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N A Totolian

Publications and source records attributed to N A Totolian.

16 recordsLinked to original sources
PubMed2006

[Clinical and radiological (PET, MRI) correlations depending on disease progression in patients with multiple sclerosis].

The aim of the study was to investigate the structural-functional changes in the cerebral gray matter (cortical and subcortical areas) of patients with multiple sclerosis (MS) depending on the disease severity. One hundred and seven patients (107) with definite diagnosis of MS (Mc Donald's criteria), aged 16-60 years, illness duration 1-30 years, and 21 healthy age-matched controls have been studied. Neurological assessment including Kurtzke and EDSS scales (range 0-8) was performed in all the patients. The patients and controls underwent MRI with a 1,5 imager and PET using 18F-flurodeoxyglucose (FDG). A type of the disease course was determined as remitting in 63 patients, primarily-progressive in 8, remitting progressive in 6 and secondary-progressive in 30. To analyze pathogenesis of the disease progression, the patients were divided into 3 clinical groups: (1) remitting (RRMS, n=63); (2) progressive (PRMS) with EDSS < or =6 (n=34); 3) PRMS with EDSS >6 (n=11). Along with the progression of MS from RRMS to PRMS and increasing of EDSS, the rCMRglu reduction of the cerebral gray matter developed from the supplementary motor cortex of a dominant hemisphere to the marked global reduction of cerebral metabolic rate in the PRMS group (EDSS >6). In the PRMS group with EDSS56, there was functional reorganization of cortical and subcortical areas compensatorily developing with the disease progression. In the PRMS group with EDSS >6, the data obtained did not support the evidence for the regional compensatory increase of rCMRglu in the same brain areas. Decompensation of the functional cortical reorganization in the PRMS group with EDSS >6 correlated with diffuse brain atrophy as well as with atrophy of the gray matter of the regional basal ganglia, first of all of the thalamus.

Adolescent↗
PubMed2005

[Magnetic-resonance tomography in differential diagnosis of brain lesions in demyelinating and systemic autoimmune diseases].

An aim of the study was to establish MRT signs that may be useful for differential diagnosis of multiple sclerosis (MS). Three groups of patients have been examined: 300 patients with MS, 35 with demyelinating diseases (acute disseminated encephalomyelitis, neuromyelitis optica--Devic's syndrome); 90 patients with systemic autoimmune diseases (systemic lupus erythematosus, primary antiphospholipid syndrome, sclerodermatitis, Sjugren's syndrome, autoimmune thyroiditis, vasculitis and vasculopathy). Classification of MRT syndromes in MS and their frequency are presented: syndrome of chronic inflammatory demyelination (79%), syndrome of acute inflammatory demyelination (9%), syndrome of multifocal degenerative leucoencephalopathy (8%), syndrome of combined multifocal diffusive leucoencephalopathy (4%). The similarity and differences in MRT semiotics of the above diseases and MS are described.

Adolescent↗
PubMed2004

[Multiple sclerosis in children and adolescents: history and current experience of immunomodulating treatment].

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.

Adjuvants, Immunologic↗
PubMed2004

[Interferon-beta treatment in patients with childhood-onset and juvenile multiple sclerosis].

Prospectively observed natural history in 10 cases of pediatric multiple sclerosis (MS), with respect to prognosis comparing to that of adult-onset MS (n=100) is presented. Poor-prognosis with severe disability was found in juvenile MS (age at onset 10-16 years old) with high annual rate of relapses in 2 years after the disease onset. The results of the long-term (2.0 to 3.5 years) beta-interferon treatment in patients with juvenile MS and the factors affecting these results are analyzed. Based on these data, together with those of published controlled clinical trials in adult-onset MS, indications for beta-interferon therapy and peculiarities of the treatment are discussed.

Adjuvants, Immunologic↗
PubMed2003

[Results of a multicenter study of Rebif-22 mcg administration in Russia].

The results of multicenter study of Rebif 22 micrograms in Russia have been reported. 167 multiple sclerosis patients have received Rebif 22 micrograms three times a week for 1 year. This study provides evidence for reduction of the relapse rate in patients with relapsing/remitting and secondary progressive multiple sclerosis. The tendency to the decrease of the severity of relapses, less need for steroid use and the decrease of EDSS score in patients with relapsing/remitting multiple sclerosis have been shown. In general Rebif 22 micrograms was tolerated well.

Adjuvants, Immunologic↗
PubMed2002

[Multiple sclerosis with childhood onset].

The clinical manifestations, magnetic resonance imaging (MRI) data, blood and cerebrospinal fluid (CSF) tests were analyzed in 19 patients with early-onset (before the age of 17 years) multiple sclerosis (MS) and in 100 patients with the definite diagnosis of MS with adult onset. Between group differences in sex ratio and initial neurological symptoms, with the prevalence of acute brainstem dysfunction (37%) and optic neuritis (37%) in the patients with early onset MS, were revealed. In childhood, the disease course was poorer with early disablement on the background of attendant unfavorable conditions. A sensitivity of various MRI parameters was analyzed and the essential proportion of the tumor-like acute inflammatory lesions was shown in early onset MS (29%). Immunological tests (albumin coefficient evaluation) revealed that in early onset MS hematoencephalic barrier dysfunction was registered more often, comparing to adult onset MS (100% vs 50%). The peculiarities of biases in concentrations of kappa-free and lambda-free light immunoglobulin chains in blood and CSF were detected. Higher levels of the kappa-free light chains concentrations in CSF were mostly found in the patients both with early and adult onset MS (86% and 99%, respectively) that confirmed the diagnostic value of this index. The results obtained may improve MS diagnosis in children.

Adolescent↗
PubMed2002

[Possibilities of magnetic resonance visualization in the diagnosis of multiple sclerosis].

Magnetic-resonance imaging (MRI) is considered to be the most informative non-invasive method in diagnosis, differential diagnosis and estimation of activity of multiple sclerosis (MS). MRI data of 270 patients with clinically and laboratory definite MS were analyzed to assess diagnostic MRI-criteria for MS, MRI presentations at the time of first clinical manifestation of the disease, neuroimaging patterns in children and elderly persons with MS. The MRI variants of MS are substantiated. Neuroimaging data of cervical spinal cord in 28 patients with MS are presented in parallel with corresponding clinical data. The most typical patterns are singled out. The data of brain 1H-magnetic-resonance spectroscopy (MRS) in 20 patients with MS and 8 patients with inflammatory and vascular disorders were analyzed to reveal biochemical distinction between MS and non-MS lesions as well as changes in normal appearing white matter in MS. The differential-diagnostic value of MRS is limited although decreased N-acetyl-aspartate peak is characteristic for MS lesions and in some cases in normal appearing white matter in primary-progressive MS.

Brain↗
PubMed1997

[Free light-chain immunoglobulins in the biological fluids of patients with multiple sclerosis].

15 patients with clinically significant multiple sclerosis (MS) were examined in terms of content of free light chains of immunoglobulins of kappa- and lambda-types in blood serum, cerebrospinal liquor, lacrimal fluid, saliva, urine, indices were compared with corresponding data of 12 patients with other neurological diseases and of 10 healthy individuals (control group). Significantly increased content of kappa-chains in cerebrospinal, lacrimal fluids and urine was revealed in patients with MS as compared with other two groups and in saliva of patients as compared with controls. The frequency of alterations was high in all biological fluids of the patients with MS. Elevated content of kappa-chains was most often observed in cerebrospinal fluid of the patients (13 individuals). The changes observed reflected systemic activation of humoral immune response in MS. Examination of cerebrospinal fluid was most informative for differential diagnosis.

Adolescent↗
PubMed1996

[Antibodies to brain galactocerebrosides in the serum and cerebrospinal fluid of patients with disseminated sclerosis].

The titers of antibodies (AB) to myelin's glycolipids galactocerebrosides (GC) as well as some other immunological indices were measured in 63 patients with multiple sclerosis (MS), in 14 patients with other similar neurological diseases and in 9 individuals with cerebellospinal ataxias. The correlation between the frequency of revelation of high serum AB titers and MS stage was observed. Thus the highest frequency was observed at primary progredient current of MS and at decline of its aggravation while the latter was found in steady remission. The correlation between level of AB to blood serum GC and blood immune complexes concentrations (complement and antistreptolysin O) was established too. Meanwhile these were not bound in patients with cerebellospinal ataxias and with other neurologic diseases or the titers of AB to GC were quite low in such cases. The titers of AB to GC in liquor were rather high in 2 patients with MS and in 1 patient with viral encephalitis while there were no AB to GC in other cases. That may be caused by determination of immunoglobulins of M class in reactions of complement binding. The determination of AB to GC in blood serum may be quite usefull in differential diagnosis of MS and other similar clinical conditions.

Adult↗
PubMed1994

[The content of free light-chain immunoglobulins in the cerebrospinal fluid and the importance of its determination for the differential diagnosis of multiple sclerosis].

The serum and liquor of 70 patients with multiple sclerosis (MS), 54 patients with other neurological diseases and 20 controls were examined for free light chains (FLC) of immunoglobulins type chi and lambda. The findings were compared to blood-brain barrier competence, liquor pleocytosis, IgG intrathecal synthesis 86% MS patients exhibited high levels of liquor chi-type FLC which appeared early in the disease course irrespectively of MS phase and pattern. Simultaneous high content of lambda-type FLC was reported in 52% of the cases. Patients in need of differential diagnosis were characterized by normal or reduced (in spinocerebellar ataxia) concentrations of FLC except for the conditions with impaired blood-brain barrier.

Adult↗
PubMed1993

[UV irradiation of the cerebrospinal fluid in the treatment of patients with disseminated sclerosis].

Cerebrospinal fluid (SF) in the quantity 5-7 ml from 26 multiple sclerosis patients was exposed to UV radiation with subsequent reinfusion. The assessment of clinical symptoms and immunological indices 7 days later showed that positive results (6 scores by Sipe scale) were achieved in 14 patients with cell abundance in the SF. The improvement was indicated by positive trends in pelvic functions, sensory and coordination disorders, normalization of the blood immunological picture. The responders exhibited elevated SF levels of B-lymphocytes, phagocytosing cells and IgM concentrations. High levels of IgG registered in 58% of the patients did not change. The only side effect was represented by short-term postpuncture syndrome in 4 patients with arterial hypotension. In 12 patients with progressive sclerosis the treatment was ineffective.

Adult↗
PubMed1991

[Status of local and general immunity in patients with multiple sclerosis].

A study was made of the general (blood) and local (CSF) immunity in 18 patients with clinically active multiple sclerosis running different course and in 14 controls. The relative and absolute count of T and B lymphocytes, phagocytizing cells, the content of IgA, IgM and IgG, circulating immune complexes, some fractions of complement, functional activity of blood granulocytes and mononuclears were measured. The patients with multiple sclerosis manifested appreciable alterations in cellular and humoral immunity of the blood and CSF. No correlation was observed in alterations of the immunological parameters of the blood and CSF whereas in some cases (E-RFL), the changes were of different character. The relationship was discovered between the intensity of alterations in local immunity and the type of the disease.

Adolescent↗
PubMed1991

[Efferent methods of the treatment of cerebrospinal fluid hypertension in exacerbation of multiple sclerosis].

Analysis is made of the efficacy of the treatment of CSF hypertension in 40 patients in the phase of exacerbation of multiple sclerosis. Use was made of sorption detoxication methods: hemoperfusion (the author's certificate No.1466754) and enterosorption (the priority certificate No.4465054/14 (115542) dated July 22, 1988). SKH-IK and SKH-2K sorbents were employed as hemoperfusion, using the venovenous scheme of perfusion, the volumetric rate of the blood flow being 100-120 ml/min during 2-3 hours. Altogether 2-3 sessions were carried out, with an interval of 5 to 7 days. For enterosorption, use was made of a crumbled up filamentous carbonic sorbent in a dose of 50-60 mg per kg bw 3 times a day for 20 days in 2 hourly intervals between food intake. Regression of the neurological symptoms began 2-3 hours after the first session of hemoperfusion and 5-6 days after the beginning of the intake of the filamentous carbonic sorbent, increasing throughout the whole treatment course. That coincided with the disappearance of CSF hypertension and normalization of the immunological spectrum of the blood serum. Sorption detoxication brought about no complications and is a method of choice in the treatment of CSF hypertension in patients in the phase of multiple sclerosis exacerbation.

Acute Disease↗
PubMed1991

[Enterosorption in the combined treatment of patients with multiple sclerosis].

Fifty-nine patients exhibiting an exacerbation of multiple sclerosis were examined for efficacy of enterosorption with the fibrous coal sorbent vaulen. The solvent powder was administered 3 times a day in a dose of 50-60 mg/kg for 20 days between meals. The relief of neurological symptoms started on treatment days 3-4 with subsequent attenuation within the course of treatment. This agreed with discontinuation of liquor hypertension and recovery of normal immunological spectra of serum parameters. The method of enterosorption is simple, safe and readily arrests the disease exacerbation.

Adult↗
PubMed1990

[Methodologic characteristics of determining immunologic indices in cerebrospinal fluid].

The authors have tried to adapt the micro-methods for assessment of the peripheral blood immunologic parameters to measurements of these characteristics in the cerebrospinal fluid (CSF) and examined a group of patients to define the diagnostic value of these parameters. Eighteen patients with disseminated sclerosis and 14 normal controls were examined. Relative and absolute counts of T and B lymphocytes, phagocytes, IgA, IgG, and IgM were measured. Normal values of the CSF cellular immunity parameters were determined; these values were essentially shifted in the patients, which recommends the developed methods for assessment of local immunity in nervous system diseases.

Adolescent↗