Biomedical subjects
Publications and source records attributed to E I Gusev.
Recording the intrinsic, thermal radiation of tissues and their associated blood supply makes it possible to diagnose cerebrovascular insufficiency at the early stage. Radiothermometry is safe and easy in operation and provides results in absolute values in some seconds, which makes it convenient during a screening.
The cytotoxic activity of natural killer (NK) cells against target cells K-562 was studied in patients with multiple sclerosis (MS). NK activity was increased in patients with remitting course of the disease, its duration of 6 to 10 years and 1 to 3 degree of neurologic defect. The immunocorrective therapy reduced the NK activity in some patients of any group. The authors discuss the possible role of natural cytotoxic system in the pathogenesis of autoimmunization in MS, and the value of NK population assessment for singling out a group of patients that would beneficially respond to immunocorrective therapy.
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The article deals with the diagnosis of somatic diseases in cases where stroke-stimulating cerebral symptoms come to the fore. On the basis of the investigation of 56 patients admitted with the diagnosis of acute impairment of cerebral circulation the authors present the criteria of the differential diagnosis of pneumonia, thromboembolism of the pulmonary artery, myocardial infarction, abscessed nephritis, visceral cancer, and cerebral stroke. The causes responsible for the appearance of focal symptoms in the absence of morphological changes in the brain and the pathogenesis of cerebral disorders in somatic diseases are discussed.
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The authors have examined 37 patients with occlusive lesions of the main vessels of the head using electroencephalogram and compression spectral analysis of the EEG findings. A group of patients with the predominant damage to the carotid and vertebral arteries has been identified on the basis of angiographic data. It has been shown that alterations in the bioelectrical activity of the brain are determined by hemodynamic disturbances in patients with transient disorders of the cerebral circulation and circulatory encephalopathy. In patients with acute impairments of the cerebral circulation, the nature of the EEG and spectrogram depends primarily on localization of the ischemic focus. The quantitative parameters of changes in the bioelectrical activity of the brain in different groups of patients are outlined.
The article deals with characteristics of the hemodynamics of the extracranial major arteries in patients with different forms of cerebrovascular insufficiency due to occlusive lesions of the brachiocephalic arteries. Clinicoangiographic characteristics of patients with this pathology associated with atherosclerosis and nonspecific aortoarteritis are presented. Angiography showed two variants of occlusive damage to the brachiocephalic arteries: bicarotid and multiple. The authors were the first to use comprehensive examination of patients with the employment of the spectral computerized analysis (SCA) of ultrasonograms (USG) of the common carotid and suprapubic arteries and ultrasonic angiography with the calculation of the circulation rate in the common carotid arteries. Using SCA of USGs criteria of different degrees of stenosis of the common and internal carotid arteries were developed. A correlation analysis of the data obtained by SCA of USGs and of the values of the circulation rate in the common carotid arteries was made. The highest correlation of these parameters was observed in patients with stenosis of 60-90% and occlusion of the internal carotid and common carotid arteries.
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A clinico-electroneuromyographic examination covered 50 patients with initial manifestations of cerebral circulation insufficiency. The results are compared with the electroneuromyographic characteristics of discirculatory encephalopathy (20 patients), transient disorders of the cerebral circulation (28 patients) and ischemic strokes (30 patients). The parameter of "the sum of maximum amplitudes of M-responses" in the musculi manus and musculi pedis upon stimulation of the median, ulnar, tibial and fibular nerves at both sides developed by the authors was found to be diagnostically effective. This parameter proved to be significantly decreased in all cases of initial manifestations of cerebral circulation insufficiency. With increasing severity of cerebral circulation insufficiency in ischemic stroke the parameter reduced to the minimal values in a step-wise manner.
Ultrastructural aspects of the secondary brain stem syndrome in patients with hemorrhages and infarcts in the brain hemispheres are considered. The secondary brain stem syndrome is manifested by diverse clinical symptomatology suggestive of dysfunction of different levels of the brain stem: a diminished level of awakening, oculomotor disturbances, changes in the muscle tone and reflexes, cardiorespiratory and other vegetative disorders. Examining the reticular formation of the brain stem under the electron microscope the authors revealed changes in neurons in the form of chromatolysis, an increase in the cellular cytoplasm of the number of lipid inclusions and lysosomes, swelling of mitochondria and (less frequently) the appearance of cells with an elevated osmiophilia of the cytoplasm. Also observed was a systemic increase in lysosomes and lipid granules in capillary structures, and in glial and nervous cells. The pathogenetic factors of secondary brain stem syndrome are discussed.
A total of 76 patients were examined, using ultrasonic dopplerography and spectral analysis of the EEG followed by computer processing of the data. The greatest benefit from operative treatment was observed in patients with transient disorders of the cerebral circulation, dyscirculatory encephalopathy and a "minor" cerebral stroke.
A combined dynamic examination of 114 patients with strokes of different nature localized in the cerebral hemispheres has shown that the degree of the hemostatic changes depends on the severity of the disease and the stage of the DIC syndrome at the time of examination. Three stages of DIC have been identified: hypercoagulation, incomplete consumption coagulopathy, and marked consumption coagulopathy. Drug correction of hemostatic alterations is possible only at stages I and II. The guidelines of the drug therapy of the DIC syndrome associated with cerebral strokes are presented.
Free amino acids were studied in the blood plasma of 37 patients with multiple sclerosis with different variants of its course. Hypoaminoacidemia and disaminoacidemia in all the patients justified the conduction of the corrective treatment with the Soviet drug polyamine manufactured from balanced crystalline amino acids. The results of treatment of 21 patients with multiple sclerosis are presented. Normalization of the metabolism of free amino acids correlated with the clinical improvement of the patients's status.
Forty patients with multiple sclerosis of a differing course, duration and severity were treated in this series. T-activin was employed as an immunocorrective agent (AFT-6 fraction). The immunological status was assessed in all patients observed prior to, during and after the treatment. Good clinical response was noted in patients with a secondary progressive course; the effect of a short course of treatment with T-activin on the state of patients with a prolonged progressive course or at the stage of stabilization in the presence of severe organic symptomatology was less prominent. AFT-6 showed a beneficial effect on the immunological status of patients, largely on the T-immunity system. Following the treatment, most patients displayed the normalization of the total lymphocyte count and of the proportional content of T-cells with their activity rising.
Immunological blood indices, neutral lipid fractions, level of daily urine C21-corticosteroid excretion, free amino acid spectrum of the blood were studied in 72 patients with disseminated sclerosis. The EEG, EMG and REG data were analyzed. Healthy persons of the same age formed the control group. The data obtained may favour more differentiated treatment (in particular, the use of immunodepressants or immunostimulants) according to the disease pattern and stage. The study is important for early diagnosis and estimation of the process acuity and drug efficacy.
Electron microscopy of the sensomotor cortex in 27 rats was performed at varying times (1, 3, 7 days) after arteria carotis communis occlusion. Three groups of rats (5 rats in every group) were treated by nootropil (500 mg/kg daily) in accordance with three time intervals. Control rats were undrugged. More preserved were neurons in the brain of rats treated by nootropil. Neuronal organelles had rare signs of irreversible damages. Membranes were more often preserved, organelles fragmentation and vacuolization were less pronounced. The experimental rats showed neurons containing numerous ribosomes and small new-formed mitochondria. The difference in neuronal structure in treated and untreated rats became more distinct 3-7 days after occlusion. The results obtained are suggested to be connected with the drug ability to normalize ATP metabolism, to stimulate phospholipid synthesis and ribosome function and to increase glucose utilization. The problem of using GABA derivatives in conditions of the most acute brain ischemia is discussed.