[The possible role of alpha 2-macroglobulin in regulating the immune components of the brain in tick-borne encephalitis]. / Vozmozhnaia rol' al'fa 2-makroglobulina v reguliatsii immunnykh komponentov mozga pri kleshchevom éntsefalite.

In tick-borne encephalitis certain immunopathological reactions develop in the tissues of the central nervous system; alpha 2-macroglobulin may serve as the marker of the activity of these reactions. The dynamic study of liquor taken from 16 patients with the meningeal and focal forms of tick-borne encephalitis (TBE), 8 patients with severe craniocerebral traumas accompanied by meningitis and 10 patients with osteochondrosis was made. As revealed in this study, in TBE patients the level of alpha 2-macroglobulin increases 3.5-fold and remains stable during the acute period of the disease.

[The permeability of the hemato-encephalic barrier in neurological cancer patients in the postoperative period]. / Pronitsaemost' gematoéntsefalicheskogo bar'era u neiroonkologicheskikh bol'nykh v posleoperatsionnom periode.

The permeability of the blood-brain barrier was studied in 48 patients by examining the protein indices of cerebrospinal fluid. The types of changes in the indices were identified, which reflected the level of the permeability and correlate with good and poor postoperative outcomes. Possible ways of correcting hypertransudation across the barrier were defined.

[Peroxide chemiluminescence of the cerebrospinal fluid in spinal cord tumors]. / Issledovanie perekisnoi khemiliuminestsentsii tserebrospinal'noi zhidkosti pri opukholiakh spinnogo mozga.

Spontaneous and initiated by hydrogen peroxide chemiluminescence was evaluated before and after freezing of the CSF from 20 patients with various spinal tumors and 10 controls with intervertebral lumbar osteochondrosis. The intensity of the above chemiluminescence was found significantly different in tumors and osteochondrosis. Cryotreatment induced marked changes in CSF chemiluminescence, especially in extramedullary spinal tumors. CSF treatment with hydrogen peroxide entailed alterations in free radical oxidation which can serve an additional criterion in combined diagnosis of spinal cord tumors.

[Changes in the immunobiochemical composition of the cerebrospinal fluid and the antitumor reactions of the local immune system in astrocytic brain tumors]. / Izmeneniia immunobiokhimicheskogo sostava tserebrospinal'noi zhidkosti i protivoopukholevye reaktsii mestnoi immunnoi sistemy pri opukholiakh golovnogo mozga astrotsitarnogo riada.

Pre- and postoperative immunochemical indices of cerebrospinal fluid (CSF) were investigated in 10 patients with fibrillary-protoplasmic astrocytoma and 10 patients with glioblastoma multiforme. Malignant neoplastic developments in the brain are associated with appearance of marked humoral reaction. Tumor-specific CSF changes observed comprise registration of ceruloplasmin immunomodulating proteins and alpha 2-macroglobulin. It is emphasized that biochemical antioxidant, antiprotease, energy-supplying systems are related directly to humoral immune reactions in the process of relevant postoperative rehabilitation.

Body position and cerebrospinal fluid pressure. Part 1: clinical studies on the effect of rapid postural changes.

Cerebrospinal fluid (CSF) pressure was recorded in 149 patients and arterial blood pressure (BP) in 11 patients while moving between lateral and sitting positions. Rapid tilting initiated waves in BP and CSF filling pressure. The postural CSF pressure wave manifested itself either as a transient or as a stationary wave similar to a plateau wave. When patients sat up, transient waves had amplitudes up to 550 and stationary waves up to 1000 mm H2O. When they lay down, transient waves had amplitudes up to 800 mm H2O. Stationary waves were found only among patients with elevated intracranial pressure and a diseased brain. The waves were mainly caused by changes in cerebral blood volume probably reflecting the postural BP wave and brain autoregulation. Most patients with stationary and large transient waves also manifested clinical symptoms. These symptoms were aggravated when a craniospinal block developed in the sitting position, and were reduced or avoided when the tilting was performed slowly over 2 to 3 minutes.

Body position and cerebrospinal fluid pressure. Part 2: clinical studies on orthostatic pressure and the hydrostatic indifferent point.

Lumbar cerebrospinal fluid (CSF) pressure was recorded in 116 adult neurosurgical patients in the lateral and sitting positions. The level of zero CSF pressure while in the sitting position (ZPS) and hydrostatic indifferent point (HIP) for lateral and sitting positions were determined and referred to the craniospinal axis. In control patients ZPS was located mainly at the upper cervical region, and showed nearly the same variation and frequency distribution as CSF pressure in the lateral position when efforts were made to reduce sources of error and there was no orthostatic change in CSF filling pressure. Under these circumstances ZPS may be used as a variable comparable from one subject to another. In control patients the HIP was located between C-6 and T-5. In 25 hydrocephalic patients, shunting resulted in a mean caudal shift of ZPS of 244 mm, and a mean pressure fall of 126 mm H2O in the lateral position. This difference was due to a caudal shift of HIP on shunting. A caudally located ZPS was found in patients with complete cervical subarachnoid block. Prevention and treatment of CSF leakage cranial to HIP is discussed.