[The mechanisms of the neuroprotective action of carbonate mineral baths in ischemic brain lesions]. / Mekhanizmy neiroprotektornogo deistviia uglekislykh mineral'nykh vann pri ishemicheskikh porazheniiakh golovnogo mozga.

Effects of Arzni effervescent mineral baths (EMB) on brain tissue metabolism were studied on white rats (normal controls and those with transitory cerebral ischemia). It was found that EMB prevent ischemia-related disorders of phospholipid and adeninnucleotide pools, promote an increase in vasoactive prostaglandins in brain tissue, shifts in catecholamines concentrations in the hemispheres and hypothalamus, inhibit the activity of monoaminoxidase and absorption of 3H-noradrenaline by brains sections. Mechanisms of neuroprotective action of Arzni EMB in cerebral ischemia are considered.

[A familial case of Kennedy's X-linked bulbospinal amyotrophy]. / Semeinyi sluchai X-stseplennoi bul'bospinal'noi amiotrofii Kennedi.

The authors describe 4 cases of Kennedy's medullo-spinal amyotrophy (BSA) which is a genetically determined disease with mutant gene inheritance by the recessive type with X chromosome cohesion. The disease largely shows up by the impairment of the nervous system in the form of BSA. However, the clinical picture is also marked by the derangement of the mesenchymal (Dupuytren's contracture) and endocrine systems (gynecomastia).

["Dynamic" component of carotid artery stenosis in patients with cerebrovascular disorders]. / O "dinamicheskom" komponente stenozov sonnykh arterii u bol'nykh s tserebrovaskuliarnymi zabolevaniiami.

Nifedipine is shown to abolish contraction of the vessel at the site of the internal carotid artery stenosis induced by a cold test. It can furthermore produce a direct 5-40% reduction of the stenosis, the effect being dependent both on the drug plasma level and the ability to rise such levels of prostacyclin. In some patients there is a possibility of nifedipine contrary action when it promotes stenosis (up to 5-30% increase) and leads to disturbances of cerebral circulation. Consequently, to make optimal therapeutic measures in relevant patients nifedipine should be tried for stenosis-directed action.

[Pharmacodynamic approach to the optimal use of calcium antagonists in patients with cerebrovascular disorders]. / Farmakodinamicheskie podkhody k optimizatsii primeneniia antagonistov kal'tsiia u bol'nykh s tserebrovaskuliarnymi zabolevaniiami.

Three hours after administration of a single 20 mg dose of nifedipine the platelet, leucocyte and red blood cells aggregation was inhibited with the red blood cells and leucocytes deformability increased. This effect proved sensitive to the plasma nifedipine concentration disappearing with its concentrations below 25 ng/ml. The nifedipine sensitivity of the blood cells was the second factor influencing its effect. This was closely related to prostacyclin. The blood cells sensitivity to the latter, and its plasma concentration and decay rates were major determinants of the nifedipine capability of inhibiting the leucocyte, red blood cells and especially platelet inhibition.

[Cholesterol-containing circulating immune complexes in patients with cerebral arteriosclerosis and disorders of cerebral circulation]. / Kholesterinsoderzhashchie tsirkuliruiushchie immunnye kompleksy u bol'nykh tserebral'nym aterosklerozom s narusheniiami mozgovogo krovoobrashcheniia.

A study was made of the level of circulating immune complexes (CIC) in patients with circulatory encephalopathy and brain infarction to find out the CIC level to be increased. The content of cholesterol in CIC was discovered to be also augmented, with that phenomenon being in agreement with the degree of atherosclerotic lesions to carotids. It has been shown that in patients with the increased content of cholesterol-containing CIC, the rise of platelet aggregation and blood coagulation is most remarkable.

[Status of the prostacyclin-thromboxane balance in patients with cerebrovascular disorders and the effect of the treatment with nifedipine]. / Sostoianie prostatsiklin-tromboksanovogo balansa u bol'nykh s narusheniiami mozgovogo krovoobrashcheniia i vliianie na nego terapii nifedipinom.

It is shown that in patients with cerebral circulatory disorders, the prostacyclin -thromboxane balance is replaced toward the latter one. As a result of nifedipine administration part of the test subjects demonstrate a rise of the content of prostacyclin and a decline of the concentration of thromboxane. This effect of nifedipine is ascertained to be in a good agreement with its action on blood inflow to the brain and platelet aggregation. It is concluded that the efficacy of nifedipine can be raised if it is combined with the drugs that enhance the synthesis of prostacyclins in the body.

[Clinical and expert opinion aspects of vertebrobasilar insufficiency]. / Kliniko- ékspertnye aspekty pri nedostatochnosti vertebral'no-baziliarnogo krovoobrashcheniia.

As many as 103 patients with vertebral basilar failure (VBF) underwent clinical expert examination. The patients' age ranged from 34 to 58 years. Bearing in mind the clinicopathogenetic characteristics, the patients were distributed into 3 groups. Group I (n = 32) included patients with the irritable vertebral artery syndrome, group II (n = 54) was made up of patients with mixed spondylogenous atherosclerotic chronic VBF, and group III (n = 17) of patients with sequelae of strokes in the vertebral basilar basin. Indications for patients' referral to the medical expert commission for evaluation of working capacity were elaborated and the clinical and socio-occupational criteria for the loss of patients' work fitness were established. A table describing stages of the development of VBF of spondylogenous atherosclerotic genesis was devised.

[Blood cells and their sensitivity to calcium antagonists in patients with cerebrovascular disorders]. / Kletki krovi i ikh chuvstvitel'nost' k antagonistam kal'tsiia u bol'nykh s tserebrovaskuliarnymi zabolevaniiami.

Patients with ischemic-type cerebral dyshematopoiesis have disturbances of blood cell function (their enhanced aggregation and reduction of leucocyte and erythrocyte deformation). Calcium antagonist nifedipine can neutralize these disturbances but it reduces blood cell sensitivity to it. The effectiveness of nifedipine can be increased by giving it in combination with prostacyclin. Blood cell sensitivity to this combination of agents changes insignificantly. It is recommended that nifedipine and medicinal agents which increase blood prostacyclin concentration be used in combination.

[Clinical expert classification of chronic cerebrovascular insufficiency]. / Kliniko-ékspertnaia klassifikatsiia khronicheskoi nedostatochnosti mozgovogo krovoobrashcheniia.

Basing on the results of an analysis and systematization of the findings of comprehensive examination of 519 patients the authors identified complexes of characteristic criteria which have served as the basis for creating a classification of chronic insufficiency of cerebral circulation (CICC) developing in cases of cerebral atherosclerosis, essential hypertension, and their combination. With regard to the stage of CICC and expert significance of either clinical manifestations of this disorder in relation to different types of professions a working scheme of medical expert examination of patients' working capacity is proposed.

[Computer-assisted differential diagnosis of cerebral stroke]. / O vychislitel'noi differentsial'noi diagnostike mozgovogo insul'ta.

An automatic system of the stage-by-stage differential diagnosis of acute disorders of the cerebral circulation has been developed. Investigation of the efficacy of computer-aided diagnosis and its comparison to the diagnosis made by physicians at different levels of the care of patients with acute impairments of the cerebral circulation have shown the advisability of employing this system in the diagnosis of brain stroke at the prehospital stage at variable levels of the public health service.

[Effect of erythrocytes on the stability of prostacyclin in healthy subjects and patients with cerebral dyshemias]. / Vliianie éritrotsitov na stabil'nost' prostatsiklina u zdorovykh lits i u bol'nykh s tserebral'nymi disgemiiami.

The authors studied the interaction between red blood cells (RBCs) and prostacycline (P) in normal subjects and patients with transient disorders of the cerebral circulation and cerebral stroke. RBCs accelerated P disintegration with the formation of inactive products, with the process being most accelerated in RBC aggregation. It has been found that hyperosmolarity of the medium and disoxygenation of RBCs increase their ability to break down P while lactacydosis decreases this ability. It has been also established that there is a greater proportion of people with a marked ability of RBCs to break down P among patients with cerebral dyshemias, particularly with cerebral stroke. This might be due to alterations in the conformation of the surface layers of RBCs in abnormal conditions.

[Possible role of prostacyclin in the pathogenesis of cerebral circulatory disorders]. / O vozmozhnoi roli prostatsiklina v patogeneze narushenii mozgovogo krovoobrashcheniia.

It has been shown that patients with cerebral ischemias are characterized by a reduction in the capacity of prostacyclin to inhibit platelet aggregation and a decrease in the time of its plasma half-life. The role of these changes in the pathogenesis of cerebral circulation disturbances is discussed. It has been established that cases of the most pronounced decrease in the antiaggregation effect of prostacyclin with its minimum stability in the plasma are the least favourable with regard to the prognosis of cerebral infarction. It is suggested that disorders of the function of the prostacyclin system (regulation of the equilibrium between platelets and the vessel wall) may be latent, predetermining a high risk of the development of thrombotic disorders.

[Role of lesions of the major arteries of the head in disorders of hemostasis and the rheologic properties of the blood]. / O roli porazhenii magistral'nykh arterii golovy v narusheniiakh gemostaza i reologicheskikh svoistv krovi.

The authors studied the process of platelet and erythrocyte aggregation in blood passing through a special chamber designed to simulate an intact vessel and a vessel which is either stenosed or pathologically convoluted. Aggregate formation was shown to be dramatically increased in simulating a part of a vessel with an altered geometrical pattern of the blood flow, with the increase being more pronounced when the blood from patients with cerebral dyshemias was applied. It was found that in patients with cerebral infarction, the antiaggregate activity of the blood passing through the internal carotid arteries on the affected side was lower than in other sections of the blood stream. The importance of identified regularities in the pathogenesis of cerebrovascular diseases is discussed.