A benign form of chronic lympholeukemia]

According to the classification of chronic lymphocytic leukemia (CLL) proposed by A. I. Vorob'ev and M. D. Brilliant in 1983, benign CLL is a distinct form of CLL which is characterized by low level of absolute lymphocytosis, absent or mild peripheral lymphadenopathy, slow progression. No specific therapy is needed. The paper presents clinical, morphological and immunological analysis of 34 cases of benign CLL (17 males and 17 females, mean age 58 years). Patients were included in the study if they had lymphocyte count less than 30,000 and no significant growth of lymphoid tissue for at least 3 years. They were followed up from 3 to 24 years (11 years, on the average). The main features of benign CLL are the following: no "B" symptoms, no essential enlargement of the lymphoid organs, a stable low level of absolute lymphocytosis, low prolymphocyte count in the blood smear (0.95% +/- 0.2), nodular or nodular-interstitial proliferation in the bone marrow. We failed to find any cases with paraprotein secretion. There was immunophenotype typical for CLL in 91% of cases (CD19+, CD20+, CD23+, CD5+, EM+, CR1-/CR2+, sIg+(-)). None was positive for CD38 activation marker. One trisomy 12 cases was detected by FISH method. 8 patients died so far, but not because of the tumor progression or transformation, median survival was 22 years.     

Non-natural aglycones of glycopeptide antibiotics of the vancomycin group. Synthesis and antibacterial activity

A new approach for the modification of the heptapeptide core of glycopeptide antibiotics was proposed based on the replacement of amino acid residues in positions 1 and 3 in teicoplanin aglycone and in position 1 in the eremomycin aglycone. Six novel nonnatural aglycones of the vancomycin type were obtained. Compounds derived from the teicoplanin aglycone exhibited in vitro activity against Gram-positive bacteria, and two of them were also active against the vancomycin-resistant enterococci.     

Laboratory support of the State Sanitary and Epidemiologic Service under the new socioeconomic conditions

The results of experimental investigations to evaluate the adverse effects of metal-containing industrial waste on warm-blooded animals are presented. Acute experiments assessing the toxicity of industrial waste were not shown to be informative. Long-term exposure to different industrial wastes was found to have varying toxicity at the cell, organ, and body levels.     

The first original Russian class-III antiarrhythmic nibentan

The paper presents experimental and clinical findings of the new antiarrhythmic drug nibentan. The agent was found to be a class-III antiarrhythmic agent in terms of its electrophysiological effects and an inhibitor of the delayed rectifier potassium current in terms of its effects on the ionic channels of cardiomyocytes. The clinical trial of nibentan shows that the drug is highly effective (in 70-100% of cases) in patients with atrial flutter and fibrillation and in those with supraventricular tachycardia and it is less effective in suppressing ventricular premature contractions and tachycardia. The rate of arrhythmogenic effects produced by the drug was inversely related to its antiarrhythmic action. Nibentan has been approved for clinical use.     

Current aspects of the diagnosis and treatment of prostatic cancer]

Prostate cancer is becoming the most frequent malignant disease in men. Its present-day diagnosis in based on the combination of digital rectal examination, detection of the prostate-specific antigen in blood serum and multifocal transrectal biopsy of the prostate under ultrasonic control. The elevation of the level of prostate-specific antigen correlates with spread of the process and extracapsular penetration of the tumor. Asymmetry of the prostate and hypoechogenic foci represent the main ultrasonic signs of adenocarcinoma of the prostate. When the histological findings speak about the absence of atypical cells, another complex examination with rebiopsy is indicated in 6 months. The principal radical method of treatment of prostate cancer is prostatectomy performed mainly for the T1-T2 stages. At the preoperative period the neoadjuvant androgen deprivation can be performed in order to lessen the tumour volume and risk of a positive surgical margin.     

Corneal opacities in Gaucher disease

PURPOSE: To describe the corneal findings in a variant of Gaucher disease. METHODS: Case report. In an 18-year-old man, ophthalmic and general clinical evaluation, and enzymatic and molecular genetics studies were performed. RESULTS: Diffuse, well-defined, small, linear, or dotlike corneal opacities were observed through, out the posterior two thirds of the corneal stroma in both eyes. The patient had calcific valvular heart disease. Enzymatic and ultrastructural studies were consistent with Gaucher disease. Analysis of the glucocerebrosidase gene disclosed homozygosity for a D409H mutation. CONCLUSION: Corneal opacities are a distinguishing ocular feature of the variant of Gaucher disease associated with the D409H mutation and with calcific cardiac disease.     

Fusarium, a significant emerging pathogen in patients with hematologic malignancy: ten years' experience at a cancer center and implications for management

Despite increasing reports of life-threatening Fusarium infections, little is known about its pathogenesis and management. To evaluate the epidemiology, clinicopathologic features, and outcome of invasive fusariosis in patients with hematologic cancer, we conducted a retrospective study of invasive fusarial infections in patients with hematologic malignancy treated at a referral cancer center over a 10-year period (1986 to 1995), as well as a literature review. Forty patients with disseminated and three patients with invasive lung infection were included in the analysis. All patients were immunocompromised. The infection occurred in three patients postengraftment following bone marrow transplantation. All patients were diagnosed antemortem. Thirteen patients responded to therapy, but the infection relapsed in two of them. Response was associated with granulocyte transfusions, amphotericin B lipid formulations (four patients each), and an investigational triazole (two patients). Resolution of infection was only seen in patients who ultimately recovered from myelosuppression. Portal of entry was the skin (33%), the sinopulmonary tree (30%), and unknown (37%). Fusarium causes serious morbidity and mortality, and may mimic aspergillosis. The infection seems to respond to newer therapeutic approaches, but only in patients with ultimate recovery from myelosuppression, and it may relapse if neutropenia recurs.     

Effects of support++ loads and stimulation of CNS on functional activity of somatotrops and thyreocytes in suspended rats

A total of 3305 ill children and adults treated for skeletal diseases and lesions underwent primary and follow-up radiation studies. Patients with spinal diseases amounted to 72%, of them 58% were found to have neurological diseases, 28% had articular diseases. The examination of patients involved X-ray tomography, contrast myelotomography, computed tomography, and magnetic resonance imaging. Surgical and laboratory verifications of the diagnosis were made in 53% of adults and 78.5% of children. It is shown that there are difficulties in diagnosing and differentiating osteoarticular tuberculosis at present and X-ray tomography and contrast myelography are essential in diagnosing spinal diseases. Indications for computed tomography and magnetic resonance imaging, osteoscintigraphy and the sequence of their use in the diagnosis of diseases were defined. The paper emphasizes that an osteoarticulogist's assessment of complex data of radiation diagnosis is very important.