[Structural and functional aspects of the nucleolar organizing region of interphase cell nuclei during hemoblastosis]. / Strukturno-funktsional'nye osobennosti iadryshkoobrazuiushchikh raionov interfaznykh iader kletok pri gemoblastozakh.

Data on concept of the nucleolar-organizing regions of the human somatic cell interphase nuclei, methods of their revealing, classifications, as well as their structural-functional peculiarities in norm and under different diseases of blood system, in particular under hemoblastosis, are reviewed in historical aspect.

[The immunophenotypic and cytogenetic characteristics of the blast cells in subvariants of acute myeloid leukemia]. / Immunofenotipicheskaia i tsitogeneticheskaia kharakteristika blastnykh kletok pri nekotorykh podvariantakh ostroi mieloidnoi leikemii.

The results of study of morpho-cytochemical peculiarities, antigenic profile and peripheric blood and/or bone marrow blast cell karyotype of 21 patients with acute myeloid leukemia are presented. Hemopoietic cell immunophenotyping was carried out with the use of cytofluorometer FACScan and chromosome cytogenetic analysis with the use of analyzer "Metascan". It has been shown that in the AML M1 blast cell plasmatic membrane carries pan-myeloid CD33 and CD13 antigens, the last having high density of expression, and the CD38 antigen, which is a myeloid cell-precursor marker. In these patients tetraploidy, being the testimony of karyotype change, has been ascertained. It has been found out that the AML M2 blasts, except pan-myeloid antigens, express the cell proliferation CD71 marker. Blast cell karyotype peculiarities typical for this leukemia sub-variant have been revealed. In patients with the AML M4 in 3 of 6 cases an anomalous karyotype has been found. It has been also shown that the CD14 antigen, and rather its percentage in blast total population, is the differential-diagnostic criterion for the AML M4 and M5.

[The morphological characteristics of a papillomavirus infection in the epithelial tissue of the cervix uteri in comparison with the data from the molecular biological identification of specific HPV DNA sequences]. / Morfologicheskie osobennosti papillomavirusnoi infektsii v épitelial'noi tkani sheiki matki v sopostavlenii s dannymi molekuliarno-biologicheskoi identifikatsii spetsificheskikh posledovatel'nostei DNK VPVCh.

Summarized cytomorphologic, molecular-biological data and the analysis results of cervix uteri multilayer squamous epithelium cells mitotic regime in benign (104 observations) and dysplastic (101 observations) processes, including 6/11 and 16/18 types DNA HPV, are presented in the paper. It has been shown that the use of HPV-infection morphologic markers as compared with cell mitotic activity and with in situ hybridization results allows one to determine the obvious virus role in the induction of flat, acute and papillar condylomas, as well as of cervix uteri dysplastic processes. To ascertain the prognosis of development of dysplasia associated with HPV DNA of 6/11 and 6/18 types, the increase of mitosis pathological forms and of their arrangement zones in epithelium layer parallel with gravity increase of three-group, multipolar and K mitosis should be considered a reliable marker of high oncogenic risk.

[The outlook for the creation of a bank of cryopreserved cord blood for clinical use]. / Perspektiva sozdaniia banka kriokonservirovannoi kordovoi krovi dlia klinicheskogo primeneniia.

Appraisal of morphological and functional features of cord blood cells involving identification of precursor cells marked with specific monoclonal antibodies makes it possible to regard cord blood as biologically valuable hemopoietic tissue with a high repopulation potential. Studies aimed at developing optimal conditions of cryopreservation allow the stocks of biologically valuable tissue to be built up.

[The cytological characteristics of the cells of the multilayer squamous epithelium of the cervix uteri in relation to the association of the pathological processes with the human papilloma virus]. / Tsitologicheskie osobennosti kletok mnogosloinogo skvamoznogo épiteliia sheiki matki v zavisimosti ot assotsiatsii patologicheskikh protsessov s virusom papillomy cheloveka.

An analysis of cytological material in benign (160 observations) and dysplastic (101 observations) processes, as well as in cervix outset cancer (38 observations) with the aim of search for koilocytic atypia markers in the cells, existing due to HPV infection, has been carried out. High association degree of the virus infection with the material under study has been ascertained. It was found out that the increase of koilocytosis phenotypic markers expression rate is a reliable criterion of cervix uteri pathologic processes progression. The signs of permanent koilocytic atypia in women with dysplasia should be considered as prognostic marker of malignant transformation of cervix uteri epithelium.

Capitation and integrated health care systems.

Integrated health care systems: a concept being discussed throughout Russia and the world. A concept with three different applications and a confusing interaction with the concept of "capitation payments." The health reform debate in Russia and the NIS can only advance if greater clarity is found for these concepts, and if medical leaders are prepared for the substantial changes in provider behavior that are required with integrated health care systems fueled by capitation payments. This article explores the twin concepts of capitation and integrated health care systems, and then the leadership challenges for Russian health sector managers as they prepare for these challenges of the twenty-first century.

[Clinico-genealogical and genetic-mathematical research on cancer of the cervix uteri]. / Kliniko-henealohichne ta henetyko-matematychne doslidzhennia raku shyiky matky.

Analysis of the family histories of 179 patients with cancer of uterine cervix was conducted to detect the influence of their heredity and environmental factors on the development of malignant tumors using clinical-genealogical and genetic-mathematical methods. Decomposition of phenotypic variance was used as a basis for detecting the contribution of genetic component (2.92%) and random environmental component (97.08%) which reflected the influence of exogenic risk factors of development of uterine cervix cancer. Clinico-genealogical analysis of probands' pedigrees was the basis for detecting association of malignant neoplasms in lung and uterine cervix epithelia.

[The course of the adaptation processes in patients with neurocirculatory dystonia during health resort treatment]. / Techenie protsessov adaptatsii u bol'nykh neirotsirkuliatornoi distoniei vo vremia kurortnogo lecheniia.

Low activity of adaptation processes which impedes obtaining good results of heath resort treatment was observed in 16.7% of patients with neurocirculatory asthenia. Such patients need additional therapeutic measures to correct neurovegetative activity, heart performance. General conditioning should be more intensive.

Health insurance in Russia--the Kuzbass experience.

The leading pilot region for health finance reform in the Russian Federation has been adapting systems to changing economic circumstances since 1986. In 1992 a 'regulated competition' model was introduced and compulsory contributions are now routed to insurers via a central compensation fund. Hospitals are paid at standard rates (using 'clinical statistical groups') per case by diagnosis and procedure, and by outcome. Primary care is moving from fundholder polyclinics to general practitioners operating under incentives to efficient gatekeeping and provision of quality out-patient care. Private insurance co-exists for about five percent of the population, but the compulsory component is regulated through the central fund and only supplements are voluntary. The region has strong natural resources, but against a background of economic and environmental problems, a one-third increase on funding available to health over the pilot period is satisfactory, with costs of health insurance administration limited to three percent.

[Changes in the hormonal content of the blood during chronic electrostimulation of the hypothalamus and amygdaloid complex]. / Izmenenie soderzhaniia gormonov v krovi pri khronicheskoi élektrostimuliatsii gipotalamusa i mindalevidnogo kompleksa.

The changes of corticotropin, thyrotropin in hypophysis, triiodothyronine, thyroxin in thyroid gland, adrenaline, norepinephrine, hydrocortisone, 11-OKS in adrenal glands and pancreas, caused by prolonged electrostimulation of hypothalamic ventro-median nucleus, lateral nucleus of amygdala and the combination of the latter with the SP injection, were studied in chronic experiments on rabbits. The electrostimulation increased the hormone contents in the blood, whereas glucagon contents as well as norepinephrine contents was decreasing in stimulation of hypothalamus and amygdala, resp. The SP injection against the background of electrostimulation of the amygdala resulted in the hormone status standardisation.

[Morphometric features of breast cancer cells in the evaluation of the degree of tumor differentiation]. / Morfometricheskie osobennosti kletok raka molochnoi zhelezy v otsenke stepeni differentsirovki opukholi.

Morphometric study of the cell and nucleus surface as well as nucleus-cytoplasmatic ratio are performed in 80 patients with mammary carcinoma using a Soviet cytoanalyzer "Integral-2MT". Highly differentiated carcinomas are characterized by a domination (61.3%) of small nuclei (up to 120 microns 2). Moderately differentiated carcinomas are polymorphic by their composition: 43.3% nuclei up to 120 microns 2, 39.3% from 120 to 160 microns 2, remaining nuclei are of a large size. Poorly differentiated carcinomas are even more polymorphic due to high percentage of large nuclei--from 140 to 200 microns 2 and larger representing 46.5% cells. The analysis of nuclear size distribution allows estimation of the degree of cell differentiation in the tumour.

[Cytologic and morphologic characteristics of human papillomavirus infection in cervix uteri pathology]. / Tsitologicheskaia i morfologicheskaia kharakteristika papilloma-virusnoi infektsii cheloveka pri patologii sheiki matki.

The role of human papilloma virus (HPV) in genital cancer is not yet clear at present, but the available data testify to serious changes in cervix uteri epithelium in the process of its infection. Close correlation was demonstrated between HPV type specificity and the degree of epithelial morphological changes as well as histologic tumor variant, and its degree of differentiation. Interrelation between HPV type and level of both regression and progression of atypically changed cervix uteri epithelium is established. Cytomorphological method of the evaluation of cell koilocytotic atypia is the marker to diagnose HPV infection when screening a chosen woman population. The development and introducing of sensitive and reliable identification methods of type-specific DNA sequences of HPV infection in diagnostic material to form a low risk (HPV-6 and II types) and a high risk group (HPV-16 and 18 types) by malignancy of cervix uteri epithelium have considerable promise. It is advisable to study HPV role in the development of adenogenic tumors of uterine cervix and body.

[The results of and prospects for the study of the interphase nucleus of eukaryotes]. / Itogi i perspektivy izucheniia interfaznogo iadra éukariotov.

Being devoted to studies in structural peculiarities of chromatin distribution of interphase nuclei from eucaryote cells, the paper embraces literature data and the authors' results in this field. Main tendencies in development of the method, based on the qualitative and quantitative estimation of hetero- and euchromatin nucleus substance are considered. Basic successes achieved while estimating experimental and clinical materials are indicated. It is determined as promising to put the method into practice.

[Pathognomonic signs of human papillomavirus infection in diagnostic material from the uterine cervix]. / Patognomonichnye priznaki papillomavirusnoi infektsii cheloveka v diagnosticheskom materiale sheike matki.

Etiological factors and mechanisms of pretumorous and tumourous processes in the female genitalia are presented in light of current concept of viral cocarcinogenesis. The utility of cytoscreening for the detection of the papilloma-virus infection in the uterine cervix mucosa is founded. Detailed cytological characteristics of cells in the uterine cervix mucosa with a cytopathic effect (coilocytosis, the presence of two or many nuclei, vacuolisation of cytoplasm, nuclear atypia) are presented. A selective localization of the human papilloma virus in the transformation zone of the uterine cervix is determined. The frequency of cells with cytopathic effect is 80.2%.

[Cytologic and morphometric features of mucosal cells of the cervical canal in the normal state and in pathology]. / Tsitologicheskie i morfometricheskie osobennosti kletok slizistoi obolochki tservikal'nogo kanala v norme i pri patologii.

Presents data on the morphology and function of the cervical canal mucosa, obtained with the use of colpocervicoscopy, as well as cytologic qualitative and quantitative characteristics of the glandular epithelium. Demonstrates high informative value and compatibility of the results obtained by different methods for the assessment of anaplasia and proliferation in the mucous endocervical cells, particularly in cases with the early evidence of the glandular epithelium malignant degeneration.

[Hormonal homeostasis and intraocular pressure in chronic emotional stress caused by influences acting on the amygdala]. / Gormonal'nyi gomeostaz i vnutriglaznoe davlenie pri khronicheskom émotsional'nom stresse, vyzvannom vozdeìstviiami na mindalevidnyi kompleks.

Changes in intraocular pressure, eye hydrodynamics and the amount of hypophyseal, thyroid, adrenal and pancreatic hormones were studied during continuous stimulation of amygdaloid complex or after administration of angiotensin II into the structure in rabbits. The effects involved changes in hormonal homeostasis and elevation of intraocular pressure due to a hypersecretion of intraocular fluid. The administration of angiotensin II during the amygdala stimulation enhanced the changes.