RESUMO
An analysis of the results of the treatment of 132 patients with isolated traumatic parenchymatous injury of the frontal lobes of the brain was made. The treatment strategy was determined in consideration of the traumatic substratum volume and a combination of neurologic status and instrumental data. There were unfavorable risk factors to the course of traumatic parenchymatous injury of the frontal lobes of the brain such as low initial GCS score, the progression of neurologic deficiency in the presence of contusion hemorrhagic foci in the frontal lobe with the volume more than 25 cm3, shifting of midline structures on 5 mm and more or signs of deformation of basilar region cisterns and the presence of mass-effect according to the tomographic data. The developed algorithm allowed improving the results of treatment and the quality of life for patients with traumatic parenchymatous injury of the frontal lobes of the brain.
Assuntos
Hemorragia Encefálica Traumática , Lesões Encefálicas , Lobo Frontal , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias , Adulto , Idoso , Hemorragia Encefálica Traumática/diagnóstico , Hemorragia Encefálica Traumática/etiologia , Hemorragia Encefálica Traumática/cirurgia , Lesões Encefálicas/complicações , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/mortalidade , Lesões Encefálicas/cirurgia , Feminino , Lobo Frontal/lesões , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Exame Neurológico/métodos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Seleção de Pacientes , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Tempo para o Tratamento , Tomografia Computadorizada por Raios X/métodos , Índices de Gravidade do Trauma , Resultado do TratamentoRESUMO
An analysis of treatment results was made in 83 patients with traumatic parenchymatous injuries of frontal lobes of the brain. Surgical interventions were performed in 31 patients and the conservative therapy was carried out in 52 patients. Regular neurological examinations were completed for all the patients. The data of neurovisual methods were estimated. A strategy of treatment of frontal lobes injury depends on not only from the traumatic substratum volume, but at the same time, it is formed by clinical neurologic constellations and instrumental data in traumatic injury of frontal lobes of the brain. Risk factors of unfavorable effect of traumatic parenchymatous injury of frontal lobes of the brain were reflected in the initially low GCS score, a neurologic deficit progression with contusion haemorrhagic foci in the frontal lobe (volume greater than 25 cm3), a midline shift on 6 mm or more and signs of base cistern compression and presence of mass-effect, according to CT scan data. The developed algorithm could improve the results of treatment and makes better the quality of life of the patients with traumatic parenchymatous injuries of frontal lobes of the brain.
Assuntos
Lesões Encefálicas , Craniectomia Descompressiva , Lobo Frontal , Complicações Pós-Operatórias , Adulto , Algoritmos , Lesões Encefálicas/diagnóstico , Lesões Encefálicas/mortalidade , Lesões Encefálicas/fisiopatologia , Lesões Encefálicas/cirurgia , Craniectomia Descompressiva/efeitos adversos , Craniectomia Descompressiva/métodos , Gerenciamento Clínico , Feminino , Lobo Frontal/lesões , Lobo Frontal/patologia , Escala de Coma de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Seleção de Pacientes , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Análise de Sobrevida , Tempo para o Tratamento , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
The synthesis of fluorescently labelled PAF-acether, 1-alkyl-2-acetyl-sn-glycero-3-phospho-[N-(9-anthrylmethyl)-N, N-dimethylethanolamine] with the label in the choline moiety is described, plasmalogen lysophosphatidylcholine of bovine heart being used as starting material.
Assuntos
Corantes Fluorescentes , Fator de Ativação de Plaquetas , Fenômenos Químicos , Química , Plasmalogênios , Espectrometria de FluorescênciaRESUMO
Significant differences in the molecular organization of lipid bilayer in remantadin-resistant and remantadin-sensitive strains of influenza virus were demonstrated by means of fluorescent phospholipid probes, analogues of phosphatidylcholine and sphingomyelin. The data on fluorescence polarization and transfer of excitation energy from protein tryptophanes on probe fluorophores showed phosphatidylcholine and sphingomyelin to be segregated in influenza virion membrane. Gradients of mobility of lipid chains in virion membrane and in phospholipid vesicles have opposite directions. The results indicate that M protein coming inside virion into contact with the lipid bilayer does not penetrate further than its middle. In virions of the resistant strain remantadin destroys the array of the entire bilayer whereas in the sensitive strain the addition of remantadin results in a marked decrease of mobility of the chains in the surface area. It is suggested that the molecular organization of lipids is one of the factors determining influenza virus sensitivity to remantadin.