И.Ю.-Марковина-З.К.-Максимова-М.Б.-Вайнштейн. Учебник для медицинских вузов и медицинских специалистов Серия xxi век Рекомендовано угчЮ по медицинскому и фармацевтическому образованию
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 JAUNDICE  1. obstructive 2. hepatocellular 3. haemolytic SYMPTOMS U ^ 4 1. " ^^ ^ Г^ 'O.r,UXjUDlС Упражнение 12. Заполнитепропускимодальнымиглаголамиcan, could; may, might; must; should. 1. If you are ill you ... consult a physician and ... do what he says. ЛSince one pack of 20 cigarettes contains 30 mg of cadmium, it is possible that chronic inhalation of cigarette smoke ... lead to an enhanced cadmium intake. 3. The patient who receives the blood of the diseased donor ... develop a positive test for the hepatitis antigen shortly iilter transfusion. 4. This patient had received 1 unit of blood at opera- lion and ... have viral hepatitis. 5. The patients with jaundice ... be Immediately transferred to an infectious hospital. 6. Sera from apparently healthy blood donors ... be always tested for the presence of hep- iititits antigen. Упражнение 13. Переведите следующие предложения с модальными II л голами и их эквивалентами. 1. Infectious hepatitis with a short incubation period can also be nansmitted during blood transfusion. 2. There is experimental evidence i hat the passive administration of Ig.G antibody interferes with the synthesis of Ig.M antibody and in this way is able to alter the immune icsponse. 3. Some researchers suggest that the. differences between se- nim hepatitis and infective hepatitis might depend on whether a common causative agent is or not bound by antibody. 4. The strong associ- Hlion of the hepatitis antigen with acute viral hepatitis increases the suspicion that donor blood containing the antigen may be infectious. 5. You should take the drug three times a day before meals. 6. We had to examine samples from normal subjects who had been exposed to hepatitis. 7. Convalescent sera from patients with hepatitis may contain trace amounts of antibody and require further study. 8. 10 patients were to be studied with a clinical picture quite compatible with acute hepatitis. 9. We were allowed to follow up sera in 27 of 49 experimental patients with positive reactions for hepatitis. Часть II Слова к части II ulcer[aIss]nязва condition [ksn'dijn] nсостояние, условие; зд. Заболевание ascribe [a'skraib] vприписывать recognize ['reksgnaiz] vраспознавать respectively [ris'pektivli]advсоотве- ственно complain [kdm'plein] v (of)жаловаться (на) heartburn ['ha:tbs:n] n изжогаsuppress [sd'pres] v подавлять Упражнения Упражнение 1. Определите значения указанных слов в данных словосочс таниях и предложениях. condition - состояние, условие, заболевание; in good, bad con dition; under favourable conditions; Ulcer is a common condition i any country. The patient is in a critical condition. to recognize — распознавать, признавать; An emotional stress a commonly recognized factor. The disease is easily recognized. Упражнение 2. Прочтите текст В (10 мин). 1) Разделите его на смыслов! части. 2) Найдите и переведите предложения с модальными глаголами их заменителями. TextВ PepticUlcer There have been many bad jokes about ulcers, but the man who 1 one really considers it not a laughing matter. Ulcer is a common con tion. What causes ulcers? A peptic ulcer, as the name says, is an erosioi the lining of the digestive tract as a result of the action of the enzj pepsin. An increase in the acid content of the gastric juice starts pepsin digesting the mucosa. Most of the symptoms are ascribed to the high degree of acidity of the juice. Not all persons with hyper-acidity must develop ulcers. The second, commonly recognized factor is emotional stress. Emotional stress produces conditions especially favourable to ulcer formation. Peptic ulcer disease can be called a psychosomatic disease; an actual bodily ailment, produced, or at least aggravated, by the mental and emotional state. There are two very distinctive varieties of peptic ulcer - gastric and duodenal. Although they are found in two different places-the stomach and the duodenum respectively — they look alike and cause similar distress. Gastric ulcer is caused by the hormone gastrin, secreted during the gastric phase of digestion. Distention of the stomach lining causes gastrin to be secreted from the antrum; gastrin in turn stimulates the gastric glands to work overtime. Gastric ulcers bleed into the stomach and may actually perforate the stomach wall. Duodenal ulcer, found in the first ten inches of the small intestine, is lour times as common as gastric ulcer. This is the «ulcer of stress» mentioned earlier, though the psychic factor is also present in other forms. The patient usually complains of a pain and «heartburn» after meals (within the first hour in case of gastric ulcer, from three to four hours after meal in duodenal ulcer). Besides the pain which the patient is often unable to bear, he may also suffer from frequent vomiting. If the gastric juice shows an abnormal concentration of HCL, the diagnosis is practically certain. Since the secretion of gastric juice is excessive in all forms of peptic ulcer, proper diet should be neccessary for the suppression of secretion. This means lhat the diet, instead of being appetizing, has to be monotonous, in order to suppress the appetite juce. Meat and alcohol are to be forbidden. Notes HCL hydrochloric acid солянаякислота Упражнение 4. Найдите в тексте В предложения, более полно выражающие, мысль данных суждений, и прочтите их вслух. 1. Ulcer is a common condition. 2. The first cause of peptic ulcer is an increase in the acid content of the gastric juice. 3. Not all persons with hyperacidity develop ulcers. 4. Gastric ulcer may perforate the stomach wall. 5. Duodenal ulcer is the ulcer of stress. 6. The proper diet should be nesessary for normal secretion. f846 Упражнение 5. Просмотрите еще раз текст В и выпишите предложения, несущие, на ваш взгляд, наиболее важную информацию. Упражнение 6. Передайте краткое содержание текста, используя предыдущие упражнения и слова к тексту В. Часть III Контрольно-обобщающие упражнения к уроку 18 Упражнение 1. Укажите, в каких предложениях модальные глаголы или их эквиваленты выражают долженствование. 1. As the proportion of low titre sera was so high among hepatitis patients, the percentages of anticomplementary sera had to be calculated. 2. You should use ampicillin intramuscularly for treatment of this infection. 3. Donors with a history of hepatitis are not allowed to give blood. 4. Two of 18 patients were to receive spaced transfusions during their hospitalization. 5. Since the antibodies in commercial y- globulin have a half-life of about 32 days, high levels of hepatitis «ап-тtibody» from the two injections must be present in the majority of patients. (Ответ: 1, 2, 4, 5. Если вы ошиблись, повторите § 17 Граммати-f 4 . ческого справочника.) Упражнение 2.Найдите в левой колонке перевод слов из правой колонки. j tobringabout 1. обращаться к кому-л.; применять lesion 2. конкурирующий, конкурсный to apply 3. еда, принятие пищи application 4. быть причиной, вызывать competitive 5. гниение, разложение, гнилость putrefaction 6. рана, поражение 1 a meal 7. применение (Ответ: 1-4, 2-6, 3-1, 4-7, 5-2, 6-5, 7-3.) Упражнение 3. Прочтите данные предложения и скажите, соответствуют ли действительности упоминаемые в них факты. 1. Both duodenal and gastric ulcers are caused by hypersecretion of gastric juice. 2. Gastric digestion is brought about by putrefaction. 3. Pure pancreatic juice or bile alone can produce a destruction of inucosa. 4. In the interval between meals minimal secretion of gastric juice occurs in healthy individuals. 5. Physiologic mechanism of regulating gastric secretion has been worked out by experimental studies on higher animals. LESSONNINETEEN KIDNEYDISEASES Повторение: Функции причастий (§§ 20, 21) Часть I Слова к части I mild [maild]а мягкий, слабый pyelonephritis [,pai9lane'fraitis] п пиелонефрит ultimate[Altimit]а последний, конечный malaise [mae'leiz] п недомогание sign [sain] п признак, симптом; знак incise [in'saiz] vделать разрез, разрезать incision [in'si3n] п разрез, надрез outcome ['autksm] п результат, исход Упражнения Упражнение 1. Прочтите и переведите следующий текст. Найдите пред- ножения, где употребляются I и II формы причастий. Patients with diseases requiring very large numbers of blood transfusions are presumably exposed to hepatitis repeatedly and might be expected to possess antibody against the hepatitis virus(es) or its products. When employing sera from such repeatedly transfused individuals as untisera, Blumberg et al. found an antigen in the serum of an Australian aborigine which has become known as the Australia antigen. On the basis of population studies it was originally proposed that the Australia antigen was another example of a genetically determined human trait. Recently, however, the association of the Australia antigen with viral hepatitis has been appreciated, and it now appears that the observations reported on the occurrence of this factor can be explained on an infec- lious basis. Using similar methods, Prince has reported the finding of an antigen in patients with serum-hepatitis (S.H. antigen), it being absent in patients with infectious hepatitis. As previously mentioned, it seems likely that the Australia antigen and the S.H. antigen are related, but uncertainty exists as to whether I hey are immunologically identical or only similar. We have detected a specific antigen in a high percentage (80%) of patients with both forms of viral hepatitis. Patients studied were from the wards and clinics of the Presbyterian, Francis Delafield, and Harlem Hospitals of New York City. Clinical diagnoses were established on the basis of history, physical findings, and laboratory values, routine laboratory tests being performed in the clinical laboratories of the respective hospitals by standard techniques. Упражнение 2. Прочтите и переведите данные слова. Запомнитеихзначение. severe, anorexia, variable, albumin, calculus (pi. calculi) radiopaque, thigh, spontaneously, descent, morphine Упражнение 3. Прочтите и переведите данные однокоренные слова. 1. ultimate, ultimately; 2. thigh, thigh-bone; 3. sign, to sign, signal, signature, sign-board; 4. to incise, incised, incision, incisive Упражнение 4. Просмотрите текст А. Передайте основное содержание текста. Text АStones in the Kidneys Clinical manifestation. In many instances stones are carried in the kidneys for years producing no symptoms. More commonly, a mild infection develops in the pelvis about the stone and gradually involves the cortex of the kidney until a severe pyelonephritis develops. If the stone is laige, or several are present, the infection may progress to a pyelonephro- sis, resulting in the destruction and ultimate loss of the kidney. Mild fever, pain, malaise and anorexia are usually present. Pus and a variable amount of albumin are present in the urine. Such symptoms as frequency of urination and mild burning pain usually accompany infection of this type. The diagnosis of renal calculi can be made by an X-ray film since most of these stones contain sufficient calcium to be radiopaque. The most dramatic manifestation of renal calculi is renal colic brought about by the entrance of a stone into the ureter and its passage downward to the bladder. The pain described usually radiates downward toward the thigh. Hematuria is a constant symptom and is an important diagnostic sign. While passing slowly, the stone may develop infection and pus as well as bacteria will be found in the urine. Fever is absent except the instances when the obstruction is present long enough to allow the development of infections. On rare occasions the stone produces sufficient ulceration in the ureter during its passage. Differentiation of renal colic From other acute abdominal conditions can usually be made by urine examination, and X-ray. 4.Treatment. Unless the renal stone is «silent», treatment should be directed toward its removal. Most stones having entered the ureter will pass spontaneously into the bladder by the prescuption of conservative treatment such as forcing fluid, sedation, etc. During the attack of colic analgetics may be required to control the pain; if after many days, there is no evidence of progression in the descent of the stone, ureteral catheterisation may be used in dislodging it. On rare occasions an operation (usually extra-peritoneal with incision into the ureter) should be performed to remove the stone. Large stones in the kidney cannot be passed by way of the ureter and if symptoms are produced operation is necessary. If the stones are present in both kidneys, it is usually preferable to operate first on the kidney with the poorer function, since the operation may produce a temporary anuria; if the better kidney is the one operated on first, and temporary anuria results, a fatal outcome may follow. Упражнение 5. Просмотрите текст А еще раз и перечислите основные симптомы и способы лечения мочекаменной болезни. Упражнение 6. Найдите в тексте А ответы на следующие вопросы и зачитайте их. 1. Do stones in kidneys usually produce pyelonephritis? 2. What symptoms help to diagnose renal calculi? 3. What is renal colic and how does it manifest? 4. When is conservative treatment used in cases of renal calculi? 5. What kidney is operated on first if the stones are present in both of them and why? Упражнение 7. Напишите возможные сочетания: а) глаголов и существительных; б) прилагательных и существительных. a) to produce the cortex b) large amount to involve X-ray film mild calculi to progress to anuria severe loss of kidney to make a pain ultimate stones to control symptoms variable pyelonephritis Упражнение 8. Прочтите и переведите аннотации. Скажите, какая из них передает содержание текста наиболее адекватно и более полно отвечает требованиям, предъявляемым к аннотации. Stones in the Kidneys Clinical manifestation. Very often an infection about the stone causes pyelonephritis or pyelo- nephrosis, resulting in the loss of the kidney. The symptoms are mild fever, pain, malaise, anorexia, pus and albumin in the urine, frequency of urination and mild burning. The diagnosis can be made by X-raying. The pain toward the thigh, hematuria, on rare occasions ulceration in the ureter, fever, are symptoms of renal colic. Treatment should be directed toward its removal unless the stone is «silent». Stones in the Kidneys Clinical manifestation. In many instances for years without symptoms. More commonly a mild infection about the stone develops into pyelonephritis or if the stone is large, into pyelonephrosis. Mild fever, pain, malaise and anorexia, pus and albumin in the urine, frequency of urination and mild burning pain accompany this infection. The diagnosis can be made by an X-ray film. Renal colic is brought about by the entrance of a stone into the ureter while passing downward to the bladder. The pain described radiates toward the thigh. Hematuria is a diagnostic sign. If the stone is not passed rapidly, infection may develop: pus in the urine, fever, when obstruction is present. Ulceration in the ureter is rare. Urine examination and X-ray help to diagnose renal colic. Treatment. If the stone is «silent», conservative treatment such as forcing fluid, sedation, etc., is prescribed. Analgetics may be required during the attack of colic. Ureteral catheterization, on rare occasions extra-peritoneal operation with incision into the ureter is necessary. If the stones are present in both kidneys, it is preferable to operate first on the kidney with the poorer function. Упражнение 9. Раскройте скобки, выбрав нужную форму причастия. Переведитепредложения. 1. One week prior to the admission, the patient developed diarrhea (associated, associating) with weakness, fever and general malaise. 2. That report describes an (immuno suppressing, immuno suppressed) patient with mucosal and serosal ulcerations of the stomach, jejunum, ileum and ascending colon. 3. Stones are often carried in the kidneys for years (producing, produced) no symptoms. 4. The ulcer most commonly (associated, associating) with the gastrointestinal system is the peptic ulcer (occurring, occurred) as a gastric or duodenal ulcer. 5. The result of nephrolithiasis may be obstruction of the kidney, ureter, or bladder leading to (increased, increasing) pressure behind the stone. Упражнение 10. Замените причастные обороты придаточными предложениями, сделав соответствующие изменения, согласно образцу; используйте союзы или союзные словаas, and, when, which. Образец: The usual manifestation of renal calculi is renal colic brought about by a stone in the kidney or ureter. The usual manifestation of renal calculi is renal colic which is brought about by a stone in the kidney or ureter. 1. The conditions for stone formation are: a cavity containing a fluid; the fluid having salts in solution. 2. The salts held in solution in the fluid are deposited on the foreign substances. 3. The foreign objects forming stones in the kidneys and bladder are bacteria and the small shreds of mucus. 4. All experimental patients described here had stones in the bladder. 5. When collected in polypropylene bottles the urine was kept in refrigerated lockers. Упражнение 11. Составьте письменно план текста А. Часть II Слова к части II susceptible [sa'septabl]а чувствительный, восприимчивый (к болезни) scarlet[ ska:ht]feverскарлатина toclog [kbg] засоряться permeable ['pa:miabl] а проницаемый diabetes[ dais'bi:ti:z] nдиабет, сахарная болезнь incompatible [,inkam'paetebl] а несовместимый hemoglobin [,hi:mD'gloubin] nгемоглобин Упражнения Упражнение 1. Прочтите текст В (10 мин). 1) Скажите, о каких заболеваниях идет речь в тексте и существует ли какая-либо взаимосвязь между ними. 2) Найдите предложения: а) где употребляются I и II формы причастий; б) определите их функции. 3) Переведитеэтипредложения. Text ВKidney Diseases There are three structures of the kidney which are susceptible to disease: the glomeruli, the tubules and the blood vessels. However, it is rare that only one of these structures is affected; what happens to one frequently affects the others as well. The disease in which the glomeruli are particularly involved is called glomerulo-nephritis. It may be acute or chronic, the first frequently leading to the second. It is often a sequel1 to such a childhood infectious disease as scarlet fever. In glomerulo-nephritis, the glomeruli become clogged with exudate and cell debris so that the blood no longer flows through them. Here a clearance test is useful; it will show that much smaller quantities of filtrate are being formed than normally. The glomeruli being still open become permeable to protein and albuminuria becomes very marked. This leads to edema. Diseases involving the tubules are called nephroses. They are usually caused by poisons of various kinds, such as mercury, bismuth, uranium, or carbolic acid. Some degree of tubular degeneration occurs, however, in such diseases as diabetes, malaria and pernicious anaemia2, and also in traumatic shock. Finally, athero-sclerosis of the kidney may occur, reducing the total blood flow through the kidney's blood vessels. What happens to the kidneys when incompatible blood has been used in a transfusion? Hemolysis of red cells occurs, of course, and the liberated hemoglobin circulates in the blood. Passing through the kidney, hemoglobin (although its molecular weight is 68.000) passes through the membrane into the tubules. If the amount is small, reabsorption occurs, but in the amounts increased after an incompatible transfusion the hemoglobin, passing through the tubules, is precipitated. This blocks the tubules; they cease to function and finally die. Patients having received the wrong type of blood can often be saved if the blood is thoroughly alkalin- ized; an alkaline filtrate is formed and thus prevents precipitation. |