THE EFFECT OF INCREASED ADHERENCE TO GLYCEMIC CONTROL ON CORONARY HEART DISEASE AND QUALITY OF LIFE IN PATIENTS WITH CONCOMITANT IMPAIRED GLUCOSE METABOLISM.

Aim of the study - to evaluate the impact of increased adherence to glycemic control on the improvement of quality of life and the course of ischemic heart disease (IHD) in patients with diabetes. The study includes 44 patients (26 males -59%, 18 females - 41%), diagnosed with IHD (functional class І-ІІІ of exertion angina) and accompanying type 2 DM. Depending on the glycaemia control method, the patients were divided in two groups. In group I (CGM, n=21) the glycaemia control was based on CGM, when in group II (self-blood glucose monitoring - SBGM, n=23) it was based on individual glucose level self-measurement, performed 4 times per day. Distribution of patients between groups I and II by gender, age, anthropometric characteristics, DM duration, functional heart and kidney condition, acute cardio-vascular events in anamnesis and harmful habits (smoking) is without significant differences. Besides glycaemia monitoring, the patients recorded their arterial pressure, pulse and duration of their physical exertions (minutes a day). During patients' elective visits (0-3 months) glycated hemoglobin was measured in both patient groups, and they filled in the life quality questionnaire. The use of CGM for monitoring glycaemia level in patients with IHD and type II DM during 3 months has been associated with statistically significant decrease of glycated hemoglobin level, increase of physical activity. Also CGM improved physical condition and life quality according to the physical health scores SF-36 (physical function, physical function role, physical pain, general health) and social function scores, with reliable increase in group I compared to group II. There are no differences in body weight decrease or improved carbohydrate metabolic data have been detected. Administration of the CGM in patients with IHD is associated with improved quality of life and higher satisfaction level, decreased fasting HbA1c and glucose, and also increasing level of physical exertion level.

Monoclonal Antibody HlyIIC­15 to C-End Domain HlyII B. cereus Interacts with the Trombin Recognition Site.

Among the panel of monoclonal antibodies to the recombinant protein HlyIICTD Bacillus cereus an antibody was found capable of forming an immune complex with a thrombin recognition region, the amino acid sequence of which is located inside the recombinant HlyIICTD. Localization of the epitope was carried out using peptide phage display methods, as well as enzyme immunoassay and immunoblotting for interaction with recombinant proteins, either containing or not containing individual components HlyIICTD. The identified epitope is located in the region of the thrombin site and retains the ability to interact with the antibody after the proteolyotic attack of the protein by thrombin.

Variability of the Expression of Reference Genes in Samples of Human Olfactory Epithelium.

We analyzed variability of the expression of three reference genes in biopsy samples of the olfactory epithelium obtained from healthy volunteers. The expression of B2M, HPRT1, and CASC3 genes was analyzed by real-time PCR. The pairs of genes B2M-HPRT1 and B2M-CASC3 were found to possess minimum individual variability of expression and can be reliable candidates for the reference genes in analysis of gene expression in neural cells.

Effect of Light Intensity under Different Photoperiods on Expression Level of Carbonic Anhydrase Genes of the α- and ß-Families in Arabidopsis thaliana Leaves.

Changes in expression levels of genes encoding carbonic anhydrases α-CA1, α-CA2, α-CA4, ß-CA1, ß-CA2, ß-CA3, ß-CA4, ß-CA5, and ß-CA6 in Arabidopsis thaliana leaves after light increase from 80 to 400 µmol PAR quanta·m-2·s-1 were investigated under short day (8 h) and long day (16 h) photoperiods. The expression of two forms of the gene, At3g01500.2 and At3g01500.3, encoding the most abundant carbonic anhydrase of leaves, ß-CA1, situated in chloroplast stroma, was found. The content of At3g01500.3 transcripts was higher by approximately an order of magnitude compared to the content of At3g01500.2 transcripts. When plants were adapted to high light intensity under short day photoperiod, the expression level of both forms increased, whereas under long day photoperiod, the content of At3g01500.3 transcripts increased, and the content of transcripts of At3g01500.2 decreased. The expression levels of the At3g01500.3 gene and of genes encoding chloroplast carbonic anhydrases α-CA1, α-CA4, α-CA2 and cytoplasmic carbonic anhydrase ß-CA2 increased significantly in response to increase in light intensity under short day, and these of the first three genes increased under long day as well. The expression level of the gene encoding α-CA2 under long day photoperiod as well as of genes of chloroplast ß-CA5 and ß-CA4 from plasma membranes and mitochondrial ß-CA6 under both photoperiods depended insignificantly on light intensity. Hypotheses about the roles in higher plant metabolism of the studied carbonic anhydrases are discussed considering the effects of light intensity on expression levels of the correspondent genes.

[PULMONARY AUTOGRAFT OPERATION IN PEDIATRIC PATIENTS].

Experience of performance of a pulmonary autograft operation (PAO, оperation of Ross) was analyzed, results were estimated, the ways of overcoming a procedure conduction problems were determined. Remote result was investigated in 151 patients: the aortal valve stenosis was diagnosed in 99 (65.6%) patients, insufficiency - in 42 (27.8%), combined aortal valve failure - in 10 (6.6%). Hospital lethality have constituted 3.6%, and a general one ­ 7.9%. Reoperations were performed in 52 patients. PAO constitutes one of surgical procedures for the aortal valve failure in children of different age. Improvement of surgical technique and application of a new procedures have promoted improvement of the investigation results ­ lethality lowering from 15.1 to 0.8%. Application of surgical modifications with the aortal radix strengthening have reduced the reoperations on neaortal valve risk trustworthy.

[RESULTS OF THE TOTAL CAVA-PULMONARY CONNECTION PROCEDURE WITH CORRECTION OF ATRIO-VENTRICULAR VALVES IN PATIENTS OF DIFFERENT AGE, SUFFERING SINGLE CARDIAC VENTRICULUS].

The investigation objective was to improve the patients' management, suffering a single cardiac ventriculus, in whom a total cavа-pulmonary connection (ТСРС) operation was performed together with correction of the atrio-ventricular valves (AVV) insufficiency, basing on analysis of immediate and middle-term results. From 2005 to 2015 yrs in the clinic the ТСРС operation was performed in 132 patients. Of them 24 patients were choosed , in whom moderate and pronounced insufficiency of systemic AVV was diagnosed. Good early and middle-term results were achieved in 92% patients. In 8 observations, while the AVV correcting, in every patient two and more procedures of plasty were applied. Complex approach, using combination of various procedures of plasty, has guaranteed the optimal result. Application of procedures for the fiber ring stabilization have promoted achievement of best results.

Participation of Two Carbonic Anhydrases of the Alpha Family in Photosynthetic Reactions in Arabidopsis thaliana.

The expression of genes of two carbonic anhydrases (CA) belonging to the α-family, α-CA2 and α-CA4 (according to the nomenclature in N. Fabre et al. (2007) Plant Cell Environ., 30, 617-629), was studied in arabidopsis (Arabidopsis thaliana, var. Columbia) leaves. The expression of the At2g28210 gene coding α-CA2 decreased under increase in plant illumination, while the expression of the At4g20990 gene coding α-CA4 increased. Under conditions close to optimal for photosynthesis, in plants with gene At2g28210 knockout, the effective quantum yield of photosystem 2 and the light-induced accumulation of hydrogen peroxide in leaves were lower than in wild type plants, while the coefficient of non-photochemical quenching of leaf chlorophyll a fluorescence and the rate of CO2 assimilation in leaves were higher. In plants with At4g20990 gene knockout, the same characteristics changed in opposite ways relative to wild type. Possible mechanisms of the participation of α-CA2 and α-CA4 in photosynthetic reactions are discussed, taking into account that protons can be either consumed or released in the reactions they catalyze.

The occurrence of Ixodes ricinus ticks and important tick-borne pathogens in areas with high tick-borne encephalitis prevalence in different altitudinal levels of the Czech Republic Part II. Ixodes ricinus ticks and genospecies of Borrelia burgdorferi sensu lato complex.

STUDY OBJECTIVE: Three years long research study (2011-2013) on population density of Ixodes ricinus and the infection rate of the pathogens that they transmit was conducted in four topographically distant areas in the Czech Republic. In the previous decade (2001-2010) thirteen loci with increased incidence of tick borne encephalitis cases were defined, suggesting the permanent interaction of human population with ticks and indicating the landmarks for study of the presence of other tick borne pathogens. The work program included the identification of existing spectrum of spirochetes from Borrelia burgdorferi sensu lato complex and the conditions of their occurrence and distribution. MATERIAL AND METHODS: In the areas of the Ústí nad Labem Region, Olomouc Region, South Bohemian Region, and Highlands Region, 600 m2 plots were selected in the local optimal I. ricinus habitats where tick flagging was performed every year in the spring-summer and autumn seasons of the tick questing activity. Collected adult ticks (1369 males and 1404 females) were individually screened for B. burgdorferi s. l. spirochets. RESULTS: Spirochetes from B. burgdorferi s.l. complex were detected in all 13 studies sites in all altitudes from 280 to 1030 meters a. s. l. The total rate of infection was determined as 11.4% (males 10.4%, females 12.4%) with range limits from 1.4% (Ústí nad Labem in 2011) to 19.7% (South Bohemian Region, 2012).Genospecies were detected in various proportions and in different combinations: Borrelia afzelii, B. garinii, B. burgdorferi s. s., B. bavariensis, B. bissettii, B. valaisiana, B. spielmanii and B. lusitaniae. The three-year observation justifies the assumption that the regional differences in infectivity of I. ricinus are based on the character of the local biocenosis of the respective region. The dynamics of its seasonal changes, conditioned by climatic factors, determines the annual differences. CONCLUSION: Three of the medically most important Borrelia species formed a core group among all detected genospecies. B. afzelii was a dominated one (115 detections), followed by B. garinii (100) and by B. burgdorferi s.s. (19). Other genospecies were detected sporadically. However, the detection of B. bissettii should be emphasized due to the recently proven pathogenic effects of this genospecies and yet little-known sporadic expansion in the Czech Republic. The medical importance and distribution of other sporadically occurred genospecies is also discussed.Key words: Ixodes ricinus - Borrelia afzelii - B. garinii - B. burgdorferi s. s. - B. bavariensis - B. valaisiana - B. spielmanii - B. lusitaniae - B. bissettii - distribution - altitude - season - medical importance.

Isolation of live Borrelia burgdorferi sensu lato spirochaetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis.

Lyme borreliosis is a multisystem disorder with a diverse spectrum of clinical manifestations, caused by spirochaetes of the Borrelia burgdorferi sensu lato complex. It is an infectious disease that can be successfully cured by antibiotic therapy in the early stages; however, the possibility of the appearance of persistent signs and symptoms of disease following antibiotic treatment is recognized. It is known that Lyme borreliosis mimics multiple diseases that were never proven to have a spirochaete aetiology. Using complete modified Kelly-Pettenkofer medium we succeeded in cultivating live B. burgdorferi sensu lato spirochaetes from samples taken from people who suffered from undefined disorders, had symptoms not typical for Lyme borreliosis, but who had undergone antibiotic treatment due to a suspicion of having Lyme disease even though they were seronegative. We report the first recovery of live B. burgdorferi sensu stricto from residents of southeastern USA and the first successful cultivation of live Borrelia bissettii-like strain from residents of North America. Our results support the fact that B. bissettii is responsible for human Lyme borreliosis worldwide along with B. burgdorferi s.s. The involvement of new spirochaete species in Lyme borreliosis changes the understanding and recognition of clinical manifestations of this disease.

[SECRETORY ACTIVITY OF ATRIAL CARDIOMYOCYTES IN NORMOTENSIVE AND HYPERTENSIVE RATS DURING STRESS].

The pioneer overall ultrastructural and immune-enzymatic evaluation of the secretory activity of atrial myoendocrine cells in WAG strain (control) and in ISIAH rats with inherited stress induced arterial hypertension has been carried out. It was revealed that under basal conditions the cardiac hormone synthesis, storage and secretion in myoendocrine cells of hypertensive rats were certainly intensified, and the atrial natriuretic peptide (ANP) blood concentration was reliably higher than in normotensive WAG rats. All rats demonstrated the unidirectional reaction during the subchronic restraint stress: the ANP release was depressed, the peptides accumulated in the cardiomyocyte numerous large secretory granules, and ANP blood concentration 6 times decreased, while interline differences preserved. It is concluded that the cardiac natriuretic peptides as a hypotensive chain of the hemodynamic regulation, compensatory response to the development of inherited arterial hypertension and participate in the realization of stress reactions.

Carbonic anhydrases in photosynthetic cells of higher plants.

This review presents information about carbonic anhydrases, enzymes catalyzing the reversible hydration of carbon dioxide in aqueous solutions. The families of carbonic anhydrases are described, and data concerning the presence of their representatives in organisms of different classes, and especially in the higher plants, are considered. Proven and hypothetical functions of carbonic anhydrases in living organisms are listed. Particular attention is given to those functions of the enzyme that are relevant to photosynthetic reactions. These functions in algae are briefly described. Data about probable functions of carbonic anhydrases in plasma membrane, mitochondria, and chloroplast stroma of higher plants are discussed. Update concerning carbonic anhydrases in chloroplast thylakoids of higher plants, i.e. their quantity and possible participation in photosynthetic reactions, is given in detail.

[C-TYPE NATRIURETIC PEP- TIDE: WHAT, WHERE AND WHAT FOR IS THIS?].

The up-to-day world-wide data about the structure, distribution, and physiological effects of the most poorly known among the natriuretic peptides--the C-type (CNP)--are summarized in the review. Despite its name, this peptide does not stimulate sodium excretion but shares the prominent vasodilating and antyproliferating effects in different organs and tissues. The special emphasis is attended to CNP functions in central nervous system. The information about the peptide molecular biology, including intracellular processing, blood peptide concentration, specific receptors structure, and signaling pathways in target cells is presented.

Ticks and tick-borne pathogens in South Bohemia (Czech Republic)--Spatial variability in Ixodes ricinus abundance, Borrelia burgdorferi and tick-borne encephalitis virus prevalence.

Spatial distribution of Ixodes ricinus tick host-seeking activity, as well as prevalence of Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV) were studied in the TBE endemic area of South Bohemia (Czech Republic). High variability in tick abundance detected in a network of 30 study sites was most closely associated with characteristics of vegetation cover. Of 11,182 tested tick samples, 12% carried DNA of spirochete from B. burgdorferi s.l. complex. B. afzelii and B. garinii prevailed among spirochete species. The presence of B. spielmanii in the region was confirmed. The median number of borrelial genome copies in positive samples reached 6.6 × 10(3) by real-time PCR. The total prevalence of TBEV in pooled samples reached 0.32% (20,057 samples tested), at least one TBEV positive tick was present in 21 out of 30 sampling sites.

Inhibition of secretory activity of atrial myocytes in hypertensive rats after losartan treatment.

Male ISIAH rats with inherited stress-induced arterial hypertension (BP 174.0 ± 1.3 mm Hg) received antagonist of angiotensin II receptors losartan in a dose of 10 mg/kg/day for 16 days. Ultrastructural study of the right atrium showed signs of dramatic and pronounced inhibition of synthesis of the natriuretic peptides (changes in the composition of secretory granules and decrease in their population density and size) the atrial myocytes against the background of persistent BP decrease in hypertensive rats to 142.0 ± 4.2 mm Hg. We concluded that myoendocrine cells in rats with stable hypertension retain ability to respond adequately to distention of the atria with blood.

[Helicobacter pylori infection in patients with functional dyspepsia, eradication rates in the Donetsk region].

We have investigated 175 patients with Rome III diagnostic criteria for functional dyspepsia. 104 (59%) patients were infected with Helicobacter pylori. Three-component (PPI + clarithromycin + amoxicillin) 7-day therapy with the addition of the probiotic was effective in 92 patients (88.4%). Dyspeptic symptoms were resolved in 37 patients with successful eradication (40%). Persistent effect for 6 months was maintained in 24 patients (26%). Eradication efficacy in eliminating of the dyspepsia symptoms was higher in epigastric pain syndrome than postprandial distress syndrome.

[Results of the cardiosurgical care delivery to teenagers and adult patients with inborn heart failures].

The results of surgical aid delivery to adult patients, suffering inborn heart failures (IHF), were analyzed for period of 15 yrs. Surgical activity in teenagers and adult patients, suffering IHF, was analyzed with the objective to create a management strategy for such patients. More close dispensary control of teenagers in a pediatrician-cardiologist was noted, while their transfer to the adult clinic it is necessary to follow them thoroughly together with dispensary registration. Progressive enhancement of the patients quantity was registered, in whom more complex and combined inborn anomalies of the heart and the main vessels were diagnosed. Enhancement of the interventions quantity, which are performed on the exit tract of left ventricle and ascending aorta and what is caused by introduction of angiographic interventions, was noted together with total rising of the operations quantity.

The size of the light-harvesting antenna of higher plant photosystem II is regulated by illumination intensity through transcription of antenna protein genes.

In arabidopsis plants, with an increase in illumination intensity during growth the extent of reduction of the plastoquinone pool in the photosynthetic electron transport chain increased, whereas the effective quantum yield of photosynthesis decreased. After 5 days of growth under high illumination intensity, these parameters in high light returned to values observed in "shade-adapted" plants in low light. During the same period, the size of the antenna decreased, correlating with a decrease in the amounts of proteins of peripheral pigment-protein complexes. It was found that the decrease in the amounts of these proteins occurred due to suppression of transcription of their genes.

[Senning operation as a method of treatment of the main vessels transposition].

Results of performance of Senning operation for the main vessels transposition were analyzed. Analysis of complications, lethality in early postoperative period and of far-remote results was conducted. The systemic right ventricle function in patients after Senning operation was estimated. Not high level of early and late postoperative lethality was established. Clinical state of patients in far-remote postoperative period was good. A systemic right ventricle function was estimated as satisfactory.

[Changes of right atrial myoendocrine cells during hypertension and after arterial pressure decrease].

It is well known now that atrial cardiomyocytes carry out both contractile and endocrine activities--they synthesize, accumulate in specific secretory granules and release the natriuretic peptides. The main physiological effects of natriuretic peptides are antagonistic to the renin-angiotensin-aldostrol system, but their role in the development of hypertension is still disputable. The aim of this investigation is to estimate using electron microscopy the secretory activities of atrial myoendocrine cells in rats with inherited stress-induced arterial hypertension (ISIAH stain). It has been shown that myoendocrine cells in the ISIAH rats with arterial pressure about 180 mm Hg reveal morphological features of increased synthesis, extra accumulation and release of natriuretic peptides compared with normotensive control rats. In the ISIAH rats treated with losartan (angiotensin II receptor blocker) and therefore having a sustained decrease in arterial pressure to 140 mm Hg, changes in granular pool composition, reduction of the number and diameter of the secretory granules, reduction of Golgi complexes, and increased intracellular degradation of secretory stores were found in the myoendocrine cells. At the same time the marked capillary hyperemia and interstitial edema in the myocardium were observed. Thus, in rats with severe inherited hypertension, the secretory activity of heart myoendocrine cells is sharply increased and directly depends on the arterial blood pressure level. This proves that natriuretic peptides actively participate in the regulation of hemodynamics during with cardiovascular pathology.

[Pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries: diagnosis and treatment].

The basic principles of diagnosis and management of pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries are systematizes in this paper. The personal experience of surgical treatment of consecutive 66 patients with this disease is analyzed, including one-stage and multistage approaches.