out within 9 days with daily administration of 5-MOT 25 mg/kg, resulted in a decrease in total peripheral vascular resistance by 46%, while cardiac index was increased by 97%; blood flow rate was increased in brain, stomach, heart and diaphragm.


[Effect of essential phospholipids on intensity of lipid peroxidation in the myocardium in experimental post-hypoxic reoxygenation].

Correction of the lipid peroxidation rate using essential phospholipids was studied. The phospholipids were used in protection of heart tissue in experimental posthypoxic reoxygenation. Administration of essential phospholipids into the rats during myocardium reoxygenation led to an increase in activity of superoxide dismutase. The drugs containing essential phospholipids may be used in clinical practice for treatment of the impairments when elevated lipid peroxidation occurred.


[Lipid peroxidation upon the use of omega-3 polyunsaturated fatty acids in the treatment of hypertension and ischemic heart disease].

Anti-atherosclerotic diet containing 10 or 20 g of ichthyenic oil, used for treatment of 29 patients with cardiovascular diseases, caused an increase in content of polyunsaturated omega 3 fatty acids species in the patients erythrocyte membranes; this pattern may be used as a sensitive criterion of evaluation of the diet fatty component effect. Despite an increase of oxidation potential substrates in tissues, elevation of malonyl dialdehyde in blood plasma and hemolysis of erythrocytes in presence of H2O2 were not observed. This suggests absence of lipid peroxidation induction in adequate consumption of antioxidants.


[Change in content of fatty acids in rabbit brain hemispheres in experimental concussion].

Content of fatty acids in rabbit brain hemispheres in dynamics of experimental brain concussion was estimated by means of gas liquid chromatography. Content of fatty acids was increased within 15 min after experimental brain concussion and then it decreased reaching minimal values within 7 days. The phenomenon observed is a pathogenetically important factor in the traumatic disease.


[Effect of alpha-tocopherol on lipid peroxidation in the liver in acute blood loss].

The effect of single administration of alpha-tocopherol at a dose of 50 mg/kg on lipid peroxidation, content of alpha-tocopherol in liver tissue and on the activities of some enzymes in rat serum was studied under conditions of acute blood loss. The rate of lipid peroxidation in liver tissue and activities of aspartate- and alanine-transferases in blood serum were increased while content of alpha-tocopherol in liver tissue was decreased under the conditions of acute blood loss. These effects were abolished after tocopherol administration. Use of alpha-tocopherol as an antioxidant drug proved to be suitable for pathogenetic correction of metabolic impairments in acute blood loss.


[Features of the structure and fatty acid composition of serum albumin in experimental myocarditis].

Properties of animal serum albumin transport and its structure were studied in experimental myocarditis. The data obtained suggest that impairments in myocardium were of chronic and recurring type. The albumin exhibited a high structure-functional variability.


[Features of the lipid peroxidation process and antioxidant activity of white rats in extreme, multi-stage supercooling].

High content of polyenic fatty acids, slight increase in antioxidative activity and decrease in content of malonic dialdehyde (MDA) in rat myocardial tissues were observed in supercooling. The data obtained suggest that intensive oxidation of fatty acids occurred in the tissues, which may be essential for synthesis of biologically active substances involved in development of resistance to supercooling. Multiple supercooling caused an opposite effect in lung tissue: saturation of lipids was increased, antioxidative activity was maintained on the level similar to the control values, while content of MDA was markedly increased apparently due to destruction of metabolic products penetrating from other tissues. The dissimilar impairments of lipid metabolism were detected in liver tissue, where multiple supercooling did not alter the rate of lipid saturation, antioxidative activity was unaltered and content of MDA was as low as in the control animals.


[Specific relationships of the content of iron, transferrin, ceruloplasmin and malondialdehyde in rat blood in various types of wound healing processes].

Correlation between parameters of iron metabolism and the antioxidative system activity was studied in blood of 220 Wistar rats with simulated aseptic and infectious types of wound healing. Deposition of iron and stability of the anti-oxidation system were impaired in purulent complication of wound healing. At the same time, a high correlation between the patterns studied was detected in aseptic form of healing, suggesting distinct co-ordination between the antioxidative system components. Approaches to the correction of the impairments observed are discussed.


[The effect of diets containing omega-3 polyunsaturated fatty acids on biochemical indicators and the fatty acid composition of the cell membranes in patients with ischemic heart disease and hereditary hyperlipidemia].

A decrease in content of total cholesterol, triglycerides, fibrinogen, and atherogeneity index as well as increase in fibrinolytic activity and prolongation of the hemorrhage time were observed in blood serum of 20 patients with ischemic heart disease and hyperlipidemia of the IIa and IIb types maintained on anti-atherosclerotic diet containing 20 g of ichthyenic oil within 4 weeks. Relative content of polyunsaturated fatty acids omega 6 was decreased while the content of omega 3 fatty acids was distinctly increased in erythrocytes and blood platelets membranes, thus demonstrating the high efficiency of ichthyenic oil.


[Age changes in brain monoamine oxidase in mice from four lines].

Mice of strains CC57/Br, A/He, C3H/He and CBA/Lac were studied at the age of 1, 2, 3, 4 and 5 months old. Activities of monoamine oxidases A and B (MAO A and MAO B) were increased in brain tissue of all the mice strain studied with ageing, although not simultaneously and dissimilarly. The ratio MAO A/MAO B approximated to 1.0 in old animals. At the age of 1 month old the MAO A/MAO B ratio was more than 1.0 in brain stem of mice of CC57/Br and C3H/He strains as well as in hemispheres of mice of A/He and CBA/Lac strains. In mice of A/He strain the MAO A/MAO B ratio exceeding 1.0 maintained within the first three months. Possible correlation between the elevated MAO A/MAO B ratio and high sexual activity of the A/He strain mice is discussed.


[Multiple forms of monoamine oxidase in the growing human placenta].

A ratio between two types of monoamine oxidase (MAO) was studied in the mitochondrial fraction of growing human placenta: MAO-A which is predominant in the tissue and the minor MAO-B. Activity of MAO-A with serotonin as a substrate was statistically distinctly lower (by 22%) in placenta within early periods of pregnancy as compared which the mature placenta during the delivery time. In the growing placenta activity of MAO-B with benzylamine as a substrate reached 365% of the MAO-B activity in the mature placenta. The ratio between MAO of the A and B types was altered during pregnancy as shown by inhibitory analysis, carried out using selective inhibitors of the MAO-A and -B types--Lilly 51641 substance and deprenyl as well as with semicarbazide as an inhibitor of benzylamine oxidase. At the early periods of pregnancy the rate of placental MAO-B oxidative deamination of benzylamine was distinctly higher as compared with that during the delivery act. At the same time, content of semicarbazide-sensitive benzylamine oxidase was increased during the delivery period. Possible biological significance of alterations in the amine oxidases ratio in the growing placenta is discussed considering the known property of the MAO-B inhibitor pargyline to cause abortion within early periods of pregnancy.


[Placental-renal prealbumin: immunochemical identification, physico-chemical characteristics and affinity chromatography on immobilized steroids].

A protein with prealbumin mobility and MW of 40 kD was identified in early placental tissue. Using immunodiffusion analysis the protein was also detected in fetal and adult kidney tissues, in urine of donors and pregnant women and in amniotic fluid. The protein was termed placenta-kidney prealbumin (PKPA). During affinity chromatography on immobilized steroid hormones, PKPA was bound to testosterone and was not bound to diethylstilbestrol.


[Physico-chemical, immunochemical, and biological activity of prolactin from human amniotic fluid].

Highly purified preparation of prolactin with molecular mass 23 kDa, which is the main form of the hormone in human amnionic fluid, was isolated from the fluid using gel filtration on Sephadex G-100, chromatography on DEAE-Sepharose, concanavalin A Sepharose, CM-cellulose. Physico-chemical, immunochemical and biological properties of the amnionic prolactin were studied as compared with those of hypophyseal hormone. Properties of the hormonal forms isolated from both these tissues were similar. The glycosylated form of prolactin with molecular mass 25.0 kDa was detected either in amnionic fluid or in hypophysis.


[Physico-chemical properties of the thrombolytic compound longolytin].

A preparation exhibiting high fibrinolytic activity and ability to activate plasminogen was isolated from cultivation medium of Arthrobotrys longa. Homogeneous protein, obtained after gel filtration on Sephadex G-100, had molecular mass 28,600, pI-3.68-3.74, optimum activity at pH 6.0-9.0 and temperature optimum at 37 degrees. The enzyme proved to be serine proteinase as shown by analysis using inhibitors; it required thiol groups.


[Features of metabolic disorders in the liver during morphine poisoning of various duration].

Administration of morphine into rats at a dose of 30 mg/kg within 6 days led to a decrease in total rate of tRNA aminoacylation in liver tissue. Content of lactate, pyruvate, malate and alpha-ketoglutarate was decreased within 6 days-long course of morphine administration, while content of lactate was only altered after 5 weeks of the intoxication. Adaptation reactions appear to be increased with time in long-term intoxication with morphine.


Gift or good? A contemporary examination of the voluntary and commercial aspects of blood donation.

The safety and ethical aspects of blood donation are examined in the light of current legislation and practice. The advantages and disadvantages of voluntary and paid donation are looked at in view of recent data concerning risk factors in various potential donor groups. It is concluded that voluntary, non-remunerated blood donation remains the safest and most ethical means of securing the blood supply.


Studies in red blood cell preservation. 6. Red cell membrane remodeling during rejuvenation.

The purpose of this study was to examine whether vesiculation of RBC plays a significant role in their rejuvenation. Outdated units of Adsol blood, were divided into two aliquots and incubated with equal volumes of a solution of 100 mM pyruvate and inosine, 103 mM phosphate and 5 mM adenine (PIPA) or 0.9% saline. Following 1 h incubation, vesicles were isolated from the supernatants and quantitated for hemoglobin content. Restoration of RBC ATP, 2,3-DPG, morphology, and osmotic fragility after rejuvenation was satisfactory. The postrejuvenation mean corpuscular volumes (88.2 +/- 6.9 fl) were significantly lower (p less than 0.001) than the prerejuvenation (94.6 +/- 6.8 fl) and control (104.0 +/- 7.3 fl) volumes. The hemoglobin shed in vesicles during rejuvenation was significantly greater than in the saline controls (0.44 +/- 0.31 vs. 0.18 +/- 0.10 mg/dl RBCs; p = 0.026). These data suggest that the decreased MCV following rejuvenation is in part due to membrane loss in exocytic vesiculation.


[Change in the lipid composition of rat tissues in hyperthermia of varying degree].

The most typical alteration of membrane phospholipids in rat tissues in acute hyperthermia was an increase in content of sphingomyelin and phosphatidylinositol. The increase in phosphatidylinositol appears to occur as a result of unspecific effect of hyperthermia on the cells, while the increase of sphingomyelin is apparently important for stabilization of membrane structure. Indirect data were obtained on increase in membrane liquidity during thermic shock.


Bone marrow fractionation by the haemonetics system: reduction of red cell mass before marrow freezing, with special reference to pediatric marrow volumes.

For purposes of freezing autologous marrow or transplants of allogeneic marrow with major ABO blood group incompatibility, 54 freshly harvested bone marrows from children of 7-65 kg of weight were depleted of their red cells with the Haemonetics V50 system. The marrow volumes ranged from 230 to 1,145 ml, with 17 small (200-399 ml), 18 intermediate (400-799 ml) and 19 large (800-1,200 ml) volumes. After processing, the median recoveries were: volume 24%, red cell mass 18%, and nucleated cells 75%. In the small marrow volume group, a good nucleated cell recovery was achieved at the expense of red cell depletion. The colony-forming units, granulocytes-macrophages (CFU-GM) were normal after thawing of processed, cryopreserved marrows, and good engraftment of both allogeneic and autologous marrows were achieved. We conclude that marrow processing with the Haemonetics V50 system results in adequate red cell depletion and good nucleated cell recovery without open-air contact of marrow or excessive time consumption. For small marrow volumes, however, the red cell depletion was suboptimal, and a bowl size smaller than 125 ml is desirable for pediatric use.


[Molecular mechanisms of damage to fractionated liver chromatin by tetrachloromethane].

Impairing effects of tetrachloromethane on genetic apparatus were shown to consist in its high affinity and binding to transcriptionally active fraction of chromatin and subsequent destruction of DNA. As a result of the impairment the density of the chromatin fraction was increased which expressed as elevated stability to hydrolysis by endogenous nucleases. At the same time, content of single-stranded structures enriched with proteins was increased in the DNA of the transcriptionally active fraction of chromatin. Two dissimilar properties were detected in the fraction of impaired chromatin from the poisoned animals: increase of density in the chromatin fraction accompanied by insensitivity to S1-nuclease, which was detected after denaturation of chromatin and slight relaxation of apparently supernucleosome structures where content of sites, sensitive to short-term treatment with DNAase I, was increased. The hypothesis of the tetrachloromethane toxic effect on genetic apparatus is considered, according to which lipid moiety of chromatin and activation of lipid peroxidation are of definite importance in effects of the xenobiotic on chromatin.


Transfusion results of filtered and subsequently stored random platelet suspensions prepared from buffy coats.

There is almost general agreement that removal of leukocytes from blood components reduces the incidence of HLA-antibody formation and refractoriness to random platelet transfusions. Recently filters have become available, which are able to reduce leukocyte contamination in platelet suspensions with acceptable platelet loss. We evaluated a cellulose acetate (CA) and a polyester (PE) filter, and stored buffy coat-derived platelet suspensions after filtration. Both filters are effective for the removal of leukocytes to levels below 5 x 10(6) per transfusate. For the CA filter, platelet recovery was 73 +/- 13% yielding 256 +/- 53 x 10(9) platelets per transfusate from 6 donors. For the PE filter, platelet recovery was 90 +/- 9% and 327 +/- 51 x 10(9) platelets per transfusate. When a loading dose of less than 5 x 10(8) leukocytes was applied, 98% of the CA-filtered suspensions and 100% of the PE-filtered suspensions contained less than 5 x 10(6) residual leucocytes. In 123 patients transfusion results of CA-filtered platelet suspensions stored for 72 h, were compared with those obtained by non-stored, non filtered, random platelet suspensions which had been leukocyte depleted by differential centrifugation. Platelet increments 1 and 20 h after transfusion showed no statistical difference between CA-filtered platelet transfusions stored for 72 h and non-stored, non-filtered platelet transfusions. In a new cohort of 117 patients, two filters and various postfiltration storage times were compared. Using both filters, the 1-hour posttransfusion increments decreased to approximately 60% after 96 h of storage compared to results of storage periods of 72 h or less.(ABSTRACT TRUNCATED AT 250 WORDS)


[Effect of alpha-acidic glycoprotein on oxyproline metabolism in experimental thermal trauma].

alpha 1-Acid glycoprotein, isolated from human blood plasma, was shown to accelerate healing of burn wounds in rats and to increase daily urine excretion. The glycoprotein restricted an elevation of the peptide-bound hydroxyproline in blood plasma, decreased the ratio between peptide-bound and free hydroxyproline within all the periods of experiment during 3 weeks as well as stimulated hydroxyproline excretion with urine at the step of active reparation of burn wounds. The glycoprotein appears to protect connective tissue metabolism in burns.


[Effect of middle molecular weight peptides, isolated from blood of intact dogs and those with burns, on proteolysis in mouse tissue].

The median molecular-weight peptides (MMP), detected in blood of patients with burns and in that of experimental animals with burns, were shown to affect various systems in vivo. The MMP from the blood of intact dogs and of the animals with burns exhibited the modifying effect on proteolysis within acid and neutral pH ranges in liver and brain tissues of mouse. The MMP appears to be involved in the regulation of proteolysis both in normal state and in burns.


Red cell and platelet concentrates from blood collected into half-strength citrate anticoagulant: improved maintenance of red cell 2,3-diphosphoglycerate in half-citrate red cells.

This study confirms previous work suggesting equivalent in vitro properties in blood components prepared from donations collected into half-citrate preservative (HCPD) compared to components derived from donations collected into standard citrate-phosphate-dextrose (CPD) preservatives. In addition, red cell products harvested from HCPD donations showed significantly improved maintenance of pH over storage, and this was reflected in improved maintenance of intracellular 2,3-diphosphoglycerate (2,3-DPG). This effect was observed in whole blood and in red cells suspended in a phosphate-containing additive solution (Tuta AAS). Collection into HCPD also improved 2,3-DPG maintenance in red cell concentrates processed following an 18-hour hold at 22 degrees C. These improvements were less pronounced in red cells suspended in a non-phosphate-containing medium (Fenwal Adsol) in which a higher pH was maintained even in units collected in CPD. Platelets harvested from HCPD blood and suspended in plasma showed equivalent quality to platelets from standard donations. Some deterioration of platelet properties was observed when HCPD platelets were stored in a non-citrate synthetic medium. Together with data indicating improved coagulation factor stability, these results suggest that collection into HCPD improves stored blood quality and may also allow logistical benefits in blood component preparation.


[Molecular types of breast milk triacylglycerols at various stages of lactation].

The composition of individual triacylglycerols was studied in women milk in various periods of lactation. The spectra of triacylglycerols were studied in the early lactation milk, in the mature milk and in the late lactation milk using a method of "main components", the program of "immediate neighbour" as well as by construction of graphic plot (by means of a set "Statgraphics"). The methods of calculation used enabled one to find great differences in the triacylglycerol spectrum of mature milk as compared with those of milk in the early and late periods of lactation.


Severe haemolytic disease in an infant born to an Rh(null) proposita.

A 35-year-old Brazilian woman (gravida 4, para 2) was delivered of a severely anaemic child whose cord red blood cells had a strongly positive direct antiglobulin test and who required two exchange transfusions within 24 h of birth. Because of the emergency of the situation and the lack of a local immunohaematology reference laboratory, the phenotype of the mother and the specificity of the relevant antibody could not be determined. Hence, compatible blood was not immediately available and the infant had to be given repeated exchange transfusions with incompatible group 0 Rh-negative blood. The infant is now healthy and thriving. The mother's red cells were subsequently found to lack all the antigens of the Rh system, and her serum reacted with all red cell samples except those of two unrelated Rh(null) individuals. Her serum gave high titres (i.e. 1,024-4,096) by the indirect antiglobulin test against red cells of normal Rh phenotype, as well as against cells with partially deleted Rh phenotypes (titres = 128-512 with -D-/-D- and .D./.D. samples, respectively), and was extremely active in antibody-dependent cell-mediated cytotoxicity and monocyte monolayer assays against red cells of normal Rh phenotypes.


Granulocyte serology findings in juvenile symptomatic idiopathic autoimmune neutropenia using a multiassay procedure. Report on 21 cases.

The serological findings on 21 children with idiopathic autoimmune neutropenia are reported. A multiassay procedure was adopted including agglutination, immunofluorescence and cytotoxicity tests. Beside a cause-effect correlation between granulocyte antibodies and clinical course, a serologic polymorphism was found. As the sensitivity of each assay seemed to be related to the characteristics of the involved antigens and antibodies, as well as to the intrinsic sensitivity of the tests, the performance of a multiassay procedure appears to be advisable for the diagnosis and the follow-up of autoimmune neutropenia.


Expression of red cell antigens C and c on neonatal and adult erythrocytes. A flow-cytometric analysis.

Red cell membrane proteins expressing Rh antigens appear to be important for the stabilization of the phospholipid membrane bilayer. Neonatal red cells possess a shorter in vivo life span and different deformability properties as compared to adult red blood cells, differences which could potentially be explained by different cell surface antigen densities of Rh-antigenic determinants. Although conventional serologic techniques have demonstrated Rh antigens on fetal and neonatal red cells, other more sensitive techniques are required when quantitative information is needed. Therefore, in this study, 40 adult and 45 neonatal red blood cell suspensions of differing Rh phenotypes were evaluated for C and c antigen density using flow cytometry. Neonatal and adult red blood cells had the same mean channel fluorescence intensity (expressed in mV) of c antigen in either the homozygous (cc) or heterozygous (cC) state: 485 +/- 44 versus 471 +/- 29 and 416 +/- 31 versus 411 +/- 23, respectively. In addition, neonatal and adult C antigen density was similar in heterozygous (Cc; 415 +/- 49 versus 455 +/- 44) and homozygous (CC; 438 +/- 53 versus 469 +/- 38 C states. As expected, homozygous (double dose) states for either C or c had greater intensities than heterozygous states for both neonates and adults. Although no differences were noted for C or c antigens, studies of other Rh antigens may indicate lower antigenic density in neonatal red cells.


Point mutation in the glycophorin C gene results in the expression of the blood group antigen Dha.

The blood group Duch (Dha) antigen is located on glycophorin C (GPC). Total RNA prepared from the reticulocyte fraction of two Dh(a+) individuals were used in the synthesis of first-strand cDNA. The first-strand cDNA served as templates for the amplification of GPC-related DNA by polymerase chain reaction (PCR). The expected PCR product consisted of 412 base pairs. On sequencing the PCR-amplified DNA, a base change (cytosine----thymidine) at nucleotide 40 of the GPC cDNA was detected. Thus, the variant GPC (GPC.Dha) on Dh(a+) red cells has a substitution of leucine by phenylalanine at amino acid residue 14.


[The psychological preparation of patients with a paroxysmal systolic tachyarrhythmia for helium-neon laser treatment].

The psychological structure was studied in 120 patients with paroxysmal disorders of the cardiac rhythm. Anxiety, obsessive-phobic, neurasthenic and ergopathic syndromes were singled out. It was established that psychological aspects of personality of the patients depended on the course of paroxysmal disorders of the rhythm and influence the number of arrhythmia triggering that often reduced the grade of medicosocial adaptation. Psychological preparation of these patients to laser treatment may be achieved by rational psychotherapy. Details of such psychotherapy are discussed.


[The differential diagnosis of syringomyelia from pseudosyringomyelitic ulcero-mutilating acropathy].

The authors describe some differential diagnostic criteria of atypical syringomyelia and pseudosyringomyelitic acropathy. It was found that trophic disorders in the skin, metatarsal bones were in atypical syringomyelia usually associated with sensibility disorders of the dissociated type in the zone of corresponding segments. In pseudosyringomyelitic acropathy trophic and skin changes precede sensibility disorders and do not always correspond to innervation zones of the lower extremities. Dysraphic state is of importance for the diagnosis of syringomyelia.


[Autoimmune processes in patients with different forms of the clinical course of ischemic heart disease].

A study of autoimmune processes in 286 patients with different clinical forms of ischemic heart disease revealed a high frequency of antibodies to "healthy myocardium" antigen in patients with non-stable stenocardia and acute myocardial infarction that may indicate acquirement of antigenic properties of the healthy myocardium. Patients with unstable stenocardia also show an increased antibody titer to vascular antigens that indicates the possible role of activation of autoimmune reactions in the mechanisms of destabilization of the clinical course of ischemic heart disease.


[The content of ceruloplasmin, fibronectin and selenium in the blood of patients with an acute myocardial infarct].

The content of ceruloplasmin, fibronectin and selenium was evaluated in the blood plasma of acute myocardial infarction patients within the first three days after onset if the disease. Results showed a reduction of fibronectin during the first hours after onset of the disease. The content of ceruloplasmin was increased, selenium reduced during the entire period of examination indicating pronounced disturbances of lipid peroxidation in the acute period of myocardial infarction as well as potentiation of antioxidant processes.


[The action of the new beta-adrenoblocker Lopressor on the hemodynamics of hypertension patients].

The authors carried out a complex clinico-instrumental investigation of the effect of a new cardioselective beta-blocking agent leprozor in 116 patients with hypertensive disease (stage II). A quantitative evaluation of the hemodynamics of the left compartments of the heart with two-dimensional echocardiography was carried out. Evaluation of the efficacy of using leprozor in this category of patients was based on an analysis of the state of their hemodynamics against the background of systematic intake of the drug for 7 months. Selection of the dosage was individual under the control of circulation parameters. It is concluded that leprozor proved effective in normalization of the hemodynamics in patients with hypertensive disease.


[The indices of thrombocyte coagulating and fibrinolytic activity in rheumatoid arthritis patients].

Blood coagulation values (thrombocyte count, adhesive-aggregation thrombocytic activity, coagulographic data) were analysed in 90 patients with rheumatoid arthritis (RA). Increase of plasma coagulation activity was observed in all coagulation activity grades. The anticoagulation activity was most pronounced in grade III RA activity. Thrombocytes of RA patients possessed procoagulant properties and lost significantly their fibrinolytic activity most expressed in grade II RA. This increased the thrombophilic tendency of the plasma potential creating favourable conditions for intravascular coagulation and microthrombus formation, resulting in deterioration of the rheological properties of the blood and the course of the rheumatoid synovitis.


[The use of thermographic and immunological indices in choosing adequate treatment for patients with rheumatoid arthritis and arthrosis deformans].

A study is presented of the thermal semeiotics and the state of cellular and humoral immunity in 29 patients with osteoarthrosis deformans, 35 patients with rheumatoid arthritis of different activity. It is recommended to use data of the thermographic picture and immunological status for objectivation of the character of the pathological process, differential diagnosis and dynamic express-evaluation of treatment adequacy.


[The importance of osteoscintigraphy for the early detection of rheumatic joint lesions].

The scintigraphic semeiotics was investigated of involvement of osteoarticular system in rheumatoid polyarthritis in 186 patients (79 of them suffered of rheumatoid arthritis, 62 of systemic lupus erythematosus, 34 of systemic scleroderma, 11 of dermatomyositis). Roentgenological examination was supplemented by consecutive local scintigraphy of axial skeleton and peripheral joint by of gamma rays with labeled 99mTc phosphate complexes. Isoactive zones with subsequent quantitative evaluation of the information were obtained as a result of computerized processing of the scintigraphic images of the joints. The results were compared with those obtained in patients with rheumatoid arthritis. It was established that inspite of the similarity of the scintigraphic manifestations, each of them has its regularities due to differences of the pathomorphological processes in the joints.


[The efficacy of treating glomerulonephritis patients with a hematuria component].

A clinical evaluation was carried out of treatment efficacy of patients suffering of glomerulonephritis with hematuria component. membrane stabilizing therapy including unithiol, dimephosphon (delagil) and alpha-tocopherol acetate. Duration of this treatment was 1 month; 2 months--with alpha-tocopherol and delagil; 6 months--with delagil. TREATMENT was carried out in 80 patients. Six-month follow-up was evaluated in 62 patients. In 48 patients the treatment was effective as concerns proteinuria and in 4--only hematuria. Comparing the results of such treatment with indomethacin treatment where a positive dynamics was observed in 10 of 38 patients and only in 2 patients improvement concerned proteinuria and erythrocyturia. membrane stabilizing therapy is the method of choice in comparison with traditional indomethacin treatment.


[The role of immune links in the gastric acid-forming function in peptic ulcer patients].

Results are of a comparative analysis of immunological and biochemical parameters in 116 patients with duodenal ulcer before operative treatment and in the follow-up (1-3 years) after different types of vagotomy. A close relationship has been established between the immune and neurohumoral links of regulation and state of the acid forming gastric function in patients with ulcer disease.


[The clinico-morphological characteristics of malignant non-Hodgkin's lymphomas].

It was established that most patients with non-Hodgkin malignant lymphomas against the background of secondary immunodeficiency show an activation of the saprophytic bacterial and mycotic flora that results in the development of different infectious complications essentially, thus, influencing the course and prognosis of the disease. A dependence was established between the malignancy grade of non-Hodgkins lymphomas and frequency of development of non-infectious complications.


[Changes in the cytochemical indices and in the phagocytic activity of the leukocytes during the combined therapy of rectal cancer].

Changes of cytochemical indices and phagocytic activity of neutrophil granulocytes of the peripheral blood were revealed in patients with cancer of the rectum at different stages of combined treatment. These changes evidence an increase of vascular permeability and catabolism, disorders of energy resources, oxidation-reduction processes and functional activity of granulocytes. The dynamics of changes of cytochemical indices of leucocytes reflect the efficacy of different methods of treatment and prophylaxis of postoperative purulent complications.


[The electrical excitability of the mimetic muscles in patients with a facial nerve lesion].

Sixty patients with lesions of the facial nerve were examined. Electroexcitability of the mimic muscles was determined. The obtained data allow to predict the state of the function of mimic muscles and institute adequate electrostimulating therapy of corresponding intensity and duration.


[The enzymatic activity of ammonia metabolism in the liver during the parenteral nitrogen feeding of animals with experimental liver failure].

It was established that liver insufficiency the activity of hepatic glutamate dehydrogenase is markedly reduced that is, apparently, the main cause of hyperammonemia that accompanies hepatic encephalopathy. Here occurs a significant reduction of the processes of ammonia detoxication with formation of glutamine in the liver as evidenced by changes of the activity of glutamine synthetase. Administration parenterally of a preparation of nitrous feeding increases essentially ammonia detoxicating function of muscular tissue which supplements the detoxicating function of the liver.


[The role of autoimmune reactions in the development of disseminated sclerosis].

The immune status was investigated in 97 patients with multiple sclerosis. Patients of this group showed marked changes at the cellular lever of the immune system. T-lymphocytopenia was accompanied by a dysbalance of the main correlative cells according to a relatively hyposuppressor variant of immune deficit with formation of circulating immune complexes and thermodependent lymphocytotoxic autoantibodies.


[Mineral metabolism in bacterial meningoencephalitis].

The authors investigated the concentration of some metals in the cerebrospinal fluid in 70 patients with bacterial meningoencephalitis in the dynamics of the inflammatory process and in different regions of the brain in 10 autopsy cases. There was a correlation between potassium, sodium, manganese, magnesium, copper and zinc in the brain and quantity of water, as well as their concentration in cerebrospinal fluid. It is shown that determination of some metals in the cerebrospinal fluid allows to diagnose edema swelling of the brain and to predict the disease sequels.


[Immunodeficiency states in lung diseases and the possible ways for their correction].

The author discusses problems on the mechanisms of formation of immunodeficiency state in pulmonary diseases. It is suggested that T-cell deficit revealed in pulmonary pathology is caused by several factors (intoxication, mediators of allergic-reactions immune complexes, C-reactive protein, hormones, endorphin-like substances etc.), the removal of which furthers normalization of the immune system. Data are reported on the possible variants of secondary immunodeficiency states and the main regularities for immunocorrection are discussed.


[A program for the accelerated activation of myocardial infarct patients and its implementation in the hospitals and sanatoria of Ukraine].

The possibility is shown of reducing the time of hospitalization for 7-12 days in 25% of patients with a history of myocardial infarction. An analysis of health resort rehabilitation of patients according to program of enhanced activation revealed that such rehabilitation program proved effective and showed the possibility of its realization in conditions of practical medicine.


[Sex hormones and cerebral hemodynamics in men with cerebrovascular insufficiency].

The authors determined content of steroid hormones (testosterone, estradiol) and gonadotropic pituitary hormones (follicle stimulating, luteinizing, prolactin) in blood plasma by means of radioimmunological assay and evaluated the state of cerebral hemodynamics by results of zonal rheoencephalography in 77 patients with initial manifestation of circulatory brain insufficiency, transient disorders of the cerebral circulation and in the restorative period of stroke against the background of cerebral atherosclerosis. Established was a significant correlation between the content steroid sex hormones and the main quantitative values of the rheoencephalograms of the above patients.


[The fibrinolytic system of bronchial asthma patients in the late terms of pregnancy].

Women suffering of infectious-dependent bronchial asthma show at the second half of pregnancy a sharp reduction of the fibrinolytic potential that is manifested in a decrease of plasminogen activator and urokinase activity of the urine, in an elevation of the antiactivator and antiplasmin activity, growth of the concentration of alpha2-macroglobulins. At the same time high levels of fibrinogen are noted and low levels of fibrin degradation.


[The pathophysiological characteristics of anaphylactic shock].

Data are reported on the course of anaphylactic shock in 27 patients. It was established that respiratory insufficiency is as a rule, a sequel of distress syndrome. The symptoms of hepatic failure are mainly manifested in patients with a previously involved liver. Hyperazotemia has a productive character.


[The incidence of urolithiasis (based on autopsy data from the Donetsk Province Clinical Hospital)].

Autopsy data indicate that urolithiasis is found in 3.6% of 100 autopsies, most frequently in men (62 cases) over 40 years of age. In 2/3 of patients the length of the disease was under 8 years, rarer over 15 years. In most cases renal involvement was bilateral (72 patients). In more that 70% two or three operations were performed. A pathogenetic relationship was found between urolithiasis and malformations of the kidneys and ureters, urinary stasis in disorders of innervation of lesser pelvis organs, hyperplasia of the prostate and disorders of the mineral metabolism.


[Senescent-hypochondriac disorders accompanied by subjective signs of involvement of the genitalia].

Examined were 65 patients complaining of unpleasant sensations in the zone of sex organs. It was established that neither the localization of hypochondriac feelings, the character of senestopathias nor their characteristic aspects of interpretation and emotional accompaniment are not of significance for differential diagnosis with neuroses and torpid schizophrenia. The diagnosis should be based on the presence or absence of characteristic for schizophrenia personality changes, thinking disorders.


[A case of bettolepsy in acute pneumonia].

Literature lists more than 300 case reports of bettolepsy developing mainly in chronic diseases of the respiratory organs (chronic bronchitis, bronchial asthma, pulmonary emphysema, cor pulmonale) as well as in patients with epilepsy and organic brain diseases. The authors describe a case of bettolepsy in a patient with acute (croupous) pneumonia without respiratory diseases in the anamnesis and without a burdened neurological status. The role of nicotin and alcohol in the development of bettolepsy is shown. The problems of pathogenesis, clinical picture, differential diagnosis and treatment of bettolepsy are discussed.


[The use of the vif gene expression product of HIV-1 in bacteria for detecting specific antibodies in the sera of infected persons].

A fragment of the genome of human immunodeficiency virus type 1 (HIV-1) coding for p23 protein, the product of vif gene, was cloned in a plasmid vector pUR291. The resulting recombinant plasmid pLacVif1 was conducive in E. coli cells to the synthesis of a hybrid polypeptide with molecular weight of 136 kDa containing antigenic determinants of p23 protein of HIV-1. The employment of this polypeptide for analysis of HIV-1-positive sera by indirect enzyme immunoassay showed that vif-specific antibodies were found in 53% of the cases and their appearance was not related to the stage of the disease.


[The isolation of HIV from children with the initial signs of an HIV infection and from symptom-free carriers].

A high rate of HIV carrier state was observed in seropositive children with early symptoms of HIV infection. The virus was also isolated from 2 seropositive adults (mothers) showing no clinical manifestations. The intervals of virus manifestation in culture varied from 6 to 30 days with maximal frequency of detection in the 2nd week. Different modifications of the procedure for HIV isolation were assayed, and it was shown that the efficacy of isolation (shortening of the period of virus detectability and increase in the number of the antigen-containing cells) could be improved by the addition to the culture of the Jurkat-tat III line expressing the product of the tat gene important for virus reproduction.


[The reproduction of reassortant influenza A and B viruses with a known genome composition in different cell systems].

Reproduction of parental strains and reassortants (with known genome composition) of influenza A and B viruses was studied in chick embryos (CE) and in different cell lines (SPEV, MDCK, BHK-21, M22, etc.). The results agree with the concept that the yield of influenza A virus in CE depends on its M-gene. At the same time, the experimental results suggest that reproduction of influenza B virus in the same system is not determined by M-gene. Reproduction (hr-phenotype) of influenza A and B viruses in cell cultures was shown to be determined not only by the gene coding for hemagglutinin but also by other virus genes, the reproduction level being dependent on different genes in different cell systems.


[The evaluation of the degree of attenuation of cold-adapted influenza A virus strains in CBA-strain mouse and Syrian hamster models].

The pattern of the infectious process induced by the epidemic A/Leningrad/134/57 (H2N2) virus and its cold-adapted (CA) variants in CBA mice and Syrian hamsters was studied. The strains under study inoculated into the animals under a mild ether anesthesia differed by virulence, reproductive capacity in the nasopharynx, trachea and lungs, as well as by the isolation rate from extrarespiratory organs of both mice and hamsters. Upon intranasal inoculation of mice without anesthesia, the CA strains were found to be incapable of dissemination into the lower parts of the respiratory tract with distinguished these viruses from the original epidemic strain A/Leningrad/134/57 as well as from the mouse-adapted strain A/PR/8/34 (H1N1) used as control. The experimental results show that both models are suitable for laboratory evaluation of the attenuation degree of human influenza viruses.


[The antigenic and immunogenic properties of a recombinant protein of the HIV-1 gag-pol gene secreted by Saccharomyces cerevisiae yeast cells].

Analysis of the immunological properties of recombinant proteins of HIV-1 gene gag-pol secreted by yeast cells S. cerevisiae was carried out. The proteins under study interacted with antibodies from HIV-1-seropositive human subjects and with antibodies of rabbit immune serum to the native virus as effectively and specifically as natural HIV-1 proteins. The yeast gag-pol-protein complex was markedly immunogenic and induced in animals synthesis of antibodies of a certain specificity spectrum. A comparative immunochemical analysis of the properties of the recombinant proteins carried out by EIA and immune blot showed a certain degree of similarity between the yeast proteins and those of analogous construction produced in E. coli system.


[The antigenic characteristics of the influenza virus subpopulations isolated from a single patient].

Examinations by HI and EIA of influenza A (H3N2) virus isolates of 1985-1990 showed the strains derived from nasopharyngeal washings from patients to present very frequently as phenotypic mixtures of stable virus variants. Immunological analysis with monospecific antibody to hemagglutinin antigenic sites revealed a wide spectrum of antigenic activity based on the degree of relationship with viruses of previous years. By means of the immune pressing with antibody of different specificity the isolated strains could be divided into 2 subpopulations each characterized by the presence of only three antigenic sites. The subpopulations homogeneous by the antigenic composition of hemagglutinin represented the strains with antigenic markers of hemagglutinins of previous variants with drift variants of epidemic nature.


[The reproductive characteristics of the tick-borne encephalitis virus in interspecific somatic hybrids].

The study dealt with features of tick-borne encephalitis virus reproduction in two series of interspecies somatic hybrids generated by fusion of transformed cells of Chinese hamster (Ag17) with human diploid fibroblasts (KM/3) and with pseudonormal cells of Indian deer (Muntiacus munjak) (KOM). The viral infection in hybrid Ag17 cells ran an acute course with cell damage, but in KM/3 and KOM cells virus multiplication was not accompanied by the development of cytopathic effect. Two other parameters of tick-borne encephalitis virus infection under study: the extent of infectious particles production and electroimmunochemical properties were found to be under control of genomes of different parental cells.


[The immunogenic properties of Marburg virus proteins].

Immunogenic and protective properties of VP40 and NP proteins of Marburg virus were studied. VP40 protein was shown to have insignificant immunogenicity and NP protein to be capable of protecting the animals from lethal infection by stimulation of cell-mediated immunity. No significant increase in the specific antibody level was found.


[The antigens and nucleotide sequences of influenza A and B viruses in the lymphocytes of human peripheral blood].

Markers of influenza A and B viruses (antigens of hemagglutinin and specific nucleotide sequences) were detected in lymphocyte preparations from normal subjects. The rate of detection of the antigens and specificity (type and subtype appurtenance) of the markers correlated with the influenza epidemic situation. Lower titers of antibodies to the virus whose antigens were present in lymphocytes were observed.


[The antiproliferative activity of monoclonal anti-idiotypic antibodies imitating the biological effects of human alpha-interferons].

The experimental data from the study of antiproliferative activity (AP-activity) of monoclonal antiidiotypic antibody (mono-Ai-At) imitating biological effects of human alpha interferons (h-IF-alpha) are presented. The mono-Ai-At present in the ascitic and culture fluids (the culture fluid was obtained from cultivation of hybrid cells immobilized in alginate-gelatine gel) were shown to inhibit propagation of IF-sensitive continuous cells from normal and tumor tissues. The AP-activity of mono-Ai-At was found to be within the range of their antiviral activity. It is concluded that mono-Ai-At may be used as a new experimental model for investigation of h-IF-alpha biological effects.


[The isolation and identification of the Sindbis virus from migratory birds in Estonia].

The data on isolation from birds and identification of two strains of alphaviruses in Estonia in the territory of Vilsandy natural reserve are presented. Electron microscopy of purified virions allowed the isolates to be classified into the family of togaviruses, and serological identification (neutralization test, CFT) using polyvalent sera and monoclonal antibody showed them to belong to Sindbis virus.


[Biotransformation of zearalenone].

The conversion of Zearalenone by some strains of microorganisms was investigated. When the selective strains of Rhodotorula sp., Arthrobacter sp., Saccharomyces sp., and Candida sp. were incubated by shaking or standing at 28 degrees C for 72 h with an alcoholic solution of Zearalenone as the substrate at a concentration of 2-10 mg/ml ethanol (50-100 micrograms/ml medium), it was readily converted to give Zearalenols, consisting either mainly of the alpha-isomer (e.g. 96% in case of Rhodotorula sp. and 84% in case of Arthrobacter sp. as determined by HPLC) or beta-isomer (e.g. 91% and 92% in Saccharomyces sp. and Candida sp., respectively). The structure of the product was confirmed by 13C-NMR, MS and HPLC.


[Microbiological production of 3-oxo-bisnorchola-1, 4-dien-22-oic acid from cholesterol by an Arthrobacter 82].

Among nineteen strains of Arthrobacter which showed to be able to decompose cholesterol in preliminary experiments, a strain of Arthrobacter 82 was selected for microbiological production of 3-oxo-bisnorchola-1,4-dien-22-oic-acid (BNC) from cholesterol. The yield is over of 50% weight percent concentration of 0.25% in the presence of cobalt sulfate. The main intermediate in such a conversion process is cholestenone. Lower glucose and higher corn steep liquor concentration were favorable for side chain degradation of cholestenone and more BNC could be produced. BNC was crystallized in acidic solution and obtained by centrifugation. The structure and characteristics of BNC has been identified by means of conventional physical, chemical and spectrometric techniques.


[Purification and characterization of alpha-glucosidase from an extreme thermophile, Thermus thermophilus HB 8].

A highly thermostable alpha-glucosidase (E C.3.2.1.20) from an extreme thermophile, Thermus thermophilus HB 8, was purified to homogeneous by ammonium sulfate fractionation, DEAE-cellulose chromatography and preparative slab gel electrophoresis. The enzyme was purified 17 fold with 21% recovery of activity. The enzyme had a molecular weight of 67000 by SDS-PAGE. The isoelectric point was pH4.5 by IEF on PAG. The enzyme hydrolized p-nitrophenyl-alpha-glucoside (PN-PG), sucrose and maltose, but not cellobiose, melibiose and soluble starch. The km value for PNPG was 0.4mmol/L, the Vmax was 0.29 mumol.min-1.mg-1. The enzyme exhibited high thermostability. After incubation at 90 degrees C for 10 h in 50 mmol/L acetate buffer pH 5.8, the enzyme retained 90% of its original activity. The half-live (t1/2) at 95 degrees C was 108 min. The enzyme was activated by Mg2+, Mn2+, Ca2+, Ba2+ and strongly inhibited by Hg2+, Cu2+. Modification of the enzyme by EDC or DEPC led to complete loss of activity, which suggests that carboxyl group(s) and histidine residue(s) are essential for activity of alpha-glucosidase.


[An urease negative Cryptococcus neoformans].

We report an urease negative Cryptococcus neoformans derived from pigeon dropping. This isolate produced brown pigmented colonies on cornmeal Tween-80 agar with 300 micrograms/ml caffeic acid, but was failure to hydrolyze urea. More identification tests were performed for this isolate, such as assimilation and fermentation of carbohydrates, nitrate assimilation, production of starch like compound, growth on GCP medium, germ tube formation and inoculation of mice, ect. Most of the results showed that the microbiological characteristics of the isolate were typical of C. neoformans except for negative urease test. Even though there has been a report about an urease negative C. neoformans derived from an AIDS patient, but we have never found any report about isolation from pigeon dropping or nature environment. We should pay attention to the exist of this atypical strain of C. neoformans in nature environment and the possibility of infection to human being. Additionally, we also be aware of the possibility of neglect when this urease negative C. neoformans is identified with urease test.


[Study and preparation of Vi-PHA reagent and its application for detection of Salmonella typhi carriers].

Purified S. typhi Vi antigen is sensitized with equal volume of tannic acid treated formalational sheep erythrocytes (SRBC) at a final concentration of 1 microgram/ml. The Vi-passive hemagglutination assay (Vi-PHA) diagnostic reagent is developed to detect Vi antibodies to S. typhi for the detection of chronic carriers after typhoid fever and the screening S. typhi healthy carriers from food-handlers, which is characterized with high sensitivity, strong specificity and good stability. This Vi-PHA reagent is able to detect 1.16 micrograms/ml of Vi antibodies and doesn't make any cross reaction with healthy sera. For the sera of other diseases, the cross rate is only 0.84%. Using this reagent, 19 positive sera (6.93%) are detected from 274 convalescent sera from typhoid fever, 14 convalescents of which are stool-culture S. typhi positive, that persists a positive rate of 73.68%; 3 positive sera are detected from 106 foodhandlers, one of which is stool-culture S. typhi positive. Therefore, the reagent is simple, convenient, rapid and easy to be applicated in basic unit.


[Expression and secretion of alpha-amylase gene from Bacillus subtilis in E. coli].

The E. coli which carrying the alpha-amylase gene fragment cloned from B. subtilis secreted the gene products into the medium. The reason is the exogenous gene fragment act on the cell wall of E. coli by some way, gives rise to the change of its structure. It leads up to the alpha-amylase and some periplasm proteins passing through the cell wall into the medium. It also causes the change of host colonial morphology. The secrete process are non-specific.


Dexamethasone and bacterial meningitis. A meta-analysis of randomized controlled trials.

A meta-analysis of 5 randomized, controlled trials using dexamethasone as adjunctive therapy in the treatment of bacterial meningitis in children was done to assess the efficacy in reducing sequelae. A 6th study including both children and adults was analyzed separately. Results of the 5 pediatric studies indicated no significant difference in case-fatality rate between the placebo and dexamethasone groups. Significantly more neurologic sequelae were found in the placebo group during the period from discharge from hospital to 6 weeks after discharge (relative risk [RR] = 1.99, 95% confidence interval [CI] 1.13 to 3.53) and during the period beginning 6 months after discharge (RR = 3.90, 95% CI 1.72 to 8.85). The incidence of neurologic sequelae from 6 weeks to 6 months after discharge, though less with dexamethasone administration, did not reach statistical significance. The frequency of bilateral hearing loss was significantly greater in the placebo group (RR = 4.12, 95% CI 1.74 to 9.79), but unilateral loss was not statistically different in the two groups. Dexamethasone administration in addition to antimicrobial therapy appears to be effective in reducing neurologic sequelae and bilateral hearing loss associated with bacterial meningitis in children.


Risk for AIDS in multiethnic neighborhoods in San Francisco, California. The population-based AMEN Study.

To examine the actual and potential spread of human immunodeficiency virus (HIV) from an acquired immunodeficiency syndrome (AIDS) epicenter to surrounding neighborhoods, we studied the prevalence of the viral infection and AIDS risk behaviors from 1988 to 1989 in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco. We surveyed 1,770 single men and women aged 20 to 44 years (a 64% response rate) in a random household sample drawn from 3 neighborhoods of varying geographic and cultural proximity to the Castro District where the San Francisco epidemic began. Of 1,369 with blood tests, 69 (5%) had HIV antibodies; all but 5 of these reported either homosexual activity (32% HIV-positive; 95% confidence interval [CI] = 23%, 41%), injection drug use (5% HIV-positive; CI = 1%, 14%), or both (59% HIV-positive; CI 42%, 74%). Homosexual activity was more common among white men than among African-American or Hispanic men, but the proportion of those infected was similar in the 3 races. Both the prevalence of homosexually active men and the proportion infected were much lower in the 2 more outlying neighborhoods. Risk behaviors in the past year for acquiring HIV heterosexually--sex with an HIV-infected person or homosexually active man or injection drug user, unprotected sexual intercourse with more than 4 partners, and (as a proxy) having a sexually transmitted disease--were assessed in 1,573 neighborhood residents who were themselves neither homosexually active men nor injection drug users. The prevalence of reporting at least 1 of these risk behaviors was 12% overall, and race-gender estimates ranged from 5% among Hispanic women to 21% among white women. We conclude that in San Francisco, infection with HIV is rare among people who are neither homosexually active nor injection drug users, but the potential for the use spread of infection is substantial, as 12% of this group reported important risk behaviors for acquiring the virus heterosexually.


Health care use by human immunodeficiency virus-infected students at a California student health service.

We report characteristics of 16 college students with human immunodeficiency virus (HIV) infection but without the acquired immunodeficiency syndrome who received care at a student health center at a major university in California. Sociodemographic and clinical data and medical expenditures were obtained retrospectively from medical charts and computerized billing records. All 16 students were men who had sex with men, and 3 had also used intravenous drugs. Dermatologic conditions, upper respiratory tract infections, gastrointestinal conditions, anemia, lymphadenopathy, sexually transmitted diseases, and ophthalmologic conditions were more frequent among HIV-infected students than among the general student population using the health center. On average, HIV-infected students visited the student health service about 3 times more often and incurred charges about 10 times higher than the general population of students visiting the health center. Student health centers, which have been at the forefront of developing strategies for HIV prevention, education, and counseling, must also develop treatment programs for HIV-infected students.


Factors influencing family physicians to continue providing obstetric care.

To determine the reasons some family physicians continue to practice obstetrics when most of their colleagues do not, we surveyed family physicians in 26 counties of northern California whose practices include obstetrics and those who have recently discontinued it. In all, 70% of family physicians practicing obstetrics cited enjoying it as a reason for continuing this practice. Over a third of family physicians practicing obstetrics thought that obstetric practice was a responsibility to the community. Only 1 in 6 reported obstetrics to be important in terms of financial implications. Despite this, family physicians practicing obstetrics had a mean gross income derived from obstetric practice of $30,000 above the cost of their total malpractice premium. In contrast, a comparison group of family physicians who had recently discontinued obstetrics cited malpractice insurance costs most frequently as the reason for discontinuing it. Nearly 40% of these physicians indicated that they would be willing to return to obstetrics if circumstances were to change substantially. The most frequently cited change necessary for these physicians to return to obstetrics was a reduction in malpractice insurance rates.


Endoscopic laser therapy in gastroenterology.

Endoscopic laser therapy has become an important and widely used tool in gastroenterology. It has become important for outpatient palliative therapy for ablating obstructing gastrointestinal neoplasms. This method has often circumvented the need for major palliative surgical resections. Caution must be applied to laser therapy for potentially curable malignant neoplasms because, with vaporization of the target tissue, no tissue specimen is available to assure that local or invasive residual carcinoma is excluded. Therefore, in good surgical candidates, surgical resection of potentially curable cancers is always recommended. In the future, however, the combination of refined endoscopic ultrasonography and laser fluorescence techniques may lead to earlier detection, more precise localization, and even curative ablation of gastrointestinal malignancy.


Use of thallium 201 in tumor evaluation.

The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in nuclear medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in nuclear medicine that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Nuclear Medicine of the California Medical Association, and summaries were prepared under its direction.


Do we need an intravenous fluoroquinolone?

Intravenous ciprofloxacin, the first parenteral fluoroquinolone available in this country, represents another class of antimicrobial agents from which physicians must choose when treating nosocomial infections. Fluoroquinolones are bactericidal antimicrobial agents that act by inhibiting DNA gyrase. They are active in vitro against most gram-negative bacteria and methicillin-susceptible staphylococci. Activity against anaerobic bacteria and streptococci is poor. The rapid development of bacterial resistance in centers with high quinolone usage is of great concern. Resistance develops most commonly in Pseudomonas aeruginosa and staphylococci. Resistance emerges most often when quinolones are used to treat chronic infections or in patients with poorly drained abscesses, necrotic tissue, or indwelling catheters. Clinical trials have shown ciprofloxacin to be as effective as ceftazidime in the treatment of infections caused by gram-negative bacteria. Although the overall frequency of side effects to fluoroquinolones is low, seizures and allergic reactions have been attributed to their use. Ciprofloxacin inhibits the metabolism of theophylline, and morbidity and death have been reported in patients taking the two drugs concomitantly. Parenteral fluoroquinolones should be reserved for the treatment of gram-negative bacterial infections in patients in whom standard agents cannot be used.


Current management of diabetic retinopathy.

Diabetic retinopathy progresses through three distinct stages. A rational approach to management is based on an understanding of the pathophysiology of each stage. Based on the results of national multicentered clinical trials of laser photocoagulation and other treatments, advances in our understanding of the pathogenesis and treatment can now make a dramatic impact on blindness in the diabetic population: Panretinal laser photocoagulation treatment can reduce the risk of vision loss from high-risk proliferative diabetic retinopathy by at least 50%. Laser photocoagulation treatment of clinically significant diabetic macular edema can reduce the risk of vision loss by more than 50%. Vitrectomy can restore useful vision to some patients with severe diabetic retinopathy and vitreous hemorrhage with or without an accompanying traction retinal detachment. Diabetes 2000 is a new project sponsored by the American Academy of Ophthalmology, the goal of which is to eliminate preventable blindness from diabetes by the year 2000. As its name implies, Diabetes 2000 will be a long-term project aimed at a specific disease--diabetic retinopathy and its complications. It will provide the latest research findings to ophthalmologists and primary care physicians as the first priority, followed by the education of patients and the general public. Recent advances and treatment guidelines for the medical and surgical treatment of diabetic eye disease will be emphasized through the continuing education of ophthalmologists, other physicians, and allied health professionals. In later phases, educational programs for diabetic persons and the public will be developed. Ultimately, improved access of diabetic patients to ophthalmologic care and a close working relationship between ophthalmologists and primary care physicians will ensure early detection of diabetic retinopathy and the timely delivery of state-of-the-art treatments.


Earthquakes and the office-based surgeon.

A major earthquake may strike while a surgeon is performing an operation in an office surgical facility. A sudden major fault disruption will lead to thousands of casualties and widespread destruction. Surgeons who operate in offices can help lessen havoc by careful preparation. These plans should coordinate with other disaster plans for effective triage, evacuation, and the treatment of casualties.


Translation is not enough. Interpreting in a medical setting.

Unique obstacles must be overcome when providing medical care to patients who have an incomplete command of the English language. Serious barriers to effective communication may arise at the exact point where our health care system must succeed or fail. Miscommunication, differences in attitudes about health care, and various other misunderstandings interfere with or frustrate good health care for these patients and their families. Such difficulties are best overcome by the use of a professional interpreter who can ensure good communication between patients and health care professionals. My daily experiences as a professional medical interpreter and translator in Spanish provide insights into the complexities of bilingual and bicultural communication in the hospital setting. Although the examples given relate to Hispanic patients, the lessons learned can be extended to other foreign language patients as well.


Modesty, sexuality, and breast health in Chinese-American women.

Although breast cancer rates among Chinese women are lower than among white women, breast cancers and other breast diseases often go undetected and untreated in Chinese women. Cultural values with respect to modesty and sexuality, especially in unmarried women, partly account for a Chinese lack of attention to breast health. In addition, institutional barriers, such as an unavailability of information in Chinese languages, few female physicians, and an absence of educational campaigns, contribute to Chinese women's neglect of breast health.


Health, illness, and immigration. East Indians in the United States.

East Indian immigrants to the United States represent the diversity in religion, language, and culture that exists in India, so it is difficult to make unequivocal statements about their health beliefs and behaviors. Despite the diversity, an understanding of Ayurvedic humoral concepts of health and illness provides a key to some pervasive and persistent ideas and practices. India has a pluralistic medical system in which Western medicine, which is increasingly popular for some ailments, is one option among many. Even those who are familiar with the "Western" medical system in India may find American medicine alien.


Health issues of Afghan refugees in California.

Since the 1979 Soviet invasion of Afghanistan, more than 6 million Afghan refugees have become the world's largest refugee population. Although refugees in Pakistan and Iran are now beginning to repatriate, continuing political turmoil in Afghanistan and children's acculturation and educational opportunities will keep many Afghans in the United States permanently. Although there are no accurate statistics, local resettlement agencies and Afghan community leaders estimate that there are 10,000 to 35,000 Afghans in northern California. They suffer from a variety of problems common to refugees: language, economic and occupational problems, and substantial challenges in psychological, family, social, and cultural adjustment to the United States. Although many Afghans are doing well, many others have depression, psychosomatic symptoms, and posttraumatic stress disorder.


Gypsies and health care.

Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death.