[Antioxidant therapy in ischemic stroke]. / Antioksidantnaia terapiia pri ishemicheskom insul'te.

The paper presents the results of investigation of emoxipin, an antioxidant synthetic drug, for treatment of patients with ischemic disorders of cerebral circulation. The drug produced a beneficial clinical effect in patients with lacunar and cardioembolic strokes of moderate severity. Therapy with emoxipin increased endogenic antioxidant activity and improved a clinical status of the patients. The protective effect of carnosine was demonstrated in experimental acute hypobaric hypoxia and cerebral ischemia in rats. The results obtained permit to recommend an inclusion of both emoxipin and carnosine in a combined treatment of ischemic disorders of cerebral circulation.

[The dynamics of lipid peroxidation in patients with acute disorders of the cerebral circulation of an ischemic nature]. / Dinamika perekisnogo okisleniia lipidov u bol'nykh s ostrymi narusheniiami mozgovogo krovoobrashcheniia ishemicheskogo kharaktera.

Lipid peroxidation (LP) was analysed in the blood and atherogenic lipoproteins of 36 patients with ischemic stroke in the internal carotid arteries at the acute stage (1, 7 and 21 days). During 1-7 days 22 patients (group 1) were treated with haemocorrecting drugs (rheopolyglucin, euphyllin, aspirin, curantyl, trental) and 14 patients (group 2) were treated with vasoactive and metabolic drugs (cavinton, complamin, actovegin). On days 8-21 all the patients received the same treatment: pyracetam and essential. Before the treatment both activation of LP and exhaustion of endogenic antioxidant background were observed in blood samples of all the patients. Significant changes of LP parameters were observed in group 1 up to day 7, but they reached the basic level on the 21 day. No significant changes were observed in group 2. Thus, haemocorrecting drugs had some antioxidant effects, but to provide a steady antioxidant effect it is necessary to use special antioxidants.

[A disorder of serotonin metabolism in patients in the acute period of nontraumatic intracranial hemorrhages]. / Narushenie obmena serotonina u bol'nykh v ostrom periode netravmaticheskikh vnutrimozgovykh krovoizliianii.

The indices of serotonin metabolism in cerebrospinal fluid (CSF) and blood were studied in 43 patients with nontraumatic intracerebral hemorrhage in the interval from 1 - 2 to 28 days after the onset of the disease. The considerable increase of tryptophan, serotonin and its main metabolite 5-hydroxyindoleacetic acid (5-HAA) in CSF and blood was found. The relationship between liquor and blood serum serotonin levels, hemorrhage focus size, severity and outcome of disease was also observed. There were no significant differences between serotonin, 5-HAA, free and bound serotonin levels in patients with the break of blood into different part of liquor space. The possible mechanisms of alteration of serotonin metabolism in patients with intracerebral hemorrhage were discussed.

[Effect of a new Soviet-made antioxidant on the processes of lipid peroxidation in the treatment of patients with transient cerebro- vascular diseases and circulatory encephalopathy]. / Vliianie novogo otechestvennogo antioksidantaémoksidina na sostoia- nie perekisnogo okisleniia lipidov pri lechenii bol'nykh s narushe- niiami mozgovogo krovoobrashcheniia i tsirkuliatornoi éntsefalopatii

The authors present for the first time the results of investigation and treatment of 55 patients with transitory cerebral circulation disorders (TCCD) and circulatory encephalopathy by the new antioxidant drug emoxipine . The drug was noted to produce a beneficial clinical effect in 39 patients. After emoxipine treatment the patients demonstrated an increase of the endogenous antioxidants, evidence of the formation of the antioxidant depot. In the patients suffering from TCCD, the content of endogenous antioxidants did not differ from normal both before and after the treatment. Improvement of the patients' clinical status correlated with the drug dose and changes in lipid peroxidation. In patients with deterioration of the health status and without any changes, the dose-dependent effect was not recorded.

[Status of microcirculation and rheological properties of blood in patients with cerebral circulatory disorders]. / Sostoianie mikrotsirkuliatsii i reologicheskikh svoistv krovi u bol'nykh s distsirkuliatornoi éntsefalopatiei.

Microcirculation and rheological properties of blood were investigated over time on the basis of the findings of biomicroscopy of the bulbar conjunctiva in 61 patients with different stages of circulatory encephalopathy in the presence of arterial hypertension and atherosclerosis. Rheological properties of blood were changed at all stages of disease. Correlations between the ability of erythrocytes to aggregation and the degree of their intravascular aggregation by the findings of biomicroscopy of the bulbar conjunctiva were not found. The importance of investigation of the intravascular aggregation of erythrocytes and theological properties of blood for assessment of the cerebral vascular microcirculation, control of therapy, and verification of some aspects of the mechanism of action of various drugs was shown.

[Clinical course of the initial manifestations of cerebrovascular insufficiency in arterial hypertension]. / Klinicheskoe techenie nachal'nykh proiavlenii nedostatochnosti krovosnabzheniia mozga pri arterial'noi gipertonii.

A study was made of the catamnesis of 96 patients with the initial manifestations of brain blood supply insufficiency. After the first examination under inpatient conditions the patients were followed up for up to 7 years on the average. During the observation period, 56 patients demonstrated an increase of cerebral complaints and their enhancement as regards the intensity. It should be noted that the patients' age did not produce any influence on the increment of cerebral complaints. During the same observation period, 49% of the patients manifest different acute disorders of cerebral circulation. Despite the apparent relatively mild and reversible clinical signs, the initial manifestations of brain blood supply insufficiency should be viewed as progressive vascular diseases of the brain. Taking into account the data obtained, it is advisable that this patients' group is to be followed up with a purpose of carrying out the treatment and prophylactic measures.

[Dynamics of blood serotonin contents in acute disorders of cerebral circulation and circulatory encephalopathy]. / Dinamika soderzhaniia serotonina v krovi pri ostrykh narusheniiakh mozgovogo krovoobrashcheniia i distsirkuliatornoi éntsefalopatii.

Blood serotonin levels have been measured by spectrofluorometry in 145 patients with various manifestations of acute disorders of the cerebral circulation (ADCC): with ischemic stroke, cerebral hypertensive crises, transient impairments of the cerebral circulation, and with circulatory encephalopathy (DE) in the presence of arterial hypertension combined with atherosclerosis. In ADCC patients the blood serotonin has been measured 7 times, in DE ones 3 times. This level has been found changed in the patients with ischemic stroke and with cerebral hypertensive crises for a long time after the cerebral circulation impairment. Serotonin levels correlated with the condition severity and course in ADCC and DE. The vestibulocerebellar syndrome in DE has been treated more effectively, particularly with trental. The blood serotonin level may be regarded as a prognostic criterion of the disease outcome and of the treatment efficacy.

[Dynamics of the histamine content and diamine oxidase activity of the blood in patients with ischemic stroke and transient disorders of cerebral blood circulation]. / Dinamika soderzhaniia gistamina i aktivnosti diaminoksidazy v krovi u bol'nykh s ishemicheskim insul'tom i prekhodiashchimi narusheniiami mozgovogo krovoobrashcheniia.

Ninety-four patients with acute impairments of the cerebral circulation (AICC) were studied for the activity of diamine oxidase and histamine levels in the blood. It was found for the first time ever that the activity of diamine oxidase was reduced in the precrisis period and in the first hours of the AICC development, and showed a tendency to rise thereafter. The histamine levels were elevated already in the precrisis period and remained high throughout the acute period of cerebral circulatory impairment. The levels of histamine and activity of diamine oxidase are determined by the previous (occurring several days earlier) impairments of the cerebral circulation. Histamine and diamine oxidase play an active part in the pathogenesis of AICC which is of practical significance in the treatment of not only ischemic stroke but also of transient impairments of the cerebral circulation.

[Prognostic significance of changes in the levels of histamine and other factors in patients with acute cerebral circulatory disorders]. / Prognosticheskoe znachenie izmenenii urovnia gistamina i nekotorykh drugikh faktorov u bol'nykh s ostrymi narusheniiami mozgovogo krovoobrashcheniia.

Histamine (H) levels in the cerebrospinal fluid and blood were studied in 95 patients with acute cerebral circulation impairments (ACCI). The results obtained were collated with a number of clinical and biochemical parameters and with some parameters of the gaseous homeostasis. The author used the spectrofluorometric assay of H and serotonin (S) in the biological fluids and was the first to establish an elevation of H levels in the blood and CSF prior to an aggravation of the patient's status, in cases of a remittent course and in protracted hypertensive crises; she also revealed a heterogeneous nature of changes in the blood concentrations of H and S in patients with ACCI, as well as a direct correlation between C concentrations in the blood and pCO2 and an inverse correlation between H levels in the blood and pCO2 levels. It has been demonstrated that in cases of ACCI both H levels, and the H/S ratio and blood gases assessed in combination have prognostic significance. The results obtained have both theoretical and prognostic significance with regard to ACCI research.

[Concentration of histamine in the cerebrospinal fluid of patients with cerebral circulatory disorders]. / O soderzhanii gistamina v spinnomozgovoi zhidkosti bol'nykh s narusheniiami mozgovogo krovoobrashcheniia.

Using the spectrofluorimetric technique, histamine levels in the cerebrospinal fluid were studied in 26 patients, including 22 with impaired cerebral circulation. Correlations were established between the concentration of histamine in the cerebrospinal fluid, the underlying illness, the localization of the impairment focus and the severity of the disease course. The results obtained suggest that histamine, along with other neurohumoral factors, is involved in the system of the pathophysiological mechanisms determining the development and the course of cerebrovascular diseases.