Evaluation of monomeric prolactin level by TRACE method and precipitation with polyethylene glycol.

Prolactin exists in various forms including the monomeric biologically active form (23kDa) and a higher molecular weight form, bound most commonly to IgG, known as macroprolactin (>100kDa). Macroprolactin lacks biological activity and is one of the causes of false-positive results. In Russian Federation the most common method for macroprolactin determination is PEG precipitation test. We had conducted a retrospective analysis of 37 samples of patients with hyperprolactinemia (3 of them were males). The mean age was 30 [25;35] years. Prolactin level was measured by the immunoenzyme method with manual PEG precipitation and TRACE. The mean values found by the immunoenzyme method with manual PEG precipitation were 461,6 [375,0;821,2] mU/l, by TRACE - 449,9 [357,2;749,2] mU/l. The number of patients with normal prolactin levels was 30% (11) confirmed by two methods, high prolactin level at 46% (17). The prevalence of clinical symptoms of hyperprolactinemia was not differ depend the groups. The phenomenon of macroprolactinemia was registered in 32% (12) of patients. In 8 persons of this group normal prolactin level was revealed and in 4 patients hyperprolactinemia was found by TRACE. Measurements of prolactin levels by the TRACE method is useful for correct diagnosis in patients with equivocal results received by traditional method with PEG precipitation.

[The comparative analysis of the results of detection of testosterone in blood serum applying analyzers Architect and Vitros and tandem mass-spectrometry, a highly efficient fluid chromatography technique.]

The testosterone is a key element of hypothalamus hypophysis gonad system. Its physiological role in males is well known and consists primarily in formation of male phenotype and support of spermatogenesis. The evaluation of androgenic status is necessary in case of such wide specter of clinical symptoms and pathological states as hypogonadism, delayed of premature puberty, polycystic ovary syndrome, particular types of cancer, etc. The precise measurements of testosterone concentrations have a decisive value in case of receiving biochemical data for supporting clinical decisions at diagnostic, treatment and prevention of androgenic diseases. The purpose of the study is to carry out a comparative analysis of the results of detection of testosterone in blood serum using analyzers Architect 2000 and Vitros 3600 and applying technique of highly-effective fluid chromatography - a tandem mass-spectrometry. The analysis was applied to samples of blood serum from 230 patients send to the endocrinological research center of Minzdrav of Russia. The comparative analysis of the results of detection of concentrations of testosterone demonstrated consistent difference in absolute values. However, a statistically significant correlation (р < 0,05) between values of testosterone obtained by different techniques was established. The correlation coefficient in different groups of patients made up to 0,894-0,920 and 0,955--0,965 correspondingly to comparing the results of Architect and Vitros and highly-effective fluid chromatography - a tandem mass-spectrometry. The calculated percentage of distribution of the results of detection of content of testosterone by the ranges of expected values demonstrated an admissible comparativeness of obtained results from point of view of practical diagnostic. The choice of technique of detection of biochemical parameters in case of primary diagnostic is very important. However, even more important is the application of the very same technique in treatment and long-term observation of patient.

[Secretion of incretin hormones in people having risk factors for type 2 diabetes mellitus].

AIM: To study the secretion of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP),and glucagon- like peptide 2 (GLP-2) in response to a carbohydrate load in people with risk factors for type 2 diabetes mellitus (DM2) in relation to the type of carbohydrate metabolic disturbances and age. SUBJECTS AND METHODS: One hundred and twenty-seven patients having DM2 risk factors who had not previously received glucose- lowering therapy underwent an oral glucose tolerance test (OGTT). The plasma levels of glucose, insulin, glucagon, GLP-1, GIP, and GLP-2 were determined at 0, 30, and 120 minutes of the test. RESULTS: According to the findings, the patients were divided into 3 groups: 1) normal glucose tolerance; 2) prediabetic states (impaired glucose tolerance and/or impaired fasting glycemia); 3) new-onset DM2. OGTT showed that the secretion of GLP-1 was lower and that of GIP and GLP-2 was higher in patients with DM2. GLP-1 secretion decreased with patient age. CONCLUSION: During OGTT, there is a statistically significantly difference in the secretion of incretin hormones in persons with varying degrees of carbohydrate metabolic disturbances: the peak GLP-1 secretion is the highest in healthy individuals and lowest in the patients with DM2; on the contrary, the peak GLP2 and GIP secretions are the highest in the patients with DM2. This may suggest that GLP-1 and the two other hormones (GLP-2 and GIP) show opposite effect in the regulatory mechanisms of carbohydrate metabolism. GLP-1 secretion is decreased with age, which may be one of the reasons for the higher prevalence of DM2 among the elderly.

[Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus].

AIM: To study the prognostic value of multifocal atherosclerosis (MFA) in patients with diabetes mellitus (DM) at high risk for myocardial ischemia who need coronary angiography (CAG). SUBJECTS AND METHODS: The investigation included 148 patients: 25 with type 1 DM (DM1), 73 with type 2 DM (DM2), and 50 without DM who had undergone CAG. Duplex ultrasound scanning of lower limb vessels and brachiocephalic and renal arteries was carried out in all the patients. RESULTS: Involvement of two or more vascular beds was noted in 60% of the patients with DM1, in 68.4% of those with DM2, and in 34% of those without DM (p < 0.05). Regression analysis showed that the risk factors of MFA were defined to be myocardial infarction (MI) in the history (OR=2.4; p=0.02), DM (OR=3.9; p=0.0002), smoking (OR=2.4; p=0.05), elevated creatinine (OR=6.5; p=0.002) and fibrinogen (OR=6.8, p=0.004) levels. Among the DM patients, there were 26.5% of those who had achieved a main assessment criterion (a combined end point (CEP)), such as death, urgent hospitalization for heart failure, nonfatal MI, nonfatal stroke, lower extremity amputation, double creatinine levels, and achievement of end-stage renal failure during a 24-month follow-up. In patients without carbohydrate metabolic disturbances, this indicator was 12% (p=0.01). During the prospective study, a total of 6.1% of patients died in the DM group; all the patients in the non-DM group completed the study. Calculation of survival rates by the Kaplan-Meier method indicated that the DM patients with concurrent atherosclerotic lesion had achieved CEP significantly more frequently than the comparison group. Such differences were absent among the persons without carbohydrate metabolic disturbances. CONCLUSION: The regression analysis has shown that prior MI, DM, smoking, creatinine and fibrinogen levels are factors associated with the development of MFA in the examined groups. In the patients with DM, concurrent atherosclerosis of two or more vascular beds is an important factor for the progression of cardiovascular and renal diseases.

[Prevalence and risk factors of extra-coronary artery disease in patients with diabetes which confirmed atherosclerosis of coronary arteries].

AIM: To assess prevalence and risk factors of extra-coronary artery disease (peripheral artery (PA) disease (D) of lower extremities (LE), brachiocephalic arterial (BCA) stenosis (S), renal arterial (RA) S in type 1 and 2 (T1 and T2) diabetes (D) patients (P) with confirmed atherosclerosis of coronary arteries (CA). MATERIAL: 100 P (48 with T2D, 18 with T1D, 34 without diabetes - PWD), with hemodynamically significant atherosclerosis of CA confirmed by coronary angiography. METHODS: All patients underwent duplex ultrasonography of PA LE, BCA, RA. Other studies included assessment of clinical characteristics and measurement of the following parameters: profibrogenic cytokines (transforming growth factor [TGF] beta1, matrix metalloproteinase 9 [MMP9], monocyte chemotactic protein-1 [MCP-1], regulated on activation normal T-cell expressed and secreted [RANTES), markers of endothelial dysfunction (von Willebrand factor [VWF], homocystein [HCYST], plasminogen activator inhibitor-1 [PAI-1], vascular cell adhesion molecule [VCAM], soluble intercellular adhesion molecules-1 [sICAM], vascular endothelial growth factor [VEGF], asymmetric dimethylarginine [ADMAD, N-terminal fragment of pro-brain natriuretic peptide (NT-pro BNP), fibroblast growth factor 23 (FGF-23), and fibrinogen. RESULTS: Portions of P with multivessel CA disease were similar in all three groups (T1D - 88.9, T2D - 85.5, WD - 82.3%). Coexistence of atherosclerosis in 2 or more vascular beds was identified in 85.3% of T2D and in 50% of WD P (p = 0.005). In T1D group 61.1 and 11.1% of P had atherosclerosis in 2 and 3 vascular beds, respectively. Levels of profibrogenic cytokines and factors of endothelial activation (RANTES, MMP-9, PAI-I, VCAM, sICAM, ADMA) were significantly higher in P with diabetes vs P WD. P with diabetes and multifocal atherosclerosis demonstrated significant increases of CRP, fibrinogen, NT-proBNP, VWF, PAI-1, ADMA, sICAM, and decrease of GFR compared with P with atherosclerosis in 1 vascular bed. Logistic regression model identified diabetes, reduced renal function, previous myocardial infarction, smoking, ADMA and fibrinogen as factors associated with presence of multifocal atherosclerosis. CONCLUSION: Coexistence of atherosclerosis in two or more vascular beds was more frequent in P with diabetes and hemodynamically significant CA atherosclerosis than in PWD. It was associated with renal and cardiac dysfunction, excessive activation of mediators of inflammation, hemostasis, and factors of endothelial damage.

[A combination of dipeptidyl peptidase-4 inhibitor and metformin in the treatment of patients with type 2 diabetes mellitus: effective control of glycemia, weight, and quantitative body composition].

AIM: To study the impact of intensified therapy with the dipeptidyl peptidase-4 (DPP-4) inhibitor vilagliptin or sulfonylurea (SU) on the control of glycemia, weight, and quantitative body composition in patients with type 2 diabetes mellitus (DM-2) who have failed to achieve compensation during metformin monotherapy. SUBJECTS AND METHODS: Forty patients (mean age 55.0 (range 53.0-60.7) years; disease duration 2.0 (range 1.1-5.0) years) with poor glycemic control (7%

[Role of circulating angiogenic factors in diabetic kidney disease].

This original article contains the authors own data on homeostasis of angiogenic growth factors (vascular endothelial growth factor - VEGF, angiopoietin 1 and 2 - Ang-1, Ang-2) in diabetic kidney disease. The aims of study were evaluation of alteration on serum concentration of circulating VEGF, Ang-l and Ang-2, and of their association with markers of renal damage (albuminuria, glomerular filtration rate) and anemia in patients with diabetes mellitus. We studied 78 patients type I diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Among this group 37patients had chronic kidney disease. The serum level of VEGF was elevated in T1DM patients and was associated with degree of proteinuria. The serum concentration of Ang-2 was higher in patients with chronic kidney disease (T1DM and T2DM), renal failure (T1DM), proteinuria and anemia (T2DM). Ang-2 strongly associated with albuminuria (T1DM and T2DM), glomerular filtration rate (T1DM) and hemoglobin (T2DM). Obtained results demonstrate that levels of VEGF and Ang-2 (but not Ang-1) are raised in patients with diabetic kidney disease and associated with markers of renal damage and anemia. These data indicate the presence of the disturbance of angiogenic growth factors (VEGF, Ang-2) homeostasis and activity in diabetic patients with chronic kidney disease.

[Early erythropoietin deficiency in diabetic kidney lesion].

AIM: To evaluate the renal production of erythropoietin (EPO) in relation to filtration function in patients with diabetic kidney lesion. SUBJECTS AND METHODS: The investigation enrolled 183 patients with types 1 and 2 diabetes mellitus (DM), of whom 128 were diagnosed as having diabetic kidney lesion. Serum EPO levels were measured by enzyme immunoassay. Patients who had a glomerular filtration rate (GFR) of below 15 ml/min/1.73 m2 and received erythropoiesis-stimulating agents were excluded from the investigation. RESULTS: The mean serum EPO levels in the patients with diabetic kidney lesion did not vary with the presence or absence of anemia, the degree of albuminuria, or GFR. A physiological inverse relationship was found between the level of EPO and that of hemoglobin in the blood of the patients with DM without kidney disease and in those with renal lesion and GFR > or = 60 ml/min/1.73 m2. The magnitude of the association of the values increased as GFR was higher. The level of EPO was found to be unassociated with hemoglobin in patients with GFR < 60 ml/min/1.73 m2. CONCLUSION: In the patients with diabetic kidney lesion, serum EPO concentrations did not depend on the stage of chronic kidney disease and the degree of albuminuria in spite of more severe anemia as renal failure progressed. These patients showed inadequate EPO production just in early diminished renal filtration function.

[The saliva cortisol level test using the automatic immunochemical analyzer Cobas e601 (Roche) to diagnose endogenous hypercorticalism in patients with obesity].

The saliva cortisol level test applies to diagnose endogenous hypercorticalism. However the methods of die format immunoassay traditionally used do not make it possible to get the study results on-the-fly. Also, reference interval and optimal takeoffs differ under implementing various techniques of cortisol tests. The purpose of actual study is to investigate the possibilities of electrochemiluminescent technique of testing free cortisol in saliva. The device Cobas e601 was applied to diagnose endogenous hypercorticalism in patients with obesity. The saliva samples were collected at 11 PM from 98 healthy volunteers and 123 patients with obesity (in 45 cases endogenous hypercorticalism was diagnosed). In total, 205 persons donated saliva at 11 PM two days running to evaluate the technique reproducibility. The samples of 197 individuals were frozen to implement the immune-enzyme assay. The minor test with dexamethasone was applied to patients with suspected endogenous hypercorticalism. The diagnosis of endogenous hypercorticalism was finally confirmed after the results of histological analysis of post-operative material or autopsy. Among healthy volunteers, the reference interval on indicators consisted 0.5-9.4 nMol/l. The correlation coefficient under free cortisol measuring at the same time two days running was -0.785. The optimal takeoff to diagnose endogenous hypercorticalism in patients with obesity consisted 9.4 nMol/l, sensitivity--84.4% (95% confidence band 71.2-92.2%), specificity--92.3% (95% confidence band 84.2-96.4%), predictive value of positive result--11.0 (95% confidence band 5.0-23.9), predictive value of negative result--0.17 (95% confidence band 0.08-0.33) and likelihood ratio for positive result--65.1 (95% confidence band 20.4-207.6). The two-fold cortisol test in saliva using immune-enzyme assay and minor test with dexamethasone with their diagnostic capabilities corresponded to one-fold saliva free cortisol test using electrochemiluminescent technique. The one-fold free cortisol test in saliva collected in 11 PM using the analyzer Cobas e601 for electrochemiluminescent immunoanalysis is a convenient and informative endogenous hypercorticalism screening technique in patients with obesity.

[Prevention of iodine deficiency diseases in pregnant and lactating women].

The objective of this work was to evaluate results of control epidemiological studies of iodine-deficiency condition in pregnant and breast-feeding women; the secondary objective was to develop standard prophylactic iodine dose schedule for these patients. The study included two groups of pregnant women treated either with a daily dose of 200 mcg potassium iodide (group 1, n=52) or with 300 mcg Kl/day (group 2, n=69). In all of them, blood TSH, free thyroxin and antithyroid peroxidase antibody levels were measured along with iodine excretion in urine. Thyroid volume was determined by ultrasound. Initially, median urinary iodine excretion in all the patients was 62.7 mcg/l. Three months after onset of the treatment with potassium iodide it significantly increased to 83.5 mcg/l and 1120.8 mcg/l in groups 1 and 2 respectively (p = 0.006 and 0.001). However, the desired level of >150 mcg/l was not achieved. Treatment with KI in the period of lactation within 2 months after delivery resulted in median urinary iodine excretion of = >100 mcg/l in 10.5% of the women in group 1. None of the patients in group 2 showed the required iodine concentration in the urine. It means that the minimal daily prophylactic dose of iodine for pregnant and lactating women should be 300 mg.

[Efficacy and safety of bivalos therapy for postmenopausal osteoporosis. Results of Russian multicenter trial].

AIM: To study effects of one-year therapy with bivalos on mineral bone density (MBD) of the spine in patients with postmenopausal osteoporosis (PMO), effects of bivalos (strontium ranelate) on MBD of the neck of the femur and femur, the levels of bone metabolism markers, quality of life, tolerance of long-term therapy. MATERIAL AND METHODS: The study was made of 60 females aged 54-75 years with PMO. MBD was measured with x-ray absorptiometry in the vertebra and proximal femur. Bone markers in blood serum were detected by enzyme immunoassay. RESULTS: After a year of taking bivalos MBD in lumbar vertebra increased by 4.68 +/- 4.94%, in the neck of the femur--by 2.0 +/- 4.29%, in the proximal femur--by 3.10 +/- 3.34%. A significant 19.5% rise in bone alkaline phosphatase and a 16.5% fall in the level of CT were noted showing a stimulating effect of bivalos on bone formation and an inhibiting effect--on bone tissue resorption. Bivalos treatment raised quality of life of the patients: better motility, regress of depression, improved self-appraisal, decreased number of patients with pain in the spine, attenuated pain. The drug was well tolerated, unwanted effects arose in 15% patients, discontinuation of the drug because of toxicity occurred in 5%. Serious side effects were not observed. CONCLUSION: Strontium ranelate is effective in PMO and is well tolerated.

[Anemia in diabetic nephropathy: prevalence, clinical and pathophysiological aspects].

AIM: To investigate detectability of anemia, its clinical and pathophysiological features in patients with diabetic nephropathy (DN). MATERIAL AND METHODS: The trial included 1020 patients with type 1 and 2 diabetes mellitus (DM). DN was diagnosed in 50% of them. Incidence of anemia was compared in 92 DN patients in type 1 DM and in 230 patients with chronic glomerulonephritis (CGN). Concentration of erythropoietin (EP) in blood serum was measured in 94 DN patients in type 1 and 2 DM. RESULTS: Anemia develops in type 1 and 2 DM patients free of DN and unaffected renal filtration function (glomerular filtration rate--GFR > 60 ml/min 1.73 m2) was 23.3 and 18.3%, respectively. In DN patients incidence rate of anemia depended on GFR and increased with growing severity of renal failure reaching 85.7% in GFR < 30 ml/min/1.73 m2. Development of anemia in DN depended also on protein urine excretion (20.0% in normoalbuminuria, 25.7% in microalbuminuria and 48.2% in proteinuria). Anemia in DN was detected more frequently and was more severe (by hemoglobin reduction) than anemia in CGN in equal GFR. At all stages of chronic disease of the kidneys EP secretion was low normal and independent of Hb and GFR. CONCLUSION: In DN anemia occurs more often and is more severe than in CGN. Anemia results from inadequate production of EP by the kidneys in response to anemia. Thus, early start of its correction is necessary for improvement of quality of life and inhibition of progression of micro- and macrovascular complications of DM.

[The results of the "tiromobil" epidemiological trial of pregnant women in the Russian Federation].

AIM: To study structural and functional changes in the thyroid gland (TG) in pregnant women living in iodine-deficiency regions; to evaluate efficacy of prophylactic measures. MATERIAL AND METHODS: Random sample method was used for examination of 1090 pregnant women living in the regions with different iodine provision. All the participants were examined clinically, measurements were made of thyroid size, TTH, free T4, iodinuria. RESULTS: Iodine salt in household was used only by 17% women. Prophylaxis of iodine deficiency was conducted in 51% pregnant women. Thyroid alterations were detected in 27% examinees, diffuse goiter was diagnosed on the average in 17% pregnant women (in some regions 36%), nodular goiter--in 3.1%, focal goiter alterations of the thyroid--in 4.4%, symptoms of autoimmune thyroid disease--in 2.7%. ldoinuria varied with regions from 72.5 to 150 mcg/l. TTH and T4 levels were mainly normal. Isolated fall of T4 in trimester II and III was registered in 70% pregnant women, low TTH--in 4.4%. CONCLUSION: Most of the pregnant women in the regions studied were at risk of diseases associated with iodine deficiency. Prevention of iodine deficiency is not adequate.

[The angiotensin II inhibition escape phenomenon in patients with type 2 diabetes and diabetic nephropathy].

AIM: To study prevalence and clinical implications of paradoxical rise of angiotensin II (AII) level in blood plasma in long-term therapy with ACE inhibitors in patients with type 2 diabetes mellitus (DM-2) and diabetic nephropathy (DN). MATERIAL AND METHODS: General clinical and hormonal (renin, AII, aldosteron, endothelin-1) examinations were conducted in 62 patients (37 males and 25 females) with DM-2 and DN on long-term ACE inhibitors. Escape of AII inhibition was defined as an increase in plasma AII more than 50 pg/ml corresponding to M+1SD in the control group (normotensive persons free of DM matched by age). Diet salt was controlled in all the patients. RESULTS: The patients received ACE inhibitors for 7.8 +/- 2.6 years. Plasma AII level in the control group was 34.5 +/- 16.1 pg/mL. The patients were divided into two groups according to their levels of AII: more than 50 pg/ml (group 1), less than 50 pg/ml (group 2). AII inhibition escape occurred in 24 patients (39%). No significant difference between the groups was registered by age, diabetes history, albuminuria, blood lipids, glycosylated hemoglobin, mean circadian blood pressure, duration of therapy with ACE inhibitors, intake of diuretics and beta-blockers. Patients of group 1 had a significantly higher cardiac interventricular septum thickness (p = 0.02), were more likely to have akinetic segments of the myocardium (p = 0.05), had lower 24-h urinary potassium (p = 0.03), insignificantly higher renal insufficiency. Plasma renin concentration was higher in group 1 (p = 0.004). AII did not correlate with aldosterone levels in both groups. CONCLUSION: A relatively large percentage of type 2 diabetics with DN is due to AII inhibition escape. It may explain the lack of reno- and cardioprotective effect of rennin-angiotensin-aldosterone system blockade.

[Comparison of the effects of carbohydrate metabolism compensation and atorvastatin treatment on lipid metabolism and C-reactive protein in type 2 diabetes mellitus].

AIM: To compare effects of atorvastatin treatment and carbohydrate metabolism compensation on lipid spectrum and a C-reactive protein (CRP) level in patients with type 2 diabetes mellitus (DM). MATERIAL AND METHODS: The lipid spectrum was studied in a random sample of 165 patients (66 males, 99 females) with type 2 DM (age median 57 years, duration of the disease 7 years). Out of this sample 26 patients with LDLP cholesterol >3 mmol/l were randomized into 2 groups. The study group received 20 mg/day atorvastatin for 3 months, the control group received no inhibitors of GMG-Coa-reductase. The patients' blood was tested for glycosylated hemoglobin, aminotransferase, creatinphosphokinase, total, HDLP, LDLP cholesterol. RESULTS: Changes in the lipid spectrum were detected in 98.2% patients, 42.4% of them had combined dyslipidemia: elevated total cholesterol (TC), LDLP cholesterol, triglycerides (TG) and low HDLP cholesterol. After 3 months of therapy both groups demonstrated the same significant lowering of HbA(1c). The control group had also elevated level of HDLP cholesterol, unchanged levels of TC, LDLP cholesterol, TG. 3-month therapy with atorvastatin lowered TC from 6.41 to 4.76 mmol/l, LDLP cholesterol from 4.19 to 1.87 mmol/l, TGfrom 2.69 to 1.62 mmol/l, apo B from 1.64 to 1.13 mg/dl, raised HDLP from 0.99 to 1.21 mmol/l (p < 0.05). CRP fell from 5.65 to 2.33 mg/dl (p=0.026) irrespective of carbohydrate metabolism compensation (CRP in the control group did not change). CONCLUSION: More than 98% type 2 diabetics have atherognic impairment of the lipid spectrum. Atorvastatin produces an antiatherogenic effect due to both improvement of the lipid metabolism and CRP level reduction irrespective of the degree of compensation of carbohydrate metabolism in type 2 DM

[Central hemodynamic changes in children reoperated on for congenital spinal cord hernia using balanced anesthesia based on midasolam and propofol].

The central hemodynamics was studied and analyzed in 51 patients reoperated on for congenital spinal cord hernia under balanced anesthesia based on midasolam and proforol. The procedure for anesthesiological provision of replastic repair of operated spinal hernia, which is based on propofol of bolus administration of midasolam with a hypnotic appliance, was found to cause no negative hemodynamic effects. When the benzodiazepine antagonist flumazenyl is used, the interval between the end of surgery and tracheal extubation is virtually identical in the propofol and midasolam groups since the intravenous injection of flumazenyl induces a drastic awakening effect.

[Mental disorders in children with congenital meningomyelocele]. / Psikhicheskie narusheniia u detei s vrozhdennoi spinnomozgovoi gryzhei.

The paper is concerned with mental disorders in 82 patients aged 3 to 14 years with a cerebrospinal hernia located primarily in the lumbosacral part of the spine. The majority of children and adolescents with relatively preserved mental development (trained in accordance with the routine school program) manifested borderline disorders that correlated in 90% of cases with the symptoms of compensated hydrocephalus and psychogenic (reactive) formations-- astheno-depressive conditions, reactions and others due to the feeling of physical deficiency (motor insufficiency and disorders of pelvic functions).

[The diagnosis of renal artery stenosis by the data from ultrasonic study methods]. / Diagnostika stenozov pochchnykh arterii po dannym ul'trazvukovykh metodov issledovaniia.

The purpose of the present investigation was to elaborate diagnostic criteria for stenosing of renal arteries according to ultrasonic dopplerography. The investigation included 35 patients suffering from vasorenal hypertension with stenoses of the renal arteries documented by angiography and 63 patients with stage II essential hypertension, who made up the control group. Ultrasonic scanning of the kidneys and dopplerography of the renal arteries were performed with the use of the Acuson-128 ultrasonic system fitted out with a sector transducer operating at a frequency of 3.5 MHz. The authors have devised a method of an ultrasonic study of the renal arteries by means of the posterolateral access. Established criteria for diagnosing stenosis of the renal artery. Among these are a decline of the pulsation index, the resistive index, and the systolic-diastolic velocity ratio as compared to the contralateral artery and nonstenosed renal arteries in the control group patients.