[Echocardiography with physical exercise in patients with stable angina pectoris concurrent with chronic obstructive pulmonary disease: safety, informative value, and performance conditions]

AIM

To define the safety, informative value, and performance conditions of exercise echocardiography (EchoCG) in patients with stable angina (SA) concurrent with chronic obstructive pulmonary disease (COPD).

SUBJECTS AND METHODS

Forty patients aged 45 to 66 years (mean age 54.8 +/- 4.9 years) with Functional Class (FC) II-III SA concurrent with COPD and 40 patients aged 46 to 65 years (mean 56.6 +/- 4.9 years) with FC II-III SA without COPD were examined. All the patients underwent exercise EchoCG during the chosen therapy.

RESULTS

Exercise EchoCG is safe in patients with SA with COPD. To enhance the informative value of this test and to achieve the ischemic threshold in patients of this category require the use of adequate bronchodilator therapy. In this case, the informative value of the technique is 75%.

CONCLUSION

Exercise EchoCG in patients with SA concurrent with COPD may serve as a reliable tool in determining exercise endurance during antianginal, bronchodilator therapy and in assessing its adequacy.

[Endothelial dysfunction in patients with combined coronary heart disease and chronic obstructive pulmonary disease]

The aim of this work was to evaluate functional incompetence of endothelium in patients with chronic coronary heart disease (CHD, stable angina) combined with chronic obstructive pulmonary disease and to choose the most informative method for the diagnosis of endothelial dysfunction. A total of 103 patients aged 36-66 (mean 57.2 +/- 7.6) years were examined. Group 1 comprised 38 patients with CHD and concomitant chronic obstructive pulmonary disease (COPD). Group 2 included 36 patients with stable angina alone, group 3 consisted of 29 patients with COPD without CHD. Attention is focused on the characteristic of endothelial function by instrumental and laboratory methods. Comparative analysis of the severity of endothelial dysfunction in patients of the three groups revealed different mechanisms of plasma nitrogen oxide dynamics in patients with CHD and/or COPD. CHD and COPD caused mutual aggravation (potentiation) of pathological reactions leading to the development of the disease. Blood levels of nitrogen oxide metabolites in patients with cardiovascular problems or with COPD alone did not reflect the actual amount of "vasodilatory" NO. Reactive hyperemia test is believed to be the most informative method for the assessment of endothelial function in patients with CHD and COPD.

[Effects of beta 1-adrenoblocker bisoprolol on endothelial dysfunction in patients with stable angina pectoris in combination with chronic obstructive pulmonary disease]

AIM

To study effects of a cardioselective beta-adrenoblocker bisoprolol on vascular wall endothelium and external respiration function in stable angina of effort combined with chronic obstructive pulmonary disease (COPD).

MATERIAL AND METHODS

Endothelial function and external respiration were studied before and after 4-week treatment with bisoprolol in 36 patients with stable angina and COPD using assessment of endothelium-dependent vasodilatation (EDVD) and concentrations of nitric oxide metabolites.

RESULTS

Significant improvement of endothelial function was achieved due to bisoprolol 4-week treatment which did not affect external respiration function.

CONCLUSION

Bisoprolol is effective and safe drug in the treatment of stable angina combined with COPD. It can noticeably improve endothelial function.

Dynamics of hydration of cicatricial tissue during local therapy with collagenase preparations

The components of complex dielectric permeability of cicatricial tissue at the frequency of 55 GHz were studied during local therapy of cicatrices with Fermenkol (a complex of collagenolytic proteases). Electrical characteristics of tissues in the microwave range were interpreted in terms of hydration parameters (total content of water in tissues and the ratio of structured and free water). The rightfulness of interpretations is discussed on the basis of the results of measurements of cell suspension models (native blood and its fractions brought to a standard hematocrit). The results attest to a relationship between hydration of the cicatricial tissue and its morphology and function.

[Implication of vinpotropile in the treatment of patients with cerebral stroke]

A control of dynamics of patient's state in the early rehabilitation period of ischemic stroke allowed to clarify the clinical value of metabolic and vasoactive therapy combined in one drug. Vinpotropile can augment metabolism of the brain due to the neurometabolic effect of a nootrop and intensification of the blood flow and microcirculation. Patients reported good tolerability and convenience of taking one capsule of vinpotropile instead of two tabs of nootropic and vasoactive drugs.

[Remote outcomes of endoscopic dissection of crural perforating veins in chronic venous insufficiency]

We studied the long-term results following endoscopic dissection of crural perforating veins (EDCPV) in chronic venous insufficiency. The study comprised a total of 36 patients (41 lower limbs) who had endured the intervention concerned. The term having passed from the time of the operation till the moment of assessing the obtained outcomes varied from I to 10 years. Ultrasonographic angioscanning within the zone of the previous intervention revealed 38 perforating veins on 3.1 of the postoperative lower limbs (75.6 %). Amongst the veins revealed, most frequently encountered were Cockett's perforants (the so-called Cockett II) in the typical place - the lower third along the medial surface of the crus (29 cases). In five cases, perforants were revealed in the middle third of the crus, which located in the close proximity from the edge of the tibia (Cockett III). Perforants on the posterior crural surface were revealed on four extremities. Only 22 veins on 20 lower limbs (48.8%) turned out incompetent. The median access to perform EDPCV was used in 28 cases (68.3%); within the zone of the operative intervention performed we found 24 perforating veins, with 15 of these being incompetent. After EDPCV performed from the posterior or posterior-medial approaches on 13 limbs (317%), we revealed 14 perforating veins (of these, 7 - incompetent). Despite this, the patients regarded the effect obtained as either good or satisfactory in 79% of cases. The obtained findings suggest that thorough diagnosis of perforating reflux and improvement of the technique of endoscopic dissection thereof should be required. Along with it, it is also necessary to attentively examine the problem of the true role of the low vein-venous shunt in the pathogenesis of vein chronic diseases.

[First experience with the modified program NHL-BFM-90 application in adult patients with primary diffuse large B-cell gastric lymphosarcoma with unfavourable prognosis]

AIM

To assess efficacy of a modified program NHL-BFM-90 in adult patients with primary diffuse large B-cell gastric lymphosarcoms (PDLBGL) with unfavourable prognosis.

MATERIAL AND METHODS

Modified courses of NHL-BFM-90 were conducted in 5 patients aged 27-67 years from January 2004 to September 2005. Four patients received chemotherapy of the first line, in one patient block therapy followed monotherapy with chlorambucil and a CHOEP course. All the patients were in a severe clinical condition and had several initial factors of unfavourable prognosis: size of the tumor more than 10 cm; stage IE and more advanced; B-symptoms; proliferative activity above 70%. The program NHL-BFM-90 was modified because of the patients' age. Chemotherapy was conducted according to the middle arm of the original program NHL-BFM-90, but methotrexate was introduced in a dose 1 g/m2 for 12 hours, while leukovorin was given 18 hours after the start of methotrexate injection. In two cases the blocks were enhanced with rituximab, 2 patients had doxorubicin in block A, in one case block C was enhanced with methotrexate. A total of 23 modified blocks NHL-BFM-90 were performed: one patient was given 6 blocks, two patients--5, one patient--4 blocks and one patient--3 blocks.

RESULTS

Four patients after block 2 and one patient after block 3 of polychemotherapy NHL-BFM-90 achieved remission of the disease of 6 to 22 months duration which still continues. Infectious complications related to hematological toxicity arose more frequently at the latest courses of chemotherapy.

CONCLUSION

Treatment according to the modified program NHL-BFM-90 in adult patients with PDLBGL and unfavourable prognosis is highly effective. For a mean follow-up of 10.2 months no recurrences occurred. The number of courses can be reduced to decrease accumulated hematological toxicity and in case of rapid achievement of remission.

[UHF-dielectrometry in the assessment of the structural organization of salt solutions and interstitial fluids in normal and cicatricial tissues]

The complex dielectric permittivity of salt solutions with positive and negative salvation as well as healthy and cicatricially changed human skin in situ at the frequencies of 42 and 56.6 GHz was measured. The relation between the dielectric characteristics of water and diluted salt solutions and changes in their structural organization conditioned by different temperatures of samples and the type of salvation of electrolytes was studied. The differences in the dielectric characteristics of healthy and cicatricially changed skin are interpreted in terms of the dependence of the structural organization of interstitial fluids on the morphological and functional state of biological tissues.

[Study of water exchange in skin tissues by microwave dielectrometry]

The complex dielectric permitivity of human skin was measured at a frequency of 42 GHz, and a method for calculating water content in skin tissues in vivo was proposed. The water content reaction of skin to standard physical exercises and nontoxic doses of nicotine was investigated. The functionally related changes in skin dielectric properties were interpreted as structural rearrangements of water contained in blood and tissues fluids.

[Extremely high frequency dielectrometry of biological fluids under conditions of disturbed water balance]

The electrical properties of fractions of blood, B-bile, and aqueous ethanol solutions were studied by UHF dielectrometry. A relationship between the electric permittivity of these biological liquids at a frequency of 62 GHz and their functional value was established. The changes in the electrical characteristics of the solutions in some disturbed functional states were explained by the rebuilding of water quasicrystaalline structure.

Ab initio calculations on bismuth cluster polycations

Ab initio calculations on bismuth polycationic species of the types Bi(n(n-2))+, Bi(n(n-4))+, and Bi(n(n-6))+ (n = 3 - 12) were performed at the Hartree-Fock and density functional theory levels in order to investigate their general properties and the applicability of Wade's rules on bismuth polycations. Some exceptions to Wade's rules were encountered, and, moreover, several predicted and calculated minima show only meta-stable behavior. The bonding in bismuth polycations is characterized by a high degree of electron delocalization and "three-dimensional aromaticity".

Proportional criterion of metabolic activity and fundamentals of drug dosage

A method for determining the drug dose is proposed, according to which the dose of injected drug is proportional to body weight to the power 2/3. The dosage of narcotic analgesic ketamine is in good agreement with the proposed relationship.

[Changes in the cerebral circulation in persons with acquired heart defects]

A comprehensive estimation of the state of cerebral circulation was performed in 57 patients with acquired heart valve diseases (AHVD) of different types, etiology and severity. Doppler sonography, rheoencephalography and quantitative electroencephalography were used. It was determined that the alterations of cerebral circulation in patients with AHVD were first of all caused by disturbances of venous outflow due to congestive heart failure. Other factors, which had also influence on the results of the studies performed are outlined.

[False irradiation method in magnetobiological experiments with Helmholtz's rings]

To carry on correct investigation of variable magnetic field influence on biological objects the method of complex usage of Helmholtz's rings is suggested. For this purpose the same Helmholtz's rings are suggested to be used to produce false radiation in the control experiments with opposite in phase current in the coils of the Rings. Calculations of the homogenuity of the magnetic field are made with nomograms drawn. With the aid of the nomograms one can choose parameters of the rings, which ensure any presettled degree of screening of initial operational magnetic field.

[Study of heart valve xenobioprostheses by ESR]

Copper (II) ions were used as paramagnetic labels to study the role of functional groups of structural proteins (SP) of xenobioprosthetic valves in the process of transition metal ions coordination as well as for investigation of changes in complexing properties of these proteins under influence of the recipient media. The dependence of Cu(II) coordination sphere composition in complexes with SP on the pH-value has been determined. Research of influence of the valves' calcification process on the coordination properties of the SP are in progress.

[A review of the suspension of paired limbs in vertebrates from functional viewpoints]

The functional interpretation is delivered of the principal morphological subdivisions of the paired limbs in the vertebrate animals, that is of the girdles and free parts. To distinguish between those, the functional criteria are suggested. On this basis the variants are considered of suspension of the fore and hind limbs in various groups of Gnathostomata. In the hind limbs the boundary between the girdle and the free part does always pass through the hip joint. In the fore limb the corresponding boundary passes through the shoulder joint in fishes. However, in most tetrapods it shifts proximally due to the release of the scapulocoracoid mobility. This tendency reached its maximum in turtles and viviparous mammals. The main attention is paid to the analysis of the arrangement of the scapulocoracoid suspension in various groups of tetrapods.

[The manifestations of a scarlatina epidemic process in a large city and their interpretation]

The average morbidity level in scarlet fever for the period of 1972-1990 in Moscow was 230.9 cases per 100,000 of the population and the annual economic damage was 2-2.5 million rubles. The highest morbidity rate values were registered among children attending children's institutions, and in this group among children aged 3-6 years. Cohort and disperse analysis revealed that age-dependent fluctuations of morbidity rate had a regular character and significantly differed. An increase in scarlet fever morbidity was registered simultaneously with elevated levels of morbidity in tonsillitis and acute respiratory diseases and occurred several weeks after a rise in tonsillitis morbidity. Contamination with group A streptococci was higher among "organized" children of preschool age than among other groups of the population. T serovars 4/28, 8/29/Imp.19, 3/13/B3254 and 1, constituting 44% of all isolated Streptococcus pyogenes strains, and OF type 2 (44%) and 22 (20%) occurred most frequently. Among the strains isolated from patients T-4 and OF-2 types prevailed.

[The quasi-resonance dependence of the arrhythmogenic action of a low-frequency magnetic field on myocardial contractile activity]

Non-monotonous quasi-resonance dependences of arising of arrhythmias on frequency and tension of magnetic field have been studied. Maximal effect was observed at 0.15 E and 40 Hz with 70% probability of the effect. The data obtained suggest that quasi-resonance effects of action of low-frequency magnetic fields are not limited to brain tissue and are mediated by the induced electric field.