Method of diagnostics of nervous system disorders with long-term influence of vinyl chloride
SUBSTANCE: anti-orthostatic test and ultrasound dopplerography of extracranial vessels are performed and visual, cognitive and auditory evoked potentials are recorded. Indicators are defined: amplitude and latency P2 of visual evoked potential, latency P300 of cognitive evoked potentials, latency P2 of auditory evoked potentials, amplitudes N1 of auditory evoked potentials, and index of reactivity in holding anti-orthostatic test. Based on the obtained indicators, taking into account discriminatory coefficients, the discriminant function (F) is calculated. Result are compared with a constant of 79.9. When F is less than or equal to the constant, the absence of signs of damage to the nervous system associated with influence of vinyl chloride is diagnosed. When F is greater than the constant, signs of damage to the nervous system associated with influence of two vinyl chloride are diagnosed.
EFFECT: method helps to increase the reliability of diagnosis by identifying signs of damage to the nervous system at the donorological stage of intoxication with vinyl chloride.
1 tbl, 3 ex
SUBSTANCE: technique involves foetus's middle cerebral artery Doppler ultrasonography prior to and after a pregnant woman holds her breath as much as possible at a depth of inhale. Diagnostically significant indices of blood velocity curves resistance in the foetus's middle cerebral artery that are a systolic/diastolic ratio, a resistance, a pulsation index are measured with a breath-holding test conducted and taking into account foetus's daily rhythmostasis. If the Doppler ultrasound measures are: the systolic/diastolic ratio at 12.00 prior to breath-holding 3.71±0.05, after breath-holding 4.56±0.08 and at 20.00 prior to breath-holding 3.92±0.06, after breath-holding 4.74±0.09; the resistance at 12.00 prior to breath-holding 0.69±0.03, after breath-holding 0.87±0.04 and at 20.00 prior to breath-holding 0.80±0.03, after breath-holding 0.91±0.04; the pulsation index at 12.00 prior to breath-holding 1.78±0.04, after breath-holding 1.92±0.03 and at 20.00 prior to breath-holding 1.84±0.04, after breath-holding 1.97±0.04, changes in the foetus's functional status are detected and chronic foetal hypoxia is diagnosed.
EFFECT: technique enables increasing the diagnostic accuracy in chronic foetal hypoxia by measuring the functional parameters taking into account the time variations of daily rhythmostasis.
SUBSTANCE: common carotid artery (CCA) is scanned. A peak systolic blood flow velocity in the CCA and the beginning of the systolic peak to peak time, a final diastolic blood flow velocity in the CCA, systolic and diastolic CCA diameters are determined. The value K is determined by formula K=(Vs-Vd)·Dd2:[AT·(Dd2-Ds2)], wherein Vs, Vd is the peak systolic and final diastolic blood flow velocities in the CCA respectively, cm/s; Ds, Dd are systolic and diastolic CCA diameters, cm; AT is the time from the beginning of the systolic peak blood flow to its peak, s. If the value K is more than 8,500, the humoral transplanted heart rejection is diagnosed.
EFFECT: method enables increasing the early diagnostic accuracy of the humoral heart rejection by assessing the reliable diagnostic value that is a hardness of the vascular wall of the common carotid artery, and avoiding the invasive diagnostic intervention.
SUBSTANCE: technique involves transabdominal ultrasonography of jejumum and colon in longitudinal and transversal projections. The transabdominal ultrasonography is native with the patient positioned on his/her back. Visualising all the jejuneal segment involves taking intestinal loops without haustra as reference points. haustra are used as reference points for visualising the colon. pulsed Doppler velocimetry is conducted to determine a blood flow velocity in mesenterial arterial branches. A transperineal examination of the anorectal area is performed in the patient placed on his/her left side with bended knees. A sensor is placed into an anal pit directly and displaced from pubic to sacrum while scanning in two projections - longitudinal and longitudinal-oblique. The reference points are sacrum, symphysis, and anal canal. The state of a distal portion of rectal ampulla is assessed. The derived values are compared to the normal criteria. If observing any changes in the jejunum: wall thickening more than 2 mm, higher echogenicity, intestinal lumen narrowing; if observing any changes in the colon: haustra flatness, contour roughness, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, the absence of clear layer differentiation, higher submucosal echogenicity, intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in adjoining organs: higher echogenicity of the greater omentum, envelopment of the jejuneal and colonic loops involved into the inflammatory process with the omentum, lengthening of the mesenterial, para-aortic lymph nodes more than 10 mm, free abdominal fluid, the changes in the anorectal area: rectal ampulla wall thickening more than 2.5 mm, higher echogenicity of perineal subcutaneous fat, anorectal fistulas and paraproctitis testify to the presence of colonic and jejuneal wall hyperplasia in the involved portions, mesenterial, para-aortic lymph node hyperplasia, reactive changes of the greater omentum, as well as the presence of a perineal inflammation, and Crohn's disease is diagnosed. The changes in the colon only: haustra flatness, smooth contours, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, reduced clear differentiation, lower submucosal echogenicity, no intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in the adjoining organs: lengthened mesenterial and para-aortic lymph nodes more than 10 mm, no reactive changes of omentum, rectal ampulla wall thickening more than 2.5 mm without involving the perineal region testifies to colonic wall hyperplasia and mesenterial, para-aortic lymph nodes and enables diagnosing non-specific ulcerative colitis.
EFFECT: technique enables performing the early differential diagnosis of chronic inflammatory intestinal diseases by using the accurate qualitative and quantitative ultrasonic criteria.
SUBSTANCE: in case of unilateral cryptorchidism measured is a linear rate index of the blood flow in the medium segment of the recurrent artery of the healthy testicle Vmax1 and testicle in the cryptorchidism condition Vmax2. In case of bilateral cryptorchidism measured is the linear rate index of the blood flow in the medium segment of the recurrent artery of the right and left testicle. As Vmax2 taken is the lower index from the two measurements of the testicle blood flow. As the index of blood flow Vmax1 taken is the lower index of the age norm, constituting for children from 0 to 12 months - 1.2 cm/sec; from 1 to 3 years - 1.5 cm/sec; from 3 to 7 years - 1.8/sec, and for children above 7 years - 2.0 cm/sec. If the difference between Vmax1 and Vmax2 is larger than 25% of Vmax1 index, impairment of haemodynamics, requiring operative treatment, is diagnosed. If the difference is in the range from 15 to 25%, dynamic US-monitoring after 3, 6 and 9 months is required.
EFFECT: method makes it possible to objectify results of USE due to the clear determination of parameters of a threshold value of the blood flow index in the testicle arteries.
2 cl, 3 ex
SUBSTANCE: patient's epicardial fat thickness is measured by transthoracic echocardiography by means of a sector transducer at a frequency of 2,500 MHz on a free anterior wall of the right ventricle. Pulse Doppler imaging is performed to determine the diastolic function of the left ventricle - the E/A ratio measured as a transmitral blood flow velocity in the early diastolic filling of the left ventricle (E peak) to a transmitral blood flow velocity in a left auricular systole (A peak). If the epicardial fat thickness is from 2.7 to 4.5 mm, whereas the E/A diastolic function is less than 0.80, insulin resistance is diagnosed.
EFFECT: higher diagnostic accuracy, as well as wider number of individuals, who had the insulin resistance diagnosis.
1 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to oncology and can be used for the prevention and early diagnosis of postmastectomy complications. The m. pectorales major et minor changes are ultrasonically assessed from the left and right in the 2-3 intercostal spaces along the midclavicular line. The muscle thickness and a degree of atrophy are determined. Phlebohaemodynamic disorders are detected by measuring a diameter and a blood flow rate with the use of thick gel pads; in v. subclavia dexter et sinister - along the clavicle between its middle and external one-thirds; in v. basilica dexter et sinister - at the border of the superior and middle one-thirds of the shoulder along the internal surface; in v. cephalica dexter et sinister - at the border of superior and middle one-thirds of the shoulder along the external surface; in v. radialis dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the lateral surface; in v. ulnaris dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the medial surface. An intensity of lymphostasis of the upper extremity is assessed by measuring the thickness of subcutaneous fat within the maximum intensity of oedema and phlebohaemodynamics in the vessels involved into the oedema, and of a symmetrical region of the counterlateral arm prior to and after treatment. The derived data are used to assess the functional disorders of the postmastectomy area.
EFFECT: method enables assessing the degree of structural changes of the postmastectomy area in relation to the healthy side, which makes it possible to predict technical difficulties in surgical repairs, to determine the presence of subclinical phlebohaemodynamic disorders, specifying the level of the maximum blood flow block, and evaluating the effectiveness of corrective actions at lymphostasis.
9 dwg, 2 ex
SUBSTANCE: invention relates to medical equipment, namely to means for performing cardio-pulmonary resuscitation of people. Device for control of cardio-pulmonary resuscitation contains ultrasound converter, unit of electrodes, connected via interface to processor, connected with display, memory unit, sound signaller, unit of light-diode signallers, unit of connection with central control panel unit of operation mode selection, unit of connection with the internet and, via USB interface, with unit of top level software. Device also contains colour television microcamera, connected via successively installed block of signal amplification and filtration and unit of processing and imposing alignment of images to additional processor input/output, illumination unit, pulse measurement unit, gas analyser, unit of microphones with matching unit, connected with processor and power supply unit. Pulse measurement unit and unit of electrodes are made with possibility of fixation on patient by means of fixation unit, with unit of microphones, controlled illumination unit and gas analyser being fixed on patient by means of additional fixation unit. Method of control contains stages of obtaining ultrasound echo signals and electrosignals, characterising blood flow in blood vessel, determination of blood flow characteristic by impedance of neck tissues in the process of performing cardio-pulmonary resuscitation, presentation of sound and visual information about patient/s condition. After that, current information about patient's condition is formed by television images and geometrical and colour characteristics of eye pupil and eye iris are determined, with estimation of colour and geometrical characteristics of blood vessels. Sound laryngeal signals, exhaled gas and patient's pulse are also read and analysed, light signals are used to signal about patient/s condition and patients condition is estimated basing on data of comparison of standard and current information.
EFFECT: application of invention makes it possible to extend functional possibilities, increase operation speed, immediacy and accuracy in performing cardiopulmonary resuscitation.
16 cl, 10 dwg
SUBSTANCE: method for detecting the burn wound granulation readiness for autografting involves the granulation microcirculation by laser Doppler flowmetry to calculate an average microcirculation (M, p.u.). That is combined with combining a granulation microcirculation effectiveness index (MEI). If the MEI is more than 1.6, and M is more than 3 p.u. the reparative ability of the burn wound granulation is considered to be preserved, and the granulation appears to be ready for autodermoplasty. If MEI is less than 1.6 regardless of the value M, the reparative ability of the burn wound granulation is considered to be diminished, the wound requires additional wound cleansing and granulation incision.
EFFECT: method enables providing the higher diagnostic effectiveness of the reparative ability of the tissues, selecting the autodermoplasty time, reducing the rate of transplant rejections and cutting the treatment costs and reducing the length of staying in hospital.
SUBSTANCE: microcirculation is assessed by laser Doppler flowmetry using combined functional tests - thermal postural leg test and thermal postural arm test. Both tests involve recording a microcirculation index. The derived data are saved. An average basic microcirculation from the 10th to 110th seconds is evaluated for the leg and arm tests according to the provided formulas. That is followed by calculating an average relative microcirculation Irel1 and Irel2 during the functional leg exposure according to the presented formulas. If any of the two values Irel1, Irel2 is below standard - Irel1<3.7; Irel2<3.5, the presence of microcirculatory disorders is stated in the person being tested.
EFFECT: method is accurate, simple, enables immediately detecting systemic microcirculatory disorders in the patients suffering carbohydrate metabolism disorders on the basis of available diagnostic tests and measured microcirculation parameters; using the combined functional tests involves most regulatory mechanisms that provides obtaining the reliable microcirculation information from the patients of this category.
2 cl, 2 dwg, 2 ex
SUBSTANCE: triplex scanning of the interlobular artery of the upper kidney pole is performed in clinostasis, and then within the first minute in orthostasis. The acceleration time (Ta), the total time of the blood flow during one cardiac cycle (Tt) are measured, their ratio Ta/Tt in clinostasis and orthostasis is calculated. After that the acceleration time index (ATI) is calculated by the mathematical formula. If Ta/Tt is less than 0.09 and ATI is less than 0, early affection of the kidneys, accompanied by arteriovenous shunting, is diagnosed.
EFFECT: method makes it possible to identify the group of patients requiring prophylaxis or treatment and in this way prevent the development of complications, disability retirement and mortality.
1 dwg, 3 tbl, 4 ex
SUBSTANCE: electromyograph is used to detect a latency of motor response and a minimal latency of F-wave in response to stimulating a tibial nerve. A transcranial magnetic stimulator is used to detect a latency of cortical response in a lead of an abductor muscle of great toe. A cortical motor response of minimal latency and maximal peak is of interest. The findings are used to determine the time of central motor passage in the minimal latency of F-wave from both sides. If the time of central motor passage in the minimal latency of F-wave differs by more than 3.45 ms between the sides, the asymmetric functional activity of the pyramid tracts in children and adolescents with multiplanar spinal deformity is stated.
EFFECT: technique enables increasing the diagnostic reliability ensured by determining the asymmetry of the time of central motor passage of the motor cortical response to the minimal latency of F-wave.
1 tbl, 5 ex
SUBSTANCE: photostimulus is supplied into a limited sector of a visual field at a visual angle of 45 degrees. The assessment procedure is performed in four main meridians of the visual field with the photostimulus successfully presented from a maximum to minimum position of 40 degrees, 20 degrees and 10 degrees along the perimeter arch with recording an encephalogram; the detected visual induced potentials testify to the presence of vision in the sector which corresponds to the presented position of the photostimulus.
EFFECT: method enables reducing the assessment time accompanied by the objective detection of the local disorders of the visual field for the purpose of the medical-social evaluation by supplying the photostimulus to the limited sector of the visual field in a combination with recording the visual induced potentials on the encephalogram.
2 dwg, 1 ex
SUBSTANCE: brainstem auditory evoked responses (BAERs) to an acoustic click are recorded, and a V-peak of the evoked response is imaged. The BAERs to stimuli 40 dB are recorded. The stimuli are presented by the acoustic click and chirp-stimuli at 4,000, 1,000 and 500 Hz. If observing the V-peak in BAERs to the chirp-stimuli with the above peak absent in response to the acoustic click, a middle ear pathology is diagnosed.
EFFECT: technique enables assessing the audition function objectively accompanying the middle ear inflammations that is ensured by recording the BAER to the click and the chirp-stimuli.
SUBSTANCE: brain imaging is performed. The maximum range of the cerebellar tonsil penetration into the great foramen is determined in a sagittal plane. Each 3 mm of the penetration is appraised as 1 point. That is followed by measuring the brain stem auditory evoked response and assessing: unilateral latency increase - 1 point, unilateral PQ interval increase - 1 point, bilateral latency increase - 2 points, bilateral PQ interval increase - 2 points. The derived points are summed. If the total score is through 7 points, the prediction is considered to be favourable for the brain stem functional recovery, and the total score of 8 points and more shows the unfavourable prognosis.
EFFECT: method enables providing the more reliable prediction ensured by the integral assessment of the morphological and functional changes accompanying the axial dislocation of the brainstem.
SUBSTANCE: method includes generating a measured synchronous pulse stream from peripheral proprioceptors via kinaesthetic irritation of the upper limb in the form of passive movement of the hand, propagating on nerves in the corticipetal direction, causing change in bioelectrical activity of the brain - kinaesthetically induced potential (KIP). Said potential is selected from the background EEG by averaging multiple realisations thereof. Passive movement of the hand is performed with a cycle of movements in the form of flexing and stretching in the wrist joint with the turning angle of the hand of 50° and maximum acceleration of 350 rad/s2. The KIP is selected automatically using the controlled electric drive of the system, which consists of a stimulator, having a housing and a movable lodgement, capable of rotating relative to the horizontal axis of the housing. An ac motor is immovably mounted inside the stimulator, the stator of said motor being rigidly connected to the housing and the rotor to the movable lodgement. An angle sensor which measures the turning angle of the lodgement relative to the housing is mounted inside the electric motor. Power inputs and outputs of the electronic unit of the system are electrically connected to the ac motor, the angle sensor, a control panel and an induced potential averaging device. The power output of the electronic unit is connected to the electric motor and operates in automatic mode to obtain KIP, and its data output is connected to the induced potential averaging device for selection thereof from the background EEG. One input of the electronic unit is connected to the angle sensor to determine the beginning and end of movement and the second input is connected to the control panel, thereby determining the trajectory of movement.
EFFECT: high reliability of results of analysing kinaesthetic sensitivity compared to the prototype by obtaining full information on the state of the somatosensory cortex of both hemispheres, faster analysis due to automation of analysis.
2 cl, 3 dwg, 1 tbl
SUBSTANCE: cognitive endogenous responses in frontal central brain are recorded. Two types of tonal clicks - significant and insignificant - are supplied. An intensity of the significant tonal clicks is less than that of the insignificant ones. That is combined with performing a motor-voice test with one hand clenched. A latency of third negative peak N3 (
EFFECT: method enables providing higher diagnostic reliability that is ensured by getting the cognitive endogenous responses from projected motor-voice areas of the brain.
2 cl, 7 tbl, 4 dwg
SUBSTANCE: cognitive endogenous responses in the frontal central brain to audio stimulation are recorded. Two types of tone flips of the intensity of 50 to 100 dB - essential and non-essential ones with the frequency of 1,000 Hz are supplied. Besides, a person being tested performs a speaking test in the form of counting the essential tone flips aloud. A latency and amplitude of the first, second and third negative peaks, as well as of the first, second and third positive peaks are recorded in both hemispheres. That is followed by processing the derived data at the analysis stage of 750-1,000 ms. An interhemispheric latency of a perception complex
EFFECT: method provides more reliable diagnosis that is ensured by studying the cognitive induced potentials and mathematical analysis of the derived data.
2 cl, 5 dwg, 7 tbl, 2 ex
SUBSTANCE: rheoencephalography (REG) is performed to measure a cerebrovascular reactivity index during hypercapnia, to record audio and cognitive induced potentials, to measure N2 spike amplitude of the audio induced potentials, length of latency P300, and blood plasma noradrenaline. A canonical variate (Cv) is calculated including the derived values. If Cv is equal to or more than a constant, the presence of the early manifestations of mercurial intoxication is stated; Cv being less than a constant enables diagnosing first degree of chronic mercurial intoxication.
EFFECT: method provides more reliable assessment that is ensured by selecting more informative values.
2 tbl, 3 ex
SUBSTANCE: invention relates to medicine. Device contains successively connected sensor, device for registration of brain electric activity, delay lines, amplifiers with regulated coefficients of amplification, adders, unit for analysis of induced potentials, unit for controlling device of sending impact signal to subject, device of sending to subject short-lasting external signal of specified value, whose maximal value is smaller than value of signal, corresponding to pain syndrome, phase detectors. Device also contains unit of preliminary correction of central frequency of filtration band, which in addition contains switching unit, smoothing filter and threshold device.
EFFECT: invention makes it possible to increase accuracy of diagnostics of induced brain potential.
3 dwg, 1 ex
SUBSTANCE: invention relates to field of medicine. Assessment of functional state of neurons of motor zones is carried out by means of navigational transcranial magnetic stimulation of brain (NBS). In the process of stimulation parameters of motor response are determined: latency and amplitude. Values of parameters are compared after single therapeutic influence and complete treatment course. If latency time is reduced by 0.4 ms and more and/or amplitude increases by 0.5 mV and more, factor is assessed as capable of producing impact on functional state of neurons of motor zones, and therapeutic influence - as efficient for rehabilitation of said particular patient.
EFFECT: method makes it possible to increase reliability of assessing individual sensitivity to factor of impact.
1 tbl, 2 ex
SUBSTANCE: method involves carrying out intraoperative neural motor evoked potential monitoring. Spinal nerve stimulation is carried out with rectangular pulses of 0.2 ms duration, frequency of 4.1 Hz, intensity of 10-25 mA and distance between electrodes equal to 4 mm. Neural motor evoked potentials are recorded in popliteal space in sciatic nerve projection area. Peak No 1 latent period being longer than 21 ms, pulse conduction dysfunction is diagnosed in spinal nerve motor fibers.
EFFECT: high accuracy of diagnosis.
5 dwg, 3 tbl