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Text F. Hepatic damage due to Chemotherapy

1. A 50-year old woman had been known to have diabetes for 20 years. Her condition had been controlled by diet and administration of 100 units of insulin preparation daily. In an effort to improve the intensity of her control she had been given in addition 1 gr of chlorpropamide¹ per day.

2. About three weeks later she noted general malaise, weakness and loss of appetite, followed in a few days by the discovery of dark urine, light stools and rash on her trunk. With the passage of an additional week by which time she had taken a total of 27 gr of chlorpropamide, she noted jaundice. There was no pain, fever, nausea, or vomiting. Her past history did not reveal liver or bile duct diseases. She was hospitalized on October 10 for further studies.

3. The findings of the physical examination showed the presence of jaundice and diffuse rash on the chest and abdomen. The liver was enlarged and there was tenderness on palpation.

4. The blood analysis revealed serum bilirubin to be at the level of 8.9 mg%, the hemoglobin level was 11.6 gr% and the white blood cell count 7,600 per cubic millimetre. Platelets averaged to 490,000 per cubic millimetre. Urinalysis revealed the presence of bile.

5. The biopsy of the liver performed on October 16 showed normal liver structure. There was mild pigmentation of Kupffer cells² and slight capillary bile stasis. Some inflammatory reaction in the portal tracts was noted, but no inflammatory or degenerative changes were observed in the hepatic cells.

6. The patient was discontinued chemotherapy with chlorpropamide and her diabetes was controlled by a diet containing 150 gr of carbohydrates, 75 gr of proteins and 80 gr of fats and the administration of 80 units of insulin preparation daily.

7. Her symptoms having been relieved after a month's treatment, the patient was discharged on November 14. She complained of neither jaundice nor any other symptoms when she was seen for a follow-up examination three months later.

Notes

1. chlorpropamide — хлорпропамид (название препарата)

2. Kupffer ['kupfs] cells—купферовские клетки в печени

LESSON 47

HOME ASSIGNMENTS Revision

I. Повторите грамматические правила, лексический и текстовой материал, цикл VI (уроки 41—46).

II. Переведите следующие предложения и определите в них сложное подлежащее:

1. Jaundice is known to be present in the diseases of liver as well as in the diseases of intrahepatic and extra-hepatic ducts. 2. The characteristic clinical manifestations of gastric carcinoma are known to be epigastric pains, loss of weight, nausea and vomiting of blood. 3. Too hot food is supposed to contribute to the development of gastritis.

III. Найдите самостоятельный причастный оборот. Предложения переведите:

1. The amount of phosphorus being small in food, children may develop general health impairment. 2. The patient developed severe haemorrhage, it being caused by the perforating duodenal ulcer. 3. The patient having developed hepatitis, severe jaundice was clearly marked.

IV. Переведите следующие словосочетания:

1. перемежающаяся лихорадка; 2. злокачественная опухоль; 3. страдать от длительного кровотечения; 4. произвести срочную хирургическую операцию; 5. сделать переливание крови и плазмы; 6. предположить диагноз язвы двенадцатиперстной кишки; 7. обнаружить нарушение пищеварения; 8. способствовать задержке стула; 9. жаловаться на раздражение кожи

1. gastric ulcer; 2. serum transfusion; 3. continuous haemorrhage; 4. carcinoma; 5. anaemia; 6. intermittent fever; 7. prophylactic vaccination; 8. profuse external bleeding; 9. chemotherapy; 10. chronic gastritis; 11. dryness in the mouth; 12. acute cholecystitis; 13. parenteral injections; 14. severe nausea

VI. * Выберите симптомы, наиболее характерные для указанных заболеваний:

In acute cholecystitis the patient suffers from... (a) atrial fibrillation; 6) intense pains in the right hypochondrium and in the umbilical area; в) slight pain and general epigastric discomfort)

In attacks of acute appendicitis the patient usually develops... (a) profuse external bleeding; 6) vomiting of blood; в) sharp pains in the epigastrium, which soon become generalized in the abdomen)

Perforating ulcers are characterized by... (a) pain which is usually dull in character; 6) acute pain in the stomach; в) sharp pain in the substernal area radiating down the arm)

The development of chronic gastritis is characterized by the appearance of... (a) the loss of appetite, pain and epigastric discomfort after meals; 6) nausea, vomiting accompanied by haemorrhage; в) cold perspiration at night and intermittent fever)

VII. Приготовьте сообщения на указанные темы, используя опорные слова:

1. Chronic gastritis: separate; to be associated with; liver disease; the impairment; catarrhal condition; to cause; inadequate food; a bad diet regimen

2. The incidence of gastric cancer: common; women; highest incidence; age; malignant course; young persons; the duration of the disease

3. Acute appendicitis: sharp pain; epigastrium; to become generalized; breathing in; to be accompanied by; retention of stools; temperature; blood analysis

4. Acute cholecystitis: inflammatory disease; bile duct; frequent; gallbladder; to occur; to be associated with; the forms of cholecystitis; to involve; the liver; purulent, gangrenous; catarrhal

VIII. 1. Прочтите текст A. 2. Найдите и переведите предложения, содержащие: а) самостоятельный причастный оборот, б) сложное подлежащее. 3. Расскажите о симптоматике перитонита. Найдите английские эквиваленты следующих словосочетаний:

неотложная операция, прободная язва, разлитой гнойный перитонит, полые органы брюшной полости, значительно способствует выздоровле­нию.

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