[Armored medical vehicles of the medical service troop link of the Russian Federation Armed Forces].
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Biomedical subjects
Publications and source records attributed to A V Pozdniakov.
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Magnetic-resonance imaging (MRI) is considered to be the most informative non-invasive method in diagnosis, differential diagnosis and estimation of activity of multiple sclerosis (MS). MRI data of 270 patients with clinically and laboratory definite MS were analyzed to assess diagnostic MRI-criteria for MS, MRI presentations at the time of first clinical manifestation of the disease, neuroimaging patterns in children and elderly persons with MS. The MRI variants of MS are substantiated. Neuroimaging data of cervical spinal cord in 28 patients with MS are presented in parallel with corresponding clinical data. The most typical patterns are singled out. The data of brain 1H-magnetic-resonance spectroscopy (MRS) in 20 patients with MS and 8 patients with inflammatory and vascular disorders were analyzed to reveal biochemical distinction between MS and non-MS lesions as well as changes in normal appearing white matter in MS. The differential-diagnostic value of MRS is limited although decreased N-acetyl-aspartate peak is characteristic for MS lesions and in some cases in normal appearing white matter in primary-progressive MS.
Proton magnetic-resonance spectroscopy (PMRS) was used to measure the levels of inositol/myoinositol (Ins), choline, creatine/phosphocreatine (Cr), glutamine/glutamate (Glx/Glx1), N-acetylaspartate (NAA), gamma-aminobutyric acid (GABA) and lipids were measured in the foci of demyelinization in the brains of 59 patients with multiple sclerosis (MS). Magnetic-resonance imaging was performed during a single investigation. A control group comprised 20 healthy individuals. PMRS revealed significant alterations in the levels of metabolite in all the patients as compared with the controls: decreases in NAA by 23-52%, in Cr by 12-21%, in choline by 15-26%; increases in Ins by 51-63%; as well as the appearance of lipids (up to 100%). In MS, there were reduction in NAA/Cr, NAA/choline, and NAA/choline/Cr ratios by 12-53; 10-19; and 57-82%, respectively. As compared with the remitting MS, secondary-progressive MS showed decreases in the content of NAA by 23-25%, NAA/(choline + Cr) by 48-54% and increases in the levels of Ins and lipids by 50-76%. In remitting MS, there was a strong correlation between the NAA/Cr ratio and the volume brain lesion. It is concluded that PMRS evaluated the extent, pattern and activity of demyelinization (by the levels of Ins, NAA, Cr, lipids) and the intensity of cerebral atrophy (by NAA levels, NAA/Cr ratio). The findings testify that there are neurochemical differences between remitting and secondary-progressive MS.
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Present paper presents proton MRS investigation results. The investigation was carried out with Magnetom Vision device. Twenty-five patients in the age of 20-44 years suffering with generalization epileptic fits validated by EEG (no visible changes on MRT) were examined. In all cases independently on the localization of the changes, decreasing of NAA and increasing of Cho were recorded. At one side temporal lobe injury recorded by EEG at the damaged part decreasing of NAA/Cr and NAA/Cho + Cr ratios were registered. Patients with bilateral changes registered by EEG showed non-equal changes of metabolite concentration on both sides. Examination of patients suffering with distinct symptoms of temple epileptics has shown ipsilaterality decrease of NAA and Cr concentration. But on the injured side NAA/Cr ratio decrease was more distinct. In general, the laterality was recorded in 14 patients out of 22 with pathological changes registered by proton MRS and in 10 patients out of 14 the above mentioned changes corresponds to the side of the fit initiation. In the patients with bilaterality changes NAA/Cr ratio asymmetry was recorded in all cases, but the most distinctly in the medium part of the temple lobe. Comparison of data recorded in 8 patients suffering with one side fit complex has shown significant asymmetry of metabolites which was observed in ipsilaterality and contra laterality NAA ratio obtained in hippocampal areas. Difference in NAA ratio obtained between left and right sides are 19-25%. Left-right ratio of other metabolites corresponded to that ratio in the control group and was symmetrical.
The role and position of proton magnetic resonance spectroscopy have been studied in diagnosis of brain diseases. 114 patients with various diseases of the brain have been examined (multiple sclerosis--41, insults of different etiology--17, encephalopathy--12, AIDS infection--23, epilepsy--12, reduction of the intellectual ability of various etiology--9). MR tomography and 1HMR Spectroscopy have been done with Magnetom "Vision", 1.5 T (Siemens) in the CRIRR, St. Petersburg. To get a proton magnetic-resonance specter, SVS_STEAM, SVS_STEAM-20 and SVS_SE-135 sequences have been used with the following parameters: TR 5000 ms, TE 10, 20 and 135 ms respectively, number of acquisitions--100. Typical changes of metabolities in every group have been revealed. The performed examinations have shown that proton magnetic resonance spectroscopy enables to widen our know-ledge about the nature of pathologic changes, that grow with different diseases of the brain.
The paper is devoted to a study of the results of clinicoroentgenological and endoscopic investigation of 188 patients aged 23 to 60 who developed jejunal peptic ulcer. It was done to specify the features of an x-ray picture of jejunal peptic ulcers with relation to the cause of ulcer development and optimum methods of x-ray investigation. The predominant localization of peptic ulcer in the jejunal efferent loop and its typical ulcero-cicatricial deformity were established. Jejunal peptic ulcers developing as a result of an insufficient area of resection, are characterized by a relatively benign course of the disease. In case ulcer development was determined by the residual antral stomach mucosa at the duodenal stump or by the Zollinger-Ellison syndrome, considerable pathological changes (gigantic ulcer sizes greater than 2.5 cm and a sharp deformity of the jejunal efferent loop) were noted.
Patients with chronic hepatitis were found to develop an inadequate di- and natriuretic responses to osmotic agents administered into the gastrointestinal tract. In liver cirrhosis, the intensity of adaptive responses decreases or they completely disappeared. The causes for these abnormalities are impairment of osmoregulatory reflex links and dyscoordination of humoral factors.
During formation of hepatic cirrhosis in animals, excessive potassium loss has been found to depend on the increased loading of a nephron by its cation at its early stage and on abnormally changed tubular processes at late stages.
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