[The diagnostic and therapeutic significance of thrombocyte functional activity and the factors in its regulation in chronic diseases of the large intestine]. / Diagnosticheskoe i terapevticheskoe znachenie funktsional'noi aktivnosti trombotsitov i faktorov ee reguliatsii pri khronicheskikh zabolevaniiakh tolstoi kishki.

To elucidate diagnostic value of platelet functional activity in chronic colon disease, we studied ADP-induced platelet aggregation (PA, in vitro) and cAMP concentration in blood plasma. If patients had chronic catarrhal, ulcerative colitis or chronic colon stasis, their serum cAMP appeared low, while initial rate of ADP-induced PA was high. The above alterations varied with the disease severity, in exacerbation and remission. CAMP, histamine and epinephrine were tried as regulators of platelet activity. Phosphodiesterase inhibitor trental proved efficient in the treatment of chronic colon diseases. It has improved clinical condition of the patients, inhibited the initial rate of ADP-induced PA, secured its partial or complete reversibility through a rise in plasma and platelet cAMP concentrations.

[The functional activity of the thrombocytes in chronic diseases of the large intestine]. / Funktsional'naia aktivnost' trombotsitov pri khronicheskikh zabolevaniiakh tolstoi kishki.

Chronic diseases of the large intestine--catarrhal colitis, colonic stasis, unspecific ulcerative colitis, and amebiasis of the large intestine are attended by marked changes in the functional activity of blood platelets and factors of its regulation. They reflect the dynamics of the disease before and after operative and nonoperative treatment. A recurrence of the disease is linked with activation of blood platelets. Trental and contrycal are used for correction of the disorders, which improves the condition of some of the patients. The authors discuss the importance of biogenic amines, cAMP, and functional activity of the blood platelets as universal mechanisms of the development of chronic diseases of the large intestine.

[Our experience in the prenatal echographic diagnosis of spinal dysraphism in the fetus]. / Nashiiat opit v prenatalnata ekhografska diagnostika na spinalniia dizrafizum u ploda.

The investigation consists of 141 cases of prenatal diagnosing structural and chromosomal anomalies of the fetus. Seventeen of the cases, quoted above, concern spinal dysraphism (spina bifida, occipital meningocele, meningoencephalocele). It has been made an analysis of ultrasound signs at this group of defects which turned out the most useful for the definite diagnosis. According to the literary survey and author's experience are formed two main groups of indices at echo-sounding study--direct and indirect. There have been considered the technics of echoscopy in searching the signs of different terms of pregnancy. It has been made a partial comparison of the reliability in the two groups ultrasound signs with this in biochemical diagnosis of spinal dysraphism in the fetus.

[Plasma histamine levels in various chronic diseases of the colon]. / Uroven' gistamina v plazme krovi pri razlichnykh khronicheskikh zabolevaniiakh tolstoi kishki.

Patients suffering from chronic colitis, chronic stasis disease and nonspecific ulcerous colitis were examined for blood plasma histamine. The level of blood plasma histamine was found to be dependent on the intensity of the pathological process. The role of histamine in the development of disorders of neurohumoral regulation, microcirculation and motor and evacuatory function of the colon is discussed.

[Antenatal diagnosis in cases of renal agenesis]. / Antenatalna diagnoza na sluchai s bubrechna ageneziia.

Renal agenesia was established by antenatal ultrasound diagnosis in 3 cases. The ultrasound image is characterized by the impossibility to visualize one or both fetal kidneys, oligohydramnios, lung hypoplasia and hypotrophy of the fetus. The possibilities for the earliest diagnosis as well as for interruption of pregnancy on account of the lethal outcome of the disease in the newborn are discussed.

[The use of prostaglandin E2 to induce labor and abortion in the second trimester]. / Prilozhenie na prostaglandin E-2 za induktsiia na razhdaneto i za izkustveno prekusvane na bremennostta prez vtoriia trimestur.

PIP: Prostaglandin F2 alpha (PGF2 alpha) venous injection was used for the first time for induction of labor in 1968. The success rate by different authors ranged from 63% to 100% with a dose of .5-1.5 mg/hour. Local use of PGE2 for the improvement of uterine cervix conditions was found more suitable than the use of PGF2 alpha. It was first used for induction of labor without side effects in 1973 by instilling transcervical extraamniotic PGE2 in patients with low pelvic scores. Also, a single dose of .2-4 mg of PGE2 extraamnially mixed in a gel such as Hydromellose was used. PGE2 gel was more effective than iv infusion of oxytocin for induction of labor in the unripe uterine cervix. In the case of a well-ripened cervix, both PGE2 gel and oxytocin gave identical results. A 1981 report showed that in the well-ripened cervix local administration of freshly prepared gel with PGE2 resulted in labor in 97% of cases with a time of induction of 6.5 hours. After cervical ripening produced by intracervical PGE2 gel within 6-7 hours, the administration of oxytocin was very effective. Termination of pregnancy in the 1st trimester was also successfully performed after intracervical instillation of PGE2. 10-12 hours later, after sufficient ripening of the cervix, easy dilatation of the cervical canal and curettage ensued. In vaginal use of PGE2 the dose has to be 5-10 times higher than the intracervical dose. Intracervical PGE2 proved to be the most effective for the unripe cervix. The tablet form of PGE2 endocervically is safer than the gel because of its sterility. In the clinical setting PGE2 reduced isthmic-cervical insufficiency that issued from the trauma of cervix from earlier birth or abortion; reduced the number of cesarean sections from 30% to 5% and from 25% to 10%, in respective reports; and it was least traumatic and best tolerated for termination of 1st and 2nd trimester pregnancies as well as for induction of labor.^ieng

[The echographic measurement of fetal transverse cerebellar diameter in the second pregnancy trimester--a "nonstandard" method for determining gestational age]. / Ekhografskoto izmervane na fetalniia naprechen malkomozuchen diametur vuv vtori trimestur na bremennostta--"nestandarten" metod za opredeliane na gestatsionnata vuzrast.

The study was carried out on 192 women with normally progressing pregnancies during the second trimester, in whom the gestational age was determined by 291 echographic measurements of the fetal anatomic parameters-the biparietal diameter, length of the femoral bone and the transverse cerebellar diameter. The coefficients of correlation between each of the indicated parameters and gestational age as high values of correlation--0.96, 0.98, 0.98 were established. A brief literary review is made on the problem for determination of gestational age by measurement of the transverse cerebellar diameter of the fetus. Making more precise some technical details of the method, the authors recommend it for routine usage in the clinical practice.

[The indirect echographic signs in the prenatal diagnosis of spina bifida aperta in the second trimester of pregnancy. A report on 2 cases]. / Indirektni ekhografski priznatsi pri prenatalna diagnostika na spina bifida aperta vuv vtoriia trimestur na bremennostta. Prinos na dva sluchaia.

The authors present a brief literary review on the frequency and etiological factors of the opened spinal dysraphism. The importance of its echographic diagnosis is indicated by using indirect signs, mainly microcephaly, ventriculomegaly, cerebellar pathology ("a sign of the banana") and characteristic fronto-temporal configuration of the fetal encephalic cranium ("a sign of the lemon") up to 24 week's of gestation. Two cases of diagnosed spinal dysraphism during the second trimester of pregnancy with established indirect echographic signs, promoting active search for direct echographic image of this congenital defect of the neural tube, are described.

[The relationship of the location of the placenta and the indices of the fetus and birth process]. / Zavisimost mezhdu lokalizatsiiata na platsentata i niakoi parametri na ploda i rodoviia protses.

The study is carried out on 200 women, pregnant for first and second time with normally progressing, pregnancy and delivered by normal mechanism at term, who are divided into groups according to the localization of the placenta, established by ultrasound examination. The number of primiparas is 50% in each group. The authors find that when the placenta is located on the uterine fundus larger children are born and hypokinetic labour activity is observed as well as protracted delivery. The site of the placenta is extremely important factor, affecting course of pregnancy and delivery.

[The results of a clinical trial of the preparation Ossopan]. / Rezultati ot klinichnoto izpitanie na preparata Ossopan.

The preparation Ossopan was used for period of one month in 20 pregnant women at 28 to 40 weeks' gestation with pain syndrome in the long bones, lumbosacral region and disturbed dental status. Its effect was studied on second group of 13 women with established clinically and roentgenologically climacteric osteoporosis, using a therapeutic course of 1 pill daily for a period of 6 months. A considerable clinical improvement of pain syndrome and dental status was found in the end of the treatment. The positive therapeutic effect, easy way of administration, its good tolerance and lack of side make it convenient for treatment of disturbances in calcium-phosphorus balance.

[Pathological positioning of the placenta at 20 weeks' gestation--its significance for the course of the pregnancy and labor]. / Patologichno razpolozhenie na platsentata v 20. gestatsionna sedmitsa--znachenie za protichaneto na bremennostta i razhdaneto.

The authors found pathologically located placenta in 5.2% of pregnant women during ultrasound examinations at 20 weeks' gestation. The pregnant women were examined periodically by the echograph every 4 weeks. Hundred women with normal localization of the placenta were included in the control group. There were 5-fold more frequent bleedings in the investigated group as 86.5% of bleedings were manifested for the first time after 20 weeks' gestation. The frequency and strength of bleedings were in close connection with the gravity of the pathological insertion. Asymptomatically progressing pregnancies with abnormally localized placenta were 66%. The authors found percentage dependence of pathological placental localization on the gestational period and the possibility for reliable diagnosis. They recommend follow-up of placental localization dynamically till the end of pregnancy on the basis of the possibility for a change in placental localization and its significance for the course of pregnancy and delivery.

[Our experience with the antenatal ultrasonic diagnosis of bilateral polycystic kidney disease]. / Nashiiat opit pri antenatalnata ultrazvukova diagnoza na bilateralnata multikistozna bubrechna bolest.

After a brief review on etiology, pathogenesis, frequency, forms and methods for diagnosis, the authors describe their experience in antenatal diagnosis of fetal bilateral multicystic renal disease. Three cases with this disease are reported, diagnosed before delivery with characteristic differential diagnostic criteria. Possibilities for interruption or reaching full-term pregnancy with the described anomalies of the fetus.

[Results of a clinical trial of the Dilapan hygroscopic cervical dilator]. / Rezultati ot klinichnoto izpitanie na khigroskopichniia tservikalen dilatator Dilapan.

The authors used Dilapan to dilate the cervical canal in women with induced abortion during the first trimester. Its effect was followed up in a group of pregnant women without preceding pregnancies (88 pregnant women). The dilator remained in the cervical canal from 90 to 210 min. The best results (dilation within 9--10 min) were achieved after its stay in the cervical canal for 3 to 3 1/2 h. In the group of nulliparas dilation of 10 sm was achieved in 49.5% of the cases after stay of dilator for a period of 120 to 180 min. The authors think that the usage of Dilapan is a method by which could be achieved lowering of the frequency of cases with isthmian-cervical incompetence. Application of Dilapan is of special value in women, who have not endured preceding abortions and deliveries and are pregnant for the first time.

PIP: The authors used Dilapan to dilate the cervical canal in women undergoing induced abortion during the 1st trimester. Its effect was followed in a group of pregnant women without a preceding pregnancy (n- 88). The dilator remained in the cervical canal from 90-210 minutes. The best results (dilation between 9-10 minutes) were achieved after its stay in the cervical canal for 3-3 1/2 hours. In the group of nulliparas, dilation of 10 cm was achieved in 49.5% of the cases after the dilator remained in place for between 120-180 minutes. The authors believe that the use of Dilapan is a means to lower the rate of isthmian-cervical incompetence. Application of Dilapan is of special value to women who have not endured a prior abortion or delivery and are pregnant for the 1st time. (author's modified)