[On the issue of cooperation in organizing the laboratory medicine education].

In the Omsk public medical Academy, the informational and technological support of laboratory medicine education at undergraduate and postgraduate stages required to organize the cooperation between the Russian Association of medical laboratory diagnostics and the Academy course of clinical diagnostics. The non-commercial interaction was organized between the Academy and the manufacturers and suppliers of laboratory diagnostic systems. This approach permitted to implement the cycle of scientific educational forums and to start the territorial program of quality management in laboratory research. The choice of the specialty "clinical laboratory diagnostics" as a prospective profession significantly increased among the Academy graduates. In addition, the Russian Association of medical laboratory diagnostics and the Omsk public medical Academy started a new joint project targeted to the support of laboratory diagnostics techniques training in concordance with the new public educational standard of higher professional education. Thereby, a specified model of joint resolution of actual issues is developed in the field of laboratory medicine education with coordinator collaboration of Russian Association of medical laboratory diagnostics as a professional non-government organization.

Triple-site antigen capture ELISA for human myoglobin can be more effective than double-site assay.

Using a panel of monoclonal antibodies against human myoglobin (Mb), we have shown that the sensitivity of antigen-capture ELISA can be significantly increased by simultaneous immobilization of two cooperating capture monoclonal antibodies on a solid phase. This method ("triple-site ELISA") uses three monoclonal antibodies to different epitopes of the same antigen (two capture/one tracer) unlike the traditional double-site assay using one capture and one tracer monoclonal antibody. We developed double- and triple-site ELISA for Mb by varying the capture and tracer monoclonal antibodies. Triple-site assays showed 4-6-fold increase in sensitivity compared to the double-site assays. A model for this effect is suggested; according to the model, in triple-site ELISA, high-affinity cyclic configurations can be formed by an antigen, two capture monoclonal antibodies, and the surface of the solid phase.

[The concentrations of somatotropic hormone and insulin in the blood of heart surgery patients with a complicated course of the postoperative period]. / Kontsentratsii somatotropnogo gormona i insulina v krovi kardiokhirurgicheskikh bol'nykh pri oslozhnennom techenii posleoperatsionnogo perioda.

It has been shown that the course of the early postoperative period in cardiosurgical patients and its outcome is to a great extent related to adequate balance of adaptation hormones, whose levels and changes are determined by the functional state of compensatory-adaptive systems. Patients with favourable outcome of the complicated postoperative period along with synchronous activation of sympathoadrenal system (SAS), hypophyseoadrenal system (HAS) and an elevated somatotropic hormone (STH) level demonstrated adequately high blood insulin content, with the equilibrium in adrenalin/insulin and cortisol/insulin ratios retained, and moderate STH predominance over insulin. In 1/4 of patients with complicated postoperative period and unfavourable outcome an attenuated SAS response was accompanied by excessively high STH, ACTH, cortisol blood content and a lower insulin level, which determined relative insulin insufficiency.

[Relations of catecholamine and prostaglandin contents in the blood of rats exposed to acute stress and during adaptation to stress]. / Sootnoshenie soderzhaniia katekholaminov i prostaglandinov v krovi u krys pri ostrom stressornom vozdeistvii i adaptatsii k stressu.

In Wistar male rats, 1-h acute immobilization stress resulted in the increased plasma adrenalin, noradrenaline and dopamine in approximately 13, 8 and 23 times, respectively. Plasma PGF2 alpha increased in 3.5 times while PGE remained unchanged; this resulted in the decreased PGE/PGF2 alpha relation in 2.8 times. The PGI2/TXA2 relation also decreased in 1.5 times due to a more pronounced growth of TXA2 than that of PGI2. In rats adapted to the repeated stress (12 sessions), the plasma catecholamine level was higher than that in control but 2-3 fold lower than in unadapted rats after acute single stress. In this situation, PGE was increased by 70% as compared to the control. This is why PGE/PGF2 alpha relation was similar to the control whereas the level of PGF2 alpha increased. PGI2 increased by 53% and TXA2--in two times as compared to the control. In these rats, acute stress induced neither plasma catecholamine enhancement nor PGE/PGF2 alpha relation decrease in comparison with the initial levels; the TXA2 content was increased but it was by 33% less than that in unadapted rats exposed to such stress. One can suggest that the decreased activation of adrenergic system respondent to acute stress in unadapted rats is associated with the increase in plasma PGE and PGI2 which are known to limit the catecholamine release from adrenergic terminals and their harmful effects.

[Epicardial destruction of the bundle of Kent by pulsating electric current and the criteria of its effectiveness in Wolff-Parkinson- White syndrome]. / Operatsiia épikardial'noi élektroimpul'snoi destruktsii i kriterii ee éffektivnosti pri sindrome Vol'fa-Parkinsona-Uaita.

The article deals with a new method of treatment of the Wolff-Parkinson-White syndrome. The operation for epicardial destruction of Kent's bundle by pulsating current was developed by the authors. It is distinguished by its simplicity and the possibility to determine the efficacy of the procedures during the operation itself. The results of examination of 44 patients in the early postoperative period and in late-term periods after this operation are discussed. It was found that the electric factor does not cause structural changes of the underlying structures and does not affect the pumping function of the myocardium. The revealed changes were recorded by means of angiocardiography, coronarography, radionuclide ventriculography, and the enzyme spectrum.

[The course of the early postoperative period in heart surgery patients in relation to the state of humoral regulatory mechanisms]. / Techenie rannego posleoperatsionnogo perioda u kardiokhirurgicheskikh bol'nykh v zavisimosti ot sostoianiia gumoral'nykh mekhanizmov reguliatsii.

It has been shown that the course and outcome of the early postoperative period in cardiosurgical patients are to a great extent related to the functioning of the adaptation systems under study and their interrelations. An essential role of sympathoadrenal system (SAS) in the control over hormonal body status has been established. It ensures, provided its activity is retained, interaction of other hormonal systems as a uniform functional mechanism in postoperative stress. Decreased activity and intrasystemic coordination of SAS combined with low activity of renin-angiotensin-aldosterone system and excessively activated hypophyseal-adrenal system in patients with postoperative complications are indicative of adaptation mechanism damage and are of negative prognostic value.

[Thyroid hormone content of the blood plasma and tolerance for physical loading in ischemic heart disease patients]. / Soderzhanie tireoidnykh gormonov v plazme krovi i tolerantnost' k fizicheskoi nagruzke u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Blood thyroid hormones were measured before and after the rationed exercise test in 79 patients with angiographically verified diagnosis of coronary heart disease. A relationship was demonstrated between postexercise blood T3 variation and functional coronary circulation reserve. Hormonal baselines, and exercise-induced blood T4 changes were basically similar in patients with coronary disease of different severity. The results are suggestive of pathogenetic importance of thyroid function in these patients.

[The scissors phenomenon in the reaction of hormonal systems to the physical load test in ischemic heart disease patients]. / "Fenomen nozhnits" pri reaktsii nekotorykh gormonal'nykh sistem na probu s fizicheskoi nagruzkoi u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A difference between baseline and final plasma hormonal (insulin, cortisol, somatotrophic hormone, triiodothyronine (T3) and thyronine (T4) levels, related to the pattern of response to physical stress, was demonstrated in 67 coronary patients with angiographically verified diagnosis. Post-exercise increase in these hormones was associated with their lowered baseline and elevated final blood levels, as compared to those patients who showed a decrease in hormonal levels in response to exercise, with the baselines exceeding final values.

Isoenzyme spectrum of creatine kinase and lactate dehydrogenase in the myocardium of patients with ischaemic heart disease.

The purpose of the study was to find out the character of the restructuring of enzymes and isoenzymes of creatine kinase (CK), lactate dehydrogenase (LDH) and glucose-6-phosphate-dehydrogenase (G 6 P-DH) in the myocardium, which occurs in patients with ischaemic heart disease (IHD), and to compare the activity of the aforementioned enzymes in the myocardium of patients with IHD, examined intra vitam, and in patients who died suddenly. An analysis was made of 11 samples obtained by myocardial biopsy from the left ventricle of patients with IHD and of 11 samples obtained at autopsy of patients with IHD who have died a sudden death. Serving as controls was bioptic material from the myocardium of 12 patients without IHD. In the myocardium of patients with IHD, examined intra vitam, a decrease in the activity of the mitochondrial isoenzyme CK (MiMi) and the isoenzyme LDH-1, and a considerable rise in the activity of G 6 P-DH were found. In patients with IHD, who have died suddenly, there was found only a decrease in isoenzyme LDH-1 activity and a reduced concentration of CK B-units. The experiments proved that the differences in the myocardial isoenzyme spectrum between the two groups of patients with IHD are not connected with the process of autolysis.

[Evaluation of the status of the myocardium during surgical correction of congenital heart defects by simultaneous study of ultrastructure and macroergic phosphates (in biopsies of the human heart)]. / Otsenka sostoianiia miokarda bol'nykh pri khirurgicheskoi korrektsii vrozhdennykh porokov serdtsa putem odnovremennogo issledovaniia ul'trastruktury i makroérgicheskikh fosfatov (po biopsiiam serdtsa cheloveka).

During surgical correction of Fallot's tetrad the authors discovered the decrease of macroergic phosphate concentration and moderately marked signs of cardiomyocytic ultrastructural changes, such as mitochondrial injuries, decrease of glycogen levels, insignificant intracellular edema, no increase of membrane penetration. Changes of endothelial cells were absent. In children not over 1 year old under myocardial protection with hypothermic perfusion (at low volume rates) some decrease of macroergic phosphates occurred, as well as a moderate decrease of the mitochondrial index, glycogen content decrease, there was no intracellular edema. The discovered structural changes are minimal and reversible. A close correlation was found between the electron microscopic data and the character of myocardial energetic metabolism, the biochemical changes preceding the ultrastructural ones. Comparison of morpho- and biochemical changes in the myocardium of the majority of patients with impaired myocardial function confirmed the existence of a complex relationship between them.

[Atherosclerotic lesion of the coronary arteries in ischemic heart disease patients with differing levels of insulin, cortisol and somatotropic hormone and the type of reactions of these hormones to physical loading]. / Ateroskleroticheskoe porazhenie koronarnykh arterii u bol'nykh ishemicheskoi bolezn'iu serdtsa pri razlichnom bazal'nom urovne insulina, kortizola i somatotropnogo gormona i tipe reaktsii étikh gormonov na probu s fizicheskoi nagruzkoi.

Plasma insulin, cortisol and somatotropic hormone (STH) levels of coronary patients are related to the extent of atherosclerotic lesion of coronary arteries. The relationship between coronary atherosclerosis and hormonal activity becomes particularly evident through the pattern of hormonal response (a rise or a fall) to rationed exercise. An elevated insulin baseline and reduced postexercise levels are typical for coronary patients with only slightly narrowed (25% or less) coronary arteries. A tendency to higher baseline and postexercise plasma cortisol levels was noted in more severe coronary cases. Increased postexercise plasma STH levels were significantly more frequent in patients with less marked atherosclerotic lesions of coronary arteries.

[Thyroid hormone content of the blood plasma and functional state of the myocardium in patients with chronic forms of ischemic heart disease]. / Soderzhanie tireoidnykh gormonov v plazme krovi i funktsional'noe sostoianie miokarda u bol'nykh s khronicheskimi formami ishemicheskoi bolezni serdtsa.

Sixty-seven patients with angiographically-confirmed coronary heart disease (CHD) were investigated. Three patterns of thyroid hormone (T3 and T4) response to exercise were identified: rising, falling and unchanged levels. Coronary patients with rising T3 levels in response to exercise typically showed smaller left-ventricular ejection values as compared to those patients whose T3 levels declined. Coronary patients with low baseline T3 tended to have elevated left-ventricular end diastolic pressure after exercise. The demonstrated changes in plasma thyroid hormone levels are related to the severity of coronary disease and can be "protective" or, on the contrary, aggravating. Because of smaller biologic activity, T4 does not basically affect clinical manifestations of CHD.