[Use of a new emulsified protein-fat product for correction of lipid metabolism disorders].
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Biomedical subjects
Publications and source records attributed to V V Makarovskiĭ.
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The serum activity of alanine aminotransferase, aspartate aminotransferase, glutamate dehydrogenase, gamma-glutamyl transferase and creatinine kinase was studied in 81 patients with chronic alcoholism and 31 patients with alcoholic psychoses. Eighty-one healthy apparently non-drinkers served as a control group. It is concluded that when acute alcoholic psychoses develop, patients with chronic alcoholism display a simultaneous increase in the activity of enzymes releasing from damaged muscular and hepatic tissues. This makes the application of a number of the diagnostic criteria developed in classical clinical enzymology impossible. The phenomenon of concurrent increases in the activity of creatine kinase, aspartate aminotransferase and glutamate dehydrogenase by 4 times or more has been proposed to be used as a criteria for identifying alcoholic psychosis in alcoholics.
The authors share their experience gained with automation of hematologic investigations at a clinical diagnosis laboratory. A CDL information system, basing on personal computers, has been created, functioning in complex with hematologic autoanalyzers. The reports on the laboratory's activity are made automatically, as is the laboratory register and processing of applications for tests.
The authors propose a new approach to evaluation of biochemical indices in internal organ diseases, namely, comparison of factually detectable results with individual initial data. It was established that in stenocardia the majority of patients showed an increase of activity of cardio-specific enzymes. Patients with exacerbation of obstructive bronchitis revealed diverse changes of the content of immunoglobulins, complement components and proteinase inhibitors. The authors suggest that an individual approach to comparison of laboratory indices reflects more precisely the response of the patient's body to the pathological process.
Hepatic function was studied in 31 patients with coronary heart disease before and after treatment with nicardipine. Clinical and biochemical findings (enhanced gamma-glutamate transferase and high cholesterol, hepatobiliary syndrome) provide evidence for hepatic function disturbance associated with coronary heart disease. Nicardipine produced a good subjective response, the attenuation of hepatobiliary syndrome. Biochemical indices did not change.
When treated by verapamil, coronary patients responded differently. Hepatic effects can be either protective or toxic depending on the drug dosage and course duration. Verapamil hepatic protection manifests in day dosage 360 mg and the course duration 3 weeks. 600 mg verapamil is toxic irrespective of the course duration.
The new calcium antagonist nicardipine (barizine) was tested for effects on platelet function and transient myocardial ischemia in 23 patients with coronary heart disease. Prior to the therapy, lower platelet function was more frequently encountered in patients with more severe angina pectoris and more prolonged myocardial ischemia. The efficacy of nicardipine was demonstrated to be related to the clinical course of coronary heart disease and the baseline platelet function. It is advisable to prescribe the drug to patients with Functional Class II stable angina and higher platelet functional activity.
The clinical efficacy of "Food ichthyenic oil", a new foodstuff, was studied in 129 patients with atherogenic dyslipidemia. The oil was given in a daily dose of 30 ml which contained 8 g polyunsaturated fatty acids of the omega-3 class. All the patients were divided into 3 groups: (1) 44 patients with 5.2-6.5 mmol/l cholesterol; (2) 37 with over 6.5 mmol/l, and (3) 48 with hypercholesterolemia (cholesterol over 5.2 mmol/l and hypertriglyceridemia (triglycerides over 2.3 mmol/l). Following 1-month therapy, all the groups displayed lower low density lipoprotein cholesterol levels and significantly higher high density lipoprotein cholesterol concentrations. After 4-month intake of ichthyenic oil, the levels of total and LDL cholesterol returned to the baseline values, whereas the concentration of HDL cholesterol was significantly higher than the baseline one. Following 12-month therapy, there were 15 and 14% decreases in total and LDL cholesterol, respectively, a 16% increase in HDL cholesterol. The patients from Group 3 exhibited low VLDL cholesterol and triglyceride levels.
In 47 patients with coronary heart disease, the function of platelet was studied and ECG ST-segment was monitored. It was found that lower platelet function was more common in patients with severe coronary heart disease if they had long episodes of transient myocardial ischemia. Following 12 days of dilzem monotherapy, the most marked ++anti-ischemic and antianginal effects were observed in patients who had had higher platelet function.
The detection rate was examined for ECG (EchoECG) equivalents of clinical coronary heart disease (CHD) forms, such as angina pectoris, focal myocardial dystrophy, small and large myocardial infarction, at various levels of the peak activity of blood creatine phosphokinase in the acute period of the disease. A series of investigations revealed in the acute period the time when myoglobin, CPK, CPK MB, AST, and LDH attained their maximal blood content, which were directly related to the molecular weight of proteins. The findings allowed the author to consider a relationship between the values obtained by diagnostic techniques and the time course of an infarct process, the mass of ischemic necrosis and its topography in the myocardium.
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A new Biolab information and computing system is intended for data processing from automated equipment for biochemical laboratory analysis; it is integrated with other subsystems of a large medical information system of a multidiscipline hospital. In technological characteristics and information volume processed the Biolab subsystem is much superior to the previous Laboratoriya subsystem.
Of 98 patients who died from myocardial infarction as evidenced by sectional and histological examinations, during their life 74 had had signs of extensive myocardial infarction (EMI), 11 had presented with small myocardial infarction (SMI), 10, focal myocardial dystrophy (FMD), 3, angina pectoris (AP). In the acute period, the highest values of hyperenzymia, CPK, MB-CPK, ACT, LDH1, LDH2, and enzyme ratios were revealed in EMI, the lowest ones were seen in AP; SMI and FMD stood midway. A significant moderate direct relationship was established between the maximum activity of CPK, MB-CPK, and LDH1 and the histological sizes of ischemic necrosis as documented by planimetry. It was suggested that the topography and site of ischemic lesion determined life-time ECG evidence of respective clinical forms of coronary heart disease during its exacerbation, and the severity of hyperenzymia governed necrotic mass.
Introduction of the complex computer-aided mechanization and automatization into the laboratory process and their integration with other automated information hospital systems significantly raise efficacy of laboratory data application in treatment and diagnosis, thus reducing work losses of the medical staff. The structure of biochemical research for clinical therapeutic and surgical departments is presented along with the main biochemical diagnostic programmes for some diseases.
Serial blood measurements of myoglobin (MG) revealed a common trend of change in acute macro- and microfocal myocardial infarction, focal myocardial dystrophy, angina of effort and angina at rest as well as unstable angina. Differences in myoglobinemic parameters (MG peak level, increment rate, normalization time) between different clinical variants of CHD are quantitative. It is suggested that there is an intravital relationship between each of the examined clinical variants, in their acute phase, and a specific equivalent of an acute myocardial ischemic damage focus, as shown by the degree of hypermyoglobinemia.
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