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Biomedical subjects

E I Gusev

Publications and source records attributed to E I Gusev.

At least 19 recordsLinked to original sources

[Treatment of vertigo with betaserk in patients with vascular and traumatic cerebral injuries].

42 patients with discirculatory and posttraumatic encephalopathy were treated with betaserk. Ultrasonic dopplerography and acoustic evoked potentials were used for assessment of the treatment results. It was established that betaserk was quite effective both for arrest of acute vertigo attacks and for prophylaxis of vertigo relapses. A decrease in frequency of vertigo attacks (by 60%, on the average) as well as in their duration and intensity were accompanied by an increase in blood flow through the arteries of vertebro-basilar system and by normalization of the parameters of acoustic evoked potentials.

Arterial Occlusive Diseases

Polyclonal antibodies from blood and cerebrospinal fluid of patients with multiple sclerosis effectively hydrolyze DNA and RNA.

It is known that in the blood of patients with some autoimmune diseases catalytically active antibodies hydrolyzing proteins, DNA, and RNA may be detected. In the present work homogeneous preparations of IgG antibodies (Ab) possessing high affinity for nucleic acids (NA) were obtained for the first time from blood and cerebrospinal fluid of patients with multiple sclerosis (MS). The fraction of IgG Ab as well as its Fab fragments and isolated light chains of both kappa- and lambda-types were shown to catalyze effectively the hydrolysis of DNA and RNA. It is shown by different methods that the capability for nucleic acid hydrolysis is an intrinsic property of the polyclonal Ab. NA-hydrolyzing Ab were detected in the blood of 69 of 72 and in the cerebrospinal fluid of 5 of 5 examined MS patients, while they were not detected in the blood of any of 50 healthy donors examined. Comparison of relative rates of RNA hydrolysis and of the substrate specificity in hydrolysis of various model RNAs--cCMP, poly(U), poly(A), and poly(C)--revealed pronounced differences of MS antibodies from ribonucleases of human blood, ribonuclease A, and all earlier described abzymes. The abzymes are usually characterized by relatively low specific activities in comparison with that of normal enzymes catalyzing analogous reactions. Ab from the blood of MS patients are the first example of autoabzymes whose specific activity in RNA hydrolysis is comparable or even higher than that of pancreatic ribonuclease A--one of the most active RNA-hydrolyzing enzymes.

Antibodies, Catalytic

[Genetic predisposition factors for multiple sclerosis (based on the data from genotyping patients of the Russian ethnic group)].

Patients' genotyping of Russian ethnic group with multiple sclerosis (MS) was performed for the first time in two loci of the main complex of histocompatibility: in DR HLA class II (gene DRB1) and in the locus of tumor necrosis factors (TNF). There was no difference in the incidence of alleles groups which correlated with some specificity of DR. Meanwhile TNF-a1 and TNF-a9 alleles were encountered significantly more frequently in patients and TNF-a7 in control group. When all the patients and controls examined were divided into groups in dependence on combination of DR and TNF it was found that relations observed between MS and TNF-a7 and TNF-a9 alleles were displayed much more in individuals which carried alleles of gene DRB1, corresponding to DR15 specificity. These are alleles which are known as the main risk factor of MS in Caucasians. The patients with "protective" TNF-a7 allele were characterized by more favorable course of the disease. Thus highly significant genetic markers were revealed for the first time in region of TNF genes which were associated with increased or decreased risk of MS development at least in Russian ethnic group. There was also possibility of their interaction with group of DR15 alleles of DRB1 gene. One of the markers revealed (TNF-a7) occurred to be bound both with decreased risk of MS and with favorable clinical course, which was observed for genetic markers of MS for the first time. Manifestation of one or another property of TNF-a7 marker depends on the presence of alleles of DRB1 gene which corresponds to DR15 specificity.

Adult

[The metabolic therapy of ischemic stroke: the use of nootropil].

54 patients were treated by notropil (pyracetam). The results of therapy were evaluated statistically according to a number of clinical scales and neurophysiologic indices (EEG and evoked potentials with mapping of bioelectric activity). The results were compared with the data about 56 patients of the control group which were treated by traditional method without application of notropil. Notropil was applied by two ways: small doses (4-12 g daily) during 5 days or high doses (10-12 g daily) during 30 days from the moment when the patient admitted to the hospital. Intravenous injections of the drug were used in all cases as well as its internal administration. It was showed either efficiency of the drug, especially in high doses, in early beginning of the treatment and its duration for at least 30 days or good tolerance of the drug. Authors supposed that application of pyracetam is not adequate in strokes with severe disorders of consciousness and cerebral edema.

Acute Disease

Asymptomatic cervical artery stenoses in Moscow.

The risk of stroke related to asymptomatic carotid artery stenosis is known to be increased in high-grade or rapidly progressive stenosis. Information of the prevalence in the general population is required for the recommendation of screening methods to detect patients needing prophylactic treatment. We studied the prevalence and the grade of severity of extracranial carotid and vertebral artery obstructions by means of Doppler sonography in 529 asymptomatic Russians (m: 343, f: 186; 36-84 years, mean: 58.4 years) living in Moscow city. Internal carotid artery obstructions of more than 50% stenosis were present in 22 (= 4.2%) subjects, 8 of them (1.5%) had bilateral lesions. Appropriate abnormal findings in vertebral arteries were found in 11 (= 2.1%) subjects, in 1 of them bilaterally. Affection of both the carotid and the vertebral arteries was noted in 4(= 0.8%) individuals. There were no sexual differences. The risk factor which correlated most significantly with cervical arterial lesions was hypertension. Carotid lesions were also significantly associated with age and smoking, but not with diabetes or hyperlipoproteinemia. The prevalence of cervical artery stenoses was found to be lower than in western reports, which may be due to different technical equipment and different study design.

Adult

[The level of autoantibodies to glutamate receptors in the blood serum of patients in the acute period of ischemic stroke].

The level of autoantibodies (aAB) to main structural component of glutamate NMDA-receptors--phencyclidin-binding protein--was measured in blood serum of 70 patients during first 3, 6, 9, 12, 24 hours, and 3, 5 days after ischemic stroke development. 200 healthy individuals formed the control group. The elevation of titers of aAB to glutamate receptors was observed in all patients with severe or moderate disease from the very first hours of stroke. It was especially pronounced by 9-12 hours after stroke. The highest increase of aAB titers was found in severe cases. The tendency to normalization of aAB titers was observed by the end of the first twenty four hours. The degree of aAB elevation had the prognostic importance. The most favourable course of stroke with good restoration of damaged functions was predicted when stable normalization of the aAB level was observed by the third day of the disease development. Patients in stupor-coma condition did not show the phenomenon of aAB level's elevation during the first days of stroke, that reflected, probably, the development of immuno-deficient state. The decrease of aAB level down to subnormal values was extremely unfavourable prognostic sign proceeding patient's death as a rule.

Acute Disease

[A comprehensive clinico-neurophysiological study of the efficacy of the pharmaceutical preparation glycine in acute ischemic stroke].

In intensive care unit 226 patients underwent step-by-step clinical and neurophysiological investigation of glycin chemotherapy efficiency in the acute period of ischaemic stroke. Investigation included double-blind placebo controlled method, monitoring (by means of EEG, toposelective mapping of EEG, SSEP, transcutaneous cortical electric stimulation, ENMG) of changes of brain functional state after the first drug dose and course of treatment, analysis of dose-dependent action of the drug, posticchemic follow-up. It was found out, that usage of the drug glycin (daily dose 1-2 grams) in the combined intensive treatment of stroke provided for significant acceleration of regress of disorders of consciousness and other general and focal signs (in comparison with severity-matched control group), and more complete and stable restoration of function to the end of acute period of the disease.

Acute Disease

[The basic factors affecting outcomes in strokes].

Outcomes in 1102 patients with 3 main types of stroke have been analysed to determine the significance of basic stroke outcome predictors. They are: type of the stroke, location of the focus, gravity of the patient's condition when the first aid is performed, spectrum of hospital facilities, diseases of the patient before and besides the stroke. A decrease of the mortality rate and optimal level of ADL score after stroke can be provided in cases when intensive care units-general hospitals are the first step of treatment.

Activities of Daily Living

Prolonged dynamic clinico-immunological observation of 85 patients with definite multiple sclerosis: first steps towards monitoring process activity.

Prolonged clinico-immunological observation of 85 patients with definite multiple sclerosis (MS) was performed in order to elucidate the connections between the clinical and immune state. A battery of immunological investigations was performed, including estimation of T-cell subpopulations in blood and cerebrospinal fluid (CSF); proliferative responses of circulating lymphocytes to mitogens, recombinant interleukin-2 (rIL2) and myelin basic protein levels in different culture conditions; levels of immunoglobulin (Ig) in sera and CSF, and of Ig production in vitro; indices of IL2 synthesis and IL2 sensitivity; production of prostaglandin E2 and tumour necrosis factor (TNF) alpha by monocytes and levels of beta-endorphin in sera and supernatants phytohaemagglutinin of (PHA)-activated cells. Clinical observation was performed periodically using Kurtzke scales and was supplemented by repeated recording of evoked potentials and magnetic resonance imaging. Initial investigations showed specific differences between patients with MS and the control groups (donors and patients with other neurological disorders of the same age). Correlative and regressive analyses showed no association between immunological and clinical parameters at the initial investigation, although immunological indexes were inter-related, and indicated specific alterations in immunoregulation in MS. Retrospective analysis revealed associations between the clinical status of patients with MS and their previous immune status. Evidence of cell activation--including a decreased percentage of circulating cells with differential antigens, lower cell mitogen-induced proliferative responses in vitro, with restoration following the addition of autoserum, greater IL2 sensitivity, and increased TNF-alpha production by macrophages--often predicted the clinical manifestation of deterioration. It is proposed that the immunopathological process in MS has a number of stages with characteristic features, and that progression from one stage to another can be subclinical. No single immunological index can be used to determine stage. Only systemic alterations reflect the real situation, whilst every patient has some abnormalities. A system of clinico-immunological monitoring could severe as the basis for a new approach to the dynamic treatment of MS.

Adolescent

[The effect of different hyperbaric oxygenation regimens on the aggregate status of the blood and on the free-radical oxidation processes in patients with the initial manifestations of cerebral blood supply failure].

Blood rheology, hemocoagulation, free-radical oxidation, acid-alkaline condition of the capillary and venous blood were investigated in 62 ICIB patients before and after treatment which consisted of 8 hyperbaric oxygenation (HBO) sessions or 3 HBO sessions (1.5 atm and 1,2 atm, respectively), the rest patients were not exposed to HBO. The best therapeutic results were achieved with a short-term HBO at a small excessive pressure. The longer HBO regimen provided no positive tendencies in clinical parameters. On the contrary, it provoked blood rheology deterioration, activation of free-radical oxidation stemming from diminished adaptation to hyperoxia in ICIB.

Adolescent

[The cerebral and central hemodynamics of patients with vertebrobasilar stroke].

Cerebral and central hemodynamics were studied in 45 patients acutely affected with vertebrobasilar apoplexy. Noninvasive methods-ultrasonic dopplerography of the extracranial carotid and vertebral arteries, unidirectional echocardiography were employed on post-apoplectic days 1, 7 and 21. The same examinations were performed in two groups of control subjects: healthy persons and patients with dyscirculatory encephalopathy degree I and II. The comparison of relevant data elucidated regularities of interaction existing in the changes of cerebral and central hemodynamics in patients with vertebrobasilar apoplexy of moderate severity. Prognostic significance of the findings is characterized.

Acute Disease

[The clinico-neurophysiological study of the effect of cerebrolysin on brain function in the acute and early recovery periods of hemispheric ischemic stroke].

Thirty patients with acute ischemic stroke and at early terms of postapoplectic recovery received cerebrolysin in daily doses 10, 20 and 30 ml for 5 days or 10 ml, i. v. for 10 days, respectively. The patients were examined for neurological status and cerebral function. In acute stroke the highest effect occurred in the affection of moderate severity. In severe stroke the drug stimulated recovery of impaired functions which tended to restore more quickly than in control subjects. In early convalescents cerebrolysin improved motor functions. Details of the results of the combined neurophysiological examination in the course of the treatment are discussed.

Acute Disease