Method of treating encephalopathy in children
SUBSTANCE: invention refers to medicine, namely - to physiotherapy, paediatrics and neurology. The patient is exposed to a EEG-assisted combination of a magnetic field and laser light. The exposure involves a running magnetic field in a continuous mode. The inductance is 6-40 mT, and frequency is 50 Hz. The exposure involves laser light at wave length 0.85-0.9 mcm, frequency 50 Hz, power 3.5-5 mWt. The exposure is bitemporal along the spinal column at the level of C1-L1. Duration of a procedure is 10-12 minutes. The procedures are daily. The therapeutic course is 10 procedures.
EFFECT: higher clinical effectiveness ensured by activation of the cognitive functions.
3 tbl, 2 ex
The invention relates to medicine, namely physiotherapy, Pediatrics, neuro-rehabilitation, neurology, and can be used for the treatment of children at the age from 1 year to 14 years with perinatal encephalopathy and its consequences in the form of syndromes residual organic brain damage.
There is a method of treatment of encephalopathy in children with impaired motor function due to perinatal brain by magnetic field inductance 35 MT and a frequency of 10 Hz on the cervical and lumbar area for 5-10 min course of 8-10 treatments (Gurova POSTGRADUATE, Babin L.M. efficiency of the dynamic magnetic therapy with a frequency of 10 Hz modulations in the complex of sanatorium-resort rehabilitation of children with cerebral palsy // Transcranial magnetic therapy / Collection of articles edited by G.N. Ponomarenko, N. Bolotova, Y.M. Raigorodsky. - Saratov: Publishing House. Sarat. the honey. Univ. - 2008. - 74-82.). However, the method is not sufficiently effective for the correction of metabolic disorders of the brain and does not allow you to activate cognitive functions, because there is no directional stimulation of neuronal excitability and axonal conduction brain.
There is a method of treatment of encephalopathy in children, including magnetic stimulation of high-intensity magnetic field amplitude of the magnetic induction on the 3,0 T, frequency of 0.1-0.2 Hz affected cortical centers and the spinal roots and nerves on the side of denervation 1-2 min and magnetic and electrical stimulation of sinusoidal modulated current nervous and neuromuscular apparatus denervated organ (Tyszkiewicz YEAR, Bersnev VP, Margolin EG, Skoromets A.A., Nikitin V.V. method for the treatment of patients with disorders of motor, sensory and speech functions due to organic lesions of the nervous system: guidelines. - SPb., 1995. - 16 S.) However, high-intensity transcranial magnetic stimulation can provoke the formation of epileptic syndrome (Hufnagel A., Elger C.E., Durwen H.F., Boker D.K., Entzian W. Activation of the Epileptic Focus by Transcranial Magnetic Stimulation of the Human Brain //Ann. Neurol. - 1990. - N27. - P.49-60). The method is insufficient for the correction of metabolic disorders of the brain.
Closest to the claimed is a method of treatment of encephalopathy in children (Kravtsov SCI, Shevchenko C.V. Dysfunction nonspecific systems of the brain in absansnyh epileptic seizures in children and the possibility of its correction laser radiation // Journal of Neurology of the Urals and Siberia. - 1999. No. 9. - P.40-44.), adopted for the prototype. Effect of low-intensity laser radiation (NEELY) a wavelength of 0.98 μm, 10 mW and the magnetic field inductance 10 MT at the region of the cervical sympathetic nodes on the both sides for 2 minutes through the emitter area of 2.5 cm 2a course of 6 treatments under EEG control. The method aims at reducing epileptic activity of the brain due to correction of autonomic disorders.
However, the prototype is not effective enough and does not provide activation of cognitive functions, as:
- the influence of permanent magnetic field on the peripheral autonomic patterns cannot create the effect of a targeted stimulation of neuronal excitability and axonal conduction brain;
- the effect of LLLT on the peripheral autonomic patterns is not sufficient for full activation of the metabolism of the brain.
The invention is directed to a method of treatment of encephalopathy in children that enhance the effectiveness of treatment due to the activation of cognitive functions.
This technical result in the implementation of the invention is achieved in that in the known method for the treatment of encephalopathy in children by magnetic field and NEELY infrared range under EEG control, the peculiarity lies in the fact that the impact traveling magnetic field in a continuous mode inductive 6-40 MT, 50 Hz synchronously with the laser radiation wavelength of 0.85 to 0.9 μm, 50 Hz, with a capacity of 3.5 to 5 mW, influence simultaneously bitemporal and along the vertebral column at the level of C1-L1, procedure duration 10-12 min, ku is som 10 daily procedures.
Traveling magnetic field allows you to activate neuronal axonal excitability and conductivity of the brain significantly more than permanent, due to transcranial direct impact. Activated not only the neurons of the cerebral cortex of the brain, but the median subcortically-brain structures by combining stimulating action from located opposite to each other, magnetic inductors. Physiology diffuse effects on the brain avoids amplification foci of epileptiform activity. Frequency 50 Hz dermal exposure is optimal to activate areas of the brain responsible for memory (N.P. Bekhtereva Healthy and diseased human brain. - L.: Nauka, 1980. - S.). Traveling magnetic field allows you to correct venous blood flow to the brain (Matyash mathematical SCIENCES. Electrical stimulation and magnetic-laser therapy in rehabilitation of patients with cerebral venous dystopian in traumatic encephalopathy // II international Congress of Rehabilitation medicine and rehabilitation. - M, September 20-21, 2005).
LLLT activates the metabolism and blood flow to the brain and spinal cord, as well as the metabolic processes in the cerebrospinal fluid indirectly through direct laser irradiation on blood vessels pools external carotid arteries and tissues of the spine. infrakrasnoe NEELY wavelength of 0.85-0.9 µm, 70% is reflected and absorbed by the soft tissues of the skull and cranial bones (Ohshiro T. Low Reactive-Level Laser Therapy. - 1991. - 264 p.), what prevents possible negative reaction of the brain in response to direct laser irradiation. Neurotransmi NEELY is seen mainly in glial structures than is provided by activation of the memory, as the most important cognitive functions, carriers which are neuroglial populations of the brain.
Diffuse effects on the Central nervous system traveling magnetic field and NEELY contributes to the activation and development of memory and speech, brain software which is distributed on the cortical-subcortical brain structures (N.P. Bekhtereva Healthy and diseased human brain. - L.: Nauka, 1980. - S-171.). Magnetic and laser effect on the projection of the spinal cord contributes to the activation neuroaxonal ways motor and sensory analyzers, vegetative structures, in particular the sympathetic chain. Improving the quality and dynamics of the cerebrospinal fluid, the functioning of life support systems through segmental levels of regulation, which provides improved metabolism of the brain and the whole body.
The method is as follows.
Directly before treatment perform EEG study, including traditional EEG with a quantitative assessment of brain biorhythms different ranges, evoked potentials - auditory, visual, somatosensory, cognit the ate.
Carry out the procedure of magnitolazeroterapii. The child laid on the couch on his stomach. The child's face slightly turned to the side to free breathing. Influence simultaneously bitemporal and along the vertebral column at the level of C1-L1 traveling magnetic field and infrared LLLT in synchronous mode. Affected by varying magnetic field in a continuous mode with 50 Hz frequency, inductance 6-40 MT. Synchronously impact NEELY wavelength of 0.85 to 0.9 μm, a pulse duration of 100±50 NS, 50 Hz (carrier frequency 1500 Hz) and a capacity of 3.5 to 5 mW (pulse 10-30). The exposure parameters depending on the age of the children is shown in table 1.
|Age (in years)||The inductance of the magnetic field||Power NEELY|
|1-3||6-10 MT||3.5 mW|
|4-5||9-15 MT||3.5 mW|
|6-7||9-16 MTL||3,5-5 mW|
|8-11||21-27 MTL||5 mW|
|34-40 MTL||5 mW|
The procedure lasts 10-12 minutes. Treatment includes 10 daily procedures.
Control EEG study (quantitative EEG, evoked potentials) perform directly after treatment, in the near-and long-term follow-up. In the presence of positive clinical and EEG characteristics, repeat the treatment after 6-12 months. In the absence of positive dynamics or expression of markers of negative reactions, which reflects the depletion of the protective reactions of the brain, courses magnitolazeroterapii not repeat.
Way passed clinical trials in the clinic IMC wounds in the treatment of 38 children aged from 1 year to 14 years with perinatal encephalopathy and its consequences in the form of syndromes residual organic brain damage. Treatment received 22 boys and 16 girls. Psychomotor development was observed in 25 children, moderate in two, moderate in 10 and expressed in 13 children. Delayed speech or mental development was diagnosed in 13 children - moderate in three, moderate in two, and severe in 8 children. The clinical picture was observed rapid exhaustion when switching attention, emotional dullness, passive behavior or hyperactivity, lower or about the absence of self-help skills, the difficulty in training and implementation of these new skills (Biking, drawing, and others). Speech disturbances in the form of Allie, depletion of speech, dysarthria was varieeruvusi depending on the age and extent of brain lesions. The motor activity was fatigue and motor disinhibition at a moderate developmental delay, hemiparesis 2-3 points with a limit of motor skills with moderate and tetraparesis 1-2,5 points to lack of motor skills in severe delays. Spasticity ranged from 1 to 4 points. Occurred vegetative dystonia in all patients, as expressed by the delay - salivation on the background of Hyper - or hypohidrosis.
MRI and PET studies indicated cystic atrophic changes of the brain, asymmetric hydrocephalus, depletion corticospinal and corticothalamic tracts, hypoplasia of the corpus callosum, diffuse or local hypometabolism of glucose. When USDG study determined the decrease of perfusion, venous Disgaea, constrictive-angiospastic type of change vessels, reducing gazokondensatnogo reserve varying degrees.
EEG study revealed disruption of brain rhythms expressed hyperactivity stem structures, diffuse disorders of the ascending thalamocortical influences at a moderate degree and delay. When the average degree was determined deformation and disruption of the spatial-zonal distribution of the background rhythm of the brain, pronounced hemispheric asymmetry, peismekery epileptiform activity. In severe delay in the picture EEG observed similar changes, as well as diffuse changes of bioelectric activity of brain epileptiform type flash nonspecific medlennovolnovoj activity in theta and Delta ranges. Investigation of induced auditory, visual and somatosensory potentials stated reduction in speed and amplitude of the potentials and longer latency period. Analysis of cognitive evoked potentials showed a decrease in the speed of cognitive processes by presenting stimuli of different characteristics.
All children underwent a course of magnitolazeroterapii according to the proposed method. Used physiotherapeutic apparatus for magnetic and infrared led therapy "TRANSRADIO" (000 "TRIM", Saratov) with the size of the emitters (in mm)are presented in table 2.
|The emitter||Length||Width||Depth||The distance between the axes of the apertures|
The emitters of the traveling magnetic field with built-in emitters NEELY was placed on the open surfaces of the body. Strengthened bitemporal soft holders pair emitter "headband" with the concave internal surfaces in accordance with the size of the head. On the back of a stacked pair emitter "prismatic" along the spine in the projection of the spinal cord at the level of C1-L1 with facing each other narrow side surface is mi, which are in contact or had a period, if the child is tall. Have simultaneously transcranial and back area traveling magnetic field and infrared LLLT in synchronous mode. Used radiators depending on the age of the children is given in table 3.
|Age (in years)||The emitters|
|1-3||"Headband baby" and "prismatic child"|
|4-5||"Headband baby" and "prismatic child"|
|6-7||"Headband baby" and "prismatic child" or "headband" and "prismatic" (depending on head size)|
|8-11||"Headband" and "prismatic"|
|12-14||"Headband" and "prismatic"|
Immediately after treatment, most patients had significant improvement or improvement, which was to increase tolerance to stress, reducing isdomainmaster, low education, lack of seizures. what was relieves the tendency to expand the number of sounds and sound combinations, stabilization of articulation, strengthening global read, the extra syllables and words. Improved circadian rhythm of sleep and wakefulness, the children became more calm and collected. In paretic extremities decreased spasticity by 1-2 points and increased locomotor activity at 0.5 points, improved foncia, decreased salivation. In children with severe developmental delay was begun to show elements of skills retention head tracking eyes, hold objects at hand, ability to sit, stand, walk. With average and moderate delay in children stabilized communication skills and self-service, they were more than adequate. Watched the relief of chronic headache, which was before treatment, 2 children, improving emotional tone, reducing symptoms of hyperactivity. Significant improvement noted in 22 (57.9 per cent) of children improved in 13 (34.2 per cent), unchanged in three (7,9%).
According to PAT had a reduction in the degree of hypometabolism of glucose. When USDG study revealed improvement in perfusion due to edema angiospastic reactions, increase gazokondensatnogo reserve.
In the EEG was a decrease diffuse changes, the manifestation of focal changes, decreased tension and diffusion bit forms, improved modality of the basic rhythm. There was an increase / min net and holding and amplitude of auditory, visual and somatosensory evoked potentials, shortening their latent period. In some cases, was a manifestation missing before treatment cortical components of somatosensory evoked potentials, reflecting the recovery thalamocortical. Registered increase in the rate of cognitive evoked potentials.
Positive dynamics in the form of tempo acceleration of a child's development continued in the coming months, the seizures were not. The pace of development was somewhat slower in 6-12 months. After repeated courses of magnitolazeroterapii under the proposed method was again observed positive dynamics in the form of tempo acceleration of development. In the picture EEG was trend toward normalization of bioelectrical activity of the brain. It was noted reduced intensity and prevalence medlennovolnovoj and epileptiform activity, stability, basic rhythm and ordering rhythm of the brain.
Examples of extracts from the histories.
Example 1. Patient D., aged 5, was on rehabilitation in the clinic IMC RAS 14.11.2011 on 06.12.2011. Diagnosis: effects of perinatal encephalopathy. Psychomotor development medium. Neuropsychological examination showed rapid exhaustion, otvlekaemost, hyperactivity, understanding speech is below normal, the dictionary distortion words, considerable difficulty oral praxis on particella and prakticheskoe type (difficulty moving the tongue, chewing). The child knew hygiene skills, drew and saw the pictures. Data testified to the mental retardation with impaired speech praxis - the combination of dysarthria with systemic underdevelopment of speech functions. In neurological status revealed left-sided cerebral spastic hemiparesis 2.5-3 points, spasticity 2 points, convergent strabismus. MRI study pointed to atrophic changes of the brain and a built-in hydrocephalus.
In EEG 16.11.2011 were recorded irregular alpha rhythm of the average amplitude 50 mV, unmodulated, without a clear zonal distribution, distorted theta and beta activity, according to the spectral modal analysis, the greatest power in the form of increase of amplitude at fronto-Central and parietal leads. Recorded reduced sharp waves alpha range in the temporal leads. When carrying out functional tests have shown reduced complexes sharp-slow wave in the frontal and temporal leads. Data suggested diffuse changes of bioelectric activity of brain dysfunction median stem structures at the diencephalic level, is ysenia clock thalamocortical influence, the emergence of functional loads in temporal and frontal areas was more pronounced local changes of bioelectric activity of irritative nature. In the study of evoked potentials were determined relative dysfunction of the stem auditory holding left with a decrease in the functional activity of the auditory nuclei on mesencephalon level, the decrease in the rate of differentiation of the auditory stimuli of different characteristics, reflecting the decrease in the rate of cognitive processes.
A course of magnitolazeroterapii according to the proposed method. Have simultaneously bitemporal and back area with emitters "headband baby" and "prismatic children alternating magnetic field in a continuous mode with 50 Hz frequency, inductance 9-15 MT and synchronously NEELY wavelength of 0.85 to 0.9 μm, 50 Hz, 3,5 mW from spacecraft TRANSCRANIAL" within 10 min the rate of 10 daily procedures. After treatment, the boy became calmer, more attentive in the classroom speech therapy and physical therapy, has become more confident gait and execute instructions. Improved pronunciation, expanded the volume of speech output, volume of active movements increased to 3-3,5 points, spasticity decreased to 1 point.
Re-hospitalization at the clinic IMC wounds after 8 months, with 13.08.2012 on 31.08.2012, history 960. When on the following preserved elements of mental retardation with impaired language functions in the form of dysarthria and underdevelopment of speech, volume of active movements in the left paretic limbs 3.5 points, spasticity 1+ points.
In EEG 16.08.2012 main rhythm regular, with an average frequency of 7.5 Hz, not modulated, moderately increased synchronization, smoothed zonal differences. Registered frequent synchronous complexes sharp-slow wave initially in the right temporal and fronto-Central leads, with emphasis on the amplitude on the left. Under functional loads these systems have become more frequent and increased in amplitude in the left temporal leads. Data testified to the delay in the formation of cortical-subcortical interactions on a background of dysfunction of the median stem structures at the diencephalic level with local epileptiform activity. In the study of evoked potentials installed the difficulty of determining hearing thresholds, basic mezhpikovoe intervals I-V in the normal range, the relative decrease in the amplitude V of wave stimulation on the right. Upon presentation of the standard and deviant auditory stimuli were recorded positive wave of sufficient amplitude with a moderately pronounced increase of the latent period of up to 439 MS (age norm 400 MS). Data testified to normalize the speed of conduction along the stem auditory pathways with moderate reduction of functional activity of the auditory nuclei of mesencephalon the level to the right, improvement of cognitive processes.
Repeated course magnitolazeroterapii according to the proposed method. After treatment installed continuing positive trend. When neuropsychological examination set age-appropriate mental development, continued General underdevelopment of speech dominated desarticulado component, neoformierung visual gnosis and visuo-spatial functions due to deficiency of right hemisphere structures. The good learning. Volume of active movements in the left paretic limbs remained within 3.5 points, but the movement was facilitated by reducing spasticity to 0-1 points. Increased motor skills, started to work on the bike.
In EEG 29.08.2012 was subdominios the basic rhythm of an average frequency of 8 Hz, bimodal, weak modulation, moderately increased synchronization, smoothed zonal differences, power dominated theta rhythm frequency of 6.5 Hz. Recorded reduced complexes sharp-slow wave initially in the right temporo-occipital and fronto-Central leads, moderately increasing the functional loads. Compared to EEG from 16.08.2012 saw a positive trend in reducing dysfunction median stem structures on diencephalic ur the outside, diffuse and local decrease the power of slow waves, a rise of power of the alpha rhythm in the Central region, reducing the severity and prevalence of local epileptiform activity.
From the given example that the courses of magnitolazeroterapii according to the proposed method accelerated psychomania development of the child with developmental delay due to perinatal encephalopathy in the form of recovery of cognitive processes, expressed in the emergence and consolidation of motor skills, the improvement of neuropsychological status up to age norms and speech praxis with decreasing dysarthria. EEG studies have revealed the period of the domination medlennovolnovoj activity, as a marker of activation of protective reactions of the brain, its compensation more than adequate zonal distribution of the basic rhythm, reduce irritative changes and the presence of markers of recovery of cognitive processes.
Example 2. Patient R., aged 11, was on rehabilitation in the clinic IMC RAS 29.05.2011 on 10.06.2011, history 703. Diagnosis: effects of perinatal encephalopathy. Severe mental retardation. The clinical picture in the background of the asthenic syndrome (headaches, insomnia, irritability, fatigue), identified negativism, vplo the ü to aggressiveness, elements of motor awkwardness, periodic ticks and bad learning in an intervention programme. For a long time received Depakine. Neuropsychological study found pronounced mental retardation, impaired communicative functions. For a patient characterized by unstable mood, rapid exhaustion, impulsivity, low intellectual-mnestic functions. It was understood, but it was difficult with the details. Had dysgraphia and dyslalia in the form of poorly coordinated words and syllables. MRI examination revealed periventricular liquor cyst in the left parietal region, hypoplasia and abnormal tortuosity of the left vertebral artery. PET study found diffuse hypometabolism of glucose (in the temporal and frontal lobes, optic tubercles, the cerebellum, the brain stem).
In EEG 09.06.2011 registered reduced epileptiform activity (sharp wave complexes sharp-slow wave) primarily in the frontal areas on the background of diffuse changes of bioelectric activity and dysfunction of the median stem structures. The study called cognitive potentials 30.05.2011 showed a decrease in the speed of cognitive processes medium upon presentation of visual stimuli of different characteristics (latency component R amounted to 548 MS) and pre is yavlenie auditory stimuli of different characteristics (latency component R amounted to 600 MS). Data testified hyperthyroidism separate brain systems, as a sign of stable pathological conditions, and reducing the adequate functioning of the brain, predicted the possible formation of epileptic foci.
A course of magnitolazeroterapii according to the proposed method. Have simultaneously bitemporal and back area with emitters "headband" and "prismatic" alternating magnetic field in a continuous mode with 50 Hz frequency, inductance 21-27 MT and synchronously NEELY wavelength of 0.85 to 0.9 μm, 50 Hz, 5 mW from spacecraft TRANSCRANIAL" for 12 min rate of 10 daily procedures.
In the process of treatment within 2 days had trouble falling asleep since 3 days, marked relief of headache. After treatment, found a decrease in irritability, aggressiveness, lack of convulsive equivalents, the child was more than adequate when dealing with relatives and others, including verbal. The tendency to stabilize mental status.
Re-hospitalized IMC wounds after 6 months, with 11.12.2011 on 23.12.2011, history 1448. During the examination using test Veksler revealed severe emotional lability, decreased criticism for his behavior, difficulty focusing perekljuchaemost attention the weakening of memory. Could repeat the mentioned 10 words only after a 10-fold repetition (usually after 3-5 times). The volume of short-term memory is reduced and was 4 information unit. Thinking specifically functional. Social intelligence below age norms. Data testified mental disorders and the weakening of organic type, the uneven nature of motivational and volitional functions of the intellect, indirect signs of affective and personality changes. The psychiatrist confirmed psychopathic behavior.
In the picture EEG 12.12.2011 in comparison with the data 09.06.2011 were not recorded reduced epileptiform activity in the frontal areas. Showed more pronounced local epileptiform changes in the occipital-parietal region on the left (sharp wave complexes sharp-slow wave), single reduced sharp waves in the left temporal and right occipital region. Remained moderate diffuse changes in the bioelectrical activity and dysfunction of the median stem structures at the diencephalic level. In the study called cognitive potentials in comparison with the study 30.05.2011 increased and the relative normalization of the speed of cognitive processes by presenting visual stimuli of different characteristics. Latency component is R upon presentation of visual stimuli decreased with 548 345 MS to MS, the amplitude N2P3 was 15-17 mV. Latency component R upon presentation of the auditory stimuli was 389-401 MS, amplitude N2P3 - 17-20 µv. Latency component R upon presentation of the auditory stimuli of different characteristics decreased from 600 MS to 389-401 MS. The latency caused by cognitive potentials almost reached the age limit of 340 MS. Data testified to the continuing trend to reduce the signs of hyperactivity of brain systems, the most prevalent sound local changes, recovery of cognitive processes.
Repeated course magnitolazeroterapii according to the proposed method 10 daily procedures. Directly after treatment, despite continuing signs of negativity (roughness), the boy became more attentive, balanced, started to watch movies. In EEG 23.12.2011 confirmed the continuing positive trend became less pronounced local epileptiform changes. Registered single reduced sharp waves in the left temporal region, local irritative changes in the bioelectrical activity in the frontal and temporal areas, with emphasis on the amplitude on the left.
From the given example that the courses of magnitolazeroterapii according to the proposed method was resolved psychic R is sweetie child, violated as a result of perinatal encephalopathy, in the form of recovery of cognitive processes, expressed in compensation of the symptoms of psychopathic behavior, the emergence and consolidation of intellectual-mental skills. EEG studies have confirmed a strong tendency to compensate for hyperactivity of brain structures, mainly responsible for the emotional-volitional sphere, as a sign of stable pathological conditions, and recovering the parameters of the cognitive potentials almost to the age norm.
Using the proposed method improves the efficiency of the treatment of encephalopathy in children of different origins due to the activation of cognitive functions.
A method for the treatment of encephalopathy in children by magnetic field and low-intensity laser radiation in the infrared range under EEG control, wherein the act of running the magnetic field in the continuous mode, the inductor 6-40 MT, 50 Hz, synchronous with the laser radiation wavelength of 0.85 to 0.9 μm, 50 Hz, with a capacity of 3.5 to 5 mW, influence simultaneously bitemporal and along the vertebral column at the level of C1-L1, procedure duration 10-12 min, rate 10 daily procedures.
SUBSTANCE: invention relates to medicine, namely to oncology and radiotherapy, and deals with prediction of efficiency of radiotherapy of malignant neoplasms of oropharyngeal zone. Before treatment index of blood microcirculation Im and average degree of oxygenation of mixed blood of microcirculature StO2 in tumour are registered. Said indices are used to determine perfusion oxygen saturation, and values of blood microcirculation index Im' and average degree of oxygenation of mixed blood of microcirculature StO2' in intact zone are measured. Average volume blood filling Vb in tumour and in intact region Vb' are registered, level of activity of oxygen metabolism in cells in examined areas MA, MA' is determined by given formulas. If MA/MA'≥2.5, efficiency of radiotherapy is predicted, if MA/MA'<2.5, conclusion about high probability of residual volume of tumour after carrying out radiotherapy is made.
EFFECT: method makes it possible to predict efficiency of tumour regression to impact of distant radiotherapy still at pre-hospital stage, which in its turn contributes to correct and timely selection of method of treatment in accordance with individual plan.
SUBSTANCE: invention relates to medicine, namely to anaesthesiology, resuscitation and urology, and can be applied for prevention of cardiovascular complications in patients with syndrome of endogenous intoxication against the background of acute purulent pyelonephritis in perioperative period. For this purpose reamberine 1.5% in dose 400 ml is introduced to patient from the moment of clinical diagnosis daily to the moment of performing operation. After that, in the process of operation, at the stage of kidney decapsulation infusion of reamberine in the same dose in combination with intravenous blood irradiation is realised, with duration constituting 25 minutes. After that, in post operational period reamberine infusion is continued in the same dose during 8 days. Simultaneously for 3 days after operation intravenous blood irradiation is realised. From the 4-th day of post-operative period for five days reamberine infusions 1 time per day are combined with transdermal laser irradiation of operated kidney projection with duration 10 minutes. Then, without stopping reamberine infusion, biologically active points, connected with heart meridian C1, C2, C3, C4, C5, C6, C7, C8, C9, sympathetic point of heart meridian V15, ear points AP19, AP21, AP60, AP100, AP105, AP115 are successively exposed to laser irradiation.
EFFECT: method ensures effective prevention of cardiovascular complications due to reduction of level of toxic action of products of peroxide oxidation of lipids on myocardium, which makes it possible to improve functional state of myocardium.
1 tbl, 1 ex
SUBSTANCE: invention refers to medicine, namely to neurooncology, and may be used for the intraoperative diagnosis of cerebral and spinal tumour borders and determination of the tumour resection quality. What is presented is an intraoperative combined spectroscopic diagnostic technique for cerebral and spinal tumours which involve the preoperative preparation including the oral administration of hydrochloride-5-aminolevulinic acid (several hours before the tumour resection). Actually the intraoperative spectroscopic analysis of the tumour marker content in the analysed tissues (5-aminolevelinic acid-induced protoporphyrin IX), as well as its desintegration products, oxygenated and reduced hemoglobin; the tissue scattering properties are varied using broadband and laser geode light source and a fibre-optic probe. The broadband light source is used within the range of 500÷600 nm, while the exiting fluorescent laser/diode light source - at wave length 620÷640 nm. The diffuse-reflectance spectra of the broadband and laser/diode light, as well as fluorescence are recorded at the same time. After the spectroscopic characteristics have been automatically classified, the operative radicality is assessed.
EFFECT: presented method enables higher reliability of the intraoperative measurements in neuronavigation, reducing time needed for implementing them, providing deeper probing and simplifying the spectra recording in vivo.
4 cl, 9 dwg, 3 ex
SUBSTANCE: invention relates to medicine, rheumatology and physiotherapy and may be used for treating gonarthrosis. A patient's rehabilitation index is calculated. Sonography is conducted, and the foot effusion volume is measured. A joint pain intensity is shown by a visual analogue scale. A body weight index is calculated, and the presence of diabetes mellitus and metabolic syndrome is stated. A radiation area is delimited and squared. The area is exposed to laser light at wave length 0.89 mcm. A pulse repetition frequency is specified in compliance with the effusion volume and joint pain intensity. An exposure dose per a session is determined with regard to the body weight index, the carbohydrate and lipid metabolic status, the patient's rehabilitation potential. At two frequencies, the exposure dose for each frequency makes ½ of the exposure dose per a session.
EFFECT: method provides higher clinical effectiveness in gonarthrosis ensured by taking into account the individual medical-biological values, more specific measurement of the exposure dose and radiation area.
SUBSTANCE: invention relates to field of medicine, namely to otolaryngology, and can be applied in treatment of benign neoplasms of larynx. method consists in surgical treatment with application of photodynamic therapy (PDT), which includes introduction of photosensitiser into patient's organism with further laser irradiation of neoplasm zone. Intubation of patient with endotracheal tube with inflatable cuff on end is carried out. Detachable reflector, facing the side of lower surface of vocal folds, is installed into endotracheal tube in lower part of larynx between vocal folds and inflatable cuff at 50-80° towards trachea side. Additional irradiation of lower part of larynx, including lower surface of vocal folds, is carried out simultaneously by reflected laser irradiation by means of reflector. Duration of photodynamic therapy session constitutes on average 600 s, with irradiation power being 1.5 W.
EFFECT: application of claimed invention makes it possible to increase treatment efficiency due to possibility of irradiation of lower part of larynx and lower surface of vocal folds, reduce terms of treatment of benign larynx diseases by carrying out a single PDT session.
SUBSTANCE: invention concerns medicine, namely neural diseases, neurosurgery, traumatology. A neck surface is exposed to autoresonant red emission in a projection of carotid sinus at wave length 0.63-0.66 mcm, power 24-26 mWt for 7-10 minutes and to infrared emission at wave length 0.87-0.89 mcm, power 9-10 Wt for 10-15 minutes. That is followed by pharmacological neuroprotection by intranasal electrophoresis with neuroprotective preparation at current intensity 0.5-2.0 mA for 15-20 minutes. The treatment is started from the third post traumatic day. The first therapeutic day required the exposure to red laser light followed by a 15-20-minute pause and the intranasal electrophoresis in the morning with the exposure to red laser light in the evening. On the second therapeutic day, the exposure to red laser light is performed in the morning, and in the evening the same is followed by a 15-20-minute pause and the intranasal electrophoresis. The treatment is conducted within 14-20 days.
EFFECT: method enables reducing the length of traumatic intracranial haematoma resolution ensured by the synergetic effect of the red and infrared laser light and therapeutic preparations.
SUBSTANCE: invention refers to experimental medicine and may be used to treat simulated spinal ischemia in a biological object. The method involves three intraperitoneal administrations of human recombinant erythropoietin in 4-6, 24 and 48 hours after the action caused spinal ischemia. The amount of human recombinant erythropoietin per an injection is 5000 IU/kg. In 30-60 minutes after the first dose of human recombinant erythropoietin has been administered, a region in a projection of a spinal ischemia centre increased by 1-2 cm from the end above the affected region is exposed to diffuse percutaneous irradiation. The patient is exposed to infrared light generated by a diode laser at wave length 890 nm, power 2 Wt. The exposure is performed in the continuous mode for 3 minutes at 3-4 cm from the body surface of the biological object within the exposure area with the light guide movable at 5 mm/sec. The light guide moves along the exposure area spirally.
EFFECT: method provides the high clinical effectiveness in spinal ischemia in experiment.
SUBSTANCE: invention relates to medicine, prevention and treatment of acquired myopia. Method includes simultaneous carrying out optical-reflex and stereoscopic exercises. For this purpose created are conditions for passage of short-wave part of spectrum of day light, which consists of violet, blue, azure, green colours with wave length in range from 380 to 575 nm, for one eye, and for the other - long-wave part of spectrum of day light, which consists of yellow, orange, red colours with wavelength in range from 575 to 760 nm, with simultaneous carrying out session of optical-reflex exercises by patient. Creation of such conditions is possible due to alternation of colour light filters, placed into slots of lens-holders on apparatus "Vizotronik", before each following session of treatment.
EFFECT: method ensures simultaneous considerable improvement of monocular, binocular, stereoscopic visual acuity, increase of fusional reserves and reserves of accommodation, perfection of visual perception system on the whole, normalisation of process of refractogenesis, stopping of myopic process progressing.
2 cl, 1 ex, 1 tbl
SUBSTANCE: invention relates to field of medicine, namely to thoracic surgery and can be used in carrying out lung resection caused by dissiminated tuberculosis, main forms of which are fibrous-cavernous tuberculosis and caseous pneumonia. Method consists in carrying out thoracotomy, isolation of lung from fusions and carrying out revision of lung parenchyma by isolation of lung tissue with main tuberculosis process and lung tissue with tuberculosis foci of dissemination, ablation of lung tissue with main tuberculosis process, performing hemostasis, drainage of pleural cavity and suturing thoracotomic wound. Puncture of parenchyma is performed in lung tissue with tuberculosis foci of dissemination. After that, light guide is introduced through it to supply irradiation directly into focus of tuberculosis changes. Impact with high-energy laser with irradiation wavelength 970 nm is performed with power of irradiation flow 10-15 W and temporary exposure 0.2-0.5 sec. Application of claimed invention makes it possible to perform destruction of tuberculosis foci in lung tissue with preservation of parenchyma which surrounds them, ensure smaller over-stretching of lung parenchyma in postoperative period and thus preserve vital capacity of lungs, to minimise risk of intra-operation complications, including damage to elements of lung root in the process of processing. Parameters of laser irradiation and exposure time ensure destruction of tuberculosis foci of lung tissue, which remain in parenchyma after cavern ablation.
EFFECT: aseptic productive character of inflammation in the process of lung parenchyma reparation in post-operative period contributes to reduction of inflammatory changes in operated lung.
SUBSTANCE: invention refers to medicine, namely urology, and may be used for treating acute epididymo-orchitis. With underlying antibacterial therapy, a photodynamic therapy (PDT) is applied by intravenous administration of the photosentitiser "Photolon" 1-1.5 mg/kg. The patient is irradiated intravenously for 10 minutes, and then locally - for 5 minutes. Wave length of the laser radiation is 662±3 nm; radiation power is 1-2.1 Wt in an exposition dose of 60 J/cm2.
EFFECT: method enables the short reduction of the acute process with underlying reduced amount of the applied antibacterial therapy, as well as preserves the reproductive function.
SUBSTANCE: invention refers to medicine, namely - to neurology. With underlying integrated therapy, the daily transcranial magnetic stimulation is generated by Neuro-MS apparatus. The exposure involves the contact coils IK-02-150 to be placed above a projection of the ischemic centre; the session length makes 1-2 minutes; the pulse train interval is 3 seconds; the train length is 3 seconds; the simulation frequency is 5 Hz, while the magnetic pulse induction peak makes 20%. The coil IK-02-150 is used to exposure the hemisphere opposite to the ischemic centre with the session length of 1-2 minutes, the pulse train interval of 3 seconds, the train length of 3 seconds, the simulation frequency of 0.1 Hz, and the magnetic pulse induction peak of 20%. A left frontal region is exposed to the coil IDU-02-100. The session length is 1-2 minutes, the pulse train interval is 5 seconds; the train length is 2.5 seconds. The simulation frequency is 10 Hz, and the magnetic stimulation peak is 20%. The procedures are daily; the therapeutic course is 10 procedures.
EFFECT: method improves the cerebral hemodynamics, improves the manifestations of cognitive disorders, and consequently enhances the general motion stereotype, reduces rate of complications and invalidisation that in the whole provides improving patient's quality of life.
SUBSTANCE: invention refers to medicine, namely to neurosurgery and rehabilitation medicine. A principal stage of the surgical intervention is followed by placing at least one electrode for neuromodulation in an abnormal focus. In the postoperative period, the Kronlein - Brusova scheme is used to localise a projection of anterior central gyri on the head skin, and the transcranial Doppler sonography follows. The presence and location of the temporal and suboccipical window are stated. It is the temporal window the closest to a projection of the anterior central gyri that is selected. Local magnetic emitters are placed in projections of the selected temporal and suboccipital windows. That is combined with the local exposure to the magnetic field by means of the placed emitters and electric current through the electrodes for neurostimulation. The 10-15-minute stimulation is performed three times a day for 15-20 days.
EFFECT: method provides higher clinical effectiveness and reduced risk of complications ensured by the combined electromagnetic stimulation of the adequately selected exposed areas.
SUBSTANCE: invention refers to medicine, more specifically to magnetic therapy, and may be used in healthcare facilities and domiciliary. Substance of the invention consists in the fact that a magnetic therapy apparatus comprises a time-varying current generator and an inductor connected to the current generator; the current generators is a flicker noise current generator, and the inductor is flat, rectangular and comprises four segments of a ribbon cable and four junction plates which are arranged between two identical rectangular solid segments and fixed in between; the flicker noise current generator is provided in an outer pocket clipped on the outer surface of the upper segment of solid tissue in the lower corner portion. In the particular case, the magnetic therapy apparatus is presented in the form of a bedcover.
EFFECT: simplified designed.
4 cl, 5 ex, 2 dwg
SUBSTANCE: invention refers to medical equipment, namely to agents for integrated magnetotherapy. The method consists in placing along the patient's body, above and below it, two layers of identical units in the form of electromagnetic filed generators, supplying electric signals of adjustable frequency and porosity thereto through control units from a control computer. Each electromagnetic field generator consists of a three-component inductor, which together with bridge current drivers, a local control device in the form of a microcontroller, and with the connected circuits of thermometers and current and magnetic field intensity probes, represents a unit cell being a part of one of the twelve unit cell matrixes with the personal address. The control computer selects the driving unit cell among the identical unit cells to generate a clock signal for the driven unit cells. There are formed three signal sets each of which comprises a impulse ratio modulation signal and a polarity signal to provide the individual exposure to magnetic field from the unit cells. The device implements the method for generating the magnetotherapeutic exposure and generating the common magnetotherapeutic medium.
EFFECT: using the invention enables enhancing the ability of generating the exposure ensured by generating the vector-controlled magnetic field.
7 cl, 4 dwg
SUBSTANCE: invention relates to medicine, namely to ophthalmology, and can be used for treating luetic optic neuropathy. That is ensured by subconjunctival administration of Cefazolin 0.3-0.5 mg. That is combined with intramuscular injection of Gliatilin 2.0-4.9 ml, 1-3% Glutoxim 2.0 ml and Milgamma 1.0-2.0 ml. Dexazon 0.5 ml is introduced parabulbarly. The preparations are introduced once a day for 10 days. Additionally, starting with the first therapeutic day, 10 sessions of percutaneous transcranial magnetic stimulation of the optic nerves are conducted daily.
EFFECT: method provides improving the visual functions and eliminating the complications of the central nervous system due to the integrated treatment developed with the severity of the pathological process in these patients.
1 tbl, 2 ex
SUBSTANCE: invention relates to medicine, namely to ophthalmology and pediatrics, and can be used for treatment of progressing myopia in children. For this purpose homeopathic medication placenta compositum is introduced into acupuncture points BL1 (UB1), ST1, EX-HN7(QIUHOU), GB1, EX-HN4(YUYAO) in dose 0.2 ml into each point. After that head area is subjected to exposure to pulse low-frequency electromagnetic field (PLEMF). Course of treatment constitutes 10 procedures, performed every second day.
EFFECT: method ensures reduction of rate of myopia progress and elimination of impairment in regional hemodynamics of eye, developed as a result of existing for a long time myopic defocus, at the background of stabilisation of processes of cell metabolism in connective tissue.
SUBSTANCE: invention refers to medicine, namely to - physiotherapy, balneology. A method involves the exposure to a low-frequency pulse magnetic field. The exposure covers 6 fields. If the exposure covers the 1st and 2nd fields, including paravertebral muscles, the mode B is used. The exposure consists of single pulses of the pulse duration for S inductor 110±10 mcs, for N inductor 260±20 mcs. Pulse length is 16 Hz, and intensity is 70-80%. The inactive N inductor is placed on the side of more evident pain sensations. Length of the exposure is 3 minutes. If the exposure covers the 3rd-6th fields including projections of the gluteus medius muscle and rectus muscle of thigh, the mode A is used. The exposure consists of paired pulses. The pulse duration for S inductor is 110±10 mcs, and for N inductor 260±20 mcs. Intensity is 80-100%. An inter-pulse interval is 40 ms. The active S inductor is placed within a projection of the gluteus medius muscle and rectus muscle of thigh in its lower one-third from the side of the surgically operated joint. The inactive N inductor is placed on a posterior thigh in its lower one-third and a projection of the rectus muscle of thigh in its upper one-third. The exposure length for the 3rd-4th and 5-6th fields makes 3 minutes for each. Total duration of a procedure is 9 minutes. The procedures are daily. The therapeutic course is 10-12 procedures. Pelotherapy by applications of peat mud onto the paravertebral lumbar spine and a projection of hip joints follows 60-90 minutes later. Mud temperature is 38 - 40°C. Duration of a procedure is 20-30 minutes. The procedures are performed every second day. The therapeutic course is 8-10 procedures. The method improves body self-adaptation ensured by optimising the immune system functioning, the lipid peroxidation system and antioxidant protection.
EFFECT: method activates the metabolic processes in joint and periarticular tissues ensured by normalising micro blood flow in the lower extremities.
2 ex, 5 tbl
SUBSTANCE: invention refers to medicine, namely - to physiotherapy and traumatology. According to the method, the initially prone patient is exposed to a traveling pulse magnetic field generated by ALMAG apparatus. Inductor coils are arranged in contact along the spine within a projection of the compression fracture. That is followed by induction of 20 mT. The exposure length is specified according to a child's age. When treating the 8-11-year-old children, the exposure length is 8 minutes, while the 12-14-year-old children are treated for 10 minutes. The procedures are daily. The therapeutic course is 8-10 procedures. Starting from the 3-5th day, the daily course of therapeutic exercises is prescribed. The therapeutic course is 8-10 procedures.
EFFECT: method reduces the length of limitation of spinal motions, arrests the pain syndrome over a relatively short time.
SUBSTANCE: invention refers to medicine, namely neurology, reflexotherapy. The method comprises the magnetic-laser therapy (MLT), acupuncture and therapeutic exercises (TE) with underlying pharmacotherapy. The MLT involves a paravertebral exposure at wave length 0.88 m, power 10 mW, magnetic field strength 40 mT, 4 minutes on each side alternately. The acupuncture represents another embodiment of the method of inhibition. At first, the acupuncture exposure is contralateral, and starting from the 3rd-5th procedure, the exposure also covers the involved side. All the exercises of each following session are conducted with rate load gain, an increase of the number and extent of the exercises. If observing paresis of the upper extremity, the MLT covers a collar region at the level of interosseus processes of the 5th-6th cervical and thoracic 1st-2nd vertebrae. At first, the acupuncture covers the point (TA) Lan-wei at a healthy ankle of the lower extremity. Starting from the 3rd-5th procedure, the exposure also involves the point Er-jian at a hand of the affected upper extremity. If observing paresis of the lower extremity, the MLT involves the lumbar-sacral region at the level of interosseus processes of the 2nd-3rd lumbar and 1st-2nd sacral vertebrae. Originally, the exposure covers the point Shou-san-li in a forearm of the healthy upper extremity. Starting from the 3rd-5th procedure, another version of the method of excitation is included on the affected side whereat the acupuncture needle is inserted into the point Tsu-syui within a foot of the affected lower extremity. If observing hemiparesis, the MLT includes the collar region at interosseus processes of the 5-6th cervical and 1rd-2nd thoracic vertebrae, then on the lumbosacral region. The exposure includes the point Lan-wei at the healthy ankle of the lower extremity and simultaneously the point Shou-san-li in the forearm of the healthy upper extremity. Starting from the 3rd-5th procedure, the exposure is added with a simultaneous effect on the point Er-jian at the hand of the affected upper extremity and on the point Tsyu-syui at the foot of the affected lower extremity. The physical exercises are combined with the correction of the hand and foot positions. For the purpose of the correction, a trainer extends the fingers and positions them properly in a combination with active-passive flexion and extension of the ankle joint. Treating the locomotor disorders starts 1-7 days after the ischemic stroke has been verified. The therapeutic course consists of 12-15 daily procedures.
EFFECT: method provides higher clinical effectiveness, reduces the length of staying in hospital and the disability rate in the patients.
3 ex, 5 tbl
SUBSTANCE: invention refers to medicine, namely - to physiotherapy, paediatrics. According to the method, the intestine is exposed to a travelling magnetic field. That is ensured by AMO-ATOS apparatus. The exposure frequency is 10 Hz, and the magnetic induction is 42 mT. The procedures are daily, the length is 15 minutes. The therapeutic course is 8-10 procedures.
EFFECT: method increases the clinical effectiveness ensured by normalising the enzyme activity, prolongs remission.
4 tbl, 3 ex
FIELD: medical engineering.
SUBSTANCE: device has power supply source, electromagnetic oscillation source, treatment element, having two inductance coils connected in series and compliance, and capacitor forming an LC-circuit with the treatment element. The electromagnetic oscillation source is designed as self-excited oscillator, which oscillatory circuit is the LC-circuit with the treatment element. The device also has modulator unit set between the power supply source and self-excited oscillator circuit, control circuit connected to the self-excited oscillator circuit and having amplitude detector, AC amplifier and indicator unit connected in series and sectional U-shaped dielectric carcass having inductance coils of the treatment element mounted on its vertical elements and electric units of the device mounted on horizontal electric elements of the device. The self-excited oscillator produces high frequency oscillations in frequency bandwidth of 100-1000 kHz. The modulator unit has low frequency oscillator operating in the bandwidth of 10-5000 Hz. Carcass members are manufactured from hard dielectric material and connected to each other by means of flexible connection members.
EFFECT: wide range of functional applications.
2 cl, 2 dwg