[Module for analyzing physiological processes of the OMIS software complex]. / Modul' analiza fiziologicheskikh protsessov programmnogo kompleksa OMIS.

The informational technology designed for systems analysis of changes in the characteristics of single variations in physiological process is outlined. This technology has been used in the module of analysis of the physiological processes of an software complex.

[Influence of berotec inhalations on pulmonary gas exchange in patients with bronchial asthma]. / Nekotorye aspekty vliianiia ingaliatsii beroteka na legochnyi gazoobmen u bol'nykh bronkhial'noi astmoi.

AIM: To determine mechanisms inducing changes in lung gas exchange after berotec inhalation in patients with bronchial asthma (BA). MATERIALS AND METHODS: A study was made of external respiration function including estimation of lung transfer factor (TLCO sbh.) and its components--transfer coefficient (KCO), membrane diffusion capacity (DM), pulmonary capillary blood volume (Vc)--by the single breath holding method on CO in 14 healthy persons and 39 patients with BA before and after berotec inhalation. The data were obtained in the absolute values and their changes after berotec inhalation were measured in percent to initial ones. RESULTS: In healthy subjects we did not observe changes of TLCO sbh. and its components after berotec inhalation, only an insignificant decrease of VA eff. was registered (p < 0.01). After berotec inhalation a considerable improvement in Sgaw, FEV1, RPV and a decrease of TLCO sbh., KCO were observed. Changes in TLCO sbh. were caused by a decrease in DM without changes in VA eff. in BA patients with initial normal values of KCO. In patients with smaller initial values of KCO moderate improvement of bronchial permeability without changes in KCO, PaO2 were observed. These changes occurred due to a decrease of VA eff. CONCLUSION: Changes of the transfer factor and its components in patients with BA reflect two types of adaptation reactions in response to berotec inhalation and their role in mechanisms of compensation of gas exchange in the lungs.

[Sequential Bayes' strategy and mechanism of decision making in the OMIS software]. / O posledovatel'noi strategii Baiesa i mekhanizme priniatiia reshenii v intellektual'noi sisteme OMIS.

The paper describes the method of image recognition in which a useful element of Bayes' approach, numerous alternatives, is united with the productive idea of heterogeneous sequential analysis--ordering of signs by their informative value for decision making. The idea of the method--a sequential Bayes' algorithm--consists in the following: the a priori probabilities are not determined before-hand but specified in turn, depending on the empirical material. The author proves that algorithms conforming to the Neumann-Pierson or Wald strategies, specifically, the heterogeneous sequential algorithm, are not to be referred to the Bayes' algorithms, as is usually done in analyses of clinical laboratory data. Ideologically the heterogeneous sequential algorithm was developed as a method for analysis of empirical data, whereas the Bayes' approach is a deductive method. Confusion of the Bayes' approach with the algorithms based on the probability ratios is methodologically unjustified at least because the Neumann-Pierson and Wald's approaches are the greatest statistical achievements of the twentieth century and have nothing to do with the Bayes' formula. The methodology of constructing the probability measure in the clinical laboratory signs space is described in detail, as are the new objects, interval and binary structures, which emerge in the course of this construction. These objects help improve the diagnostic significance of clinical laboratory information even in cases when the results of analyses are apparently normal. The sequential Bayes algorithm is compared with the traditional Bayes approach to certain clinical problems. The author concludes that the sequential Bayes algorithm is a serious alternative to algorithms for making multiple-alternative decisions in the solution of clinical tasks.

[Tumor diseases of the blood system: age, cholesterol level and erythrocyte count]. / Opukholevye zabolevaniia sistemy krovi: vozrast, uroven' kholesterina i kolichestvo éritrotsitov.

AIM: Illustration of potentialities of computer technologies in processing data from case histories MATERIALS AND METHODS: Routine clinical and laboratory data on 263 hemoblastosis patients were processed with the use of the exploring system. RESULTS: A paradoxical negative relationship was discovered between blood cholesterol and age (R = -0.345, p < 0.00001), and a positive correlation between cholesterol and number of red cells (R = 0.379, p < 0.00001). In comparison of groups with low and high cholesterol, the latter group showed more favourable values of hemoglobin, red cells, other hematological and biochemical parameters. It seems that among hemoblastosis patients and healthy subjects there are subjects with standard age-related changes of cholesterol and paradoxical changes (a negative correlation). The conception about high level of cholesterol as a factor stimulating proliferation of normal and affected cells in patients with hemoblastoses appears doubtful. At least it is not correct to connect a combination hypocholesterolemia + anemia with low pool of dividing cells. On the contrary, hypocholesterolemia in hemoblastoses indicates active tumor process with consequent anemia. CONCLUSION: Investigation of paradoxical relationships between age, cholesterol and red cell count (hemoglobin) will help understand general mechanisms of regulation of hemo- and immunogenesis in blood malignancies.

[Metrological problems of laboratory diagnosis]. / Nekotorye metrologicheskie problemy laboratornoi diagnostiki.

Medical laboratory diagnosis is progressing from one analysis to a group of analysis with rather intricate statistical processing of data via multidimensional analysis, at the same time it is necessary to define a patient's individual normal levels, i.e. a "health certificate". In this regard, the process may be achieved when complex analyzers, which have a reliable metrological support, and systems for collection of both clinical and laboratory information and its simultaneous analysis are put into laboratories' practical work.

[Lymphogranulomatosis: a systems analysis of the age- and sex-related characteristics of hemopoiesis and metabolism]. / Limfogranulematoz: sistemnyi analiz vozrastnykh i polovykh osobennostei gemopoéza i metabolizma.

72 clinical and laboratory features were analyzed on the IBM PC 486 for 126 new cases of lymphogranulomatosis prior to treatment. Myelograms were found to vary with sex and age of the patients demonstrating close relations between hemopoiesis and processes in the lymph nodes. In males maturation of myeloid elements KM was inhibited, though they had more monocytes KM. These monocytes got more numerous in unfavorable histological variants and generalization. Lymphopenia and monocytosis were more pronounced in patients under 30 becoming more severe in generalization and intoxication. Age-related changes in cholesterol in lymphogranulomatosis patients were abnormal: in older patients cholesterol was low. This phenomenon is extremely unfavorable. The findings elucidate prognostic value of sex and age in lymphogranulomatosis and suggest a hypothesis that monocytes (macrophages) and secreted by them monokines are responsible for specific intoxication, neutrophilia and lymphopenia. Berezovsky-Sternberg cells may be hybrids of macrophages and B-lymphocytes.

[Coefficients of correlation of clinical laboratory data as signs of mechanisms of regulation]. / Koeffitsienty korreliatsii kliniko-laboratornykh dannykh kak priznaki mekhanizmov reguliatsii.

Differences in the coefficients of correlation of clinical laboratory signs in patients with diseases of the blood and lymph, respiratory organs, and cardiovascular system were analyzed using OMIS research biomedical system (Intellectual Systems, St. Petersburg. 1993). Correlation coefficient is interpreted not as a measure of relationship between signs, but as an indicator of regulation processes in a live organism. The coefficients of correlation are most frequently different for the signs whose mean values are unchanged under the same conditions. This means that a comparative analysis of relationship between the signs largely contributes to such branches of medicine in which the conclusions are based on analysis of the mean tendencies. Such branches are primarily new tests for early diagnosis of tumorous diseases, assessment of dissemination and malignancy of the process, understanding of the processes of malignant degeneration, etc. Automated analysis of differences in correlations may be useful to decipher the ambiguous and dynamic relationships between different submultiplicities of immunocompetent elements in different forms of immune response (and in various states of the organism). Use of the new system opens new vistas in studies of the signs of vital activity of cardiovascular and respiratory systems. Not only new mechanisms regulating the hemodynamics, respiration, and cardiorespiratory relationships were disclosed; relationships between physiological parameters and cellular elements were revealed, which could be hardly suspected before. A fragment of a study of survival factors in acute nonlymphoblastic leukemia (carried out in cooperation with N.N. Mamayev) is presented for illustration. A close positive relationship between the humoral and cellular immunity (at least of their components analyzed in this study) is demonstrated to be destructive for patients with acute nonlymphoblastic leukemia. An optimal variant is their independent regulation or regulation leading to variously directed changes.

[The thrombocyte count and potassium concentration of the blood in acute nonlymphoblastic leukemia (towards an understanding of the regulatory mechanisms of hemopoiesis)]. / Kolichestvo trombotsitov i kontsentratsiia kaliia v krovi pri ostrom nelimfoblastnom leikoze (k ponimaniiu mekhanizmov reguliatsii gemopoéza).

The authors show that when platelet count and potassium concentrations in ANLL patients correlate positively or do not correlate, there is a positive and negative correlation between survival and hemoglobin level (number of red cells), respectively. Clinically, it means that in certain conditions hemotransfusion of red cell mass may be useless or even harmful. In groups with different relationships between platelet count and blood potassium levels, other indicators also vary in interrelations. Thus, in the groups compared cholesterol concentration correlated differently with platelet number, hemoglobin and potassium concentrations. It is suggested that in certain conditions group correlation may be similar to individual (physiological) correlation of the signs. In situation when it is true, great methodological prospects are opened for quantitative description and investigation of physiological regularities.

[The binary ratio method: new possibilities in solution of research and differential diagnosis tasks]. / Metod binarnykh otnoshenii: novye vozmozhnosti resheniia issledovatel'skikh i differentsial'no-diagnosticheskikh zadach.

Binary ratio is the key notion in the general theory of systems, a generalization of functional relationship. A clinical laboratory parameter or sign is merely an element of the analyzed information system, and situations are possible when signs analyzed separately without consideration for their interrelationships are not informative at all, whereas the structure of binary ratio helps solve differential diagnostic problems and other tasks. The information reflected in binary ratios characterizes the relationships between signs and the intricate features in the vital activity of the organism, such as mechanisms of regulation, homeostasis, etc. A method for assessment and comparison of the structure of binary ratios is described as a new method for analysis of biomedical data. The method is realized in a research system OMIS (PC-based) and was tried in the solution of complex problems in hematology, pulmonology, cardiology, oncology, etc.

[A statistical mean dyad test (tt-criteria for comparison of mean trends of two samples)]. / Statisticheskii kriterii diady srednykh (tt-kriterii sravneniia srednikh tendentsii dvykh vyborok).

The authors claim that widely used statistic tests (Student, Berence-Fisher, Wilcoxon-Mann-Whitney, etc.) may fail to detect differences in average trends. A new statistical tt-test is suggested for such situations when samples are compared belonging to essentially different distributions and one of these distributions is bimodal or U-shaped. This test consists in comparison of the arithmetic means calculated not for the whole sample but separately for values higher and lower than the respective medians. The authors persuasively illustrate the efficacy of this method used in analysis of routine clinico-laboratory data. The statistical mean dyad test (tt-test) is realized in GEMA intellectual system statistical module and used automatically only in cases when routine methods are ineffective.