[Certain aspects of prevention and treatment of cutaneous melanoblastoma].
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Biomedical subjects
Publications and source records attributed to M D Podil'chak.
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In patients with pancreatic head cancer and virus hepatitis the lowest values of alpha glycerophosphate dehydrogenase and adenosine triphosphatase in the peripheric blood lymphocytes were determined. The dynamic study of these values in patients with pathology of liver and biliary ducts permits to estimate the disease severity course and equally with other clinico-laboratory data may have prognostic significance.
The plasmapheresis (PP) with the help of the PP-05 apparatus was applied in the treatment of 70 patients with the low extremities diabetic angiopathy. The optimal plasma exfusion dose is from 600 to 1100 ml. Under the PP influence the blood glucose level reduced proportionally to the excreted plasma quantity, the rheovasographic index on the low extremities increased from 0.41 +/- 0.15 to 0.64 +/- 0.6; the bloodflow velocity in the peripheral arteries of low extremities have got the 2.2-fold rise according to the dopplerography data. In comparison with a control group of patients the exarticulation conduction frequency decreased from 20 to 8, and extremities amputation--from 14 to 5.
In patients with purulent inflammation foci of various location, reduction in the number of natural killers (NK) and in the activity of alpha-glycerophosphatedehydrogenase (alpha-GPDH) and adenosinetriphosphatase (ATP-ase) of lymphocytes was revealed. Maximum reduction in indices of NK, alpha-GPDH and ATP-ase was noted in patients with diffuse peritonitis, phlegmonous-gangrenous cholecystitis, destructive appendicitis. After treatment, the mentioned indices increased, but by the time of discharge of the patients from the hospital they were lower than the normal ones.
Decrease in activity of alpha-GPDG and ATP-ase observed in peripheral lymphocytes of patients with diabetes mellitus correlated well severity of the disease. The lowest indices of enzymatic activity were registered in patients with grave diabetes complicated by angiopathies, foot gangrene, and purulent inflammatory processes. Compensation of carbohydrates metabolism and improvement of clinical picture were accompanied by the trend to normalization of enzymes' activity. Dynamic study of alpha-GPDG and ATP-ase in patients with diabetes mellitus allows to evaluate degree of hypoxia, comprehend the nature of compensation mechanisms and assess effectiveness of the treatment.
It was established that patients with hepatobiliary pathology showed a reduction of SH groups and activity of lymphocyte succinate dehydrogenase of the peripheral blood. The level of this reduction depended on the severity of the pathological process and was lowest in viral hepatitis and cancer of the head of the pancreas. A dynamic study of SH groups and SDG in these groups of patients makes it possible to evaluate disorders of oxidation, oxidation, severity of the disease; it is also of prognostic significance.
A study of 42 patients with thyrotoxic goiter revealed a reduction of SH groups in the peripheral blood lymphocytes. The reduction depended on the severity of the pathological process. Changes of the SH groups are an informative criterion of the severity of the disease and treatment efficacy.
Patients with diffuse toxic goiter reveal an increased adhesive capacity of lymphocytes evidencing a reduction of lymphokine production by lymphocytes which would suppress adhesiveness. The degree of increase of adhesive properties of lymphocytes depended on the severity of the clinical picture of diffuse toxic goiter, being higher in those with a severe course. Results of the test of lymphocyte adhesion suppression reflect the state of cellular immunity, severity of the clinical course of diffuse toxic goiter and efficacy of treatment.
In patients with gastric cancer, decrease in the level of SH-groups and activity of succinate dehydrogenase (SDH) of the peripheric blood lymphocytes which is indicative of the disturbance in oxidation-reduction processes was revealed. Degree of decrease in the indices depended on stage of the disease and severity of the course of a pathological process. SDH lymphocytic activity is the more sensitive test than content of SH-groups. The indices mentioned are used as an informative test for evaluation of the effectiveness of treatment.
In patients with gastric cancer, the increase in adhesive lymphocytic capacity, as compared to a control, was revealed. It is indicative of the reduction in production of lymphokines, causing inhibition of adhesion. The highest value of the index was noted in IV stage gastric cancer. The results of study of the adhesive properties of the peripheric blood lymphocytes allow to judge about the state of cellular immunity, and in the complex with the other clinico-laboratory findings, are of a prognostic value.
In the complex treatment of 121 patient with purulent-inflammatory diseases with the aim of detoxication, reinfusion of the blood irradiated with ultra-violet rays was used. Judgment about the effectiveness of treatment was based on the findings of clinical and laboratory studies. There were no complications. In 8 patients, a hyperthermal reaction occurred. Under the influence of irradiation, a quantity of the natural killer cells has normalized, while in the control group, it was smaller than in healthy subjects.
Performance of infusion-transfusion therapy before the operation, suboperative intravenous administration of antibiotics, metrogil, sanitation of the abdominal cavity with the use of antiseptics, performance of transnasal intraoperative intubation of the small intestine, Hartmann operation in patients with cancer of the left colon complicated by acute ileus (AI), liquidation of ileus at operation permitted considerable improvement of treatment of the patients with AI. The incidence of postoperative complications reduced from 9.7 to 4.1%, lethality--from 12.6 to 5%.
In 28 patients with diffuse toxic goiter, the attenuation of activity of lymphocytic succinate dehydrogenase and decrease in number of large granule-containing lymphocytes in the peripheral blood was revealed. A degree of these changes depended on severity of the course of the disease.
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