[Cerebrocardiorenal syndrome--the new concept in geriatrics].

In the review risk factors of the development and progressing of the brain, cardiovascular system and kidneys pathology are considered in details. The literature analysis testifies to uniform pathogenetic mechanisms of development and progressing of the pathology of kidneys and cardiovascular system, including the cerebrovascular diseases; about set in parallel proceeding pathophysiological processes in brain, kidney and heart. At the comparative analysis of the risk factors the general come to light for all listed systems mechanisms of development and disease progressing, i.e. risk factors cerebrovascular diseases simultaneously are also risk factors of the cardiovascular illnesses and chronic kidney disease. The conclusion that, along with introduction of concepts "cardiorenal continuum", "chronic kidney disease", defensible is occurrence of the undernosological new concept--"cerebrocardiorenal syndrome" or cerebrocardiorenal continuum becomes. Concept introduction of cerebrocardiorenal syndrome or cerebrocardiorenal continuum predetermines necessity of the interdisciplinary approach under the authority of geriatric patients.

Raised prolactin levels in myasthenia gravis: two case reports and a study of two patient populations.

OBJECTIVES: To describe two patients with myasthenia gravis (MG) and prolactinoma and analyze the associations between MG and prolactin (PRL) levels. DESIGN: Two case reports and a case-control study of PRL levels in 192 patients with MG. PARTICIPANTS: The Immunological Research Laboratory, Center for Molecular Medicine, Department of Medicine and the Department of Neurology, Karolinska Institutet, Stockholm, Sweden; St Petersburg Medical Academy for Postgraduate Studies, and St Petersburg State Medical Pediatric Academy, Russia. RESULTS: Two women with MG and thymic hyperplasia accompanied by prolactinomas are described. The levels of plasma PRL were raised in 101 women with MG, but not in 91 men. There was an association between high PRL levels and high levels of autoantibodies against the acetylcholine receptor. CONCLUSIONS: There is an association of MG with raised levels of PRL in women. PRL has stimulating effects on immune activation and the increased levels might thus be implied in the pathophysiology of MG.

[Photochromotherapy of experimental compression-ischemic neuropathy]. / Fotokhromoterapiia éksperimental'noi kompressionno-ishemicheskoi nevropatii.

Effects of monochrome light of the green and red spectra (mean wave length 540 and 670 nm, respectively) were studied on experimental rat model of compression-ischemic neuropathy (40 animals). The nerve under compression was exposed to green and red light using light-diode physiotherapeutic unit "Spectr-LC" with different intensity. Electromyographic parameters of the compressed nerve improved significantly after exposure to monochrome green light with intensity 500 mJ/cm2. The effect was dose dependent. Green light produced better effect.

[Development of occupational vertebral radiculopathies and tunnel syndromes]. / Formirovanie professionalnykh vertebrogennykh radikulopatii i tunnelnykh sindromov.

The study proved occupational and everyday strain of muscles and ligaments to be risk factor for ischemic and compression neuropathy. The pathologic changes appeared to involve not only compression points, but also the sites distant from the primary area and ultimately the whole axon. Therefore, spinal roots and nerves could be affected by complicated and multiple ischemic and compression radiculopathies demonstrating typical clinical signs.

[The differentiation of the pathogenetic variants of nerve trunk lesions]. / Differentsiatsiia patogeneticheskikh variantov porazhenii nervnykh stvolov.

There are two major variants of nerve trunk disease progression: demyelinating and axonal-axial. The authors have developed a significant and rapid diagnostic procedure to differentiate the type of nerve trunk affection based on simultaneous assessment of two parameters (immunological and electroneuromyographic) carrying out correlations between them. The immunological investigation included measurement of the serum autoantibodies to galactocerebrosides titer.

[Autonomic vascular disorders in neuropathies and the methods for their pathogenetic therapy]. / Vegetativno-sosudistye rasstroistva pri nevropatiiakh i metody patogeneticheskoi terapii.

Investigations were made to examine vegetovascular disorders in patients with inherited and acquired neuropathies (regional vegetative innervation, peripheral circulation and the thermal status of the limbs). Comprehensive, pathogenetically based treatment methods were developed. Using clinico-neurological, thermography, rheovasography and electrothermography research methods the following alterations were revealed in the autonomic areas of innervation of affected nerves: the signs of vegetovascular irritation; the signs of vegetovascular depression; a phenomenon of thermovision "amputation". Bearing in mind the diagnostic data, the patients were given differentiated pathogenetic therapy including physiotherapy and vegetotropic drugs.

[Laser correlation spectroscopy of the blood serum in assessing the efficacy of hemosorption with myasthenia patients]. / Lazernaia korreliatsionnaia spektroskopiia syvorotki krovi v otsenke éffektivnosti gemosorbtsii u bol'nykh miasteniei.

In 30 patients with myasthenia the authors studied the dynamic of changes of subfraction content of the blood serum using the method of laser correlation spectroscopy. Significant changes of the blood serum homeostasis have been revealed in the process of hemosorption. The obtained results make it possible to develop objective criteria for indications to hemosorption as well as for the assessment of the efficacy of therapy.

[Status of the carpal canal in compressive neuropathy of the median nerve (computerized-tomographic examination)]. / Sostoianie zapiastnogo kanala pri kompressionnoi nevropatii sredinnogo nerva (komp'iuterno-tomograficheskoe issledovanie).

Computer-aided tomography of the carpal canal was performed in 30 patients syndromes of the carpal canal and in 20 healthy persons. Topographoanatomic interrelations of carpal canal structures were specified, degenerative and dystrophic alterations of the carpal bones, proliferation of the connective tissue, displacement of carpal structures and of the median nerve itself were revealed.

[Definition and systematization of compression-ischemic neuropathies]. / Opredelenie i sistematizatsiia kompressionno-ishemicheskikh nevropatii.

The authors give a definition of tunnel neuropathies which makes it possible to differentiate them from neurites (of the infectious nature), and to differentiate compression ischemic lesions of the nervous trunks from compression ischemic vertebrogenic radicular involvements (radiculitis) and from other lesions and diseases of the peripheral nervous system. The working classification of compression ischemic neuropathies is built on topographic principles of the arrangement of nerves and their correlations with compressed structures with due consideration for clinical and pathogenetic manifestations.

[Extracorporeal hemosorption in the intensive care of myasthenia]. / Ekstrakorporal'naia gemosorptsiia v intensivnoi terapii miastenii.

Extracorporeal hemosorption was included into the multiple-modality treatment of crises in 4 patients with severe generalized forms of myasthenia. The method was followed by a rapid and considerable regression of myasthenic disturbances, as well as by complete disappearance of respiratory disorders. Electromyographic examination revealed a two-fold increase in the amplitude of the potentials. Improvement in the patients' status made it possible to decrease the daily dose of anticholinesterase drugs by more than two times.

[Criteria for severity and prognosis of the course of myasthenia]. / Kriterii tiazhesti i prognoza techeniia miastenii.

On the basis of clinical, radiological, electromyographical and histochemical examinations the authors describe criteria of the severity and prognosis of myasthenia and show their significance in the selection of an adequate pathogenetically-substantiated therapy.