VALUE OF AMBULATORY BLOOD PRESSURE MONITORING IN THE VERIFICATION OF ARTERIAL HYPERTENSION IN SCHOOL AGE CHILDREN.

Arterial hypertension is a common pathology in children of different ages. The introduction of daily monitoring of blood pressure into the practice of pediatric cardiologists makes it possible to more accurately establish a diagnosis, determine the prognosis of the course of the disease and monitor treatment of hypertension. Objective - to assess the daily fluctuations of blood pressure in schoolchildren with arterial hypertension. 70 children of school age were examined. The main group (38 people) included children with high blood pressure, the control group included 32 clinically healthy children. All children underwent tonometry. The results for each child evaluated by percentile nomograms regarding age, gender and height. Verification of the diagnosis of arterial hypertension performed according to the recommendations of the American Academy of Pediatrics (AAP). In addition, children underwent ambulatory blood pressure monitoring. In 79% of children of the main group, the level of blood pressure assessed as arterial hypertension of the first stage, in 21% of children - arterial hypertension of the second stage. When conducting daily monitoring of blood pressure in 35 children (92.1%) of the main group, 2 peaks of systolic blood pressure observed: the first peak between 23:00 and 01:00 at night (from 5.5 to 18.8 mm Hg.), the second peak - in 28 children (73.7%) between 6.30 and 8.00 (from 6.8 to 10.1 mm Hg). At the same time, peaks in the level of diastolic blood pressure appeared in fewer children and were not so pronounced. In schoolchildren with stage 1 hypertension, a night peak observed in 60% of children, and a morning peak was in 22% of children. Among children with second stage of arterial hypertension a night peak observed in 100% persons and a morning peak observed in 72% of children. This suggests that the nocturnal peak of blood pressure may be a marker of the severity of arterial hypertension. In healthy children, there were no peaks in the rise in blood pressure. The presence of a non-dipper circadian profile in a school-age child in combination with the morning and/or night peak of systolic blood pressure can serve as a marker for the development of arterial hypertension. Therefore, such children must be attributed to the risk group for the development of this pathology.

Definition of a natural killer NKR-P1A+/CD56-/CD16- functionally immature human NK cell subset that differentiates in vitro in the presence of interleukin 12.

Human natural killer (NK) cell differentiation from immature lineage negative (Lin-) umbilical cord blood cells was examined in vitro. Cells expressing differentiation antigens of mature NK cells (CD56, CD16, CD2, CD8, NKR-P1A) were generated from Lin- cells cultured with interleukin (IL)-2 and a murine bone marrow stromal cell line expressing the human membrane-bound form of stem cell factor. Two subsets of NK cells were identified in these cultures: one expressed both NKR-P1A and CD56 and, in variable proportions, all other NK cell differentiation antigens; the second subset expressed only NKR-P1A and, unlike the former, was not cytotoxic. Neither subset expressed interferon (IFN)-gamma mRNA even after stimulation with phorbol di-ester and Ca2+ ionophore, but both expressed tumor necrosis factor alpha mRNA and the cytotoxic granule-associated proteins TIA-1, perforin, and serine esterase-1. After 10-d culture with IL-2, IL-12, and irradiated B lymphoblastoid cells, approximately 45% of the NKR-P1A+/ CD56- cells became CD56+, and the same cultures contained cells capable of cytotoxicity and of IFN-gamma production. These results indicate that NKR-P1A expression in the absence of other NK cell markers defines an intermediate, functionally immature stage of NK cell differentiation, and that effector functions develop in these cells, concomitantly with CD56 expression, in the presence of IL-12. These cells likely represent the counterpart of a CD3-/NKR-P1A+/ CD56-/CD16- cell subset that, as shown here, is present both in adult and neonatal circulating lymphocytes.

[Pattern of excitation in isolated heart of hibernator ground squirrel Citellus undulatus].

Aim of our study was to measure conduction velocity and pattern of excitation during hypothermia in hearts of ground squirrels Citellus undulatus, known to be most resilient hibernators. We imaged electrical conduction in intact isolated hearts of summer active and winter hibernating ground squirrels at temperatures varying from +37 degrees C to +3 degrees C. Electrical activity was mapped using CCD camera (500 frames/sec) and voltage-sensitive dye di-4-ANEPPS during normal sinus rhythm and ventricular pacing. No spontaneous tachyarrhythmia was observed in all hearts at any temperature. Hearts were able to maintain spontaneous sinus rhythm and normal pattern of epicardial excitation throughout the whole range of studied temperatures. Despite responsiveness to pacing in all hearts ventricular conduction velocity was significantly reduced (about 10-fold) at low temperatures +3 degrees C. Our data provides the first direct demonstration that isolated heart of the summer active and winter hibernating ground squirrel Citellus undulatus is able to maintain normal excitation pattern in a range of temperatures from +37 degrees C to +3 degrees C.

Protection of myelin basic protein immunized mice from free-radical mediated inflammatory cell invasion of the central nervous system by the natural peroxynitrite scavenger uric acid.

Peroxynitrite (ONOO(-)), the product of nitric oxide (NO(radical)) and superoxide (O(2)(-radical)), is believed to be a major contributor to immunotoxicity when produced by activated cells expressing inducible nitric oxide synthase (iNOS). Uric acid (UA) is a natural scavenger of ONOO(-) that is present at high levels in the sera of humans and other higher order primates relative to most lower mammals. We have previously shown that UA treatment is therapeutic in experimental allergic encephalomyelitis (EAE), a rodent model of multiple sclerosis (MS). In this study we have examined the effect of UA therapy on the dynamics of the appearance of iNOS-positive cells in central nervous system (CNS) tissue of mice subjected to the stimuli that cause EAE. The results indicate that UA prevents activated monocytes from entering CNS tissue where they may contribute to the pathogenesis of MS and other CNS diseases.

Preparation and characterization of hybridomas secreting monoclonal antibodies to tick-borne encephalitis virus.

Monoclonal antibodies (MA) were prepared to two strains of tick-borne encephalitis (TBE) virus: strain 4072 isolated from a patient in the U.S.S.R. and low-pathogenic for mice strain Skalica, isolated from a bank vole (Clethrionomys glareolus) in Slovakia. MA specific to the 4072 and Skalica strains were produced by hybridomas of the KEN (60 clones) and NEK (65 clones) series, respectively. Chromosomal analysis of MA producing 114 hybridoma clones of both series revealed a great variability in the number of chromosomes either in the range of given clones or between individual clones. The hybridoma cells under study possessed a high degree of transformation manifested by good growth in the mouse peritoneal cavity and marked accumulation in ascitic fluid (AF).

Two kinds of monoclonal antibodies to tick-borne encephalitis virus.

Two types of monoclonal antibodies (MA) of the KEN and NEK series prepared to tick-borne encephalitis (TBE) virus differed in the spectrum of their reactivity in serological tests and in their ability to react with individual representatives of the TBE virus complex. The KEN series MA were induced to the 4072 strain isolated from the blood of a patient in the U.S.S.R. The NEK series MA were prepared to the Skalica strain isolated from a bank vole in Czechoslovakia. Both groups of MA belonged to IgG class, reacted in immunofluorescence (IF) test, but possessed no haemagglutination inhibiting (HI) activity. MA of the NEK series reacted in the IF and complement fixation (CF) tests with all members of the TBE virus complex, except of the Powassan virus. MA of the KEN series had no CF activity and in the IF test, they did not react with Powassan and Langat TP-21 viruses and with the Skalica strain of TBE virus.

[Morphologic analysis of the consequences of simultaneous lesioning of the hippocampus and amygdala in the rat]. / Morfologicheskii analiz posledstvii odnovremennogo povrezhdeniia gippokampa i mindaliny u krys.

The comparison of damage localization in the region of the hippocampus and amygdala with changes of behaviour components in operated rats revealed an increase of alimentary excitability, motor and intersignal activity following damage of the dorsal part of the hippocampus and destruction of all the parts of amygdala, whereas the elaboration of transswitching of heterogeneous (alimentary and defensive) conditioned reflexes became difficult. If the hippocampus was fully destroyed and amygdala damage was confined to its corticomedial part, then the motor activity was enhanced only in some animals and alimentary excitability and intersignal activity, as a rule, did not differ from those in the intact rats. The elaboration of transswitching of heterogeneous conditioned reflexes in this case was facilitated.

[Hybridoma cloning by the end-point dilution method]. / Klonirovanie gibridom metodom predel'nykh razvedenii.

Hybridomas producing monoclonal antibodies to tick-borne encephalitis, Venezuelan equine encephalomyelitis, and vaccinia viruses were cloned and recloned by the end-point dilution method in 96-well Linbro plates on a cell feeder layer. With decreasing of the cell seed dose the average number of clones per well decreased and the effectiveness of clone production increased. When an average of one cell per well was introduced, the portion of vells with single clones for hybridomas of various origins ranged from 5.4% to 37.5%. As a rule, the first cloning resulted in a significant rise in titres of monospecific immunoglobulins secreted by hybridomas and improved growth characteristics of the hybrid cell population. Repeated cloning required in most cases for stability of the hybrid line was usually not accompanied by changes in the productivity of the cell cultures.

[Monoclonal antibodies to flavivirus antigens induced by a vaccinal strain of yellow fever]. / Monoklonal'nye antitela k flavivirusnym antigenam, indutsirovannye vaktsinnym shtammom zheltoi likhoradki.

Monoclonal antibodies (MABs) YEL-2 induced by the vaccine FNS Dakar yellow fever (YF) virus were characterized for their capacity to enter into serological reactions and to react with heterologous flaviviruses. YEL-2 MABs belong to the IgG2a class of immunoglobulins, possess the antihemagglutination properties, are active in indirect IF test but do not activate complement and have no neutralizing properties. The inability to enter into CFT in the presence of antihemagglutinating properties suggests that YEL-2 MABs are directed for the structural E glycoprotein. YEL-2 MABs reacted similarly with the vaccine 17D strain and the FNS Dakar strain by which they had been induced. In addition to YF virus, YEL-2 MABs reacted with Tyuleniy, Rosio, Ilhéus, Uganda S, Karshi, and Sokuluk viruses, the reaction with Tyuleniy virus reaching the same titer as with the homologous virus but was of one-way nature. No reaction of YEL-2 MABs was observed with the viruses of the tick-borne encephalitis complex, Japanese encephalitis, West Nile, Dengue 2 and 4 viruses. These results specify the antigenic classification of flaviviruses.

[Local destruction of Deiters' lateral vestibular nucleus (an experimental model of a focal brain stem lesion)]. / Lokal'noe razrushenie lateral'nogo vestibuliarnogo iadra Deistersa (éksperimental'naia model' ochagovogo porazheniia stvola mozga).

The experimental rat model of the local brainstem destruction by isolated electrical coagulation of the lateral vestibular nucleus Deiters was offered for studying the adaptive-compensatory CNS reactions after acute brainstem lesions. Morphological changes and functional derangements were correlated in 22 animals. Neurological disorders and behavioural reactions were reproducible and stable in rats with exact localization of coagulated foci. The results demonstrate the adequacy of the proposed model.

[Monoclonal antibodies to the Karelian fever virus. The characteristics of their biological properties]. / Monoklonal'nye antitela k virusu karel'skoi likhoradki. Kharakteristika biologicheskikh svoistv.

Biological properties of 6 variants of monoclonal antibodies (MAb) to Karelian fever virus, a member of the alpha-virus serocomplex Sindbis-WEE, produced by the available hybridomas. The productivity of hybridomas of the "Karel" series in tissue culture and in cultivation as ascitic fluid was evaluated. Among the antibodies analysed, all were specific to envelope proteins, of them 2 were against protein E2 and four against protein E1. Comparison of MCA biologic activity (neutralizing, antihemagglutinating activities, participation in immunofluorescence, EIA, and immune blotting) allows one to distinguish four different hybridomas among them producing specific antibodies differing in their properties.

[Prognostic significance of the results of a physical loading test in myocardial infarct patients]. / Prognosticheskoe znachenie rezul'tatov proby s fizicheskoi nagruzkoi u bol'nykh infarktom miokarda.

The predictive value of clinical, hemodynamic and electrocardiographic changes in response to an exercise test was assessed with respect to the probability of fatal outcome within 2 years after myocardial infarction (MI). A total of 421 male MI patients were studied; their age averaged 49 +/- 7.7 years. Exercise tests (bicycle ergometry) were carried out 6 to 12 weeks after MI in 364 (86.4%) patients; they were contraindicated to 57 (13.6%) patients. Within 2 postinfarction years, 19 (5.0%) patients died of coronary heart disease in the tested group, and 5 (8.7%) died in the group where the tests were contraindicated. Poor prognosis was associated with low exercise threshold (450 kgm/min for 2 min or less) and horizontal or slanting ST depression. The presence of medical contraindications to exercise tests is as significant with respect to mortality as the low exercise threshold (450 kgm/min for not more than 2 min).

[Importance of tolerance to physical exercise in the study of the blood coagulation and anticoagulation systems after myocardial infarct]. / Znachenie tolerantnykh fizicheskikh nagruzok v izuchenii svertyvaiushchei i protivosvertyvaiushchei sistemy krovi u bol'nykh perenesshikh infarkt miokarda.

The results of dynamic studies of some indices of the blood coagulation and anticoagulation systems are presented for 130 male patients surviving myocardial infarction and examined during the first year after this development. Along with signs of hypercoagulation, a high activity of the anticoagulation system was noted throughout the period of observation. 90 patients were examined before and after a tolerance test (with threshold physical exercises on a bicycle) 3, 6 and 12 months following acute myocardial infarction. The physical exercises permitted to reveal the compensatory reserve of the anticoagulation system that manifests itself most clearly 6 months following the onset of the infarction.

[ECG changes during an attack of stenocardia caused by physical exertion]. / Izmeneniia EKG pri pristupe stenokardii, vyzvannoi fizicheskoi nagruzkoi

In 85 patients suffering from ischemic heart disease ECG changes appearing at the time of an attack of angina pectoris provoked by a physical effort were studied. An analysis of these changes helps substantiate an objective choice of criteria for stopping a physical load test in this category of patients. As shown by pertinent investigations there is good reason for broadening the criteria for cancelling the load test in persons with a manifest coronary incompetence. A complete scientific justification of criteria for cancelling tests involving physical efforts is possible through contrasting the described changes against coronarographic, clinical and catamnestic findings.

[Use of levamisole in the combined therapy of patients with slowly progressing juvenile schizophrenia]. / Ispol'zovanie levamizola v kompleksnoi terapii bol'nykh iunosheskoi maloprogredientnoi shizofreniei.

Immunomodulating drug Levamisole was studied as a component in the combined treatment of juvenile slow progredient schizophrenia. Apart from normalizing the immune parameters, the drug improved the patients' clinical conditions. Most prominent was its clinical effect in patients with immune system sensitive to the drug. The patient's condition ameliorated in relation with the features of his initial state. Treating the patients with depressive-asthenic states has yielded the best results. Weaker was the effect on patients with obsessive-phobic disorders. The least curable were senesto-hypochondriac and dysmorphophobic disorders with sensitive delusions of relation.

[Clinical effectiveness and safety of citalopram in patients with depression after myocardial infarction]. / Klinicheskaia éffektivnost' i bezopasnost' tsitaloprama u bol'nykh s depressiei posle perenesennogo infarkta miokarda.

Citalopram (20 mg/day for 42 days) was given to 20 patients (mean age 54.4+/-2.5 years) with depression after myocardial infarction. This was associated with substantial antidepressive effect (50% and more lowering of the total score of the Beck depression questionnaire) in 89% of patients, reduction of number and severity of somatic complaints, and improvement of parameters of quality of life. Citalopram did not affect blood pressure and according to Holter ECG monitoring data produced no arrhythmogenic or proischemic effects. Overall tolerability of citalopram was good however 21% of patients experienced slight drowsiness, dizziness or sweating.

[Use of the immunomodulator levamisole in the complex treatment of juvenile schizophrenics with an unfavorable course]. / Ispol'zovanie immunomoduliatora levamizola v kompleksnoi terapii bol'nykh iunosheskoi neblagopriiatno tekushchei shizofreniei.

The authors investigated the effect of the immunostimulant levamisole on the immunological reactivity of schizophrenics and the resultant decrease in the therapeutic resistance of these patients toward psychotropic therapy. Thirteen patients with juvenile malignant continuously progressive schizophrenia were studied, using a double blind design of examination. The number of suppressor T-cells in patients treated with levamisole increased from 16.6% to 22.8% (p less than 0.001) which was not observed in patients on placebo. It has been demonstrated that the immunological parameters in patients with juvenile malignant continually progressive schizophrenia can be fully recovered. Yet, the changes observed in the clinical picture were heterogeneous and unremarkable. The experimental findings suggest that the use of levamisole may be more effective in patients with less progressive forms of the disease.

[Effect of treatment with psychotropic preparations on suppressor T-lymphocytes in juvenile continuously-progressing schizophrenia]. / Vliianie lecheniia psikhotropnymi preparatami na supressornye T-limfotsity pri iunosheskoi nepreryvnotekushchei shizofrenii.

The paper deals with the effect of psychotropic drugs on blood levels of suppressive T-lymphocytes in patients with continuously progressive schizophrenia. The patients were examined three times: the first sample of blood was taken after a long psychotropic therapy, the second 3 weeks after the discontinuation of the therapy and the third one 3 weeks after the resumption of treatment. The lowest levels of suppressory T-lymphocytes (averaging 16.3%) were observed during the first examination. Following the discontinuation of therapy the content of T-suppresspors increased to 21.3% (P less than 0.001) failing, however, to reach the mean level characteristic of normal donors (25.7%). The amount of suppressory T-lymphocytes decreased again after treatment resumption. It is concluded that one of the factors contributing to changes in the immunological status in patients with juvenile continuously progressive schizophrenia may be a long-term use of psychotropic drugs.

[Effect of complex rehabilitation by stages on the physical work capacity of myocardial infarct patients]. / Vliianie kompleksnoi poétapnoi reabilitatsii na fizicheskuiu rabotosposobnost' bol'nykh infarktom miokarda.

The authors examined 233 patients after myocardial infarction. The principal and control groups were formed at random. The principal group was composed of patients who had undergone complex stage-by-stage rehabilitation. The changes in the working capacity were determined by the bicycle ergometry test. It was established that the values of physical working capacity were significantly higher in patients of the principal group than in patients of the control group. The effect of the rehabilitation program was different in various age groups. It was most favourable in patients over 45 years of age. A significant difference was also disclosed in the parameters of the physical working capacity depending on the character of psychological readaptation.

[Suppressor T-lymphocytes in continuously progressive juvenile schizophrenia]. / T-limfotsity supressory pri iunosheskoi nepreryvno tekushchei shizofrenii.

The study of T lymphocyte suppressors in juvenile continuously progressive schizophrenia showed that the number of suppressor cells in patients was significantly decreased as compared to a group of mentally normal donors; 20.4% and 28.9% respectively. The parallel study of the number of suppressor cells in the peripheral blood and the proliferative activity of T lymphocytes upon their stimulation with mitogenic lectins of PHA and Con A demonstrated that in the mentally normal donors, these parameters were inversely correlated, whereas in the patients with juvenile continuously progressive schizophrenia, there was no such correlation between the above indices. The data obtained are indicative of the impaired regulatory activity of T lymphocyte suppressors in this group of schizophrenic patients.