[Localization of tremor generator].
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Hand↗
Biomedical subjects
I N Shevelev
Publications and source records attributed to I N Shevelev.
[Changes in peripheral blood flow during the acute period of severe cranio-cerebral injury (quantitative study)].
The results of a quantitative investigation of the circulation rate and peripheral vascular resistance effected by the method of venous occlusive plethysmography in 37 patients with severe cerebro-cranial injuries are reported. A correlative dependance of changes in the peripheral hemodynamics on the clinical manifestations of a traumatic brain lesion was disclosed. At this juncture three types of the peripheral blood flow changes that corresponded to the syndromes observed were recognized, namely: infra-axial, supra-axial and, pre-eminently, hemispheral ones. The grossest alterations were seen to occur in the case of the infra-axial syndrome of the affection, which manifested themselves in a steep decline of the circulation rate and an appreciable increase of the peripheral vascular resistance.
Adolescent↗
[Microsurgical treatment of compression of the rear wall of the spinal artery in intervertebral arthrosis].
Vertebral artery stenosis caused by cervical spondylosis is generally caused by compression of the artery by osteophytes arising from an uncinate process. Compression caused by facet joint osteophytes is rarely reported. The paper shows that compression may also occur posteriorly by osteophytes from the facet complex. Careful evaluation of preoperative angiograms and computed tomographic or MRI scans is required to determine whether an anterolateral, posteriorlateral or posterior approach might be more beneficial for decompression.
Arteries↗
[A method of venous occlusion plethysmography for quantitative study of peripheral hemodynamics in cranio-cerebral trauma].
A method of quantitative investigation of the peripheral blood flow (in ml/100 cm3/min) involving the use of venous occlusion plethysmography is described. Mathematical procedures applied in processing the arterial in flow curves are adduced. Conditions attending an investigation of the blood flow in the forearm vessels are depicted. The expediency of a bilateral examination of the peripheral circulation and vascular resistance in a cerebro-cranial injury is shown, there being, as a rule, a considerable asymmetry between the sides.
Brain Injuries↗
[Modern aspects of spinal surgery].
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Biomechanical Phenomena↗
[Evoked potentials in the diagnosis of traumatic lesions of the brachial plexus].
The level of damage to the brachial plexus in different forms of trauma was appraised in 106 patients with traction trauma of the plexus by means of evoked potentials (EP)--short-latent somatosensory EP and EP of peripheral sensory nerves. Whether the plexus was damaged on the pre- or postganglionic level was the main question. The corresponding changes of the electrophysiological values characterizing pre- or postganglionic level of the damage to the plexus were noted, they were verified during the operation. Correlation of the electrophysiological values and the results of myeloradiculography was revealed. Electrophysiological diagnosis is most informative in damage to the plexus at one level (pre- or postganglionic, total or partial) and in combined damages (when some radices are injured on the pre- and others on the postganglionic level). The diagnosis of multiple injuries to the plexus based only on electrophysiological methods is impossible; only one level of the damage is diagnosed.
Accidents, Traffic↗
[Posterio-median approach in ventral tumor compression of the spinal cord].
The paper describes two types of resection of primary and metastatic spinal tumors via a posterolateral approach: by curettage and en-block resection. The outcomes of treatment in 15 patients operated on by curettage and 2 patients undergone en-block resection are analyzed. Postoperative pain relief was noted in 100% of the patients. Six (55%) patients who had not been able to move became outpatient after surgery. There was a neurological improvement in 5 (29%) patients, i.e. they were at a higher stage by the Frankel scale. The above results show that removal of spinal tumors via posteriomedian access with lateral extension by curettage or en-block resection might be effective in surgically treating this pathology. Choice of a type of surgery (carcinological or palliative) primarily depends on the histological nature of a tumor, on the degree of neurological deterioration, on the extent and site of a tumorous process, and on the expected survival of a patient.
Adolescent↗
[Modified anteriolateral retroperitoneal approach for surgical treatment of patients with compression of the cauda equina and lumbar nerve roots (topographic anatomical study)].
Mini-invasive techniques have been increasingly used in lumbar surgery in the past decade, most commonly during operations on the intervertebral disks. However, mini-invasive interventions may be used as a modified traditional approach to treating more serious and challenging pathology, such as tumors of the lumbar vertebrae, metastatic disease, as well as lumbar fractures of different origin. In the literature, there are only several papers on the mini-invasive anterolateral retroperitoneal approach (ALMIRA) to corpectomy with repair of the lumbar spine. This paper deals with the autopsy of 15 cadavers (aged 55-83 years) and 5 blocks of the lumbar spine. The approach is described with illustrations being given. All the results are analyzed and shown in a table. Fifteen corpectomies of L2, L3, and L4 vertebrae were performed by ALMURA, using a self-retaining retractor. The duration of a procedure from skin incision to complete preparation of a spinal specimen for retractor's attachment averaged 50 min (30-70 min). The corpses were rotated in the axial plane at 45, 35, and 25 degrees for corpectomy of L2, L3, L4, respectively. The procedure was easier-to-use when convex binding of the spine was performed after the approach and before insertion of a retractor, in obese cases in particular. Damage to the peritoneum occurred in 5 cases, that to the ascending lumbar vein took place in 4 (during L4 corpectomy) and m. psoas in 2 cases, both in a cachectic cadaver. In the authors' opinion, the method is effective, but before applying it in the clinical theater, spinal surgeons should be well trained under experimental conditions.
Aged↗
[Vertebroplasty in the treatment of spinal diseases].
The results of surgical treatment by vertebroplasty are analyzed in 28 patients with different spinal diseases. A procedure for percutaneous vertebroplasty with polymethyl methacarylate is presented. This miniinvasive method has been shown to be highly effective in treating vertebral hemangiomas, osteoporotic compression fractures, and vertebral metastases and in strengthening the anterior vertebral column as compared with anterior spondylosis in open surgical operations.
Adolescent↗
[Preoperative study of the good condition of nerve neurotizers].
In traumatic injury of the brachial plexus, neurotization of peripheral nerves of the hand with different nerve donors is indicated at the preganglionary level in order to restore motor function. This communication describes a procedure for preoperatively determining the state of the nerves to be neurotized. This procedure evaluates the, state of the estimated nerve donors and presents a means of planning in advance the way of performing an operation aimed at recovering the lost motor functions, by considerably reducing the time of the operation.
Arm Injuries↗
[The action of an impulse magnetic field on the motor function recovery of the peripheral nerve trunks].
The cut sciatic nerve trunk was sutured perineurally to study in chronic rabbit experiments of the neuromuscular functional recovery upon the exposure to impulse magnetic field with the intensity 1.2 T. Nonexposed animals served control. Myographic activity of reinnervated crural muscles in the irradiated animals recovered two times more rapidly compared to the controls, so did motor function of the limb operated on. It is inferred that impulse magnetic field produces therapeutic and preventive effect on neurodystrophy resultant from the nerve dissection.
Animals↗
[The microsurgical treatment of traumatic lesions of the brachial plexus].
The article deals with the results of examination and surgical treatment of 213 patients with various forms and levels of traumatic damage of the branchial plexus. Five levels of damages are suggested: I--preganglionic; II--postganglionic damage of the spinal nerves and primary trunks of the brachial plexus; III--damage of the secondary trunks in the clavicular region; IV--damage of the distal parts of the brachial plexus; V--isolated damages of the initial parts of the peripheral nerves. The authors describe surgical management by the method of differentiated neurotization with nerves arising from different segments of the spinal cords, by-passing the brachial plexus. Pathological changes in the region of the trauma, the character and level of the damage, the condition of the circulatory system, the presence or absence of pain, the applied rehabilitation therapy, the duration of the disease, the patient's age, and other factors have a marked influence on the outcome of the operation. Charts of distribution of the nerve fibres of the brachial plexus in the nerve trunks were compiled more exactly on the basis of data obtained during the operative intervention and autopsy.
Accidents, Traffic↗
[Motor function study in traumatic lesions of the brachial plexus].
The muscular tone of flexors and extensors was studied in dynamics in patients with trauma of the brachial plexus. The study involved measurement of mechanical resistance of a passive limb periodical movements at the elbow joint. The electrogram was registered synchronously with the mechanogram to study the reactions of the agonists and the antagonists. The results made it possible to judge the maintenance of nerve conduction along the efferent and afferent pathways. The method also enabled the authors to determine the degree of disorders and restoration of functioning of the neuro-muscular connections and to reveal the presence of pathological nerve connections which formed as a result of the trauma and interfered with the performance of voluntary movements. The character of the mechanical reaction of the muscles to passive movements allowed judgement of the presence of muscular contractures or stiffness of the joint.
Arm↗
[Mechanism of disorders in intracranial volume correlations in severe craniocerebral injury].
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Acute Disease↗
[Gamma-topography of the cerebrospinal fluid passages of the spinal cord in traumatic injuries of the brachial plexus at the preganglionic level].
Gamma-topography of the cerebrospinal fluid tracts of the spinal cord (GCTSC) was conducted in 28 patients with traumatic injuries of the brachial plexus at the preganglionic level. The object of GCTSC was to identify the character of damage inflicted to the spinal cord, its meninges, and the roots at the preganglionic level in the presence of the pain syndrome. Spatial-temporal distribution of the radiopharm agent in the submeningeal space served as the basis for setting apart radiological signs characterizing the anatomical disorders and disturbances in cerebrospinal fluid dynamics in the submeningeal space of the spinal cord. The radiological picture was always composed of adhesive-cicatricial and adhesive-cystic processes with arachnoid cysts or cerebrospinal fistulas in the cervicothoracic segment of the spinal cord.
Adult↗
[Transcapillary filtration of electrolytes in the brain after craniocerebral injuries].
A new method was used to determine the value and direction of electrolyte filtration through the walls of capillaries in the brain in patients with craniocerebral injury. It was found that the period of the development of brain edema coincided in time with the prevalence of the processes of sodium, calcium, and fluid escape from the cerebral vessels into the cerebral tissue. The movement of potassium through the capillary wall was counter-current to that of sodium filtration in most cases. Transcapillary filtration of electrolytes in patients with craniocerebral injury during the posttraumatic period was characterized by recurrent changes in the direction of filtration. Electrolytes (sodium, potassium, and calcium) possess their own, often independent of one another, mechanisms of transfer through the membranes of the histohematic barriers.
11-Hydroxycorticosteroids↗
[Results of combined studies on the electric excitability of the color perception apparatus of the visual analyzer under normal and pathological conditions].
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Adolescent↗
[Results of interfascicular autotransplantation in the treatment of traumatic injuries of the median and ulnar nerves].
The results of operation for interfascicular autotransplantation conducted on 50 patients with traumatic injuries to the median and ulnar nerves are analysed. The study confirmed the high efficacy of repairing defects in nerves with autografts and interfascicular apposition of the separate elements of the nerve trunks. The best results were produced with the use of short autografts. At the current stage of the development of the surgical treatment of injuries to the peripheral nerves, microsurgery with interfascicular suture and autotransplantation should be considered the method of choice.
Adolescent↗