[Acupuncture in the prevention and treatment of stroke: a review of foreign studies]. / Akupunktura v profilaktike i lechenii insul'ta: obzor zarubezhnykh issledovanii.

Acupuncture has been recommended by the World Health Organization (WHO) as an alternative and complementary method for treating stroke and a way to increase the effectiveness of rehabilitation. The data available in the literature suggest that acupuncture has a beneficial effect on the status of patients with stroke. The mechanism of action of acupuncture for stroke includes the following components: 1) stimulation of neurogenesis and cell proliferation in the CNS; 2) regulation of cerebral blood flow; 3) antiapoptosis; 4) regulation of neurotransmitters; 5) improvement of the neuronal synaptic function, stimulation of long-term potentiation; 6) stimulation of neuroplasticity; and 7) decrease in blood-brain barrier permeability. Acupuncture has been proven to have a positive impact on the restoration of stroke-related dysfunctions, such as motor disorders, spasticity, cognitive impairment, and dysphagia. The most commonly used acupuncture points for the treatment of motor disorders are GV20, GB20, LI4, ST36, SP6, LI11, GB39, and motor scalp area; those for the treatment of cognitive dysfunction are GV20 and EX-HN-1, and those for the treatment of dysphagia are GV20, GV16, and CV23. A review of the literature indicates that studies of the clinical potential of acupuncture in the treatment of complications and the prevention of stroke are insufficient. It is assumed that the international community's recent interest in acupuncture methods used in the treatment of stroke will lead to the emergence of new studies and publications.

[The method of cryotherapeutic correction for premature aging and permeability of the blood-brain barrier in Afghanistan veterans with initial manifestations of insufficient blood supply to the brain].

The levels of neurospecific peptides in the systemic circulation and the rate of biological aging of veterans of war in Afghanistan were studied. A significant increase in the level of matrix metalloproteinase-9 reflecting the increased permeability of the blood-brain barrier in the initial manifestations of insufficient blood supply to the brain was found. After a course of general aerocryotherapy the optimization of biological and cardiopulmonary age were marked, which indicates a slowing of the biological aging.

[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.

[Treatment of trophic ulcers of the lower extremities with Trental-400]. / Lechenie troficheskik iazv nizhnikh konechnostei "Trentalom-400".

Thirty-two patients with arterial and venous trophic ulcers were treated by Trental-400 in a dose of 1200 mg a day within 6 months. The full success has been achieved in 65.6% of all cases. Significant progress was in 9.4% of all patients. There were several reasons for no success in other cases. The mains of them are: aterial insufficiency in a complex with an old age, other severe problems, unadequate local therapy.

[The neurohormonal changes in acute pulmonary embolism (clinico-experimental research)]. / Neirogormonal'nye izmeneniia pri ostroi legochnoi émbolii (kliniko-éksperimental'noe issledovanie).

The state of sympathetic-adrenal and adrenocortical systems was studied in experimental massive pulmonary embolism (PE) and also in patients with massive PE or with embolism of pulmonary artery branches. In experimental massive PE the marked stimulation of adrenal medulla cells was due to specific pathophysiological changes. On the contrary, the moderate activation of adrenal cortex cells was due to nonspecific stress factors such as immobilization of the dogs or catheterization of the heart and vessels. The experimental massive PE was characterized by parallel activation of both parts of the sympathetic-adrenal system. A significant rise of cortisol blood concentration was revealed in the patients with massive PE, but not in those with embolism of the pulmonary artery branches or during the first 6 hours of experimental massive PE. Thus, this investigation shows the activation of the sympathetic-adrenal and adrenocortical system during PE and also the dependence of these neurohormonal changes on the volume and duration of embolic occlusion.

[Effects of infusion therapy during anesthesia on circulating blood volume, osmolality and colloid-osmotic pressure]. / Vliianie infuzionnoi terapii vo vremia anestezii na ob'em tsirkuliruiushchei krovi, osmolial'nost' i kolloidno-osmoticheskoe davlenie.

The problems of infusion therapy during anesthesia and surgery, relevant for clinical practice, have been reviewed. The changes in circulating blood volume, plasma osmolality and colloid-osmotic pressure have been studied depending on quantitative and qualitative structure of the infusion therapy as well as on the duration of surgical intervention. The dependence observed indicates that infusion therapy during anesthesia and surgery must not be considered a routine procedure. The data obtained will help practicing anesthesiologists to choose the right technique.

[The sympathetic-adrenal system in experimental massive pulmonary embolism]. / Sostoianie simpatiko-adrenalovoi sistemy pri éksperimental'noi massivnoi legochnoi émbolii.

The density of adrenergic nervous plexus in ventricular myocardium, the concentration of catecholamines in blood and in adrenal medulla were studied on 24 dogs with acute massive pulmonary embolism (MPE) and also on 13 control dogs. Moderate and shortterm activation of adrenal system took place in control group. During the first hour of MPE the activation of both adrenal and mediator systems was revealed. To the six hour of MPE the enlarged activity of adrenal chromaffin cells was maintained, but the density of adrenergic nervous plexus in ventricular myocardium decreased. In cases, when MPE was followed by heart failure, a quick and significant decrease of mediator concentration in myocardium and increase of adrenal medullary cells activity took place. Thus, the velocity of revealed changes may be the reason of transition processes exit to compensative or decompensative state.

[Change in the metabolic functions of the lungs and the content of biologically active substances in the blood of patients with the adult respiratory distress syndrome]. / Izmenenie metabolicheskikh funktsii legkikh i soderzhanie biologicheski aktivnykh veshchestv v krovi bol'nykh respiratornym distress-sindromom vzroslykh.

In 48 patients operated on for peritonitis of different etiology the postoperative period was complicated by the onset of adult respiratory distress syndrome. A considerable increase in the blood level of biologically active compounds (adrenalin, noradrenalin, histamine, serotonin) and the activation of kinin system have been observed. Marked humoral shifts trigger a sequence of reactions manifested in microcirculation disturbances and the onset of tissue hypoxia, thus inducing the damage of metabolic lung functions and the development of adult respiratory distress syndrome.

[Clinical aspects and pathogenesis of infarction of the brain stem]. / K klinike i patogenezu stvolovykh infarktov golovnogo mozga.

Clinical and hemodynamic studies were carried out in 75 patients with stem brain infarction in the acute period, including repeated infarctions. The total rupture of the autoregulatory mechanisms of the brain blood flow was discovered, leading to the development of different phenomena of "brain steal" determining the clinical course of stem brain infarction. In the given pathology, the acute period is characterized by the development of the vicious circle of hemodynamic disorders, which is coupled with pathological dissociation in coagulation hemostasis. The progression of the hemodynamic changes requires pathogenetic correction of central and cerebral circulation.

[Disorders of carbohydrate metabolism and their correction during open heart surgery]. / Narusheniia uglevodnogo obmena i ikh korrektsiia pri operatsiiakh na otkrytom serdtse.

The use of glucose-insulin mixture (0.5 g/(kg.h) glucose and 1 U/(kg.h) insulin) during preperfusion period in 26 cardiosurgical patients subject to cardiopulmonary bypass surgery prevented the disturbances in carbohydrate metabolism, reduced hemoglobin glycosylation, and normalized thromboxane-prostacyclin system functions, as compared to the data obtained in control groups.

[Short-term preservation of venous transplants and evaluation of their viability]. / Nedlitel'naia konservatsia venoznykh transplantov i otsenka ikh zhiznesposobnosti.

A method for short-term (7 days) storage of venous grafts was developed. The grafts were stored in 2% solution of neutral formaldehyde and isotonic buffer solution (Henks' solution). The viability and tissue metabolism were studied in grafts taken from 54 patients who underwent operation for primary varicosity of the lower limb veins without trophic disorders. Light and electron microscopy as well as biochemical tests showed that grafts stored in Henks' solution maintain viability for up to 7 days, while those stored in a 2% neutral formaldehyde solution for 2 days cannot be used as allografts in reconstructive operations on the lower limbs.

[The use of venous allografts in vascular surgery]. / K voprosu o primenenii venoznykh allotransplantatov v sosudistoi khirurgii.

Biochemical, morphological and biomechanic study of various veins which were taken from 54 patients without trophic disorders during phlebectomy and kept for 7 days was made. 2% solution of neutral formalin and isotonic buffer solution (Henx solution) was used; results of the study show, that conserved veins can be used for grafting in arterial reconstructive surgery in cases of absence of autogenous vein material. Optimal period of conservation is 1 day.

[Dynamics of various blood electrolytes in patients with Menière's disease after desiccation]. / Dinamika nekotorykh élektrolitov krovi u bol'nykh bolezn'iu Men'era pri provedenii degidratatsii.

The serum concentrations of Na, K, Ca, and Cl were measured in 25 patients with Meniere's disease. In the patients with hydrops, the concentrations of K, Ca, and Cl were initially increased and during dehydration slightly decreased. In the patients without hydrops, the concentration of K and Ca was near the upper limit and that of Cl was within normal limits. No specific patterns of variations of C, Ca, Cl concentrations were detected in the patients without hydrops. The K:Cl, Ca:Cl and K:Ca ratios were stable in the patients without hydrops and unstable in the patients with hydrops. They depended on the time of dehydration, which suggests that in patients with hydrops compensatory and adaptive mechanisms are persistent and flexible.

[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.

[The use of ketamine in cesarean section]. / Primenenie ketamina pri kesarevom sechenii.

During cesarean section and basal nitrous oxide anesthesia ketamine was given to 31 parturients in an intravenous, drop fashion at a rate of 2 mg/kg/min concurrently with atropine, pipolphen, and droperidol premedication. The objective monitoring of anesthesia by using electroencephalography and blood adrenaline, noradrenaline, and cortisol levels showed that ketamine added to the complex of anesthetics provided a good analgesia and caused no drug-induced fetal depression.

[The humoral regulatory systems in thromboembolism of the pulmonary arteries]. / Sostoianie gumoral'nykh reguliruiushchikh sistem pri tromboémbolii legochnykh arterii.

The work deals with the results of biochemical and angiographic studies in 26 patients with thromboembolism of the pulmonary arteries (TEPA) and pulmonary hypertension of various degree. Acute occlusion of the pulmonary arterial channel calls forth a response of the organism's humoral regulating systems. The degree of hypertension of pulmonary circulation in TEPA, which is determined by the volume of affection of the pulmonary vascular channel, is directly dependent on the functional activity of the adaptation system and the severity of disorders of the intra- and intersystemic connections.

[The status of the adaptation system and hemodynamics in patients with chronic post-embolic pulmonary hypertension]. / Sostoianie sistem adaptatsii i gemodinamiki u bol'nykh s khronicheskoi postémbolicheskoi legochnoi gipertenziei.

The article discusses the results of biochemical, hemodynamic, and angiographic studies in 33 patients with chronic post-embolic pulmonary hypertension of various degree. The authors show that prolonged occlusion of the pulmono-vascular channel causes predominant activity of the sympathoadrenal, hypophyseal-adrenal, and renin-angiotensin-aldosterone systems, which maintains and aggravates pulmonary hypertension. The degree and character of these changes are directly dependent on the volume of the affection of the pulmonary vascular channel.