ABSTRACT
The brain blood flow autoregulation (BFA) has been studied in normalcy and different variants of atherosclerosis in 97 subjects. Group 1 included 32 patients with obliterating atherosclerosis of the arteries of the low extremities with different stages of chronic artery insufficiency without hemodynamic lesions of brachiocephalic arteries; group 2 consisted of 30 patients wit different forms of chronic brain ischemia with hemodynamically significant unilateral atherosclerotic stenosis of the inner carotid artery (from 70 to 95%). The control group included 35 healthy volunteers aged 20-25 years. BFA parameters were assessed using the original technique worked out by the authors. In the normalcy, the BFA mechanism is able to maintain the constancy of perfusion pressure in the brain due to two major components. In the first stage, it is the aggravation of arterial blood inflow lasting for 1,5 min after the removal of pneumatic cuffs with the following surpassing increase of the venous blood outflow from the scull that decreases the tissue pressure. The most distinct BFA changes were seen in patients with hemodynamically significant stenosis of the inner carotid artery while patients with peripheral atherosclerosis had less marked BFA disturbances.
Subject(s)
Atherosclerosis/physiopathology , Brain/blood supply , Cerebrovascular Circulation , Hemodynamics , Homeostasis , Aged , Atherosclerosis/diagnostic imaging , Brain Ischemia/diagnostic imaging , Brain Ischemia/physiopathology , Carotid Stenosis/diagnostic imaging , Carotid Stenosis/physiopathology , Humans , Male , Middle Aged , Peripheral Arterial Disease/diagnostic imaging , Peripheral Arterial Disease/physiopathology , UltrasonographySubject(s)
Arteriosclerosis Obliterans/surgery , Hyaluronoglucosaminidase/therapeutic use , Ischemia/prevention & control , Peripheral Arterial Disease/surgery , Postoperative Complications/prevention & control , Aged , Anastomosis, Surgical , Arteriosclerosis Obliterans/pathology , Constriction, Pathologic/pathology , Constriction, Pathologic/prevention & control , Female , Humans , Ischemia/pathology , Male , Middle Aged , Peripheral Arterial Disease/pathology , Postoperative Complications/pathology , Tunica Intima/pathologyABSTRACT
The authors have hereby proposed a method to diagnose lower-limb muscular ischaemia by means of scintigraphy, used in 35 patients suffering from atherosclerosis obliterans with stage IIB and III A chronic arterial insufficiency of limbs. To do so, administration of the radioactive agent "Myoview" (99m)Tc-tetrophosmine) manufactured by the "Nycomed" Company into a patient's peripheral vein was followed by assessing its accumulation in lower-limb muscles at rest and after standard physical load. Alterations in the parameters studied relative to the norm made it possible to judge on the presence of lower-limb circulatory impairments. The method proved highly efficient, thus making it possible to use it for both therapeutic decision-making and probably in future for dynamic control after the treatment performed. Minimally invasive nature and simplicity in use of the methodology open wide possibilities for its use.
Subject(s)
Arteriosclerosis Obliterans/diagnostic imaging , Perfusion Imaging/methods , Regional Blood Flow/physiology , Adult , Arteriosclerosis Obliterans/physiopathology , Diagnosis, Differential , Humans , Injections, Intra-Arterial , Male , Middle Aged , Organophosphorus Compounds/administration & dosage , Organotechnetium Compounds/administration & dosage , Radiopharmaceuticals/administration & dosage , Reproducibility of Results , Severity of Illness IndexABSTRACT
Data on the therapeutic effectiveness of intravenous injections of immunoglobulins in high doses in patients with bronchial asthma are analyzed. Some possible mechanisms of this therapeutic effect are considered, which are related to of immunoglobulin fragments capable of interacting with cytochrome P-450 and NO-synthase systems of the liver.
