[Prognostic value of the ultrasonic determination of the degree of interstitial edema in patients with intermediate ejection fraction of the left ventricle after treating acute decompensation of heart failure].

Aim To study ultrasonic characteristics of lung tissue in patients with heart failure with left ventricular (LV) mid-range ejection fraction (HFmEF) and predictive value of these characteristics after reversing acute decompensated heart failure (ADHF).Material and methods Ultrasonic characteristics of lung tissue were studied by prospective observation in 71 patients (mean age, 65.2±3.6 years; men, 64.3 %) with HFmEF (LVEF from 40 to 49 %) following ADHF reversal. Semiquantitative evaluation of B-lines was performed by the E. Picano (2016) method at 5+2 days after hospitalization and on discharge from the hospital. The distance between B-lines was 3 mm (В3 lines) and 7 mm (В7 lines). Patients' catamnesis was studied for determining the predictive value of lung tissue ultrasonic characteristics for two years since the index hospitalization. Statistical analysis was performed using the McNemar's χ2 test (for evaluation of linked samples and of changes in the presence/absence of B-lines as determined by lung ultrasound examination (USE)) and the Wilcoxon test (for evaluation of quantitative changes). Differences were considered significant at p<0.05.Results B7-lines characteristic of interstitial component of pulmonary parenchymal edema prevailed in patients with HFmEF. В3-lines characteristic of alveolar edema were found in a small amount. In the anterior-superior segment, B7-lines predominated over B3-lines (80 % vs. 20 %, p<0.01) on the right; however, on the lest, significant differences were not observed (64 % vs. 36 %, p>0.05). In the anterior-inferior segment, В7-lines prevailed over В3-lines on the right (75 % vs. 25 %, p<0.05); however, on the left, the difference was not significant (67 % vs. 33 %, p=0.05). In the lateral superior segment on the right, В7-lines predominated over В3-lines (75 % vs. 25 %, p<0.01); in contrast, on the left, there were no differences (67 % vs. 33 %, p>0.05). In lateral-basal segments on both sides, significant differences were present (73 % vs. 27 % on the right, p<0.05; 72 % vs. 28 % on the lest, p<0.05). The results of lung ultrasound were also used for evaluation of the B-line predictive value in patients with ADHF and mid-range EF on discharge from the hospital after reversal of X-ray and clinical symptoms of pulmonary congestion. In the next two years, 35 patients (49.2 % of sample) were rehospitalized with signs of ADHF (39 hospitalizations, 1.1 hospitalizations per patient). The rehospitalized patients were divided into two subgroups, with an increased number of B-lines and small congestion on discharge (6-15 В-lines) and without signs of congestion (<5 В-lines). For patients with a minimal (small) congestion on pulmonary ultrasound but regression of clinical and X-ray congestion, the number of rehospitalizations was 25 vs. 11 in patients with the number of B7-lines <5. In the ROC-analysis, the area under the curve was 0.706, which corresponded to the expert assessment as "good". The position sensitivity was 78.6 % and the specificity was 79.7 %.Conclusion "Ultrasonic pulmonary edema syndrome" in patients with LV mid-range ejection fraction after reversing ADHF was characterized by predomination of the interstitial component, despite the absence of X-ray congestion, correlated with the blood level of NT-proBNP measured at the same time, and was associated with rehospitalizations.

[Model of Two-Years Forecasting of the Anti-Existent Patients With Acute Decompensation of Heart Failure on the Background of the Intermediate Fraction of Left Ventricle].

OBJECTIVE: Build a prognostic model using clinical, laboratory, and instrumental data to predict mortality in patients with midrange left ventricular ejection fraction (mrLVEF) within two years after hospitalization for acute decompensated heart failure (ADHF). MATERIALS AND METHODS: The study included 121 patients hospitalized for ADHF with mrLVEF ranging from 40% to 49.9% (91 males and 30 females, mean age 64.6±14.8 years). The independent sample used to validate the statistical model included 71 patients with ADHF and mrLVEF with a mean age of 65.59±12.12 years. Sex distribution of the independent sample was 51 males (70.8% of the independent sample), 20 females (27.8% of the total independent sample). In-hospital mortality of patients included in the study was 4.2%, and long-term mortality was 36.8%. We developed a tool to assess the risk of two-year mortality using classification trees. RESULTS: The root node is the red blood cell distribution width-coefficient of variation (RDW-CV); its diagnostic value in this model was 13.3%. The second-level nodes are glomerular filtration rate (GFR), with a cutoff level of 35 mL/min/1.73 m2, and chronic kidney disease (CKD). The third-level nodes are sex, the anterior-posterior dimension of the left atrium, with the cutoff level >47 mm, and low red blood cell count <4.22x1012/L. The estimated sensitivity of the model is 71.4%; estimated specificity is 85.7%. CONCLUSION: This model can be used to assess long-term mortality risk and identify groups of patients with mrLVEF who require closer monitoring.

[Characteristic of infectious status in patients with acutely decompencated chronic heart failure and its impact on annual prognosis].

AIM: The assessment of infectious status in patients with acutely decompensated chronic heart faiure (ADCHF) without evident signs of acute inflammatory stress and its impact on the 1 year prognosis. MATERIAL AND METHODS: Totally, 65 patients with ADCHF of ischemic origin investigated, age 67,3±2,3 y.o. All patients were taken markers of phagocytosis and inflammatory stress as well as antibodies to Streptococcus, Cytomegalovirus (CMV), Epstein-Barr virus (VEB), Candida albicans, Toxoplasma gondii, Aspergillus, Mycoplasma hominis and pneumonia and also level of lipopolysaccharids (LPS) of gram-negative bacteriae. RESULTS: More often LPS of gram-negative bacteriae were revealed in patients with ADCHF and further in decreasing order - antibodies to CMV, VEB, Streptococcus, Candida, Aspergillus and LPS. All patients have been infected by at least 2 pathogens, more than 90 % of them had 3 ones or more. Mortality in first 12 months observation correlated with quantity of patient`s pathogenic patterns (r=0,52, p=0,004). Dependency of one-year mortality from degree of viral-bacterial mixt contamination was almost linear. CMV was a monopathogen with strongest correlation with mortality (r=0,39, p=0,001). In patients with more significant infection bigger rate of re-hospitalizations about new ADCHF correlated with number of pathogens was observed (r=0,61, p=0,001). CONCLUSION: Chronic latent infection with a significant number of pathogens is characteristic of patients with low-ejection ADCHF of ischemic genesis with a significant number of pathogens: more than 90 % of patients had three or more. The most common exogenous pathogens in the study sample of patients with chronic obstructive heart failure were CMV, EBV, and hemolytic streptococcus, of the potentially endogenous ones, gram-negative intestinal bacteria. The number of infectious agents in patients with chronic obstructive heart failure has a direct correlation with deaths and re-admission to hospital with total heart failure within 1 year after discharge from the hospital.

[Clinical case of thromboembolism of small branches of the pulmonary artery on the background of the single ventricle id type with the opening of the сava-caval collaterals].

A three-compartment heart - a severe congenital defect, can develop after genetic mutation or teratogenic influence on fetus at early stages of embryogenesis. According to the literary data, the survival of such patients without surgery is 6-7 %. This publication demonstrates clinical case of the patient who has single ventricle of the heart and lived up to 56 without surgery.

[Genogeographic variability and genetic differentiation of the root vole (Microtus oeconomus Pallas, 1776, Cricetidae, Rodentia) from the Kuril Islands]. / Genogeograficheskaia izmenchivost' i geneticheskaia differentsiatsiia polevki-ékonomiki (Microtus oeconomus Pallus, 1776, Cricetidae, Rodentia) kuril'skikh ostrovov.

Electrophoretic analysis of 12 enzyme systems and 3 nonenzyme proteins (in all, 24 interpretable loci) was carried out for Microtus oeconomus from ten Kuril islands, Kamchatka Peninsula, and the vicinity of the city of Magadan. Gene geographic variation was examined and the coefficients of genetic variation and differentiation were estimated. The inter-population allozyme differentiation was low (DNEI, 1972 not higher than 0.053) and caused by variation in the allele frequencies of polymorphic loci. The greatest genetic distances were found between the populations belonging to different subspecies. Allozyme differentiation of Far Eastern M. oeconomus and M. fortis are discussed in relation to the data on the age of the island isolation and paleontological records. Karyological analysis (G-, C-, and NOR-banding) demonstrated the absence of differences between M. oeconomus from Kamchatka and the vicinity of Magadan.

[Changes of mitochondrial oxidation and phosphorylation in the testes of white rats under excessive supply of sodium nitrate into the organism]. / Izmeneniia mitokhondrial'nogo okisleniia i fosforilirovaniia v semennikakh belykh krys v usloviiakh izbytochnogo postupleniia v ikh organizm nitrata natriia.

The functional state of mitochondria, obtained from the testicles, after chronic intoxication by sodium nitrate (in a dose of 200 mg/kg during 14; 30 and 90 days) was investigated in experiment on white rats. It was revealed, that in dynamics of changes of mitochondrial oxidation and phosphorylation in the testicles under the excessive supply of sodium nitrate into the organism the determined phases should be marked: on the 14th day of intoxication this is the ascending of rate of respiration, on the 30th and 90th day--separation of the mitochondrial oxidation and ADP phosphorylation. It is supposed, that in pathogenesis of these changes the essential role belongs to nitric oxide production.

[Gene-geographical variation and genetic differentiation in red-backed voles of the genus Clethrionomys (Rodentia, Cricetidae) in the Okhotskii region]. / Genogeograficheskaia izmenchivost' i geneticheskaia differentsiatsiia lesnykh polevok roda Clethrionomys (Rodentia, Cricetidae) Priokhot'ia.

Thirteen enzyme systems and three nonenzyme proteins were electrophoretically analyzed in red-backed voles of the genus Clethrionomys. In total, 25 loci were interpreted. Gene-geographic variation was studied and indices of genetic variability and differentiation were determined. By the distribution of electrophoretic variants of hemoglobin, C. rutilus was shown to be divided into two geographical groups (northern and southern). A low level of genetic differentiation was revealed in the island isolates of C. rutilus and C. rufocanus. Separation of C. rufocanus, C. rex, and C. sicotanensis into a superspecies complex was confirmed. A study of differential G- and C-banding on C. rutilus and C. rufocanus chromosomes did not reveal intraspecific variation of autosomes. In these species, karyotypes of voles from Kamchatka Peninsula were studied for the first time. They appeared to be morphologically similar to the karyotypes continental voles by both autosomes and sex chromosomes.

[Apoptosis in the cells of parenchymatous organs in subacute sodium nitrate poisoning]. / Apoptoz v kletkakh parenkhimatoznykh organov pri podostroi intoksikatsii nitratom natriia.

Subacute intoxication was induced by the oral administration of sodium nitrate 200 mg/kg during 150 days to Wistar rats. After the time had been up severe damaging were found in liver, kidney, heart and thymic tissues. In the liver cells the DNA fragmentation in "scale" manner was found, but not in kidney and heart cells. Simultaneously, the Ca2+, Mg(2+)-depended endonucleases activity were increased in the liver nuclei extracts under intoxication. It was suggested that increasing of apoptosis in liver is the universal reaction to toxins.

[Chromosome variation and anomalous karyotypes in the red-backed mouse Clethrionomys rufocanus (Rodentia, Microtinae)]. / Khromosomnaia izmenchivost' i anomal'nye kariotipy u krasno-seroi polevki Clthrionomys rufocanus (Rodentia, Microtinae).

G-banding and C-banding of chromosomes were studied in populations of the red-backed mouse Clethrionomys rufocanus from 11 localities of eastern Russia. Intrapopulation polymorphism of autosome 3 caused by the deletion-duplication of the short-arm heterochromatin (2n = 56; NFa = 56-58) was demonstrated. The karyotype of Cl. rufocanus from continental populations and Sakhalin Island was shown to have a large subtelocentric chromosome of pair 3 (NFa = 58), whereas in the population from Kunashir Island, chromosomes of this pair were acrocentric (NFa = 56). One animal from the population of the Kedrovaya Pad' Reserve (Primorsk krai) had a pericentric inversion (acrocentric morphology) of the Y chromosome. In two animals, a female from the Ussuriiskii Reserve (Primorsk krai) and a male captured near the Tomari Settlement (Sakhalin Island), a pericentric inversion of one chromosome of pair 6 was found (NFa = 59). The inversion detected in the animal from the Sakhalin population was accompanied by the loss of the centromeric heterochromatin. In contrast, the inversion of the chromosome pair 6, which was found in the mouse from the Primorsk krai population, did not involve the loss of centromeric heterochromatin. Analysis of our results and data from the literature showed that the karyotype of Cl. rufocanus is not constant, as was thought earlier. The percentage of animals with abnormal karyotype (1.6%) was higher than in other groups of red-backed mice studied (0.12-0.7%).

[The dynamics of energy and metabolic exchange in kidneys after the new absorbable surgical sutures "Biophil" implantation]. / Dinamika protsessov énergeticheskogo i plasticheskogo obmena v pochkakh posle implantatsii novoi khirurgicheskoi rassasyvaiushcheisia niti Biofil.

The influence of a new surgical absorbable material Biofil on the energetical metabolism processes, contents and ratio of the nucleic acids in the operated kidney tissue was studied in experiment. The oxidizing phosphorylation inhibition, the RNA content and RNA/DNA coefficient lowering were noted on the 14th day after the catgut thread application in a sutured tissues. The phosphorilizing respiration activation, the respiration control and RNA synthesis rising were promoted by biofil application. It had a significance for stimulation of regeneration processes in kidneys and for more early restoration of their function.

[Effect of surgical thread from the dura mater, modified with succinate, on the energy metabolism of white rat kidney mitochondria]. / Vliianie modifitsirovannoi suktsinatom khirurgicheskoi niti iz tverdoi obolochki mozga na énergeticheskii metabolizm mitokhondrii pochek belykh krys.

The activity of energy metabolism has been studied in the experiment with white rats, which had been carried out nephrotomia with following use for suture such absorbable surgical threads as catgut plain, biofil (of dura mater spinalis of the cattle) and biofil modified with succinate. The research proves the use of catgut plain decreases of energy quotient and such polarographic index as the rate of phosphorylating respiration of mitochondria of the kidneys in postoperative period. The greater activity of energy metabolism during this period has been stated with the use of biofil. The use of biofil modified with succinate results in the activation of bioenergy processes.

[Effects of hyperbaric oxygenation on oxidative phosphorylation in post-nephrotomy tissues sutured with different surgical threads (an experimental study)]. / Vliianie giperbaricheskoi oksigenatsii na protsessy okislitel'nogo fosforilirovaniia v tkani posle nefrotomii, sshitoi razlichnym shovnym materialom (éksperimental'naiarabota).

The activity of mitochondrial respiration and oxidative phosphorylation (OP) was studied in white rats subjected to nephrotomy. The suture was made with absorbable surgical threads such as catgut plain, biofil (from dura mater spinalis of the cattle), dexon II (polyglycolic acid). The use of catgut plain inhibits biosynthetic processes 7 and 14 days after operation. Hyperbaric oxygenation enhances oxidative phosphorylation in postoperative renal tissue sutured with different biological and synthetic absorbable surgical threads (catgut, biofil, dexon II) and prevents sharp depression of the above processes in the course of catgut biodegradation. This fact is of great importance for reduction of normal functional and metabolic activity of the operated kidney.

[The effect of ethonium-modified bio-fibril surgical threads on the metabolism in the kidneys of white rats]. / Vliianie modifitsirovannoi etoniem khirurgicheskoi niti iz biofila na plasticheskii metabolizm v pochkakh belykh krys.

In experiment on white rats it was established that after the catgut application the RNA concentration and the RNA/DNA levels ratio are reducing in the renal tissues. This indexes in the sutured tissues have increased more while the biofibril, modified with ethonium, application than using other suture materials.

[Effects of absorbable suture materials on intracellular regeneration processes in animal experiments]. / Vliianie rassasyvaiushchikhsia shovnykh materialov na protsessy vnutrikletochnoi regeneratsii v éksperimente.

The influence of various absorbable suture materials on the intracellular regeneration processes in the rat's kidneys was studied up. Nephrotomy and suturing, using conventional and original suture materials were conducted in the animals. The RNA and protein biosynthesis inhibition on 14-30 days after chromic catgut implantation were revealed using radionuclide method. The most active course of biosynthesis was observed while using suture material manufactured from biofil and porcine material.

[General anesthesia during surgery of breast cancer]. / Obshchaia anesteziia pri operatsiiakh po povodu raka molochnoi zhelezy.

In 1982-1989 intravenous anesthesia was performed to 1160 patients operated on for breast cancer. Intravenous analgesia has a number of advantages over endotracheal anesthesia. The analgesic techniques have been compared. Absence of complications in the operative and postoperative periods, prompt recovery of the patients' physical and psychic activity following intravenous anesthesia make it a method of choice for surgical treatment of cancer patients who require no myorelaxation.