[Variants of Botkin's biliary-cardiac syndrome in acute cholecystitis]. / Varianty biliarno-kardial'nogo sindroma Botkina pri ostrom kholetsistite.

4 cases of little-known syndromes in acute cholecystitis are described. Cholecystic-pericardial and syncopal-cardiac syndrome are seen in 1.33 and 1.78% cases of acute cholecystitis, respectively, and are the variants of Botkin's biliary-cardiac syndrome. These syndromes disappear after surgery on biliary tract, therefore they must be indications for surgical treatment of cholecystitis.

[Importance of echocardiography in prognosis of surgical outcomes in cholecystitis in elderly patients]. / Znachenie ékhokardiografii v prognoze iskhoda operatsii pri kholetsistite u pozhilykh liudei.

The authors propose to use more often echocardiography (EchoCG) in examination of elderly (over 60 years) of age patients with cholecystitis that permits to increase surgical activity to 92.4%. Left ventricular ejection fraction is the most informative. When this fraction is lower than 45% surgery must be recommended on vital indications only. EchoCG was used in 155 patients with cholecystitis, 131 of them were operated. 2 (1.52%) patients died due to acute cardio-vascular insufficiency and pulmonary artery thromboembolism.

[The characteristics of cardiomyopathy in different geographical regions]. / Osobennosti kardiomiopatii v raznykh geograficheskikh regionakh.

Region-specific characteristics of hypertrophic cardiomyopathy (HC) and dilated cardiomyopathy (DC) were compared for 108 relevant patients living in Dubai (United Arab Emirates) and Moscow (Russia). Out of 49 citizens of Dubai 17 had HC, 32 DC, and 59 Moscow patients had HC in 23, DC in 36 cases. It was found that HC in Dubai tends to run a silent latent course, involving mainly basal septum and right ventricle. Apical lesions were more typical for Moscow citizens who also display more severe myocardial impairment. DC in Dubai produces weaker cardiac insufficiency and arrhythmia. Incidence of idiopathic and periportal DC proved higher in Dubai, while alcohol and virus infection underlie DC more frequently in Moscow.

[The viral and immunological characteristics of cardiomyopathies and myocarditis]. / Virusoimmunologicheskaia kharakteristika kardiomiopatii i miokarditov.

As many as 97 patients with myocardial lesions: congestive and hypertrophic cardiomyopathy (CMP), postmyocarditis CMP (PM CMP), myocarditis (MC), alcoholic heart injury (AHI), coronary heart disease (CHD), vegetodysovarian myocardiodystrophy were examined by means of a complex of the virological tests (for Coxsackie B, Epstein-Barr and hepatitis B viruses) and immunoassays (for antibodies to different components of the myocardium, leukocyte migration inhibition test, antibody-dependent cellular cytotoxicity test, measurements of T and B lymphocytes and their subpopulations, and so forth). Virus infection was shown to be of a role for the onset of acute MC (usually reversible) and congestive CMP. At the same time the autoimmune mechanisms of the lesions were conclusively ascertained in MC associated with heart failure and in PM CMP. In patients with congestive CMP and AHI coupled with heart failure, antibodies to nerve fibers of the myocardium could be demonstrated in the presence of T-lymphocyte deficiency and high titers of antibodies to Epstein-Barr virus. This does not allow excluding myocardial denervation leading to refractory heart failure. Some immunological parameters made use of in the study provide an opportunity of an objective evaluation of the effect glucocorticoid treatment produces on patients suffering from MC and PM CMP.

[The physiological adaptation functions of cellular and humoral immunity in patients with phlegmons of the maxillofacial area]. / Adaptatsionno-fiziologicheskie funktsii kletochnogo i gumoral'nogo immuniteta u bol'nykh s flegmonami cheliustno-litsevoi oblasti.

In order to evaluate the necessity in immunocorrective therapy the patients with maxillofacial phlegmons were tested for their cellular and humoral immunity. A slight increase or decrease in immunity indices before surgery in several patients were not beyond the physiological norm. Postoperative repetitive investigations the immune parameters attained the mean levels or even went higher without immune-correcting therapy. The above changes are characteristic of the peculiarities of cellular and humoral immunity in individual patients and do not require any interference into the immune system.

[Cardiomyopathies, nonspecific myocarditis and alcoholic heart lesions (data from the clinical study of 100 patients)]. / Kardiomiopatii, nespetsificheskii miokardit, alkogol'noe porazhenie serdtsa (dannye klinicheskogo izucheniia 100 bol'nykh).

Echocardiography and immunological tests were applied to follow and examine 100 patients with grave non-coronarogenic myocardial lesions. Of these, 14 patients had hypertrophic cardiomyopathy (CMP) of the obstructive type, 21 hypertrophic non-obstructive CMP (symmetrical, apical, septal), 15 congestive CMP, 34 nonspecific myocarditis, and 16 alcoholic lesion of the heart. Congestive CMP, nonspecific myocarditis, and alcoholic lesion of the heart were characterized by some symptoms in common: dilatation of heart chambers, heart insufficiency, arrhythmias, thromboembolism. Myocarditis can be diagnosed according to the common and laboratory signs of inflammation, appearance of inflammatory pathology in other organs, changes in the immunological characteristics (reduction in the leukocyte migration index under the effect of cardiomyocyte membrane antigen), therapteutic effect of steroidal therapy. Alcoholic lesion of the heart can be recognized on case history specification (including the questioning of the subjects having relations with the patient), and identification of other symptoms of alcoholism. The possibility of making differential diagnosis of the diseases under consideration has been demonstrated.