Biomedical subjects
Publications and source records attributed to V V Pavlov.
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A new economic mechanism provides for independence of health units, their financial independence and the possibility of developing specialized health care for the population of the territorial health complex. The necessity of preserving large health units within the newly developed regional public health infrastructure is stressed.
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In 25 patients, when treating purulent peritonitis, the extracorporeal connection of a porcine spleen was used (33 séances). A considerable reduction in intoxication was noted. A technique for the porcine spleen connection and tests for checking its effectiveness are described.
Indices of platelet function, plasmic coagulation and fibrinolysis were studied during gamma-beam therapy in patients with laryngeal, gastric and cervical tumors (potentially at risk for thrombosis) against a background of metronidazole administration. During the above therapy the thrombophilic status of gastric cancer patients was preserved. These patients were considered at risk for thrombosis. In patients with laryngeal and cervical cancer platelet capacity to adhesion was considerably reduced during radiotherapy with the use of metronidazole. As a result of it the thrombogenic blood potential and danger of intravascular thrombogenesis were decreased.
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Some peculiarities in a course of stage I-II Hodgkin's disease with a primary site below the diaphragm are analyzed. This site is more common in men and in a mixed cell histological variant of lymphogranuloma. The frequency of recurrence is higher in this group than in patients with a primary site above the diaphragm. Recurrences affect more frequently the lymphatic areas above the diaphragm. The data obtained suggest the necessity of irradiation of the lymphatic collectors on both sides of the diaphragm in a primary site below the diaphragm, particularly in patients with "mixed cell" and "lymphoid depletion" histological variants of lymphogranuloma.
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A study was made of the bone marrow status in unirradiated zones of 33 patients with stage I-II Hodgkin's disease in complete 9-12 year remission after therapeutic irradiation of the lymphatic collectors of the upper part of the trunk in combination with irradiation of the spleen (16 patients) or splenectomy (17 patients). The total count of myelokaryocytes, myelogram, a relative and absolute content of lymphoid cells, immature granulocytes and elements of the erythroid series were defined in the punctates of the upper portion of the ilium. T- and B-lymphocyte count, the number of granulocytomacrophage (CFU-C) and stromal (CFU-F) precursor cells were defined using morphocytochemical and immunological methods. At that time an increase in the relative and absolute content of C- and B-lymphocytes was noted. The T-cell count and the total number of myelokaryocytes, on the one hand, and the content of immature granulocytes and erythronormoblasts, on the other hand, showed correlation of various degree which was particularly noticeable in the group of unoperated patients. The total number of myelokaryocytes in 1 microliter of the bone marrow of the patients after splenectomy, on an average, significantly exceeded that in the group of patients with the irradiated spleen. These changes were considered to be a result of the rearrangement of T-differentiating lymphocytes with their raised accumulation in the bone marrow after irradiation of a considerable volume of the lymphoid tissue and spleen or after splenectomy.
Platelet functional activity, plasma coagulation and fibrinolysis were studied in patients with rheumatoid arthritis (RA) against a background of various therapeutic modalities. Therapy with non-steroid anti-inflammatory agents resulted in an increase in platelet and plasma coagulating activity and inhibition of fibrinolysis. An insignificant rise of disaggregation of platelet aggregates was noted 2 weeks after intraarticular administration of 198Au against a background of therapy with non-steroid anti-inflammatory agents. Mydocalm incorporated in a dose of 1-2 mg/kg in the therapeutic scheme did not change significantly blood coagulation indices.
Diagnostic investigation of 36 patients with reciprocal paroxysmal tachycardias, using intracardiac electrophysiologic tests, revealed supraventricular paroxysmal tachycardia in 29 patients, and ventricular paroxysmal tachycardia in 7. Serial trials of antiarrhythmic drugs in acute experiments with simultaneous electrophysiologic studies made possible efficient medication in 80% of the patients. A high correlation was demonstrated between the results of acute antiarrhythmic drug tests and subsequent long-term treatment. Ritmilen proved particularly effective in patients with paroxysmal tachycardias in the presence of the ventricular pre-excitation syndrome, while cordarone and etmozin were most effective antiarrhythmic drugs for reciprocal ventricular tachycardias. No preferential antiarrhythmic agent could be established for patients with reciprocal paroxysmal tachycardias due to double atrioventricular conduction.
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The concealed Wolff-Parkinson-White (WPW) syndrome, the electrophysiologic and morphologic basis of cardiac arrhythmias, was shown to be a cause of the attacks of supraventricular tachycardia. The latter is rooted in the concealed WPW syndrome in about 30% of patients showing no electrocardiographic signs of pre-excitation. Electrophysiologic criteria of the diagnosis of supraventricular tachycardias due to the concealed WPW syndrome are listed. Concealed Kent's bundle was most commonly found on the left side. As regards antiarrhythmic therapy, disopyramide is one of the most effective drugs for patients with supraventricular tachycardias due to the concealed WPW syndrome.
Intracardiac electrophysiologic studies were carried out in 41 patients with paroxysmal supraventricular tachycardias. Reciprocal atrioventricular tachycardia due to dissociated conduction through the atrioventricular junction was diagnosed in 29 patients. Electrophysiologic data suggested trifascicular atrioventricular conduction in 4 patients, and quadrifascicular conduction in 2. A concept of polyfascicular impulse conduction through the atrioventricular junction in some cases of reciprocal nodal tachycardia is proposed. It is demonstrated that combinations of congenital cardiac conduction abnormalities may be possible in the same individual.
Three types of myocardial contractility and central hemodynamic response were identified on the basis of myocardial function and heart rate during an attack of paroxysmal tachycardia. Heart rates of up to 180 beats per minute are not associated with any myocardial contractility disorders, and hemodynamic disturbances are controlled by elevated myocardial inotropism. Heart rates reaching 190 beats/min are associated with a suppression of myocardial relaxation, and the Frank-Starling mechanism is added to elevated inotropism to control the disturbance. Where the heart rate is above 200 beats per minute, both myocardial relaxation and contraction are suppressed; the Frank-Starling mechanism is responsible for the control here.
The experiments have been performed on 24 guinea pigs (48 labyrinthes), 6 of them--control and 18 have been subjected to noise (one octava) with the average geometrical in diaposone of 2,000 Hz, at intensity level 100 dB. Six animals are subjected to a single effect for 6 h and 12--to repeated effect during 6 days running, 4-6 h daily. Isolation of both the vestibular and the cochlear parts of the membranous labyrinth is performed simultaneously. This gives a possibility to study all the receptors of the internal ear as a whole. Certain ultrastructural changes in all the vestibular receptors both at a single and repeated effects are revealed. Dilatation of the granular endoplasmic reticulum is observed, situating mainly in the basal part of the cell; swelling of mitochondria is accompanied with a sharp clearance of their matrix. In some mitochondria there is a local destruction of their external and internal membranes. Moreover, in cytoplasm of the receptory cells sharply osmiophilic fibrillar structures are revealed, they resemble crists and are arranged in bundles. In some cells they are not numerous and localize mainly in mitochondria, in others--their number is greater, and they localize not only in mitochondria, but in the surrounding cytoplasm, too. Similar structures are observed in some preganglionic myelin fibers. These phenomena can be considered as development of calcification processes. The changes described, evidently, form the basis of the vestibular disorders under the noise effect.