[New data on characteristics of the chemism of erythrocytes in patients with metabolic-alimentary obesity]. / Novye dannye ob osobennostiakh khimizma éritrotsitov u bol'nykh obmenno-alimentarnym ozhireniem.

A study was made of the erythrocytic membranes in patients with stage II-III metabolic and alimentary obesity. The red blood cells may serve as model of the membranes of other cells of the internal organs, that is why their changes are likely to mirror the total impairment of the function of the cell membranes in the illness under consideration. The patients' red blood cells were characterized by high permeability, increased ATPase activity, catalase activation, reduction of the content of the thiol groups, and by the displacement of the thiol-disulfide balance towards oxidized forms. A correlation was discovered between the elevation of red blood cell permeability and red blood cell K+, Na+-ATPase activation. The changes in the thiol-disulfide balance brought about inconclusive shifts in the magnitude of permeability, in the activity of ATPase isoenzymes, and in the content of cholesterol fractions in red blood cells of patients with metabolic and alimentary obesity. The changes thus discovered are of paramount importance for understanding the pathogenesis of metabolic abnormalities associated with obesity and for rational treatment of this patients' group.

[Programmed fluid removal during hemodialysis in patients with unstable hemodynamics]. / Programirano izvlichane na technostite pri bolni s nestabilna khemodinamika po vreme na khemodializa.

In 7 anuric patients with chronic renal failure treated by hemodialysis for a period from 36 up to 73 months a programmed drawing out of fluids was applied by using a dialyzing solution with variable sodium concentration in order to avoid heavy hypotensive incidents. The concentrations of potassium, sodium in serum and erythrocytes, plasma osmolarity, arterial pressure, body mass, use of medicaments were examined. The "programmed dialysis" led to a greater with 1.6% decrease of body mass and to a lower expenditure of medicaments. 10% sodium chloride solution--6 times less, peripheral vasoconstrictors--2.4 times less, there had been no need of infusions. No subjective complaints from the patients and no premature discontinuing of the hemodialysis before attaining the optimal postdialysis body mass took place.

[Clinical testing of the Bulgarian Diamex dialyzers]. / Klinichno izprobvane na bulgarskite dializatori "Diameks".

The Bulgarian dialyzers "Diamex" were clinically tried as well as original patterns of the firm Fresenius--"Hemaflow" in 28 patients from the Centre of hemodialysis at the Medical academy. The results obtained for the clearances of Bulgarian dialyzers (urea clearance--2.61 ml/s, creatinine clearance--2.18 ml/s, clearance of inorganic phosphor--1.63 mg/s and clearance of uric acid--2.14 ml/s) and their ultrafiltration possibilities revealed no statistically significant difference as regards the data of the original patterns. No essential deviations in those indices with the first and third use of the dialyzers. The percentage of clearing during 4-hour hemodialysis, being 51.7% for urea, 48.2% for creatinine and 52.6% for uric acid, remains unaltered even with their third use. No allergic reactions have been established to the membrane in the groups of patients examined. It could be stress in conclusion that the Bulgarian dialyzers, according to quality and effectiveness, correspond to the original patterns could be used several times with no risk for the patients.

[Acid resistance of the erythrocyte membranes in patients undergoing periodic hemodialysis treatment]. / Kiselinna ustoichivost na eritrotsitnite membrani pri bolni na periodichno khemodializno lechenie.

The method of acid erythrograms were used in the study of age structure of the erythrocyte population in 38 patients treated with periodical hemodialysis. It was established that the number of young erythrocytes predominated in 76.3 per cent of the patients studied, being 164 per cent of the norm. That was established by the shifting of the erythrogram to the right of the normal. Erythrograms shifted to the left were established in 5,3 per cent of the patients and normal--the rest 18,4%. The number of the blood cells in the erythrograms shifted to the left is reduced to 23.3 per cent from the norm. A different degree of anemia in all three groups was observed but no correlation could be confirmed between the severity of anemia and the changes in erythrograms.

[Determination of the plasma aluminum concentration of hemodialysis patients]. / Opredeliane na plazmenata aluminieva kontsentratsiia pri bolni na khemodializa.

Plasma aluminium concentration was followed up in 28 patients with chronic renal insufficiency, treated with hemodialysis in the course of four years. Increased value of plasma aluminium was established as compared with a control group of healthy subjects, not observing any clinical signs of dialysis dementia. Slight increase of plasma aluminium at the end of the dialysis, was observed when the dialysis solution was prepared with non-purified potable water. When purified water, by reverse osmosis, was used the plasma aluminium concentration of the patients was not changed during the dialysis (the differences observed were not statistically significant). That fact provided grounds the authors to admit that the reason for the plasma aluminium increase during dialysis was the aluminium found in the dialysis solution, which necessitates water meeting the standard requirements for the allowable aluminium content, to be used for the needs of hemodialysis.

[Study of iron depot in patients on periodic hemodialysis by determination of serum ferritin]. / Izsledvane na zheleznite depa u bolni na periodichna khemodializa chrez opredeliane na serumniia feritin.

The studies on 81 patients with periodic hemodialysis revealed that serum ferritin concentration is increased, with statistical significance, as compared with the healthy controls. The effect of various factors was established--the duration of the hemodialysis treatment, frequent hemotransfusions, high doses of parenterally administered iron-containing drugs and tissue predisposition to overloading the organism with iron. The practical value of the method is underlined as a non-invasive and reliable way for control of iron depots in patients on hemodialysis treatment.

[Measurement of blood losses in the Kill-type dialyzer]. / Izmervane na kruvnite zagubi ot dializators tip "Kiil".

Blood loss in the dialyzer, the blood lines after their utilization, and the blood needed for laboratory investigations are the main causes of anemia in patients undergoing treatment with periodic hemodialysis. With the aim to reduce blood losses in the dialyzer, to improve dialyzation techniques, and to discover eventual errors in work, measurement of residual blood in the Kill type dialyzer is undertaken. The hemoglobin method and an original formula for blood loss calculation are used. By means of a model experiment a recovery of the method exceeding 95 per cent is determined. Results obtained in a series of forty measurements vary from 8.2 to 114.6 ml blood loss. A number of factors are listed as causes bringing about the recorded higher values: low and insufficient output, faulty Kill apparatus replenishment, blood return in the patient with air and the like. In conclusion, recommendations are made to improve the work and the method of blood return into the patient by means of which blood loss in the dialyzers may be reduced.

[Serum zinc dynamics in chronic renal insufficiency treated with periodic hemodialysis]. / Vurkhu dinamikata na serumniia tsink pri bolni s khronichna bubrechna nedostatuchnost, lekuvani s periodichna khemodializa.

Serum zinc concentration and the effect of dialysis was followed up in 35 patients with chronic renal insufficiency, included in the programme dialysis treatment. Zinc level, at the end of dialysis was established to be elevated, being explained by the high zinc concentration in fountain water, with which the dialysis solution was prepared. Owing to the fact that the elevated values of serum zinc are included in the normal region, the authors think that no deionization of water is necessary aiming at the reduction of zinc concentration in it.

[Bone isoenzyme fraction of alkaline phosphatase in patients undergoing prolonged hemodialysis treatment]. / Kostna izoenzimna fraktsiia na alkalnata fosfataza pri patsienti s produlzhitelno khemodializno lechenie.

The values of serum concentration of alkaline phosphatase and of bone isoenzyme fraction, determined by thermal inactivation of serum were followed up in 42 patients with chronic renal insufficieny, treated with hemodialysis for a long time. The authors found that the elevation of those valuse correlates with the degree of the manifested changes in the bone skeleton. Attention is paid to the fact that the determination of bone and liver isoenzymes of alkaline phosphatase could help the earlier diagnosis of bone changes and infectious hepatitis, both being frequent complications in patients treated with hemodialysis.