Biomedical subjects
Publications and source records attributed to I I Protas.
This is a report on three patients with the diagnosis of Creutzfeld-Jakob's disease, presenting clinical descriptions of the disease and the results of histological studies. The tasks of further research into various aspects of this slow infection are discussed.
A histological study of a peculiar progressive disease of the central nervous system (CNS) named amyotrophic leukospongiosis was carried out in 5 observations. The regular histological signs included the loss of motor neurons in the spinal cord and encephalon, the status spongiosus of the white matter in the anterior and lateral columns of the spinal cord and different parts of the white matter in the encephalon. Unlike amyotrophic lateral sclerosis, amyotrophic leukospongiosis is characterized by intact myelin fibers of the anterior and lateral columns (including pyramidal tracts). The clinical, epidemiological, and histological data allow the disease to be classified into the group of slow virus infections.
Within a period of 24 years 17 patients suffering from a specific spinal amyotrophy were observed in Byelorussia. The disease steadily progressed and ended in death. Family and group morbidity, and less frequently sporadic cases were registered. Clinical examinations revealed a selective affection of the anterior horns resembling subacute anterior poliomyelitis. The truncal structures remained intact during the whole course of the disease. Two or three years after the disease onset spinal disturbances of respiration joined. The average duration of the disease was 2.5 to 3 years. Morphological examinations revealed total destruction of thoracic mononeurons and spongiosis of the white matter of the brain and the spinal cord, but without signs of demyelinization of the corticospinal tract. The specificity of the epidemiological, clinical, and pathomorphological features of the disease has given the authors grounds to designate it as "amyotrophic leukospongiosis".
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The paper deals with clinical and morphological studies of 2 cases with subacute anterior poliomyelitis. The authors attract special attention to the development of flaccid pareses with a simultaneous inhibition of tendinous and periosteal reflexes, the absence of any pyramidal signs during the entire disease and a clear prevalence of degeneration in spinal cord motoneurons in the cervical and thoracel parts and their preservation in the brain cortex. These symptoms are distinctive signs from the poliomyelitic variant of the amyotrophic lateral sclerosis.
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The authors analyzed the data obtained in a study of 7 cases of peculiar spinal amyotrophy seen in some patients who lived in 3 adjacent villages. The disease had an incipient onset, with a prevalent localization of the pathological process in the anterior horns of the cervical part of the spinal cord and a subsequent progressive development with a lethal outcome accompanied by symptoms of respiratory insufficiency of the spinal type. The CNS was characterized by specific morphological changes. The authors are more in favour of the assumption that this disorder is of infectious nature of the group of gradual infections of the CNS.
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Cases are described of chronic zoster encephalitis presenting with the leading progressive focal epilepsy syndrome. The clinical presentation of the trouble can include both general cerebral signs and those of the focal affection of the central nervous system only. The progressive course and duration of remission suggest to us a persisting infection manifesting against the background of immune deficiency.
The clinical picture of the experimental tick-borne encephalitis, the time course of viremia, the virus content in the central nervous system and the morphological picture were studied in 15 sheep inoculated intracerebrally with viruses isolated in Byelorussia. The two phases of clinical manifestations (febrile-meningeal and neurological stages) were found to be one of the pathogenetic features of the experimental infection due to both virus multiplication and toxico-allergic reactions on the part of the nervous system. This suggests differences in the pathogenesis of clinical manifestations in the general infectious and neurological stages of the acute period of tick-borne encephalitis in man.
The paper presents the results of epidemiological and clinical studies of the peaks of tick-borne encephalitis (TBE) in the Belovezhskaya Pushcha region in 1993-2001. The findings confirm the concept worked out by Byelorussian researchers on nosological differences in the western and eastern subtypes of TBE.