[Prognostic value of D-dimer fibrin level in neurosurgical patients before elective hospitalization].

Deep vein thrombosis and pulmonary embolism in postoperative period are very dangerous complications for patient with any surgical pathology. Frequency of deep vein thrombosis in neurosurgical patient can be up to 25-30%. D-dimer level is considered as one of the most reliable indicator of thrombosis.

[Secondary abdominal compartment syndrome in postoperative period in patients with tumors of sellar region].

The abdominal compartment syndrome (ACS) can lead to multiple organ dysfunction syndrome (MODS), sepsis and death. In neurosurgical patients ACS used to be interesting for specialists only in respect of its impact on ICP. However injury of diencephalic structures of the brain can theoretically cause ACS.

[Monitoring the depth of anesthesia in neurosurgical patients].

The study reports the results of monitoring the depth of anesthesia with BIS technology in 456 neurosurgical patients with different neurosurgical pathology: sub- and supratentorial tumors, aneurisms, arteriovenous malformations, spinal pathology, etc. BIS reflects hypnotic state of the brain during anesthesia in almost all the cases, except for bifon-tal surgical approach when sensor placement is impossible. BIS monitoring of the depth of anesthesia is most advantageous in the following cases: epilepsy surgery, spine surgery with neurophysiological monitoring, awake craniotomy, severe cardiovascular pathology, massive blood loss, neurosurgery in pregnant patients.

[Structural features of cerebral arteriovenous malformations according to the data of optic microscopy and scanning electron microscopy of corrosion specimens].

The aim of this study was to investigate structure of cerebral arteriovenous malformations (AVM). We examined and treated 5 patients with AVMs of cerebral hemispheres. Treatment consisted of endovascular embolization with subsequent surgical resection of AVM.

[Investigation of anti-hypoxic action of 3-hydroxypyridine derivatives in animals with some types of experimental pathology].

Experiments with occlusion of the common carotid artery in mice demonstrated that, unlike mexidol and SK-170, single injection of new derivatives of 3-hydroxypyridine (3-HP) SK-100 and IBKhF-2, and semax have an anti-hypoxic action on the model of acute normobaric hypoxia with hypercapnia. In analogous experiments with rats the distinct anti-hypoxic action was produced by 4 new 3-HP derivatives (SK-100, SK-170, IBKhF-22 at the dose of 100 mg/kg and IBKhF-2 at the doses of 10 and 30 mg/kg--extension of life span by 25-39%), mexidol (100 mg/kg) and reference-class antihypoxant amtisol (30 mg/kg, life span expansion by 19 and 27%, respectively). A series of experiments with rats with acute pancreatitis, a distinct anti-hypoxic action was shown by SK-100, SK-170 at 100 mg/kg and IBKhF at 10 and 30 mg/kg (life span extension by 26-40%), mexidol (100 mg/kg) and amtisol (30 mg/kg) which extended life span by 17 and 22%, respectively.

[Experience in using normofundin and sterofundin solutions for the correction of hypernatremia].

The efficacy of Sterofundin, Normofundin, and physiological solutions in correcting hypernatremia and impaired acid-base balance was analyzed in patients with sellar region tumors. Twenty-one patients were enrolled in the study; three groups were formed. Physiological solution added by 4% of potassium chloride and 25% magnesium sulfate solution was used in Group 1 (n = 7).

[Transcranial magnetotherapy for the correction of initial manifestations of diabetic retinopathy in children].

This study included 45 children at the age from 5 to 17 years with type I diabetes mellitus complicated by diabetic retinopathy. All the patients showed retinal thickening at the macula and reduced amplitude of local electroretinogram suggesting compromised capillary circulation. The capillary blood flow was corrected by transcranial magnetotherapy with the use of an AMO-ATOS Ogolovie unit.

[Non-pharmacological treatment of microcirculation disturbance in children with diabetic polyneuropathy].

Twenty-five boys and 20 girls, aged 5-17 years, with diabetes mellitus type I and illness duration from 2 to 10 years have been studied. All of them suffered from diabetic neuropathy. Laser-Doppler flowmetry has been used.

[Specificiety of DNA-protein interactions within transcription complexes of Escherichia coli].

Current requirement for description of each new promoter assumes identification of all DNA-protein and protein-protein contacts important for transcription complex formation. Experimental approaches allow estimating which one of seven alternative sigma-subunits is employed for RNA synthesis and verifying transcription dependence on known regulatory proteins. Promoter sequence by itself also contains this information.

[Reliability of the sterilization of surgical instruments is a key point in prevention of surgical infection].

Occurrence of postoperative purulent-inflammative complications (PPIC), their structure and dynamics after improvement of sterilization are studied. For epidemiological analysis 65,246 medical histories of operated patients were studied, in 404 of them PPIC were revealed. The PPIC rate reduced from 3.

[The effect of selective dorsal rhizotomy on motor function in patients with infantile cerebral palsy].

The authors analyze the outcomes of surgical treatment in 15 CP patients with lower paraparesis who had been treated with selective dorsal rhizotomy at the L2-S2 level. All the patients were examined by neurological study, EMG, EEG, visual evoked potential (VEP) recording and motor reaction time estimation. Based on the findings, it is suggested that SPR lumbosacral spinal level may affect cerebral function.

[Analysis of stage IV stomach cancer diagnostic and treatment results in permanently followed-up group of population].

982 case records of the patients with cancer of the stomach (CS) were analyzed for the period from 1980 to 1997. Among them tumor of stage IV made up 21.1% (autopsy data were not taken into account).

[The identification and functional tracking of the facial nerve during the removal of tumors of the cerebellopontine angle].

Intracranial identification by electrostimulation and monitoring of the status of the facial nerve was intraoperatively used in 21 patients with cerebellopontine angle tumors of varying histological structure. Monopolar and bipolar electrostimulation, as well as electromyography and mechanography for recording the function of the facial nerve were compared. During removal of cerebellopontine angle tumors, identification and monitoring of the function of the facial nerve provide anatomic retention of this nerve when the tumor is radically eliminated.

[The use of propofol (Diprivan) for inducing anesthesia in neurosurgical patients. II. Its effect on intracranial pressure and on cerebral perfusion pressure].

Clinical study of the effect of propofol (diprivan) on intracranial and cerebral perfusion pressure (ICP and CPP, respectively) in 30 patients with neurosurgical diseases of the brain showed that propofol without narcotic analgesics did not block ICP increase in response to tracheal intubation. If it was combined with narcotic analgesics, the optimal combination was with pyritramide in a dose of 0.4 mg/kg, because this combination blocked ICP increase in response to laryngoscopy and tracheal intubation and did not appreciably decrease CPP.

[The results of treating stomach cancer at a medical center].

Results of diagnosis and treatment of gastric cancer according to the program of screening in permanently followed-up population group during 1980-1995 years, developed and introduced into practice of Medical Center of the President of Russia Administration, are analysed. According to the Cancer Register data through this period, total number of cases of this disease comprised 896 patients. Active revealing of cancer of the stomach made up 61%.

[Use of cerebral oximetry in early diagnosis of cerebral ischemia in neurosurgical patients with cerebrovascular diseases].

Using a new device, INVOS-3100 cerebral oximeter, the rSO2 parameter (oxygen saturation of blood hemoglobin in cerebral vessels) was monitored during neurosurgical interventions in 84 patients with cerebrovascular diseases (arterial aneurysms, arteriovenous malformations, and carotid-cavernous anastomoses). Six patients developed grave ischemic complications. In five of them the cerebral oximeter showed a more than 5% reduction of the parameter in question (by 11%, on an average).

[Use of propofol (diprivan) for induction of anesthesia in neurosurgical patients. I. Pressor reaction to laryngoscopy and intubation of the trachea].

Pressor reaction to laryngoscopy and intubation of the trachea was studied in 32 patients with neurosurgical diseases of the brain (supratentorial tumors and arterial aneurysms) under conditions of induction anesthesia with propofol (diprivan) in the mean dose of 2.85 mg/kg. Diprivan alone did not block the development of pronounced pressor reaction to intubation.

[Monitoring of eye movements in surgery of the brain stem and parastem structures].

Intraoperative electrooculograms (EOG) of 44 patients with bulky formations in the posterior cranial fossa demonstrated a good correlation of the sum of EOG waves caused by mechanical stimulation (aspiration, retraction, etc.) and the sum of complexes of EOG waves, on one hand, and the outcome, on other, in patients with brain stem involvement and less so in those with involvement of the cerebellum. The method is not informative for predicting the status of stem structures in surgery on the pontocerebellar angle.

[Retraction pressure: a new parameter in intraoperative monitoring of neurosurgical patients].

The injurious effects of self-retained retractors on brain tissue during surgery were studied in patients with various neurosurgical diseases of the brain. The first part of the study was devoted to retraction pressure in neurosurgical patients. The highest values were observed in patients with abnormalities of the chiasmal-sellar area, median cranial fossa, and aneurysms of the anterior portions of Willis' circle.

[Intraoprative identification and monitoring of motor structures of the brain stem].

The purpose of this work was to evaluate the method of identification of motor structures of the bottom of the IV ventricle in order to find the zone through which it is possible to safely approach the bulky formation and to assess the efficacy of subsequent monitoring of these structures for the prevention of their intraoperative injury. Fourteen patients with bulky tumors of the caudal portions of the brain stem aged 4 to 57 were examined. Motor structures of the brain stem (nerves VII or IX, X, and XII, depending on the site of injury) were identified by direct electrostimulation of the surface of the rhomboid fossa and recording of the motor functions by mechanography of EMG.