[Normoxic therapeutic compression in stroke treatment]. / Normoksicheskaia kompressiia v lechenii insul'ta.

Objective. To analyze the effect and mechanisms of therapeutic compression in stroke. Material and methods. Clinical efficacy of normoxic therapeutic compression (NTC) was studied for two hyperbaric therapeutic regimes in patients with ischemic stroke of moderate severity. Results and conclusion. The therapeutic effect of the method was caused by the effect of excessive pressure on the energy metabolism, but not by the hyper oxygenation, with the elevation to normal pC02 and CO2 content in the exhaled air. The effect is stable only in the range 1.05-1.1 ATA and increased from session to session. In this range, there were the activation of energy metabolism and the recovery of cerebral microcirculation with the normalization of the acid-base state (ABS) and lipid peroxidation (LPO). The more excessive pressure in the pressure chamber (1.15-1.2 ATA ) resulted in less treatment effect, decreased pC02, increased blood plasma viscosity, worse AAE parameters and LPO activation. The degree of blood plasma oxygenation proved to be the main feature of hyperbaric therapeutic regimes studied.

[Immunological markers of severity and outcome of traumatic brain injury].

A microscopic immunological study of cerebral spinal fluid (CSF) of 100 patients with traumatic brain injury (TBI) of different severity was carried out in the 1st, 10th and 21st days after trauma. The content of antibodies to basic myelin protein (BMP) and phospholipids (PL) significantly differed from that in the control group (patients with soft tissue head injuries without TBI) and was significantly higher in patients with severe TBI. The level of antibodies to BMP in the CSF was strongly correlated with scores on the Glasgow Coma Scale in the 1st day after TBI and the degree of recovery of neurological status in the 21st day. The level of antibodies to PL was strongly correlated with the severity of cytosis, content of CSF erythrocytes and proteins. The correlation between antibodies to BMP and antibodies to PL was weak. The different diagnostic value of antibodies to BMP and to PL in the most acute period of TBI was found. In conclusion, content of antibodies to BMP may be used as a marker of TBI severity and outcome while the significant elevation of antibodies to PL indicates the severity of vascular complications of trauma.

[The normoxic therapeutic compression effect on microcirculation in acute stroke].

The study evaluates efficacy of two hyperbaric therapeutic regimes--1,-51,1 atm and 1,2 atm in patients with an acute ischemic stroke. Acid-base equilibrium dynamics of capillary and venous blood, whole blood and plasma, platelet aggregation and lipid peroxidation were investigated. An analysis of the data revealed that, comparing to the conventional method, barotherapy in stroke is accompanied by a marked therapeutic effect. Barotherapy or normoxic therapeutic compression is principally different from other methods of oxygen therapy, because it is not resultant in blood plasma hyperoxygenation and in lipid peroxidation augmenting. Activation of tissue respiration in barotherapy accompanied by normalization of lipid peroxidation process and CO2 resources restoration leads to renewal of MKT microcirculation and autoregulation, thus providing a stable therapeutic effect of the method in brain ischemia.

[Barotherapy in cerebrovascular diseases]. / Baroterapiia pri sosudistykh zabolevaniiakh mozga.

It has been shown that the main problem of treating patients with cerebral ischemia using minimal excessive pressures is the choice of the optimum therapeutic dose. We propose a new method of treatment for cerebral vascular disorders with an application for minimum high pressure doses (< 1.1 ata with oxygen a air mixture). The aim of the present report is to summarize clinical results of this method and to estimate the mechanisms of its action. The main feature of the method described (barotherapy) is to bring external and cell respiration and recovery of oxygen autoregulation of cell respiration to normal values in patients with increased CO2 inner production. The administration of antioxidants transporting electrons on mitochondrial respiratory chain significantly improves the clinical outcome after barotherapy and leads to stabilization of lipid peroxidation.

[An evaluation of the immunotropic and hemopoietic effects of hyperbaric oxygenation as an experimental pathological model]. / Otsenka immunotropnogo i gemopoéticheskogo éffektov giperbaricheskoi oksigenatsii v kachestve éksperimental'noi patologicheskoi modeli.

Apoptosis, programmed cell death, being a physiological process is manifested by degenerative changes of the cell structures. Augmentation of apoptosis or distributed receptor-signal interaction of the cells may be caused by the toxic products of radiolysis and cancerogenesis. Hyperbaric oxygenation (HBO) was used as a model resembling apoptosis. The parameter of the humoral immune response to different HBO regimens and correction of immunodepression by a carotene-tocopherol complex (CTC) were compared. The next stage in the study of the CTC antioxidant effect in gamma-radiation was determination of the extent of endogenous colony formation under the influence of different HBO regimens. A moderate immunodepressive effect of HBO was noted. Combination of CTC and HBO in small regimens induced a moderate immunostimulating and hemopoietic response. The suggested pathological model may be used in study of antioxidants. CTC showed hemopoietic and immunocorrective action.

[The effect of different hyperbaric oxygenation regimens on the aggregate status of the blood and on the free-radical oxidation processes in patients with the initial manifestations of cerebral blood supply failure]. / Vliianie razlichnykh rezhimov giperbaricheskoi oksigenatsii na agregatnoe sostoianie krovi i protsessy svobodnoradikal'nogo okisleniia u bol'nykh s nachal'nymi proiavleniiami nedostatochnosti krovosnabzheniia mozga.

Blood rheology, hemocoagulation, free-radical oxidation, acid-alkaline condition of the capillary and venous blood were investigated in 62 ICIB patients before and after treatment which consisted of 8 hyperbaric oxygenation (HBO) sessions or 3 HBO sessions (1.5 atm and 1,2 atm, respectively), the rest patients were not exposed to HBO. The best therapeutic results were achieved with a short-term HBO at a small excessive pressure. The longer HBO regimen provided no positive tendencies in clinical parameters. On the contrary, it provoked blood rheology deterioration, activation of free-radical oxidation stemming from diminished adaptation to hyperoxia in ICIB.

[Effects of different regimens of hyperbaric oxygenation on transcriptional activity and morphology of frontal cortex neurons in occlusion of the common carotid artery in rats]. / Vliianie razlichnykh rezhimov GBO na transkriptsionnuiu aktivnost' i morfologiiu neironov lobnoi kory pri okkliuzii obshchei sonnoi arterii u krys.

The effect of different regimens of hyperbaric oxygenation (HBO) on cortical pyramids morphology and transcription were studied under occlusion of common arteria carotis. The effect of early (3 hours after occlusion) and late (14 hours after occlusion) use of 1.2 and 2.0 ata of HBO was estimated. The rats were killed 15 minutes or 24 hours after HBO session. The effect of early use of HBO was normalizing, stabilizing and independent on the dose. Protecting effect of the late HBO on morphology and transcription activity of nuclear chromatin of pyramids was higher in the 1.2 ata regimen. In case of late HBO both pressures produced depressing effect on the nucleoplasmic chromatin, transcription.

[Effects of different doses of hyperbaric oxygenation on morphology and transcription of cortical neurons of rats with experimental cerebral ischemia]. / Issledovanie vliianiia razlichnykh rezhimov GBO na morfologiiu i transkriptsiiu neironov kory krys s éksperimental'nym insul'tom.

Its effect of hyperbaric oxygenation (the doses 1.2 and 2 ata) on cortical pyramids of the rats with one-or both-side ligation of common arteria carotis 2.5 or 24 hours after operation was studied. The neuron survival and transcription activity were estimated. In all experimental situations except the most serious, e.g. 24 hours after the both-side artery ligation, the dose 2 ata was more effective. On the contrary, in most serious cases the dose 1.2 ata or applying in the baro-camera the air instead of oxygen provided the better result.

[Use of hyperbaric oxygenation in the treatment of acute cerebrovascular disorders in ischemic heart disease]. / Primenenie giperbaricheskoi oksigenatsii v lechenii ostrykh tserebrovaskuliarnykh rasstroistv pri ishemicheskoi bolezni serdtsa.

Altogether 22 patients with concomitant cardio-cerebral acute pathology underwent all-round examinations during and after sessions of hyperbaric oxygenation (HBO). The highest clinical effect was produced by minor, substituting doses of HBO. The revealed phasic nature of the action of HBO in the treatment of patients with acute large-focal myocardial infarction and acute cerebrovascular disorders was found to be due to changes in the function of diencephalic and brain stem formations, determining the decrease of adaptation potentialities in this patients' group. HBO was found to be clinically effective in the treatment of such patients. In order to raise the treatment efficacy, it is necessary that an individual approach be exercised in the choice of therapeutic HBO sessions.

[Clinico-metabolic status of fetuses and newborn infants with fetal macrosomia]. / Kliniko-metabolicheskii status ploda i novorozhdennogo pri rozhdenii s krupnoi massoi tela.

A study was made of the development of large fetuses during pregnancy with regard to the clinical picture, ultrasound screening of the placenta and fetuses, biochemical and immunological monitoring of blood of pregnant women, fetuses and neonates. 172 pregnant women were placed under observation. Of these, large fetuses (the main group) were born in 70 cases, whereas in 102 cases, the fetuses were of medium body weight (the control group). The comparison of the data obtained allows a conclusion that macrosomia gives rise to the acceleration of maturation of the fetal organs and systems, to the intensification of metabolism within the system mother--placenta--fetus.

[Mechanisms of the therapeutic effect of hyperbaric oxygenation in minor differential pressure in stroke]. / O mekhanizme lechebnogo deistviia giperbaricheskoi oksigenatsii pri malom izbytochnom davlenii pri mozgovom insul'te.

Analysis is made of a complex of clinicoelectrophysiologic, biochemical and biophysical studies conducted in 220 patients with brain stroke, receiving a course of hyperbaric oxygenation (HBO) at minor differential pressure (1.2-1.3 absolute atmospheres). It is shown that HBO can be applied as pathogenetic therapy in patients afflicted with brain stroke. It produces a marked clinical effect and normalizes EEG, REG and acid-alkaline balance, brings about a decrease of initially high lipid peroxidation (LPO), activating antioxidative processes and superoxide dismutase. However, such an effect is only produced by the first HBO sessions at minor differential pressure, which is likely to be due to the substitution action of hyperoxia and activation of antioxidative processes. The studies thus made validate the efficacy of short-term sessions of HBO in patients with brain stroke and the possibility of hyperoxia over-dosage in patients with disturbed antioxidant defence.

[Mechanisms of action of hyperbaric oxygenation in ischemic stroke]. / Mekhanizmy deistviia giperbaricheskoi oksigenatsii pri ishemicheskoi insul'te.

A comprehensive clinico-polygraphic study (EEG, ECG, REG, sphygmography of the temporal arteries, phlebography of the jugular veins) of 60 patients with ischemic stroke before, during and after hyperbaric oxygenation (HBO) was carried out to investigate the mechanisms of action of HBO in ischemic stroke and to develop the most effective schedules of HBO. Acid-base balance was determined in all patients. The authors elucidated that the effect of HBO on the functional status of the vessels of the intact and impaired hemisphere in hemispherical ischemic stroke was phasic and nonunitary. The authors describe the most effective schedules of HBO and the optimum duration of the therapeutic course. The pathogenetic orientation of the suggested schedules of HBO in ischemic cerebral stroke was shown. The basis of the therapeutic effect of HBO is the liquidation of metabolic acidosis in the ischemic focus in the brain and normalization of the functional status of the cerebral vessels and brain.

[Various pathogenetic mechanisms of ischemic stroke in cardiac rhythm disorders]. / Nekotorye patogeneticheskie mekhanizmy ishemicheskogo insul'ta pri narusheniiakh serdechnogo ritma.

Computerized results of polygraphic examinations of EEGs, ECGs, sphygmograms of the temporal artery, and phlebograms of the jugular vein carried out in 60 patients with a history of ischemic stroke and attendant heart rhythm disorders are discussed. The control group comprised 30 practically healthy subjects. The studies showed that in cases of ischemic stroke, there is a direct relationship between the degree of changes in the cerebral bioelectric activity and the intensity of disorders in general hemodynamics, which may be accounted for by the disruption of the vascular tone autoregulation, largely on the side of the ischemic focus.