[Heart rate turbulence and T-wave alternans as markers of risk of sudden cardiac death in patients with hypertrophic cardiomyopathy].

AIM: to study microvolt T-wave alternans (mTWA) and heart rate turbulence (HRT) in patients with hypertrophic cardiomyopathy (HCMP). MATERIAL AND METHODS: We examined 50 patients with HCMP: 15 (28%) with obstructive form, 23 (46%) with major risk factors of sudden cardiac death (SCD), 7 (14%) with left ventricular thickness more or equal 3 cm, 6 (12%) with family history of SCD, 16 (32%) with attacks of nonsustained ventricular tachycardia (NVT), 5 (10%) with episodes of syncope. Control group comparable by age and gender composition comprised 50 persons without cardiovascular diseases. All patients were subjected to 24-hour ECG monitoring with registration of parameters of variability and HRT (turbulence onset [TO], turbulence slope), maximal mTWA values, mTWA at heart rate 100 bpm, mTWA at 05.00 AM (mTWA05:00). RESULTS: Patients with HCMP compared to controls were characterized by significantly higher values of mTWA05:00 (19 [13;30] and 9 [4;15] mcV, respectively, p<0.001). There was tendency to greater prevalence of pathological HRT values in patients with HCMP compared with healthy subjects (p=0.083). Prevalence of pathological TO values among patients (16%) was significantly higher than among controls (2%), (p<0.05). CONCLUSIONS: Compared to healthy subjects patients with HCMP were characterized by higher mTWA05:00 and higher prevalence of pathological values of TO. mTWA was directly related to numbers of ventricular extrasystoles and NVT attacks. Patients with attacks of NVT compared with those without had lower SDNN pNN50.

[Emergence of tick-borne spotted fever group rickettsiosis in Moscow].

AIM: Analysis of clinical cases of tick-borne spotted fever (TSF) group rickettsiosis in 2005 - 2010. MATERIALS AND METHODS: General clinical, biochemical and serological parameters were determined in 10 tick-borne spotted fever group rickettsiosis patients who had visited various geographical regions of the World. RESULTS: TSF group rickettsiosis diagnostic criteria, optimal serological diagnostics timing were determined. Possible diagnostic errors, features of serological diagnostics and antibacterial therapy of this nosologic form are discussed. CONCLUSION: Indication for TSF examination are primarily epidemiologic including tick attachment indication and clinical data. Serological studies are positive only in 3 - 4 weeks after the onset of the infection and thus can not be used for early diagnostics.

[Far-eastern spotted fever: description of new infectious disease].

Historical data concerning description and identification of etiology of tick-borne spotted fever in Russia are presented in the paper. Review of studies shows that by uncovering the etiology of tick-borne spotted fever in the Russian Far East, an emerging disease may be discovered. Another, different from classical Rickettsia sibirica, bacteria causes spotted fever there. The application of described methods resulted in first isolation of etiological agent of far-eastern spotted fever, Rickettsia heilongjiangensis, strains from patients.

[Contribution of all-USSR (Russian) Center of Rickettsioses and Collaboration Centre of WHO to the study of rickettsioses of tick-borne spotted fever group].

The manuscript presents the results of studies of rickettsioses of spotted fever group in the territories of USSR (Russia) and ChSSR (Slovakia). Authors review data about isolation of strains of rickettsiae of spotted fever group, improvement of isolation techniques, diagnostics and diagnostic preparations.

[Survival of Coxiella burnetii in soil].

For the first time the survival of Coxiella burnetii of five types in soils has been studied. The survival of C. burnetii has been found to depend on the content of organic substances in black earth, as well as soil temperature. The method for the prevention of an epidemic outbreak of Q fever directly under the natural conditions has been proposed.

[The effect of new synthetic prostanoids on the aggregation activity of human thrombocytes]. / Vliianie novykh sinteticheskikh prostanoidov na agregatsionnuiu aktivnost' trombotsitov cheloveka.

We found that a number of new synthetic prostanoids caused a prominent reduction of human platelet aggregation in the in vitro experiments. Moreover, two of this agents, IOS 3933 and IOS 4732, gives storage stability. Hemoxygenase activity, metabolic homeostasis of bilirubin in brain and transport function of serum albumin in animals receiving cobalt chloride.

Astrakhan fever rickettsiae: antigenic and genotypic analysis of isolates obtained from human and Rhipicephalus pumilio ticks.

Two spotted fever group rickettsia strains, A-108 and A-167, were isolated from the hemolymph of Rhipicephalus pumilio ticks collected in the Astrakhan region of Russia, which is area endemic for Astrakhan fever. These tick isolates were compared with a strain isolated from a patient suffering from Astrakhan fever and with reference spotted fever group rickettsiae strains. New tick isolates and the human strain were identical in their serologic, antigenic, and genetic characteristics by several methods: microimmunofluorescence, protein gel electrophoresis with immunoblotting, polymerase chain reaction followed by restriction endonuclease fragment length polymorphism analysis, and pulsed-field gel electrophoresis (PFGE). Astrakhan fever rickettsiae were found to be serologically and antigenically similar to Israeli spotted fever rickettsiae. Both of them probably belong to a single Rickettsia conorii pathotype complex. Only PFGE pattern analysis could clearly discriminate Astrakhan fever rickettsiae from other isolates.

Studies of a "new" rickettsiosis "Astrakhan" spotted fever.

The acute febrile disease with characteristic rash seen in Astrakhan region and named as "viral exanthema of unknown etiology" was proved to be a spotted fever group rickettsiosis. Serological examination of humans from endemic areas by complement fixation test revealed antibodies to R. conorii, R. akari and strains Netsvetaev and AR-74 of R. sibirica in titres from 20 to 640 in sera from ill persons. Of 429 sera from healthy persons, 5.1% were serologically positive in a titre of 20-40. The presence of spotted fever group rickettsiae was detected in 8 of 104 Rhipicephalus sanguineus ticks removed from dogs and tested by haemocyte test with Gimenez staining and indirect immunofluorescence technique. Attempts at isolation of rickettsiae in guinea pigs and cell cultures resulted in appearance of specific spotted fever group rickettsiae antibodies in guinea pigs (4 of 8 samples examined were positive) and detection of rickettsiae by immunofluorescence technique in cell cultures (in 2 of 12 samples tested).

[The ultrastructure of the interaction of Rickettsia sibirica and R. slovaca with the cells of ixodid ticks]. / Ul'trastruktura vzaimodeistviia Rickettsia sibirica i R. slovaca s kletkami iksodovykh kleshchei.

The ultrastructural aspects of the interaction of R. sibirica and R. slovaca with cells of mites of the species Dermacentor reticulatus, D. marginatus and Ixodes ricinus after their parenteral infection, as well as in the organs of D. marginatus infected naturally in the environment, have been studied. Both rickettsial species have similar morphology in different organs of the vector. These rickettsiae not only multiply, their populations are also partly destroyed in phagolysosomes. The natural mixed infection of R. sibirica and orbivirus in cells of D. reticulatus is described. As shown in this study, both associates pass through the complete ontogenetic cycle of development on the level of the host body and also on the level of an individual cell.

[Monoclonal antibodies to the species-specific and group antigens of Rickettsia prowazekii]. / Monoklonal'nye antitela k vidospetsificheskomu i gruppovomu antigenam Rickettsia prowazekii.

A number of hybridomas to different R. prowazekii determinants were obtained by the hybridization of spleen cells of BALB/c mice immunized with R. prowazekii corpuscular and soluble antigens. Some of the monoclonal antibodies (McAb) reacted with R. prowazekii thermolabile species-specific protein and did not react with R. typhi antigens (McAb of batches B4/4 and A-D3). McAb C5/2 and A3/2 reacted with the group thermostable antigen, common for R. prowazekii and R. typhi. McAb to the species-specific thermolabile antigen belonged to IgG2a. The McAb thus obtained permit the identification of R. prowazekii and R. typhi and the solution of the problem of the intragroup differentiation of rickettsiae belonging to the typhus group.

[Psychometric study of the intellect in patients with hepatocerebral dystrophy]. / Psikhometricheskoe issledovanie intellekta u bol'nykh gepatotserebral'noi distrofiei.

Psychometric investigation was performed in 35 patients with hepatocerebral dystrophy. The techniques of Vexler, Raven, Kussi were used. Moderately marked signs of reduced intellect were found. The intellectual defect pronounced itself in the impairment of imaginative-active mental component irrespective of educational level. Verbal-logical notional thinking was preserved and matched the educational level. Cu depleting therapy caused regression of the intellectual deficit in a majority of patients. These peculiarities of intellect reduction in hepatocerebral dystrophy patients and the possibility of their therapeutic correction should be taken into account in assessment of labor capability and in recommendations as to future occupation.

[Characteristics of monoclonal antibodies directed to species specific and group specific antigens of Rickettsia prowazekii]. / Kharakteristika monoklonal'nykh antitel, napravlennykh k vidospetsificheskomu i gruppovomu antigenam rikketsii provacheka.

A number of hybridomas against different determinants of R. prowazekii were obtained by hybridization of splenocytes from BALB/c mice immunized with whole cells or soluble antigens of the organism. Some of the monoclonal antibodies bound to thermolabile species specific protein of R. prowazekii and did not react with R. mooseri antigens (monoclonal antibodies series B4/4 and A3). Monoclonal antibodies C5/2 and A3/2 reacted with group specific thermostabile antigen which is common for both R. prowazekii and R. mooseri. Monoclonal antibodies against species specific antigen were found to be of Ig G2a subclass. The monoclonal antibodies can be used to identify R. prowazekii and R. mooseri and solve the problem of differentiating Rickettsiae of typhus group.

[Circulating tissue antigens in multiple sclerosis and hepatocerebral dystrophy]. / Tkanevye tsirkuliruiushchie antigeny pri rasseiannom skleroze i gepatotserebral'noi distrofii.

Using complement fixation test (CFT) in cold, the authors measured the circulating tissue antigens of the brain and liver in 50 subjects (22 patients with hepatocerebral dystrophy, 18 with multiple sclerosis and 10 healthy subjects). The total circulating levels of liver and brain antigens were found to be dependent on the activity and progression of the pathological process in these organs. The CFT may be recommended as an additional test for diagnosing the destructive process in the brain and liver of patients with hepatocerebral dystrophy and multiple sclerosis and for assessing the efficacy of the conducted treatment.

[Pathogenesis of cerebral disorders in hepatocerebral dystrophy]. / O patogeneze tserebral'nykh narushenii pri gepatotserebral'nom distrofii.

On the basis of data obtained in the course of long-term observation of more than 60 patients with hepatocerebral dystrophy and analysis of the literature the authors consider the problems related to the pathogenesis of cerebral disorders in this disease. It has been found that the underlying mechanisms of the disorder is chronic intoxication of the central nervous system which is induced by the glut of "non-ceruloplasmin" copper and brings about a cascade of secondary metabolic disturbances, including defect of the amino acid pool in the blood plasma, zinc deficit, and disorders of redox processes. The possible role of each of these disorders has been considered in the pathogenesis of cerebral disturbances associated with hepatocerebral dystrophy.

[Phenocopy of hepatocerebral dystrophy (Wilson-Konovalov disease)]. / O fenokopirovanii gepatotserebral'noi distrofii (bolezni Vil'sona-Konovalova).

For differentiating between hepatocerebral dystrophy (HCD) and its phenotypic analogues 70 patients with diseases of the subcortical ganglia and the cerebellum were examined. Some signs pathognostic of HCD (a transient drop of the ceruloplasmin level in the serum, a slight rise of the copper content in the hepatic tissue, subclinical signs of a hepatic pathology) may be encountered, though rarely, also in diseases of the subcortical ganglia and the cerebellum of other etiology. In obscure cases the diagnosis can be made clear only after carrying out a full complex of examinations, such as, revealing Kaiser-Fleischer rings, carrying out functional, radioisotopic and morphological examinations (by puncture biopsy) of the liver and determining the copper level in the latter. In patients with affections of the subcortical ganglia and the cerebellum, the liver is involved rather infrequently; the disturbances are of a subclinical character and can be classed with manifestation of drug disease, the extremes of which are fatty dystrophy and more frequently nonspecific changes.

[Plasma non-ceruloplasmin copper in hepatocerebral dystrophy (criterion for the diagnosis and evaluation of cuprogogue therapy)]. / Netseruloplazminovaia med' plazmy pri gepatotserebral'noi distrofii (kriterii diagnostiki i otsenki éffektivnosti medegonnoi terapii).

Results of determining the plasma levels of non-coeruloplasmin copper in 29 patients with hepatocerebral dystrophy (before and during cuprogogue therapy) and in 15 practically healthy individuals are presented. A statistically significant rise of this level (as compared with that in the control group) was revealed in the patients with Wilson-Konovaloff's disease. The clinical improvement of the patients with hepatocerebral dystrophy was accompanied by normalization of the plasma level of non-coeruloplasmin copper. This gives one grounds to conclude that this parameter can be used as a criterion for evaluating the efficacy of the treatment given.

[Antigenic structure of Rickettsia of the tick-borne spotted fever group isolated in the Armenian SSR]. / Antigennaia strukura rikketsii gruppy kleshchevoi piatnistoi likhoradki, vydelennykh v Armianskoi SSR.

The authors present data concerning the study of the antigenic properties of rickettisa of the tick-borne spotted fever group isolated from the Ixodes ticks in the Armenain SSR. In order to determine the species of the isolated strains a method of serological identification of rickettsia in the complement fixation reaction with the species-specific immune sera of albino mice was used. The results obtained permitted to refer the Armenia-74, No. 11, 29, and 57 species to the R. sibricia species.