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Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

The medical rehabilitation in all areas of medicine is developing actively and rapidly. In cardiology, medical rehabilitation contributes to prevention of recurrent myocardial infarction and other complications in patients with myocardial infarction. The study evaluated impact of anaerobic exercise and strength rehabilitation program on hemodynamics in patients with myocardial infarction using the David back concept mechanotherapy method.

The article presents historical essays concerning each method of rehabilitation, period of its revision depending on time and pathological etiology of each disease, application of rehabilitation (health path, mechanotherapy), different modes of choosing each method of rehabilitation. The term "rehabilitation" became widespread after adoption of the Federal Law No. 181 of November 24, 1995 "On social protection of disabled people in the Russian Federation". This is the set of measures targeted to recuperation of functional reserves of organism, improving quality of life, maintaining working capacity of patient, one's integration into society, reducing incapacitating states impact to support people with impaired functions to adapt to new conditions of life in society. The rehabilitation and habilitation are processes targeting to ensure that the disabled could be able to achieve and maintain optimal levels of physical, sensory, intellectual, psychological and/or social functioning. The rehabilitation covers wide range of activities, including rehabilitative medical care, physiotherapy, psychotherapy, logopedics and ergotherapy and supportive services too. The disabled are to have access to both general medical services and appropriate rehabilitation services.

At all stages of recovery after myocardial infarction (MI), the expansion of physical activity of elderly patients is one of the most important components. Of course, certain restrictions can reduce the load on the myocardium, reduce its oxygen needs and create conditions for early healing. Subsequently, depending on the dynamics and indicators of the cardiovascular system, the elderly patient is transferred from one stage of activity to another, the level of blood pressure, the number of heartbeats, the presence of arrhythmia, electrocardiogram data, EchoCG data, as well as individual load tolerance are evaluated. To date, there is a huge selection of optimal options for selecting methods of medical rehabilitation for elderly patients who have suffered a MI, and one of them is mechanotherapy. The mechanical therapy program of the David Back Concept complex - strength training is a set of simulators for working on the back muscles. The medical and diagnostic complex is designed for the diagnosis, treatment and prevention of pathologies of the musculoskeletal system, as well as for the rehabilitation of patients after surgical interventions and spinal injuries. Medical rehabilitation of elderly patients with coronary heart disease and after a MI through mechanotherapy, the program of the David Back Concept complex, provides for the restoration of their physical and social status to an optimally achievable level, determined by the capabilities of adaptive mechanisms.

A series of benzotriazole, cyclic amides and pyrimidine derivatives, containing 2,6-di- tert -butyl-phenol fragments, were synthesized. The redox properties of obtained compounds were studied using the cyclic voltammetry on a platinum electrode in acetonitrile. The oxidation potentials of all substances were comparable to those of BHT. The obtained compounds were tested for their antibacterial activity, and N -(2-(3,5-di- tert -butyl-4-hydroxyphenyl)-2-oxoethyl)isatin (32 μg/mL) exerted good activity against Staphylococcus aureus.

The import of superoxide dismutase-2 (SOD2) into mitochondria is vital for the survival of eukaryotic cells. SOD2 is encoded within the nuclear genome and translocated into mitochondria for activation after translation in the cytosol. The molecular chaperone Hsp70 modulates SOD2 activity by promoting import of SOD2 into mitochondria. In turn, the activity of Hsp70 is controlled by co-chaperones, particularly CHIP, which directs Hsp70-bound proteins for degradation in the proteasomes. We investigated the mechanisms controlling the activity of SOD2 to signal activation and maintain mitochondrial redox balance. We demonstrate that Akt1 binds to and phosphorylates the C terminus of Hsp70 on Serine631, which inhibits CHIP-mediated SOD2 degradation thereby stabilizing and promoting SOD2 import. Conversely, increased mitochondrial-H 2 O 2 formation disrupts Akt1-mediated phosphorylation of Hsp70, and non-phosphorylatable Hsp70 mutants decrease SOD2 import, resulting in mitochondrial oxidative stress. Our findings identify Hsp70 phosphorylation as a physiological mechanism essential for regulation of mitochondrial redox balance., (Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.)

Calixarenes have found widespread application as building blocks for the design and synthesis of functional materials in host-guest chemistry. The ongoing desire to develop a detailed understanding of the nature of NO bonding to multichromophoric π-stacked assemblies led us to develop an electron-rich methoxy derivative of calix[4]arene (3), which we show exists as a single conformer in solution at ambient temperature. Here, we examine the redox properties of this derivative, generate its cation radical (3 +. ) using robust chemical oxidants, and determine the relative efficacy of its NO binding in comparison with model calixarenes. We find that 3/3 +. is a remarkable receptor for NO + /NO, with unprecedented binding efficacy. The availability of precise experimental structures of this calixarene derivative and its NO complex, obtained by X-ray crystallography, is critically important both for developing novel functional NO biosensors, and understanding the role of stacked aromatic donors in efficient NO binding, which may have relevance to biological NO transport., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Biaryl cation radicals are important electroactive materials, which show two mechanisms of hole delocalization: static delocalization at small interplanar dihedral angles and dynamic hopping at larger angles, reflecting the interplay between electronic coupling and structural reorganization. Herein, we describe the rational design of biaryls possessing an invariant hole delocalization mechanism.

Nitroxyl (HNO), a reduced form of the important gasotransmitter nitric oxide, exhibits its own unique biological activity. A possible biological pathway of HNO formation is the S-thiolation reaction between thiols and S-nitrosothiols (RSNOs). Our density functional theory (DFT) calculations suggested that S-thiolation proceeds through a proton transfer from the thiol to the RSNO nitrogen atom, which increases electrophilicity of the RSNO sulfur, followed by nucleophilic attack by thiol, yielding a charge-separated zwitterionic intermediate structure RSS + (R)N(H)O - (Zi), which decomposes to yield HNO and disulfide RSSR. In the gas phase, the proton transfer and the S-S bond formation are asynchronous, resulting in a high activation barrier (>40 kcal mol -1 ), making the reaction infeasible. However, the barrier can decrease below the S-N bond dissociation energy in RSNOs (≈30 kcal mol -1 ) upon transition into an aqueous environment that stabilizes Zi and provides a proton shuttle to synchronize the proton transfer and the S-S bond formation. These mechanistic features suggest that S-thiolation can easily lend itself to enzymatic catalysis and thus can be a possible route of endogenous HNO production., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Psychoemotional stress is one of the leading cardiovascular risk factors. The aim of this study was to explore manifestations of arterial hypertension (AH) in young men employed in the stress associatedfield works. Material and methods. A total of 68 young men, exposed to job stress (JS) of different severity during 1 to 5 years were surveyed. The control group was formed of persons whose daily work was unrelated to operational activities. The study included ambulatory monitoring (AM) blood pressure (BP) on different days of the week, comparing the results of the office and DMBP determination and assessment of resistance to a variety of diagnostic loads. Results. The study revealed an increase of AMBP indicators during the working day and their normalization at weekend. The comparison of the results of office and ambulatory determination of BP demonstrated that different forms of stressful AH (stable, isolated office and latent) occurred significantly more often than in the control group. These changes almost completely disappeared at weekends. The tolerance ofpsychoemotional testing was much worse than that of traditional exercises. It is proposed to more extensively use AMBP during regular medical examinations of young men exposed to JS in order to establish a timely differential diagnosis of various forms of stressful hypertension.

Based on ab initio molecular dynamics simulations, we show that small nanoclusters of about 1 nm size spontaneously generated in a low-temperature silane plasma do not possess tetrahedral structures, but are ultrastable. Apparently small differences in the cluster structure result in substantial modifications in their electric, magnetic, and optical properties, without the need for any dopants. Their non-tetrahedral geometries notably lead to electron deficient bonds that introduce efficient electron delocalization that strongly resembles the one of a homogeneous electron gas leading to metallic-like bonding within a semiconductor nanocrystal. As a result, pure hydrogenated silicon clusters that form by self-assembly in a plasma reactor possess optical gaps covering most of the solar spectrum from 1.0 eV to 5.2 eV depending simply on their structure and, in turn, on their degree of electron delocalization. This feature makes them ideal candidates for future bandgap engineering not only for photovoltaics, but also for many nano-electronic devices employing nothing else but silicon and hydrogen atoms.

The used methodology of the scientific substantiation of indicators is in the establishment of the conformity of laws of vital activity of indicator and pathogenic microorganisms in the real conditions of the action of the complex of factors, including disinfecting agents. In the one water sample simultaneously there were determined both the general indicator (GICB), thermotolerant (TTCB), glucose positive (GPCB) coliform bacteria, E.coli. On the base of long-term research in the various regions of the Russian Federation, as well with bearing in mind the analysis of domestic and foreign data, comparing the water quality and the incidence of intestinal infections in population it is recommended to use the index of determination of the total number glucose positive coliform bacteria (GPCB), which brings together a much broader range of bacteria of the Enterobacteriaceae family in comparison with total coliform bacteria (TCB) and thermotolerant coliform bacteria (TTCB) and warrants the absence in the test volume of water as an indicator lactose positive (E.coli, TCB, TTCB) and pathogens (salmonella) and potentially pathogenic bacteria which do not ferment lactose. Proposed index of GPCB is shown to allow to assess epidemiological risks not only more accurate, but also more efficiently without increasing the cost performance of bacteriological research.

The increasing chemicalization of production and life leads to the pollution of water bodies by chemicals, the effect of which on the micro - and macro - organisms is poorly understood. This section of the study in sanitary bacteriology is becoming ever more topical and is an important task of modern hygienic science. One of complicacies of the study of the problem is related with the fact that the presence of only experimental data fails to be sufficient, as the impact of any given chemical substance on different bacteria in the experiment does not mean that under natural conditions, similar results will be obtained. One reason for this may be the inhibitory effect of the given chemical on biological properties of bacteria, while in field conditions in the water several chemicals interacting with each other can exist. In this regard, the aim of the work was to assess the indicator value of sanitary and microbiological indices of epidemic hazard of water use in conditions of chemical pollution of surface water bodies.

The wide circulation of Klebsiella bacteria in water ofwater objects of different climatic zones of Russia and various function is established. So bacteria of the Klebsiella strain are in superficial sources of the centralized water supply depending on extent of their biological and chemical pollution; underground waters at the unprotected water-bearing horizons; in drinking water at insufficiently effective system of its cleaning and disinfecting. Klebsiella circulating in water was shown to keep properties of pathogenicity and a virulence, possess resistance both to modern preparations and disinfecting agents (chlorine, an ultraviolet to radiation). Bacteria of the Klebsiella strain have high penetration in the water-bearing horizons. At strains of Klebsiella there is allocated considerable pathogenic potential (adhesive, invasive, phosphatase, lecithinase, DNA-ase, hemolytic activity) and genetic markers of pathogenicity of cnf-1. The etiologic role of bacteria of Klebsiella and an infecting (100, COE/dm3) dose emergence of acute intestinal infections (AII) is established. Detection of Klebsiella in water objects and especially in water of drinking appointment, in the absence of total coliform bacteria (TCB) contributes to the epidemic danger of water use.

A new family of over-coordinated hydrogenated silicon nanoclusters with outstanding optical and mechanical properties has recently been proposed. For one member of this family, namely the highly symmetric Si19 H12 nanocrystal, strain calculations have been presented with the goal to question its thermal stability and the underlying mechanism of ultrastability and electron-deficiency aromaticity. Here, the invalidity of these strain energy (SE) calculations is demonstrated mainly based on a fundamentally wrong usage of homodesmotic reactions, the miscounting of atomic bonds, and arithmetic errors. Since the article in question is entirely anchored on those erroneous SE values, all of its conclusions and predictions become without meaning. We provide evidence here that the nanocrystal in question suffers from such low levels of strain that its thermodynamical stability should be largely sufficient for device fabrication in a realistic plasma reactor. Most remarkably, the two "alternative," irregular isomers explicitly proposed in the aforementioned article are also electron-deficient, nontetrahedral, ultrastable, and aromatic nicely underlining the universality of the ultrastability concept for nanometric hydrogenated silicon clusters., (© 2015 Wiley Periodicals, Inc.)

The authors presented results of the study concerning human papillomavirus infecting of military students of higher military educational institutions of the Ministry of Defence of the Russian Federation. In the Center for Obstetrics and Gynaecology of the Kirov Military-Medical Academy was performed a dynamic examination of 478 female cadets aged 17-25. The high level of high-risk HPV viruses was revealed during the examination what proves the necessity of prophylaxis enhancing with the aim to prevent gynecological diseases and reproductive health promotion. The main ways of cervical cancer prophylaxis are health education, in-depth medical examination of women with the aim to reveal and treat gynecological diseases (this medical examination should be carried out twice a year), primary prevention of cervical cancer by vaccination.

Thionitrous acid (HSNO), the smallest S-nitrosothiol, has been identified as a potential biologically active molecule that connects the biochemistries of two important gasotransmitters, nitric oxide (NO) and hydrogen sulfide (H2S). Here, we computationally explore possible isomerization reactions of HSNO that may occur under physiological conditions using high-level coupled-cluster as well as density functional theory and composite CBS-QB3 methodology calculations. Gas-phase calculations show that the formation of the tautomeric form HONS and the Y-isomer SN(H)O is thermodynamically feasible, as they are energetically close, within ∼6 kcal mol(-1), to HSNO, while the recently proposed three-membered ring isomer is not thermodynamically or kinetically accessible. The gas-phase intramolecular proton-transfer reactions required for HSNO isomerization into HONS and SN(H)O are predicted to have prohibitively high reaction barriers, 30-50 kcal mol(-1). However, the polar aqueous environment and water-assisted proton shuttle should decrease these barriers to ∼9 kcal mol(-1), which makes these two isomers kinetically accessible under physiological conditions. Our calculations also support the possibility of an aqueous reaction between the Y-isomer SN(H)O and H2S leading to biologically active nitroxyl HNO. These results suggest that the formation of HSNO in biological milieu can lead to various derivative species with their own, possibly biologically relevant, activity.

For the purpose of harmonization of microbiological and parasitological indices and benchmarks there was performed the comparative analysis of the requirements for the quality of drinking water in respect of the epidemic safety on the basic regulations of Russia, the Directive Council of the European Union EU, WHO, the United States, Canada, Australia, Finland, Sweden, Brazil, France, Japan and China. As a result, there were revealed the priority bacteriological, virological and parasitological parameters: E. coli--indicator of recent fecal contamination, coliforms, heterotrophic bacteria colony count (Heterotrophic plate count), which is in the water legislation of the Russian Federation is characterized as total bacterial count (TBC), being an integral index of the quality of wastewater treatment technologies and hygienic condition of the water supply systems, coliphages as an indicator of viral contamination. In the Guidelines for drinking-water quality control, WHO and a set of countries there is recommended a more wide range of indicators: enterococci, Clostridium perfringens, Pseudomonas aeruginosa, enteroviruses, parasitological indices. With aim of harmonization of the requirements for the quality of drinking water in the Russian Federation with international approaches to the revision of the Sanitary Regulations and Norms (SanPin) 2.1.4.1074 into the project there are introduced priority indicator parameters of bacterial, viral and parasitic contamination of water, evidence-based guidelines.

The analysis of literature data was carried out and performed research justifying the epidemic value of detection in water P. aeruginosa in drinking and domestic water use. The were revealed features of the vital activity of P aeruginosa in water bodies as opposed to conventional microbiological indicators. It was shown that the coliform group indices can not guarantee the epidemic safety of drinking water use in relation to P aeruginosa. The data obtained justify the need for the introduction of P aeruginosa as an additional index in monitoring the water quality of centralized and decentralized water supply.

Promising application of nanoparticles and nanomaterials is the creation of sanitary hygienic means of new generation used for disinfection of water and indoor surfaces of mass use, furniture, sanitary technical equipment by virtue of modifying traditional materials to bring them effective biocidal properties, and for the development of methods in vitro for assessment their toxicity In this paper the possibility of the use various forms of silver, copper and aluminum as disinfectant for bacterial test organisms in the aquatic environment and assess their toxicity on biological models of continuous culture of BGM cells (a stable line of African green monkey kidney cells) and HEp-2 (Human epithelial type 2 (HEp-2) cells, derived from a human laryngeal carcinoma) is considered.

The vegetative correlates of individual differences in the effectiveness of the purposeful activity during computer sensory motor test and computer testing of the level of knowledge of students were studied. For the students, who reached the high results of sensory motor and training tests it was characteristic the lability of vegetative indices, which is manifested in a change in the absolute values and relationship of the characteristics of heart rate and hemodynamic in accordance with the stages of activity. These changes were specific for each of the forms of activity and connected with the results of tests. By the physiological prerequisites of the high lability of vegetative characteristics, which ensures the capability of the subject successfully to be adapted for the conditions of activity, appeared high initial values TP, power LF and HF of the ranges of spectrum.

Summary. The paper provides comparative characteristics of water quality in the assessment of a risk for intestinal infections in drinking water use. It has shown that of the greatest predictive value is direct detection of potentially pathogenic microorganisms, as well as the integral indicator determined by glucose fermentation, such as glucose-positive coliform bacteria. Estimation of the per cent of nonstandard samples of water before its entering the distribution network and in the latter, including glucose-positive Escherichia coli GPEC, is recommended. The samples containing GPEC in a quantity of more than 2 CFU/100 ml should be singly taken into account.

In the buccal epithelial micronuclear test, only the higher frequency of cells with any nuclear degenerative changes is considered to be attributable to the adverse influence of environmental factors. Comprehensive examination of 223 children of 5-7 years of age, going to kindergartens and schools has indicated that the frequency of cells with nuclear chromatin condensation and incomplete nuclear lysis decreased when ambient air contamination was increased in the territories of children's establishments and when the child's throat was contaminated with Staphylococcus aureus or the pharyngeal resident microflora inhibited. Some poor conditions of the nasal and buccal mucosae were also associated with the increase or decrease of cell frequencies. It is suggested that nuclear chromatin condensation and nuclear lysis (rather than other signs of cell degeneration and death) reflect natural cell aging. A moderate toxic effect causes epitheliocytic physiological development retardation and a more intensive effect accelerates aging of cells and induces their death.

The paper presents materials to provide a scientific rationale for the microbiological parameters enhancing the efficiency of drinking water quality control from the point of view of reliability in the provision of epidemic water consumption safety (coliform bacteria being identified by the glucose index; E. coli). Based on the criterion assessment of the significance of microbial water contamination in relation to morbidity rates, the authors have been developed bacteriological standards--the absence of microorganisms in a 300-ml water sample. Evidence is provided for the epidemically significant level--more than 2 CFU of coliform bacteria in 100 ml. A rapid determination procedure has been substantiated in the experimental studies of the effects of oxidase reagents on the viability and biochemical properties of E. coli bacteria. In search for current technologies for membrane filtration, experimental rationale has been made for the possibility of using track membranes for sanitary and bacteriological water analyses.

The article contains the results of comparison of the methods of evaluation of the microbiological danger of antimicrobial agents by the example of oligo- and polyguanidines. The study demonstrates that choice of an adequate study model (a bacterial or protozoa species) and exposure time depends on the characteristics of the preparation to be tested. It shows that the microbocide activity of polyguanidines should be studied on a bacterial model using long (24 hours) exposure. The most sensitive to XG6 was a protozoa culture in short-time exposure. To evaluate the biological danger ofantimicrobial agents, it is also possible to apply techniques that allow revealing reversable physiological changes in a culture of test objects.

Quantitative relationships were studied between the indicators (common coliform bacteria (CCP), glucose-positive bacteria (GPB), thermoduric bacteria (TDB), coliform bacteria, enterococci, clostridia, coliphages) and the opportunistic (Pseudomonas aeruginosa, Proteus, Klebsiella) and pathogenetic (Salmonella and intestinal viruses) microorganisms at the stages of effluent purification and decontamination, in processes of self-purification in the water reservoirs and of water preparation at water-supplying stations, as well as in the association with the incidence of acute intestinal infections of bacterial and viral genesis in different climatic zones of the country. Salmonella and the opportunistic bacteria of the Enterobacteriaceae family and Pseudomonas aeruginosa were found to be highly resistant to detoxifying agents and environmental factors, adaptable, able to reproduce in pure water, to long survive in underground waters, and to accumulate when water is desalinated at the erections. The cases of intestinal infections were found in the population using the portable water of the standard quality in terms of E. coli, TDB, CCB, and enterococci. In this case only the wider integral index of GPB, which includes the indices of E. coli, TDB, CCB, as well as lactose-negative pathogenic and opportunistic species retains its sanitary significance in terms of all signs and is a reliable indicator of the potential epidemic hazard of drinking water use. Long-term studies have provided evidence for the sanitary value of coliphages as indicators of viral drinking water contamination.

Performance of cognitive tests and EEG spectral power were evaluated in 39 students aged from 19-21 years in two conditions: during common educational process and immediately before examination (stress condition). Before examination, the performance was better in subjects with low level of spectral density in the delta band (in the occipital, parietal, central and frontal cortical areas) and high level of the alpha-rhythm spectral density in all the cortical areas, A decrease in performance scores before examination was correlated with an increase in the delta activity (in the right frontal and temporal cortical areas) and rise of the anxiety level (tested by Spielberger).

Background: Recently, amylolytic activity was detected in IgMs isolated from the sera of the patients with multiple sclerosis., Material/methods: All purified samples of IgM were electrophoretically homogenous and did not contain any co-purified a-amylase and a-glucosidase activities, in accordance with a set of criteria developed for abzymes. The amylolytic activity of abzymes was studied in the hydrolysis of p-nitrophenyl a-D-maltooligosaccharides with different degrees of polymerization from 1 to 8 by TLC and reverse-phase HPLC techniques., Results: All IgM samples isolated from 54 patients with clinically definite multiple sclerosis demonstrated hydrolytic activity towards the above artificial substrates. The Michaelis constant values (Km) in the hydrolysis of p-nitrophenyl a-D-maltoheptaoside were in the range of 10 p-nitrophenyl or p-nitrophenyl a-D-glucosides, thus indicating the presence of an a-D-glucosidase activity. For a number of the investigated samples, specific amylolytic activity increased depending on the length of substrates (from p-nitrophenyl maltopentaoside to p-nitrophenyl maltohexaoside); for other IgMs, the opposite dependence was observed. All IgMs studied did not exhibit any other glycoside hydrolase activities toward p-nitrophenyl glycoside substrates., Conclusions: Abzyme fractions from different donors demonstrated catalytic heterogeneity in Michaelis-Menten parameters and different modes of action in the hydrolysis of p-nitrophenyl maltooligosaccharides. Enzymatic properties of the IgMs tested varied from human a-amylases. All investigated abzyme samples did not show transglycosylating ability.

An analysis is presented of solid cancer incidence during 11 years of follow-up (1991-2001) of Chernobyl emergency workers residing in Russia. The analysis is based on data from the cohort of male emergency workers from 6 regions in Russia including 55718 persons with documented external radiation doses in the range of 0.001-0.3 Gy who worked within the 30 -km zone in 1986-1987. The mean age at exposure for these persons was 34.8 years and the mean external radiation dose 0.13 Gy. In the cohort 1370 cases of solid cancer were diagnosed and 3 follow-up periods were considered: 1991-1995, 1996-2001 and 1991-2001. The second follow-up period was chosen to allow for a minimum latency period of 10 years being characteristic of solid cancers. For risk assessment two control groups have been introduced, the first 'external' one representing incidence rates for corresponding ages in Russia in general, the second 'internal' one consisting of emergency workers. The risk estimates were based on spontaneous incidence rates of solid cancer. The estimated standardized incidence ratio (SIR) is in good agreement (95% CI) with that of the control. The values of excess relative risk per unit dose (ERR/Gy) for solid malignant neoplasms have been estimated to be 0.33 (95% CI: -0.39, 1.22) (internal control) for the follow-up period 1991-2001 and 0.19 (95% CI: -0.66, 1.27) for 1996-2001.

The authors made an experimental study of the efficiency of water purification procedures based on the combined use of active chlorine and coagulants and hygienically evaluated the procedures. The study included the evaluation of water disinfection with various coagulants and active chlorine; the investigation of the processes of production of deleterious organic chlorine compounds; the assessment of the quality of water after its treatment. The coagulants representing aluminum polyoxychloride: RAX-10 (AQUA-AURATE 10) and RAX-18 (AQUA-AURATE 18), and aluminum sulfate, technically pure grade were tested. The treatment of river water with the coagulants RAX-10 and RAX-18, followed by precipitation, filtration, and chlorination under laboratory conditions, was shown to result in water disinfection to the levels complying with the requirements described in SanPiN 2.1.4.1074-01. RAX-18 showed the best disinfecting activity against total and heat-tolerant coliform bacteria, but also to the highly chlorine-resistant microrganisms--the spores of sulfite-reducing Clostridia, phages, and viruses. Since the coagulants have an increased sorptive capacity relative to humus and other organic substances, substitution of primary chlorination for coagulant treatment may induce a reduction in the risk of formation of oncogenically and mutagenically hazardous chlorinated hydrocarbons.

Aim: To study expression of topoisomerases (TI) I and II alpha (DNA-bound enzymes involved in transcription and replication) in renal tissue as markers of activity and prognosis of glomerulonephritis (GN) decisive for choice of immunodepressive therapy., Material and Methods: TI expression was studied immunohistochemically in renal biopsies from 177 patients with different morphological variants of GN and in the samples of unaffected kidney tissue removed in 12 patients for local tumors., Results: There are definite differences between proliferative and non-proliferative GN variants--elevation of TI levels and monocytic infiltration in proliferative GN. Focal-segmental glomerulosclerosis is characterized by a high TI II alpha level in mesangial cells and monocytic infiltration of the glomeruli which are typical for inflammation. A statistical relationship between TI levels in mesangial cells and glomerular epithelium suggests a pathogenetic relation between these links of the pathological process. Molecular markers of activation and proliferation of cells and direct inductors of the inflammatory process (cells of monocytic infiltrate) closely correlated with the activity index--an integral indicator of inflammatory activity, as well as with the integral indicator of sclerotic processes in renal tissue--sclerosis index. Monocytic infiltration in the interstitium correlated both with morphological manifestations of activity, progression of nephritis and their clinical equivalents. In high TI expression GN resistance to immunodepressive therapy rose. To overcome the resistance, immunodepressive therapy must be more active--large doses and duration of treatment. In patients with lupus nephritis and mesangiocapillary GN renal prognosis was worse in the presence of high TI expression in mesangial cells and epithelium of the renal canaliculi., Conclusion: The authors are the first to demonstrate TI expression in renal tissue of GN patients, correlation of its level with activity of renal process as well as its role in prediction of response to treatment and the rate of renal failure progression. It is suggested that high TI expression entails a progressive course of GN.

Aim: A retrospective analysis of a clinical course of mesangioproliferative glomerulonephritis (MPGN) in patients with glomerular deposition of IgA (IgA nephropathy--IgA-N), with glomerular deposition of other Ig to determine prognostic factors of MpGN progression including IgA-N and to examine the patients' sensitivity to immunodepressive therapy., Material and Methods: 2000 patients with primary MPGN followed up from 1980 to 1999 from the disease onset to development of chronic renal failure (creatinine > 2.5 mg%). Factors affecting kidney survival were studied using the Cox regression model, factors predicting sensitivity to immunodepressive therapy--using multiple logistic regression., Results: IgA-N differed by the course and prognosis from other forms of MPGN. In IgA-N urinary syndrome and macrohematuria were encountered more frequently, in other forms of MPGN more frequent was nephrotic syndrome. Prognosis of patients with IgA-N was worse than in MPGN patients without IgA deposition: 10-year "renal survival" (creatinine < 2.5 mg%) was 64 and 97% (p < 0.05), respectively. Prognosis-deteriorating factors for MPGN patients were the following: male sex, nephritis onset in 40-year-olds and older subjects, acute nephritic syndrome (creatinine > 1.5 mg%), high proteinuria, hematuria (> 50 in sight), the presence of synechia and TIC in renal biopsy, location of immune deposits both in the mesangium and basal glomerular membranes. The responders to the immunodepressive therapy had 10-year renal survival 100%. Positive results of immunodepressive therapy were observed significantly more frequently in patients with normal level of creatinine, moderate hematuria, absence of synechias and TIC in renal biopsy, given large total course dose of corticosteroids and cytostatics. Efficiency of oral cyclophosphamide and its intravenous pulse-therapy did not differ significantly. In pulse therapy an average cumulative dose was lower 6 times, side effects occurred 3 times less frequently., Conclusion: The importance of morphological information for prognosis and predicting sensitivity of MPGN patients to immunosuppressive therapy necessitates renal biopsy before therapy. Intravenous pulse therapy with cyclophosphamide is preferable as an active treatment in patients with sclerosis in renal biopsy.

Multiple factors interact during the evolution of renal diseases. In the present study, we examined the expression of DNA topoisomerases type I and IIalpha, which reflect gene transcription and DNA replication, respectively. Enzyme content was assessed by immunohistochemistry using two specific monoclonal antibodies, C21 and Ki-S4, on 81 archival punch-biopsy specimens from patients with renal diseases, including minimal change disease (MCD; n = 10), focal segmental glomerular sclerosis (FSGS; n = 6), mesangial proliferative glomerulonephritis (MPGN; n = 11), membranous glomerulonephritis (MGN; n = 10), mesangial capillary glomerulonephritis (MCGN; n = 7), rapidly progressive glomerulonephritis (RPGN; n = 12), lupus nephritis (LN; n = 15), and tubulointerstitial nephritis (TIN; n = 10). Both enzymes were strongly expressed in diseases tending to rapid progression, notably RPGN and LN, whereas MCD and MGN showed low protein levels in both the glomerular and tubular compartments. Moreover, topoisomerase expression was significantly associated with the density of monocytogenic infiltrates (monitored by means of the monoclonal antibody Ki-M1p), such pathogenesis-associated factors as antinuclear antibodies and paranuclear antineutrophilic antibodies, and serum immunoglobulin levels. There also was a positive correlation with serum creatinine levels and an inverse association with proteinuria and nephrotic syndrome. We conclude that the expression of DNA topoisomerases may be linked to pathogenetic mechanisms and may provide prognostic information. Because of their comparatively low nephrotoxicity, topoisomerase inhibitors might prove to be useful therapeutic agents in the treatment of renal diseases.

Background: Circulating autoantibodies to human topoisomerases have been reported in glomerular kidney disease associated with scleroderma and systemic lupus erythematosus. However, limited information is available about the expression of topoisomerases in the kidney under normal and pathological conditions., Methods: The expression of DNA topoisomerases I and IIalpha was studied by immunohistochemistry on archival biopsies from 70 patients with chronic renal diseases. Normal kidney tissue was examined for comparison. Topoisomerase I was detected by means of monoclonal antibody (mAb) C21, and topoisomerase IIalpha was detected by means of mAb Ki-S4. In addition, mAb Ki-M1p was used to assess the density of monocytic infiltrates. All parameters were assessed in a semiquantitative manner., Results: Glomerular topoisomerase IIalpha levels were increased in mesangial proliferative glomerulonephritis (MPGN), rapidly progressive glomerulonephritis (RPGN), and lupus nephritis (LN) and were reduced in membranous glomerulonephritis (MGN), chronic transplant nephropathy (CTN), and tubulointerstitial nephritis (TIN). Tubular epithelia displayed high topoisomerase IIalpha levels in mesangiocapillary glomerulonephritis (MCGN), RPGN, TIN, miscellaneous entities (MISC) and LN, and displayed low levels in MPGN and CTN. Topoisomerase I expression was high in the glomeruli of focal segmental glomerulosclerosis (FSGS), MCGN, and RPGN and was extreme in LN, whereas it was strikingly diminished in the glomeruli of MGN, CTN, and TIN. Almost all conditions displayed lower tubular topoisomerase I levels than normal kidney, except for LN, in which the enzyme content was markedly increased. Increased glomerular monocytic infiltrates were found in FSGS, MCGN, RPGN, TIN, and LN, and tubulointerstitial Ki-M1p+ cells were seen at high numbers in MCGN, RPGN, TIN, MISC, and LN. The expression of the topoisomerases I and IIalpha was significantly correlated; also, topoisomerases showed a positive association with the density of monocytic infiltrates. The parameter profiles exhibited significant differences between distinct types of chronic renal disease., Conclusion: Topoisomerase IIalpha expression is tightly linked to cell cycling, and topoisomerase I is likely a reflection of gene transcription. Rapidly progressing glomerular disease therefore appears to be accompanied by active mesangial cell proliferation and increased metabolic activity in glomerular cells. The correlation with inflammatory infiltrates is likely to reflect a positive feedback mechanism involving cytokines, growth factors, and adhesion molecules. Assessment of topoisomerases may therefore be of diagnostic help and might allow prognostic predictions. Provided that our observations are supported by clinicopathological follow-up studies, one might envisage the use of topoisomerase inhibitors in the therapy of chronic proliferative renal disease refractory to current treatment protocols.

Aim: Comparison of two cyclophosphamide (CPA) treatment regimens in chronic glomerulonephritis (CGN) patients: oral daily CPA versus intravenous CPA pulses (IV-CPA) MATERIALS AND METHODS: 31 nephrotic patients entered the trial: 12, 16 and 3 with membraneous, mesangial proliferative and mesangiocapillary CGN, respectively. The patients were randomized into two groups. 13 patients of group 1 received oral CPA (1.5-2.0 mg/kg/day for 6 months, while 18 patients of group 2 received IV-CPA pulses (20 mg/kg/monthly, at least 6 pulses) combined with oral prednisolone (40-6-mg/day during 1.5 mo with subsequent tapering). At entry, no statistical differences (p > 0.05) were found between groups 1 and 2 by age, gender, duration of the renal disease, serum creatinine levels, frequency of arterial hypertension. Mean duration of follow-up was 27.6 and 22.6 mo (p > 0.05) for group 1 and 2, respectively., Results: After 6 months of follow-up there was no difference in the rate of complete and partial remission between the groups (69 and 83% for group 1 and 2, respectively). The rate of renal function deterioration was also similar. Side effects occurred 3 times more frequently in group 1 than group 2. The mean cumulative course dose of CPA per 1 patient in group 1 was 35.6 g, in group 2--5.6 g., Conclusion: The effectiveness of methods was similar irrespective of CGN morphological form, but in spite of similar rates of remission of nephrotic syndrome, pulse CPA is preferable being more safe as to possible complications.

The relaxing effects of local heat-air exposures (TAE) on man (60 male students aged 19-21 years) were studied using a specially designed device which may control temperatures and time on an individual basis depending on the examinees' sensation of a positive emotion. On study days and under examination stress. TAE was shown to reduce situation-induced anxiety, to increase the duration and variability of R-R intervals on ECG, to make EEG right-frontal delta- and theta-indices lower and EEG right occipital and frontal alpha-index higher. The range of visual accommodation increased. The findings suggest that the proposed graded local heat-air exposure procedure is an effective tool of relaxation and prevention of negative effects of emotional stress.