[THE STRUCTURALLY AND FUNCTIONALLY DIFFERENT POOLS OF FAT TISSUE: INSULIN-INDEPENDENT VISCERAL CELLS, INSULIN-DEPENDENT SUBCUTANEOUS ADIPOCYTES AND BROWN CELLS OF THERMOGENESIS].

Three phylogenetically, morphological and functionally different pools of fatty cells are function in vivo according phylogenetic theory of general pathology. The first one is a phylogenetically early and limited in number of cells pool of visceral fatty cells of omentum and retro-peritoneal cellular tissue. The late in phylogenesis insulin renders no regulatory effect on visceral fatty cells.

[BASIC PHYSIOLOGICAL MECHANISMS OF HUMAN ADAPTATION TO COLD].

The article provides an overview of the literature that focuses on the main types of human adaptation to cold and mechanisms for increasing heat production. It is shown that the studies in recent years, aimed at studying the molecular mechanisms of adaptation to cold, confirmed the results of previous physiological studies have demonstrated that the major contribution to adaptive thermogenesis during cooling made by oxidative fibers in skeletal muscle (birds, marsupials, large placental and people) and brown adipose tissue (small placenta, especially rodents). The main sources of thermoregulatory heat generation are the contractile activity (thermoregulatory shivering and muscle tone), the uncoupling of oxidative phosphorylation and decrease in thermodynamic efficiency of the ATP-powered pumps (ATPase), which are induced by noradrenaline and thyroid hormones and accompanied by an increase in the consumption of oxygen and energy substrates.

[The physiological and biochemical methods of increasing of energy diffusion in vivo as a reaction of compensation under obesity.].

The article presents the analysis concerning main directions of physiological increasing of expenditure of energy in organism that probably can be used for prevention of obesity. First of all, it's increasing of physical load and activation of heat production at cold adaptation. In both cases the leading role belongs to skeletal muscles and consists in both implementation of biological function of locomotion and regulation of metabolism.

[The becoming of function and metabolism of subcutaneous insulin-dependent adipocytes on stages of phylogenesis. The etiologic factor and pathogenesis of obesity as a pandemic].

The visceral fatty cells of omentum and insulin-depended subcutaneous adipocytes implement simultaneously three reactions: a) biological reaction of exotrophy - absorption of fatty acids in the form of non-polar triglycerides; b) active depositing of fatty acids in non-polar triglycerides and c) releasing of fatty acids in blood plasma only in the form of unesterified fatty acids. The single pool of intercellular medium is a little bit of the third world ocean that: a) was privatized by every entity in the moment of going out to dry land and in which b) as millions years in ocean before, continue to live cells. At the level of paracrin cenosis of cells regulation is worked out related to: a) a single pool of intercellular medium; b) local pools of medium; c) size (number of cells) and organs.

PHYSIOLOGICAL MECHANISMS OF ADAPTATION TO COLD.

The literary review is devoted to human adaptation to cold and rehabilitation and therapeutic uses of cryosauna. Main physiological mechanisms of adaptation to cold are analyzed. It is shown that adaptation to polar latitudes increases primarily the risks of cardiovascular diseases, as well as disorders in the respiratory and peripheral nervous systems.

[Basic mechanisms of QRS voltage changes on ECG of healthy subjects during the exercise test].

Electrocardiography is the most commonly used technique for detection stress-induced myocardial ischemia. However, the sensitivity of ECG-criteria is not high. One of the major problem is the difficulty in differentiating ECG changes caused by various factors.

[Alteration of the QRS complex in electrocardiograms of healthy people in the course of test loading].

QRS amplitudes were analyzed in ECG records obtained from exercising healthy people to evaluate the sensitivity of QRS waves to exaggerated pulmonary ventilation, blood pressure (BP) and heart rate (HR). Seventeen normal subjects aged >35 years were involved in a series of three test loading sessions aimed to define QRS alterations caused by shifting and rotation of the heart, and changes in conductivity of thoracic organs and tissues as a consequence of a different respiration pattern. They also participated in a second series of three loading sessions aimed to trace QRS alterations stemming from changes in central hemodynamics (systolic and diastolic BP and HR).

[Effect of sex on informative power of various electrocardiographical criteria of left ventricular hypertrophy in patients with excessive body mass].

Aim of the study was to analyze dependence of various voltage parameters of QRS complex on increase of left ventricular myocardial mass (LVMM) in samples of men and women with excessive body mass or obesity. We included data from 223 patients with excessive body mass and diagnosis of stage I - II arterial hypertension. ECG was registered in 12 standard leads.

[Increased QRS voltage during dehydrating].

Aim: To assess QRS voltage changes with lower total amount of biological fluids under ultrafiltration during hemodialysis.

Materials And Methods: The study included 14 patients with chronic renal failure. An average of 2.

[Electrocardiographic diagnosis of hypertrophy of the left ventricular myocardium in patients with arterial hypertension and overweight].

Aim: To study efficacy of different ECG criteria of hypertrophy of left ventricular myocardium (LVH) in hypertensive patients with reference to overweight and obesity.

Material And Methods: The authors analyse data on 100 patients (42 males and 58 females) aged 19-79 with diagnosis of arterial hypertension stage I-II. ECG was conducted in 12 leads.

[The problem of indexation of left ventricular myocardial mass by body size in obese patients].

Aim: To assess efficacy of different ECG-criteria of left ventricular myocardial hypertrophy (LVH) in hypertensive patients as regards body mass (obesity).

Material And Method: Data on 100 patients (42 males and 58 females, age 19-79 years) with diagnosis of hypertension of the first-second degree were analysed. ECG was registered in 12 leads.

[Dynamics of ECG voltage in changing gravity].

Comparative analysis of the QRS voltage response to gravity variations was made using the data about 26 normal human subjects collected in parabolic flights (CNERS-AIRBUS A300 Zero-G, n=23; IL-76MD, n=3) and during the tilt test (head-up tilt at 70 degrees for a min and head-down tilt at-15 degrees for 5 min, n=14). Both the parabolic flights and provocative tilt tests affected R-amplitude in the Z lead. During the hypergravity episodes it was observed in 95% of cases with the mean gain of 16% and maximal--56%.

ECG voltage modifications as response to gravity changes.

The aim of the study was to analyze ECG (QRS) voltage responses to body fluid shift due to gravity chances. Acute changes in gravity were created by two ways: 1) changes in gravity value during parabolic flights (within 27 subjects 45 ECG have been analyzed); 2) changes in gravity direction due to rotation of the body during postural tests (within 11 subjects 14 ECG have been analyzed). Results and conclusions.

Variations of intrathoracic amount of blood as a reason of ECG voltage changes.

Background: It is known that electroconduction of intrathoracic organs and tissues significantly influences the ECG voltage. It changes during therapy or exercise test due to redistribution and/or volume variations of blood and body fluids and their electroconductivity variations. This fact must be taken into consideration during interpretation of corresponding ECG.

[The differential diagnosis of the ECG changes in ischemic heart disease combined with arterial hypertension (the data from precordial mapping)].

The authors have developed the algorithm for differential diagnosis of coronary heart disease associated with arterial hypertension. The algorithm was devised using the comparative data of precordial mapping made for 29 and 60 coronary disease patients with arterial hypertension and coronary stenosis without left ventricular myocardial cicatrices, hypertrophy and dilatation, respectively, as well as for 30 hypertensive subjects without coronary angiography signs of coronary stenosis, but with left ventricular hypertrophy established at echocardiography. Sixty normal subjects served as control.

[The differential electrocardiographic diagnosis of dilated cardiomyopathy and ischemic heart disease (the data from precordial mapping)].

The authors suggest a new criterion for differential diagnosis according to the mapping of 35 ECG leads (PECG-35) in dilated cardiomyopathy (DCMP) and coronary heart disease (CHD). Analysis was made of 12 and 35 ECG leads in 120 patients. There were 60 cases of DCMP and 60 cases of CHD.

[The use of non-linear methods of statistical analysis in the differential electrocardiographic diagnosis of hypertrophic cardiomyopathy (data from precordial mapping)].

An algorithm was proposed to make a differential diagnosis of hypertrophic cardiomyopathy by precordial ECG mapping in 35 leads (PECG-35) of 82 patients with hypertrophic cardiomyopathy and 339 matched patients: those with isolated left and right ventricular hypertrophy, concurrent ventricular hypertrophy, those with coronary heart disease having scars of various sites and having no cicatricial myocardial changes, including those in the presence of left ventricular hypertrophy, as well as 98 healthy individuals. Computer-aided analysis of their mapping was used to calculate the area of Q, R, S, T waves and ST segment and the prolongation of QRS complex. ECG parameters were analyzed by using cluster and dispersion analyses and the kNN method.

[Use of integral indicators of precordial mapping in differential diagnosis of focal-cicatricial lesions of the myocardium].

The paper proposes new criteria for differential diagnosis of myocardial "focal scarring" and "++pseudo-scarring" changes in various cardiac abnormalities and homogeneous morphological alterations in the ventricular complex on ECG (the QS, Qr-type abnormalities of the R line) by using the findings of 35 lead ECG mapping (PM-35). ECG-12 and PM-35 were analysed in 427 patients, including those with coronary heart disease (n-122), arterial hypertension and aortic malformations (n-130), dilated cardiomyopathy, congenital cardiac disease (n-175). Electrocardiographic signs of focal scarring lesions were revealed in all the cases with coronary heart disease and 66 with myocardial hypertrophy.

[Diagnosis of ischemic heart disease based on the data of precordial mapping].

To improve the efficiency of electrocardiographic diagnosis of coronary heart disease, a search for new meaningful ECG parameters has been carried out, using precordial mapping and automated analysis of the maps. The study included 95 coronary patients, whose diagnosis was verified by visual techniques (coronaroangiography and left ventriculography). ECG-12 showed no signs of past focal/scarry lesions in any of the patients, and detected ischemic changes in 23% only.

Diagnosis of ischaemic heart disease based on data of precordial mapping.

To increase the efficacy of electrocardiographic diagnosis of ischaemic heart disease (IHD), the authors searched for new ECG parameters using the method of precordial mapping and computer map analysis. The study was made in a group of 95 IHD patients, with diagnosis confirmed with the use of visual methods (coronary angiography and left ventriculography). On 12-lead ECG, the signs of focal cicatrization were found in none of examined patients, and ischaemic changes were present in 23% only.