[Features of changes in volume-impedance hemodynamic indicators during the tilt test in young males with a history of vasovagal syncopes].

BACKGROUND: The direction of changes in hemodynamic parameters during the tilt test (TT) nin individuals with history of vasovagal syncope (VVS) is a subject of discussion. OBJECTIVE: to study changes of volume-impedance hemodynamic indicators in the process of tilt test in somatically healthy young men with history of VVS. MATERIALS AND METHODS: A total of 102 men aged 18-30 years were divided into 4 groups, taking into account the specific features of fainting history and response to TT. Persons of group 1 (n=14) had history of VVS and positive response to TT (syncope). Subjects of group 2 (n=14) had history of VVS and a pattern of postural tachycardia without fainting during TT. Persons of group 3 (n=42) had history of VVS and negative response to TT. Subjects of group 4 (n=32) had no history of VVS and negative response to TT. During TT, we studied dynamics of some indicators, including cardiac output (CO) and total peripheral vascular resistance (TPVR). RESULTS: In individuals of all groups in the initial horizontal phase of TT values of CO and TPVR corresponded to the norm. Subjects of group 1 had significantly lower CO compared with subjects of groups 2, 3, 4 (p<0.05, p<0.01, p<0.05, respectively). Values of TPVR in subjects of group 1 were significantly higher than in subjects of groups 2, 3, 4 (p<0.05; p<0.05; p<0.05, respectively). In response to orthostasis CO values increased in groups 1, 2, 4 (by 18%, 10%, 5%, respectively) and did not change in group 3; TPVR values decreased in groups 1, 2 (by 8%, 0.5%, respectively), and increased in groups 3, 4 (by 8%, 4% respectively). In the final horizontal phase of TT, CO values in group 1 were significantly lower than in groups 3, 4 (p<0.05), while TPVR values did not significantly differ between all groups (p>0.05). CONCLUSIONS: In tilt-positive and tilt-negative subjects with history of VVS, standardized postural stress leads to unidirectional changes in cardiac output, but to multidirectional changes in total peripheral vascular resistance.

[Changes of Nonspecific Proteinases and Proinflammatory Cytokines in the Clinical Course of Acute Myocardial Infarction of Various Severity].

PURPOSE: to study changes of serum levels of nonspecific proteinases, their inhibitors, and proinflammatory cytokines during short term observation of patients with acute myocardial infarction (MI). MATERIALS AND METHODS: We included in this prospective short-term study 82 patients (27 with uncomplicated non-Q wave MI, 30 with Q-MI complicated by Killip class I-II acute left ventricular failure [ALVF], 17 with Q-MI complicated by Killip class III-IV ALVF, and 8 non-survivors due to development of cardiogenic shock) and 12 healthy controls. Serum levels of interleukin (IL) - 1ß, IL-6 and tumor necrosis factor (TNF)-α were measured by ELISA. Elastaselike (ELA) and trypsin-like (TLA) activities as well as characteristics of proteinase inhibitors (antitrypsin activity and acid-stable inhibitors) were also determined. Blood samples were taken at hospital admission within 24 hours after onset of symptoms. The GUSTO Score at admission was used for risk stratification. RESULTS: All cytokines levels were significantly elevated in MI patients in comparison to controls. Mean concentrations of IL-6 and TNF-α at baseline were higher among patients with MI complicated by ALVF than in the group with uncomplicated MI (27.45 vs 16.04 pikogram / mL, р.

[Nerve Growth Factor in Patients With Arterial Hypertension: Neuropsychical, Hemodynamic, Metabolic Relationships].

AIM: To investigate the changes of serum nerve growth factor (NGF) level in patients with arterial hypertension (AH) and obesity in dependence on the degree of psycho-emotional stress and physical activity. MATERIALS AND METHODS: We examined 76 male patients with stage I and II AH with mean age 46.75±0.56 years (36 patients with and 40 without obesity). Control group consisted of 26 individuals without AH, obesity, and cardiovascular diseases. All patients underwent ambulatory blood pressure (BP) monitoring. Serum concentrations of NGF ß-subunit and cortisol were determined by enzyme linked immunosorbent assay. For assessment of levels of psycho-emotional stress, reactive and personal anxiety, and physical activity we used Psychological Stress Measure (PSM-25), the Spielberger-Khanin questionnaire, and brief International Physical Activity Questionnaire (IPAQ), respectively. RESULTS: Level of NGF in patients with AH and obesity (0.94±0.28 ρg/ml) was higher than in non-obese patients with AH (0.21±0.06 ρg/ml; p=0.018) with highest figures in patients with insufficient physical activity and high level of psychoemotional stress. In all groups of patients there was unidirectional reverse correlation between serum NGF and cortisol levels. According to ambulatory BP monitoring, NGF level was inversely proportional to systolic and diastolic BP variability in patients with AH and obesity and in the control group. Reduced serum concentration of NGF was associated with increased levels of reactive and personal anxiety. CONCLUSION: Obtained data suggests that NGF plays an important role in complex multifactorial interactions between neuropsychic, cardiovascular and metabolic processes.

Changes of humoral anti-endotoxin immunity and low-intensity inflammation in diabetes mellitus type 1 and 2.

The purpose: The purpose. Investigate the levels of different classes serum anti-endotoxin antibodies in patients with diabetes mellitus type 1 and 2 and to hold the cluster analysis of the relationship between the individual levels of such antibodies and the concentration of C-reactive protein in the blood. Methods: We examined 51 patients with diabetes mellitus type 1 and 60 patients with diabetes mellitus type 2. The diagnosis of diabetes mellitus type 1 or type 2 has been delivered in accordance with the criteria of the World Health Organization. The control group included 49 healthy people who have not a history of any chronic disease, and the clinical manifestations of acute diseases were absent at the time of the survey. By sex and age, the control group of healthy people matched to a group of patients with diabetes type 1 and type 2. The concentration of C-reactive protein in the blood and the levels of serum anti-endotoxin antibodies of different classes (A, M and G) was determined by ELISA. Results: Using cluster analysis revealed that 40.8% of patients with type 1 diabetes increased concentration of C-reactive protein in the blood is associated with a significant reduction of levels of serum anti-endotoxin antibodies classes A, M and G. In 56.7% of patients with type 2 diabetes the high concentration of C-reactive protein in the blood levels of serum anti-endotoxin antibody classes A and M were not significantly different from the normal values, but the levels of serum anti-endotoxin antibodies of class G were significantly increased. The activation of inflammation with a further increase of C-reactive protein in the blood of patients with type 2 diabetes mellitus accompanied by a significant increase in levels of serum anti-endotoxin antibodies classes A and G, and also a tendency to reduce of levels anti-endotoxin antibodies class M. Conclusion: The results suggest about the relationship between low-intensity inflammation and immune response to enterobacterial endotoxins in patients with diabetes mellitus type 1 and 2.

[Use of spectral index of heart rate variability as a predictor of poor clinical outcome in patients with severe combined chest trauma].

Use of spectral index of heart rate variability as a predictor of poor clinical outcome in patients with severe combined chest trauma. The article provides information on results of research of connection between spectral index of heart rate variability, got during 5-minutes record of echocardiography in acute period of traumatic disease, and severity of trauma, severity of health condition and level of impairment of consciousness in patients with combined chest trauma. Defined correlating connections between separate indexes of spectral analysis of heart rate variability and scales, reflecting health status severity and severity of trauma when admission the patients. Defined accurate differences between indexes of a power of very low frequency, low frequency and high-frequency waves, indexes of a vagosympathetic balance in groups of patients with poor clinical outcome and lethal outcome. Proved the possibility of the use of definite, during 12 hours after getting injury, relative powers of low- frequency and high-frequency waves, expressed in normalized units, index of a vagosympathetic balance as physiological markers of poor clinical outcome in patients with severe combined chest trauma.

[LEVELS OF SERUM ANTIBODIES TO ENTEROBACTERIAL LIPOPOLYSACCHARIDES AND THEIR RELATIONSHIP WITH CONCENTRATION OF C-REACTIVE PROTEIN IN DIABETES MELLITUS PATIENTS].

We examined patients with type 1 (DM 1) and type 2 (DM 2) diabetes mellitus. The concentration of C-reactive protein (CRP) in the blood and levels of serum antibodies to different classes of enterobacterial lipopolysaccharides (LPS) were determined by ELISA. Using cluster analysis it was shown that in 40.8% DM-1 patients the increased concentration of CRP is associated with a decrease in the levels of serum anti-LPS-IgA, anti-LPS-IgM and anti-LPS-IgG. In 56.7% of DM-2 patients with increased concentration of CRP levels of serum anti-LPS-IgA and anti-LPS-IgM were not significantly different from the normal values, but the levels of serum anti-LPS-IgG were significantly increased. Activation of inflammation and increase of concentration of the CRP in the blood of DM-2 patients is accompanied by a significant increase in the levels of serum anti-LPS-A and anti-LPS-G, as well as the tendency to reduce the levels of anti-LPS-IgM. The results of this study suggest an association between low intensity inflammation and immune response to enterobacterial LPS in type 1 and 2 diabetes mellitus.

[CHARACTERISTIC OF ALTERATIONS OF ARTERIES IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CHRONIC HEPATITIS C].

The article presents an assessment of degree and type of atherosclerosis of coronary and non-coronary vessels in old patients with ischemic heart disease associated with chronic viral hepatitis C (VHC), the incidence of myocardial infarction and the possibility of participation chronic VHC in atherogenesis. Patients with ischemic heart disease have correlation of atherosclerosis of arteries with age, hypercholesterinemia. Patients without chronic VHC more often give a higher risk of myocardial infarction, especially in early period (1-1,5 years) of onset of ischemic heart disease clinical implications. Patients with ischemic heart disease associated with chronic viral hepatitis C more often have generalized alterations in vessels, multifocal type of alteration. So, participation of VHC in atherogenesis is most probably connected with maintenance of chronic immune inflammation in vascular endothelium.

Mechanisms of resistance in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors.

Up to date, two major mechanisms have been proposed as an explanation for myeloid cells expansion in chronic myeloid leukemia (CML). One is a reduced susceptibility of hematopoietic stem or progenitor cells to apoptosis, while the other one is an increased activity within the hematopoietic progenitor cell population. The aim of the study was to identify specific features of functional activity, proliferation rates and differentiation potential of CML hematopoietic progenitor cells of patients treated with tyrosine kinase inhibitors (TKI) by identifying number of Ki-67, Bcl-2 and CD34 positive cells in bone marrow, as well as in vitro colony-forming unit assay in patients with different response to the TKI therapy. Our results indicated that there was a significant decline in proliferation activity of HSCs and HPCs in group of patients with optimal response to the TKI therapy. Correlation analysis, performed on individual basis for patients independently of response to the TKI therapy demonstrated that there was a negative correlation (ρ=0.7648) between the number of Ki67+ and CD34+ cells. As to colony to cluster ratio our results showed, that there is a correlation (ρ=0.6783) between CCR index and number of bone marrow cells with Philadelphia chromosome. It was indicated, that index of maturation correlates with level of bone marrow cells, containing Philadelphia chromosome, so as with percentage of CD34+, Bcl-2+, Pgp-170+ and Ki67+ cells in bone marrow of CML patients. In summary, obtained results suggest that different mechanisms (bcr-abl dependent and independent) may be involved in CML progression process in the same time. Disease prognosis should be preferably carried out on an individual basis.

[Spiritual ties of the Military Medical (Medical and Surgical) Academy].

Before the revolution in its educational, research and clinical potential of Military Medicine (medical and surgical) Academy was on the head position among European institutions. Not less outstanding position among all secular institutions Russian Academy held by the number and wealth of churches, chapels and baptisteries. In the temples of the academy was concentrated a significant number of miracle-working icons and of the particles holy relics, there served some of faith and piety devotees and some of them were canonized. The article presents a brief historical overview of the major Academy shrines--spiritual ties of the different generations.

Functional activity of CD34-positive cells in chronic myeloid leukemia patients with different response to imatinib therapy.

INTRODUCTION: It is believed that the reason of the leukemic clone cell resistance to treatment with tyrosine kinase inhibitors during chronic myeloid leukemia (CML) is mutations in the genome of an early bone marrow progenitor cells that are CD34-positive. Such cells, regardless of treatment, acquire ability to proliferation and differentiation. This leads to the re-expansion of the CD34(+) cells. AIM: to determine the CD34 antigen expression in bone marrow and peripheral blood cells in CML patients with different response to imatinib therapy using the results of hematopoietic cells culturing and the data of flow cytometry. METHODS: Bone marrow aspirate from 39 patients who were treated with imatinib was studied with cytogenetic, flow cytometry and culture methods in vitro. RESULTS: In patients with an optimal response to imatinib therapy the number of colonies was 1.8 times lower than the number of those in the group of patients with a suboptimal response to therapy. In turn, in patients with failure of imatinib therapy the number of colonies was the highest and was 2.1 times higher than the patients with optimal response. The results of cytometric studies have shown that the number of CD34(+) cells in bone marrow was significantly higher compared to the number of CD34(+) cells in peripheral blood cells and increased with the acquisition of leukemic cells the resistance to imatinib. There was a direct correlation between the number of colonies and clusters in semisolid agar in vitro and the number of CD34(+) cells in the bone marrow of patients. CONCLUSIONS: The correlation between the number of CD34(+) cells and the number of cell aggregates in semisolid agar in vitro indicates the prognostic value of the method for determining CD34(+) cells in the patient bone marrow. The parallel increase of their number in the peripheral blood will allow developing express methods for the detection of individual patient response to imatinib therapy.

[Features of morbidity community-acquired pneumonia among young recruits].

Were examined 3338 military personnel of the combined training center. 183 of them diagnosed community-acquired pneumonia, in 3155 focal and infiltrative changes in lung tissue were not identified. The analisys of prevalence been made among young recruits of the acute respiratory illness before arriving in part and at the assembly point, foci of chronic infection, smoking, low body weight. 511 military personnel arrived at the training center in the disease state with symptoms of acute respiratory illness. Examined the relationship these risk factor to the development of community-acquired pneumonia in this category of servicemen.

[Correlation between basal concentration of C-reactive protein in the blood, levels of serum antiendotoxin antibodies and endotoxin-binding capacity of monocytes and granulocytes in healthy people].

The associative links between base concentration of C-reactive protein (hsCRP), levels of serum antiendotoxin antibodies of different classes and endotoxin-binding capacity of monocytes and granulocytes of healthy volunteers were investigated by cluster analysis. In the group of healthy volunteers with increased base concentration of hsCRP in blood the levels of serum antiendotoxin antibodies of different classes and endotoxin-binding capacity of monocytes and granulocytes were reduced. Thus, the disbalance of detoxification and clearance of endotoxin by humoral and cellular mechanisms can be one of the possible causes of development of low intensity inflammation and increase of hsCRP concentration in blood.

[Bacillus subtilis and streptomycin resistant mutant growth in the medium with saponite].

The influence of dispersed saponite on growth activity of Bacillus subtilis IMV B-7023 and its streptomycin resistant mutant has been shown. The effectiveness of this process depends on the content of dispersed material and phosphate in the medium. It has been found that when B. subtilis is cultured in the medium containing 0.6 g/l PO4(3-) stimulation of bacteria growth is observed, but at a lower concentration (0.1 g/l PO4(3-)) there is a decline in the culture growth activity. At the same time streptomycin resistant mutant is shown to increase growth activity in the growth medium which contains up to 1.0 g/l saponite, regardless of the concentration of phosphate. It is shown that this effect is a consequence of uniformity of surface properties of streptomycin resistant strain of bacteria and similar parent strain at a concentration of 0.6 g/l PO4(3-).

[Therapeutic morbidity rate among female military personnel, with exposure to occupational hazards in the period of service in the Armed Forces its influence on the course of pregnancy and fetal development].

The study was made into therapeutic incidence among female military personnel who had contact with various kinds of occupational hazards in the period of military service, its impact on pregnancy and fetal development. Special attention was also paid to long-term consequences of obstetric and therapeutic pathological comorbidity on the development of the child. It has been established, that in the spectrum of therapeutic morbidity among female military personnel chronic gastritis, pyelonephritis and autoimmune thyroiditis prevail and often have a chronic stress as a background for their development. Children born to mothers, who in the period of pregnancy showed the combination of chronic pyelonephritis, autoimmune thyroiditis and late gestosis are a group of high risk for the development of the intracranial hypertension in children and/or infectious diseases.

[Avidity and competitive inhibition of binding native and chaotropically modified immunoglobulins with protein and glycolipid antigens].

It is established, that native and chaotropically modified immunoglobulins essentially differ by avidity and character of competitive inhibition of binding with protein (ovalbumin), glycolipid (lipopolysaccharides) antigens and native double-strand DNA. Apparently, it is connected with structural and functional distinctions of their antigen-binding centres.

[Features of Bacillus subtilis IMB B-7023 and its streptomycin-resistant strain].

Features of phosphate-mobilizing bacteria Bacillus subtilis IMB B-7023 and its streptomycin-resistant strain were investigated. While cultivated in medium with glucose and glycerophosphate, the growth rate of the antibiotic-marked strain was approximately similar to this parameter for Bacillus subtilis IMB B-7023 but cell sizes were 1.3-fold less. Both strains significantly stimulated the germinating of plant seeds, attached to their roots, and insignificantly differed in antagonistic activity toward phytopathogens and quantitative content of cell fatty acids and phosphatase activity. Streptomycin-resistant strain may be used for monitoring of Bacillus subtilis introduced to agroecosystem.

[Endoscopic ureterolithotomy in large concrements of the upper third of the ureter].

Endoscopic ureterolithotomy was made in 38 patients who had concrements in the upper third of the ureter more than 1 cm in size. Operations were retroperitoneoscopic and laparoscopic in 20 and 18 cases, respectively. Five patients had recurrent stones, 7 patients had prior extracorporeal shock-wave lithotripsy, 2 patients failed contact ureterolithotripsy. In the rest cases endoscopic ureterolithotomy was a first-line treatment. A complete elimination of the stone was achieved in all the cases. Mean time of the operation in a retroperitoneoscopic approach was 149 min, in laparoscopic - 125 min. Mean blood loss was the same. Conversion was performed in one case in the group of retroperitoneal approach. Postoperative stay in hospital in retroperitoneo- and laparoscopic ureterolithotomy was 3 - 16 days. Laparoscopic ureterolithotomy produced a complication in one case - an insignificant injury of the colon. Urinous infiltration and pneumonia developed after retroperitoneoscopic ureterolithotomy in one and one case, respectively. Thus, endoscopic ureterolithotomy in large stones of the upper third of the ureter via retroperitoneal and transperitoneal approach is a safe, low-invasive and effective operation which provides complete stones elimination. Endoscopic ureterolithotomy should be done in uneffective first-line treatment. It is a leading method in the treatment of large and long-standing stones of the upper third of the ureter.

Proliferation and survival of rat C6 glioma culture in the presence of implants coated with modified carbon-based films.

The survival of rat C6 glioma decreased in the presence of implants from VT-16 titanium alloy. Diamond-like carbon coating of VT-16 alloy slightly increased cell death on day 5 of the experiment (39.9+/-2.1%). The percentage of dead C6 glioma cells inside titanium rings with diamond-like carbon coating, incorporating up to 3.5 atom.% Ag nanoparticles, was 53.7+/-4.3% on day 5 of culturing, while after doping to 6.7 atom.% Ag cell death reached 66.7+/-3.2% (p<0.05). The maximum toxic effect towards C6 glioma was detected in the specimens coated with diamond-like film with silver nanoparticles.

[Influence of titanium dioxide on growth of Azotobacter vinelandii IMV V-7076].

Adding highly dispersed titanium dioxide particles of the culture medium has a stimulatory effect on growth of Azotobacter vinelandii. The maximum effect was observed when using 5 g/l and 10 g/l concentrations of this component. Under these conditions the number of grown bacteria is several times more than in the control variants. It was shown that the stimulatory effect could not be the consequence of saccharose sorption on the surface of particles of the dispersed compound. Possibly, the contact interaction of bacterial cell with titanium dioxide causes an increase of cell wall permeability which leads to an increase of substrates transport to the cell.