[The history of the Hospital Therapy Clinic of the I. M. Sechenov Moscow Medical Academy (centenary of the Clinic in Devich'e Pole)].
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Biomedical subjects
Publications and source records attributed to A V Sumarokov.
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The paper provides measurements of maximal Na+, K(+)-ATPase activity in 20 patients with hypertensive disease, 20 patients with secondary hypertension and 20 healthy donors. The investigation was made by high-resolution nuclear magnetic resonance using sodium nuclei. A significant decrease was found in Na+, K(+)-ATPase activity in the patients with hypertensive disease (9.0 +/- 0.3 mg-equiv. per lites cells an hour) as compared with those with secondary hypertension (10.3 +/- 0.3 mg-equiv. per liter cells an hour) and the controls (10.5 +/- 0.3 mg-equiv. per liter cells an hour), which supports the findings of impaired membrane morphology in hypertensive disease.
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The efficiency of various combinations of antiarrhythmic agents (quinidine, etmozin, disopyramide, mexitil, and allapinine) was assessed in 24 cases of frequent ventricular and supraventricular extrasystoles, where treatment with one of the above listed drugs had been ineffective. Combined use of the drugs produced anti-arrhythmic effect in 22 of the patients. Mechanisms of the combined action are discussed.
A study of 37 children and 32 adults with abnormally located chords in the left ventricular cavity detected by ultrasonic investigation of the heart, revealed a number of minor developmental defects of connective tissue which served as the basis for establishing diagnosis of connective tissue systemic involvement (probably, congenital).
The immune cytotoxic mechanism of myocardial lesion was studied in 15 patients with non-specific myocarditis (NM) and in 10 patients with idiopathic congestive cardiomyopathy (ICC). In addition, 10 control patients having ischaemic heart disease (IHD) with congestive heart failure (CHF) and a control group of blood donors were examined. The following parameters were examined: anti-heart antibodies (by indirect enzyme-linked immunosorbent assay), lymphocyte sensibilization (by leucocyte migration inhibition test; the antigen used was cardiomyocyte membrane protein), and killer cells (K-cells) activity in the course of antibody-dependent cell-mediated cytotoxicity. Anti-heart antibodies were found in 73% of patients with NM, 50% patients with ICC and 33% patients with CHF. Lymphocyte sensibilization to the myocardium was found in 87% of patients with NM, and in more than half of the patients with ICC. Cardiospecific cytotoxic immune reaction was reproduced in vitro in 9 patients with NM and in 4 patients with ICC. It is assumed that an analogical mechanism of myocardial lesion functions in vivo.
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Basing on the literature data and their own observations of patients with chronic hemodialysis the authors have analysed the pathogenesis, course, hemodynamic shifts and possibilities of purposeful treatment in terminal uremia. Besides two variants of the hypertension course (controlled and noncontrolled), a third type has been revealed--hypertension difficult to control, in the pathogenesis of which, as well as in the noncontrolled variant, an important role is played by the activization of the renin-angiotensin system. Hemodynamic mechanizms of an abrupt change in the arterial pressure (acute hypotension and hypertensive crisis) in the process of hemodialysis are analysed.
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In 40 patients with umcomplicated hypertension their general haemodynamics was compared with the excretion of catecholamines and their metabolites. On the initial stage of the disease the hormonal link was found to prevail over the mediator one; the decreasing excretion of bound catecholamines after the administration of Isuprel indicates that a disbalance between the secretion and inactivation of catecholamines develops as early as on this stage of the disease. Later, in resistance hypertension the administration if Isuprel resulted in an increased excretion of free noradrenalin, which is interpreted as a sign of increased reactivity of this link; no such reaction is noted in ejection hypertension. A study of all these links of the sympathoadrenal system is important for the understanding of the pathogenesis of hypertension and for the choice of this therapy.