[Experience with video-computer method of assessing the mental state with the help of "Vidicor" in a psychological survey of entrants in Suvorov Military School].

The authors analyzed the use of two different survey methods (PPO and "Vidicor") of entrants of the St. Petersburg Suvorov Military School. It is shown that the methods of the final results do not contradict each other. The discrepancy between the results is 4,4%, but the method of "Vidicor" has several advantages: lower labor costs and psycho trauma of surveyed, most dynamic and effective, the possibility of creating an electronic database. This allows us to recommend it for use.

[Clinical and immunobiochemical study of efficacy and stress-protective properties of thyroliberin at the acute stage of carotid ischemic stroke].

Stress-promoting system is known to be involved in course and outcome of acute stage of ischemic stroke. An important predictor of an unfavorable course of stroke is so-called "low T3-syndrome". Therapy with drugs increasing T3 level on the background of reduced reaction of oxidative stress is one of a perspective direction of neuroprotection. The study aimed at investigating thyroliberin influence on a clinical course and an outcome of ischemic atherothrombotic stroke as well as on thyroid hormones level in 46 patients (27 women and 19 men) aged 55-75 years admitted to the hospital at the first 24 hours of the disease. Twenty-one patients were switched to thyroliberin in dosage 500 mcg twice a day during 5 days. A control group included 25 patients. Neurological status of the patients was evaluated on days 1, 3, 7 and 21 using the Orgogozo scale and functional recovery was assessed on day 21 with the Bartel scale. Radioimmunoassay of TTH level, cT3 and free thyroxine (cT4) in blood plasma was conducted on days 1, 2, 3 and 7 using test-kit IRMA TTG CT (Belorus). Atherosclerotic changes of MAG were measured with USDG on day 1. All the patients underwent MRI of the brain on days 1, 7 and 21 using tomograph Ellips (Russia) 0.15 Tesla. The dynamics of regress of neurological disturbances in patients receiving thyroliberin appeared as the higher total score on the Orgogozo scale on days 3, 7 and 21 especially in a severe course of the diseases compared to the control group (p<0,007 on day 7). The T3 level in these patients was significantly higher (p<0,05) on days 2, 3 and 7 and the thyroxine level was increased significantly on the 3rd day of stroke (p<0,005) as compared to the control group. In patients with moderate severity of the disease, the TTH level was significantly higher on the 2nd day of stroke (p=0,0004). However, in patients with a severe course TTH and T4 concentrations did not differ in both groups. The results of the study suggest that the use of thyroliberin in an acute stage of ischemic stroke prevents development of "low T3 syndrome" that promotes more rapid and essential regress of neurological disturbances.

Connection between p53 gene Bam HI RFLP polymorphism with the volume of brain infarction in patients with carotid atherothrombotic ischemic stroke.

PURPOSE: The aim of our investigation was to study the connection between p53 gene Bam HI RFLP polymorphism and the brain infarction volume in patients with atherothrombotic ischemic stroke that could highlight certain genetic aspects of the individual sensibility of brain tissue to acute ischemia. MATERIALS AND METHODS: Diallelic Bam HI RFLP polymorphism in 5' flanking region p53 gene was studied in 96 patients with carotid atherothrombotic stroke from Moscow population. Magnetic resonance imaging was conducted on day 7 after the stroke onset. The manual morphometry and "Osiris" morphometric hardware (by the Hospital of the University of Geneva) were used for assessment of the infarction volume. RESULTS: The predominance of small-size infarctions (< 40 cm3) was revealed in patients with (-/-) Bam HI RFLP p53 genotype versus patients with (-/+) (X2 = 19.7; P < 0.001) and (+/+) (X2 = 12.288; P < 0.001) genotypes. According to the Bayesian's statistics, in patients with (-/-) p53 Bam HI genotype the development of a small-size infarction in atherothrombotic ischemic stroke can be prognosticated with probability more than 65%. CONCLUSIONS: A significant association between p53 gene Bam HI RFLP polymorphism and the infarction volume was found in patients with carotid atherothrombotic stroke from Moscow population. These results additionally confirm that apoptosis plays an important role in the formation of ischemic brain lesion and that drugs with anti-apoptotic properties may prove beneficial in stroke patients.

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.

[Association between Bam HI RFLP p53 gene polymorphism and brain infarction volume in patients with atherothrombotic ischemic stroke]. / AssotsiatsiiaBam HI RFLP polimorfizma gena p53 s ob"emom infarkta mozga u patsientov s aterotromboticheskim ishemicheskim insul'tom.

A significant association between Bam HI RFLP p53 gene polymorphism and brain infarction volume in patients with atherothrombotic ischemic stroke (AIS) from Moscow population was found. Biallelic Bam HI polymorphism in exon 5 of p53 gene was studied in 96 AIS patients, 100 their healthy siblings, 41 patients with chronic ischemic disease and 42 their healthy siblings. Magnetic resonance tomography with morphometric program "Osiris" (the Hospital of the University, Geneva) for infarction volume measuring was used on day 1 and 7 after stroke onset. The patients with (-/-) p53 Bam HI genotype had the smaller brain infarction sizes (< 40 cm3), comparing to those with (-/+) (chi 2 = 19.7; p < 0.001) and (+/+) (chi 2 = 12.3; p < 0.001) genotypes. According to Bayes statistics, development of smaller infarction size in AIS may be predicted with over than 65% probability in the patients with (-/-) p53 Bam HI genotype. A significant association between p53 Bam HI polymorphism and infarction volume in patients with carotid atherothrombotic stroke confirms an important role of apoptosis in ischemic brain lesions formation that demands temporary antiapoptotic influence on patients with stroke.

[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.