[Lesions of the cortical part of the auditory analyzer in explosive injury]. / Narusheniya korkovogo otdela slukhovogo analizatora pri vzryvnoi travme.

A survey of 48 victims aged 19-36 years with explosive trauma and combined damage to the auditory system was conducted to assess the level of damage to nerve structures by analyzing the bioelectric activity of the cerebral cortex. All patients underwent electroencephalography (EEG). It is established that akubarotrauma of explosive genesis almost always leads to lesions of the function of the cortical part of the auditory analyzer. Desynchronized activity on the EEG after acubarotrauma is a favorable prognostic sign, indicating only functional disorders of the cortical part of the auditory analyzer. On the contrary, EEG changes of an organic type of cortical or stem nature are an unfavorable prognostic factor, usually accompanied by sensorineural hearing loss with prolonged and incomplete hearing recovery. Promising drugs for the treatment of otoneurological disorders are antihypoxants, in particular, derivatives of triazine indole, which affect the molecular mechanisms of hypoxia development.

[Modern approaches and prospective directions in treatment of acute sensorineural hearing loss following acoustic trauma]. / Sovremennye podkhody i perspektivnye napravleniya v lechenii ostroi sensonevral'noi tugoukhosti akutravmaticheskogo geneza.

The article presents a review of the literature on the treatment of acute sensorineural hearing loss, acoustic trauma in people exposed to impulse noise. Groups of the most used drugs for the pharmacological correction of hearing impairment in this pathology are present, such as glucocorticosteroids, antioxidants, nootropics, antihypoxants, and others, are covered. Particular attention is paid to use of drugs taking into account the main links of pathogenesis.

[The role of genetic mutations in the patents with the acquired forms of sensorineural impairment of hearing].

The objective of the present work was to study the role of GST genes in pathogenesis of various neurodegenerative conditions with special reference to sensorineural impairment of hearing. The DNA samples obtained from 200 subjects were available for the investigation; 109 of them were the patients hospitalized in the otorhinolaryngologcal clinic of S.M. Kirov Military Medical Academy for the treatment of uni- or bilateral impairment of hearing. The polymerase chain reaction with subsequent specific restriction endonuclease analysis was used to study genetic mutations. The analysis was focused on the 35delG mutation in the GJB2 gene (DFNB1). In addition, the MTRNR1 (12S rRNA) and MTTS1 (serine tRNA) genes in the patients with acquired sensorineural impairment of hearing were subjected to analysis. Polymorphism of the second detoxication phase gene (GSTM1) was investigated. It was shown that mitochondrial genes MTRNR1 and MTTS1 contribute to the development of acquired sensorineural impairment of hearing. The frequency of heterozygous 35delG mutations of the GJB2 (DFNB1) gene among the subjects with impaired hearing does not significantly differ from its prevalence in the general population. The allelic mutation of the GSTM1 gene is believed to be a predisposing factor for the development of sensorineural impairment of hearing under the action of intoxication and/or infections.

[The pathogenetic approach to the development of tools and methods for the improvement of statokinetic stability in the operators of aerospace systems].

The objective of the present study was to estimate the efficacy of the tools and methods for the optimization of the activity of the central nervous system (CNS) and analyzers involved in the maintenance of the statokinetic (SK) stability in man. To this effect, we evaluated the outcome of bemitil treatment during 10 days with and without A.I. Yarotsky test and the influence of these procedures on the pathophysiological characteristics of selected elements of the work of operators of aerospace systems. Based on the data obtained in the study, the tools and methods have been developed that allow the efficacy and quality of certain aspects of the operators' activity to be improved, viz. general working capacity under conditions requiring enhanced statokinetic stability, self-confidence, emotional and somatic comfort.

[The early diagnosis of the severity of blast trauma to the brain and auditory system]. / Ranniaia diagnostika tiazhesti vzryvnoi travmy golovnogo mozga i slukhovoi sistemy.

This paper presents the information on the early period of an explosive head trauma and trauma to the auditory system. Different types of hearing impairment, the staging of the pathological process were determined along with various immunological and biochemical changes occurring in this group of patients. The results of the study call for necessity of the early ENT observation of all patients in whom an explosive trauma is suspected.

[Problems in the early rehabilitation of minor casualties with injuries to the ENT organs]. / Voprosy rannei reabilitatsii legkoranenykh s povrezhdeniem LOR-organov.

The article examines the questions of a specialized otorhinolaryngological care to the minor wounded with mine injuries. There are description of evacuation procedures for this category of wounded. Up to 70% of such patients can be treated at the HMW. The article contains schemes concerning the conservative treatment of auditory disorders caused by mine traumas. The authors describe the methods of conduction anesthesia via the low palpebral fissure in cases when patients have traumas of the middle facial zone.

[The neurological manifestations of blast trauma to the brain]. / Nevrologicheskie proiavleniia vzryvnoi travmy golovnogo mozga.

The article describes mechanisms of cerebral injuries and clinical symptomatology of light and medium trauma. It is stressed that a certain succession in medical and diagnostical measures must be observed, as well as physicians of several medical specialties must participate in the treatment of such cases. There is a description of morphological picture of cerebrum in this type of trauma. The article also shows pathogenetical and clinical differences between burst and mechanical brain injuries.

[The basic principles of extracorporeal detoxication in military field surgery]. / Osnovnye printsipy ékstrakorporal'noi detoksikatsii v voenno-polevoi khirurgii.

Extracorporal detoxication (ED) was used in 64 operations of 40 wounded with gunshot injuries, thermal burns and acoubarotraumata. ED was applied with plasmapheresis, plasmosorption, hemoxygenation, ultrafiltration and hemodialysis. Combinations of these methods also were used. Indications and contraindications for extracorporal management of blood were elaborated for each category of wounded. Alterations were made in the methods of operations with reference to the peculiarities of pathogenesis. Positive results were marked at 30 persons. The authors propose a scheme of indications, as well as basic principles and criteria of efficiency for ED management of surgical patients. The article makes a conclusion that these operations must be preferably realised at the stages of secondary care.

[Agents for combined pharmacotherapy in severe trauma to the brain and ENT organs]. / Sredstva kompleksnoi farmakoterapii pri tiazheloi travme golovnogo mozga i LOR-organov.

Early complex treatment of a critical brain traumas should be aimed not only at men's life and personality saving, but also at their performance' rehabilitation. Complicity and to some degree individual nature of a critical trauma pathogenesis depend on the associative active methods of surgery interference and conservative pharmacotherapy. The article deals with well-practiced means and methods of symptomatic pharmacotherapy at the early and later stages of the brain traumas with vestibular and hearing system injures and with theoretical and clinical base for modern "quick-action adaptogens" usage in addition to psychoneurocorrectors.

[The interdependence between neurodynamic indices and the state of the hearing in blast trauma]. / O vzaimozavisimosti mezhdu pokazateliami neirodinamiki i sostoianiem slukha pri vzryvnoi travme.

The authors have proved that in the blast trauma diagnosis of the organ of hearing in slight or middle-gravity cases it was necessary to applicate such important additional methods of researching as pure-tone and speech audiometry, and EEG. It gives the possibility to reveal the affections in primary and secondary cortical fields of temporal, occipital and frontal lobes, prognosticate the possible outcome of hearing pathology, elaborate optimal schemes of treatment, control the efficiency of therapy, and also make expert evidence conclusions. It was proved that the diminished hearing in patients who had suffered from blast injuries have a direct correlative dependency upon pathological deviations in EEG indexes. The severe neurodynamic disorders form an unfavourable background for recovery of hearing.

[The diagnosis of damages to the auditory system in the early period of explosive mine trauma and the optimization of treatment for the victims]. / Diagnostika povrezhdenii slukhovoi sistemy v rannii period minno-vzryvnoi travmy i optimizatsiia lecheniia postradavshikh.

The wide use of the mine-explosive weapon in modern military conflicts is accompanied by high specific weight of mine-explosive traumas (MET), which achieve 30-40% of all traumas. In the departments of the hospital in 21.3-35.8% of the wounded with MET accompanying defeat of acoustical system with probable subsequent development of neurosensory hypoacusis and invalidism of the injured is established. It defines necessity of early ENT-inspections of all injured with such traumas. Steady up to 1-6 months reduction of hearing is accompanied by biochemical infringements of a cerebrospinal liquid.

[Clinical and statistical patterns of the hearing system lesions caused by explosive mine trauma]. / Kliniko-statisticheskie zakonomernosti porazhenii slukhovoi sistemy pri minno-vzryvnoi travme.

Mine-explosive trauma has become the predominant type of pathology in the structure of surgical sanitary losses. In 70-75% of the cases it is combined with acoustic injury that requires the improvement of diagnosis and prediction of acoustic injuries at the stage of qualified medical care. In 772 casualties with mine-explosive trauma admitted to the different departments of Kabul Central Hospital the conditions of explosive injury were identified and statistical analysis of acoustic injury dependence on the above-mentioned conditions was conducted. The quantitative patterns obtained could be used in prognosis of the possible value and structure of acoubarotraumatic losses in the mine-explosive injuries.