[Lifespan of patients after endured embolism of the aorta and major arteries of the limbs]. / Prodolzhitel'nost' zhizni bol'nykh, perenesshikh émbolii aorty i magistral'nykh arterii konechnostei.

The authors analysed the remote results of treatment of patients having endured embologenic arterial obstruction. Over the last 47 years, specialists of the Department of Cardiovascular Surgery No1 of the North-Western State Medical University named after I.I. Mechnikov have rendered emergency medical care to a total of 3,455 patients presenting with embolisms of the aorta and arteries of the limbs. The remote results of treatment were followed up in 978 patients within the terms varying from 1 year to 30 years. The cumulative survival of patients at 1 year of follow up amounted to 72±2.9%, at 2 years to 55±3.3%, at 3 years to 46.1±3.3%, at 5 years to 33.5±3.4%, and at 10 years to only 17.8±3.8%. The subanalysis of the remote results of treatment of patients having sustained arterial embolisms was carried out in three groups of patients, depending on the character of the underlying disease. In patients of the 1st group, the development of arterial embolism was caused by atrial fibrillation of non-valvular aetiology, taking course on the background of hypertensive disease, IHD. The cumulative survival of patients of this group at 1 year of follow up amounted to 66.6±4.5%, at 3 years to 37.5±4.8%, at 5 years to 23.1±4.9% and at 10 years to less than 6%. Death was caused by progressing cardiovascular insufficiency in more than 60% of patients, by acute myocardial infarction in nearly 20% of cases and in 10% by impairment of cerebral circulation. In patients of the 2nd group, arterial embolisms were the consequences of endured infarction; their cumulative survival at 1 year of follow up amounted to 70.1±6.5%, at 3 years to 34.5±7.1%, at 5 years to 23.6±6.6%, and at 10 years to 12.5±6.5%. Patients of the 3rd group suffered from acquired heart valve disease of rheumatic aetiology, with the cumulative survival at 1 year amounting to 76.8±5.4%, at 3 years to 56.3±6.4%, at 5 years to 43.3±6.7% and at 10 years to 19.6±6.9%. In the thanatogenesis of more than 60% of patients there were thromboembolic complications, with progressing cardiac insufficiency present in nearly 30% of cases. The pattern of the remote results of treatment of patients with embolisms of the aorta and arteries of the limbs is strongly suggestive of the necessity of working out a comprehensive programme of medical rehabilitation.

Effects of Secondary Metabolites of Permafrost Bacillus sp. on Cytokine Synthesis by Human Peripheral Blood Mononuclear Cells.

We studied the effects of secondary metabolites of Bacillus sp. isolated from late Neogene permafrost on secretion of proinflammatory (TNF-α, IL-1ß, IL-8, IL-2, and IFNγ) and antiinflammatory (IL-4 and IL-10) cytokines by human peripheral blood mononuclear cells. It was found that metabolites of Bacillus sp. produced more potent effect on cytokine secretion than mitogen phytohemagglutinin and metabolites of Bacillus cereus, medicinal strain IP5832. Activity of metabolites depended on the temperature of bacteria incubation. "Cold" metabolites of Bacillus sp. (isolated at -5°C) primarily induced Th1-mediated secretion of IFNγ, while "warm" metabolites (obtained at 37°C) induced Th2-mediated secretion of IL-4. The results suggest that Bacillus sp. metabolites are promising material for the development of immunomodulating drugs.

[TREATMENT OF SEVERE INTRAPATUM ASPHYXIA.]

THE AIM: Estimate of efficiency of newborns with severe birth asphyxia treatment using systemic therapeutic hypothermia. MATERIALS AND METHODS: a retrospective open-controlled clinical research with a resolution of the Ethics;Committee performed in 33 neonates born in asphyxia and treated at the NICU All newborns due to the presence of indications, overall controlled hypothermia was conducted according to the approved protocol, using the apparatus Allon 2001". RESULTS: The neurological status at admission: Sarnat II was detected in 60.6% (20) children; Sarnat III was detected in 39.4% (13) children. The correlation ofApgar scores with the most severe hypoxic ischemic encephalopathy. Pupillary reflexes admission absent in 48.5% (16) newborns. Convulsions within first hours of lfe were observed in 57.6% (19) newborns. Convulsions within I day of life were observed in 81.8 % (27) newborns. The correlation of the amniotic infection (AI) and meconium aspiration syndrome (MAS) treatment using high-frequency mechanical ventilation (p<0,05) and prolongation of mechanical ventilation for more than 5 days (p<0,01). At the beginning of systemic hypothermia fraction of inspired oxygen (FiO2), mean airway pressure (MAP), respiratory rate (RR) were down to the 12th hour of life and reaches a minimum at the end of the third day. These trends have been observed in children with MAS. The correlation of the use of high-frequency mechanical ventilation using high doses ofcardiotonics and the transition to the infusion of epinephrine or norepinephrine (p <0.01).There were no deaths in the studying group. CONCLUSIONS: 1. Reliable predictor of the clinical outcomes severity of hypoxic-ischemic encephalopathy (HIE) by the end of the first month lf is the presence of convulsions within the first hour of lf (p<0. 03). 2. When comparing the evaluation on Apgar scale with the data of acid-base balance and severity of HIE a significant correlation between the estimation at the first minute is I point and at the fifth minute 3 point and more severe pH shift, base deficiency, hyperlactatacidosis and severe HIE. 3. MAS and AI are the most frequent accompanying diseases that complicates the severity of newborn status causing prolonged artificial ventilation and the infusion ofcardiotonics. 4. There is a decrease in all parameters of artficial lung ventilation to the twelfth hour life in early systemic hypothermia and reached minimum by the end of the third day.

Effects of Ultrasonic Disintegrates from Epimastigote Biomass of Trypanosoma cruzi Albarrada Strain (Mexico) on the Development of L5178Y Solid Malignant Transplanted Tumors in Male BALB/c Mice.

We studied in vivo antitumor effect of epimastigote form detritus of Trypanosoma cruzi, Mexican Albarrada strain, on L5178Y malignant tumor in BALB/c mice. The antitumor effect of ultrasonic detritus of the parasite was confirmed by shrinkage of the tumor and changed size of its symplastic necroses.

[Sensitivity of corynebacterium diphtheriae strains to antibacterial preparations].

AIM: Study the prevalence and mechanisms of resistance in circulating C. diphtheriae strains. MATERIALS AND METHODS: 664 C. diphtheriae strains isolated in 1987 - 2013 in various regions of Russia and sent to the reference center of Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology were the object of the study. Antibiotic sensitivity of the strains was studied by disk-diffusion and E-test methods using 10 antimicrobial preparations. Nucleotide sequence analysis was carried out by using BLAST program and EMBL/GenBank database. RESULTS: Most of the studied strains turned out to be sensitive to all the antibacterial preparations used. 1.2% of C. diphtheriae strains turned out to be resistant to penicillin and 6.0% had intermediate level of resistance. 0.4 - 0.6% of the strains had intermediate level of resistance to macrolides, and 4.0 - 4.4% were resistant. 2.0% of the strains had multiple resistance. Erm(X)-specific PCR carried out in this study showed that all the C. diphtheriae strains resistant to macrolide antibiotics carry erm(X) gene. CONCLUSION: The results of the study indicate a fairly high level of prevalence for C. diphtheriae strains resistant to antibiotics.

[Optimization of cholecystectomy method in patients with professional diseases of respiratory organs].

Results of cholecystectomy performance were analyzed in 99 patients with a biliary calculous disease, the course of which have become complicated by cholecystitis occurrence, in 49 of them professional diseases of respiratory organs, including silicosis, antracosis, were registered. Estimating results of laparoscopic and open cholecystectomy, we have established, that carboperitoneum in laparoscopic cholecystectomy impacts negatively the course of early postoperative period, what manifests with hemodynamic and respiratory disorders. The level of fibronectin and endotelin--1 in the blood plasm directly depends on the respiratory disorders severity and may be applied as a test for respiratory dysfunction. The method of cholecystectomy in patients, suffering professional diseases of respiratory organs, must be selected, depending on severity of functional disorders of respiratory organs.

[Structural-functional characteristics of cervical vessels in hypertensive patients under changed atmospheric pressure].

The ultrasonic location technique was used to measure intima-media thickness (IMT), as well as internal systolic diameter of and linear blood velocity in the cervical arteries in people with initial hypertension. Correlation analysis elicited a temporal contingency between these parameters and daily average values of atmospheric pressure. Thus, common carotid artery IMT tended to increase on high-pressure days. Besides, diameters of the common and internal carotid arteries, and vertebral artery were narrowed and, consequently, linear blood velocity in these vessels increased. This relationship is more evident in men than women and in elderly subjects than young. These results are suggestive of a vasoconstrictive action of high atmospheric pressure on these arteries. The relationship is not universal, as it is nonlinear for diameter of the internal carotid artery and inverse for the external one. This implies different sensitivity of arteries to the factor under study and possible blood redistribution in the arterial basin depending on external pressure. The relationship was observed equally on the day of investigation and previous days, which points to its temporal stability.

[Genotypic differences between Corynebacterium diphtheriae biovar gravis and mitis strains].

AIM: Study structure ofa genetic determinant of amylase activity (amygene) in Corynebacterium diphtheriae biovar gravis and mitis strains. MATERIALS AND METHODS: 87 C. diphtheriae strains (31 gravis biovar strains and 56 mitis biovar strains) as well as C. diphtheriae PW8 strain were analyzed to detect structural features of C. diphtheriae strains of various biovars. 10 pairs of primers were used in PCR that flank mutually overlapping regions within DIP0357 locus as well as additional primers that flank DIP0353-DIP0354, DIP0357 and DIP0358 loci. RESULTS: All the C. diphtheriae biovar gravis strains were established to contain a full-size DIP0357 locus (amy gene) whereas in all the mitis biovar strains this genome fragment is absent. All the studied C. diphtheriae biovar gravis strains do not have significant changes within DIP0354-DIP0357 loci (amy gene) whereas in genome of 57 studied C. diphtheriae biovar mitis strains the major part of this fragment including the complete nucleotide sequence of amy gene is absent. CONCLUSION: C. diphtheriae biovar gravis strains have a genetically determined ability to produce amylase that can be viewed as an additional pathogenicity factor giving microorganisms wider capabilities to colonize the mucous membrane of oropharynx.

[Comparative analysis of gas exchange and cardiorespiratory systems reactions to increasing normobaric hypoxia and physical load of swimmers and skiers].

Qualification comparable groups of young men engaged in cyclic kinds of sports were tested with stepwise accruing loads on bicycle ergometer and 25-minute exponential increasing normobaric hypoxia to final concentration of 10% oxygen. Group of skiers, having the greatest values of the maximal oxygen consumption at muscular work, show the relaxed cardiorespiratory reactions and more falling of blood oxygen in the hypoxia. The swimmers, having restrictions of ventilatory function in the course of trainings, form preadaptation to hypoxia with changes of external respiration and gas exchange functions that allows at hypoxia to better oxygen sate the blood in lungs. The joint assessment of aerobic capacity at physical work and physiological reactions to hypoxia shows the direct relation between individual maximal oxygen consumption and the descent rate of blood oxygen saturation at accruing hypoxia that can be useful at an assessment of a sportsman functional state and its correction at training processes.

[Heliogeophysical correlates of early biodemographic variables in the south of western Siberia].

In order to verify associations between solar and geomagnetic activities and perinatal variables the monthly distributions of population characters in Novosibirsk region over the period 1980-2001 were compared by stepwise correlation analysis with monthly averaged physical parameters at lags from 0 to 10 months. Three indices used were as follows: the number of sunspots, solar flux at 10.7 cm wavelength and Ak index measured at local ionospheric station near Novosibirsk city. Official data on the number of single and multiple live births, stillbirths and infant deaths at the age under one year by the type of population and sex were provided by State Statistical Committee. All three physical parameters positively correlated with the number of single births and infant mortality rate and negatively with twin births in both populations, urban and rural, irrespective of lags. The direct association between Ak index and relative number of stillbirths in urban setting was mostly pronounced at a lag of 5 months. The number of live births increased along with Ak index due to the enhanced proportion of female births whereas the number of stillbirths after the increase in solar and geomagnetic activities elevated because of male deaths.

[Response of arterial blood haemoglobin saturation to short-term intermittent normobaric hypoxia in humans].

The paper presents experimental data supporting a hypothesis that the changes of arterial blood haemoglobin saturation during breathing the hypoxic gas mixture (10-13% O2) can be fitted by exponential function. The formal description of the saturation curves allowed verifying their stages and evaluating interindividual variability. It is suggested that the parameters of exponents can be used when estimating an individual hypoxic resistance of a human organism.

[Solar phase effect on elasticity of the brachial artery and blood flow in humans].

Single and double examinations of normal males and females in the course of 11-year solar cycle with the use of oscillovasometry and occlusive plethysmography established a direct correlation between the effective diastolic radius of the brachial artery and solar activity characteristics on the day of examination, i.e. number of solar spots and intensity of radiation with the 10.7 cm wavelength. Other blood flow parameters demonstrated opposite correlations with the factors in males and females. As solar activity increased, females displayed linear decrements of arterial elasticity and regional peripheral resistance and growth of the volumetric blood flow velocity equally at rest and at the peak of post-occlusion reactive hyperemia. In males, the correlations had the reversed sign. Besides, males were noted to reduce venous reserve and venous outflow from antebrachial muscles proportionally to the increase of Wolf number. It is inferred that elevated solar activity may be responsible for impairment of the feeling of well-being of people with reduced cardiovascular reserve, particularly in space tight or at high altitudes in the absence of or under weak protection of the geomagnetic field and ozone layer.

[Relict microorganisms of cryolithozone as possible objects of gerontology].

Permafrost is widely distributed in the Northern Hemisphere, and its age reaches hundreds of thousands and millions of years. Permafrost contains alive microorganisms which are not frozen due to relatively high temperature of the environment (-2...-8 degrees C), but the microorganisms are immobilized and therefore aged probably similar to the age of permafrost. Longevity of the relict microbial cells is related obviously to their mechanism of protection against heat, radiation, free radicals and other damaging agents. A strain of Bacillus sp. was isolated from permafrost aged of about 3 million years, 16S rDNA sequence was identified and preliminary testing of bacterial culture on Drosophila melanogaster and mice was made. Immune stimulation and improvement of physical condition were observed, and that, together with the age of the microbial cells, presents the relict microorganisms as objects of gerontology.

[The state of radioactive pollution in the Techa River].

The concentration of radionuclides in the upper river water depends on radionuclides flow from the Techa Cascade of Reservoirs (TCR) with filtration waters and water of bypass canals. Further concentration dynamics over the river depends on floodplain and bottom sediments contamination level. Perennial concentration dynamics of 90Sr and 137Cs in the Techa River water is stably decreases. At present time concentration of 90Sr in the water depends on TCR inflow mainly and concentration of 137Cs depends on the outflow from contaminated swampy floodplain of the upper rive. From the dam-11 to the river entry radionuclides content in the silt, as well as in the water is stably decreases. Specific activity of 137Cs in the silts is 5 rates higher than in the water and 90Sr - 3 rates higher. In the silts 137Cs prevails in the difficult of access forms, 90Sr prevails in the exchangeable and moveable forms. The highest contamination density of floodplain soils is registered in the Asanov and Muslyumov swamps area. With time content of 90Sr and 137Cs planes along the soil septh, so overall deposits are decreases. The floodplain soils contains 66.5% of 90Sr in water soluble and exchangeable forms and 94.3% of 137Cs in difficult of access forms.

[Present-day 90Sr and 137Cs contamination levels of soil and agricultural products in the East-Urals Radioactive Trace area].

Data represent present-day 90Sr and 137Cs contamination levels of soil and agricultural products (grain, vegetables and forage crops, milk and meat) in the East-Urals Radioactive Trace area, and the accumulation coefficients of these radionuclides in cash crop.

[Polymorphism of tox and dtxR genes in circulating strains of Corynebacterium diphtheriae].

Polymorphism of tox and dtxR genes responsible for diphtheria toxin synthesis was revealed. Seven point mutations in tox gene were detected; study of their combinations allowed to determine 10 allelic variants of the tox gene in C. diphtheriae strains. Majority of mutations did not lead to changes in substitutions in amino acid sequence of diphtheria toxin. In tox gene from 2 strains of mitis biovar, ribotype "Otchakov" isolated in Saint-Petersburg, mutation in position 1252 (G --> C), which corresponds to change of glycine on arginine in amino acid sequence of diphtheria toxin (G393R), was identified. Mutation localizes in R domain of fragment B of diphtheria toxin. In the dtxR gene 16 point mutations were registered; study of their combinations allowed to determine 10 allelic variants of the dtxR gene. Two mutations led to amino acid substitutions in regulatory protein DtxR: in position 640 (C --> A), which corresponds to change of leucine on isoleucine (L2141), and in position 440 (C --> T), which corresponds to change of alanine on valine (A147V). Mutation A147V is characteristic for all strains of epidemic clonal group (strains of biovar gravis, ribotype "Sankt-Peterburg/Rossija", enzyme types of complex 8), dominated in Russia during diphtheria epidemic at 1990s. Strains of this group were characterized by high level of diphtheria toxin production.

[The diagnosis and course of progressive disseminated pulmonary tuberculosis].

A hundred and forty-six patients with disseminated pulmonary tuberculosis were examined. Hematogenous disseminated tuberculosis at this stage was ascertained to run more frequently as acute and acutely progressive. The proportion of lymphogenous tuberculosis was shown to increase among all the types of disseminated pulmonary tuberculosis. Identification of the lymphobronchogenic type of disseminated pulmonary tuberculosis is recommended.

[Fasting diet therapy in gastrointestinal tract diseases].

The article is devoted to an effective not medicamentous method of therapy--to the medical starvation. Indications and contra-indications to carrying out of medical starvation are given. Own results of use of medical starvation are resulted at diseases of bodies of digestion. Practical recommendations on applications of medical starvation for patients with diseases of bodies of a gastroenteric path are submitted.