[Lactase deficiency: somatoneurology and neurodietology].

Neurologic and somatoneurologic aspects of lactose intolerance are considered in the article. Authors stress the role of adequate diet therapy in this form of food intolerance.

[Temporary preventive clipping of the major brain arteries in the surgical treatment of arterial aneurysms].

Preventive temporary clipping of the carrying arteries reduces the incidence of intraoperative hemorrhage in anterior connecting arterial aneurysms from 26 to 13%, in middle cerebral arterial arterial aneurysms from 29 to 4%. In anterior connecting arterial aneurysms, the use of preventive temporary clipping of the carrying arteries fails to affect surgical outcomes. In middle cerebral arterial arterial aneurysms, this procedure decreases postoperative mortality from 17 to 12% by reducing the incidence of intraoperative hemorrhage; however, the rates of disability due to possible brain ischemia in the middle cerebral arterial bed rates increases from 32 to 40%.

[Intraoperative hemorrhages during the surgical treatment of aneurysms of the cerebral vessels].

The study indicated that intraoperative hemorrhages more frequently occurred at early surgery. During operations made in the first 7, 8-14 days of and after a fortnight of aneurysmal rupture, the incidence of hemorrhage was 27.5, 23, and 22%, respectively.

[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.

[The mechanism of tautomeric transitions of nucleic acid bases with limited access to water molecules].

Pathways of tautomeric transformations of nucleic acid bases have been considered in the conditions when only few separate water molecules can interact with the bases. Field ionization mass-spectrometric study has demonstrated that substitution of one of the labile hydrogen atoms for deuterium takes place when thymine (or 1-methylthymine) interacts with heavy water in vacuo. This observation was explained by a supposition that a transient water-thymine complex is formed and then tautomeric transition of the base occurs via double proton transfer along hydrogen bonds.

[Identification of bis-quaternary ammonium compounds using mild ionization mass spectrometry].

Ethonium, an antimicrobial chemotherapeutic agent, was investigated by mass spectrometry (MS) under various ionization conditions: electron impact, field ionization, field desorption (FD) and fast atom ionization. FDMS was found to be the most suitable procedure for ethonium identification. Relation of the ED mass spectra to the distance between the nitrogen atoms in bis-quaternary ammonium compounds is discussed.

[Mass-spectrometric analysis of an anti-microbial preparation decamethoxine].

I. I. Mechnikov Kharkov Research Institute of Microbiology, Vaccines and Sera, Ministry of Public Health of the Ukrainian SSR.

[Odontogenic septic endocarditis].

In the operative treatment of 34 patients with septic endocarditis the identic microflora was isolated from odontogenous and cardiogenic foci of infection in 35% of the patients. Surgical sanitation of foci of odontogenous infection immediately before operation on the heart contributed to prophylactics of postoperative complications and recurrences of the main disease.

[Surgical treatment of cerebral aneurysms complicated by vasospasm in the acute period].

The results of clipping of an aneurysm in the acute period of subarachnoid hemorrhage are analysed. It is shown that vascular spasm is an increased risk factor if it involves up to 3-4 and more arterial basal segments and is attended by marked general cerebral and focal neurological symptomatology and gross disorders of cerebral function. Such vascular spasm is unfavourable from the standpoint of prognosis in determining the outcomes of the operation.

[Effect of temporary interruption of blood flow through the major intracranial vessels on the outcome of surgical treatment of arterial aneurysms].

During operations for clipping an aneurysm, the blood flow along the artery supplying this aneurysm was temporarily arrested in some patients to prevent intraoperative hemorrhage. It has been proved that the arrest of blood flow along the main vessel for more than 20 minutes during an operation in the acute period of subarachnoidal hemorrhage, particularly in the presence of a vascular spasm, aggravates the course of the postoperative period and is conducive to the lethal outcome.

[Results of surgical treatment of intracranial arterial aneurysms].

The results of surgery for arterial aneurysms of the brain are analysed. It was found that the severity of the patient's condition rather than the time of the operation had an effect on the outcome of surgery. The severity of the patient's condition and the outcome of the operation were determined first of all by the presence of the intracranial hematoma, cerebrovascular spasm, escape of blood into the ventricles of the brain, and the degree of manifestation of subarachnoid hemorrhage.

[Prediction of recurrent hemorrhages from ruptured arterial aneurysms in the acute period].

In a series of 61 patients the authors studied the effect of some risk factors on the development of recurrences of haemorrhage from arterial aneurysms of cerebral vessels in the acute period of their rupture. The highest risk of recurrences was associated with an elevated fibrinolytic activity of the cerebrospinal fluid, spasm of the cerebral vessels, aneurysms of the anterior connective and internal carotid arteries as well as the patients' grave condition. Consideration of these factors makes it possible to specify the indications for surgical or conservative treatment.

[Fibrinolytic activity of cerebrospinal fluid as an indicator of the risk of repeated ruptures of arterial aneurysms].

The fibrinolytic activity of the cerebrospinal fluid and common venous blood flow was studied in 28 patients with ruptured aneurysms of cerebral arteries. Recurrent hemorrhage from the aneurysm was encountered in 8 of 11 patients with increased fibrinolytic activity of the cerebrospinal fluid but in none of the patients with absence of fibrinolysis in the cerebrospinal fluid. At the same time, intensified fibrinolytic activity was found in the common venous blood flow.

[Diagnosis and treatment of patients in the acute period of a subarachnoid hemorrhage as a result of rupture of arterial aneurysms of the brain].

The authors suggest a complex of measures for examination of patients with subarachnoidal hemorrhage (SAH), which makes it possible to elucidate the genesis of the hemorrhage and to decide on the tactics of treatment within the first hours after the stroke. They prove the necessity of hospitalization or transfer of patients with SAH to neurosurgical departments as well as of surgery in the acute stage of aneurysmal rupture.

[Analysis of causes of death in the acute period of ruptured intracranial aneurysms].

The causes of death of 80 patients with ruptured aneurysms of the brain are analysed; 37 of them underwent operation. Intracranial hypertension with edema and dislocation of the brain was the main cause of death both of patients who were operated on and of those not subjected to surgery. Intensive subarachnoid hemorrhage, vascular spasm, intracranial hematoma, and the escape of blood into the ventricles of the brain lead to the development of intracranial hematoma.

[Hyperbaric oxygenation and prevention of recurrent cerebral circulatory disorders in the acute stage of a stroke].

The course of the acute period of cerebral stroke was compared in two groups of patients matched by the major clinical criteria: the test group receiving hyperbaric oxygenation (HBO) and the control one given no such treatment. It was found that the patients of the test group developed no recurrent impairments of the cerebral circulation in the acute period whereas in the control group this complication occurred in ten patients. Possible mechanisms of action of hyperbaric oxygen in preventing recurrent cerebral strokes are discussed.

[Hyperbaric oxygenation in the prevention of mental disorders in patients during the acute period of severe craniocerebral injuries].

On the basis of a comparative analysis of the incidence of psychic disturbances seen in two groups of patients with craniocerebral trauma (subjects receiving HBO treatment and those without it), it is concluded that HBO is effective in preventing trauma-associated psychoses. The effect of HBO on the external respiration and central hemodynamics was also examined. The obtained results formed the basis for discussing possible pathogenetic mechanisms of hyperbaric oxygen action in this pathology.