Asunto(s)
Homocigoto , Mutación Missense/genética , Miastenia Gravis/genética , Mutación Puntual/genética , Regiones Promotoras Genéticas/genética , Subunidades de Proteína/genética , Receptores Colinérgicos/genética , Adulto , Análisis Mutacional de ADN , Electromiografía , Femenino , Humanos , Músculo Esquelético/fisiopatología , Miastenia Gravis/diagnóstico , Miastenia Gravis/fisiopatología , LinajeRESUMEN
The authors have rejected applying of image identification algorithms and searching for given sequence in favor of algorithms sorting, eliminating thereby an influence of subjective factors on diagnostic process. To create the program, the diagnostic signs with probability coefficient 1 (positive indicator) or 0 (negative indicator) were used. To positive signs were attributed indicator muscles and indicator sensitive zones--the cutaneous areas where sensitive disorders appeared in the first turn, in response to a lesion in corresponding segment of peripheral nervous system, and disappeared in the last turn; to negative ones--muscles or cutaneous areas, being never affected by paresis or hyperesthesia in response to the given lesion type. The first part of the algorithm concerns a definition of defect level and the second one--an establishment of final diagnosis. The use of the algorithm developed simplifies diagnostics and raises its efficacy.
Asunto(s)
Algoritmos , Paresia/diagnóstico , Paresia/fisiopatología , HumanosRESUMEN
Despite a vast body of studies carried out over the past years, there is no single definite opinion about the topography of sensitive innervation zones. The reason, underlying such a situation, is analyzed in the report. Based on laser dopplerfluorometry and evoked somato-sensory potentials, an original method for determining autonomic innervation zones is described. High sensitivity of the method allows measuring dermatome topography in the absence of corresponding clinical disorders.
Asunto(s)
Hiperalgesia/diagnóstico , Hiperalgesia/fisiopatología , Sistema Nervioso Autónomo/fisiología , Procesamiento Automatizado de Datos , Potenciales Evocados Somatosensoriales/fisiología , Humanos , Microcirculación/fisiología , Nervios Periféricos/fisiopatología , Piel/irrigación sanguínea , Piel/inervaciónRESUMEN
Photopheresis with blood lymphocytes UV radiation exposure was for the first time used in the treatment of patients with myasthenia. Twenty-three patients with generalized form of the disease, aged 23-66 years, were treated. Twenty patients (87%) exhibited clinical improvement after a treatment course (4 sessions). One photopheresis session was shown to be more or less beneficial in 16 out of 23 patients (70%). The treatment resulted in strengthening of all the muscles studied, especially of mimic, platysma, biceps, deltoid, illiopsoas and gastrocnemius. Photopheresis was effective not only in a mild and moderate but in severe form of myasthenia as well. Compared to plasmapheresis, photopheresis exerts a more prolonged effect. Clinical improvement correlated with positive changes in immune status of the patients.
Asunto(s)
Miastenia Gravis/terapia , Fotoféresis , Adulto , Femenino , Humanos , Linfocitos/sangre , Masculino , Persona de Mediana Edad , Miastenia Gravis/sangre , Resultado del TratamientoRESUMEN
Despite a widespread application of computer technologies in medicine, there is currently a lack of diagnostic computer programs, meeting neurological needs. Most of the existing programs depend on some subjective factors. The authors propose their own computer program named "indicated diagnosis", and demonstrate its potential for diagnosis of peripheral monoparesis. Indicated diagnosis included testing and structuring of clinical and anatomical traits, along with the data of instrumental examination of the patients, ranging from patients complaints to establishing topic and nosologic diagnosis. Indicated diagnostics algorithm may be used for measuring of the lesions of nerves, plexuses, terminals and spinal cord segments involved in limb innervation.
Asunto(s)
Diagnóstico por Computador/métodos , Paresia/diagnóstico , Programas Informáticos , Algoritmos , Cibernética , Humanos , Sensibilidad y EspecificidadRESUMEN
Acethylcholine receptor (AChR) antibodies in patients with myasthenia were studied for the first time in Russia with radioimmuno-assay application. Seronegative result (antibody titer lower than 0.2 nmol/l) was obtained for 33% of the patients and seropositive one (antibody titer higher than 0.2 nmol/l)--for 67%. AChR antibodies level varied from 1.9 to 115.0 nmol/l. The AChR antibodies were found more frequently and in higher titers in women than in men. Correlation analysis revealed strong correlation between AChR antibodies level and severity of myasthenia.
Asunto(s)
Anticuerpos/inmunología , Miastenia Gravis/inmunología , Receptores Colinérgicos/inmunología , Adolescente , Adulto , Femenino , Humanos , Masculino , Miastenia Gravis/epidemiología , Miastenia Gravis/cirugía , Cuidados Posoperatorios , Cuidados Preoperatorios , Índice de Severidad de la Enfermedad , TimectomíaRESUMEN
HLA-phenotype was determined in 59 juvenile patients of Russian nationality and in their 50 relatives by means of lymphocytotoxic test. There was a positive association with HLA-A1, B8 and DR3 and the negative one--with HLA-A2, A9, B5, B7, and DR7. The frequencies of HLA-A1, B8, DR3 were higher in boys than in girls with myasthenia. There were no significant changes of HLA frequencies in ocular form of the disease in comparison with the healthy group. The frequencies of HLA-B8 and DR3 were significantly higher in relatives of the patients with juvenile myasthenia than in control population.
Asunto(s)
Antígenos HLA-DR/inmunología , Miastenia Gravis/inmunología , Niño , Femenino , Humanos , Masculino , Modelos Biológicos , Miastenia Gravis/fisiopatología , Fenotipo , Timo/inmunología , Timo/fisiopatologíaAsunto(s)
Miastenia Gravis/sangre , Sistema del Grupo Sanguíneo Rh-Hr/fisiología , Niño , Preescolar , Femenino , Humanos , MasculinoAsunto(s)
Benzamidas/uso terapéutico , Encéfalo/irrigación sanguínea , Estimulantes del Sistema Nervioso Central/uso terapéutico , Trastornos Cerebrovasculares/terapia , Hexobendina/uso terapéutico , Teofilina/análogos & derivados , Anciano , Trastornos Cerebrovasculares/diagnóstico , Terapia Combinada , Combinación de Medicamentos , Fenómenos Electromagnéticos/métodos , Femenino , Humanos , Oxigenoterapia Hiperbárica/métodos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Teofilina/uso terapéuticoRESUMEN
Cases of young patients with different diseases of nervous system in which tremor was the main symptom, clinical peculiarities of trembling hyperkinesis in essential tremor, in olivopontocerebellar degeneration, in strionigral atrophia, in residual phenomena of organic brain damages as well as their differences from functional hyperkinesia are characterized. The data are presented on comparative efficiency of different methods of examination.
Asunto(s)
Degeneración Hepatolenticular/diagnóstico , Atrofia de Múltiples Sistemas/diagnóstico , Atrofias Olivopontocerebelosas/diagnóstico , Temblor/diagnóstico , Adolescente , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/fisiopatología , Diagnóstico Diferencial , Electroencefalografía , Degeneración Hepatolenticular/complicaciones , Humanos , Hipercinesia/complicaciones , Hipercinesia/diagnóstico , Imagen por Resonancia Magnética , Masculino , Atrofia de Múltiples Sistemas/complicaciones , Atrofias Olivopontocerebelosas/complicaciones , Tomografía Computarizada por Rayos X , Temblor/etiologíaAsunto(s)
Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Músculos/fisiopatología , Sistema Nervioso/fisiopatología , Adolescente , Adulto , Anciano , Neuropatías Diabéticas/fisiopatología , Estimulación Eléctrica , Electromiografía/instrumentación , Electromiografía/métodos , Potenciales Evocados Motores/fisiología , Humanos , Persona de Mediana EdadAsunto(s)
Vértebras Cervicales , Desplazamiento del Disco Intervertebral/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Compresión de la Médula Espinal/diagnóstico , Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/etiología , Vértebras Cervicales/patología , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Humanos , Desplazamiento del Disco Intervertebral/complicaciones , Imagen por Resonancia Magnética , Neoplasias Meníngeas/complicaciones , Neoplasias Meníngeas/cirugía , Meningioma/complicaciones , Meningioma/cirugía , Persona de Mediana Edad , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/cirugía , Neoplasias de la Médula Espinal/diagnósticoAsunto(s)
Enfermedad de Alzheimer/diagnóstico , Demencia/diagnóstico , Anciano , Enfermedad de Alzheimer/etiología , Enfermedad de Alzheimer/patología , Atrofia/patología , Encéfalo/patología , Demencia/etiología , Demencia/patología , Diagnóstico Diferencial , Femenino , Actividad Nerviosa Superior , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The authors report a case of low spine vascular insufficiency. The clinical neurological syndrome resulted from compression of the accessory radiculomedullary artery by a dystrophic disk in a female patient with lumbar osteochondrosis. NMR tomography registered specific changes in the intervertebral disks and dural space which is decisive for differential diagnosis with similar symptoms of other affections.