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Biomedical subjects

V G Savchenko

Publications and source records attributed to V G Savchenko.

At least 109 records · Page 6Linked to original sources

[The characteristics of the clinical course of lymphosarcomas in conformity with the morphological variants of the WHO and Working Formulation classifications].

Histological and cytological preparations of the lymph nodes, spleen, bone marrow and other tumors from 140 patients with different variants of lymphosarcomas were subjected to a comparative clinicomorphological analysis. The data obtained were correlated to the WHO classification and the working formulation of non-Hodgkin's lymphomas intended for clinical use. It has been found desirable that the working formulation may be used for predicting the disease course and elaboration of the programs of lymphosarcoma treatment.

Adolescent↗

[The effectiveness of plasmapheresis in treating long-term nonhealing gastroduodenal ulcers].

Plasmapheresis followed by reinfusion of unfrozen autologous plasma favours the healing of previously non-healing gastroduodenal ulcers refractory to the treatment with histamine H2-blockers. Comparative analysis of the use of plasmapheresis in patients with torpid and common relapses has shown that ulcer healing supervenes within the same time that is significantly shorter as compared to the time of gastroduodenal ulcer healing in the patients' group receiving medicamentous treatment alone.

Adult↗

[Generalized immune-complex vasculitis combined with pulmonary hemosiderosis and dilated cardiomyopathy].

The paper is concerned with observations over 3 patients in whom unusual vasculitis lay at the basis of the clinicopathological manifestations. All the patients were men of the young age. The disease debut was marked by fever, weakness, dyspnea, palpitation, cough, hemoptysis, the articulation syndrome. In two cases, there was hemorrhagic rash on the leg skin. All the patients manifested liver and spleen enlargement, two patients had lymphoadenopathy. The leading clinical symptoms included dilated cardiomyopathy, complete blockade of the inferior peduncle of His bundle and reduction of myocardial contractility. Anemia belonged to iron deficient one. The clinical examples provided indicate that immunocomplex vasculitis with evident lesions of the lungs and myocardium, not going into criteria for the known diseases, is not likely to be a casuistic rarity. Those syndromes may be associated with more or less pronounced hemosiderosis of the lungs (and, probably, of the lymph nodes, spleen and liver), with transitory or steady derangements of myocardial conduction, which attests to diffuse lesions of the myocardium possibly with both immune complexes and hemosiderin. The pathology requires further studies.

Adult↗

[Toxic complications in bone marrow recipients].

The authors provide the data on the rate and main clinical manifestations of toxic complications seen in bone marrow recipients in the early posttransplantation period. Analyze the causes of those complications. Give practical recommendations aimed at the prophylaxis of toxic complications and their early removal.

Adult↗

[Recombinant alpha-interferon (reaferon) in the treatment of patients with chronic myeloleukemia].

The authors relate the results of a clinical study of the Soviet recombination alpha-interferon (reaferon) in 46 patients with chronic myeloleukemia at different stages of the disease. Reaferon is shown to be tolerated well, to have a low percentage of side effects in particular high temperature and allergic reactions, to possess no hepato-, nephro- and cardiotoxicity. It has been proved that in patients with chronic myeloleukemia reaferon produces an independent antiproliferative effect and is capable of controlling the leukemic process without chemotherapeutic drug (in the stable chronic phase of the disease). Doses and administration of reaferon for a long time are suggested in order to prolong the disease course.

Antineoplastic Combined Chemotherapy Protocols↗

[The comparative efficacy of splenectomy and antilymphocyte globulin therapy in patients with aplastic anemia].

Analysis of the clinical efficacy and long-term survival of patients with grave and not grave forms of aplastic anemia, subjected to splenectomy or treated with antilymphocytic globulin has shown that in grave aplastic anemia, the clinical efficacy of antilymphocytic globulin is higher than the efficacy of the operative treatment methods. The 30-month survival can be attained in 42% of the patients given globulin and in 28% of the patients after splenectomy. In patients with grave aplastic anemia, it is recommended that the treatment be instituted from the use of antilymphocytic globulin in a dose of 15 mg/kg bw daily for 5 days, provided there are no contraindications. In patients with not grave aplastic anemia, the results of splenectomy and therapy with antilymphocytic globulin are approximately the same: the 5-year survival amounts to 94 and 93%, respectively. Therefore, the use of globulin may be recommended as a method of choice for the above patients' group, since surgical approaches to the treatment are still coupled with a high risk for the patient's life.

Actuarial Analysis↗

[The results of 5 years' use of a method for heparin cryoprecipitation of plasma proteins (selective plasmapheresis) in patients with an immune-complex pathology].

The paper treats the results of the 5-year use of plasma protein heparin cryoprecipitation (selective plasmapheresis) (SPA) in patients with immune complex pathology. The method consists in the removal of fibronectin and bound complement components, cryoglobulins, cryofibrinogen, circulating immune complexes (CIC), and other gross-dispersed proteins in the presence of heparin in the cold. The SPA was applied to 122 patients with immune complex diseases and syndromes. Altogether 1279 procedures were carried out. The method turned out effective in 80% of patients with hemorrhagic vasculitis, systemic lupus erythematosus, rheumatoid arthritis, and other types of vasculitis. The changes in the blood serum concentration of immune complexes correlated with the time-course of changes in the clinical and laboratory parameters. The SPA efficacy was in agreement with the reduction in the level of immune complexes. Provided 2-3 procedures were carried out a week, the lowering of the level of immune complexes and other laboratory parameters marking the degree of inflammation could be seen by procedures 4-6. Therefore, to attain a stable clinical effect, its is necessary to perform not less than 6 SPA procedures. It has been demonstrated that SPA can be used an unlimited number of times, for the use of the method does not entail the development of plasma protein deficiency. This circumstance is of paramount importance for the treatment of chronic relapsing immune complex diseases.

Adolescent↗

[Apheresis of euglobulins, cryoglobulins and the von Willebrand factor in vasculitis].

A method of apheresis of plasma euglobulin fraction, cryoglobulins and Willebrand factor was developed. In one session of plasmapheresis 1500-1700 ml of patient's plasma were removed, fractionated and returned. The method was used in 2 patients with immune complex vasculitides. In one of them the disease developed against a background of chronic active hepatitis, in the other patient it manifested itself in cryoglobulin- and cryofibrinogenemia. Clinical improvement was noted in both cases: the absence of myalgia, arthralgia, hemorrhagic eruption, and ulcerative-necrotic skin changes. The normalization of increased ristomycin-cofactor activity of Willebrand factor and CIC levels was noted in one case. A decrease in the content of plasma cryoglobulins, cryofibrinogen, and urine protein concentration (from 1.5 up to 0.03%) was noted in the other case. A possibility of the use of the method in other pathological conditions (DIC-syndrome, unstable angina, atherosclerotic angiopathy) accompanied by endothelial damage, was discussed. Willebrand factor multimers form complexes with low density lipoproteins therefore the removal of these complexes may be useful in the treatment of hypercholesteremia and atherosclerosis.

Chemical Precipitation↗

[Effect of cryoapheresis on the course of immune complex diseases].

The paper is concerned with an analysis of the results of the method of cryoheparinoprecipitation of plasma proteins in patients with immune complex pathology. The essence of the method is that in plasma cooling cryofibrinogens, cryoglobulins, immune complexes and other components of the complement system aggregate and precipitate. The process is potentiated by adding heparin to the plasma. After removal of cryoproteins the plasma is frozen and returned to a patient during a session of plasmapheresis. The method makes it possible to give up the use of various protein preparations as substitutes. It was applied to 90 patients: 52 females and 38 males aged 15 to 64. The total number of plasmapheresis sessions was 831, an average of 6 sessions per patient; repeated sessions were performed in 20 patients in different time-intervals. Indications for therapy were the absence of a response to routine drug therapeutic methods for a long period of time and steroid-related complications. Cryoapheresis was applied to 18 patients with hemorrhagic vasculitis. Signs of the abdominal, dermal and articular syndrome were eliminated in all the patients; the urinary syndrome was retained in half of the cases necessitating other therapeutic modalities. A CIC level investigated by a method of precipitation with 3.5% polyethylene glycol was not a criterion of assessment of the gravity of diseases: in cases of its increase before therapy initiation there was a clear tendency to a decrease and normalization by the end of treatment. In hemostasis investigation hypercoagulation activation and hyperfibrinogenemia were revealed in most of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Treatment of gastroduodenal ulcer by plasmapheresis and transfusion of thawed-out autologous plasma].

Curative plasmapheresis was performed in 21 patients with duodenal ulcer (DU) and in 3 patients with gastric ulcer (12 DU patients and 3 patients with gastric ulcer were taken as controls). The controls were treated by common pharmaceuticals (except Tagamet). Altogether 117 sessions of plasmapheresis were performed (an average of 5 sessions for each patient 2-3 times a week). Fibrogastroscopy was performed before and after a series of plasmapheresis (2-3 weeks after the start of therapy). In the DU patients treated by plasmapheresis ulcer cicatrization occurred in 18 days, in the controls in 27 days (p less than 0.001). In 3 patients with gastric ulcer treated by plasmapheresis cicatrization occurred on the 24th day, in the controls on the 41st day (p greater than 0.2). This method was proposed for patients with severe conditions due to the fact that a positive effect was also obtained in persons with persistently recurrent ulcers.

Adult↗

[Effect of the method of extracorporeal heparin precipitation of plasma proteins (selective plasmapheresis) on the level of immune complexes in the blood].

A study was made of the effect of selective plasmapheresis (SPP) on the concentration of circulating immune complexes (CIC). The method is based on precipitation at 4 degrees C of plasma fibronectin and associated macromolecular complexes by means of heparin. Sterile plasma of the patient is separated from the precipitate, frozen and kept at -20 degrees C till the next plasmapheresis during which it is returned to the patient instead of the donor's one. All 15 patients examined were exposed to 6 SPP with an interval made every 2 to 5 days. Six patients were diagnosed to have rheumatoid arthritis, 2 systemic lupus erythematosus, 3 hemorrhagic microthrombovasculitis, and 4 multiple sclerosis. The concentration of CIC was measured by precipitation with 3.5% polyethylene glycol before and after SPP, in some cases between sessions. All the patients with rheumatoid arthritis and systemic lupus erythematosus and 2 out of the 3 patients with hemorrhagic vasculitis showed an elevated content of CIC (greater than 0.150 Units OD). The CIC content appeared normal in all the patients with multiple sclerosis. After SPP 4 patients manifested a reduction in the CIC concentration, whereas in 6 it returned to normal. Such a time course correlated with the improvement of other clinical and laboratory findings. It was established that after the first session of SPP the CIC content sharply declined followed by a gradual increment and exceeded the initial values toward the beginning of the second session. After the second SPP the patients manifested the same tendencies. The CIC content reached a maximum by the third SPP and then fell from session to session.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Clinical effectiveness of the method of extracorporeal heparin precipitation of plasma proteins (selective plasmapheresis) in patients with immune complex pathology].

The authors analyse the efficacy of extracorporeal heparin precipitation of plasma proteins (selective plasmapheresis) in patients with immune complex pathology. The method lies in extracorporeal precipitation at +4 degrees C of fibronectin, cryofibrinogen and other macromolecular complexes with the aid of heparin, followed by plasma return to the patient. The method was applied to 39 patients. Hemorrhagic microthrombovasculitis was diagnosed in 7, vasculitis paralleled by hepatosplenomegaly of unclear genesis in 1, generalized vasculitis with marked systemic manifestations in 1, immune complex vasculitis complicated by recurrent polychondritis in 1, chronic active hepatitis associated with immune complex vasculitis in 1, rheumatoid arthritis in 8, systemic lupus erythematosus in 4, spleen lymphoma and Sjögren's syndrome in 1, idiopathic amyloidosis in 2, multiple sclerosis in 10 patients. Altogether 309 sessions of selective plasmaphapheresis were carried out. The time course of the clinical and laboratory criteria of the disease activity were studied before and after each plasmapheresis session. It was ascertained that the method is highly effective in the treatment of hemorrhagic vasculitis. It is mostly used if conventional therapy with heparin, cryoplasm, and deaggregating agents appears abortive. Apparently, it is the only method that may rapidly arrest the abdominal syndrome associated with hemorrhagic vasculitis. The possibility and advisability of the use of chronic plasmapheresis are discussed. Application of the method to the treatment of rheumatoid arthritis permits reducing the dose of steroid hormones, thereby not stimulating the disease activity. The method is the therapy of choice in different diseases associated with polyvalent allergy. In amyloidosis and multiple sclerosis, the method efficacy is questionable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Plasma fibronectin level in patients with depression of hematopoiesis].

Plasma fibronectin is regarded to play an important part in a decrease of the resistance to infections. To specify the role of fibronectin in the pathogenesis of infectious complications in patients with depressions of hemopoiesis, the content of this opsonin was measured by ELISA in 113 patients with different patterns of hemoblastoses, lymphoproliferative diseases and with an aplastic syndrome. In 42 patients, the concentration of opsonin was measured in the presence of the superimposed infection of varying gravity. The fibronectin content was examined in 39 patients before, during and after completion of the cytostatic polychemotherapy. It turned out that in patients with paraproteinemic hemoblastoses, lymphogranulomatosis, aplastic anemia, chronic lympholeukemia, acute lympho- and myelo(mono)blastic leukemias, cyclic neutropenia, chronic myelosis and hematosarcomas, the concentration of fibronectin remained normal in the absence of infections. The computation of the linear correlation ratio did not reveal any association between the opsonin level and the concentration of neoplastic elements in the peripheral blood. Repeated measurements of the fibronectin level in patients whose underlying disease ran its course in association with marked neoplastic fever failed to detect any deficiency of the glycoprotein. The lowering of the fibronectin level was recorded in patients with a grave concomitant infection of the type of sepsis, necrotic enteropathy and lobar pneumonia. The degree of opsonin deficiency correlated with the patients' disease gravity. Prolonged reduction in the blood fibronectin level was of unfavourable prognostic importance. Cytostatic polychemotherapy, myelotoxic agranulocytosis as well as infectious complications of low gravity did not influence the concentration of fibronectin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Changes in fibronectin concentration during therapeutic plasmapheresis. Therapeutic effectiveness of selective removal of fibronectin in immune complex pathology].

Variation in the concentration of plasma fibronectin (FN) seen during 65 sessions of therapeutic plasmapheresis was studied in 20 inpatients with the following diagnoses: acute leukemias (4), paraproteinemic hemoblastoses (5), Sjögren's syndrome (2), protracted septic endocarditis (1), systemic lupus erythematosus (17), acute polyradiculoneuritis (1), multiple sclerosis (3). The patients' age ranged within 19 to 64 years. There were 10 men and 10 women. The concentration of FN in 218 plasma samples was measured by the ELISA. It was discovered that plasma of healthy donors contained 200 to 400 micrograms/ml FN (M +/- 1.5 sigma). Prior to plasmapheresis the glycoprotein content in all the patients was on the average within normal (300 micrograms/ml). After the session the concentration of FN decreased almost two-fold (130 micrograms/ml); after 6 hours it was 175 micrograms/ml on the average, whereas after 24-48 hours it reached the initial level. Repeated plasmapheresis sessions carried out once every 3-4 days did not lead to the depletion of the FN pool, since its level reached the initial one over the first 24-48 hours. Such a mechanism was unchanged regardless of the initial level of FN recorded in the patients blood (high, normal or low). No relationship was found between FN deficiency which developed after plasmapheresis and infectious complications. It is assumed that FN deficiency per se cannot be responsible for the patients' decreased resistance to infection. Three patients received a series of selective plasmapheresis. Sjögren's syndrome and immune complex vasculitis was diagnosed in one female patient, hemorrhagic vasculitis due to chronic hepatitis in another female patient, the third female patient manifested gammapathy with cryoglobulinemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗