The fundamentals of association of natural foci of zoonoses

Reports on the role of hydrological conditions in the functioning of parasitic systems are analyzed. The authors point out that a range of issues including different aspects of combination phenomena is discussed there. They suggest that a concept of combination shall be replaced by a concept of association of parasitic systems and their relevant natural foci of zoonoses, which is of a larger scope. The fundamentals of the formation and functioning of associated parasitic systems and natural foci of zoonoses are discussed. These include the hydrological conditions of floodplain-river regions, the multiparasitic capacity of hosts and vectors, the multihost pattern of causative agents, and a diversity of mechanisms of their transmission. The transmission mechanism without which movement of causative agents and the existence of parasitic systems and foci are impossible is shown to be a global combining onset of parasitic systems. The hydrological conditions of floodplain-river regions act as the universal mechanism of transmission of pathogens. The dynamics of the mechanism determines the functioning of all other mechanisms of transmission.     

Nonischemic ventricular arrhythmias: classification, clinical manifestations, diagnosis, and treatment

Clinico-electrocardiographical and electrophysiological features of noncoronarygenic ventricular arrhythmias are presented. Characteristics of localization of arrhythmogenic focus in various parts of left and right ventricular myocardium, in interventricular septum, and in immediate vicinity of each of 4 valves are discussed. Spectrum of necessary diagnostic measures is delineated, and assessment of efficacy of drug therapy is given. Characteristics of technique of endocardial mapping of noncoronarygenic ventricular heart rhythm disturbances are presented. Indications to radiofrequency catheter ablation, physical characteristics of radiofrequency intervention, effectiveness of catheter methods of treatment in dependence of localization of arrhythmogenic focus and spectrum of possible complications of the procedure are also discussed.     

The neuronal reaction of the amygdaloid complex in the dynamics of the estrous cycle

For investigation of the structural and functional organization of the amygdaloid complex (the cerebral neuroendocrine center) a response of its neurons to the fluctuations of circulating hormones was studied in the time course of the estrous cycle. Karyometry of 22 zones of the corticomedial group and 25 zones of the basolateral groups of the structure of the amygdaloid complex was performed in adult Wistar rats. A response of neurons of several zones of the corticomedial group of nuclei was revealed. A response of neurons of the basolateral nucleus at the caudal level of the central region was revealed in the basolateral group of structures of the amygdaloid complex.     

The novel method of assessment of individual total cardiovascular risk for the population of Russia

Novel innovative technology of assessment of level of total cardiovascular risk with consideration of a broad list of parameters of the state of individual health and its determining factors is described. The proposed model of risk is based on results of 20-year prospective observation of large contingents of population of Russia. For the first time the model of risk was constructed taking into account in addition to traditional risk factors and clinical characteristics peculiarities of population of Russia, in particular level of education. It was found in prospective studies that level of education in this country appeared to be an independent marker of risk and that traditional risk factors (behavioral, biochemical etc) had different prognostic value at different levels of education. Novel scale of risk and elaborated on its basis computer program of risk assessment allow to widen indications to its application, elevate accuracy of estimation of risk of development of fatal cardiovascular diseases for population of Russia, to obtain for a concrete patient parameters of absolute as well as relative risk (in % of excess or lowering of risk relative to its average statistical value for population with same age, sex, and level of education). The elaborated technology of estimation of total individual risk was tested on various contingents of patients with verified diagnoses of cardiovascular diseases as well as in groups of relatively healthy volunteers. Medical technology of risk assessment by novel scale is designed for application during primary screening of various population groups and can be fulfilled by both physicians and intermediate medical personnel. At present the computer program for assessment of cardiovascular risk based on this novel method is being prepared for clinical testing and subsequent implementation.     

The program of lowering of residual risk (the residual risk reduction initiative). Part I. Factors of residual risk

Substantial residual risk of development of macro- and microvascular complications is retained in most patients despite contemporary standards of therapy. The search for the solution of actual problem of lowering of residual risk of vascular complications is the aim of multiple current scientific studies conducted in medical practice of the world. The program Residual Vascular Risk Reduction Initiative (R3i) was called upon to join efforts of medical professionals and patients from different countries for solution of the global problem of residual risk of development of vascular complications. In the review we describe objective and main directions of activity of this project. We also give characteristics of individual component factors of residual risk of development of vascular complications investigated in the framework of the R3i program as well as possible methods of improvement of their correction.     

Detection and morphofunctional predictors of left auricular thrombosis in patients with atrial fibrillation

Atrial fibrillation significantly worsens quality and duration of patient's life because of frequent development of thromboembolic complications. The main cause of these complications is formation of intracardiac thrombosis. Prevalence of left atrial thrombosis in patients with atrial fibrillation varies from 8 to 24%. About 90% of thromboses are localized in left auricle. This paper contains review of different methods of detection of left auricular thrombosis. Main structural and functional predictors of thrombosis and possibilities of modern techniques of their visualization are also described. Different methods of echocardiography first of all transesophageal echocardiography are at present foremost in assessment of structural and functional predictors of thrombosis development. With the help of transesophageal echocardiography it is possible to accomplish functional monitoring of the state of left auricle during treatment with different drugs and/or after cardioversion. Detection of risk factors of left auricular thrombosis is an important clinical task because it allows to select a group of high risk patients in which long-term therapy with anticoagulants is indicated.     

Apheresis of immunoglobulins - new approach to the treatment of severe dilated cardiomyopathy

Two courses of immunoadsorption with 'Ig Adsopak' were used in the treatment of a patient with dilated cardiomyopathy (DCM) during which all class G and partially class M and A immunoglobulins were removed. Every course consisted of 5 daily procedures and resulted in removal of 98% of immunoglobulins. This was associated with complete removal of autoantibodies to beta1-adrenoreceptor. After the end of a course loss of immunoglobulins was replenished by intravenous infusion of Pentaglobin and Oktagam. Echocardiographic study carried out before, during and after second course of apheresis revealed reduction of left and right ventricular and atrial volumes and dimensions, improvement of contractility of anterior part of interventricular septum and of anterolateral left ventricular wall. As efficacy of drug therapy of dilated cardiomyopathy is low and facilities of cardiac transplantation are limited the method of therapeutic apheresis reveals novel perspectives of the treatment of dilated cardiomyopathies.     

Hibernation and stunning as manifestations of ischemic dysfunction of the myocardium

Hibernation and stunning are phenomena which constitute a basis of dysfunction of the myocardium appearing as a consequence of chronic ischemic heart disease and of myocardial revascularization. Myocardial stunning is an acute derangement of contractility of ischemic myocardium at the moment of restoration of coronary blood flow by various interventions (bypass grafting, angioplasty, thrombolysis). Myocardial hibernation implies presence of chronically developing foci of reduced contractility located in the area of myocardium supplied by obstructed artery. There is a following difference between these phenomena: stunning is a complex of structural and metabolic disorders during the state of "ischemia-reperfusion" while hibernation is a process of adaptation of the myocardium to chronic ischemia consisting in switch of metabolism to alternative type of energy production (anaerobic glycolysis). Exploration of pathophysiology and morphology of hibernating and stunned myocardium is necessary for elaboration of methods of protection against ischemic injury.     

Use of tritium oxide for the study of metabolism during development of experimental arteriosclerosis]

Theoretical grounds are presented for some methods (administration of isotope and time of sacrifying the animal, estimation of radioactivity in ther material examined, and mathematical processing of the data obtained) with which radioactive water is used as a universal precursor for the study of the integral rates of metabolism in various organs and biochemical components of the body. An analysis of the dynamics of tritium inclusion into the water of the blood and urine of the control animals and of those with experimentally induced atherosclerosis permitted to establish that the development of hypercholesterinemia is accompanied by a decrase (by 26%) of the rate of autorenuewal of the water phase of the macroorganism, one of its causes consisting in an enhanced hydrophility of the tissues in cases of this pathology. A monthly periodicity was noted in the changes of the tritium concentration in the body waters of rabbits, as well as its correlation with the periodical changes in the concentration of serum cholesterol during the development of experimental atherosclerosis. It is suggested that the water and cholesterol metabolism have a joint centralized regulation in the body which essence consists in maintaining the rhythm of each separate kind of metabolism for its synchronization with the other kinds of metabolism in unfavourable outer and inner situations for the macroorganism.     

蚤类的虫态变化

在平皿中潮湿滤纸上培育蚤卵、三龄老熟幼虫和无茧裸蛹,镜下连续观察卵的孵化、幼虫化蛹和蛹的羽化等动态过程,并通过显微录像法记录了上述虫态变化的详细过程。虫体自后向前一系列迭进式收缩所引起的压力增高是实现各期蜕变的基本动因。孵化开始于幼虫头部破卵器孵化刺将卵壳的割开,幼虫先后以胸—头—腹的顺序孵出,在2至数分钟内完成。化蛹时蛹体胸部首先从幼虫胸节背板中缝裂口处膨出,随之幼虫后头背中骨缝及一侧菱形骨缝裂开,蛹头、足和腹部相继蜕出,幼虫旧表皮腹节各背板均不裂开,化蛹过程多在10～20分钟内完成。羽化则以头—胸—腔的次序进行,一般需经5～20分钟。蛹衣从头顶横向裂开并脱下一个盔形物是羽化开始的标志。 观察了4属5种蚤41枚卵的孵化、8属10种蚤56条幼虫的化蛹和5属6种蚤25个蛹的羽化过程。结果表明,在以上虫态变化中,各种蚤的变化程序及虫体行为基本一致。对观察到的有关生物学和生态学现象进行了讨论。     

Clinical value of antracycline toxicity: modern approaches to diagnosis, prevention, and treatment

In this literature review we present analysis of various aspects of the problem of cardiotoxicity of antracyclines used for the treatment of the breast cancer. We consider mechanisms of their cardiotoxic action, role of risk factors, clinical manifestations of acute and chronic cardiotoxicity, and dependence of their severity on treatment duration and drug dose. We give data on contemporary methods of diagnostics of early toxic cardiac effects of antracyclines from the side of cardiovascular system. We also conducted assessment of possibility of prevention of toxic action of antracyclines with the use of combination of different methods including dose sparing regimens and schemes of treatment, combinations of drugs, use of cardioprotectors as well as novel preparations from the antracycline group, possessing lesser cardiotoxicity. Clinical and experimental data on the treatment of manifestations of cardiotoxicity with consideration of pathogenetic mechanisms of their development are given.     

Association of a polymorphic marker Trp719Arg of KIF6 gene with effects of atorvastatin and simvastatin in patients with early ischemic heart disease

Action of statins is characterized by pronounced variability what is caused by effects of a multitude of factors. Main of these factors appears to be genetic peculiarity of patients. We studied influence of polymorphic marker Trp719Arg of KIF6 gene on lipid and nonlipid effects of atorvastatin and simvastatin. The studied genetic marker is associated with risk of development of ischemic heart disease and myocardial infarction as well as efficacy of therapy with statins according to data of a number of large multicenter studies. We examined 60 men with ischemic heart disease which had manifested in young age when genetic factors were most expressed and had special significance. Efficacy of 40 mg/day simvastatin did not depend on genotypes of polymorphic marker Trp719Arg of KIF6. Therapy with 10 mg/day atorvastatin was more effective in carriers of polymorphic marker Trp719Arg of KIF6 gene by action on dynamics of changes of high sensitivity C-reactive protein and dispersion of high density lipoprotein response. Increase of atorvastatin dose to 80 mg/day abolished influence of genotypes. Thus for the first time we discovered influence of polymorphic marker Trp719Arg of KIF6 gene on individual response to therapy with 10 mg/day of atorvastatin, while and apoA1, structural protein of high density lipoproteins can be considered as a marker of "fast response".     

Ecological bases of the combination of natural foci of Trematoda infections in the floodplain-river ecosystem of the Konda River. Communication 2. Host population-combined foci of Trematoda infections

In the context of the present-day teaching of parasitocenoses and the proposition that the pathogen's population is the only compulsory and specific component of a natural focus, the author discloses the ecological bases of the combination of natural foci of opisthorchiasis and methorchiasis (M. bilis), methorchiasis (M. bilis) and methorchiasis (M. xanthosomus). These foci are host population-combined. While analyzing the combination of foci, it is expedient to consider them in pairs since this provides a way of identifying only the combination bases that are unique to these foci. The parasitic systems of flukes, the parasitocenoses of co-acting parasitic systems of "twin types", the structure of foci, the species-specific composition of ecosystems, and the ecological relations of the Opisthorchis fluke hosts act as the biotic bases of a combination of foci of Trematoda infections. By coinciding, the multihost hemipopulations of parasites and the susceptibility of host populations predetermine the combination of Opisthorchis fluke foci. The susceptibility of hosts, the multihost pattern of Opisthorchis flukes, the identity of parasitic systems, and the common mechanism of pathogen transmission act as the epizootic bases of a combination of invasion foci. The morphological structure and hydrological regime of a landscape act as the abiotic bases of a combination of foci. The hydrological regime is by its nature a universal mechanism of pathogen transmission. The foci of Opisthorchis flukes at the level of parasitocenosis of metacercarium populations and fish populations in the Konda River ecosystem are combined in the age groups of only carp (Cyprinidae) underyearlings and yearlings. The abiotic, biotic, and epizootic bases of a combination of natural foci of Opisthorchis flukes are, in the aggregate, the ecological bases of a combination of foci.     

The Evaluation of the Effectiveness of Reinforcement by Cemented-Carbide Plates in Two Design Variants of the Chisels Intended for Cultivation–Sowing Aggregates

Field tribological tests of two design variants of chisels used in the teeth of a cultivation-sowing unit were carried out in this research. A characteristic feature of the first variant of chisels was the reinforcement of their contact surface and almost the entire rake surface by plates made of cemented carbides. On the other hand, the second variant of chisels was reinforced only in the area of the blade by two plates made of cemented carbides, soldered on the rake face of the elements. The use of the first variant of chisels contributed to a significant reduction in the wear rate of elements, especially in terms of thickness and width loss. Effective reinforcement of the rake face, with relatively lower resistance to length reduction in the elements, raises doubts as to the validity of the use of cemented-carbide plates on almost the entire length of their rake face, because the applied variant of chisels contributed to a significantly higher price. However, the second variant of chisels effectively limited the intensity of the loss of the length of the elements, and the cause of the loss of their usefulness as part of the base material wear. It was found that the main wear mechanism of the cemented-carbide plates consisted of matrix removal under the influence of the finest fraction of the soil, which weakened the embedding of carbides, and then crushing or chipping of carbide grains from the matrix, whereas the dominant wear mechanisms of martensitic steel were grooving and micro-cutting.     

Pathogenetic mechanisms and morphological manifestations of medical liver damage

In the review of literature the modern data on mechanisms of development, features of pathogenesis and morphological appearance of drug-induced lesions of liver are presented. The cytotoxic lesions resulting in development of acute or chronic hepatitis, cholestatic lesions linked to structural changes in elements of bile excretion system or mechanisms of formation of bile are illustrated. The morphological features of infringement of a lipid metabolism in hepatocytes with development of steatosis of liver and steatohepatitis are described also. In some cases the influence of medicaments resulted in the damage of vascular network of liver, in accumulation of pigments, development of granulomas and liver fibrosis is observed. The main morphological signs of drug-induced lesions of liver are illustrated on the own histological data from liver biopsies.     

Expression of angiopoietin-1, 2 and 4 and Tie-1 and 2 in gastrointestinal stromal tumor, leiomyoma and schwannoma

AIM: To investigate the role of angiopoietin (Ang) -1, -2 and -4 and its receptors, Tie-1 and -2, in the growth and differentiation of gastrointestinal stromal tumors (GISTs).METHODS: Thirty GISTs, seventeen leiomyomas and six schwannomas were examined by immunohistochemistry in this study.RESULTS: Ang-1, -2 and -4 proteins were expressed in the cytoplasm of tumor cells, and Tie-1 and -2 were expressed both in the cytoplasm and on the membrane of all tumors. Immunohistochemical staining revealed that 66.7% of GISTs (20 of 30), 76.5% of leiomyomas (13 of 17) and 83.3% of schwannomas (5 of 6) were positive for Ang-1. 83.3% of GISTs (25 of 30), 82.4% of leiomyomas (14 of 17) and 100% of schwannomas (6 of 6) were positive for Ang-2. 36.7% of GISTs (11 of 30), 58.8% of leiomyomas (10 of 17) and 83.3% of schwannomas (5 of 6) were positive for Ang-4. 60.0% of GISTs (18 of 30), 82.4% of leiomyomas and 100% of schwannomas (6 of 6) were positive for Tie-1. 10.0% of GISTs (3 of 30), 94.1% of leiomyomas (16 of 17) and 33.3% of schwannomas (2 of 6) were positive for Tie-2. Tie-2 expression was statistically different between GISTs and leiomyomas (P < 0.001). However, there was no correlation between expression of angiopoietin pathway components and clinical risk categories.CONCLUSION: Our results suggest that the angiopoietin pathway plays an important role in the differentiation of GISTs, leiomyomas and schwannomas.     

Fifteen years experience of the use of magnesium preparations in patients with mitral valve prolapse

We followed for 15 years 31 patients with mitral valve prolapse (MVP) who during follow-up regularly took orotic acid (1500 mg/day) for 3 months twice a year. We revealed peculiarities of dynamics of clinical picture, their interrelation with phenotypic manifestations of connective tissue dysplasia, changes of electrocardiogram, structure of valvular apparatus of the heart, state of vegetative homeostasis, changes of levels and 24-hour profile of arterial pressure, tone of sympathetic and parasympathetic parts of vegetative nervous system. We noted significant reduction of mean and maximal heart rate, number of episodes of tachycardia, duration of QTc intervals, incidence of paroxysmal supraventricular and ventricular extrasystoles. We fixed statistically significant lowering of maximal systolic and diastolic arterial pressure, hypertensive burden and elevated variability of systolic and diastolic arterial pressure. Data of retrospective analysis showed absolute normalization of these parameters in all studied patients. Decrease of the tone of sympathetic part of vegetative nervous system was also established. There was 2 to fold decrease of number of persons with sympathicotonia, 3 to fold increase of those with vagotonia, and 5 times increase of number of patients with equal tone of sympathetic and parasympathetic parts. Regular use of magnesium salt of orotic acid was associated with significant elevation of quality of life of patients with MVP. Clinically valuable improvement of work and social life scores was noted in 54.8%, of personal life score - in 45.2% of individuals. In half of patients with MVP index of efficacy of therapy with orotic acid was significant.     

Quantitative determination of dopamine receptor subtypes not linked to activation of adenylate cyclase in rat striatum.

The binding of [3H]domperidone and [3H]spiroperidol was examined in membranes prepared from rat striatum. Scatchard analysis of the binding of [3H]domperidone resulted in curvilinear plots consistent with the presence of multiple classes of binding sites. Nonlinear regression analysis of untransformed data showed that the curvature was best explained by the presence of two populations of binding sites. Scatchard plots of the binding of [3H]spiroperidol were linear, suggesting that this radioligand binds to a single class of receptors. However, results obtained in studies of the inhibition of [3H]spiroperidol binding by a number of competing ligands were not consistent with the interaction of these agents with a single class of binding sites. Computer-assisted analysis of the Hofstee plots of six competing ligands gave the same relative proportion for two classes of sites as determined by analysis of the binding of [3H]domperidone. The two classes of receptors labeled with [3H]spiroperidol had affinities for domperidone that were similar to those of the two populations of binding sites for [3H]domperidone. Furthermore, the number of binding sites for [3H]spiroperidol was equal to the total number of binding sites for [3H]domperidone. These findings suggest that the two radioligands bind to the same two classes of binding sites. It is unlikely that either of the two classes of striatal sites are receptors for serotonin. The approach described will make it possible to assess the effects of physiological or pharmacological manipulations on the densities or properties of subtypes of dopamine receptors.     

Diurnal rhythm of carbohydrate, lipid and protein metabolism and 11-hydroxycorticosteroid secretion in rats

The results of study of the rhythms of secretion of 11-OCS, synthesis and metabolism of glucose, formation of urea and esters of fatty acids in male rats in the course of 12 hours of the daily period are presented in this work. A definite rhythmic character and conjugation of the processes of corticosteroid secretion and carbohydrate, fat and protein metabolism were revealed. Participation of the adrenal cortex hormones (glucocorticoids) in the regulation of direction of the carbohydrate metabolism by the type of glycolysis, hexosomonophosphate way and gluconeogenesis is discussed.