Biomedical subjects
Publications and source records attributed to M R Guseva.
Presented are the results of the use of histochrome in animals with experimental hemorrhagic stroke. An influence of the compound on cerebral edema and the dynamics of hemoglobulin converting as well as a role of MRT in diagnostic of experimental hemorrhagic stroke in different periods of the disease are discussed.
An agreement accepted worldwide for treatment of multiple sclerosis (MS) in adult patients has not been achieved so far for children and adolescents, mostly due to the insufficient information on the features of MS with early age-at-onset. New methods of immunomodifying treatment and the conception of early MS treatment have changed the attitude to prognosis of MS with early onset. In such cases, a course of the disease is less aggressive and characterized by more intensive remyelination as well as brain plasticity and less neurological deficit that may predict highest efficacy of the disease modifying treatment timely started in these patients. Such drugs, as beta-interferons, glatiramer acetate and high-dosage intravenous immunoglobulines G, which are able to decrease MS relapse frequency and disability progression in adult patients, are poorly studied in children and adolescents. Preliminary positive results of international and Russian investigations on the efficacy and tolerability of immunomodulating therapy of MS with early age-at-onset require further investigations in this field.
The aim of this study was to determine the role of the HLA-DRB1 gene [6p21] in susceptibility to juvenile MS (JMS) (age at onset < or =15 years) of children of Russian descent. Association of DR2(15) with JMS has been found by the comparison of patients with JMS with both unrelated and affected family-based healthy controls. The linkage of DR2(15) with JMS was shown by transmission disequilibrium test. There were no significant differences in the frequencies of DRB1 alleles and genotypes between 56 patients with JMS and 234 patients with MS with age at onset > or =16 years.
Early onset multiple sclerosis (MS) has some peculiarities in the disease course. 56 patients with definite MS with the onset at the age under 15 years were included in this clinical, immunogenetical and neurophisiological study. The analyses of the relations between different clinical characteristics of MS in children has shown, that patients with onset under 10 years, had rare relapses, but more progressive development of disability in contrast to the patients with MS onset at the age of 11-15 years. Duration of the first remission was associated with the time to sustained disability in children with MS. The number and volume of MRI T2-positive lesions in the white matter of the brain was associated with the age of onset, duration of the disease and with the number of relapses. In several cases the phenomena of clinical-MRI dissociation was observed. Generic HLA-DRB1 genomic typing was performed in all the patients. High frequency of DR2(15) genotype in MS-affected children in comparison with the group of healthy controls was more expressed as compared with MS-affected adults. The comparison of frequencies of DRB1 alleles in transmitted, i.e. appeared in the affected child haplotypes and in non-transmitted haplotypes confirmed results of the case-control study showing the very significant association of MS with DR2 alleles and extremely significant--with its DR15 subtype in children. The data of transmission/disequilibrium test (TDT) analysis provide strong evidence for linkage of DR15 alleles and susceptibility to sporadic MS in patients with disease onset before 15 years. The positive experience of management (beta-interferon-1a) was shown in MS-affected children in three cases.
The frequency of multiple sclerosis (MS) with clinical onset before 16 years of age in different regions of Russia fluctuates from 2 to 10% of all MS patients. One of the most frequent signs of MS manifestation and/or exacerbation at this age is optic neuritis (ON). Forty-seven children with MS were observed in Moscow. Diagnosis of MS in every case was clinically definite and proved by serial MRI. Clinico-tomographic dissociation was noticed: numerous large lesions, typical for MS on T2 images were often seen in children with mild or moderate residual neurological symptoms. All patients had relapsing/remitting MS course, mean EDSS was 2.24+/-0.26. Thirty-eight children (80%) had ON at least once, ten (21.3%) - twice or more times. In several cases ON had subclinical course or might be missed and the damage of the optic nerve with partial atrophy was found only after complex ophthalmological investigation including visual evoked potentials. Thus, the clinical course of MS and ON have some peculiarities in children and may be genetically based. Analyses of allelic polymorphisms of HLA-DR and TNF loci on chromosome 6 was performed. Data from children with MS were compared with data from their parents, healthy controls and other MS patients from the same ethnic group. Children with MS had increased frequency of DR2(15) and TNF-a11, but not TNF-a9 as adult MS patients from the same ethnic group. The presence of TNF-a7, rare in adult patients, could be proposed as a marker of early MS onset.
The purpose of the trial was to investigate efficacy of cerebrolysin in children with partial optic atrophy and to compare different ways of injections of the drug. Cerebrolysin was injected in retrobulbar space and in Tenon's space. The drug was given separately and in combination with trental. Favorable effect has been achieved in all the patients treated with cerebrolysin injections in Tenon's space. In patients treated with retrobulbar injections of cerebrolysin and with injections of cerebrolysin and trental improvement occurred in 50% of cases. In control group, who did not receive cerebrolysin favorable results were achieved in 25% of patients. A 12-month follow-up study stated stability of the effect of cerebrolysin.
Pattern electroretinograms and visual evoked potentials (VEP) were investigated in response to reversal checker-board patterns with different sizes of checks in 13 adolescents with monosymptomatic optic neuritis in acute period and in the course of convalescence 1-2 and 12-36 months after the disease onset. All the children underwent computer tomography of the orbit and brain. The results allowed identification of high and low multiple sclerosis risk groups. The high risk can be proved by a progressive increase of VEP latency 1-2 months after the disease onset and its significant advance in later period of optic neuritis. Normal VEP latency in late optic neuritis shows a low degree of its development.
The authors discuss the results of study of the immune status in 55 patients with chronic osteomyelitis, it was found that the condition of the patients' immune system reflects the duration and severity of the disease and the individual reactivity of the organism. The inclusion of laser treatment in the complex of therapeutic measures should be based on appraisal of the condition of the immune system and conducted under dynamic immunological control. In deficiency of the thymus-dependent immunity the sessions of blood intravascular laser irradiation activate the organism's defence forces and facilitate correction of the imbalance in the system of the regulating cells. Laser irradiation of blood in mild changes of the immunological status is expedient because it may lead to negative dynamics of the immune system. Attainment of an optimal immunological condition in the preoperative period is conductive to a favourable course of the postoperative period and a favourable outcome of the disease.
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The article deals with the comparative analysis of the results of treatment of 98 patients with chronic hematogenic osteomyelitis of the long tubular and pelvic bones with the use of hypervolemic and normovolemic hemodilution as a method of infusion-transfusion therapy of intraoperative blood loss and its compensation with donor blood. It is shown on the basis of clinical evaluation and the study of hemodynamic, hematological, and rheological blood values, the values of the blood coagulation system and the acid-base balance that the use of hypervolemic hemodilution is limited and can be applied in blood loss not exceeding 10% of the circulation volume. The use of the method of normovolemic hemodilution makes the transfusion of donor blood unnecessary and thus allows the complications associated with it, infectious among others, to be avoided. It can be used in blood loss of up to 20% of the circulation volume.
The article analyzes results of complex surgical treatment of 109 patients with chronic hematogenic osteomyelitis of long tubular bones and pelvis, 53 of them were subjected to correction of intraoperative blood loss with autogenic blood. Autohemotransfusion with procurement of 400-600 ml of blood immediately before operation in combination with normovolemic hemodilution allows to correct intraoperative blood loss up to 20% of the circulating blood volume. Autohemotransfusion with the preliminary taking of blood as much as 800 ml allows to correct intraoperative blood loss more than for 20% of the circulating blood volume.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.