Features of Femtosecond Correction of High Myopia through Small Access

Aim. To modify the calculated parameters of the lenticle extraction refractive surgery through a small access (SMILE), evaluate its safety and clinical efficacy in correcting high myopia.Materials and methods. 34 patients (68 eyes) underwent surgery by a modified SMILE technology under local anesthesia. In all cases, the patients had a high degree of myopia, in 37 % in combination with astigmatism.Uncorrected visual acuity before surgery averaged 0.05 ± 0.11, best corrected visual acuity of 0.94 ± 0.1, the pre-operative spherical refraction component was –7.23 ± 0.75, the cylindrical component was –0.48 ± 0.59.During the operation, to obtain the maximum possible refraction result using the proposed method, the standard operation parameters were changed: the corneal flap thickness was reduced to 100 μm, the neural optical layer by 5 μm, the diameter of the optical zone depended on the residual cornea thickness, which should exceed 280–290 μm. Corneal access was increased by 15–20 degrees.Results. The next day after surgery, monocular uncorrected visual acuity in distance in 73 % of patients was 0.8 or higher, and in 41 % of cases it was equal to or exceeded 1.0. The spherical equivalent on the first day after surgery had a slight hypermetropic shift, which was completely leveled by the year of follow-up. During the surgical intervention and in the postoperative period, no complications were noted.Conclusion. Using the proposed algorithm for calculating the refractive effect of the operation SMILE with a high degree of myopia allows obtaining a high refractive effect and avoiding possible complications

ВОЗРАСТНЫЕ ОТЛИЧИЯ ИНФЕКЦИОННОГО МОНОНУКЛЕОЗА ЭПШТЕЙНА - БАРР ВИРУСНОЙ ЭТИОЛОГИИ

During the dynamic observation, clinical and laboratory results of 194 patients with infectious mononucleosis of Eрstein-Barr etiology of different age groups were summarized. In the comparative aspect, the identity of the symptoms is revealed. Along with this, the dependence of some clinical and laboratory parameters on the age of patients was found. Patients with preschool and school age often registered febrile fever, decreased appetite, raids on tonsils, the first appeared «snoring in a dream», hepatosplenomegaly. For teenagers and adults, icterus, a pronounced mononuclear response and cytolysis syndrome are more common. При проведении динамического наблюдения обобщены клинические и лабораторные данные 194 больных инфекционным мононуклеозом Эпштейна – Барр этиологии различных возрастных групп. В сравнительном аспекте выявлена идентичность симптоматики. Наряду с этим, обнаружена зависимость некоторых клинико-лабораторных показателей от возраста пациентов. У больных дошкольного и школьного возраста чаще регистрировались фебрильная лихорадка, снижение аппетита, налеты на миндалинах, впервые появившийся храп во сне, гепатоспленомегалия. Для подростков и взрослых более характерны желтуха, выраженная мононуклеарная реакция и синдром цитолиза.

RESEARCH AND TECHNOLOGY DEVELOPMENT FOR CONSTRUCTION OF 3D VIDEO SCENES

For the last two decades surface information in the form of conventional digital and analogue topographic maps has been being supplemented by new digital geospatial products, also known as 3D models of real objects. It is shown that currently there are no defined standards for 3D scenes construction technologies that could be used by Russian surveying and cartographic enterprises. The issues regarding source data requirements, their capture and transferring to create 3D scenes have not been defined yet. The accuracy issues for 3D video scenes used for measuring purposes can hardly ever be found in publications. Practicability of development, research and implementation of technology for construction of 3D video scenes is substantiated by 3D video scene capability to expand the field of data analysis application for environmental monitoring, urban planning, and managerial decision problems. The technology for construction of 3D video scenes with regard to the specified metric requirements is offered. Technique and methodological background are recommended for this technology used to construct 3D video scenes based on DTM, which were created by satellite and aerial survey data. The results of accuracy estimation of 3D video scenes are presented

Clinical and morphological features of the leukoplakia in the Perm region

Leukoplakia is a chronic precancerous skin and mucosal lesion with a multifactorial etiology.Aim: To retrospective analyze clinical and morphological characteristics of leukoplakia in the Perm region.Materials and methods: The study was based on the data extracted from outand in-patient medical files and biopsy samples of 332 patients referred to the Perm Regional Oncological Dispensary (Perm, Russian Federation) in 2005 to 2016. The analysis of clinical and morphological characteristics was carried out with consideration of anatomical localization, gender and histopathological findings.Results: Among the patients with leukoplakia, there were mostly women (77.7%) of the older age (61.6 ± 3.5 years), with frequent lesions of the vulvar mucosa (71.7%). Men had similar prevalence of genital (47.3%) and oral (52.7%) leukoplakia. Simple (flat) leukoplakia was found in 31.7% of the cases, verrucous in 45.0%, and erosive/ ulcerative in 23.3%. Verrucous leukoplakia was more often characterized by hyperkeratosis (95.5%) and vacuolar degeneration (94.8%). The erosive/ulcerative type was characterized by parakeratosis (95.7%), acanthosis (84.3%), dyskeratosis (90.0%), and dermal vascularization (95.7%). Dysplasia was observed in 52.3% of the cases, with 90% in erosive/ulcerative leukoplakia, 31.5% in simple leukoplakia and 47.4% in verrucous type. The frequency of dysplasia signs increased with an increase of the dysplasia grade (SIN).Conclusion: In the Perm region, leukoplakia was more prevalent in female patients and had predominantly genital localization (96.9%). The risk of verrucous and erosive/ulcerative genital leukoplakia in women was 2,27and 1,75-fold higher than in men, respectively. In all clinical types, there was a slight predominance of SIN1, whereas the ratio of dysplasia grades was similar. Only combined assessment of clinical and morphological data could improve prediction of transformation to cancer

Diagnosis of actinic keratosis by dermatoscopy

Introduction: Actinic keratosis (AK) is a local introepidermal atypia of keratinocytes, formed as a result of intense and prolonged exposure to sunlight. AK lesions located on exposed areas of skin, mostly on the face, in this regard, a more relevant non-invasive diagnostic techniques, primarily dermatoscopy. Material and methods: We examined 35 patients and revealed they have 204 hearth. Results: Of the 204 lesions erythematous form was found in 160 (78, 4%) cases, keratotic - 24 (11,8%), pigmental (9.8 %). Patients with AK most private dermatoscopic signs were erythema (90,2%), vascular structures (67,65%), keratin scales (51,47%), pseudonetwork (23,04%). Discussion: Analyzing dermoscopic picture of the most common forms of AK met the characteristics for each shape. A detailed study of vascular structures allows for the differential diagnosis of cancer in situ. While AK watched point and the glomerular vessels of not more than 10% of cases, which helped to differentiate AK from cancer in situ, in which such vessels were found in 40%. Glomerular vessels are not met in our study and the points were only 2.45% of the cases. Keratotic AK was characterized in 100% of cases the presence of keratin scales. In pigment form, we revealed the dark brown streaks (80%), dark brown points (50%), brown globules (30%), dark brown blots (10%) and slate-grey dots (10%). But the gold standard for the differential diagnosis with maligna lentigo is a morphological study. Conclusion: AK has specific characteristics in treatment research, which helps to differentiate it from other benign and malignant tumors of the skin, and to diagnose it in its earliest stages without resorting to invasive procedures. Effective diagnosis of AK reduces the risk of malignant transformation and contribute to the selection of adequate and necessary treatment tactics

Specifics of type IV collagen expression in basal cell skin carcinoma

Rationale: Type IV collagen is the main component of the basal membrane ensuring its integrity. Basal membrane destruction is associated with absent type IV collagen expression being directly related to an increased tumor invasion risk. Specifics of the protein expression in various morphological types of basal cell carcinoma have not been well described. Aim: To study the association between type IV collagen expression and basal cell carcinoma morphological structure and invasion potential. Materials and methods: We performed an immunohistochemistry analysis with anti-type IV collagen antibodies on 30 biopsy specimens of the skin involved with basal cell carcinoma. Results: The superficial multicentric type of basal cell carcinoma differed from the solid, micronodular, and infiltrative types by linear continuous type IV collagen expression (р < 0.0083). Most often, there was no type IV collagen expression in the micronodular and infiltrative basal cell carcinomas; however, no significant difference of the solid type and each of the abovementioned types was found. Aggressive basal cell carcinoma types (micronodular and infiltrative, taken together) were significantly different (р = 0.033) from the solid type by the absence of type IV collagen expression. Linear continuous expression was seen exclusively in basal cell carcinomas with the invasion of < 0.825 mm. Conclusion: We have identified the difference in type IV collagen expression depending on the morphological type of basal cell skin carcinoma, prevailing linear continuous expression in the superficial multicentric type and its absence in the micronodular and infiltrative types

PREOPERATIVE ASSESSMENT OF THE INITIAL CONDITION OF THE EYE SURFACE IN PATIENTS WITH MYOPIA

The purpose is to assess the structural state of the cornea and pre-corneal lacrimal film in patients with myopia before refractive surgery, to identify the relationship with changes in cytokine concentration in the tear. Material and methods. 62 patients (124 eyes) with myopia were examined. The first group included 26 patients, only glasses were used for the correction of myopia, and in the 2nd group, 36 patients who used soft contact lenses during 5 to 15 years. Methods of examination: determination of the thickness of the corneal epithelium, height and width of the lacrimal meniscus, assessment of the biomechanical properties of the cornea, the Norn and Schirmer tests. Content of cytokines in the tear – interleukin 10 and tumor necrosis factor α – was measured using the test set «BEST» by enzyme immunoassay. Results. The decrease in the thickness of the epithelium of the cornea, the height and width of the lacrimal meniscus, the stability of the tear film, and the ratio of interleukin-10 to the tumor-α necrosis factor in patients who use contact lenses for a long time are revealed. The conclusion. Prolonged wearing of contact lenses for correction of myopia is accompanied by signs of symptomatic dry eye syndrome against a background of moderate oppression of the anti-inflammatory activity of tears

Relex Smile and its features for the correction of high degree myopia

Purpose: to modify the calculated parameters of the refractive operation - extraction of the lenticle through small access (Smile), evaluate its safety and clinical effectiveness in correcting high-grade myopia. Material and methods. 34 patients (68 eyes) were operated by the modified Smile technology under local anesthesia. In all cases, patients had a high degree of myopia, in 37 % - in combination with astigmatism. Uncorrected visual acuity before surgery was on average 0.05 ± 0.11, Best corrected visual acuity was 0.94 ± 0.1, preoperative spherical refractive component -7.23 ± 0.75, cylindrical component -0.48 ± 0.59. During the surgery, in order to obtain the maximum possible refractive result according to the proposed method (patent No. 2018113414 of April 13, 2013), the standard parameters of the operation were changed: the thickness of the corneal flap was reduced to 100 μm, the neutral optical layer was 5 μm, the diameter of the optical zone depended on the residual thickness of the cornea, which should exceed 290 microns. The increase in corneal access was 15-20 degrees. Results. During the surgical intervention and in the postoperative period there were no complications. The next day after surgery, monocular uncorrected visual acuity in the distance in 73 % of patients was 0.8 and above, and in 41 % of cases it was equal to or exceeded 1.0. The spherical equivalent in the first day after the operation had a small hypermetropic shift, which was completely leveled by the year of observation. Conclusion. Using the proposed algorithm for calculating the refractive effect of the SMILE operation in high degree myopia allows obtaining a high refractive effect and avoiding possible complications