Experimental Study of the Efficacy of Sodium Deoxyribonucleate Used in Combination with Co-Transplantation of Mesenchymal and Hematopoietic Stem Cells after Exposure to γ-Radiation

We studied the possibility of using sodium deoxyribonucleate (Derinat) for improving the efficiency of co-transplantation of mesenchymal (MSC) and hematopoietic stem cells (HSC) to female F1(CBA×C57BL/6) mice with bone marrow aplasia caused by exposure to γ-radiation. It was found that immunomodulator Derinat enhanced the effect of co-transplantation, in particular, triple post-irradiation administration of Derinat accelerated hematopoiesis recovery judging from the parameters of peripheral blood, total cellularity of the bone marrow and spleen, and animal survival. Single or double administration of Derinat prior to irradiation was ineffective. The optimal result was obtained when the following scheme was applied: MSC→HSC with an interval of 48 h starting during the first hours after irradiation and triple administration of Derinat (in 10-15 min, 3 and 7 days after irradiation) in a dose of 3 mg/mouse.

Effect of Different Regimens of Co-Transplantation of Hemopoietic and Mesenchymal Hemopoietic Stem Cells on the Rates of Hemopoietic Recovery in Laboratory Mice Treated with Cyclophosphamide in Sublethal Doses

We studied the effect of mesenchymal stem cells and hemopoietic stem cells co-transplanted in different regimens (sequence and intervals between the injections within 0-48 h) on the rate of the bone marrow hemopoiesis recovery in 468 inbred mice with cytostatic aplasia caused by a single injection of cyclophosphamide in a dose of 500 mg/kg. The efficacy of stem cells was evaluated by animal survival and general physical condition, body weight dynamics, peripheral blood counts (leucocytes, platelets, and reticulocytes), total cellularity and the presence of hemopoietic stem cells in the bone marrow on day 9 after cyclophosphamide injection. The relative content of hemopoietic stem cells in the total myelokaryocyte pool was assessed by flow cytofluorometry using specific monoclonal antibodies to CD117 and CD184. The stimulating effect of co-transplantation of mesenchymal stem cells and hemopoietic stem cells on hemopoiesis was demonstrated by the indices of total cellularity and the relative content of CD117⁺ hemopoietic stem cells. The schemes with injection of mesenchymal stem cells 24-48 h prior to injection of hemopoietic stem cells were most effective.

Experimental study of the antibacterial activity of the lytic Staphylococcus aureus bacteriophage ph20 and lytic Pseudomonas aeruginosa bacteriophage ph57 during modelling of its impregnation into poly(methylmetacrylate) orthopedic implants (bone cement)

Background: The problem of bacterial colonization of implants used in medical practice continues to be relevant regardless of the material of the implant. Particular attention deserves polymeric implants, which are prepared ex tempore from polymethyl methacrylate, for example - duting orthopedic surgical interventions (so-called "bone cement"). The protection of such implants by antibiotic impregnation is subjected to multiple criticisms, therefore, as an alternative to antibiotics, lytic bacteriophages with a number of unique advantages can be used - however, no experimental studies have been published on the possibility of impregnating bacteriophages into polymethyl methacrylate and their antibacterial activity assessment under such conditions.Aims: to evaluate the possibility of physical placement of bacteriophages in polymethylmethacrylate and to characterize the lytic antibacterial effect of two different strains of bacteriophages when impregnated into polymer carrier ex tempore during the polymerization process in in vitro model.Materials and methods:  First stage - Atomic force microscopy (AFM) of polymethyl methacrylate samples for medical purposes was used to determine the presence and size of caverns in polymethyl methacrylate after completion of its polymerization at various reaction  temperatures (+6…+25°C and +18…+50°C).The second stage was performed in vitro and included an impregnation of two different bacteriophage strains (phage ph20 active against S. aureus and ph57 active against Ps. aeruginosa) into polymethyl methacrylate during the polymerization process, followed by determination of their antibacterial activity.Results: ACM showed the possibility of bacteriophages placement in the cavities of polymethyl methacrylate - the median of the section and the depth of cavities on the outer surface of the polymer sample polymerized at +18…+50°C were 100.0 and 40.0 nm, respectively, and on the surface of the transverse cleavage of the sample - 120.0 and 100.0 nm, respectively, which statistically did not differ from the geometric dimensions of the caverns of the sample polymerized at a temperature of +6…+25°C.The study of antibacterial activity showed that the ph20 bacteriophage impregnated in polymethyl methacrylate at +6…+25°C lost its effective titer within the first six days after the start of the experiment, while the phage ph57 retained an effective titer for at least 13 days.Conclusion: the study confirmed the possibility of bacteriophages impregnation into medical grade polymethyl methacrylate, maintaining the effective titer of the bacteriophage during phage emission into the external environment, which opens the way for the possible application of this method of bacteriophage delivery in clinical practice. It is also assumed that certain bacteriophages are susceptible to aggressive influences from the chemical components of "bone cement" and / or polymerization reaction products, which requires strict selection of bacteriophage strains that could be suitable for this method of delivery.

[ASSESSMENT OF ENERGY NEEDS AND THE ROLE OF NUTRITIONAL SUPPORT IN SENILE PATIENTS WITH INTESTINAL FAILURE IN ORTHOPEDIC SURGERY OF HIGH RISK]

The study of anamnestic, clinical, laboratory, endoscopic, morphological parallels of senile patients in knee and hip joints prosthesis shows the presence of intestinal failure while perioperative period. A direct connection between a natural intestinal and immune dysfunction and nutritional deficiency was diagnosed. The use of nutritional-metabolic correction of comorbid pathology and determination of basal metabolism in the perioperative period enabled to normalize indicators of homeostasis, microflora of the colon, indicators of immune status, and get a reduction in the number of early postoperative complications.

Magneto-Stark effect of excitons as the origin of second harmonic generation in ZnO

The magneto-Stark effect of excitons is demonstrated to be an efficient source of optical nonlinearity in hexagonal ZnO. Strong resonant second harmonic generation signals induced by an external magnetic field are observed in the spectral range of 2s and 2p excitons. The microscopic theoretical analysis shows that for excitons with a finite wave vector, exciton states of opposite parity are mixed by an effective odd parity electric field induced by the magnetic field despite its even parity. The field, spectral, and polarization dependencies of the second harmonic generation intensity validate the proposed mechanism. The observed phenomenon is not limited to a certain symmetry class and therefore must be effective in other semiconductors.

[Molecular-biological properties of blood lymphocytes of Hodgkin's lymphoma patients. Plausible possibility of treatment effect prognosis]

Hodgkin's lymphoma (HL) patients were investigated before and during chemical and radiation therapy. The properties of peripheral blood lymphocytes of the HL patients before treatment have been compared with healthy donors and the patients during the treatment. The genetic damage--frequency of cells with micronuclei (MN), the level of DNA single- and double-strand breaks (SSB and DSB), DNA-protein cross-links (DPC) have been studied. Biochemical and physiological parameters have been compared as well: the concentration of reactive oxygen species (ROS), the ability to the adaptive response induction. The radiosensitivity of lymphocytes in vitro exposed to the 1 Gy irradiation has also been determined (by MN test). It was shown that in Hodgkin's lymphoma patients' lymphocytes (in comparison with healthy donors) the frequency of cells with MN does not change, the level of SSBs and DSBs increases, the amount of DPC does not change, and ROS concentration (on average) significantly increases because of the part of the population that have high ROS content. The ROS concentration decreases to control level, the frequency of cells with MN increases, the level of DSBs does not change but the level of DPCs (which prevents the determination of DSB) increases in the patients during treatment. It was also discovered that lymphocyte radiosensitivity correlates with the MN cells frequency before treatment and the ROS concentration. These results make it possible to suppose that the high MN frequency and high ROS concentration in Hodgkin's lymphoma patient lymphocytes (before treatment) can serve as prognostic factors for the effectiveness of radio and chemical therapy.

[Criteria of antibacterials choice for prophylaxis and therapy of implant-associated infections in prosthetic joints]

Prosthetic joints infection is a serious medical, social and financial problem. Significant achievements in prophylaxis of such infections are well known. In cases of primary endoprosthetics of large joints, the frequency of infection in the leading world clinics is 0.5-2%. However, the approaches to the treatment of such infections are different especially with respect to the antibacterial therapy: choice of drugs, administration routes, treatment course and discontinuation. Under conditions of global growth of resistance in nosocomial pathogens, the choice of antimicrobials requires consideration not only of the formal susceptibility criteria, but also of the pharmacokinetic and pharmacodynamic indices.

Study of nonrandom chromosome aberrations in bone marrow and blood cells of patients with non-Hodgkin's lymphomas

Complete karyotyping of G-stained chromosomes of bone marrow and blood cells was carried out in patients with non-Hodgkin's lymphomas before and after antitumor therapy, in remissions and relapses. Clones with 1q41-43, 2q35, and 6q24-27 deletions were most incident. Their incidence in patients increased after antitumor therapy.

[Molecular-cellular characteristic of blood lymphocytes in Hodgkin lymphoma]

The molecular-cellular parameters complex has been studied on the blood lymphocytes of malignant Hodgkin's lymphoma (HL) patients: the frequency of cells with micronuclei (MN) and chromosome aberrations; the level of DNA single and double strand breaks - OR and DR DNA (DNA comet assay), oxidative status--the content of reactive oxygen species (ROS) by using nonfluorescent dye that is oxygenated in the cells to fluorescent reagent and detection of fluorescence intensity after there. It was shown that the patients with LH had the increased level of DR and OR DNA, the increased frequency of cells with chromosome aberrations and the number of aberrations per cell was increased too. The concentration of ROS is increased too for the most individuals with intoxication. In the process of the chemical and radiation therapy the increase of OR DNA level, the frequency of the cell with MN has been registered. The ROS concentration correlates with the level of DNA-strand breaks. So the blood lymphocytes of HL patients before treatment differ from the lymphocytes of healthy donors. The damage of genome and the change of oxidative status have been observed that can be additive markers for the HL diagnosis, their sensitivity to the treatment and the characteristic of lymphocytes changes by this disease.

Spin-induced optical second harmonic generation in the centrosymmetric magnetic semiconductors EuTe and EuSe

Spectroscopy of the centrosymmetric magnetic semiconductors EuTe and EuSe reveals spin-induced optical second harmonic generation (SHG) in the band gap vicinity at 2.1-2.4 eV. The magnetic field and temperature dependence demonstrates that the SHG arises from the bulk of the materials due to a novel type of nonlinear optical susceptibility caused by the magnetic dipole contribution combined with spontaneous or induced magnetization. This spin-induced susceptibility opens access to a wide class of centrosymmetric systems by harmonics generation spectroscopy.

[The analysis of chromosome lesions in lymphocytes of Hodgkin's lymphoma patients after chemotherapy and radiation therapy]

The analysis of chromosome lesions in peripheral blood lymphocytes of Hodgkin's lymphoma (HL) patients after chemotherapy and chemotherapy with the subsequent course of radiation therapy is carried out. Is shown, that the mean aberration frequency was significantly higher in HL patients after chemotherapy (7.20 +/- 0.58 per 100 metaphases) than in non-treated HL patients (4.80 +/- 0.54, p < 0.01). The subsequent carrying out of radiation therapy enlarges number of chromosome aberrations on 100 metaphases up to 46.7 +/- 10.7 (p < 0.05), of which chromosome-type aberrations (43.2 +/- 10.3 on 100 metaphases) averaged 92.5%. In lymphocytes of 37 out of 43 HL antitumoral treatment patients, we found, in addition to ordinary aberrant cells, a large number of multiaberrant (MA-cells) cells, i.e. metaphases carrying multiple (at least four) chromosome-type exchange aberrations. In 30 non-treated HL patients only one MA-cell was found. From 171 MA-cells which were in 43 HL patients after antitumoral treatment, 114 MA-cells were found at inspection of 9766 diploid metaphases, and the remaining 57 MA-cells were found at inspection of 196 polyploid metaphases. The carrying out after chemotherapy of radiation therapy enlarges in lymphocytes frequency of appearance of MA-cells. The analysis of MA-cells in diploid and polyploid metaphases shown, that the MA-cells could be formed both in vivo, and in vitro in absence of influence of clastogenic factors, and could survive at least two rounds of in vitro replication.

Ultrafast optical pumping of spin and orbital polarizations in the antiferromagnetic Mott insulators R(2)CuO(4)

We demonstrate that optical pumping by circularly polarized light at the charge-transfer transition can induce spin and orbital polarizations in the strongly correlated Mott insulators R(2)CuO(4) (R=Pr, Nd, Sm) providing a means of ultrafast nonlinear manipulation of spin states on time scales of less than 150 fs. We propose a model which includes both orbital- and spin-related processes possessing different spectral and temporal properties. This allows us to model the optical response of antiferromagnetic Mott insulators to circularly polarized light and estimate the spin relaxation time as tau(s) approximately 30-50 fs.

Dolphin skin as a natural anisotropic compliant wall

Although the success of compliant walls in mimicking dolphin skin is well known, the drag-reducing properties of a dolphin's skin are still unclear. Moreover, little is known about the relation between the 3D structure of the skin and the local flow conditions. To study the role of a dolphin's skin in reducing the drag the skin morphology parameters were compared with the parameters of an anisotropic compliant wall and a possible flow-skin interface was considered. The 3D structure of skin from different locations was modelled using serial histological sections of the skin. The hydrodynamics of the dorsal fin of the harbour porpoise was studied by means of computer simulation of the flow around virtual models of the fin. It was found that the distribution of the skin morphology parameters is correlated with the local flow parameters on the fin surface. The skin structure appears to allow the flow-skin interface to behave similar to an anisotropic compliant wall in the regions of favourable and adverse pressure gradients on the fin. The relation founded between the skin morphology and the local flow parameters could be useful in the design of multipanel anisotropic compliant walls.

Spin and orbital quantization of electronic states as origins of second harmonic generation in semiconductors

Basically different mechanisms of optical second harmonic generation (SHG) in semiconductors, induced by an external magnetic field H, have been identified experimentally by studying the diluted magnetic semiconductor (Cd,Mn)Te. For paramagnetic (Cd,Mn)Te the SHG response is governed by spin quantization of electronic states, in contrast with diamagnetic CdTe with its dominating orbital quantization. The mechanisms can be identified by the distinct magnetic field dependence of the SHG intensity which scales with the spin splitting in the paramagnetic case as compared to the H2 dependence observed for the diamagnetic case.

[Low-dose accelerated hyperfractionated radiotherapy for local control of chemoresistant Hodgkin's disease (a prospective randomized trial)]

The results are evaluated of the combined treatment of 154 patients with relapsed refractory Hodgkin's disease, which was conducted using standard dosage of conventional chemotherapy. Out of those, 117 with residual lesions were randomized to receive either focal radiotherapy (20-24 Gy) in accelerated hyperfractionation (1.3-1.5 Gy, twice a day, at 5-hr interval) or 38-40 Gy in standard fractionation. Local control persisted in 85-97% of irradiated sites (median follow-up of 24 months), irrespective of irradiation technique. TTD being lowered down to 20-24 Gy due to use of accelerated hyperfractionation, the frequency of late-onset radiation injuries of paramediastinal lung tissue was lower than in standard treatment, with a subsequently lower fraction of patients with stage II fibrosis.

Magnetic-field-induced second-harmonic generation in semiconductor GaAs

We show that application of a magnetic field induces optical second-harmonic generation (SHG) in GaAs. This phenomenon arises from field-induced symmetry breaking causing new optical nonlinearities. A series of narrow SHG lines is observed in the spectral range from 1.52 to 1.77 eV that we attribute to Landau-level quantization of the band energy spectrum. The rotational anisotropy of the SHG signal distinctly differs from that of the electric-dipole approximation. Model calculations reveal that nonlinear magneto-optical spatial dispersion that comes together with the electric-dipole term is the dominant mechanism for this nonlinearity.

[Optimization of isolation of the concentrate of stem cells from the umbilical blood]

AIM

To study correlations between body mass and height of the newborn, Apgar scale estimates, gestation time, volume of the obtained umbilical blood (UB), number of nucleated cells (NC); to compare manual and automatic modes of UB processing.

MATERIAL AND METHODS

330 procurements of UB were made, 230 (69.7%) samples were frozen. Comparison of 2 techniques of UB processing was made in 73 cases of double centrifugation with hydroxyethylstarch (HES) and 47 cases of using separator Sepax (Biosafe, Switzerland). Blood cell count before and after UB processing and number of CD34+ cells were estimated.

RESULTS

A correlation analysis was made of dependence of the volume of 102 samples of UB on the weight (r = 0.268, p < 0.01) and height of the fetus (r = 0.203, p < 0.05), estimation by Apgar scale (r = -0.092, p < 0.1) and gestation term (r = -0.003, p > 0.1); analysis of the number of NC dependence on the volume of UB (r = 0.102 p < 0.1), mass (r = 0.073 p > 0.1) and fetus height (r = 0.121 p > 0.1), gestation time (r = 0.159 p > 0.1), Apgar scale assessment (r = -0.174 p > 0.1). In manual UB management NC yield made up 71.9 +/- 6.7%, in automatic--81 +/- 8.0% (p < 0.05). Percent of erythrocytes removal was 73 +/- 5.7% and 80.5 +/- 6.1% (p < 0.05), respectively.

CONCLUSION

A weak correlation was found between UB volume, mass and height of the fetus. The number of NC in UB depends on none of the parameters. Automatic processing of UB provides a greater release of NC and better elimination of erythrocytes in minimal risk of contamination.

[Some pathophysiological aspects of hyperthermic pharmacotherapy and its clinical use]

The use of artificially induced general controllable hyperthermia (GCH) of high degree is acknowledged as the 21st century intensive technology; it is used in the treatment of diseases and conditions that can be hardly cured by routine methods. Pathogenetic pharmacotherapy was made use of to enhance, purposefully, the GCH efficiency. The suggested concept, i.e. reproduction of the most efficient use of positive effects from high temperature and thermally mediated effects of pharmacotherapy, was named as "hyperthermic pharmacotherapy". The controllable maintenance of the "biological zero" phenomenon in the brain (registered by EEG) at 42-44 degrees C is the safety criterion of high-level GCH. The described intensive-care technique can be referred to as promising considering the modern anesthesiological-management potentialities related with GCH safety.

[Use of thymodepressin for treating autoimmune cytopenia]

AIM

To study influence of thymodepressin on the course of autoimmune cytopenia.

MATERIAL AND METHODS

Thymodepressin is a new synthetic hemoregulatory dipeptide (gamma-D-Glu-D-Trp). It was used for the treatment of 22 patients with autoimmune cytopenia.

RESULTS

Hemoglobin levels were elevated in autoimmune hemolytic anemia and platelet levels were high in idiopathic thrombocytopenic purpura. A thymodepressin course resulted in a fall of total lymphocyte count and activated CD3+CD69+ lymphocytes.

CONCLUSION

The above results, safety, absence of toxicity and allergenicity, parenteral and intranasal useability open perspectives for further studies of therapeutic action of thymodepressin as an immunodepressant in autoimmune processes.

Agar cultures of human clonogenic hemopoietic precursor cells for early diagnosis of some myeloproliferative diseases

Growth characteristics of human hemopoietic cells in erythremia and chronic myeloid leukemia were studied using agar cultures with and without hemopoietic growth factors. Agar cultures, similarly to cultures on other semisolid media (plasma clot, methylcellulose) can be used for early differential diagnosis of polycythemia vera (erythremia) and secondary erythrocytosis: erythremia, but not erythrocytosis, is characterized by spontaneous (erythropoietin-independent) formation of colonies from erythrocyte precursor cells. Spontaneous colony formation from granulocyte-macrophage precursor cells can serve as an important test for early diagnosis of chronic myeloid leukemia. The study of colony formation from granulocyte-macrophage precursors and of the capacity of bone marrow cells to form colonies from hemopoietic stromal precursor cells revealed new characteristics of the studied myeloproliferative diseases. Presumably, spontaneous colony formation from erythrocytic and myeloid precursors should be regarded as a sign of tumor transformation of the studied hemopoietic cells.

Second harmonic generation in the centrosymmetric antiferromagnet NiO

In spite of the fact that inversion is a symmetry operation of both the crystalline and the magnetic lattice of NiO, second harmonic generation (SHG) has been observed below the Néel temperature. A spectroscopic study shows that the signal is due to combined magnetic-dipole and electric-dipole transitions between the (3d)(8) levels of the Ni(2+) ion in the crystal field. The SHG is resonant in both the incoming and the outgoing light waves and thus greatly enhanced. A quadratic coupling of the nonlinear polarization to the order parameter was found. This allows the investigation of individual domains.

[Marriage in old age groups (medico-social aspects)]

Recently married elderly people change attitude to hospital treatment and living in asylums; they prefer care rendered at home and hospital-substituting forms of care; hospitalization and ambulance care are less needed and permanent social workers are required less. All this promotes rational utilization of the potentialities of therapeutic institutions and saving of public health and social protection resources.

[Organization of medical and social hospital care of elderly persons in Russia]

Hospital forms of medicosocial care of elderly and senile subjects in Russia are reviewed on the basis of published reports and authors' data. Together with outpatient forms, hospital forms of care of the elderly have been widely used of late and are functioning within the framework of public health and social protection systems. Integration of medical and social services in the sphere of health protection of the elderly is emphasized.

[Development of hospital-substituting forms of medical care in the Samara region]

Development of hospital-substituting forms of medical care in the Samara region is discussed, 13% of patients treated at hospitals were rendered medical care through hospital-substituting institutions, which resulted in economy of 137 million roubles. The authors make their suggestions on optimizing statistical forms of files and records to be used in registration of medical care at day-time hospitals.

Determination of the magnetic symmetry of hexagonal manganites by second harmonic generation

Optical second harmonic spectroscopy is introduced as a powerful supplement for the determination of complex magnetic structures. Experimental efforts are simplified and new degrees of freedom are opened. Thereby, some principal or technical restrictions of neutron or magnetic x-ray diffraction experiments are overcome. High spatial resolution leads to additional information about magnetically ordered matter. As an example, the noncollinear magnetic structure of the hexagonal manganites RMnO3 ( R = Sc, Y, Ho, Er, Tm, Yb, Lu) is analyzed. The results show that some earlier conclusions on their magnetic symmetry and properties should be revised.

[The outpatient forms of the organization of social medical care for older persons in Russia]

Presents data on the non-hospital forms of medicosocial care of elderly and senile subjects in the Russian Federation, which proved to be the most effective as regards the economy and staff under conditions of the population aging.

[Emission tomography in the diagnosis of ischemic heart disease]

Myocardial perfusion scintigraphy was made at rest and during bicycle ergometer exercise to diagnose coronary heart disease (CHD), to define the site and extent of left ventricular aneurysms, and to determine the compensatory potentialities of coronary circulation, to evaluate the efficiency of drug therapy. This was performed on a two-detector emission tomograph by using 99mTc. The data obtained were processed by two protocols: 1) tomographic heart specimens and 2) large protruding eye. In patients with a questionable diagnosis, the method evidenced stenotic coronary arteries in 60% of cases and exclude coronary abnormality. In CHD patients, exercise testing could reveal the extent of resting perfusion defects and new defects, i.e. define the reserve potentialities of coronary circulation, which is of great prognostic value. The site and extent of lesions were specified in extensive myocardial cicatricial lesions and left ventricular aneurysms.

[Complications of indirect lymphotropic therapy in patients with suppurative wounds]

With the aim to reveal the frequency of complications in indirect lymphotropic therapy, retrospective analysis of 2136 case records of patients with festering wounds was carried out. In 1.59% of patients the following complications in the area of introduction of preparation were detected: protracted oedemas of hands and feet, severe painful syndrome, infiltration, necroses of soft tissues and the areas of atrophy and aseptic inflammation. Most commonly the complications arose in patients with peripheral circulation disturbances. The authors suggested this method of treatment to be contraindicated in peripheral blood flow disturbances and before its application the additional examination for revealing vascular disturbances is obligatory. In cases of painful syndrome, oedema, infiltration, hyperemia in the area of introduction of the drugs one day after the injection, indirect lymphotropic therapy should be discontinued.

[Complications of sorption-application therapy of purulent wounds]

A retrospective analysis of 187 case records was made for elucidation of the frequency of development of complications in sorption-applicational treatment of festering wounds. It was revealed that late after strewing sterile sorbent into the wound in 6.4% of patients the development of fistulas and going out of preparation granules though fistula occurred. It is concluded, that sorbent's granules incapsulate together with living microorganisms adsorbed on their surface. For prevention of this complication the corbent is recommended to be introduced into the wound in small porous containers, which provide quick replacement of the preparation during wound dressing and its complete elimination in the end of healing.

[Method of medicamentous saturation of lymphatic system]

Data of experimental study in 18 mongrel dogs followed by clinical trial in 96 patients are represented, which concerns a method of indirect medicamentous saturation of lymphatic system, consisted in creation of medicamentous subcutaneous infiltration in the thighs followed by pneumocompression. Gentamycin contents in blood lymphatics and organs of experimental animals was studied in various periods of time. The obtained data have determined identity of the effect with the method of introduction of the antibiotics together with the media, which possess hyaluronidaze-like action, and followed by 2 hours duration phlebohypertension (by V.M.Buyanov, 1991). It promotes reduction of time for the procedure more than 3 times and gives possibility to avoid introduction of additional preparations, which are unnecessary load to the procedure. Gentamycin contents in blood serum of patients in various time intervals are demonstrated.

[New developments in understanding the compensatory hematological reactions and their outcomes in local fractionated therapeutic gamma irradiation]

We have carried out a study of the bone marrow status in both irradiated and non-irradiated zones of 56 patients with stage I-II Hodgkin's disease in complete 9-12 (33 patients, group 1) and 18-23 (23 patients, group 2) year remission after therapeutic irradiation of the supradiaphragmatic lymphatic collectors at a dose of 40 Gy with irradiation of the spleen (33 patients) or splenectomy (23 patients). The total count of myelokaryocytes, myelogram, a relative and absolute content of lymphoid cells, immature granulocytes and elements of erythroid series were calculated in the aspirates from the exposed to radiotherapy sternum and non-irradiated upper portion of the ileum. The number of granulocyte-macrophage (CFU-GM) and stromal (CFU-F) precursor cells were defined using in vitro culture technique. There was a complete annihilation of the bone marrow in the irradiated zones, when the dose exceeded 35 Gy in 3-4 weeks. The concentration of myelokaryocytes, immature granulocytes, erythronormoblasts, CFU-GM, CFU-F in non-exposed bone marrow were significantly lower in all patients of group 2 than in normal subjects and in group 1 patients. Absolute lymphoid count in patients with 18-23 year remission was found to be normal but was considerably reduced in comparison to patients of group 1. These changes may be the result of the previous hyperactivity of the non-irradiated bone marrow which could be a cause of stem cell compartment depletion. The differential calculation of compact and diffuse subpopulations of CFU-F revealed a significant reduction of compact colony-forming CFU-F in both irradiated and unexposed bone marrow. Almost all the stromal precursor cells from irradiated zone formed diffuse colonies in cultures. These results confirm experimental data concerning greater radiosensitivity and proliferative potential of CFU-F, forming compact colonies versus diffuse colony-forming CFU-F. Aplasia of the irradiated bone marrow and hypoplasia of the non-irradiated bone marrow 18-23 years after radiotherapy completion coexisted with normal circulating CFU-GM and granulocyte blood count suggesting a compensatory mechanism involving a mitotic amplification between the progenitor cell and the final differentiated cell.

[Role of the general practitioner in the organization of the primary component of medical care]

A program "Introduction of General Practitioners (Family Doctors) in the Primary Health Care System" has been developed in the Samara region. The first results are presented.

[Organization of geriatric care in the Samara region under conditions of obligatory medical insurance]

The authors share the experience they gained in rendering medical care to elderly and senile patients and describe the specific features of such care under conditions of obligatory medical insurance. The study was carried out in the Samara region.

[Lymph dilution as a method of treatment in endotoxicosis]

Lymph dilution was used in 26 females with inflammation of the uterine appendages and 22 patients with appendicular infiltrate. 500 ml of sodium chloride solution with gentamycin (1.4 mg/kg) were dripped in the subcutaneous fat of the femur anterior surface. Pneumocompression was performed on the unit APKU-5. The response was identical to the direct endolymphatic antibiotic therapy.

[Means for the rational utilization of the bed resources under obligatory medical insurance]

Presents a multivariant system of rational use of the bed fund used in Samara Province [correction of district]. This system helped preserve the scope of hospital aid rendered to the population in 1993-1995 which was planned by the district program of obligatory medical insurance, despite cutting down about 5,000 beds in premises previously adjusted for therapeutic needs and old premises.