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Biomedical subjects

D N Dzhibladze

Publications and source records attributed to D N Dzhibladze.

At least 19 recordsLinked to original sources
PubMed2006

[A relationship between clinical and biological disturbances in atherosclerotic lesions of the carotid arteries].

A study of the functional state of cerebral hemodynamics using transcranial dopplerography and blood excitotoxic amino acids, playing an important role in the pathogenesis of ischemic brain damage, has been carried out in 43 patients with atherosclerotic lesions of the carotid arteries. Neurological deficit that developed as a result of ischemic stroke was related to the changes of cerebral hemodynamics (a decrease of hemodynamic reserve and blood flow velocity in the middle cerebral artery) and an increase of the level of blood amino acids involved in excitotoxic mechanisms of the nerve tissue lesions in brain ischemia. These biochemical disturbances in the non-acute period of ischemic stroke may be explained by the state of chronic excitotoxicity that developed because of blood circulation insufficiency in the brain and a decrease of cerebrovascular reserve. The authors admit that genetically determined features of cerebral metabolism of excitotoxic amino acids, concomitant with their higher release to the extracellular space, along with hemodynamical disturbances, may be risk factors of ischemic brain lesion when cerebral blood flow decreased as a result of stenosis or occlusion of the carotid arteries. This should be taken into account for elaboration of complex methods of neuroprotection in atherosclerosis of the great brain arteries.

Adult↗
PubMed2005

[A state of hemorheological system in patients subjected to carotid endarterectomy with atherosclerotic lesion of the major cerebral arteries].

To study the influence of changes in the blood rheological indices and blood coagulation on development, progression and clinical course of restenosis and thrombosis, 62 patients (mean age 63.4 +/- 6.0 years), were followed up for 2-15 years after carotid endarterectomy. Above 50% (maximum 70%) restenosis was observed in 7% cases. No critical postoperative restinosis was observed. In 12% patients, restenosis was accompanied with carotid artery occlusion and hematocrit, with fibrinogen (FG) being significantly increased in the absence of fibrinolytic activity (FL) elevation, indicating hemorheological disorders and homeostasis activation in such patients. Long-term follow-up showed that viscosity blood characteristics were elevated but functional activity of platelets and FA in patients did not differ from those in healthy subjects. At the same time, FG was high and fibrinolysis index was lower than mean statistical value that indicated predominance of blood procoagulation activity.

Adult↗
PubMed2005

[The influence of coronary artery bypass graft surgery on cerebral hemodynamics].

The influence of coronary artery bypass graft surgery (CABGS) on cerebral hemodynamics is still understudied. At the same time, ischemic heart disease (IHD) is often comorbid to atherosclerotic carotid artery stenosis, with significantly higher risk of post CABGS cerebrovascular complications in patients with cerebral hemodynamics lesion. Indices of cerebral hemodynamic reserve have been studied in 40 patients with severe IHD before and after CABGS. In most patients, there was a significant postoperative improvement of cerebral hemodynamics related to enhancing of blood flow along medial cerebral arteries and to amelioration of the parameters of cerebral hemodynamic reserve. But CABGS did not positively impact on cerebral hemodynamics in patients with initially reduced ejection fraction that appears to be a consequence of insufficient increase of stroke volume and in patients with a history of ischemic lesions of cerebral blood circulation. Therefore, the results obtained suggest a close relationship between coronal and cerebral blood circulation that should be taken into account in the analysis of pathogenetic mechanisms of cerebral blood circulation lesion in patients with IHD as well as in elaboration of adequate individual preventive treatment measures.

Adult↗
PubMed2004

[Cerebral embolia in patients with prosthetic mechanic heart valves].

The review focuses on embolia of cerebral vessels in patients with prosthetic mechanic heart valves. The highest risk for embolia is observed in the first 3 months after the surgery, a frequency of embolia being dependent on the type and position of the artificial valve. Methods for prevention of post-surgery thromboembolic complications are considered.

Heart Valve Diseases↗
PubMed2003

[The follow up of patients with extracranial pathology of the carotid arteries and ischemic disorders of cerebral circulation].

According to the populational studies, about 50% of ischemic disorders of cerebral circulation, both persistent and transient, are induced by thrombotic or embolic complications of atherosclerotic plaques which produce an adverse effect on the large and small caliber arteries; about 20-25% is associated with lesion of the small diameter intracranial vessels, about 20% with embolism from the heart, and the remaining disorders fall within other rare causes. The prevalence of atherosclerotic lesions of the vessels feeding the brain, the severity of their clinical manifestations, insufficient efficacy of conservative therapy and the high risk of surgical treatment remain as before a matter of great medical and social concern. In connection with an appreciable progress of vascular surgery carotid endarterectoray (GEAE) as one of the radical approaches to correction of the pathology of the carotid artery segment is widespread at the large centers of vascular surgery of different countries. However, in spite of the fact that CEAE is an advanced and radical technique of preventive operation, it produces only a local effect on vascular diseases whereas the other, no less important pathogenetic mechanisms leading to disorders of cerebral circulation remain unchanged and demand drug correction to avoid repeated disorders of cerebral circulation. Analysis of the long-tern results evidences a stable and lasting effect of CEAE. The postoperative clinical manifestations can be used as the main criterion for the efficacy of CEAE, especially as compared to the purely conservative therepy. The results of the long-term follow up (over the period as long as 15 years) of a large group of operated patients demonstrate that the majority of them did not show the emergence of the new focal neurologic symptomatology in the ipsilateral hemisphere and only a small percentage of cases developed stroke. The major western statistics provide the analogous results.

Brain↗
PubMed2000

[Pathology of the brain in Creutzfeldt-Jakob disease].

The autopsy cases of Creitsfeldt-Jacob disease (a sporadic form) are reported which were diagnosed clinically and supported by the data of biopsy and autopsy of the brain (classic triad: death of neurons, astrogliosis and spongiform degeneration of the gray substance of the cortex of brain hemispheres, preferentially), followed by clinical morphologic comparisons. The focal character of the disease was observed on the early stages of the disease, while diffuse alterations were found on the late stages.

Basal Ganglia Diseases↗
PubMed1998

[Clinical course of restenosis after carotid endarterectomy].

Angiologic and neurologic examinations, ultrasonic dopplerography were performed in 89 patients after operation of carotid endarterectomy. Period of observation was 6-182 months after operation (61 months on the average). Positive clinical effect (absence of disorders of cerebral circulation-DCC) was achieved in 91% of cases. The frequency of both repeated transitory ischemic attacks and the strokes was 9%, the best frequency being in patients with initially asymptomatic course. It was found that the degree of restenosis directly correlated with frequency of neurologic symptom development: there were no repeated DCC in normal state of the operated artery. Meanwhile DCC frequency was less than 4% in cases with the degree of restenosis less than 60% and was equal to 15.8% in more than 60% restenosis. DCC were more frequently found in occlusion of internal carotid artery. Rather favourable course of restenosis of carotid artery was also conditioned by low content of the plaques dangerous in terms of embolism. Progression of atherosclerotic damages in other parts of extracranial arteries promoted clinical manifestation of cerebral ischemia. Moreover, negative neurologic dynamics developed in 7% of the patients with restenosis less than 60%, and in 13.8% of cases with restenosis more than 60%. The conclusion was made about efficiency of carotid endarterectomy in patients with atherosclerotic damages of carotid arteries. For prevention of repeated DCC it is recommended both to perform conservative therapy after the operation and to examine dynamically the patients using ultrasonic dopplerography beginning 6 months after the operation.

Adult↗
PubMed1998

[Functional evaluation of cerebral hemodynamics using transcranial dopplerography and nitroglycerin test in occlusion of the internal carotid artery].

42 patients with one-sided atherosclerotic occlusion of internal carotid artery (ICA) out of acute stage of stroke were examined by means of method of transcranial dopplerography with application of nitroglycerin test. Unstable course of the disease with development of repeated ischemic disorders of cerebral circulation were found in most of the patients with decreased hemodynamic reserves in homolateral hemisphere. Differences revealed were statistically significant. It was established by means of nitroglycerin test that the decrease of pike systolic linear rate of blood flow through the median cerebral artery on the side of ICA occlusion less than 10% was the sign of unstability of cerebral circulation and could serve as an indication for surgical correction of the circulation.

Adult↗
PubMed1998

[In vivo diagnosis of Creutzfeldt-Jakob disease].

The paper presents the data concerning usage of some original method of vital laboratory diagnostics of Creutzfeldt-Jacob disease that belongs to the group of prionic diseases. The method consisted in the inoculation of inoculative culture of rat Gasser ganglion's neurinoma by biologic materials investigated (serum and clot of blood) with the following passivation and investigation of the contaminated culture by means of both morphologic and electron microscopic methods. As an example of vital verificated case the wide pathomorphologic analysis of the biopsy sample of brain was presented. Besides, the efficiency of the investigation of cognitive evoked potentials (P300) together with EEG was also demonstrated as the method of objectification of the development of dementia in this disease.

Brain↗
PubMed1997

[New findings concerning pathogenesis of disorders of cerebral circulation].

The data about the role of blood flow in atherosclerosis development were examined. The aim of the study was determination of hydrodynamic blood resistance and Toms effect in patients with ischemic disorders of cerebral circulation in different periods of the disease. 45 patients with atherosclerotic damages of major arteries of head were observed. Such damages were combined with arterial hypertension in 32 individuals. The value of hematocrit, asymptotic viscosity, hydrodynamic resistance and Toms' effect were determined in blood as well as levels of cholesterol, beta-lipoproteins and platelets. The presence of Toms' effect was found in blood samples of both patients and controls. There was a significant increase of hydrodynamic blood resistance in all the patients as compared to control group. The patients with ischemic disorders of cerebral circulation were compensated by their own blood factor in less degree in acutest and acute periods than later. Low values of Toms' effect in separate patients were prognostic sings for good restoration of neurologic functions; higher values were observed in patients with arterial hypertension. The conclusion was made that hemodynamic properties of blood flow may be considered as predictors of the severity of the course of cerebral circulation disorders.

Acute Disease↗
PubMed1996

[Retrospective analysis of cerebrovascular disorders in patients with lesions of the major arteries of the head].

378 cases of cerebrovascular disorders with the history of apoplexy were analyzed retrospectively. It was found that initial symptoms of cerebrovascular insufficiency occurred in 7.4%, episodes of cerebrovascular failure were registered in 31.2% of cases. In most of the patients the stroke came as a debut of vascular abnormalities in the brain. They had no stages in the development of cerebrovascular pathology. It is necessary to detect asymptomatic disturbances of major cerebral vessels using modern non-invasive diagnostic techniques--ultrasonic dopplerography and duplex scanning.

Adult↗
PubMed1995

[The catamnesis of patients with stenosis of the internal carotid artery who have undergone carotid endarterectomy and of unoperated patients].

Investigation of catamnesis of 100 patients with atherosclerotic carotid artery stenosis (50 were operated and 50--non-operated) revealed, that in some cases carotid endarterectomy prevented repeated cerebrovascular disorders and had prophylactic significance. The frequency of repeated stroke in the group of non-operated patients was 3 times higher than in the group of operated patients. In operated cases no more TIAS were observed, but they persisted in non-operated cases.

Adult↗