[Early physical rehabilitation after elective percutaneous coronary interventions during incomplete revascularization: exercise regimen calculation by ergospirometry].

AIM: To evaluate the efficiency and safety of outpatient physical exercises (PE), calculated using ergospirometry (ESM) in patients in the early periods after elective percutaneous coronary interventions (PCI) during incomplete coronary bed revascularization. SUBJECTS AND METHODS: Three hundred and eighty-three patients were screened. The trial enrolled the patients after elective PCI in its early periods (3 to 14 days) who had signed an informed consent document to participate in the investigation and who could perform themselves PE at home or visit the medical center. Patients with angioplasty complications (myocardial infarction, severe hematomas, major bleeding, etc.) who had standard contraindications to exercise testing and PE were excluded. The patients included in the trial (n = 50) were divided into 2 groups: (1) 21 patients who had undergone incomplete revascularization; (2) 29 patients who had complete revascularization. The authors estimated exercise endurance by ergospirometry before the investigation, 8 weeks after a course of exercises, and following 6 months and assessed quality of life (QL) using the SF-36 questionnaire. A physical rehabilitation program was elaborated for all the patients according to exercise test results. During the trial, all the patients were allocated to groups of home and clinic exercises using exercise bikes. Medical control of the patients who were exercising at home was made by their telephone conversation, control visits to the medical center at least once monthly, and their concurrently keeping an exercise diary in which each training (duration, intensity), health status, and blood pressure were recorded. The patients could consult their physician at any time if required. RESULTS: In the incomplete and complete revascularization groups, VO2 max increased by 6 and 15%, respectively. Following 6 months, no additional increment in VO2 max was seen in the study groups. According to SF-36 data, QL improved in patients in both groups after 8 weeks and remained at the same level after 6 months. CONCLUSION: An early time course of exercises only in combination with regular medical control has a positive impact on exercise tolerance and QL and preserves its efficiency for at least 6 months regardless of the degree of revascularization.

[Apoptosis of host cells regulation by Chlamydia].

In a study on the impact of chlamydial infection on host cell apoptosis, C. trachomatis were shown to protect host cell against staurosporin-induced apoptosis only at the middle stage of infection development (at 20 hours post infection), C. pneumoniae--at different stages of its growth cycle (from 2 to 7 day post infection). We found, that C. trachomatis elementary bodies fail to inhibit staurosporin-induced apoptotic stimuli. The clear antiapoptotic effect of cell lysate filtrate, infected with C. trachomatis, was demonstrated by cytometric analysis and luminescent microscopy. Our findings make it possible to use biochemical approach to identification of chlamydial antiapoptotic factors in future. Investigations directed at chlamydial antiapoptotic activities may aim to create the therapies of chronic chlamydial infection.

[The apoptosis-supressing activity of clamydia].

The paper covers data from literature, concerning the influence of bacteria upon apoptosis program of host's cells. The mechanisms of apoptosis induction and suppression, developed by bacteria and directed towards the maintenance of conditions favorable to the infection, are quite varied. These mechanisms are realized via complex interaction between biologically active bacterial molecules and particular targets of signal paths which lead to apoptosis. In intracellular parasitism the apoptosis-suppressing activity of bacteria may be considered to be one of the mechanisms of pathogenic organism's persistence which provide favorable conditions for the development of chronic infections. Infection caused by C. pneumoniae in human fibroblasts has been experimentally demonstrated to protect the cells from spontaneous and induced apoptosis.

[Role of Chlamydia, mycoplasma and cytomegalovirus infection in the development of coronary artery disease]. / Rol' khlamidiinoi, mikoplazmennoi i tsitomegalovirusnoi infektsii v razvitii ishemicheskoi bolezni serdtsa.

AIM: To assess relationship between some infection factors and presence of coronary heart disease. MATERIAL: Patients with myocardial infarction (n=56), unstable angina (n=50), stable angina (n=50) and age - matched controls (n=49). METHODS: Levels of IgG, IgM, IgA antibodies to Chlamydia pneumonia, Chlamydia trachomatis, Chlamydia psittaci, IgG, IgM antibodies to Cytomegalovirus, and also of antibodies and antigen to Mycoplasma pneumoniae were measured in blood serum. RESULTS: Compared with controls patients with coronary heart disease had higher frequency of seropositivity to Chlamydia pneumonia, Mycoplasma pneumonia and Cytomegalovirus (p< 0.05 ) and similar levels of seropositivity to Chlamydia trachomatis and Chlamydia psittaci. Infectious burden (quantity of antibodies per one patient) was significantly higher in patients with myocardial infarction, unstable and stable angina than in controls (1.58, 1.42, 1.41 and 0.95, respectively). CONCLUSION: Our results confirm presence of association between infection and coronary heart disease.

[Role of Chlamydia pneumoniae in the etiology of atherosclerosis]. / Rol' Chlamydia pneumoniae v étiologii ateroskleroza.

The review of literature on the role of C. pneumoniae in the etiology of atherosclerosis is presented. The patients with coronary disease show a greater detection rate and higher titers of antibodies to C. pneumoniae. The causative agent can be detected in atheromas in of immunocytochemical studies and by means of electron microscopy, as well as in the polymerase chain reaction. In addition, live C. pneumoniae can be isolated from atheromas. The process of atherogenesis is modeled by infecting susceptible animals with chlamydiae. C. pneumoniae induce the formation of foam cells in the culture of human macrophages due tho the surplus absorption of cholesterol by macrophages from low-density lipoproteins. Chlamydial lipopolysaccharide is capable of inducing the formation of foam cells. The conclusion has been made that C. pneumoniae is one of the possible etiological agents of atherosclerosis. The possible role of the endotoxins of bacteria of the intestinal microflora, regularly supplied to the blood stream in the presence of sharply decreased immunity to endotoxins, in the etiology of atherosclerosis is also supposed.

[Investigation of oxosubstances in plant leaf lipids]. / Doslidzhennia oksospoluk poverkhnevykh lipidiv lystkiv roslyn.

Surface lipids of plant leaves of different groups were investigated by spectral, chromatographic and functional analysis methods. Absence of oxosubstances in surface lipids of coniferous and their characteristics in tropical species were shown. Functions of oxosubstances are discussed.

[Pathogenetic aspects of chlamydia-associated urogenic arthritis: feasibility of microorganism reproduction in cells of articular cartilage]. / O patogeneticheskikh aspektakh urogennykh artritov, assotsiirovannykh s khlamidiiami: vozmozhnost' mikroorganizma razmnozhat'sia v kletkakh systavnogo khriashcha.

AIM: The study of feasibility of Chlamydia trachomatis infection and reproduction. This microorganism is an essential etiologic factor in urogenic arthritis, in chondrocytes and fibroblasts of human skin. MATERIALS AND METHODS: Infection of human skin chondrocytes and fibroblasts was made with chlamydia CP-1 strain isolated from joint fluid of the patient and serially passaged in the hen's embryo yolksacs. The inoculation results were assessed by direct staining with the use of monoclonal and fluorescent antibodies and hematoxiline. RESULTS: Chlamydial infection of human skin connective tissue, chondrocytes of the auricular cartilage and fibroblasts in particular, is possible. CONCLUSION: The findings confirm the ability of Chlamydia trachomatis to reproduce in the cartilage tissue.

[The use of Cordanum in combination with Corinfar-Retard for the treatment of ectopic arrhythmias in the sick sinus syndrome in patients with ischemic heart disease]. / Primenenie kordanuma v sochetanii s korinfarom-retard dlia lecheniia éktopicheskikh aritmii pri sindrome slabosti sinusovogo uzla u bol'nykh ishemicheskoi bolezn'iu serdtsa.

38 patients with ischemic heart disease (IHD) and sick sinus syndrome (SSS) received combined therapy with nifedipine (Corinfar-Retard) and talinolol (Cordanum). The former drug had a positive chronotropic effect on the heart, the latter's chronotropic effect was slightly negative. All the patients had sinus bradycardia and ectopic arrhythmia which needed therapeutic correction: supraventricular and ventricular extrasystoles, fibrillation paroxysms or/and atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia. Cordanum was given in a dose 50 mg twice a day, Corinfar-Retard 20 mg twice a day for 16 days. 30 patients responded to the treatment. In addition to good subjective response, episodes of extrasystoles, paroxysms, flutter and fibrillation occurred much less frequently. Side effects resulted in the treatment discontinuation in 3 patients.

[Cytomegalovirus infection in women of reproductive age with an at-risk obstetrical history]. / Tsitomegalovirusnaia infektsiia u zhenshchin reproduktivnogo vozrasta s otiagoshchennym akusherskim anamnezom.

Studies aimed at the detection of cytomegalovirus infection (CMVI) in women of reproductive age with obstetric complications in their medical history were carried out. 230 women aged 17-44 years were examined with the use of virological and serological tests. As the result of complex examination, CMVI markers were detected in 159 (69%) of women. Three forms of CMVI were detected in the examined women: latent (30%), reactivated (14%) and persistent (25%). This investigation revealed that the most complete detection of CMVI and the evaluation of its activity in women with obstetric complications in their medical history requires the combined use of virological and serological tests.

[Effect of oxygen aeroions on hemostasis and development of arteriosclerosis in hypodynamia]. / Vliianie aéroionov kisloroda na gemostaz i razvitie arterioskleroza pri gipodinamii.

Experiments on 50 rabbits examined the hemostatic effects of negative oxygen aeroions (AI). In control experiments, keeping the animals under hypodynamia led to 40% animal death, significant aortic atherosclerosis and myocardial infarction. The animals developed the thrombohemorrhagic syndrome with hypercoagulemia and drastically suppressed blood fibrinolytic activity. Keeping the animals in the excess AI-containing premise saved all rabbits' life and prevented arteriosclerosis and myocardial infarction. Unlike the controls, these animals failed to develop the thrombohemorrhagic syndrome. Clotting time, plasma recalcification time, and plasma silicon and kaolin time did not reduce, but prolonged. There was no drop in the content of antithrombin III or rise in values of paracoagulation tests. It is recommended that Chizhevsky's electroeffluvial chandeliers should be used to prevent hemostatic disorders and arteriosclerosis in hypodynamia.

[Preparation of monoclonal antibodies to super early human cytomegalovirus proteins and their use for detecting infected cells]. / Poluchenie monoklonal'nykh antitel k sverkhrannim belkam tsitomegalovirusa cheloveka i ikh primenenie dlia vyiavleniia infitsirovannykh kletok.

Twenty-six mouse hybridomas producing monoclonal antibodies (MAB) to human cytomegalovirus (CMV) proteins have been obtained. MAB produced by three hybridomas were studied in detail. MAB were active in indirect immunofluorescence and solid-phase enzyme immunoassay, being directed to the super-early viral protein p72. Use of the resultant MAB for analysis of CMV-infected cells demonstrated that by specificity and sensitivity of viral antigen detection they were not inferior to anti-CMV antibodies manufactured by Ortho, USA. Screening of 258 patients with suspected CMV infection showed that these MAB may be used for immunofluorescent detection of CMV antigens in the material isolated from patients and infected subjects.

[The seasonal dynamics of hemostasis and fibrinolysis in the central belt of Russia]. / Sezonnaia dinamika gemostaza i fibrinoliza v srednei polose Rossii.

Upon evaluating seasonal shifts in hemostasis in healthy subjects (3200 examinees aged 18-40) it was established that coagulation rate is the highest in spring. This phenomenon occurred in association with activated fibrinolysis, reduced levels of antithrombin III and more marked paracoagulant tests. Natural lysis of the clot and euglobin fibrinolysis proved more intensive in spring, while least intensive in winter. Frequency of clot lysis inhibition varies with season of the year. In winter the inhibition is observed in 45%, in spring in 21.6%, in summer in 41% and autumn in 36.2% of the examinees. The facts allowed the conclusion on more active hemostasis in spring and less active fibrinolysis in winter, this making these seasons in the Middle Russia most risky as regards vascular accidents.

[The bacteriologic background and an analysis of the resistance of the agent to antibacterial preparations in patients in the postresuscitation period]. / Bakteriologicheskii peizazh i analiz rezistentnosti vozbuditelei k antibakterial'nym preparatam u bol'nykh, nakhodiashchikhsia v postreanimatsionnom periode.

A total of 6848 bacteriological passages have been performed in 57 patients during postresuscitation period under bacteriological monitoring that included the investigation of different body media twice daily. A microbial pattern has been compiled, typical of a certain intensive care unit, which served the basis for analysis of the resistance of the most widespread agents of pyoseptic complications to antibacterial preparations, with due consideration for the process site. The scheme of antibacterial therapy suggested made it possible to reduce the incidence of those complications due to the increased efficacy of antibacterial therapy in the postresuscitation period.

[The diagnostic problems in cytomegalovirus infection in patients with a transplanted kidney]. / Problemy diagnostiki tsitomegalovirusnoi infektsii u patsientov s transplantirovannoi pochkoi.

Several methods of cytomegaloviral (CMV) infection diagnosis were studied in patients with a transplanted kidney. EIA was used to examine clinically normal subjects and patients with CMV infection symptoms for the presence of anti-CMV IgM and IgG. Pulmonary cells of the human embryo were infected with the patients' blood and urine, followed by examination for the presence of antigen. After 7 to 14 days part of the infected cultures were examined for virus isolation. The cytological specimens prepared from the saliva and urinary sediment were investigated for the presence of cells containing characteristic CMV inclusions. Altogether 87 patients were examined. Of these, 27 had evident signs of the disease. As for the patients, virus from the blood was isolated in 60, that from the urine in 90% of cases. Viral antigen was found in the cells infected with material from the urine (in 70% of cases) and blood (in 80% of cases). It the group of the clinically normal subjects, the same parameters turned out much lower: virus from the blood was isolated in 12, that from the urine in 11% of cases. In the clinically normal subjects, anti-CMV IgG and IgM were demonstrated in 80 and 21% of cases, respectively. As for the patients, anti-CMV IgG was discovered in 100 and anti-CMV IgM in 70% of cases. All the patients with a transplanted kidney exhibited markers of CMV infection.