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Biomedical subjects

V V Lebedev

Publications and source records attributed to V V Lebedev.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Volume of surgical procedures in severe craniocerebral injuries].

The case records of 3,150 patients with severe forms of craniocerebral injury (intracranial hematomas, contusion and crushing of the brain) are analysed. The causes of fatal outcomes in surgical management of this contingent of patients are considered. Not only the time factor (operation performed within 3-6 hours after admission) but also the volume of the surgical intervention are determinant in the treatment of severe craniocerebral injury. The operation must be radical with removal of the hematoma and foci of brain contusion and must include measures for relieving the CSF system and freeing the brain stem from compression; a system of irrigation and active aspiration from the region of the cerebral wounds must be applied in the postoperative period.

Brain Concussion↗
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[Determination of the degree of severity of cerebral contusions].

Three degrees of severity of the brain contusion are generally distinguished today for working out the most rational and purposeful treatment. It is quite difficult to judge the severity of the contusion from the neurological picture alone because neurological manifestations of the brain contusions are very diverse and dynamic in character. The authors analysed 630 case records of patients with contusion of the brain and disclosed signs most characteristic of each degree of contusion. In appraising the severity of the contusion, the authors recommend resorting to the laboratory and instrumental diagnostic methods accepted currently in neurosurgical practice in addition to the neurological examination. The complex method of appraising the patients' condition makes the determination of the degree of severity of the brain contusion more trustworthy and objective.

Brain Concussion↗
PubMedDate not supplied

[Surgical strategy in the treatment of cranio-cerebral injuries associated with fractures of tubular bones].

The work is based on the analysis of 450 patients with combined injury; 272 of them underwent osteosynthesis in different periods after the injury. Examination and treatment of the combined injuries must be conducted simultaneously. Operations on the extremities are performed only after the patient recovers from shock. Indications and contraindications for applying instrumental methods of examination are discussed. The volume of the neurosurgical intervention in patients with combined craniocerebral injury comprises removal of the hematoma, correction and prevention of dislocation and secondary compression of the brain stem in the postoperative period, and hemostasis. Preference is given to resection trephination and to encephalotomy for removing an intracerebral hematoma. Secondary stem disorders are managed by tentoriotomy; ventricular drainage is applied in hydrocephalus. A classification is suggested which takes into account the severity of the craniocerebral injury and the severity of the injury to the extremity.

Brain Injuries↗
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[Surgical treatment of ischemic strokes].

The following operations were performed for ischemic strokes in 116 patients: resection of a loop of the internal carotid artery on the neck, resection of the sympathetic ganglion, and the creation of anastomosis between the branch of the superficial temporal artery and the cortical branch of the middle cerebral artery. The method of the microsurgical intervention is described in detail and the indications and contraindications for various operations in ischemic strokes are discussed. Elaboration and improvement of the methods of microsurgery will make it possible to map out the prospects in the treatment of cerebral circulatory disorders.

Brain Ischemia↗
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[Visual evoked potentials in cerebral contusions].

The authors carried out neurophysiological examination of 70 patients with mild and moderate degree contusion on the convex surface of the brain by the method of induced visual potentials. Changes in the amplitude-time characteristics of visual induced potentials were revealed, which is evidence of pathophysiological changes in the brain limbico-reticular structures. Study of the induced makes it possible to reveal the character and side of the injury in early periods and guide pathogenetic treatment.

Brain↗
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[Isolation, characterization, and translation of heterogeneous nuclear RNA from plasmacytoma cells].

It was found that during hot phenol fractionation of plasmacytoma MOPC-21 cells, which produce immunoglobulins of gamma 1 chi-type, separation of nuclear and nucleolar RNAs, differing in kinetics of accumulation of radioactive precursors, distribution during gradient centrifugation procedures and in base composition, takes place. D-RNA 63 degrees and D-RNA 85 degrees, which possess similar characteristics with D-RNAs, discovered earlier in other cells were isolated. It was stated, the D-RNA 85 degrees is considerably enriched by 3'-terminal poly(A) sequences in comparison with D-RNA 63 degrees. During translation in cell-free protein synthesising system from Xenopus oocytes, these two fractions of hnRNA induced formation of immunospecific products. D-RNA 85 degrees stimulated synthesis of gamma 1 and chi chains more efficiently, that D-RNA 63 degrees. Polyadenylated and non-adenylated both D-RNAs stimulated synthesis gamma 1 and chi chains of immunoglobulin G1 during translation. This fact indicates the absence of significant differences in the informational content. These results give opportunity to propose the existence of two levels of processing pre-mRNA for immunoglobulin chains.

Animals↗
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[Errors in treatment and its organization in craniocerebral injuries].

The authors studied 428 case records of patients who had been treated at 9 multiprofile hospitals and died from a severe craniocerebral trauma. The defects revealed in aid given before hospitalization and in the hospital allowed the main principles of the organization to aid and treatment to be formulated: hospitalization of patients with severe craniocerebral trauma in specialized in-patient clinics; the conduct of a complex of neurosurgical examinations simultaneously and in parallel with resuscitation measures; early surgical intervention (within the first 3-6-8 hours after infliction of the trauma) which must be radical, i. e. including extensive trephination of the skull (osteoplastic or resection), total removal of intracranial hematomas and foci of contusion-crushing of the brain, active aspiration dosaged drainage of the postoperative wound and, whenever indicated, tentoriotomy (in specialized departments).

Adult↗
PubMedDate not supplied

[Pneumoencephalographic picture of changes in the cerebrospinal fluid containing spaces of patients who have suffered severe craniocerebral injuries].

Dynamic X-ray follow-ups were conducted after pneumo-encephalography (PEG) of 28 patients who had suffered a severe craniocerebral trauma (intracranial hematoma, crushing of the brain), and those suffering from a post-traumatic disease of the brain. PEG was carried out in periods from 3 months to 3 years after the trauma had occurred. X-ray control was established immediately after the endolumbar infusion of air into the intracranial cerebrospinal fluid spaces, and subsequently every 24 hours till the complete disappearance of air from the ventricles of the brain. Investigation showed that in most cases a more reliable picture of the size of the ventricles can be obtained not on the day that PEG is performed, but in remoter periods (24--48 hours). The internal hydrocephaly that occurs in most patients is evidently of aresorptive character. The expansion of subarachnoidal spaces, rather than their obliteration, is more characteristic of a traumatic disease of the brain, including post-traumatic epilepsy. These changes, however, are not pathognomonic for a complicated severe craniocerebral trauma.

Brain Injuries↗
PubMedDate not supplied

[Stereotaxic destruction of the ventrolateral thalamic nucleus in combination with the transplantation of fetal and xenogeneic tissue in Parkinson's disease].

Four patients with Stage III-IV Parkinson's disease were operated on. Stereotactic cryodestruction of the ventrolateral nucleus was made, followed 10 minutes later by implantation of mixed fetal and xenogenic nerve tissue cells. The nerve cells-the fetal part-are obtained from human fetuses in the age range of 14-18 weeks of development. Tissues from the ventral portion of the midbrain and basal ganglia of the forebrain were used. Neurogenic layings of Notch Drosophila melanogaster mutants serve as a xenograft. The mixture of nerve cells were prepared in ratios of 1000:20 and 1000:12. The follow-up of the patients lasted a year. Relapses were absent. The effect occurred on the operating table (in the combination of nuclear destruction and nerve cell transplantation) and only 6 months later only during transplantation of nerve cells (without destruction). An attempt of transplanting the above fetal xenogenic mixture of nerve cells to patients previously undergone 2 ineffective stereotactic operations provided no significant clinical effect. The concurrent destruction of ventrolateral nuclei in combination with fetal xenogenic tissue grafting is considered to be promising.

Animals↗
PubMedDate not supplied

[The surgical treatment of arterial aneurysms in the acute period of subarachnoid hemorrhage].

The paper presents the surgical outcomes of 300 patients with brain arterial aneurysms. A total of 43% of the patients were admitted to the unit within the first 72 hours of the onset of hemorrhage, 165 patients were operated on within the first fortnight, 135 were operated on in later periods. The aneurysms of the anterior communicating artery, internal carotid, middle cerebral artery were 42, 24, and 22%, respectively. Multiple aneurysms were 12% according to the Hunt and Hess classification, the preoperative severity of the patients was as follows: Degree I, 39 (13%), patients, Degree II, 130 (43%), Degree III, 106 (36%), Degree IV, 18 (6%), Degree V, 7 (2%). In 14% of the patients, aneurysm rupture was accompanied by the formation of intracerebral hematoma. The qualitative analysis of angiograms revealed vascular spasm in 70% of cases, the quantitative one indicated it in 80%. Aneurysm clipping was performed in 269 patients, its wrapping with a free muscle flap was done in 31 patients. Among the patients operated on, the mortality was 35% in the first fortnight of the onset of the disease and 17% during operations in later periods.

Aneurysm, Ruptured↗
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[Clinical features and cellular immunity in patients with icterohemorrhagic leptospirosis].

Time course of cellular immunity parameters was followed up in 56 patients with different forms of icterohemorrhagic leptospirosis of various severity. A grave course of the disease was associated with development of secondary structural immunodeficiency manifesting by reduction of E = RFC count, of immunoregulatory index, and of the count of T lymphocytes. The course of convalescence was found related to the immune response: if immunodeficiency persisted during the early convalescence period, the patients developed late complications.

Adolescent↗
PubMedDate not supplied

[Tumor necrosis factor and possibilities of correction of its production in patients with suppurative-septic complications in terminal states].

The production of tumor necrosis factor (TNF) by mononuclears was studied in 37 patients after critical states of various origins. A relationship was revealed between the TNF production and the patient's condition severity and the development of pyoseptic complications. Use of thymohexin, a new drug for correction, provided a modulating effect and helped reduce the excessively increased TNF production both in vitro and in the patients with pyoseptic complications.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Surgical results in intracerebral hematomas using stereotaxic puncture aspiration under guided ultrasonic brain scanning].

The paper outlines experience gained in stereotaxic aspiration of intracerebral hematomas in 27 patients within 1 to 20 days after hemorrhage. Hematomas of hypertensive and traumatic origin were present in 24 and 3 patients, respectively. Puncture and decision to remove hematomas were made according to operative ultrasonic scanning evidence. Aspiration was performed by an electric mechanical aspirator. Seven patients with hypertensive hematomas died after surgery. The advantage of the procedure is that the completeness of hematoma removal can be monitored just during an operation.

Adult↗
PubMedDate not supplied

[Prognostic significance of the NBT test in patients with ichterohaemorrhagic leptospirosis].

The values of spontaneous NBT test significantly rise at the peak of leptospirosis in patients with an uncomplicated course of the disease (p < 0.05). Low values of the spontaneous NBT test with stimulation with Staphylococcus in patients with grave leptospirosis predict the development of life-threatening complications. Leptospirosis vaccine reduced the elevated values of the NBT in leptospirosis. The depressing effect of leptospirosis vaccine is indicative of a high risk of development of late complications.

Adolescent↗
PubMedDate not supplied

[Comparative effectiveness of treatment of non-Hodgkin's lymphoma in children using protocols BFM NHL-90 and non-programmed courses based on the ACOP regimen].

170 NHL children aged 1-14 [mean age 6] have been treated for the last 5 years. The diagnostic examination included the disease history, physical examination, bone marrow cytology, tumor histology (all patients), immunophenotyping (17 cases), x-ray and sonography of the chest and abdomen. According to the International NHL staging system, 35% of the patients had NHL stage II, 65% stage III or IV. The study entered 71 patients who underwent additional lactate dehydrogenase test, CT-scanning. 44 of them received nonprogrammed therapy on the basis of ACOP (group I), 27 patients were treated according to BFM-NHL-90 for B-, non-B- and large-cell anaplastic lymphomas (group II). The efficiency of the methods did not differ for patients at stage IIR. At the II NR stage complete remission (CR) was up to 41% in the group I and 60% in the group II. 50% of the children from group I and 20% from the group II were resistant to treatment. All the group I patients developed relapses, none got relapses in the group II. CR was observed in 64% and 78% of patients from group I and II, respectively, who had NHL stage III and IV. Relapses occurred in 41% and 14%, respectively. CCR was in 22% in the group I and in 67% of the group II patients. Effectiveness of B-NHL treatment according to BFM protocols was higher than in other types of NHL as to the number of relapses and frequency of CCR: the latter was 76% compared to 50% of non-B-NHL.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Tumor necrosis factor in patients with suppurative-septic complications in terminal states and the possibilities for correcting its production].

The authors review the results of study of tumor necrosis factor (TNF) production by mononuclears in 37 patients recovered after critical conditions of various genesis. Relationships between TNF production, condition severity and complications development have been established. Use of a new correcting agent thymogexin ensured a modulating effect and reduced an excessively high TNF production both in vitro and in patients with pyoseptic complications.

Acute Disease↗