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Aim of the study was to determine criteria of phases of stress reaction in humans to psychoemotional loading taking into account regulatory systems of adaptational reserves of organism. We examined representatives of professions potentially exposed to stress and investigated a spectrum of derangements of regulatory systems of the organism (neurovegetative system and cognitive function) under conditions of development of different phases of stress reaction to psychoemotinal loads. The proposed approach will allow to obtain efficiently quantitative assessment of phases of stress reaction in humans at different levels of adaptation to it. This approach can be used in clinical medicine.

Social and economic transformations of the society enable to suggest an ever increasing role of psychoemotional factors in the development of cardiovascular pathology. The paper contains a review of psychoemotional functional stress tests (arithmetic, speech, information, computer games). Stroop-testing method, which over the recent half of a century has been acknowledged asgold standard, is described in detail. Criteria for assessment of psychoemotional stress tests, including ECG and blood pressure dynamics, echocardiography, heart rate variability etc., are also described. Method for quantitative evaluation of effectiveness of psychoemotional Stroop-testing from the positions of information theory is suggested. The method is based on correlations between physiological response and flow of information being processed (bit/s).

Heart failure is a frequent often in the practice of a cardiologist but data on its actual incidence are inconsistent. This can be explained by variations in methodological approaches. Screening studies require simple easily obtainable and safe techniques capable to characterize activity of a patient. Their results should be compatible with widely accepted NYHA classification. Six minute walking test is one of possible solutions. Its results agree with NYHA classes, peak oxygen consumption and prognosis of survival. For improvement of accuracy of estimation of physical working capacity it is important to consider body mass. This can be achieved by a simple portable device constructed by the authors. To assess sufficiency of circulation during testing it is advisable to determine the load at which decorreleation between dynamics of effort and that of physiological parameters is revealed. Basing on the above considerations the authors suggest to define heart failure as a condition when decorrelation of physiological functions causes deterioration of perfusion and worsening of quality of life.

Radio-ecological and cytogenetic assessments were made in the vicinity of Totsk nuclear explosion in the Orenburg Region. Increased contents of radioactive isotopes Cs and Pu were detected in the soil. A comparative cytogenetic analysis indicated that the population continued to be exposed to radioactive agents.

Gastric secretion, motor function and tonicity of the stomach and duodenum, duodenogastric reflux were studied in inpatients with two clinicopathogenetic types of duodenal ulcer: observed at young age (type 1) and in later life (type 2). The examination included pH-metry with simultaneous balloon cimography, chromogastroduodenoscopy with Kongo-red, tests for Helicobacter pylori conducted on the biopsy samples. All the patients were found to have continuous acid production. High acid production was more frequently registered in males with the disease type 1, the lowest production was in females with the disease type 2. Duration of the acid inflow into the duodenum in patients with the disease type 2 was greater than that in young subjects. Mild ulcer was associated with moderate acidity in the duodenum, in severe ulcer the acidity was very high. Males with the disease 1 and 2 and females with type 2 had hyperkinetic, hypertonic gastric motor function. In duodenal ulcer prevalent is hypertonic, hyperkinetic type of duodenal motor function being most frequent among males with the disease type 2. Duodenogastric reflux occurs more often in patients with intensive acid production associated with hypotonic, hypokinetic motor type and duodenal tone.

Time-related course was studied of vegetative indicators during the hyperbaric oxygenation (HBO) sessions in 36 liquidators of the effects of the Chernobyl Nuclear Power Plant breakdown, who suffered from early forms of cerebrovascular insufficiency. Shown for the first time in therapeutic hyperoxia in the liquidators are features of the time-related course of vegetative regulation. Significant group particularities of changes in vegetative regulation have been stated, that suggest a different approach to the tactics of HBO employment. Those patients experiencing a higher tenseness of vegetative regulation demonstrated antecedents of toxic action of oxygen at minute 35 to 40 HBO. The employed vegetative indicators monitoring technology allowed the establishment of individualized hyperoxia doses, with the early signs of oxygen overdose being revealed in real time.

The authors analyze findings from a comprehensive clinical and instrumental evaluation of 59 patients presenting with duodenogastric reflux. The above findings suggest that underlying the duodenogastric reflux in those patients having surplus body mass might be hypotonia of the stomach, particularly its pyloric portion. In patients with body mass that do not deviate from physiologic norms regurgitation of bile into the stomach results from the presence of duodenal dyskinesia by hypertonic type. The results obtained suggest that patients with gastroduodenal reflux need treatment options for them to be carefully thought out. The above reflux appeared to be particularly pronounced in those patients presenting with alimentary obesity as per analysis of the gastric content. Patients with grade II obesity show more noticeable tonic disorders of the pyloric portion of the stomach.

The paper presents the results obtained upon examination of inpatients with various types of biliary dyskinesia. The examination included: fraction chromatic duodenal intubation, stepwise manometry, cholecystography, ultrasound investigation of the liver, gall bladder, biochemical tests of the bile. Fraction duodenal intubation discovered gall bladder dysfunction. The manometry was necessary for diagnosis of duodenal hypertension. X-ray revealed primary defects in gall bladder motility. It is concluded that the diagnosis of functional disorders implies combined clinical and instrumental modalities.

Data are submitted on the condition of haemodynamics of greater and lesser circulation in patients with ischemic heart disease (IHD) presenting with the bundle-branch block. On the basis of the results from a combined clinical-instrumental investigation involving electro- and echocardiography the authors present the early objective quantitative criteria for the diagnosis of those haemodynamic shifts occurring in formation of the bundle-branch block. The blockade of the left bundle of His has a more pronounced effect on the greater circulation haemodynamics while that of the right one--on the lesser circulation. The authors give a comparative assessment of haemodynamic effects of a single dose of isosorbide dindtrate and nifedinin in the patients. Nitrosorbide and corinfar improve contractility of the left ventricle, decrease pulmonary hypertension and overloading of the right side of the heart.

The time course of biliary secretion of prostaglandins (PG)E1 and F2 alpha was studied in 20 patients with primary dysfunctions in the cholepoietic system. The studies indicated that baseline high PGE1 levels and slow increases in PGF2 alpha during vesical reflex might be one of the factors predisposing to biliary hypokinesia. In patients with Oddi's sphincter spasms, the period of active PGE1 synthesis coincides with that of sphincter spasm. It is suggest that the latter is due to PGE1-induced muscle spasm of the duodenum whose fibers are an integral part of the intricate muscle system of Oddi's sphincter. In Oddi's sphincter spasm concurrent with biliary dyskinesia, the curve of PGF2 alpha virtually little differs from that in Oddi's sphincter spasm alone. PGE1 increases at the closed sphincter stage in the same way as that elevates in isolated sphincter spasm, but in patients with biliary hypokinesia contaminant with Oddi's sphincter spasm PGE1 shows its concentration in the vesical reflex phase, which appears to result in biliary hypokinesia. PGE1 and PGF2 alpha imbalance is one of the links in the pathogenesis of biliary dyskinesia.

Doppler echocardiography was used to quantify pulmonary hypertension and phase pattern of right heart systole in 140 patients with nonspecific pulmonary diseases to study hemodynamic characteristics of pulmonary circulation and right heart as well as external respiration. There appeared a relationship between the severity of pulmonary hypertension, bronchial obstruction and arterial hypoxemia. It seems that in nonspecific pulmonary diseases hemodynamic changes arise prior to functional disorders of external respiration.

The response to intermittent normobaric hypoxia (INH) created in breathing gas hypoxia mixture (10% oxygen, 90% nitrogen) was evaluated in 123 patients with essential hypertension stage I and II. Hypoxia adaptation effects on central hemodynamics, physical performance, kinetics of oxygen exchange were studied. A pronounced response to INH persistent for 6 months was demonstrated in 80.5% of the patients. The reduction of the arterial pressure resulted from different mechanisms depending on hemodynamic type. Physical performance of the patients rose, oxygen consumption and transport normalized.

The authors provide evidence on the condition of external respiration and hemodynamic shifts in the lesser and greater circulation in coronary patients with bundle-branch block; establish early objective quantitative criteria of the diagnosis of hemodynamic impairment arising in formation of the above blocks basing on ECG, phonocardiography, echocardiography findings; compare hemodynamic effects of single-dose nitrosorbide and corinfar in the above patients. Nitrosorbide and corinfar correct hemodynamics and external respiration, the former being more effective in normalizing the greater, while corinfar the lesser circulation.

Clinical and functional condition was examined for 75 patients with essential hypertension stage I and II who had developed adaptation to normobaric cyclic-fractionated hypoxia. The latter was produced by gas hypoxic mixture (10% oxygen, 90% nitrogen) in its inhalation. A pronounced positive effect of such treatment modality was registered in 86.7% of the patients and persisted for 6 months and more in 84.3%. A normal correlation was achieved of cardiac ejection to peripheral vascular resistance, this reducing arterial pressure. An optimal hemodynamic response arose to the hypoxic effects which also improved psychoemotional status of the patients.

The paper covers questions of the emergence and progressing of cardiorespiratory disturbances in coronary patients with defective atrioventricular conduction. The authors characterize central and peripheral hemodynamics in the above patients, diastolic ventricular filling, external respiration, the disturbances of which were studied in correlation with hemodynamic features and lipid peroxidation. The patients were examined for effects on their cardiorespiratory system of cardioselective beta-blockers, adrenomimetics, antioxidants, membrane stabilizers.

The paper deals with hemodynamic parameters in the greater and lesser circulations in patients with CHD concurrent with left bundle branch block. Based on the results of clinical and instrumental studies involving electrocardiography, phonocardiography and echocardiographic techniques, the authors provide early objective measures for diagnosing the hemodynamic changes occurred with development of left bundle branch block. The authors make a comparative assessment of hemodynamic effects produced by single administration of nitrosorbide, corinfar, obsidan, and spesicor in the patients examined. Nitrosorbide and corinfar improve left ventricular contractility, reduce the degree of pulmonary hypertension and right cardiac overload, while obsidan and spesicor aggravate the hemodynamic changes in patients who have CHD and left bundle branch block.

Forty-five patients with duodenogastric reflux and defective gastroduodenal motor tonicity (gastroduodenal hypotonia, duodenal hypertension, gastric hypotonia in combination with duodenal hypertension) were exposed to He--Ne laser radiation. The impact was focused on the biologically active points G14, TR5, VC15, E21. The treatment resulted in normalization of the gastrointestinal pressure gradient, in discontinuance or reduction of duodenogastric reflux.

Adaptive reactions were studied in 80 patients with acute pneumonia. In the hospital 94.1% patients showed reactions of stress and incomplete reactions of training and activation. With improvement of the clinical condition the number of stress reactions reduces, while the number of physiological reactions of training and activation increased. The stress reaction is an unfavourable factor as to transition of acute pneumonia into chronic unspecific pulmonary diseases. These studies may be of value for evaluation of the prognosis and care of acute pneumonia.

He-Ne laser irradiation of biologically active points and infrared laser irradiation of the liver were employed to improve gallbladder and sphincter functions, bile production and biochemistry, respectively, in a total of 57 patients with biliary dyskinesia presenting as hypokinetic dyskinesia of the gallbladder, hyperkinetic dyskinesia of the sphincter of Oddi or the combination of the two affections. Simultaneous use of the two kinds of laser irradiation appreciably shortens treatment duration, abolishes biliferous dysfunction, reestablishes physiological balance of bile components in case of its initial lithogenic potential.

A complex Doppler echocardiographic study was performed in 134 patients with complete block of the left bundle branch, its anterior branch or with concurrence of these two types of intraventricular conduction disturbance. The authors identified 5 types of paradoxical ventricular septal motion, which were related to the specific features of intraventricular asynchronism and ventricular electric systole. Type I shows the greatest decrease in left ventricular contractility, left atrial overload and phasic destruction of left ventricular systole, which reflects the processes of depolarization and repolarization propagation in the myocardium. Type IV is characterized by the lowest number of hemodynamic abnormalities. Cardiac hemodynamics is also related to the type of intraventricular block, being the least changed in isolated anterior left bundle-branch and the most changed in concurrent anterior branch and entire left bundle-branch block.

Electrocardiographic, echocardiographic and Doppler echocardiographic studies were performed in 44 patients with coronary heart disease and complete right bundle branch block. The patients were found to have an impaired phase pattern of left ventricular systole and diastole as more prolonged length of its isometric relaxation and contraction, lower economic feasibility and efficiency of its contraction, moderate dilation and hypertrophy. Hemodynamic abnormalities in the left heart in these patients are closely correlate with the changes in the phase pattern of right ventricular systole and they turn out to be so greater as the degree of its hypertrophy is. In complete right bundle branch block, left ventricular pump dysfunction leads to decreased cardiac output and cardiac index, increased total peripheral vascular resistance, thus predisposing to impaired greater circulation.

The paper presents clinical and morphological assessment of therapeutic response in 97 patients aged from 20 to 65 years with the diagnosis of duodenal ulcer from 1 to 15 years. Routine treatment was performed in 32 and drug therapy in combination with local He-Neon radiation of the ulcer was performed in 65 patients. Higher therapeutic response especially in those with the disease duration not longer than 5 years was revealed in case of laser therapy versus the routine drug treatment. The effect of laser radiation either on the ulcer mucous coat or far from it resulted in a moderation of inflammatory and an increase of reparative processes. More rapid terms of ulcer healing is of a certain time-saving effect.

Diagnostic potentialities of Doppler sonography in assessment of portal hemodynamics in patients with chronic active hepatitis and hepatic cirrhosis were compared to those of noninvasive (rheohepatography) and invasive (angiography) techniques. Dopplerograms of the portal vein and its branches are described in specific details. Meals and treatment with beta-adrenoblockers reducing portal hypertension are evaluated in relation to their influence on the portal hepatic circulation.

Based on an analysis of 4980 ECGs of patients, the authors could distinguish and classify the clinico-electrocardiographic versions of the early ventricular repolarization syndrome (EVRS): permanent, occurring for the first time, suddenly disappearing, intermittent with a gigantic T wave; with a negative T wave, with a short-term T wave inversion, marked by the combination with Wolff-Parkinson-White syndrome, and additional chordae of the left ventricle. The clinico-electrocardiographic classification of the EVRS is of paramount importance for practitioners owing to an assumption that the EVRS is not only a version of the normal ECG but also can be a marker of CHD. The authors view the EVRS as an independent version of the preexcitation syndrome along with Wolff-Parkinson-White and CLK syndromes, with the manifestations of which it may combine.

The paper reviews literature data available and first-hand experience in relation to hemodynamics of portal blood flow, lesser and greater circulation in patients with chronic diffuse hepatic diseases. Relevance of circulatory changes to hepatic lesions is also considered. With regard to specific features of hemodynamic disturbances in hepatic lesions it is suggested to use cardiovascular drugs. A pharmacodynamic effect is compared for beta-adrenoblockers, calcium antagonists and nitrates administered to patients with affected hepatobiliary system.

The data obtained during the complex clinical and instrumental investigation of the hemodynamics in patients with the syndrome of portal and pulmonary hypertension against the background of acute drug tests with nitrosorbide, corinfar and obsidan, are presented. By using modern ultrasound and rheographic techniques, the degree and the relationship of portal and pulmonary hypertensions in patients with chronic hepatitis and cirrhosis of the liver are evaluated, the criteria of their early diagnosis are characterized. There was shown a positive action on the renal blood flow of nitrosorbide, an improvement of the pulmonary hemodynamics in patients with diseases of the liver against the background of corinfar exerting no influence on the hepatic blood flow. Obsidan induced a significant decrease of both portal and pulmonary hypertensions, normalization of the total hemodynamics thereby producing the greatest positive effect.

Ninety-eight patients were exposed to low-energy laser irradiation. Of these 52 and 31 had duodenal ulcer in aggravation phase with mucosal erosion and without it, respectively, 15 patients developed isolated erosive lesions of gastroduodenal mucosa. The energy was delivered to the target cites optically using fiber optics endoscope. Microcirculation was studied by bulbar biomicroscopy. Therapeutic response in the laser utilization proved positive being the highest for patients with a short disease history, moderate signs, small-size lesions. Normal microcirculation was not achieved though there was a trend to its improvement.

Two-dimensional and Doppler echocardiographies were used to examine right cardiac and pulmonary hemodynamics in patients with various types of coronary heart disease (CHD). All the patients were divided into 3 morphofunctional groups of CHD according to the left ventricular volume/mass index. They all were found to exhibit decreased left cardiac contractility and pump function, parallel with moderately elevated pulmonary pressure and right cardiac compensatory hyperfunction, which was largely evident in hypertrophic morphofunctional CHD. The degree of pulmonary hypertension was related to the severity of left ventricular pump dysfunction, but to its disturbed contractility in the dilated type.

During acute obsidan testing, the hemodynamics was evaluated in the pulmonary circuit and right heart cavities of 60 patients with Functional Classes III-IV exertional angina pectoris, by using two-dimensional and Doppler echocardiographies of the pulmonary artery. According to the left ventricular myocardial volume/mass ratio, the patients were divided into 3 morphofunctional types of coronary heart disease (CHD). All the patients were found to have diminished contractility and pump function in the left heart along with moderately elevated blood pressure in the left heart and compensatory hyperfunction in the right heart, which are largely evident in the hypertrophic morphofunctional type of CHD. The degree of pulmonary hypertension was related to the severity of left ventricular dysfunction, whereas in the dilated type it was associated with its contractile disorders. In patients with the dilated and mixed types of CHD, obsidan caused a marked decrease in pulmonary hypertension, while in those with hypertrophic CHD it promoted its slight increase.

Two-dimensional and Doppler echocardiographies were used to examine 102 hypertensive patients who were found to have pulmonary hypertension, whose manifestation was determined by the degree of arterial hypertension, cardiac contractile insufficiency and diminished left heart pump function. The degree of pulmonary hypertension was related to the hemodynamic type and maximal with hypokinetic circulation when the pump function of the heart was minimal. Obsidan caused a decrease in pulmonary and systemic arterial hypertension, producing higher effects with hypokinetic hemodynamics. Corinfar was demonstrated to attenuate pulmonary hypertension to a greater extent. Its action on systemic arterial hypertension was highest in patients with hyperkinetic circulation. Heterodirectional hemodynamic effects of these drugs make it expedient to study their combined action on the hemodynamic of hypertensive patients.

The authors analyze data obtained in a complex clinico-instrumental study of the functional activity of the liver, portal and hepatic blood flow in 77 patients with different forms of dyskinesias of the biliary tract. Obtained data evidence in these patients development (against the background of cholestasis) functional insufficiency of the liver and involvement of its parenchyma associated with a moderate pressure increase in the portal vein, reduction of the hepatic blood flow intensity, increase of its lability that may be a proof of development (in patients with functional bile secretion disorders) of chronic diffuse inflammatory process in the liver with subsequent appearance of clinically clear portal hypertension.

Detailed examination of hemodynamics in patients with portal and pulmonary hypertension was performed upon acute drug tests and course administration of nitrosorbide++, corinfar and propranolol. Ultrasound and rheography investigations were employed to elucidate the relations between portal and pulmonary hypertension in cirrhosis patients. Criteria of early diagnosis are discussed. Nitrosorbide++ produced positive effect on hepatic blood flow, corinfar improved pulmonary hemodynamics in lack of its influence on hepatic blood flow, while propranolol resulted in the drop of both portal and pulmonary hypertension, normalization of general hemodynamics.

Data on treatment of 42 patients with nonformed intestinal fistulas with the help of ferromagnetic rheological suspensions are presented. The authors have shown that their method tested under experimental conditions is close to universal since it does not require selection of the individual obturator. The use of the method is not possible in patients with one or multiple abscesses of the abdominal cavity, through which the formed fistula passes.

The paper presents clinical and instrumental evidence on 47 patients with hepatic cirrhosis. The revealed ventilatory disorders and worse bronchial permeability closely correlated with the degree of pulmonary hypertension which in its turn depended on portal hypertension degree. Pulmonary hypertension decreased with a decline in the activity of the pathological process in the liver due to treatment. External respiration insufficiency observed in hepatic cirrhosis contributes to the onset of arterial hypoxemia and hypoxic impairment of the liver activating in it a pathological process. It is recommended that such patients should receive a combined treatment incorporating oxygen therapy, calcium antagonists, antioxidants.