[Epidemiology and Management of Heart Failure Patients With Atrial Fibrillation].

The number of patients with heart failure and atrial fibrillation is huge. Population of patients with heart failure in combination with atrial fibrillation is characterized by poor quality of life and adverse outcomes. In this review we summarized data on the guideline adherence and prevalence of long-term anticoagulant therapy in patients with atrial fibrillation and heart failure.

[Comparative characteristics of immunological tests in differentiation of systemic and cutaneous forms of lupus erythematosus].

AIM: To study immune disorders in cell immunity and cytokine profile in integument lupus erythematosus (ILE) and systemic lupus erythematosus (SLE). MATERIAL AND METHODS: Lymphocyte phenotype, oxygen-dependent and non-oxygen-dependent functions of circulating neutrophils and monocytes, serum levels of circulating immune complexes (CIC), cytokines (IL-1beta, IL-4, IL-6, TNFalpha), antibodies to aDNA were studied in 177 patients with lupus erythematosus aged 20-60 years (143 had SLE and 34 ILE) and 33 healthy controls. RESULTS: CIC levels, serum aDNA, IL-1beta and IL-4, oxygen-dependent neutrophil metabolism were higher both in SLE and ILE. Only SLE was characterized by high oxygen stress of monocytes, acid phosphatase and cation proteins in neutrophils and monocytes. Lymphocyte phenotype both in SLE and ILE was characterized by low count of CD3+ lymphocytes and high count of cells with markers of activation and apoptosis. SLE patients had lower count of HLA-DR+ cells and higher count of CD16+ and CD25+ lymphocytes. CONCLUSION: Identification of metabolic functions of circulating phagocytes, serum cytokines and lymphocyte phenotype can be used for differentiation between SLE and ILE.

Inactivation of the Hansenula polymorpha PMR1 gene affects cell viability and functioning of the secretory pathway.

In yeast, functions of the endoplasmic reticulum (ER) depend on the Golgi apparatus Ca2+ pool, which is replenished by the medial-Golgi ion pump Pmr1p. Here, to dissect the role of the Golgi Ca2+ pool in protein folding and elimination of unfolded proteins in the ER, the manifestations of the pmr1 mutation in yeast Hansenula polymorpha were studied. The PMR1 gene was disrupted in a H. polymorpha diploid strain. Haploid segregants of this diploid bearing the disruption allele were viable, though they showed a severe growth defect on synthetic medium and rapidly died during storage at low temperature. Disruption of H. polymorpha PMR1 led to defects of the Golgi-hosted protein glycosylation and vacuolar protein sorting. This mutation increased the survival rate of H. polymorpha cells upon treatment with the proapoptotic drug amiodarone. Unlike Saccharomyces cerevisiae, the H. polymorpha pmr1 mutant was not hypersensitive to chemicals that induce the accumulation of unfolded proteins in the ER, indicating that the elimination of unfolded proteins from the ER was not essentially affected. At the same time, the pmr1 mutation improved the secretion of human urokinase and decreased its intracellular aggregation, indicating an influence of the mutation on the protein folding in the ER.

[Mathematical analysis of EEG in consciousness recovery after traumatic brain injuries].

The clinical and EEG study of 20 patients with post-comatose consciousness disturbances caused by severe traumatic brain injuries (9 patients with autonomic state and 11 with Korsakoff syndrome), applying a statistical method of analysis of EEG spectrum and coherent connections developed by the authors, has revealed pathological features of the EEG interhemispheric connections. Patients with consciousness disturbances exhibited (1) total functional disconnections of hemispheres which was characteristic of the autonomic state and (2) disconnection in frontal areas of the brain in patients with Korsakoff syndrome as compared to the normal spatial distribution of coherence observed in 40 healthy people. Consciousness recovery has been accompanied by interhemispheric connections normalization, at first in the posterior regions of the hemispheres and then in the anterior ones as well as by transforming of coherence profile in the shape of "envelope" being most typical for the normal pattern of coherence distributation.

[Oxygen-dependent metabolism of neutrophils and monocytes in patients with unstable angina pectoris and its correction with preductal]. / Osobennosti kislorodzavisimogo metabolizma neitrofilov i monotsitov u bol'nykh nestabil'noi stenokardiei i ego korrektsiia preduktalom.

Spectrophotometric NBT-test and luminol-dependent chemiluminescence were used to study oxygen-dependent metabolism of neutrophils and monocytes; antioxidant defense was evaluated by activity of superoxide dismutase measured by spectrophotomety and peroxide chemiluminescence of blood plasma; heparin and trimetasidine (preductal) effects on the above metabolism were studied in 39 patients with unstable angina pectoris. All the patients were found to have a significant rise in functional activity of neutrophils and monocytes by NBT-test and insignificant one by chemiluminescence, unchanged activity of serum superoxide dismutase, reduced total antioxidant potential of blood serum, moderate elevation of circulating immune complexes in high parameters of NBT-test. The latter points to a mild activation of leukocytes through FcR or CR and suggests the presence of another activator of membrane NADP.H-oxidase in unstable angina. Use of heparin in unstable angina activated oxygen-dependent metabolism of neutrophils and monocytes in the absence of reduction in the degree and extent of ischemic myocardial damage. This reduction was observed in the treatment of unstable angina with preductal. This effect is due to suppression, primarily, of NADP.H- and NAD.H-oxidase of leukocytes. It also demonstrates antioxidant properties of this drug.

[Oxygen dependent metabolism of neutrophils and monocytes in patients with unstable angina and its correction with preductal]. / Osobennosti kislorodzavisimogo metabolizma neitrofilov i monotsitov u bol'nykh nestabil'noi stenokardiei i ego korrektsiia preduktalom.

Oxygen-dependent metabolism of neutrophils and monocytes and antioxidant defense and heparin and trimetasidine effects on them were studied in 39 patients with unstable angina. All the patients showed a significant activation of neutrophils and monocytes by NBT-test, insignificant one by chemiluminescence in active serum superoxide dismutase and reduced total antioxidative serum potential. There was also a moderate rise in the level of CIC in enhanced HBT-test. Heparin in unstable angina pectoris produced stimulation of oxygen-dependent metabolism of neutrophils and monocytes, ischemic damage to the myocardium was not changed. This was observed after treatment with preductal indicating antioxidant properties of this drug.

[Intercentral EEG relationships in regressive and chronic post-traumatic Korsakoff syndrome]. / Mezhtsentral'nye otnosheniia EEG pri regressiruiushchem i khronicheskom posttravmaticheskom Korsakovskom sindrome.

Dynamic EEG study of patients with posttraumatic Korsakoff's syndrome (KS) with the application of complex analysis methods revealed a complicated pathological structure of the intercentral relations of cortical electrical activity. The interhemispheric EEG coherence between symmetrical frontal cortical areas are sharply reduced, while the intrahemispheric coherence are increased in comparison with the normal values. The proposed technique of segregation of statistically homogeneous spectro-coherent characteristics made it possible to reveal the earlier intercentral EEG relations formed by stable and variable coherence spectra. The structure formed by the stable and variable coherence spectra in KS differs from that reflected in the mean coherence levels. During the KS regression, the EEG coherence between the right and left frontal areas increased to the normal level, and the variable spectra are revealed. In the chronic KS syndrome, the pathological intercentral relations persist, while the variable relations in the frontal areas are absent. A reduction of pathologically decreased intrahemispheric coherence selectively revealed in the right hemisphere during the KS regression and formation of variable relations in this hemisphere point to a leading role of the right hemisphere in development of compensatory processes in KS. The reciprocal relations between the intra- and interhemispheric coherence and coherence dynamics in the theta rhythm suggest that pathological activity in the basal diencephalic structures plays an important role in formation of the pathological EEG pattern in KS.

[The orthostatic resistance of the cerebral and peripheral circulations in patients with contusive brain lesions]. / Ortostaticheskaia ustoichivost' mozgovogo i perifericheskogo krovoobrashcheniia u bol'nykh s kontuzionnymi porazheniiami golovnogo mozga.

Orthostatic tests with printing recording of EEG, REG, RVG were used to examine the functional status of the truncal level of circulatory regulation in patients with brain confusions. Within the first 24 hours after brain injury there was a significant reduction in the pulse blood filling of cerebral vessels in the vascularization areas of carotid and vertebral arteries along with higher vascular tone; pulse blood filling of peripheral vessels in the lower extremities remained normal with a marked decrease in their vascular tone. Orthostatic tests showed the asymmetric enhancement of a dilating arterial response in the virtual absence of a constrictive response of lower extremity vessels. Following 2-3 weeks of brain injury, cerebral and peripheral hemodynamics tends to normalize: in orthostasis, the responsive dilatation of cerebral vessels diminished, inter-hemispheric asymmetry levelled; as compared to the normal values, cerebral vasodilation, however, remained enhanced with drastically suppressed peripheral vascular responsiveness. The described impaired vascular responsiveness were more evident in the presence of EEG truncal dysfunction syndromes. The findings suggest that central regulatory disorders of vascular tone play an important role in the pathogenesis of traumatic brain disease. A particular phasic periodicity of vascular responses to orthostatic exposure, which are characteristic of the acute and early rehabilitative periods of moderate brain injury.

[General anesthesia, hormones and hemodynamics during the excision of tumors of the posterior cranial fossa]. / Obshchaia anesteziia, gormony i gemodinamika pri udalenii opukholei zadnei cherepnoi iamki.

The levels of tropic and peripheral hormones (ACTH, TSH, STH, T3, T4, hydrocortisone, insulin) have been assessed in 74 patients, aged 16 to 64 years, operated on for posterior cranial fossa tumors. Depending on the basic anesthesia component the patients were divided into 3 groups: patients on halothane anesthesia, patients on anesthesia with azeotropic mixture, patients on neuroleptanalgesia. Three hemodynamic variants in the course of operation and postoperative period have been established: patients with normal blood pressure, heart rate, stroke volume; patients with elevated and high blood pressure; patients with unstable hemodynamics. It has been found that general halothane and azeotropic mixture anesthesia is associated with marked changes in intraoperative endocrine function. Endocrine function is changed on the 3rd and 7th day postoperatively due to surgical brain trauma.

[Descending myelography with water contrast media by the methods of lateral puncture of the great occipital cisterna]. / Niskhodiashchaia mielografiia s vodorastvorimymi kontrastnymi preparatami metodom bokovoi punktsii bol'shoi zatylochnoi tsisterny.

A method of lateral puncture of the great occipital cistern for descending myelography with water soluble contrast substances was employed. It was used in 150 neurosurgical inpatients aged 4 to 70 with various diseases of the spinal marrow and its coats. A new water soluble drug iopamidol-200 (or 300) (Bracco, Italy) was used for diagnosis of spinal tumors. The drug dosage was worked out for adults as well as for children. A study was made of possible side-effects on a vast clinical material (80 patients). The new contrast substance iopamidol possesses better tolerance by patients and better roentgenocontrast properties than amipack.

[Descending myelography with water-soluble contrast agents using methods of lateral puncture of the great occipital cistern]. / Niskhodiashchaia mielografiia s vodorastvorimymi kontrastnymi preparatami metodom bokovoi punktsii bolshoi zatylochnoi tsisterny.

A method of lateral puncture of the great occipital cistern for descending myelography with water soluble contrast substances was employed. It was used in 150 neurosurgical inpatients aged 4 to 70 with various diseases of the spinal marrow and its coats. A new water soluble drug iopamidol-200 (or 300) (Bracco, Italy) was used for diagnosis of spinal tumors. The drug dosage was worked out for adults as well as for children. A study was made of possible side-effects on a vast clinical material (80 patients). The new contrast substance iopamidol possesses better tolerance by patients and better roentgenocontrast properties than amipack.

[Natural autoantibodies of neonatal rats detectable by a hybridoma technic]. / Estestvennye autoantitela neonatal'nykh krys, vyiavliaemye gibridomnoi tekhnikoi.

Neonatal rat hybridomas were tested for natural autoantibodies (NAA) production, using different screening procedures. NAA were discovered in 35% of immunoglobulins producing hybridomas. Radioimmunoassay (RIA) on brain and liver homogenates and immunocytochemistry on brain sections are the procedures of choice revealing the major part of the identified NAA. On the contrary, only a small portion of NAA could be detected with indirect immunofluorescence on fixed fibroblasts and with RIA on individual autoantigens. All the NAA revealed proved to be of the IgM type and almost all of them possessed neither organ nor species-specificity. In spite of that, most of the NAA reacted with definite cell populations of nervous tissue such as glia, neurons, ependyma or brain vessel cells. The studied panel of NAA from neonatal rats has common features with similar panels from newborn and old mice, though some species-specific characteristics do exist.