Delayed results of transplantation of fetal neurogenic tissue in patients with consequences of spinal cord trauma.

We analyzed delayed effects of transplantation of nervous and hemopoietic fetal cells to patients with consequences of spinal trauma. A decrease in neurological deficit associated with pronounced improvement of functional independence was observed in 48.9% cases. The best results were observed in patients receiving cell transplantation within the first 2 years after trauma and in younger individuals. The pattern of morphological changes in the spinal cord at site of injury, severity of damage, and the method of transplantation had no appreciable effects on its delayed results.

Immunological and clinical aspects of cell therapy in the treatment of aftereffects of craniocerebral injury.

Cell suspension consisting of cells from immature nervous and hemopoietic tissues was transplanted subarachnoidally to patients with craniocerebral injury aftereffects. In some patients cell therapy led to immune sensitization to donor antigens, detected by the leukocyte migration inhibition test. No signs of tissue-destructive autoimmune reactions were detected in patients receiving cell therapy. Follow-up of 56 patients showed that cell therapy was associated with significant improvement of the neurological status. No serious complications of this treatment modality were observed. Presumably, cell therapy is a safe method which can be used in the treatment of craniocerebral injury aftereffects.

Cell therapy of comatose states.

We demonstrated that liquor from adult humans can maintain proliferative activity of cells of immature nervous tissue in vitro. The paper presents the results of a retrospective clinical study of the efficiency of cell therapy in the treatment of II-III degree comatose patients with severe brain injury. Cell suspension consisting of cells derived from immature nervous and hemopoietic tissues was injected into the recipient subarachnoidal space through a cerebrospinal puncture. The mortality in the study group was 8% vs. 56% in the control group. The 1.5-year follow-up demonstrated significantly better quality of life in patients receiving cell therapy in comparison with patients of the control group. Cell therapy proved to be ineffective for patients in a comatose state caused by hypoxic encephalopathy. The study demonstrated the efficiency of cell therapy in patients with severe brain injury during the acute period of the disease.

Cell therapy of brain stroke.

Cell suspension consisting of cells from immature nervous and hemopoietic tissues was subarachnoidally transplanted to 10 patients with brain stroke consequences. Clinical effect of different degree was attained in all patients. Six months after cell therapy functional activity significantly increased in contrast to clinically comparable control group. No serious complications of cell therapy were observed. Presumably, cell therapy is a more or less safe method of treatment, which can be effectively used in the treatment of brain stroke consequences.

Cell therapy of cerebral palsy.

The paper presents the results of a controlled study of cell therapy in 30 patients with severe forms of cerebral palsy. A cell suspension from immature nervous and hemopoietic tissues was injected into the subarachnoidal space of a recipient through a spinal puncture. Immune sensitization to donor antigens (detected by suppression of lymphocyte migration) was noted in few patients. In none patients laboratory and clinical signs of tissue-destructive autoimmune reactions were observed. One year after treatment activity of the major psychomotor functions in treated patients considerably surpassed the normal. No delayed complications of cell therapy were noted. These findings suggest that cell therapy is an effective, safe, and immunologically justified method of therapy for patients with cerebral palsy.

[The evolution of a contusion focus after the microsurgical autotransplantation of the omentum (an experimental study)]. / Evoliutsiia kontuzionnogo ochaga posle mikrokhirurgicheskoi autotransplantatsii sal'nika (éksperimental'noe issledovanie).

The purpose of treatment of head trauma cannot be limited by simple life saving, it also should be targeted at the improvement of the quality of life. Twenty dogs with graded local head trauma underwent microsurgical revascularization of the area adjacent to the contused brain with an autologous omental graft to provide functional improvement. The effectiveness of surgery was demonstrated in series of 5 experiments when the operation was performed on posttraumatic days 7-14, with the follow-up of as long as 180 days. After the procedure, no macroscopic signs of contusion could be demonstrated. Microscopically the contused area resembled a slit two times smaller than in controls. Microscopic and histochemical studies revealed both the morphologic recovery and an improvement in cellular enzyme activity. The data obtained adds some more information regarding clinical applications of microsurgical revascularization technique.

[A case of the clinical manifestation of the Arnold-Chiari syndrome in middle age]. / Sluchai klinicheskogo proiavleniia sindroma Arnol'da--Kiari v pozhilom vozraste.

The article presents description of Arnold-Chiari syndrome in 62-year-old woman. The diagnosis was made clinically, by means of MRT and verified during the operation.

[Magnetic resonance tomography in the diagnosis of tumor processes in the area of the cerebellopontile angle]. / Magnitno-rezonansnaia tomografiia v diagnostike opukholevykh protsessov v oblasti mostomozzhechkovogo ugla.

The paper provides the results of magnetic resonance tomographic examination of patients with acoustic neurinoma, and shows that the method can be used in the defining the site of a focus, its size, and relations of the tumor with adjacent tissues. The paper also outlines the image structure of the tumor in relation to scanning techniques and gives magnetic resonance criteria for differential diagnosis of tumor processes in the region of the cerebellopontine angle. It is concluded that magnetic resonance tomography is of high informative value in the diagnosis of extra-axial tumors of the posterior cranial fossa.

[The postaggressive reactions of the early period in acute craniocerebral trauma]. / Postagressivnye reaktsii rannego perioda ostroi cherepno-mozgovoi traumy.

Experiments were conducted to study metabolic reactions developing in the first hours and days in response to craniocerebral trauma (CCT). Analysis of dynamics of the metabolism of glucose, lactate, and pyruvate, activity of enzymes in the blood, brain tissue, and in the cells, and the condition of the mitochondria made it possible to reveal the features of the course of postaggressive reactions in the early period of CCT. These reactions were hyperergic and their degree and trend depended on the severity of the brain damage.

[The adaptational reactions in mild experimental craniocerebral trauma and its combination with alcoholic intoxication]. / Adaptatsionnye reaktsii pri legkoi cherepno-mozgovoi travme i ee sochetanii s alkogol'noi intoksikatsiei v éksperimente.

The article deals with the results of experimental study of adaptation reactions in mild craniocerebral trauma (MCCT) combined with acute alcoholic intoxication on the basis of appraisal of the dynamics of endocrine and neuromediator shifts. A stress character of these shifts was revealed. Acute alcoholic intoxication levelled the stress reaction occurring in MCCT.

Correlation of MRI and CT data with outcome of cerebral revascularization after stroke.

Sixteen patients with the occlusion of the internal carotid artery (ICA) underwent extra-intracranial bypass surgery. All patients had stroke in evolution or completed stroke with mild or moderate (n = 9) or severe (n = 7) neurological deficits. In each case, the clinical course, magnetic resonance imaging (MRI), computed tomography (CT) and angiographic (AG) findings were evaluated. Patients were followed up from 9 months to 2.5 years postoperatively. MRI was much more sensitive than CT for appreciating the ischaemic tissue. The infarct volume determined by MRI had greater extent than previously detected by CT. If the difference of the infarct volume, detected by MRI and CT was more than 30% the patients appeared to have benefited from bypass surgery as demonstrated clinically as well as with postoperative MRI and AG studies. Patients with lesser difference showed insignificant or no postoperative improvement.

[The dynamic NMR tomographic picture after cerebral revascularization in patients with ischemic stroke]. / Dinamika IaMR-tomograficheskoi kartiny posle revaskuliarizatsii golovnogo mozga u bol'nykh s ishemicheskim insul'tom.

The authors discuss the results of a MR tomographic examination in 12 patients with ischemic apoplexy who underwent operation for the formation of an extra-intracranial microanastomosis. It is shown that MR tomography is a valuable diagnostic method which allows visualization of the ischemic foci. It is proved that in combination with CT it yields valuable information for determining the indications for revascularization of foci of ischemia in the brain.

[Local blood flow and metabolism in a focus of cerebral crushing]. / Lokal'nyi krovotok i metabolizm v oblasti ochaga razmozzheniia golovnogo mozga.

Study of ECoG, local cerebral circulation, and brain pO2 in 39 patients in the acute period of severe craniocerebral injury, as well as morphohistochemical measurements around the focus of crushing (in experiments) showed that the transitional zone is a risk zone because the "enzymatic death" of the tissue of this zone occurring at the moment of the injury predetermines extension of the areas of necrosis later on. The most effective measure is the removal not only of the detritus but also of the transitional zone of the focus within the range of tissue that had hardly suffered any changes and the inclusion of vasoactive and dehydration agents in the therapeutic complex.

[Histochemical and electron-microscopic study of brain structures during the acute period of experimental craniocerebral injuries]. / Gistokhimicheskoe i élektronno-mikroskopicheskoe issledovanie struktur golovnogo mozga v ostrom periode cherepno-mozgovoi travmy v éksperimente.

Three stages of cerebral metabolism differing in tension were revealed in the acute period of closed craniocerebral trauma. In the mobilization stage (1 hour after trauma) enzymatic reactions reflecting the activity of aerobic and anaerobic glycolysis are sharply intensified. In the resistance stage (from 3 hours to 2 weeks after trauma) stable conversion to anaerobic glycolysis is noted, which leads to marked deficiency in macroergic compounds. Activation of alpha-glycerophosphate, pentose shunt by means of pharmacological agents in combination with hypothermia may be recommended in this stage. In the restoration stage (more than 2 weeks after the trauma) the metabolic processes are gradually normalized and therapy need not be so intensive.