[Hormonal markers of cognitive impairment in patients with the first stroke].

The relationship between the content of serum hormones (thyrotrophic hormone, thyroxin, dehydroepiandrosterone (DHEA), DHEA sulfate, prolactin) and cognitive impairment at the acute phase of ischemic stroke in the 1(st), 7(th) and 21(st) day was investigated. There was the correlation between the hormone concentrations and severity of cognitive impairment. This finding supports the role of the hormones in cognitive functioning and their impairment in the acute phase of stroke. The lack of the hormones was mostly expressed in the group with severe cognitive impairment. The study of the hormonal pattern of cognitive regulation allowed to isolate the key biochemical pattern, i.e. the decrease in DHEA concentration, during the acute phase of stroke in the presence of marked cognitive deficit.

The effects of hormones of the hypothalamo-hypophyseal-adrenal, renin-angiotensin, and thyroid hormone systems on the formation of dyscirculatory encephalopathy.

Measurements were made of plasma levels of free (f) thyroxine (fT4), triiodothyronine (fT3), thyrotropic hormone (TSH), adrenocorticotrophic hormone (ACTH), aldosterone, and renin in patients with dyscirculatory encephalopathy (DE). Their influences on the development of chronic circulatory insufficiency were assessed. A total of 39 patients were studied (aged 45-73 years) with DE stages I and II, without acute or chronic (in the exacerbation phase) somatic illness. These observations showed that diffuse lesions of brain tissues of different severities were accompanied by the following changes in thyroid homeostasis: 1) significant combined increases in TSH without alteration to the "fT3-TSH" negative feedback regulatory mechanism in patients with stage I DE; 2) significant combined decreases in TSH levels with marked suppression of the conversion of thyroxine into triiodothyronine and an interaction with impairments in the "fT3-hypophysis" system in patients with stage II DE. In addition, there were changes (increases) in cortisol levels with simultaneous decreases in renin levels in patients with stage II DE as compared with patients with stage I DE. Correlation analysis demonstrated the absence of any relationship between the age of the patients, the state of hormonal homeostasis, and the extent of vascular stenosis. These results suggest a role for hormones of the hypothalamo-hypophyseal-adrenal, thyroid, and renin-angiotensin systems in the mechanism by which DE develops as well as the possibility of using tests for these hormones as additional criteria for assessing the severity of diffuse brain lesions.

[The influence of the hormones of hypothalamo-pituitary-adrenal, renin-angiotensin, and thyroid hormonal systems on formation of vascular encephalopathy]. / Vliianie gormonov gipotalamo-gipofizarno-nadpochechnokovoi, renin-angiotenzinovoi i tireoidnoi sistem na formirovanie distsirkuliatornoi éntsefalopatii.

The aim of the study was to investigate the concentration changes of free (f) thyroxine (fT4), triiodothyronine (fT3), thyrotrophic hormone (TTH), adrenocorticotrophic hormone (ACTH), aldosterone and renin in the blood plasma of patients with vascular encephalopathy (VE) and to evaluate their influence on formation of chronic blood circulation deficiency. Thirty-nine patients with VE of stages I and II, aged 45-73 years, without current acute or chronic (in exacerbation stage) other somatic diseases have been studied. The results revealed that a different extent of diffuse lesion of brain tissue was accompanied by an own pattern of thyroid homeostasis: 1) significantly higher TTH levels with intact regulatory negative feedback "fT3-TTH" in patients with VE, stage 1; 2) significant TTH concentration decrease, with pronounced suppression of thyroxine conversion to triiodothyronine and interaction disturbance in the "fT3--pituitary gland" system, in patients with VE in stage II. A distinct trend towards plasma cortisol level increase as well as significantly lower active plasma renin levels were found in the patients with VE in stage II comparing to those in stage I. Correlation analysis demonstrated the absence of an interaction between patient's age and hormonal homeostasis state and an extent of vascular stenosis. The data suggest involvement of the hormones of hypothalamopituitary-adrenal, thyroid and renin-angiotensin systems in VE formation thus enabling using of the results of their testing as an additional criterion for estimation of brain diffusive lesion severity.

[The influence of hormones of stress-promoting system on the course of acute ischemic stroke]. / Vliianie gormonov stressrealizuiushchei sistemy na techenie ostrogo perioda ishemicheskogo insul'ta.

Experimental and clinical studies have proved an important role of the reaction of a stress-realizing endocrine system for both a course and an outcome of acute somatic diseases. That is why plasma concentrations of thyroxine (T4), triiodo-thyronine (T3), thyrotropic (TTH) and adrenocorticotropic (ACTH) hormones as well as of renin were measured during the 1-st week of acute ischemic stroke (AIS) in relevant patients for determination of their prognostic significance. 16 patients with hemispheric AIS were examined. A complex clinical biochemical investigation performed in patients with acute disorders of cerebral circulation revealed the presence of the "low T3 syndrome" accompanied by an increase of blood plasma levels of T4 by the 7-th day of the disease as well as an increase of the concentrations of TTH, ACTH and renin on the 2-nd day of the stroke. That reflected the severity of cerebral ischemia. Close correlation observed between the degree of normalization of hormonal concentrations and manifestations of neurologic disorders' regression by the 7-th and the 21-st days gave a good ground to consider these indices as a prognostic criterion for determination of an outcome of the acute period of ischemic stroke.

[Effectiveness of computerized tomography of the temporal bone in the diagnosis of chronic suppurative otitis media]. / Effektivnost' komp'iuternoi tomografii visochnoi kosti v diagnostike khronicheskogo gnoinogo srednego otita.

Temporal bone computed tomography findings were compared to those obtained at operation in 30 patients with chronic OMP. The comparison demonstrated high informative value of CT examinations which provide exhaustive characteristics of the pathological process important for preparation to and performance of relevant surgery.

[Complex preoperative diagnosis of the dissemination of stomach cancer to abdominal and retroperitoneal organs and tissues]. / Kompleksnaia dooperatsionnaia diagnostika rasprostraneniia raka zheludka na organy i tkani briushnoi i zabriushnnoi lokalizatsii.

An analysis of 136 cases of stomach cancer led to the determination of the role and place of gamma-topography, echography, computerized x-ray tomography, angiography and laparoscopy in specified preoperative diagnosis of extra-organ spreading of primary tumors. The informative value and shortcomings of certain methods were shown. A high accuracy of the entire set of diagnostic procedures (94.8%) in the preoperative definition of stomach cancer involvement of the abdominal and retroperitoneal organs and tissues was emphasized.