[Laboratory control over warfarin therapy in patients with acute coronary syndrome].

AIM: To elicit the most sensitive and reliable method of control over administration of indirect anticoagulants. MATERIAL AND METHODS: Sixty patients with acute coronary syndrome were studied. They received varfarin under the control of international normalized ratio (INR) calculated by the tables in cases of prothrombin time (PT) estimation on a stationary turbidynamic hemocoagulometer from venous and capillary blood by thromboplastins. In parallel, PT was estimated from whole capillary blood on individual portable coagulometer "Coagu Check C" by means of standard test-strip (prothrombin test--PT) on the study day 1, 3, 5, 7, 14 and 21. The results were assessed on the study day 21. All the patients were treated in hospital then outpatiently. RESULTS: The assessment of PT results implied calculation of variation coefficient (VC) and error (m) by each index obtained with thromboplastins. VS and m were the lowest when INR was made from whole capillary blood on coagulometer "Coagu Check C". CONCLUSION: An optimal method of control over efficacy of varfarin treatment is calculation of INR from capillary blood on coagulometer "Coagu Check C" as calculation of INR from capillary and venous blood on stationary coagulometer is complicated and reliability depends on thromboplastin used.

[Serum lipoproteins in different types of obesity in lipid loading challenge]. / Lipoproteidy syvorotki krovi pri razlichnykh tipakh ozhireniia v usloviiakh zhirovoi nagruzki.

The impact of food fat load on plasmic lipid transport system (LTS) was studied in persons with abdominal and gluteofemoral obesity by the standard fat test proposed by J. Patsch. The lipoprotein spectrum in abdominally obese patients was characterized by high atherogenicity of lipoprotein spectrum on an empty stomach aggravating under fat intake: prolongation of postprandial lipemia up to 6 hours with growing apoB and apoB/A1. Patients with gluteofemoral obesity differed from normal weight persons only by higher fasting values of triglycerides. They showed no atherogenic trend in changes in response to food fat.

Low-density lipoprotein subfractions during abdominal and gluteofemoral obesity.

Subfractional spectrum of plasma low-density lipoproteins in people with normal body weight and patient with obesity was studied by gradient electrophoresis (3-12%) in polyacrylamide gel. Low-density lipoprotein subfractions in fasting patients with abdominal and gluteofemoral obesity were primarily presented by small particles (compared to people with normal body weight). The composition of low-density lipoprotein subfractions underwent most pronounced changes in patients with abdominal obesity after single fat load.

[Endoscopic and histological changes in the mucosa of the gastric stump in Helicobacter pylori infection]. / Endoskopicheskie i gistologicheskie izmeneniia slizistoi obolozhki kul'ti zheludka pri infitsirovanii Helicobacter pylori.

Under investigation there were 50 patients with resected stomach at different terms after operations: 37 patients after subtotal resection of the stomach for cancer and 13 patients after resection of 2/3 of the stomach for ulcer disease. The overwhelming majority of the patients with the resected stomach had chronic gastritis of the stump diagnosed endoscopically and histologically. No reliable difference of the endoscopic and histological indices of the state of the gastric stump mucosa was found in relation to the disease which was the cause of resection and to the time since the operation. The presence of Helicobacter pylori in the gastric stump mucosa was found in 37 of 50 examined patients (74%). In the group of patients with Helicobacter pylori in the gastric stump mucosa there were no reliable differences in endoscopic findings but changes in the histological picture were found significantly more often independent of the disease which caused the resection. Atrophic alterations in the gastric stump mucosa after resection in patients with Helicobacter pylori develop in patients of younger age and in earlier terms after operation.

[The effect of a one-time fat load on indicators of the plasma lipoprotein system in patients with ischemic heart disease and in healthy patients]. / Vliianie odnorazovoi zhirovoi nagruzki na pokazateli sistemy lipoproteidov plazmy krovi bol'nykh ishemicheskoi belezniu serdtsa i zdorovykh lits.

Effects of fatty loading on patterns of the lipoprotein system were studied in blood plasma of 39 patients with ischemic heart disease and of 21 healthy volunteers and were carried out on fasting individuals within 3 and 6 hrs after the loading. Alterations were detected in the lipoprotein system of the patients as compared with healthy persons. In the patients with ischemic heart disease content of apoI was not increased while subfraction of high density lipoproteins HDL3b was elevated within 3 hrs and cholesterol content was decreased within 6 hrs after the fatty loading. These alterations appear to be applicable as tests for detection of latent atherogenous defects in the HDL system.

[Functional state of the vascular wall in patients with coronary arteriosclerosis and different types of reactions to psycho- emotional stress]. / Funktsional'noe sostoianie stenki sosudov u bol'nykh koronarnym aterosklerozom s razlichnymi tipami reagirovaniia na psikho- emotsional'nuiu nagruzku.

With changes in psychoemotional stress, antithrombogenic properties of the vascular wall and hemostatic parameters were evaluated in 25 healthy subjects and 46 patients with coronary heart disease (CHD) who differently performed a leader function when intrapersonal interaction was simulated by using a bioengineering "Gomeostat" device. There was a significant increase in the functional activity of the hemostatic system involving enhanced platelet functional activity and diminished blood procoagulative fibrinolytic activity and decreased antithrombogenic activity of the vascular wall in patients with CHD who showed a managerial tactics during simulated intrapersonal interaction in a minor group as compared to a group of followers among CHD patients.

[Willebrand's factor, functional activity of blood platelets and antiaggregation activity of the vascular wall in ischemic heart disease]. / Faktor Villebranda, funktsional'naia aktivnost' trombotsitov i antiagregatsionnaia aktivnost' stenki sosudov pri ishemicheskoi bolezni serdtsa.

Fifty coronary male patients aged 34 to 63 (the mean age 46) and 32 normal male subjects aged 18 to 32 (mean age 23) were examined for the levels of Willebrand's factor, induced platelet aggregation, beta-thromboglobulin, thromboxane, prostacyclin levels, and vascular wall antiaggregation activity (by the cuff test). Basing on literature data and their own findings the authors come to a conclusion that elevated plasma concentration of Willebrand's factor combined with increased functional activity of platelets and reduced vascular wall antiaggregation activity is the key factor in the pathogenesis of atherosclerosis development and progress.