a person grows, the stomach enlarges, and the emptying time increases.

Unit 12

Pre-text assignments

1 Learn the key words and phrases:

deaminating amino acids, blood clotting, bile, fibrous capsule, hepatic cells, gallstones

2 Use the following words and expressions in sentences of your own to show that you understand their meaning and use:

use by expiration date; if pain persists; the advice of a health professional; to depend on; reduced doses are recommended; rectal route of administration; oral route of administration; intravenous route of administration; subcutaneous route of administration; drug introduction into

Liver

The liver is located in the upper right and central portions of the abdominal cavity, just below the diaphragm. It is partially surrounded by the ribs, and extends from the level of the fifth intercostal space to the lower margin of the ribs. It is reddish brown in color and well supplied with blood vessels.

The liver is the largest gland in the body, and it carries on many important metabolic activities. For example, it plays a key role in carbohydrate metabolism by helping maintain the normal concentration of blood glucose.

The most vital liver functions are probably those related to protein metabolism. They include deaminating amino acids; forming urea; synthesizing various blood proteins, including several that are necessary for blood clotting ; and converting various amino acids to other amino acids.

The liver also stores a variety of substances, including glycogen, iron, and vitamins A, D, and B12. Iron storage occurs when the

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concentration of blood iron is excessive. The extra iron is combined with a protein (apoferritin) in liver cells, and as a result, a substance called ferritin is formed. The iron remains stored in this form until the blood iron concentration reaches a certain low level. Then some of the iron is released. Thus, the liver plays an important role in the homeostasis of iron.

In addition to the above functions, various liver cells help destroy damaged red blood cells and foreign substances by phagocytosis, alter the composition of toxic substances such as alcohol (detoxification), and secrete bile. The liver can also store from 200 to 400 milliliters of blood, thus it serves as a blood reservoir.

The liver is enclosed in a fibrous capsule and is divided by connective tissue into lobes—a large, right lobe and, a smaller, left lobe. Within the liver lobules, are many fine bile canals, wich receive secretions from the hepatic cells. Bile is a yellowish green liquid that is secreted continuously by the hepatic cells. It is the only liver secretion that directly affects digestion. Bile contains bile salts, bile pigments, cholesterol, and various electrolytes. Only the bile salts have digestive functions. The gallbladder stores bile between meals. Release of bile from the common bile duct is controlled by a sphincter muscle. Gallstones may sometimes form within the gallbladder.

Post-text assignments

1 Choose the proper terms for the definitions:

1 Yellow coloration of skin and tissues. 2 Lack of hydrochloric acid. 3 Lesion of the mucous membrane when it is injured and necrosed. 4 Collection of bile (calculi) which forms in the gallbladder and bile ducts. 5 Protrusion of an organ or part of it through the wall of the cavity which contains it. 6 Binding or twisting of the intestine upon itself. 7 Removal of the gallbladder. 8 Inflammation of the pancreas. 9 Incision of the esophagus. 10 Visual examination of the stomach.

(a – gallstones; b – hernia; c – volvulus; d – gastroscopy; e – ulcer; f – achlorhydria; g – pancreatitis; h – cholecystectomy; i – esophagotomy; j – jaundice)

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2 Translate in writing:

Gallstones may form if the bile is concentrated excessively, if the hepatic cells secrete too much cholesterol, or if the qallbladder is inflamed (cholecystitis). If such stones get into the bile duct, they may block the flow of bile, causing obstructive jaundice and considerable pain. Generally gallstones that cause obstructions are surgically removed. At the same time, the gallbladder is removed by a surgical procedure called cholecystectomy. Following such surgery, the person is unable to produce gallstones or store bile. However, bile continues to reach the intestine by means of the hepatic and common bile ducts.

Unit 13

Pre-text assignments

1 Read the text. Write a plan of it in the form of questions:

Hepatitis

Hepatitis is an inflamation of the liver. Most commonly it is caused by a viral infection, the presence of toxins, or the effects of various drugs, including alcohol.

One form of viral hepatitis, called type A hepatitis (infectious hepatitis), usualy occurs in children or young adults. It is sptead by contract with food or objects, such as eating utensils or toys, that have been contaminated with virus-containing faces. This form of hepatitis is often mild, although itmay be accompanied by weakness, abdominal discomfort, nausea, and jaundice. Usually the person recovers completely, with no lasting damage to the liver.

Type B hepatitis (serum hepatitis) produces symptoms similar to those of type A, but the effects may last for a much longer time. This form of the disease is spread by contact with virus-containing body fluids, such as blood, saliva, or seminal fluid. Thus, it may be transmitted by means of blood transfusions, hypodermic needles, or sexual activiti. Most victims recover completely from type B hepatitis; however, some perons continue to harbor live viruses and

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become “carriers” who may seem healthy, but can transmit the condition to others.

People who exhibit the symptoms of hepatitis for six months or more are said to have chronic hepatitis. In such cases, there is danger that the liver will be permanently damaged and its functions impaired. In addition to being caused by viral infections, chronic hepatitis maybe caused by the effects of certain drugs or by autoimmune reactions.

2 Now that you have read the text and written the plan write an essay on the topic Hepatits.

Unit 14

Pre-text assignments

1 Learn the key words and phrases:

ulcer, open sore, localized breakdown, buffer, unbuffered acid

2 Match the following phrases with Ukrainian ones:

1) life-threatening disease		a) м’язовий клапан
2) muscular valve		b) кислий сік
3) harmful effect		c) слизова оболонка кишечника
4) peptic ulcer		d) смертельне; небезпечне
5) immunosuppressive		захворювання
6) lining of the intestine		e) виразка дванадцятипалої кишки
7) acidic juice		f) пошкоджувальний ефект
8) duodenal e		g) пептична виразка
		h) імуносупресорне лікування
3 Find descriptions of the following terms:
1) ulcer	a) splashing of the acidic juices from the
2) heartburn	stomach into the esophagus
3) digestion	b) the conversion of food into material
4) distress	assimilated by the body
5) stomach	c) open sore in the lining of the stomach or
6) esophagus	duodenum

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7) valve	d) the passage for food from the pharynx to
8) bile	the stomach
9) acid	e) the state of suffering, pain, misery
10) relapse	f) the large, saclike organ into which food
11) liver	passes from esophagus or gullet for
	storage while undergoing the early
	processes of digestion
	g) sour, sharp and biting to the taste
	h) the bitter, greenish fluid secreted by the
	liver and found in the gallbladder; it helps
	digestion
	I) (in anatomy) a membranous structure
	which permits body fluids to follow in
	one direction only
	j) the largest glandular organ; it secrets bile
	and has an important function in
	metabolism
	k) to slip back into a former condition,
	especially after improvement or seeming
	improvement
	Ulcers

An ulcer is an open sore on the surface of an organ that results from a localized breakdown of the tissues. Although ulcers may occur in various parts of the alimentary canal, they often develop in the stomach and are called gastric ulcers.

Ulcers are also common in the first portion of the small intestine, the duodenum. Duodenal ulcers occur in regions that are exposed to pepsin as the contents of the stomach enter the intestine. Because gastric ulcers and duodenal ulcers are usually caused by pepsin, both are commonly called peptic ulcers. Ulcers often develop in people who are emotionally stressed and whose stomachs secrete increased amounts of acidic gastric juice between meals, when the stomach is essentially empty.

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For example, some research suggest that smoking might increase a person's risk of infection with the bacterium Helicobacter pylori (H.pylori). Most peptic ulcers are caused by this bacterium.

Stomach acid is also important in producing ulcers. Normally, most of this acid is buffered by the food we eat. Most of the unbuffered acid that enters the duodenum is quickly neutralized by sodium bicarbonate, a naturally occurring alkali produced by the pancreas. Some studies show that smoking reduces the bicarbonate produced by the pancreas, interfering with the neutralization of acid in the duodenum. Other studies suggest that chronic cigarette smoking may increase the amount of acid secreted by the stomach.

Whatever causes the link between smoking and ulcers two points have been repeatedly demonstrated. People who smoke are more likely to develop an ulcer, especially a duodenal ulcer, and ulcers are less likely to heal quickly among smokers in response to otherwise effective treatment. This research tracing the relationship between smoking and ulcers strongly suggests that a person with an ulcer should stop smoking.

Post-text assignments

1 What disease is this?

1 The disease, which causes pain and diarrhea, usually affects the small intestine, but it can occur anywhere in the digestive tract.

2 It happens when acidic juices from the stomach splash into the esophagus.

3 It is an open sore in the lining of the stomach or duodenum, the first part of the small intestine.

4 Most cases of this disease are caused by the bacterium

Helicobacter pylori.

2 Say it in one word:

1)a small, solid mass sometimes formed in the gallbladder or bile

duct

2)the passage for food from the pharynx to the stomach

3)causing hurt, injury or damage

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4)the large, sacljke organ into which food passes from esophagus for storage while undergoing the early processes of digestion

5)the lower part of the alimentary canal, extending from the stomach to the anus and consisting of a convoluted upper part and a lower part of greater diameter

3 Give full answers:

If a patient has 95% of the stomach removed (subtotal gastrectomy) as treatment for severe ulcers or cancer, how would the digestion and absorption of foods be affected? How would the patient's eating habits have to be altered? Why?

Unit 15

Pre-text assignments

1 Learn the key words and phrases:

cardiovascular system, circulatory system, nutrients, excretory organs, target tissues, favourable cellular environment, viscous, platelets, blood sample, cellular wastes

2 Match the following English word combinations with the Ukrainian

ones:
1) red blood cells	a) згортання крові
2) to combat infection	b) підтримувати
3) to destroy bacteria	потрібну кількість крові
4) the clotting of blood	с) червоні кров’яні тільця
5) to maintain an adequate	d) боротися з інфекцією
blood volume	e) знищувати бактерії

3 Translate the following:

1 The cellular fraction consists of red blood cells, white blood cells and blood platelets. 2 The normal coagulation time is from three to five minutes. 3 Plasma is the fluid portion of the blood.

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Blood

The blood, heart, and blood vessels constitute the circulatory system and provide a link between the body's internal parts and its external environment. More specifically, the blood transports nutrients from the digestive tract, oxygen from respiratory organs to the body cells, and carries wastes from these cells to the respiratory and excretory organs. It transports hormones from the endocrine glands to target tissues and bathes the body cells in a liquid of relatively stable composition. It also aids in temperature control by distributing heat from the skeletal muscles and other active organs to all the body parts. Thus, the blood provides vital support for cellular activities and aids in maintaining a favorable cellular environment. The heart and the closed system of blood vessels comprise the apparatus that moves blood throughout the body. These organs constitute the cardiovascular system.

Blood is a type of connective tissue whose cells are suspended in a liquid intercellular material. It plays vital roles in transporting substances between the body cells and the external environment, and it aids in maintaining a stable cellular environment.

Whole blood is slightly heavier and three to four times more viscous than water. Its cells, which are formed mostly in red bone marrow, include red blood cells and white blood cells. The blood also contains cellular fragments called platelets.

The volume of blood varies with body size. It also varies with changes in the fluid and electrolyte concentrations and the amount of fat tissue present. However, an average-sized male (70 kilograms) will have a blood volume of about 5 liters.

If a blood sample is allowed to stand in a tube for a while, the cells will become separated from the liquid portion of the blood and settle to the bottom. This separation can be speeded by centrifuging the sample so that the cells quickly become packed into the lower part of the centrifuge tube. When the amounts of cells and liquid are

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measured, the percentage of each in the blood sample can be calculated.

A blood sample is usually about 45% cells. This percentage is called the hematocrit (HCT), or packed cell volume (PCV). The remaining 55% of a blood sample consists of clear, straw-colored plasma.

In addition to red cells, which comprise over 99% of the blood cells, the solids of the blood include white blood cells and blood platelets. The plasma is composed of a complex mixture that includes water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes.

Red blood cell production is significantly influenced by the availability of two of the B-complex vitamins – vitamin B12 and folic acid. These substances are required for the synthesis of DNA molecules, so they are needed by all cells for growth and reproduction. Since cellular reproduction occurs at a particularly high rate in red blood-cell-forming tissue, this tissue is especially affected by a lack of either of these vitamins.

Iron is also needed for the synthesis of hemoglobin. Although much of the iron that is released during the decomposition of hemoglobin is available for reuse, some iron is lost each day and must be replaced.

White blood cells, or leukocytes, function primarily to control various disease conditions. Although these cells do most of their work outside the circulatory system, they use the blood for transportation to sites of infection.

Normally, five types of white cells can be found in the circulating blood. They are distinguished by their size, the nature of their cytoplasm, the shape of their nucleus, and their staining characteristics.

Post-text assignments

1 Complete the sentances:

1 The most numerous of the cellular elements of the blood are...

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a) white blood corpuscles; b) red blood corpuscles; c) blood platelets

2 The blood is...

a) connective tissue; b) muscular tissue; c) fluid tissue; d) nervous tissue

2 Read the passages and answer the questions:

1 This substance is composed of plasma, red corpuscles, white corpuscles and platelets. What substance is it?

2 These cellular elements are the most numerous in the blood. They range from 4 to 5 million per cu mm in healthy adults. Their colour(ing) is red. What cellular elements are they?

3 Answer the questions using the thematic words:

1 What is the main function of the blood?

2 How are the products of metabolism removed from the tissues? 3 What components does the blood consist of?

4 What is the chief constituent of the red blood cells? 5 What are the major components of blood?

6 What factors affect blood volume?

7 How is hematocrit determined?

8 What vitamins are necessary for red blood cell production? 9 Why is iron needed for the normal development of red blood

cells?

10 What are the primary functions of white blood cells?

4 Read and render the article:

Try this. Fill two caps half full with corn syrup. Stir two drops of red food coloring in each cup, so it looks like blood. Sprinkle one teaspoon of sugar in one cup and one teaspoon of flour in the other. Record how long it takes for the "blood" to absorb the sugar and flour. Which one was absorbed more quickly – the sugar or the flour?

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5 Read and translate the text:

One of the scientific research Institutes carried out an interesting experiment. Six young persons – four men and two girls did not sleep for 124 hours. They were under the constant observation of the doctors who took their cardiograms, determined the pulse and blood pressure and carried out many other investigations.

Not to fall asleep they were allowed to do physical exercises, dance and play, but they were not allowed to take any stimulants. Vision, hearing and muscular reflexes were often examined during the experiment.

The experiment was successful. Its findings showed that prolonged sleeplessness increases the amount of sugar in the blood, decreases the level (amount) of vitamins B1 and B6, produces considerable increase of white boood cells and decreases the amount of iron in the blood.

Unit 16

Pre-text assignments

1 Learn the key words and phrases:

transmit, clump together, obstruct, agglutinogens, agglutinins, dilute, adverse reaction, inherited trait

2 Translate and memorize the explanation to the terms:

transfusion	the act of transfusing fluid into a vein or
precaution	artery
	a measure taken beforehand to prevent harm
inheritance	or secure good
	the reception of genetic qualities by
	transmission from parent to offspring
3 Find substitutes for the given phrases:
1) pertaining to injury		a) transfusion
2) introduction of blood into the veins		b) hypertension
3) inflammation of the bladder		c) traumatic
4) high blood pressure in the arteries		d) transplant

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5) to remove and plant in another place

e) cystitis

Blood Groups and Transfusions

Early attempts to transfer blood from one person to another produced varied results. Sometimes the person receiving the transfusion was aided by the procedure. At other times, the recipient suffered a blood reaction in which the red blood cells clumped together, obstructing vessels and producing other serious consequences.

Eventually, it was discovered that each individual has a particular combination of substances in his or her blood. Some of these substances react with those in another person's blood. These discoveries led to the development of procedures for typing blood. It is now known that safe transfusions of whole blood depend upon properly matching the blood types of the donors and recipients.

Agglutinogens and Agglutinins

The clumping of red cells following a transfusion reaction is called agglutination. This phenomenon is due to the presence of substances called agglutinogens (antigens) in the red cell membranes and substances called agglutinins (antibodies) dissolved in the plasma.

Blood typing involves identifying the agglutinogens that are present in a person's red cells. Although many different agglutinogens are associated with human erythrocytes, only a few of them are likely to produce serious transfusion reactions. These include the agglutinogens of the ABO group and those of the Rh group.

Avoiding the mixture of certain kinds of agglutinogens and agglutinins prevents adverse transfusion reactions.

ABO Blood Group

The ABO blood group is based on the presence (or absence) of two major agglutinogens in red cell membranes – agglutinogen A and agglutinogen B – which are present at birth as a result of inheritance. The erythrocytes of each person contain one of the four following combinations of agglutinogens: only A, only B, both A and B, or neither A nor B.

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A person with only agglutinogen A is said to have type A blood; a person with only agglutinogen B has type B blood; one with both agglutinogen A and B has type AB blood; and one with neither agglutinogen A nor B has type 0 blood (also called type H). Thus, all humans have one of four possible blood types – A, B, AB, or 0.

Because an agglutinin of one kind will react with an agglutinogen of the same kind and cause red blood cells to clump together, such combinations must be avoided. The major concern in blood transfusion procedures is that the cells in the transfused blood not be agglutinated by the agglutinins in the recipient's plasma. For this reason, a person with type A (anti-B) blood must not be given blood of type B or AB, because the red cells of both types would be agglutinated by the anti-B in the recipient's type A blood. Likewise, a person with type B (anti-A) blood must not be given type A or AB blood, and a person with type 0 (anti-A and anti-B) blood must not be given type A, B, or AB blood.

Because type AB blood lacks both anti-A and anti-B agglutinins, it would appear that an AB person could receive a transfusion of blood of any other type. For this reason, type AB persons are sometimes called universal recipients. It should be noted, however, that type A (anti-B) blood, type B (anti-A) blood, and type0 (anti-A and anti-B) blood still contain agglutinins (either anti-A or anti-B) that could cause agglutination of type AB cells. Consequently, even for AB individuals, it is always best to use donor blood of the same type as the recipient blood. If the matching type is not available and type A, B, or 0 is used, it should be transfused slowly so that the donor blood is well diluted by the recipient's larger blood volume. This precaution usually avoids serious reactions between the donor's agglutinins and the recipients agglutinogens.

Similarly, because type 0 blood lacks agglutinogens A and B, it would seem that this type could be transfused into persons with blood of any other type. Therefore, persons with type 0 blood are sometimes called universal donors. Type 0 blood, however, does contain both anti-A and anti-B agglutinins, and if it is given to a person with blood type A, B, or AB, it too should be transfused slowly to minimize the chance of an adverse reaction.

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Rh Blood Group

The Rh blood group was named after the rhesus monkey in which it was first studied. In humans, this group includes several Rh agglutinogens (factors). The most important of these is agglutinogen D; however, if any of the Rh factors are present in the red cell mernbranes, the blood is said to be Rh positive. Conversely, if the red cells lack Rh agglutinogens, the blood is called Rh negative.

As in the case of agglutinogens A and B, the presence (or absence) of an Rh agglutinogen is an inherited trait. Unlike anti-A and anti-B, agglutinins for Rh (anti-Rh) do not appear spontaneously. Instead, they form only in Rh-negative persons in response to special stimulation.

If an Rh-negative person receives a transfusion of Rh-positive blood, the recipients antibody – producing cells are stimulated by the presence of the Rh agglutinogen and will begin producing anti-Rh agglutinin. Generally no serious consequences result from this initial transfusion, but if the Rh-negative person – who is now sensitized to Rh-positive blood – receives another transfusion of Rh-positive blood some months later, the donor's red cells are likely to agglutinate.

Post-text assignments

1 Respond to the given assigments:

1 Distinguish between agglutinogens and agglutinins.

2 What is meant by blood type?

3 What is the main concern when blood is transfused from one individual to another?

4 Why is a type AB person called a universal recipient?

2 Form sentences of your own using the following words and phrases:

immunity to infection, on exertion, mistaken for plasma, life-span, combatting infection, reversible function, responsible for, ulcerative lesions, engulf, deficient in vitamin K, due to hemorrhage, to test for the presence of, capillary fragility

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3 Translate into English:

1 Кров - це рідка тканина, яка виконує багато різноманітних функцій.

2 Рідка частина крові називається плазмою.

3 Кров насичується киснем у легенях.

4 У дорослих кров становить від 1/12 до 1/14 маси тіла. 5 Білірубін - продукт гемоглобіну.

6 Запальні стани характеризуються підвищенням ШОЕ, тобто швидкості осідання еритроцитів.

7 Білі кров'яні тільця, або лейкоцити, відіграють важливу роль у боротьбі з інфекціями.

8 Грунтовні знання про сумісність груп крові є необхідними для переливання крові.

Unit 17

Pre-text assignments

1 Learn the key words and phrases:

leukocytes, myloid leukemia, red bone marrow, lymphoid leukemia, lymph nodes, mature, neutrophils, crowd out, invade, weaken, counteract

2 Find substitutes for the given phrases:
1) fatal disease with marked increase in
number of blood leukocytes	a) myeloma
2) inflammation of the skin	b) cytopenia
3) a tumour composed of cells of the	c) lupus erythematousus
type normally found in the bone	d) occult
marrow	e) merrow
4) deficiency in the cells of the blood	f) leukemia
5) obscure or hidden from sight
6) soft material filling most of
the cavities and cancel of the bones

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Leukemia

Leukemia is a form of cancer characterized by an uncontrolled production of specific types of leukocytes. There are two major types of leukemia. Myeloid leukemia results from an abnormal production of granulocytes by the red bone marrow, while lymphoid leukemia is accompanied by increased formation of lymphocytes from lymph nodes. In both types, the cells produced usually fail to mature into functional cells. Thus, even though large numbers of neutrophils may be formed in myeloid leukemia, these immature cells have little ability to phagocytize bacteria, and the patient has a lowered resistance to infections.

Eventually, the cells responsible for the overproduction of leukocytes tend to spread (metastasize) from the bone marrow or lymph nodes to other parts, and as a result white blood cells are produced abnormally in tissues throughout the body. As with other forms of cancer, the leukemic cells finally appear in such great numbers that they crowd out the normal, functioning cells. For example, leukemic cells originating in red bone marrow may invade other regions of the bone, weakening its structure and stimulating pain receptors. AIso, as the normal red marrow is crowded out, the patient is likely to become anemic and develop a deficiency of blood platelets (thrombocytopenia). The lack of platelets is usually reflected in an increasing tendency to bleed.

Leukemias are also classified as either acute or chronic. An acute condition appears suddenly, the symptoms progress rapidly, and death occurs in a few months if the condition is untreated. Chronic forms begin more slowly and may remain undetected for many months. Without treatment, life expectancy is about three years.

The greatest success in treatment has been achieved with acute lymphoid leukemia, which is the most common cancerous condition in children. This treatment usually involves counteracting the side effects of the condition, such as anemia, hemorrhaging, and an increased susceptibility to infections, as well as administering chemotherapeutic drugs.

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Although acute lymphoid leukemia may occur at any age, the chronic form usually occurs after fifty years of age. Acute myeloid leukemia also may occur at any age, but it is more frequent in adults; chronic myeloid leukemia is primarily a disease of adults between twenty and fïfty years of age.

Post-text assignments

1 Answer the qustions using the topical unit:

1 What is leukemia?

2 Distinguish between myeloid and lymphoid leukemia.

3 Is acute leukemia easily found?

4 Where can the symptoms of the disease appear?

5 How is acute leukemia developed?

6 What factors are involved in the course of acute leukemia?

2 Translate the following terms and use them in making sentences of your own:

chemotherapy, granulocytic, dysfunction, hematologist, marrow, immunoglobulin, lymphatic, disorder

3 Discuss the problems of leukemia speculating about the chances of finding an effective treatment in the foreseeable future.

Unit 18

Pre-text assignments:

1 Learn the key words and phrases:

ducts, pump, mediastinum, bluntly pointed apex, apical heartbeat, atria, ventricles, septum, atrioventricular orifice, cardiac cycle

2 Choose the correct description of the following terms:

1) disease	a) the pressure exerted by the blood
	against the inner walls of the blood
	vessels
2) stroke	b) any departure from health, a

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