[A rare case of pronounced disorders of atrioventricular conduction combined with a permanent form of atrial flutter].
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Biomedical subjects
Publications and source records attributed to G B Berliner.
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Basing on the results of follow-up of 212 lymphogranulomatosis patients in long-term remission, the authors have identified most frequent and serious complications. Contribution of different treatment components to development of these complications is specified. Signs of mono- and polyorganic lesions due to combined therapy are described, recommendations on the follow-up and prevention of the complications are provided.
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The paper reports 7 cases of dimorphic anemia, development of Addison-Biermer disease in preexisting chronic posthemorrhagic anemia. The authors consider some diagnostic and therapeutic aspects. It is thought valid to discontinue iron preparations prior to vitamin B12 therapy and to start them again upon the arising reticulocytic crisis.
The review of the literature data and the evidence obtained on 85 own patients with B12-deficiency anemia concerning iron metabolism underlie 3 variants proposed by the authors: pronounced manifestations of secondary sideroachresia before B12 therapy, utilization iron deficiency upon B12 introduction, dimorphic anemia (development of megaloblastic erythropoiesis in prior iron deficiency). The causes of megaloblastic erythropoiesis incompetence (slow rate, hemolytic component, secondary sideroachresia) are discussed.
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The authors describe three comparatively rare cases of extremely severe symptomatic autoimmune thrombocytopenia associated with systemic lupus erythematosus. The use of glucocorticoids in large doses and in two cases of splenectomy turned out ineffective. The next therapeutic measures are suggested in the following succession: glucocorticoids----cytostatic drugs (vincristine)----splenectomy to be performed only in special cases.
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The paper is concerned with a case of Brill-Symmers' disease started with the thrombocytopenic syndrome relating to hypersplenism. After splenectomy the first benign stage of disease without eradication therapy lasted over 10 years. Signs of immunological incompetence (signs of secondary infection) and recurring immune thrombocytopenia were noted in that period. A regular use of glucocorticoids and antibiotics resulted in the improved condition. The development of the second stage of disease (malignant diffuse lymphoma with the involvement of the internal organs) was fast resulting in the patient's death.
The results of splenectomy followed by chemotherapy are analysed. Fifteen patients with chronic myeloid leukemia (CML) were entered into the study. The maximal survival of one of the patients subjected to splenectomy was 102 months. The authors come to the conclusion that it is desirable that CML patients should be subjected to splenectomy after preliminary preparation (chemotherapy and chemoprotectors) at the early stages of the illness, which is to be followed by monochemotherapy. Provided the latter is unsuccessful, the change over to polychemotherapy similar to the treatment protocols for myeloid leukemia is suggested.
The cytochemical test for PAS-positive material in CSF smears can be used for identification of leukemic cells of the lymphoid line. Qualitative smears were obtained from the CSF by the sedimentation method. Five patients were examined. A very suggestive case is described. The cytochemical studies of CSF smears help diagnose neuroleukemia and evaluate the treatment efficacy.
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The authors report the use of the cytostatic drug cytosar in the control of herpetic complications in patients with acute leukemia and lymphogranulomatosis. A distinct effect was obtained as a result of intravenous drip of cytosar in a dose of 0.03-0.05 g for 2 days. It is desirable that cytosar therapy may be instituted within the first days of the development of herpetic infection.
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