[Peculiarities of the circulating phagocytes functional activity in patients with different forms of drug-resistant pulmonary tuberculosis].

Functional activity of circulating phagocytes (macrophages--Ms and neutrophils--Ns) was studied in 30 patients with infiltrative (I) and 30 patients with fibro-cavernous (FC) pulmonary tuberculosis (PT). Difference of the functional activity of both types of cells depending on the PT form was revealed: more significant increase in the oxygen-depending activity in FCPT while bactericide potential estimated with a zymosane induced NST-test was more pronounced in IPT patients. These data correlate with the blood levels of neopterin and elastase, the markers of the M and N activity, respectively. Participation of intracellular ADA in realization of oxygen-depending processes was demonstrated. Results of the multivariant analysis of the whole complex of the studied phagocyte characteristics, reflect their different roles in ther pathological process a prevailing role of Ms in the firstly diagnosed acute tuberculosis process (IPT) and Ns in the chronic progressive process (FCT).

[Characterization of destructive pulmonary tuberculosis (by the results of a clinicomathematical analysis)].

The results of examination of 56 patients with destructive pulmonary tuberculosis, which involved the study of biochemical parameters characterizing different stages of an inflammatory process, as well as clinical and X-ray findings were analyzed, by applying various multivariate statistical methods. This approach was shown to be promising for estimating the severity of the process and for specifying the stage of development of an inflammatory process in some patients.

Evidence of combined therapy of dyslipoproteinemia by HMG-CoA reductase inhibitors and "essential" phospholipids.

Platelets are involved in the initiation of atheromas and arterial thrombosis and thus may play a cardinal role in the pathogenesis of myocardial and cerebral infarction. In 18 patients with coronary artery disease and hypercholesterolemia resistant to low-lipid diet a 12 week treatment with lovastatin (HMG-CoA reductase inhibitor) leads to the reduction of total cholesterol, LDL-cholesterol and triglycerides but also to a marked increase of platelet activity. Lovastatin is an inactive lacton prodrug which must be enzymatically or chemically transformed to the active form. In in-vitro experiments, it was discovered that both chemically hydrolysed lovastatin and plasma containing lovastatin metabolites stimulate induced platelet aggregation in whole blood samples. "Essential" phospholipids (Lipostabil) added to the blood samples in concentrations according to those which are used clinically prevent this stimulation. This corresponds to data obtained earlier from Lipostabil-treated ischemic heart disease patients. Besides a lipid-lowering effect Lipostabil showed a 50% reduction of spontaneous aggregates in plasma, an increase of the susceptibility threshold to aggregation inducers and a decrease of the platelet aggregation amplitude in whole blood samples. Therefore, it would be promising to combine the therapy by lovastatin with "essential" phospholipids possessing a remarkable improving effect on the platelet function based on a molecular action independent of their moderate lipid-reducing action.

[Clinico-hemodynamic characteristics of patients with initial signs of hypertension]. / Kliniko-gemodinamicheskaia kharakteristika lits s nachal'nymi stadiiami gipertonicheskoi bolezni.

Multifactor analysis was used to make clinical and hemodynamic comparisons in 42 patients with borderline arterial hypertension, 27 with Stage I hypertension, 40 with Stage II hypertension, and 40 healthy persons. Central hemodynamic parameters at rest and during graded bicycle ergometer exercise were measured by the Defares carbon dioxide return respiration method modified by V. L. Karpman. As compared with patients with hyperkinetic circulation, those with hypokinetic one were older, had a longer history of arterial hypertension, obesity, more common left ventricular hypertrophy, higher baseline diastolic pressures and total peripheral vascular resistance, less increase in cardiac index and greater enhancement of total peripheral vascular resistance during submaximal exercise. There was a clear-cut correlation between the progression of arterial hypertension and increase in values of factors I (clinical and hemodynamic) and III (cardiotonic).

[Study of the effect of the parameters of physical exercise on the dynamics of ischemic reaction in patients with stable stenocardia]. / Issledovanie vliianiia parametrov fizicheskoi nagruzki na dinamiku ishemicheskoi reaktsii u bol'nykh so stabil'noi stenokardiei.

The intensity and duration of exercise were investigated for their influence on the parameters of myocardial ischemia and its severity in 25 patients with Functional Classes II-IV angina who underwent intermittent, stepwise increasing exercises. It was ascertained that there were basic correlations between the intensity and duration of exercise and conventional myocardial ischemic parameters and there were no such correlations for threshold parameters that allowed the coronary reserve and function to be objectively evaluated in patients with angina. The maximal correlation slope angles between heart rate, ST regiment displacement and exercise intensity of various duration were proposed for individual characterization of the specific features of control of the cardiovascular system and severity of myocardial ischemia.

[The osmoregulatory and natriuretic functions of the kidneys in the early stages of the evolution of hypertension]. / Osmoreguliruiushchaia i natriiureticheskaia funktsiia pochek na rannikh étapakh évoliutsii gipertonicheskoi bolezni.

Overall 78 men were examined. Of these, 30 presented with borderline arterial hypertension (BAH), 30 with stage I essential hypertension (EH), and 18 healthy subjects served as control. To assess osmoregulating and natriuretic renal functions, water and water plus salt were administered (at a rate of 22 ml water or isotonic sodium chloride per kg bw). Use was made of classic approaches in this case, with the determination of K+, Na+ excretion, blood plasma and urine osmolarity, calculation of the concentration index, clearance of osmotic-active substances and free water, total reabsorption of Na in the distal parts of nephron and intensity of that process. Besides, flame photometry was employed to measure blood K+, Na+ concentration and RIA to examine plasma renin activity. The data obtained indicate the heterogeneity of the patients with BAH and stage I EN according to the response to water and water and salt administration. Approximately 1/3 of the patients showed a tendency towards water retention in the body as well, which is common to patients with the volume-dependent form of arterial hypertension. In that case the compensatory potentialities of modulating renin-angiotensin system activity were preserved.

[Demonstration of individual predisposition to myocardial infarct based on immunogenetic status]. / Vyiavlenie individual'noi predraspolozhennosti k infarktu miokarda po immunogeneticheskomu statusu.

Statusometry, a method of automated quantitative assessment of the state of composite multiparametrical objects, is proposed for the detection of genetic predisposition to myocardial infarction as an instrument of integral quantitative assessment of systemic immunogenetic status on the basis of HLA phenotype. The prognostic error does not exceed 15%. Large-scale application of the new method appears a promising approach to individualization and better efficiency of preventive cardiologic treatment.

[Immunogenetic characteristics of patients with ischemic heart disease]. / Immunogeneticheskaia kharakteristika bol'nykh ishemicheskoi bolezn'iu serdtsa.

The distribution of the principal erythrocyte and HLA-antigens was investigated in 202 males aged 20-50 years with a history of myocardial infarction and various courses of coronary heart disease. The occurrence of one or the other group of antigens differed both as compared with a group of healthy subjects (619 subjects) and in relation to the anamnestic and clinical characteristics of the disease course. The findings helped to draw a conclusion as to the presence of associative links between a number of the studied antigens (A (II), MN, HLA-B7, HLA-B14, HLA-B15, HLA-CW4) and the risk of the development of, at least, some forms of coronary heart disease.