[The cardiovascular system of patients with lymphogranulomatosis in long-time remission]. / Sostoianie serdechno-sosudistoi sistemy u bol'nykh limfogranulematozom v stadii dlitel'noi remissii.

AIM: To study the cardiovascular system in patients with lymphogranulomatosis (LGM) at prolonged remission. MATERIALS AND MATERIALS: 78 patients received radiation and chemotherapy for lymphogranulomatosis in 1973 to 1995. All the patients underwent electro- and echocardiography (EchoCG), 40 patients had radioisotopic ventriculography (RVG). RESULTS: EchoCG revealed nonspecific changes in the ST segment in 19 (24.3%) patients. Systolic function was decreased vto 46% only in 1 patient. RVG showed a significant reduction in ejection fraction in the experimental group as compared to the control one (55.5 +/- 9.5 and 68.4 +/- 8.0, respectively; p < 0.05). CONCLUSION: Cardiac disorders revealed in patients with LGM at prolonged remission are mainly insignificant. The risk for cardiac events is not a guide for reducing radiation doses and the intensity of chemotherapy.

[Hemoglobin oxygen-transport activity in lymphosarcomas]. / Kislorodtransportnaia aktivnost' gemoglobina pri limfosarkomakh.

To evaluate oxygen transport function of Hb in lymphoid sarcomas, 15 patients aged 16-63 were examined for Hb oxygen capacity, concentrations of fetal Hb and creatinin, basic ligands H+, CO2, 2,3-diphosphoglycerate (2,3-DPG). Oxy-Hb dissociation curves were plotted. The patients' blood contained HbF in elevated quantities, whereas red cells had high creatinin. This emphasizes the role of hemolysis in genesis of anemia in lymphosarcomas. 70% of the examinees retained normal Hb affinity to oxygen in vivo, in 30% this affinity exceeded the standard. Compensatory mechanism responsible for low Hb affinity to oxygen in this disease fails. Therefore lymphosarcoma patients with anemia need early replacement hemotransfusions.

[Role of hemoglobin in adaptation to hypoxia in patients with iron-deficiency anemia]. / Rol' gemoglobina v adaptatsii k gipoksii bol'nykh zhelezodefitsitnoi anemiei.

To define Hb role in compensation of hemic hypoxia, the authors studied HbO2 dissociation curves (HDC), blood acid-base equilibrium, concentrations of 2,3-DPG and creatinine in red cells from females with moderate iron-deficiency anemia resultant from frequent haemorrhages. This form of anemia was found associated with a 34% increase in the level of 2,3-DPG against normal amounts of other two ligands essential to Hb affinity to oxygen, i.e. H+ ions and CO2. A 3-fold increase in creatinine concentrations and its direct relationship with 2,3-DPG quantitative characteristics gave ground for considering rejuvenescence of the red cells in the peripheral blood to be the underlying factor in enhancement of 2,3-DPG synthesis. A 2,3-DPG-induced in vivo HDC shift to the right by 2.5 mmHg stimulates oxygen release from HbO2. The resultant 15% additional oxygen partially compensates for low Hb blood levels in the anemic patients.

[Status of the oxygen transport system of hemoglobin in physiological pregnancy and pregnancy complicated by iron deficiency anemia]. / Sostoianie kislorodtransportnoi funktsii gemoglobina pri fiziologicheski protekaiushchei i oslozhnennoi zhelezodefitsitnoi anemiei beremennosti.

The oxygen-binding properties of Hb molecule are unchanged in the third trimester of normal pregnancy and in pregnancy complicated by slight iron-deficiency anemia. Hb affinity to oxygen in whole blood is formed under the effect of the three main ligands H+, CO2, and 2,3-DPH. The development of hypocapnia in pregnant women results in elevation of pH values, reduction of pCO2, increase of intraerythrocytic 2,3-DPH concentration by 15-18%. Variously directed effects of H+, CO2, and 2,3-DPH on Hb affinity to O2 result in normal P50 values and therefore the Hb-O2 dissociation curve is not shifted to the right. Thus, in pregnant women with alkalosis 2,3-DPH effect on Hb affinity to oxygen completely eliminates H+ and CO2 effects but not compensates for Hb deficiency in the blood.

[Oxygen-binding properties of blood in hemoglobinosis M Boston detected in the USSR for the first time]. / Kislorodsviazyvaiushchie svoistva krovi pri gemoglobinoze M-Boston, vpervye vyiavlennom v SSSR.

Hemoglobin M-Boston comprising 30% of the total blood Hb was detected in two members of a Russian family. The stages of its identification were described. An analysis was made of probands' whole blood oxy-Hb dissociation curves. At pO2 = 100 mm Hg oxygenation of Hb M-Boston beta-chains was 44% only, while mutant alpha-chains were completely oxidated. Despite a significant decrease in arterial blood oxygen content arteriovenous variation by O2 content at pO2 differential from 100 to 40 mm Hg is within the normal level due to various directions of changes in P50 and Hill's coefficient of probands' whole blood. The authors consider that pronounced cyanosis in Hb M-Boston carriers is not the consequence of tissue hypoxia but is caused by a higher content of nonfunctioning Hb M-Boston that changes the blood color.

[Biochemical and functional characteristics of erythrocytes in paroxysmal nocturnal hemoglobinuria]. / Biokhimicheskie i funktsional'nye osobennosti éritrotsitov pri paroksizmal'noi nochnoi gemoglobinurii.

Hb composition in varying populations of red blood cells as well as the oxygen-transport function of hemolysates and blood were studied in patients with paroxysmal nocturnal hemoglobinurea (PNH). The dissociation curves obtained for oxyhemoglobin of blood and hemolysates were diphase, that denoted heterogeneity of Hb content and appearance of Hb with high O2 affinity in the blood of PNH patients. Isoelectrofocusing permitted detection of two additional fractions X1 and X2. The immunochemical method was used to show that X1 fraction was semi-Hb, and X2 fraction, by its physicochemical properties, was affined to Hb conformer--Hb precursor during its biosynthesis. The data obtained have shown that in PNH patients a pathologic population of red blood cells with incomplete process of hemoglobin formation appears in the blood flow.

[An algorithm for calculating and analyzing the dissociation curves of human blood oxyhemoglobin standardized by 2 and 3 allosteric ligands]. / Algoritm rascheta i analiza krivykh dissotsiatsii oksigemoglobina krovi cheloveka, standartizovannykh po dvum i trem allostericheskim ligandam.

An algorithm of an "OXYHEM" programme intended for standardization of experimentally changed human blood oxyhemoglobin dissociation curves by two (H+, CO2) and three (H+, CO2, 2,3-DPG) allosteric ligands is presented. In the former case all the points of the curve are adjusted to the values of pH--7.4, pCO2--40 mmHg, while in the latter case--to values of pH--7.4, pCO2--40 mmHg and 2,3-DPG concentration 5 mmol per 1 of PBC. Every standardized curve makes it possible to determine P50, Hill's ratio, arteriovenous difference by O2 saturation and content. A comparative analysis of the parameters calculated presents a wide range of data reflecting the state of oxygen transport hemoglobin function in the studied blood.

[Characteristics of oxygen balance and acid-base equilibrium of the blood in patients with hereditary erythrocytosis]. / Osobennosti kislorodnogo balansa i kislotno-osnovnogo ravnovesiia krovi u bol'nykh nasledstvennym éritrotsitozom.

Blood oxygen balance and acid-base equilibrium were studied in 22 Chuvash patients with hereditary erythrocytosis. Despite the lack of the anomalous types of hemoglobin in the given type of erythrocytosis a number of the patients showed secondary tissue hypoxia associated with hyperoxia of the peripheral venous blood. It is shown that tissues are capable of extracting oxygen from the blood. It is assumed that the development of tissue hypoxia in the patients is determined by a fall in the rate of oxygen diffussion from the capillaries to the tissues or by blood shunting via the arteriolo-venular anastomoses because of microcirculatory disorders. The lowering of hematocrit to the level close to normal with the aid of bloodlettings makes oxygen balance return to normal and reduces tissue hypoxia.