[Endovascular treatment of a patient with post-thrombotic disease and obstruction of a cava filter]. / Éndovaskuliarnoe lechenie bol'nogo s posttromboticheskoi bolezn'iu i obstruktsiei kava-fil'tra.

Balloon angioplasty and stenting have increasingly been gaining widespread application for treatment of post-thrombotic alterations in the system of the vena cava. Endovascular ultrasonographic examination makes it possible with the utmost degree of reliability to determine both the extension and degree of the narrowing of venous segments, thus proving a possibility of choosing a venous stent of an appropriate diameter. Restoration of an adequate venous lumen leads to normalization of blood flow and elimination of venous hypertension. However, unsolved as yet remains the problem concerning proper management of post-thrombotic obstructions of the inferior vena cava at the level of a cava filter. Owing to a wide variety of configurations of cava filters to deploy, there are no common approaches to elimination of such obstruction. Presented herein is a clinical case report regarding successful endovascular treatment of a patient diagnosed with post-thrombotic disease secondary to endured thrombosis. The findings of both phlebography and endovascular ultrasonographic examination made it possible to diagnose obstruction of the left common iliac vein, external iliac vein, and inferior vena cava to the level of the cava filter previously deployed. In the segment of the inferior vena cava at the level of the cava filter also revealed was a pronounced luminal narrowing exceeding 90% of its diameter. We carried out stenting of the common and external iliac veins, inferior vena cava, and the cava filter. Swelling of the left leg subsided spontaneously within 2 weeks and the first postoperative month was accompanied by gradual disappearance of the previously existing feeling of heaviness in the lower limbs and a dramatic decrease in fatigue by the end of the working day.

[Potassium transport in erythrocytes from patients with gentamicin intolerance]. / Issledovanie transporta kaliia v éritrotsitakh bol'nykh s lekarstvennoi neperenosimost'iu k gentamitsinu.

A study was made of rubidium (potassium analog) influxes via ouabain-sensitive Na/K pump, bumetanide-sensitive cotransport and resistant to ouabain bumetanide membrane ion pathways and of the intracellular potassium and sodium contents in red blood cells from patients with high gentamicin sensitivity (GSP) and healthy patients (HP). It is found that red blood cells from two groups of donors do not differ in both intracellular potassium and sodium contents and pump-mediated rubidium influxes, however, bumetanide-sensitive rubidium influxes were twice as low in GSP as compared to HP (0.28 against 0.46 mumole per gram of hemoglobin). In the presence of gentamicin (10(-6) M) bumetanide-sensitive rubidium influxes were shown to decrease in red blood cells of GSP, being unchanged in erythrocytes of HP. It is suggested that the increased rates of hemolysis in response to hypotonicity in red blood cells of GSP may be due to a decreased activity of bumetanide-sensitive cotransport in plasma membrane of these cells.

[Use of metoclopramide (cerucal) in Tourette syndrome]. / O primenenii metoklopramida (tserukala) pri sindrome Turetta.

The action of cerucal was investigated in 22 children with Tourette syndrome. Positive effect was obtained in 59.1% of the cases. Personality types were described which presented a continuum between asthenic and psycho-asthenic+ poles. Cerucal proved effective in patients with psycho-asthenic+ traits.

[Characteristics of the Tourette syndrome-like disorders in various mental disorders]. / Osobennosti turettopodobnykh rasstroistv pri nekotorykh psikhicheskikh zabolevaniiakh.

Fifty-four children with Gilles de la Tourette's syndrome were examined from 1987 to 1989. In 11 of them, Gilles de la Tourette-like disorders occurred within the framework of schizophrenia and in 6, of encephalopathy. The characteristic features of hyperkinesis associated with those conditions and their differences from the routine syndrome are depicted. The typology of Gilles de la Tourette's syndrome reflecting its clinical pleomorphism is suggested.

[Differential therapy of Gilles de la Tourette's syndrome]. / K differentsial'noi terapii sindroma Zhilia de lia Turetta.

The previous works of the author demonstrated the clinical heterogeneity of Gilles de la Tourette's syndrome (GTS). Based on statistical treatment of the efficacy of 138 courses of the treatment with benzodiazepine tranquilizers, neuroleptics, antidepressants, and anticonvulsants, methods of the individualized treatment of GTS were elaborated. It is recommended that low doses of neuroleptics (orap, haloperidol) be applied in patients with typical GTS. Schizophrenia associated with Tourette-like disorders requires the use of higher doses of neuroleptics and, in some cases, of the combined therapy. In encephalopathy accompanied by Tourette-like disorders, the treatment with anticonvulsants and benzodiazepine tranquilizers turned out most effective.

[Clinical variability of the Gilles de la Tourette's syndrome: the heterogeneity of the classical syndrome]. / Klinicheskie raznovidnosti sindroma Zhilia de lia Turetta: geterogennost' klassicheskogo sindroma.

Altogether 54 children with Gilles de la Tourette's disease (GTD) were under observation. Of these, 37 manifested disorders corresponding to the classical depiction of the disease. According to the results of a study into the patients' personality traits, carried out in connection with motor disturbances, the inhibitory (15 patients) and the excitable (22 patients) versions of the classical GTD were distinguished.

[Familial background of patients with Gilles de la Tourette's disease]. / Semeinyi fon bol'nykh s sindromom Zhilia de lia Turetta.

A study was made of hereditary loading of probands with Gilles de la Tourette's syndrome (GTS) and of the degree of genetic homogeneity of the clinical varieties of the disturbance. Among 131 relatives of the patients, GTS was encountered in 1.52% of cases, whereas tics in 8.3% on the whole. It turned out as a result of a genetico-statistical analysis of different varieties of GTS that the excitable and inhibited subtypes of the typical Tourette's syndrome are homogeneous in terms of their hereditary loading and significantly differ (p greater than 0.05) from schizophrenia with Tourette-like disorders in the pathology of the schizophrenic spectrum (schizophrenia, schizoid psychopathy). Schizophrenia with Tourette-like disorders is genetically similar to sluggish schizophrenia of childhood (p = 0.95). In homogeneous hereditary predisposition to hyperkineses, their clinical diversity is determined both by the ground which gives rise to their development and by contribution of environmental factors.

[Status of local and general immunity in patients with multiple sclerosis]. / Sostoianie mestnogo i obshchego immuniteta u bol'nykh rasseiannym sklerozom.

A study was made of the general (blood) and local (CSF) immunity in 18 patients with clinically active multiple sclerosis running different course and in 14 controls. The relative and absolute count of T and B lymphocytes, phagocytizing cells, the content of IgA, IgM and IgG, circulating immune complexes, some fractions of complement, functional activity of blood granulocytes and mononuclears were measured. The patients with multiple sclerosis manifested appreciable alterations in cellular and humoral immunity of the blood and CSF. No correlation was observed in alterations of the immunological parameters of the blood and CSF whereas in some cases (E-RFL), the changes were of different character. The relationship was discovered between the intensity of alterations in local immunity and the type of the disease.

[Various neurophysiological aspects of examination of children with Gilles de la Tourette's syndrome]. / Nekotorye neirofiziologicheskie aspekty issledovaniia detei s sindromom Zhilia de la Turetta.

EEG mapping was used to study the ECG and brain electric activity in 45 normal children and in 33 patients with Gilles de la Tourette's syndrome. Significant differences were discovered in the test parameters in groups of patients and normal children as well as in subgroups of patients with different varieties of the syndrome. Analysis of the ECG has shown that 78% of children with typical Tourette's syndrome manifest neurovegetative regulation impairment in the form of bradycardia and cardiac arrhythmia. In tourette-like disorders within the framework of schizophrenia and encephalopathy and in normal test subjects, such alterations occur much more seldom. The data of the EEG mapping and analysis of spectral power of different rhythmic ranges attest to the existence of mainly nonspecific changes in the EEG common to all varieties of the syndrome. At the same time a tendency was recorded toward definite abnormalities in one or another patients' group. The data obtained can be of help for differential diagnosis of the syndrome under study.

[Absolute diet therapy and antibiotic tolerance in bronchial asthma patients]. / Razgruzochno-dieticheskaia terapiia i perenosimost' antibiotikov bol'nymi bronkhial'noi astmoi.

In 10 patients with bronchial asthma (BA) treated conventionally (control group), 10 BA patients on absolute diet therapy (group 1) and 10 BA patients in absolute diet therapy combined with wheat herb juice (group 2) tolerance to 12 antibiotics of different classes and some immunity factors were determined using a complex of diagnostic methods. The latter implies: case history, humoral and cell immunity defense system tests and special tests (chemical erythrograms and leukocyte migration inhibition test in plane capillary tubes with tested drugs). The data obtained evidence for increased tolerance of the antibiotics in groups 1 and 2 as well as for changes in humoral defense system, especially in immunoglobulin E. The drug tolerance may be a therapeutic criterion of absolute diet therapy in bronchial asthma patients.

[Methodologic characteristics of determining immunologic indices in cerebrospinal fluid]. / Metodicheskie osobennosti opredeleniia immunologicheskikh pokazatelei v tserebrospinal'noi zhidkosti.

The authors have tried to adapt the micro-methods for assessment of the peripheral blood immunologic parameters to measurements of these characteristics in the cerebrospinal fluid (CSF) and examined a group of patients to define the diagnostic value of these parameters. Eighteen patients with disseminated sclerosis and 14 normal controls were examined. Relative and absolute counts of T and B lymphocytes, phagocytes, IgA, IgG, and IgM were measured. Normal values of the CSF cellular immunity parameters were determined; these values were essentially shifted in the patients, which recommends the developed methods for assessment of local immunity in nervous system diseases.

[UV irradiation of the cerebrospinal fluid in the treatment of patients with disseminated sclerosis]. / UF-obluchenie tserebrospinal'noi zhidkosti v lechenii bol'nykh rasseiannym sklerozom.

Cerebrospinal fluid (SF) in the quantity 5-7 ml from 26 multiple sclerosis patients was exposed to UV radiation with subsequent reinfusion. The assessment of clinical symptoms and immunological indices 7 days later showed that positive results (6 scores by Sipe scale) were achieved in 14 patients with cell abundance in the SF. The improvement was indicated by positive trends in pelvic functions, sensory and coordination disorders, normalization of the blood immunological picture. The responders exhibited elevated SF levels of B-lymphocytes, phagocytosing cells and IgM concentrations. High levels of IgG registered in 58% of the patients did not change. The only side effect was represented by short-term postpuncture syndrome in 4 patients with arterial hypotension. In 12 patients with progressive sclerosis the treatment was ineffective.