[Brain edema as a cause of critical states in neurosurgical patients]. / Otek mozga kak prichina kriticheskikh sostoianii u neirokhirurgicheskikh bol'nykh.

The results of the studies in 120 patients after resection of tumours located in cranial fossa (40 cases), basal-diencephalic area (45 cases), hemispheres (35 cases) have shown the role of brain edema in the onset of critical conditions after neurosurgery (with consideration of a new concept concerning the mechanisms of brain edema development). It has been demonstrated that brain edema at its early stages is a biologically expedient adaptation response to any damage and is manifested in hyperhydration of all the tissues, most marked in the affected focus. Specific (neurogenic, neurohumoral) and non-specific (biochemical, autoimmune, mechanical, etc.) factors of brain edema onset have been identified. It turned out that the location of the affected focus determines the differences in neurogenic and neurohumoral mechanisms of the edema onset. The nearer the affected focus to the stem and diencephalic structures, the more marked the effect of neurogenic and neurohumoral factors and the more distinct the tendency towards edema generalization. Brain edema may be a cause of critical conditions and lethal outcomes only when it leads to dislocation and strangulation of them brain structures, and disturbances of brain metabolism and blood flow.

[Changes in the levels of neurotensin and adenohypophyseal hormones in the acute period of craniocerebral injury]. / Izmenenie urovnei neirotenzina i gormonov adenogipofiza v ostrom periode cherepno-mozgovoi travmy.

Clinico-biochemical study in 51 patients in the acute period of craniocerebral trauma (CCT) and in 12 healthy individuals revealed impairment of the functional condition of the hypothalamus and hypophysis in the acute period of CCT. Evidence of this was the change in the blood neurotensin, prolactin, somatotropin, and thyrotropin levels. A dependence was found of the increase in the prolactin level on the severity of impaired consciousness (coma-sopor, stunning) on admission of the patient; changes in the prolactin and neurotensin contents were detected during the examination. Improvement of the condition of patients who were in a state of coma-sopor on admission was attended by an increase of the neurotensin level and reduction of the prolactin content in the blood. Correction of motor excitement was also attended by increase of the blood neurotensin content.

[Status of biogenic amine metabolism in tumors of chiasm-sellar localization]. / Sostoianie obmena biogennykh aminov pri opukholiakh khiazmal'no-selliarnoi lokalizatsii.

Histamine, serotonin, and catecholamine metabolism was studied in 47 patients with tumors of diencephalic localization. It was shown that the degree of involvement of the hypothalamus in the tumor determined the different character of metabolic changes of biogenous amines. Three stages of biogenous amine metabolism were distinguished: activation, compensation, and exhaustion. The degree of metabolic changes manifestation before the operation determined to a great measure the organism's reaction to it. The work substantiates the necessity for taking into consideration the metabolism of biogenous amines before undertaking surgery.

[Endocrine function of the pancreas in tumors of the chiasmal-sellar region]. / Sostoianie endokrinnoi funktsii podzheludochnoi zhelezy pri opukholiakh khiazmal'no-selliarnoi oblasti.

A clinicobiochemical study of 10 patients with tumors of the chiasmal sellar region and 8 healthy persons using the i. v. glucose tolerance test (IGTT) made it possible to reveal disorder of pancreatic alpha- and beta-cell function in the patients with tumors. A distinct picture of the chiasmal sellar process with the involved hypothalamus was clinically determined in all the patients. Radioimmunoassay of immunoreactive insulin, glucagon, C-peptide and glucose revealed fasting hyperinsulinemia in the presence of both hypo- and hyperglycemia. The latter was accompanied by a raised level of glucagon in the blood. The IGTT revealed in the patients with tumors of the chiasmal sellar region hyperreactivity of beta-cells and a decrease in the sensitivity of alpha-cells to glucose as well as glucose tolerance that may be both regarded as pathogenetic factors of the development of a prediabetic condition in such patients.

[Reaction of the sympathetic-adrenal system of patients with tumors of the sellar-diencephalic region in the postoperative period]. / Reaktsiia simpatiko-adrenalovoi sistemy u bol'nykh s opukholiami selliarno-dientsefal'noi oblasti v posleoperatsionnom periode.

The character of the reaction of the sympatheticoadrenal system (SAS) to operation in 51 patients with tumor of the sellar-diencephalic area was studied. A dependence was demonstrated between the character of postoperative SAS activity and the degree of involvement of the subthalamic area and the doses of hydrocortisone given in the postoperative period. The necessity of taking into account the condition of the SAS in conducting intensive therapy in neurosurgical patients in substantiated.

[Features of the hormonal regulation of water-electrolyte balance in patients with tumors of the chiasmatic-sellar area in the early postoperative period]. / Osobennosti gormonal'noi reguliatsii vodno-élektrolitnogo obmena u bol'nykh s opukholiami khiazmal'no-selliarnoi oblasti v rannem posleoperatsionnom periode.

The response of water-electrolyte metabolism regulating hormones to neurosurgical stress was studied in 54 patients with tumors of the chiasma-sellar area of the brain. Three types of responses of hormones (the activity of renin, aldosterone, cortisol, and vasopressin) were revealed. Type I was characterised by a sharp activation of the hormones studied, type II by an absence of a response, type III by activation of renin and aldosterone and a decrease in vasopressin activity. Responses of types II and III were attended by deep disorders of water-electrolyte balance. The work substantiates the necessity of taking into account the state of the humoral mechanisms of regulation in conducting intensive therapy in neurosurgical patients.

[Use of correlation analysis of clinical biochemical indices for a study of the pathogenesis of acute arterial obstruction]. / Primenenie korreliatsionnogo analiza kliniko-biokhimicheskikh pokazatelei dlia izucheniia patogeneza ostroi arterial'noi neprokhodimosti.

The role of serotonin, histamine, and the kallikrein-kinin system in acute arterial occlusion during ischemia was studied from the standpoint of multivariate correlation analysis. The mechanisms of their participation in the genesis of pathophysiological disorders in the organism in acute arterial occlusion are discussed. The important role of serotonin and the kallikrein inhibitor in this pathological condition is shown.

[Attempt at mathematical prognosis of the effect of surgery in embolism of the main arteries, according to various clinico-biochemical indicators]. / Popytka matematicheskogo prognozirovaniia éffekta operatsii pri émboliiakh magistral'nykh arterií po nekotorym kliniko-biokhimicheskim pokazateliam.

The possibility, in principle, of mathematical prognostication of the results of an operative intervention according to the initial clinicobiochemical indices is shown. The duration of ischemia, the blood serotonin level, and the severity of the atherosclerosis and cardiovascular insufficiency are the most significant of the studied indices influencing the outcome of operation for embolism of the major limb arteries.

[Importance of determining the renin activity in the blood plasma of the renal veins in symptomatic hypertension]. / Znachenie opredeleniia aktivnosti renina v plazme krovi pochechnykh ven u bol'nykh s simptomaticheskoi gipertenziei.

In patients with vasorenal hypertension blood plasma renin activity was always higher on the side of the lesion than on the contralateral side, whereas in patients with nephrogenic hypertension and coarctation of the aorta this value was within physiological norm. After reconstructive operations in vasorenal hypertension (in an unilateral lesion) a hypotensive effect was produced when the ratio of blood plasma renin activity on the side of the lesion to that on the healthy side was 1.4 and more. The ratio of renin activity in plasma of blood in the renal veins is an important diagnostic and prognostic criterion.

[Role of the sympathetic-adrenal and kallikrein-kinin systems in regulating central hemodynamics in acute experimental occlusion of the terminal portion of the aorta]. / Rol' simpatiko-adrenalovoi i kallikrein-kininovoi sistem v reguliatsii tsentral'no gemodinamiki pri ostroi éksperimental'noi okkliuzii terminal'nogo otdela aorty.

The role of the sympatheticoadrenal and kallikrein-kinin systems in the pathogenesis of hemodynamic disorders was studied in 29 dogs with acute experimental occlusion of the terminal part of the aorta. Data confirming the close dependence of the indices of central hemodynamics on the activity of the sympatheticoadrenal and kallikrein-kinin systems are presented. Close positive correlative connection between activation of the sympatheticoadrenal and kallikrein-kinin systems was revealed. The possible mechanisms of the correction of hemodynamic disorders in severe degree of ischemia by means of agents blocking the kallikrein system are discussed.