[Spontaneous reperfusion of the infarct-related artery in patients with ST elevated myocardial infarction].

AIM: To characterize a clinical course of ST elevation myocardial infarction (STEMI) and spontaneous reperfusion of the coronary arteries (SR) as well as in patients after reperfusion thrombolytic therapy (TLT) and/or transluminal balloon coronary angioplasty (TBCA); to compare effectiveness of different approaches to treatment of SR patients: conservative--early medication and active--TBCA on the first postmyocardial 24 hours. MATERIAL AND METHODS: We studied 479 patients admitted to hospital not later than 6 hours since STEMI onset and either having SR (n = 49) or treated using active methods of coronary circulation restoration--prehospital thrombolysis (n = 127), thrombolysis after hospitalization (n = 127), primary TBCA (n = 60) and TBCA after initiation of TLT (n = 116). We made a more detailed analysis on the sample of 149 SR patients. RESULTS: SR was diagnosed in 10.2% cases with STEMI and occurred much earlier than recovery of coronary circulation due to TLT and/or TBCA. Patients with SR developed Q-MI, right ventricular infarction, cardiac failure and atrioventricular block less frequently. They had the lowest peak activity of creatin phosphokinase and a higher left ventricular ejection fraction versus patients without SR (50.7 +/- 6.8 and 45.4 +/- 6.6%, respectively; p < 0.05). As shown by coronaroangiography, SR patients had no "no reflow" phenomenon (0% and 17%, respectively). Active policy of SR patients treatment had no significant advantages over conservative treatment. CONCLUSION: Early SR had more favourable course of MI, less mass of the affected myocardium and better contractile function of the left ventricle. The conservative policy of STEMI treatment in the presence of SR is more effective than the active one if a due control over the patients' condition is provided.

[The role of multidetector computed tomography in detection of myocardial infarction].

UNLABELLED: The aim of the study was to assess the diagnostic value of multidetector computed tomography (MDCT) in detection of myocardial infarction (MI) in acute and chromic stages. MATERIAL AND METHODS: 49 patients with suspected MI were included in the study. In 44 patients the diagnosis of acute MI had been confirmed according to standard criteria. Contrast-enhanced MDCT of the heart and vessels was performed with 4-row MDCT scanner. RESULTS: MDCT detected areas of MI in 39 of 44 patients with proven MI. In 66,7% of cases they were transmural and in 33,3% -- subendocardial. In arterial phase the density of infarcted area was significantly lower than in normal myocardium (mean, 32,6 +/- 3,7 HU versus 101,9 +/- 3,7 HU, correspondingly, p < 0,0001). Mean values of myocardial density in the area of the MI did not change during follow-up (32,6 +/- 3,7 HU vs 41,3 +/- 4,5 HU, ns). In comparison to SPECT, sensitivity and specificity of MDCT in detection of transmural MI were 96,9% and 100%. corr. In the whole group of patients, taking results of troponin test as a gold standard, the sensitivity of MDCT in detection of Q-MI and non-Q MI were 89,1% and 93,5%, correspondingly. CONCLUSION: Cardiac MDCT can reliably detect and localize areas of acute and chronic MI. Contrary to SPECT, it also gives information about stenosis and occlusions in the coronary arteries.

System of hemopoiesis and morphogenesis.

Method of transplantation of hemopoietic cells is proposed for acceleration of recovery of damaged tissue structures. The morphogenetic effect of transplantation depended on the state of damaged tissue and was determined by not only hemopoietic stem cells, but also lymphocytes, macrophages, and mast cells.

[Prophylaxis and treatment of reflux cholangitis]. / Profilaktika i lechenie refluks-kholangita.

A method of creation of choledochojejunoanastomosis (CJA) was developed experimentally on 12 dogs. The method lies in creation of valvular CJA using walls of the common bile duct and submucosous-mucosous membrane of the small intestine mobilized by Roux. According to this method 103 patients with obstructive jaundice due to lesion of distal part of common bile duct were operated. Postoperative complications were seen in 6 (5.8%) patients, 3 (2.9%) patients died. In the period from 3 months to 10 years after operation 63 patients were examined, there were no cases of reflux-esophangitis.

[Pharmacological analysis of the role of central alpha-2 adrenergic and imidazoline receptors in mechanism of the hypotensive effect of clonidine in rats]. / Farmakologicheskii analiz roli tsentral'nykh al'fa2-adrenergicheskikh i imidazolinovykh retseptorov v mekhanizme gipotenzivnogo deistviia klonidina u krys.

The role of alpha 2-adrenergic and imidazoline receptors in the hemodynamic response to clonidine (manifested by reduced arterial pressure, heart rate, and renal blood flow rate) was studied by injecting their antagonists with different affinity (yohimbine and idazoxan) into narcotized Sprague--Dawley rats. The local introduction (microinjection into rostral ventrolateral medulla) and systemic administration (intraperitoneal injection) of the drugs showed that the hemodynamic effect of clonidine is mediated predominantly by the central alpha 2-adrenergic receptors, rather than by the imidazoline receptors.

[Effectiveness of treatment in patients with pulmonary tuberculosis and chronic bronchitis by exposure on vertebro-osteo-sternal joints]. / Effektivnost' lecheniia bol'nykh tuberkulezom legkikh i khronicheskim bronkhitom metodom vozdeistviia na vertebrokostnosternal'nye sochleneniia.

A hundred and twenty six patients with infiltrative destructive pulmonary tuberculosis were examined. In 62 patients of them, the vertebroosteosternal joints were exposed as part of multimodality treatment in order to arrest an exacerbation of chronic bronchitis. A control group included 64 patients. The exposure of vertebroosteosternal joints was found to enhance the efficiency of treatment for chronic bronchitis in patients with pulmonary tuberculosis. This treatment promotes lower inflammatory intensity, diminished antigenemia and anti-protein antibody production. To arrest lesions in the bronchial tree with the proposed package of methods also favours a higher efficiency of treatment of a tuberculous process.

[Nutrients of natural origin for prevention and treatment of radiation disease in experiment]. / Issledovanie radiozashchitnykh svoistv produktov prirodnogo proiskhozhdeniia pri odnokratnom total'nom obluchenii myshei.

The preventive and medical effect of some nutrients of plant origin suggested as food supplement was studied in mice subjected to acute irradiation. The evidence of increased radioresistance was revealed.

[Chronic stress increases the reactivity of central depressor mechanisms]. / Khronicheskii stress uvelichivaet reaktivnost' tsentral'nykh depressornykh mekhanizmov.

The activity of noradrenergic system of lateral hypothalamus and hemodynamics were studied during acute restraint in chronically stressed and control rats. Arterial blood pressure in rest was negatively proportional to basal norepinephrine concentration in dialysate of lateral hypothalamus. Animals with high increase of norepinephrine levels in dialysate during acute stress had rapid return of arterial blood pressure to basal values while stress-induced hypertension in the beginning of restraint was the same as in rats with low increase of norepinephrine levels. Data obtained show the depressor role of noradrenergic system of lateral hypothalamus. The enhanced reactivity of noradrenergic depressor system may be one of the mechanisms providing cardiovascular adaptation to stress.

[The activity of the monoaminergic systems of the rat hypothalamus in acute stress after chronic stressing]. / Aktivnost' monoaminergicheskikh sistem gipotalamusa krys pri ostrom stresse posle khronicheskogo stressirovaniia.

The influence of chronic stress (footshock combined with randomized light flashes) on acute stress-induced (immobilization) release of noradrenaline, dopamine and serotonin in rat lateral hypothalamus was assessed by microdialysis. The chronic stress resulted in an increase and prolongation of the acute stress-induced release of noradrenaline but not of dopamine and serotonin. The increased rate of accumulation of dioxyphenylacetic acid and unchanged accumulation of homovanillic acid (dopamine metabolites) and dopamine during and after the acute stress in chronically stressed animals reflect a rise of synthetic activity of catecholaminergic systems in response to acute stress and reuptake increase. Marked stress-induced increase in hydroxyindoleacetic acid in chronically stressed rats without any changes in the ST dynamics may be regarded in a similar way. A significant increase in potassium-stimulated release of all the studied monoamines was found while their basal level remained unchanged. The conclusions was made that the hyperergic release of neurotransmitters may be the basis of an inadequate response of animals to acute stress, i.e., one of the neurotic symptoms.

[Atropine effect on physostigmine- and stress-induced secretion of catecholamines by adrenal gland: microdialysis study in awake rats]. / Vliianie atropina na fizostigmin- i stress-stimulirovannuiu sekretsiiu katekholaminov nadpochechnikami: mikrodializnoe issledovanie u bodrstvuiushchikh krys.

Physostigmine and an 1-hour immobilisation stress similarly affected functions of the sympatho-adrenal and cardiovascular systems activating the catecholamine secretion and increasing the blood pressure. Yohimbine potentiated the secretory effect but did not change the pressor effect. Intermediate administration of atropine completely eliminated both effects of physostigmine but, being administered prior to the immobilisation, it potentiated the secretory response without affecting the pressor response. The findings reveal a difference in central cholinergic mechanisms of neurohumoral and haemodynamic responses to physostigmine and stress.

[The effect of tyrosine-containing dipeptide on neuroglycopenia-induced changes in the activities of the sympathetic nervous system and of the systemic hemodynamics in waking rats]. / Vliianie tirozinsoderzhashchego dipeptida na vyzvannye neiroglikopeniei izmeneniia aktivnosti simpaticheskoi nervnoi sistemy i sistemnoi hemodinamiki u bodrstvuiushchikh krys.

A modulatory role of the precursor of catecholamines--tyrosine (TYR)--in 2-deoxyglucose (2DG)-induced changes in blood pressure (BP), renal sympathetic nerve activity (renSNA), plasma levels of epinephrine (EPI) and norepinephrine (NE), total spillover of NE (TSO), and sensitivity of baroreceptor reflex (SBR) is studied. Chronically instrumented male Wistar rats were injected with 2DG (125 - 500 mg/kg iv), and BP, heart rate (HR), renSNA, TSO, EPI, NE, plasma clearance NE (CINE) and SBR were monitored before and after 2DG administration. The responses to 2 DG in control rats were compared with those in rats pretreated with tyrosile-tyrosine dipeptide (TYR-TYR). SBR was estimated by bolus i.v. sodium nitroprusside injection. 2DG evoked an increase in renSNA by 23%, 40-fold and 2.5-fold increases in EPI and NE concentrations, 2,7-fold increase in TSO, a decrease in HR by 5% in 45 min without reliable changes in BP and CINE. TYR-TYR administration did not affect 2DG-induced changes in HR, TSO, EPI and NE concentrations, but potentiated changes in renSNA by 53% and significantly increased BP by 10%. 2DG produced an increase in the chronotropic (by 87%) and sympathetic (by 72%) components of SBR. TYR-TYR restored the normal values of SBR in 2DG-treated rats. Thus, tyrosine modulates 2DG-induced changes in hemodynamic parameters and renSNA and normalizes SBR via central mechanisms.