[Combined endovascular and surgical management of carotid paraganglioma].

Surgical intervention is the only method of radical treatment of carotid paraganglioma (CP). Intraoperative blood loss may exceed 2 litters. Ligation of the external carotid artery (ECA) is not always possible technically due to tumour invasion to the ECA's walls. Prior to operation, in order to diminish blood loss it is suggested to perform endovascular embolization (EE) of the vessels feeding the tumour. The case report presented herein concerns an 18-year-old male patient with CP after comprehensive diagnosis including ultrasonographic duplex scanning with Doppler colour mapping, enhanced-contrast spiral computed tomography, selective carotid angiography. The patient was subjected to selective. EE of the afferent vessels of CP. Embolization of the branch of the ascending pharyngeal artery travelling to the lower pole of the tumour, and that of the large branches feeding the upper pole of the tumour from the initial portion of the occipital artery with poly vinyl alcohol (PVA-300) and hydrogel "Embox" was followed by surgical intervention: removal of the tumour, closure of the ostia of the tumour's own arteries, ligation of the EC A. The volume of intraoperative blood loss amounted to 350 ml. The postoperative period proved uneventful with nothing to report. During the check-up examinations of the patient, performed 3, 6, 12 and 24 months after the operation, a good postoperative therapeutic outcome was noted to persist.

[Endovascular correction of a multi-level arterial lesion in an elderly patient with lower-limb critical ischaemia].

Presented herein is a clinical case report showing possibilities of endovascular surgery in comprehensive treatment of a multi-level stenosing lesion in an elderly male patient presenting with pyo-necrotic alterations of the crus and foot. A 67-year-old male patient suffering from diabetes mellitus, lower-limb vessels atherosclerosis, critical ischaemia, indolent wound of the left foot following amputation of the toes was subjected to collaterally approached balloon-mediated angioplasty of critical stenoses of the left common iliac artery and deep femoral artery. During the operation, we used elements of coronary interventions technique. The wound healed completely. Two years after the operation, a good result persists, with the patient being capable of moving unassisted, completely serving himself, and the distance of pain-free walking amounts to more than 150 metres.

Innervation and properties of the rat FDSBQ muscle: an animal model to evaluate voluntary muscle strength after incomplete spinal cord injury.

Muscles innervated from spinal segments close to the site of a human spinal cord injury are often under voluntary control but are weak because they are partially paralyzed and partially denervated. Our objective was to develop an animal model of this clinical condition to evaluate strategies to improve voluntary muscle strength. To do so, we examined the spinal and peripheral innervation of the flexor digitorum superficialis brevis quinti (FDSBQ) muscle of the rat foot, characterized the muscle and motor unit properties, and located the FDSBQ motoneurons. Retrograde labeled motoneurons were in L4 to L6 spinal cord. Unilateral stimulation of L4 to S1 ventral roots and recording of evoked force showed that FDSBQ motor axons exited via two ventral roots (L5 and L6 or L6 and S1) in 38% of rats and via one ventral root in 62% of rats. FDSBQ motor axons traveled via two peripheral nerves, the lateral plantar (76% of axons) and sural nerves (24%). Each ventral root contributed motor axons to each nerve branch. Thus, by combining conduction block of one peripheral nerve to induce partial muscle paralysis and ventral root section to induce partial denervation, it is possible to produce in one rat muscle the consequences of many human cervical spinal cord injuries. FDSBQ muscles and motor units were mainly fast-twitch, fatigable, and composed of fast-type muscle fibers. The narrow range of motor unit forces (1-13 mN), the low mean twitch force (5.1 +/- 0.3 mN), and the large number of motoneurons (31 +/- 4) suggest that rat FDSBQ muscle is a good model of distal human musculature which is frequently influenced by spinal cord injury. We conclude that the FDSBQ muscle and its innervation provide a useful animal model in which to study the consequences of many spinal cord injuries which spare some descending inputs but also induce substantial motoneuron death near the lesion.

Afferent control of central pattern generators: experimental analysis of scratching in the decerebrate cat.

Systematic quantitative analysis of changes in the spinal scratching generator motor activity evoked by tonic and phasic peripheral afferent signals during "fictitious" scratching was carried out in the cat. Correlations between the kinematics of hindlimb scratching movement, sensory inflow, and primary afferent depolarization were investigated. Reliable correlations between the parameters of generator motor activity during fictitious scratching were revealed: they depended on tonic peripheral afferent inflow. The functional role of these dependencies consists of providing stability for aiming the hindlimb to the itch site. It was shown that scratching generator reaction to a phasic sensory signal depended significantly on afferent input, signal intensity, and its arrival phase in the cycle of motor activity. Phase correction of "scratching" rhythm was performed by inhibition of the current stage of "scratching" cycle, the inhibition magnitude depending on the intensity of a sensory signal run along high threshold afferent fibers. The moments in the scratching cycle, in which the afferent signal caused no rearrangement in scratching generator activity, were discovered for all investigated afferent inputs. These moments corresponded to the transitions from one scratching cycle phase to another. Integral afferent activity was distributed unevenly in the cycle during real scratching. The main part of it was observed just in that scratching cycle part which included the above mentioned no rearrangement phase points. The data obtained allowed us to conclude that the scratching generator should be considered as a working program for the motor optimal control system containing the intrinsic model of the controlled object dynamics (e.g. hindlimb scratching movement dynamics), which produces an inner analog of peripheral flow. This inner flow interacts with peripheral afferent inflow just as one of the latter components. Centrally originated modulation of primary afferent depolarization is a result of affecting the depolarization generating system by this inner "sensory" activity. It is the model, with the aid of which the generator can work after deafferentation. The functional organization of a central pattern generator is considered.

Afferent control of central pattern generators: experimental analysis of locomotion in the decerebrate cat.

Changes in the motor activity of the spinal locomotor generator evoked by tonic and phasic peripheral afferent signals during fictitious locomotion of both slow and fast rhythms were analysed in the cat. The tonic afferent inflow was conditioned by the position of the hindlimb. The phasic afferent signals were imitated by electrical stimulation of hindlimb nerves. The correlation between the kinematics of hindlimb locomotor movement and sensory inflow was investigated during actual locomotion. Reliable correlations between motor activity parameters during fictitious locomotion were revealed in cases of both slow and fast "locomotor" rhythms. The main difference between these cases was that correlations "duration-intensity" were positive in the first and negative in the second case. The functional role of "locomotor" pattern dependence on tonic sensory inflow consisted of providing stability for planting the hindlimb on the ground. For any investigated afferent input the phase moments in the "locomotor" cycle were found, in which an afferent signal caused no rearrangement in locomotor generator activity. These moments corresponded to the transitions between "flexion" and "extension" phases and to the bursts of integral afferent activity observed during real locomotion. The data obtained are compared with the results previously described for the scratching generator. The character of changes in "locomotor" activity in response to tonic and phasic sensory signals was similar to that of such changes in "scratching" rhythm in the case of fast "locomotion". Intensification of the "flexion" phase caused by phasic high-intensity stimulation of cutaneous afferents during low "locomotor" rhythm was changed to inhibition (such as observed during "scratching") when this rhythm was fast. It is concluded that the main regularities of peripheral afferent control for both the locomotor and scratching generators are the same. Moreover, these central pattern generators are just working regimes of a general spinal motor optimal control system containing the intrinsic model of limb movement dynamics. The consequences of this concept and ways of further research are discussed.

[Autologous transfusion of UV-irradiated blood in the treatment of occlusive arterial diseases of the lower extremities]. / Autotransfuziia UFO-krovi v lechenii obliteriruiushchikh zabole- vanii arterii nizhnikh konechnostei.

Complex examination of 72 patients with obliterating atherosclerosis and 10 patients with obliterating endarteritis was performed. All the patients were given autotransfusion of UV-irradiated blood as conservative treatment, preoperative preparation and postoperative management. The course of AUVIB was followed by a decrease of the lactic acid level, increase of functional properties of hemoglobin, activation of humoral immunity, change of the blood hemostatic potential to the side of hypocoagulation. The AUVIB treatment was most effective in patients at initial stages and those with peripheral forms of the disease.

[Changes in the intensity of integral afferent inflow from limb receptors and the level of polarization of primary afferent endings in the decerebrate cat during scratching]. / Izmeneniia intensivnosti integral'nogo afferentnogo pritoka ot retseptorov konechnosti i urovnia poliarizatsii terminalei pervichnykh afferentov u detserebrirovannoi koshki vo vremia chesaniia.

The experiments performed on decerebrated cats have shown that afferent activity during scratching consisted of two components--tonic and periodic phasic ones. The first component was determined by the limb position, the second was closely related to the amplitude and velocity of joint angle changes. Maximum of integral afferent activity in the cycle coincided with the scratching jerk phase. These two components of afferent activity evoked corresponding depolarization changes in primary afferent terminals and these changes added to those elicited by central generator. Statistical correlations between the aforementioned parameters were studied. The afferent control mechanisms of scratching generator are under discussion.

[Changes in the segmental reactions in the decerebrate cat during scratching and locomotion]. / Izmeneniia nekotorykh segmentarnykh reaktsii u detserebrirovannoi koshki vo vremia chesaniia i lokomotsii.

Experiments on decerebrate cats have shown that N1 component potential of dorsal surface and dorsal root potential elicited by electrical stimulation of paw plantar surface tonically decrease during locomotion and scratching. Phase changes occur against a background of tonic changes in the rhythm of limb movements. The dynamics of the observed changes correlates well with that of primary afferent depolarization during these movements. It is concluded that presynaptic inhibition underlies the changes in segmental reactions.

[Interrelation of the kinematics of hindlimb movement and efferent activity in the decerebrate cat during scratching]. / Vzaimosviaz' kinematiki dvizhenii zadnei konechnosti i éfferentnoi aktivnosti u detserebrirovannoi koshki vo vremia chesaniia.

Statistical dependence between parameters of hindlimb scratching movements and muscle electrical activity was studied in decerebrated cat during real scratching. Power of electrical signal to scratching and aiming muscles and duration of aiming muscle activity are determining factors of movement parameters (amplitude, velocity and phase duration). Experiments with limb deafferentation had shown that statistical dependences between movement parameters and muscle electrical activity reflect the peculiarities of the scratch generator functioning. Some investigated statistical dependences change under the afferent signal influence.

[Structural organization and connections of the locomotor strip of the medulla oblongata of the cat]. / Issledovanie strukturnoi organizatsii i sviazei lokomotornoi poloski prodolgovatogo mozga koshki.

The bulbar locomotor strip was studied by means of the horse-radish peroxidase technique. HRP microinjections were carried out under functional control of the evoked treadmill locomotion. The experiments have failed to reveal a special cellular column along the locomotor strip and the existence of such a strip as a separate structural formation is questioned. In fact the bulbar locomotor strip may conceal the spinal trigeminal tract and its nucleus. It is postulated that nonspecific afferent activation of the brainstem reticular formation plays a significant role in the locomotion initiation.

[Surgical treatment of magistral vein injuries]. / Khirurgicheskoe lechenie povrezhdenii magistral'nykh ven.

The article generalizes the experience with the surgical treatment of 83 patients with injuries of major veins. The integrity of injured veins in 71 patients was restored by reconstructive operations. Good and satisfactory results were obtained in 71 patients. The method of choice of the surgical treatment of major veins is reconstructive operation on the vessels.

[New locomotor areas of the brain stem of the cat]. / Novye lokomotornye oblasti stvola mozga koshki.

New sites in the brainstem eliciting treadmill locomotion have been revealed in decerebrated cats by means of electrical stimulation. These sites--cochlear nuclei, ventral spinocerebellar tract and resciform body which includes dorsal spinocerebellar tract--are located outside the known locomotor regions. It is suggested that the nonspecific afferent activation of the brainstem reticular formation during electrical stimulation of the mentioned sensory tracts is sufficient for the initiation of the treadmill locomotion.

[Efferent projections of neurons of the mesencephalic locomotor region of the cat brain]. / Efferentnye proektsii neironov mezentsefalicheskoi lokomotornoi oblasti mozga koshki.

Efferent projections of mesencephalic locomotor region neurons were studied by means of horseradish peroxidase technique in cat. Ascending and descending projections of these neurons to different structures of the brain with predominant course to the brainstem reticular formation were traced. Some fibres passed through the bulbar and spinal locomotor strip. Mutual bilateral interconnections of the mesencephalic locomotor regions were observed.

[Depolarization of primary afferents of the lumbosacral division of the spinal cord during real locomotion]. / Depoliarizatsiia pervichnykh afferentov poiasnichno-kresttsovogo otdela spinnogo mozga pri real'noi lokomotsii.

Changes of polarization of central afferent terminals during evoked locomotion of mesencephalic cats were studied in lumbar spinal cord. Significant part of primary afferent depolarization was shown to be evoked by afferent impulsation; intensity of such impulsation increased during limb flexion and decreased during extension.

[Depolarization of primary afferents during real scratching in the cat]. / Depoliarizatsiia pervichnykh afferentov vo vremia real'nogo chesaniia u koshki.

Changes in depolarization of primary afferents and their correlation with afferent impulsation and limb movement were studied in the lumbar spinal cord during real scratching of decerebrated cats. Two components in rhythmic dorsal root potential were observed. First--centrally evoked, retained during fictitive scratching after immobilization; second--evoked by afferent discharge, coming to the spinal cord during the scratching phase of the limb movement.

[Phase-frequency characteristics of afferent activity and depolarization of primary afferents during passive displacement of the hindlimb of the cat]. / Fazovo-chastotnye kharakteristiki afferentnoi aktivnosti i depoliarizatsii pervichnykh afferentov pri passivnom peremeshchenii zadnei konechnosti koshki.

Frequency response characteristics of afferent activity and primary afferent depolarization (PAD) evoked by this activity were investigated in decerebrated cats during passive movement of hindlimb in ankle joint. At the frequencies of 0.2-1.7 Hz the lead of the level of depolarization was determined by the value of phase changes of afferent activity. Above 1.7 Hz a phase lag of the level of depolarization was observed. This lag was caused by the dynamic properties of PAD generation system.

[Depolarization of primary afferents evoked by cyclically modulated natural activity of proprioceptors of the hindlimb of the cat]. / Depoliarizatsiia pervichnykh afferentov, vyzvannaia tsiklicheski modulirovannoi estestvennoi aktivnost'iu propriotseptorov zadnei konechnosti.

The primary afferent depolarization (PAD) evoked during passive sinusoidal movements of a hindlimb in the ankle joint was investigated in decerebrated cats. The frequency of movements varied within 0.14-5.0 Hz, the amplitude of the joint angle with respect to the axis of the tibia changed from 90 degrees to 130 degrees. The dorsal root potential (DRP) negativity increased both during flexion and during extension of the joint. The amplitude of the evoked DRPs was about 50-100 mV. A strong negative correlation was observed between the latency and rise time of the DRP and the frequency of the joint angle changes. During flexion the latency changed from 650 ms at 0.14-0.16 Hz frequency to 100-110 ms at 2.0 Hz and higher frequencies; during extension at the same frequencies the latency changed from 300 ms to 80-85 ms. The latency and rise time became minimal at 2.0 Hz frequency and practically did not change during the further increase of the oscillation frequency. The cord dorsum potential (CDP) evoked by the cutaneous nerve stimulation was recorded in parallel with the DRP. Periodical changes of the N-component of the CDP were in the opposite phase to changes of the DRP. Mechanisms of the observed changes of the PAD and functional significance of these changes during rhythmical motor acts are discussed.

[Changes in the excitability of central endings of the superior laryngeal nerve following activation of the respiratory center]. / Izmenenie vozbudimosti tsentral'nykh terminalei verkhnegortannogo nerva pri aktivatsii dykhatel'nogo tsentra.

Changes in polarization of central afferent terminals of the superior laryngeal nerve with variations in the level of the respiratory generator activity evoked by a short (up to 1 min) asphyxia were investigated in experiments on anesthetized and paralyzed rabbits using Wall's method. Antidromic responses decreased up to 5-20% of the control level during activation of the respiratory generator with an increase in frequency and amplitude of rhythmic discharges in the phrenic nerve evoked by a short asphyxia. It is supposed that the primary afferent polarization depends not only on the level of afferent inflow but also on the activity of the central respiratory generator.