ЭКСПРЕССИЯ РАКОВО-ТЕСТИКУЛЯРНЫХ ГЕНОВ PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 У БОЛЬНЫХ МНОЖЕСТВЕННОЙ МИЕЛОМОЙ, ИХ ВЛИЯНИЕ НА ПОКАЗАТЕЛИ ОБЩЕЙ ВЫЖИВАЕМОСТИ И СКОРОСТЬ ВОЗНИКНОВЕНИЯ РЕЦИДИВА

Objective: to study the prognostic significance of the expression of cancer-testis (CT) genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in patients with multiple myeloma (MM) and their influence on overall survival and relapse rate. To determine their effect on suсh clinical parameters as levels of lactate dehydrogenase, leucocytes, hemoglobin, calcium, albumen, creatinine, beta-2-microglobulin.Materials and methods. Real-time polymerase chain reaction was performed on complementary DNA obtained from bone marrow of 77 patients with MM. The statistical analysis was performed using the Statistica 10.0 software package. To estimate prognostic values of the CT gene expression data were analyzed by the Kaplan – Meier method.Results. The study was conducted to determine the level of expression of CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 in a group of patients with MM. The group included primary and receiving cancer treatment in MM patients. According to the log-rank criterion expression of any of the CT genes PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 exerts a significant influence on overall survival and progression-free survival/relapse. It was also determined that providing expression of some CT genes, the levels of creatinine, calcium, beta-2-microglobulin were much higher to compare with patients without expression.Цель исследования – изучить прогностическое значение экспрессии раково-тестикулярных генов (РТГ) PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 у больных множественной миеломой (ММ) и их влияние на показатели общей выживаемости и скорость возникновения рецидивов, определить их влияние на такие клинические показатели, как уровни лактатдегидрогеназы, лейкоцитов, гемоглобина, кальция, альбумина, креатинина и бета-2-микроглобулина.Материалы и методы. Количественную полимеразную цепную реакцию в реальном времени проводили на комплементарной ДНК, полученной из образцов костного мозга 77 больных с установленным диагнозом ММ. Статистический анализ выполняли с помощью программного пакета Statistica 10.0. Для построения кривых общей выживаемости использовали метод Каплана–Майера.Результаты. Проведено исследование для определения уровня экспрессии РТГ PRAME, NY-ESO1, GAGE1, MAGE A3, MAGE A6, MAGE A12, SSX1, SLLP1, PASD1 в группе больных ММ. В группу вошли как первичные пациенты, так и получающие лекарственную противоопухолевую терапию при ММ. Согласно log-rank-тесту существенное влияние на показатели общей выживаемости и выживаемости без прогрессирования/рецидива заболевания оказывает экспрессия любого из РТГ NY-ESO1, MAGE A6, MAGE A12, SSX11, PASD1. Также определено, что при экспрессии некоторых РТГ уровни креатинина, кальция и бета-2-микроглобулина были на порядок выше, чем у больных без экспрессии

An experimental study of drainage properties of fibrillar-structured materials for glaucoma surgery

Purpose: to study the drainage properties of fibrillar-structured materials under conditions of hydrodynamics which are maximally close to physiological conditions, using the results of a bench experiment.Material and methods. Drainage properties of fibrillary-structured materials have been studied in several bench experiments using an original device that creates conditions of eye hydrodynamics maximally close to physiological conditions. The studied materials were produced by the method of electrospinning, vacuumized and sterilized. The effect of drainage structure density and drainage type (polylactide, copolymer of polylactide and caprolactone, polycaprolactone) on the drainage capacity were evaluated, as well as the stability of their drainage properties.Results. The research revealed considerable drainage properties of all investigated objects. The study of various drainages showed a statistically significant effect of the density of the internal structure and type on the drainage capacity. Also, a nonlinear increase in the filtering capacity with a regular increase in perfusion pressure was revealed. This phenomenon, regarded as adaptive hydrodynamic properties, in addition to reducing the level of the intraocular pressure (IOP), can contribute to smoothing of diurnal fluctuations, thereby enabling the stabilization of visual functions. In the experiment, the optimal structure was determined, which corresponds to the conditions of physiological hydrodynamics of the eye and ensuring the maintenance of intraocular pressure in the low-norm region. Fibrillar structured drains made of polylactide and its copolymer with polycaprolactone with a porosity of 78–84 %, an average fiber diameter of 5–5.7 μm and a pore size of 25.8–29 μm optimally correspond to hydrodynamic conditions maximally close to physiological conditions.Conclusion. Fibrillar-structured materials have significant drainage properties depending on the density of the internal structure and the type of drainage due to threshold activation of additional pores create the conditions, close to the physiological ones, for the regulation of the IOP, and ensure the persistence of visual functions after operations

BASIC CHARACTERISTICS OF ANTIGLAUCOMATOUS DRAINAGES

The literature review analyzes the most commonly used drains (collagen, metal, synthetic polymer based, and biopolymer) based on their main characteristics: biocompatibility, bio-resorption, possibilities of the saturation with the drug substances, abilities to a transportation of aqueous humor, and in case of non-penetrating deep sclerectomy – to a maintenance of a volume of intrascleral cavity. A special attention was paid to aspects and mechanisms of bio-resorption drainage implants

EXPERIMENTAL MORPHOLOGICAL STUDY IN RESORPTION MECHANISM OF FIBRILLAR-STRUCTURED DRAINAGE IMPLANTS FOR GLAUCOMA SURGERY

Purpose. To study a resorption mechanism of fibrillar-structured drainage implants for glaucoma surgeries based on an experimental morphological investigation.Material and methods. The study was carried out in 24 chinchilla rabbits, which were divided into 3 groups of 8 animals in each. drainage implants made of polyethylene terephthalate (PET) were implanted in rabbits from the group 1, drainage implants made of polyamide-6 in rabbits from the group 2, and drainage implants made of polylactide (PLA) in rabbits from the group 3. Postoperative inflammatory reaction was evaluated in the postoperative follow-up period. After the removal of the animals from the experiment the morphological investigation of their eyes was performed.Results. The eyeball inflammatory reaction to the implantation of polymeric material corresponded to the degree 0 during the entire followup period in the group 1. Histology showed a thin capsule formation at the edge of the drainage implant, containing a low amount of extracellular matrix and a lot of cellular elements. In the group 2 the eyeball inflammatory reactions corresponded to the degree 1. Histologically, the fibrous structure of the drainage implant could hardly be observed, that indicates a diffuse resorption type. The whole structure of the drainage implant was permeated with large amount of cells: macrophages and multinuclear giants prevailed, fibroblasts were presented as well, fibrocytes, lymphocytes, newly formed collagen fibers between drainage implant fibers were also observed. In evaluation of results obtained during implantation of the polylactide matrix the eyeball inflammatory reaction corresponded to the degree 0. Histological examination showed that the implant retained its original position, was partially resorbed. Fibrous structure of the implant was retained, that indicated a superficial resorption type. A moderate accumulation of macrophages was determined among its fibers, isolated giants and lymphocytes were also presented.Conclusions. The drainage implant made of polylactide exhibit a superficial resorption type that is optimal for structure maintenance, local reaction reduction and better resorption level prognosis. The fibrillarstructured framework of the drainage implant along with superficial resorption type provides better conditions for aqueous humor flow. The experiment revealed no toxic effect of polylactide drainage implant on a rabbit eye

Experimental-Morphological Study of Several Types of Fibrillar Structured Drainages for Glaucoma Surgery

Purpose: based on the results of an experimental study in vivo, to determine the optimal type of fibrillar structured drainages for glaucoma surgery.Material and methods. An experimental morphological study was performed on 32 rabbits of the chinchilla breed, which were divided into 4 groups of 8 animals each. The rabbits were implanted with fibrillar structured drains from polyurethane, polyethylene terephthalate, polyamide, polylactide. In the postoperative period, a postoperative inflammatory reaction was assessed. After removing the animals from the experiment, the eyes were subjected to morphological examination.Results. In rabbits with drainage from polyurethane, a mild congested hyperemia was noted in visual evaluation compared with the pair eye during the entire follow-up period. The eye reaction to the operation was regarded as a 1st degree. In more distant terms, there was a proliferation of subconjunctival tissue in the projection of the operation zone. In histological examination, the implant was represented by thin fibrous structures throughout the volume of drainage, a uniform distribution of macrophages, lymphocytes, among the fibers. In rabbits with drainage from polyethylene terephthalate, the reaction of the eyeball to the implantation of the polymeric material corresponded to the 0 degree. When a histological study was carried out along the periphery of the drainage, a thin capsule was formed. In rabbits with drainage from polyamide, the reaction of the eyeball corresponded to 1 degree. Histological examination showed that the fibrous structure of drainage was practically not determined, an abundance of cellular elements was observed throughout the drainage: macrophages and multinucleate giants predominated, fibroblasts, fibroblasts, lymphocytes, and newly formed connective tissue fibers between the drainage fibers were present. When analyzing the results obtained during the implantation of the matrix from the polylactide, the reaction of the eyeball corresponded to the 0 degree. Histological examination showed the preservation of fibrous structure of drainage, a moderate accumulation of macrophages was determined between the fibers, single giants, single lymphocytes were present.The conclusion. Fibrillar structured drains based on polylactide due to a stable highly porous structure, high biocompatibility and biodegradability create favorable conditions for transport of aqueous humor and formation of outflow pathways

ANATOMIC-TOPOGRAPHICAL CHANGES IN THE EYES OF A MIXED FORM OF PRIMARY OPEN-ANGLE GLAUCOMA AFTER LASER IRIDECTOMY

Purpose. To investigate anatomic and topographic parameters in patients with a mixed form of primary open-angle glaucoma with the presence of segmental closure of the anterior chamber angle after the performed uncomplicated laser iridectomy.Material and methods. The study included 78 eyes with residual closure of the anterior chamber angle after laser iridectomy, with the preserved shallow anterior chamber, offset forward irido-lens diaphragm and compensated IOP – 19.2±0.16mmHg. The control group included 34 eyes with similar anatomic and topographic parameters without diagnosed glaucoma. Ultrasound biomicroscopy (UBM), B-scan ultrasound and optical coherence tomography of the anterior segment of the eye were used.Results. According to UBM in the study group a high frequency of pseudoexfoliative syndrome of the stages 2-3 was revealed with stretching and rupture of ciliary zonules fibers with pronounced asymmetry in the parameters of the anterior chamber angle, decreasing of the depth of the posterior chamber, increasing the thickness of the lens with its forward shifting. Anatomic and topographic changes of the anterior segment were accompanied by posterior vitreous detachment.Conclusions. Shallow anterior chamber, segmental closure of the anterior chamber angle after the uncomplicated laser iridectomy in patients with a mixed form of glaucoma were caused by an increase in the lens thickness, shifting forward the iris-lens diaphragm and weakness of ciliary zonules. Changes caused by the pseudoexfoliative syndrome contributed to the violation of topographical relations of ocular structures, the segmental closure of the anterior chamber angle and the lack of recovery of anterior chamber depth after laser iridectomy