[Intracranial (arterial and venous) and carotid hemodynamics in patients with severe pulmonary pathology]. / Sostoianie vnutrimozgovoi (arterial'noi i venoznoi) i karotidnoi gemodinamiki u bol'nykh s tiazheloi legochnoi patologiei.

A distinctive feature of cerebral blood circulation in patients with chronic non-specific lung diseases (CNLD) complicated with chronic pulmonary heart (CPH) is a pronounced disturbance of cerebral venous drainage without a reliable reduction of both cerebral circulation and blood flow in common carotid arteries. Correlation between the degree of venous drainage disturbance and an extent of CNLD was found. Atherosclerotic damage of major arteries of the head in patients with ischemic stroke (IS) and CNLD was less marked. A comparative comprehensive study of the state of cerebral circulation was performed in two groups of patients. Predominance of the disturbance of venous outflow was found in the patients with IS and CNLD. The volumetric blood flow reduction prevailed in a group of patients with IS due to carotid occlusion. There was no significant difference in local cerebral circulation between the two groups. Obviously the disturbance of venous outflow causes the decrease of cerebral blood circulation in patients with CNLD, therefore "venous stroke" is possible in some patients with CNLD. Poor prognosis of IS in patients with CNLD and CPH is registered. It is stated that venous drainage disturbance and volumetric blood flow reduction in common carotids are main factors affecting progress and outcome of IS.

[The factors in decreased blood flow in the carotid arteries]. / Faktory snizheniia krovotoka v sonnykh arteriiakh.

The circulation volume (CV) in the carotid arteries (CA) has been studied at ultrasonic duplex scanning in 219 patients with a history of acute cerebral circulation disturbance (ACCD), 26 patients with vascular dementia (VD) and in 54 healthy controls. Reduced CV in CA was registered both in ACCD and VD patients who had or were of CA stenosis. More severe fall of CV in CA for VD patients was not associated with increasing occlusion of CA. In the absence of obvious cardiac affection (fibrillation, myocardial infarction) in ACCD and VD patients echocardiography recorded insignificant reduction of myocardial contractility and cardiac output. The majority of these patients without cardiac disease or CA stenosis had arterial hypertension which is supposed to be an essential factor of CV lowering in CA.

[Hemodynamic and rheologic aspects of the pathogenesis and prevention of cerebrovascular diseases]. / Gemodinamicheskie i reologicheskie aspekty patogeneza i profilaktika tserebrovaskuliarnykh zabolevanii.

Ultrasonography was used to study carotid and central hemodynamics in patients with cerebrovascular diseases and to analyze the factors responsible for reduction of cerebral blood supply. Comparative studies of the regulatory system for blood aggregation in patients elucidated the contribution of the system to the pathogenesis of cerebral hemorrhage and ischemia, defined the modes of preventing hemorrhagic and ischemic events in cerebrovascular diseases. The authors also discussed pathogenetic and prophylactic aspects of the diseases in childhood.

[Carotid artery hemodynamics during increased arterial blood pressure]. / Gemodinamika v sonnykh arteriiakh v period povysheniia arterial'nogo davleniia.

Ultrasonic duplex scanning was used to measure the volumetric rate of the blood flow (VRBF) in the common carotid artery (CCA) during arterial pressure (AP) rise in 46 patients suffering from arterial hypertension. The group of patients (n = 27) with a moderate rise of AP (by 10-20% of the common AP values) did not manifest any changes in the VRBF in the CCA during AP rise. In the group of patients with a considerable rise of AP (by more than 20% of the common AP values), there was a significant (p less than 0.01) decrease of the total VRBF in both CCA to 747.6 +/- 34.6 ml/min in AP rise as compared with the VRBF in common AP values--815.6 +/- 37.2 ml/min. Apparently, cerebral complaints in the majority of cases of AP rise are not due to excess blood inflow to the brain; the rise of vascular cerebral resistance associated with AP elevation may be of importance.

[Evaluation of the functional state of the peripheral motor neuron apparatus in patients with diabetes mellitus]. / K otsenke funktsional'nogo sostoianiia perifericheskogo neiro- motornogo apparata u bol'nykh sakharnym diabetom.

As many as 84 patients suffering from diabetes mellitus with and without clinical manifestations of diabetic neuropathy (DN) underwent clinical and electromyographic examinations. The patients with clinical manifestations of DN showed a decrease of the rate of wave spreading in the distal and proximal parts of lower limb nerves, an increase of the proximal distal gradient, a decline of the amplitude of the maximal M-response, an increase of the latent period or the lack of H-reflex. The data point to generalized impairment of the peripheral neuromotor apparatus with primary involvement into the process of the distal parts of limb nerves. In the majority of the patients without clinical manifestations of DN, electromyography also demonstrated injury to the peripheral nerves, evidence of a possibility of electromyographic diagnosis of the subclinical stage of DN.

[Informative value of complex electromyographic and immunologic examinations of patients with diabetic neuropathies]. / K otsenke informativnosti kompleksnogo élektromiograficheskogo i immunologicheskogo obsledovaniia bol'nykh diabeticheskoi nevropatiei.

As many as 43 patients suffering from diabetes mellitus associated with the clinical manifestations of diabetic neuropathy underwent ++clinico-electromyographic and immunologic examinations. The control group comprised 30 practically healthy persons of the same age. The electromyographic++ examination included measurements of the rate of wave spreading in motor fibers of the limb nerves in the distal and proximal parts (in accordance with the F-wave), a study of H-reflex from the musculus soleus of the leg together with M-response of hand and foot muscles. The immunologic examination consisted in measurements of different class immunoglobulins in the blood serum. Based on the electromyographic findings, 3 groups of patients were distinguished: group I included patients with primary injury to the myelin membrane of the nerves; group II was made up of patients with primary injury to the axon, and group III of patients with concomitant injury to the nervous membranes and axons. There was a significant elevation of the concentration of anti-myelin activity possessing IgM in the blood serum of patients belonging to groups I and III, which attests to the involvement of the immunopathological mechanism into myelopathy development.

[Volumetric blood flow in the carotid arteries in various forms of cerebrovascular pathology (based on data from two-dimensional Doppler ultrasonography)]. / Ob''emnyi krovotok v sonnykh arteriiakh pri nekotorykh formakh tserebrovaskuliarnoi patologii (po dannym dvukhmernoi ekho- doplerografii).

A total of 86 patients with a history of insult in the carotid system and 105 patients with the early clinical forms of cerebrovascular pathology (ECFCVP) were examined for the volumetric blood flow in the general carotid artery (GCA) using two-dimensional dopplerography. In the group of insult patients, the total volumetric blood flow in bot carotid arteries decreased by 13% on the average, in the group with ECFCVP by 8% as compared to the group of healthy persons. The decrease of the blood flow was recorded not only in the presence but also in the lack of the stenosing process in the carotid arteries.

[Comparative evaluation of drugs used in the treatment of brain edema in cerebral stroke and their effects on cerebral blood flow]. / Sravnitel'naia otsenka preparatov dlia lecheniia oteka golovnogo mozga pri tserebral'nom insul'te i vliianie ikh na gemoreologiiu.

Altogether 102 patients with grave cerebral stroke were examined for the efficacy of the treatment of brain edema with lasix, mannitol+, glycerol and dexamethasone and for the influence of the drugs on the rheological blood properties. Blood osmolality was studied depending on the time elapsed since the moment of stroke as were its changes after administration of the osmoactive substances (mannitol+, glycerol). Analysis of the data obtained indicates that dexamethasone and glycerol produce the highest clinical effect together with a favourable influence on the rheological blood properties. The use of lasix and mannitol+ did not produce any positive clinical effect. At the same time lasix was noted to exert an untoward effect on the rheological blood properties. The conclusion is made that combination of dexamethasone and glycerol is advisable in the treatment of brain edema in patients with grave cerebral stroke.

[Functional status of spinal motoneurons in patients with acute cerebral circulatory disorders]. / Funktsional'noe sostoianie spinal'nykh motoneironov u bol'nykh s ostrymi narusheniiami mozgovogo krovoobrashcheniia.

The article presents the results of clinico-electromyographic examinations of 75 patients with a history of acute impairment of circulation in the carotid system. The study revealed differences in changes in the antidromic excitability of spinal motoneurons as judged from the amplitude parameters of the F wave in relation to the time elapsed from the moment of the stroke and to the nature of neurologic disturbances. Examination of the F wave is shown to be informative in monitoring the recovery of motor functions.

[Comparative characteristics of the effectiveness of antiaggregant and anticoagulation therapy of ischemic stroke]. / Sravnitel'naia kharakteristika éffektivnosti antiagregantnoi i antikoaguliantnoi terapii ishemicheskogo insul'ta.

The efficacy of antiaggregate versus anticoagulant therapy administered in the acute period of ischemic stroke was compared, with such factors as the incidence and nature of side effects also taken into account. Antiaggregates were found to be as effective as anticoagulation therapy which, in some instances, renders the latter unnecessary.

[Neurohumoral correlations in lumbar pain syndromes]. / Neirogumoral'nye sootnosheniia pri poiasnichnykh bolevykh sindromakh.

The hemostasis system, activity of opioid peptides, hormonal status, vegetative and emotional parameters were studied in patients with lumbar pains of a vertebrogenic nature. The results obtained revealed a whole series of generalized shifts determining the reaction of the body to a local pain syndrome. These shifts were shown to exert an unfavourable effect on the course of a local pathological process. It is suggested that the generalized neurohumoral changes should be corrected by anti- and deaggregation agents, vasodilators, and a combination of psychotropic drugs.

[Camphor preparations in the overall therapy of cerebral infarct]. / Preparaty kamfory v kompleksnoi terapii bol'nykh s mozgovym infarktom.

The authors studied the platelet functional properties and the brain bioelectric activity in 20 patients with acute cerebrovascular diseases before and after subcutaneous injection of 2.0 ml of racemic camphor T, as well as before and after oral taking of monobromated camphor in a dose of 0.5 g 3 times a day. The platelet aggregation was examined by the method of Born (1962) with automatic recording of aggregatograms. The brain bioelectric activity was examined using an Alvar electroencephalograph. As a result, the authors discovered an inhibitory effect of camphor preparations on the platelet aggregation. Racemic camphor T and monobromated camphor were found to produce a stimulant effect on the brain.