[Effectiveness of diagnostics and treatment of complicated hypertensive disease taking into account results of 3 day arterial pressure monitoring].

UNLABELLED: Empirical choice of antihypertensive therapy (AGT) for patients with complicated hypertensive disease (HD) encounters difficulties due to high variability of arterial pressure (AP) and inadequate response to intake of medicines. The objective methods for the choice of AGT methods are absent. AIM: To evaluate effectiveness ofthe choice of AGT taking account of AP profile calculated based on the analysis of results of 3 day AP monitoring in patients with complicated HDfor whom the empirical prescription of medicines does not give the desirable result. MATERIALS AND METHODS: The study included 51 patients aged 56 +/- 19 yr with HD 18 +/- 13 yr in duration without adequate control of AP despite combined AGT AD was measured (BPLab, Nizhni Novgorod) every 30 min for 3 days, the AP profile was calculated by special FORM-based algorithm. Peak time and magnitude were calculated, the first and second derivatives of the process were determined, AGT was prescribed at the computed AD maximum points. RESULTS: Systolic and diastolic AP decreased within 2 weeks after AGT The number of patients with enhancedAP in the daytime and at night and those with highly variable AP decreased from 33 to 11% (chi2 = 8.4, p < 0.005), from 61 to 33% (chi2 = 10.1, p < 0.005), from 51 to 26% (chi2 = 8.2, p<0.005) respectively. The number ofpatients with inadequate lowering of night-time AP and those with abnormally high fluctuations of AP decreased from 53 to 24% (chi2 = 9.3, p < 0.005) and from 31 to 15%, (p < 0.005) respectively. The frequency of intake of AGT drugs did not change. CONCLUSION: Approximation of real AP circadian profile fluctuations based on results of 3 day monitoring is a sensitive diagnostic tool facilitating the choice of rational AGT for patients with markedly altered circadian rhythms when empirical prescription of AGT does not ensure desired control ofAP

COSMIC INHERITANCE RULES: IMPLICATIONS FOR HEALTH CARE AND SCIENCE.

Countering the trend in specialization, we advocate the trans-disciplinary monitoring of blood pressure and heart rate for signatures of environmental cyclic and other variabilities in space as well as terrestrial weather on the one hand, and for surveillance of personal and societal health on the other hand. New rules (if confirmed novel laws) emerge as we recognize our inheritance from the cosmos of cycles that constitute and characterize life and align them with inheritance from parents. In so doing, we happen to follow the endeavors of Gregor Mendel, who recognized the segregation and independent assortment of what became known as genes. Circadians, rhythms with periods, τ, between 20 and 28 hours, and cycles with frequencies that are higher (ultradian) or lower (infradian) than circadian, are genetically anchored. An accumulating long list of very important but aeolian (nonstationary) infradian cycles, characterizing the incidence patterns of sudden cardiac death, suicide and terrorism, with drastically different τs, constitutes the nonphotic (corpuscular emission from the sun, heliogeomagnetics, ultraviolet flux, gravitation) Cornélissen-series.

[Several-day arterial pressure and heart rate monitoring in patients with paroxysmal atrial fibrillation].

Patient N presented with a well-apparent abnormality of chronological structure of heart beat biorhythms despite the absence of subjective complaints throughout the six-month long observation period. It was shown that AP peaks were associated with a significant decrease of circadian index (CI), i.e. the development of a rigid daily heart contraction rhythm. The reduction of CI as a specific indicator of stability of the daily cardiac contraction rhythm gave evidence of altered vegetative regulation of cardiac function during hypertension. Rigidity of the daily heart contraction rhythm increased with increasing severity of the disease. Smoothing of the circadian rhythm profile suggests depletion of adaptive reserve and the development of the "denervated" heart phenomenon. Cardioversion created a tendency towards normalization of circadian index.

Why continued surveillance? Intermittent blood pressure and heart rate abnormality under treatment.

Several opinion leaders have monitored their blood pressure systematically a sufficient number of times a day for chronomic (time structural) analyses, from the time of encountering chronobiology until their death; they set an example for others who also may not wish to base treatment on single spotchecks in a health care office. Such self-measurements, while extremely helpful, were not readily feasible without a noteworthy interruption of activities during waking as well as of sleep. New, relatively unobtrusive instrumentation now makes monitoring possible and cost-effective and will save lives. Illustrative results and problems encountered in an as-one-goes self-survey by GSK, a physician-scientist, are presented herein. Both MESOR-hypertension and CHAT (circadian hyper-amplitude-tension) can be intermittent conditions even under treatment, and treatment is best adjusted based on monitoring, rather than "flying blind".

Time microscopy for all kinds of data including circadian clock biology.

Data showing a rhythm to the naked eye prominently, barely or not at all were described as kinds A, B and C, respectively. Here, we document good agreement between estimates of maxima and minima with eyeballing and with the addition of point and interval estimates of parameters in kind A data. We also construct a chart that provides estimates of uncertainties that can be obtained objectively while they are more difficult to quantify subjectively; again there is agreement. Interval as point estimates of rhythm characteristics and parameter comparisons are useful in charting all kinds of data and become indispensable as we proceed from kind A to kind C data. Illustrations included herein from molecular biology apply equally to all aspects of transdisciplinary science.

Chronomics, neuroendocrine feedsidewards and the recording and consulting of nowcasts--forecasts of geomagnetics.

A multi-center four-hourly sampling of many tissues for 7 days (00:00 on April 5-20:00 to April 11, 2004), on rats standardized for 1 month in two rooms on antiphasic lighting regimens happened to start on the day after the second extremum of a moderate double magnetic storm gauged by the planetary geomagnetic Kp index (which at each extremum reached 6.3 international [arbitrary] units) and by an equatorial index Dst falling to -112 and -81 nT, respectively, the latter on the first day of the sampling. Neuroendocrine chronomes (specifically circadian time structures) differed during magnetically affected and quiet days. The circadian melatonin rhythm had a lower MESOR and lower circadian amplitude and tended to advance in acrophase, while the MESOR and amplitude of the hypothalamic circadian melatonin rhythm were higher during the days with the storm. The circadian parameters of circulating corticosterone were more labile during the days including the storm than during the last three quiet days. Feedsidewards within the pineal-hypothalamic-adrenocortical network constitute a mechanism underlying physiological and probably also pathological associations of the brain and heart with magnetic storms. Investigators in many fields can gain from at least recording calendar dates in any publication so that freely available information on geomagnetic, solar and other physical environmental activity can be looked up. In planning studies and before starting, one may gain from consulting forecasts and the highly reliable nowcasts, respectively.

Near 10-year and longer periods modulate circadians: intersecting anti-aging and chronoastrobiological research.

Biological cycles with relatively long and some unusual periods in the range of the half-week, the half-year, years, or decades are being discovered. Their prior neglect constituted a confounder in aging and much other research, which then"flew blind" concerning the uncertainties associated with these cycles when they are not assessed. The resolution of more about 10-year and other cycles, some reported herein, replaces the admission of complete unpredictability, implied by using the label "secularity." Heretofore unaccounted-for variability becomes predictable insofar as it proves to be rhythmic and is mapped systematically to serve as a battery of useful reference values. About 10-year cycles in urinary 17-ketosteroid excretion and in heart rate and its variability, among others, are aligned with cycles of similar length in mortality from myocardial infarction. Associations accumulate between cycles of natural physical time structures, chronomes such as the 10.5-year (circadecennian) Schwabe and the 21-year (circavigintunennian) Hale cycles of solar activity, and chronomes in biota. There are about 50-year (circasemicentennian) cycles in mortality from stroke in Minnesota and in the Czech Republic and also in human morphology at birth, the latter result reducing the likelihood that these cycles are purely human made. Associations among large populations warrant long-term systematic coordinated sampling of natural physical and biological variables of interest for the design of countermeasures against already documented elevated risks of stroke, myocardial infarction, and other catastrophic diseases, notably in elderly adults. New findings will be introduced against the background of the documented value of mapping rhythms in medicine and gerontology. In both these fields, rhythms promise the seeming paradox of better care for less.

About 8- and approximately 84-h rhythms in endotheliocytes as in endothelin-1 and effect of trauma.

Population densities (PD) of capillaries (C) and endotheliocytes (E) were determined in pinnal dermis of C57BL mice before and after trauma. Moving (and overall) least-squares spectra before trauma detected in EPD (versus CPD) pronounced 3.5-day (circasemiseptan) and 8-h oscillations corresponding to components of the endothelin-1 chronome in human blood plasma reported earlier. Circadians were more pronounced in CPD. After trauma, circasemiseptan oscillations appeared also in CPD; their period gradually shortened and in two weeks split into about 2.5- and about 4.5-day oscillations; and circadian components became very pronounced. The pre-traumatic chronome was not restored within three weeks following trauma.

[The dynamics of the reparative regeneration of the rat epidermis exposed to lysylproline]. / Dinamika reparativnoi regeneratsii épidermisa krysy pri vozdeistvii lizil-prolinom.

Under study was the spatial distribution of mitotic activity (MA) of the rat epidermis in the process of reparative regeneration of the skin for a distance of 6 mm aside from the wound margin, as well as the action of lysyl-proline (LP) on the process which is a product of natural decay of collagen. The wound was made by cutting a skin flap (0.5 x 3 cm) from the area of the back. A teflon ring was introduced through the incision in the cranial direction at a distance of 3 cm. Control animals were given 1 ml of the isotonic solution of sodium chloride injected in the hole of the ring, for experimental animals the solution additionally contained 20 mkg of LP. Healing of the wound in control and experimental animals had the features generally corresponding to the regularities established earlier. It was also found that mitotic activity was growing irregularly forming waves. During 11 days of observations these waves sometimes came nearer to the center of the wound, sometimes moved away. The influence of LP manifested itself in the waves of MA reaching the wound center 1 day earlier, and the approximation and divergence of the waves were smoother, MA was higher and epithelialization of the wound surface also came 1 day earlier. Since the contraction of the wound in experimental animals was also more rapid (activization from the 3rd day), a conclusion can be made of the stimulating influence of LP on the course of the reparative regeneration of the epidermis observed as long as 1.5 weeks after a single injection of LP.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pathogenesis of experimental thyrotoxic myopathy]. / K patogenezu éksperimental'noi tireotoksicheskoi miopatii.

The data obtained in mice with experimental thyrotoxic myopathy included a decrease in the median diameter of the muscle fibers by 17.1 per cent and various focal degenerative changes in less than 20 per cent of the muscle fibers; a statistically significant elevation in the activity of alpha-glycerophosphate dehydrogenase, as well as a reduction in phosphorylase activity and glycogen levels. There was also a significant diminution in the median diameter of the motor terminal plates, a decrease in cholinesterase activity and intensified collateral ramification of the distal axons. The major cause of the muscular weakness and structural changes in the skeletal muscles in thyrotoxic myopathy seems to lie in lowered cAMP concentrations and a weakened cAMP-dependent regulation of protein kinase.

[Morphometric study of the thyroid gland]. / Morfometricheskoe issledovanie shchitovidnoi zhelezy

The article surveys the most important morphometric methods used for investigating the thyroid gland. Applicability of various histophysiological criteria for evaluation of the functional state of the organ and investigation of changes in its individual structural components in physiological and pathological processes is discussed. The connection between various quantitative indices and the most rational morphometric techniques based on the methods of planimetry and stereology are considered.

[Study of circadian (diurnal) rhythm of intraocular pressure in healthy persons and patients with glaucoma]. / Issledovanie tsirkadiannoi (okolosutochnoi) ritmiki vnutriglaznogo davleniia v norme i u bol'nykh glaukomoi.

35 patients (65 eyes) were examined; 10 patients (18 eyes) were without glaucoma or ophthalmic hypertension, and 25 patients (47 eyes) had an open-angle glaucoma of stages I-III. Glaucomatous patients were divided into 2 groups: patients of one group were examined in hospital (26 clinical studies), and those of another group were examined in policlinics (21 clinical studies). The studies resulted in elaborating a nearly daily rhythm correlating with the modern chronological-and-biological recommendations, i.e. 9 measurements during 4 days were made in hospital and 11 measurements during 5 days were made in policlinics. Such tonometry method was proven to have advantages before Maslennikov's daily tonometry. It was established that the cyclic nature of fluctuations of intraocular pressure (IOP) is individual not only for each person but also for each eye. The obtained data support the advisability of measuring the IOP by using the chronological-and-biological method in diagnostically complicated situations, at so-called glaucoma with pseudo-normal IOP, and in choosing the treatment schemes for patients with glaucoma.

Multiple resonances among time structures, chronomes, around and in US. Is an about 1.3-year periodicity in solar wind built into the human cardiovascular chronome?

AIMS: Velocity changes in the solar wind, recorded by satellite (IMP8 and Wind) are characterized by a solar cycle dependent approximately 1.3-year component. The presence of any approximately 1.3-year component in human blood pressure (BP) and heart rate (HR) and in mortality from myocardial infarction (MI) is tested and its relative prominence compared to the 1.0-year variation. MATERIALS AND METHODS: Around the clock manual or automatic BP and HR measurements from four subjects recorded over 5 to 35 years and a 29-year record of mortality from MI in Minnesota were analyzed by linear-nonlinear rhythmometry. Point and 95% confidence interval (CI) estimates were obtained for the approximately 1.3-year period and amplitude. The latter is compared with the 1.0-year amplitude for BP and HR records concurrent to the solar data provided by one of us (JDR). RESULTS: An approximately 1.3-year component is resolved nonlinearly for MI, with a period of 1.23 (95% CI: 1.21; 1.26) year. This component was invariably validated with statistical significance for BP and HR by linear rhythmometry. Nonlinearly, the 95% CI for the 1.3-year amplitude did not overlap zero in 11 of the 12 BP and HR series. Given the usually strong synchronizing role of light and temperature, it is surprising that 5 of the 12 cardiovascular series had a numerically larger amplitude of the 1.3-year versus the precise 1.0-year component. The beating of the approximately 1.3-year and 1.0-year components was shown by gliding spectra on actual and simulated data. DISCUSSION AND CONCLUSION: The shortest 5-year record (1998-2003) revealed an approximately 1.3-year component closer to the solar wind speed period characterizing the entire available record (1994-2003) than that for the concurrent 5-year span. Physiological variables may resonate with non-photic environmental cycles that may have entered the genetic code during evolution.

[Osteoplasty of the lower jaw with composite grafts]. / Osteoplastika nizhnei cheliusti kombinirovannymi transplantatami

Experimentally on 32 white rats of Wistar line and on 15 outbred dogs the authors studied plastic properties and healing processes of composite transplants, employed for replacement of mandibular defects. It was found that the composite transplant consisting of an allogenic lower jaw, treated according to "os purum" type, and an autobone was more resistant to infection, showed no rejection response and possessed adequate plastic properties. This enable the authors to apply the mentioned combination clinically in 7 patients with mandibular defects from 3.5 to 15 cm. Favourable results were obtained in every patient: the anatomical shape of the jaw and its functioning was restored, a good cosmetic effect was gained.