The results descemet-stripping automated endothelial keratoplasty at bullous keratopathy

Purpose: to evaluate outcomes of the descemet-stripping automated endothelial keratoplasty using eye drops Kombinil-Duo dur- ing postoperative period.Methods: 26 patients suffered from bullous keratopathy underwent descemet-stripping automated endothelial keratoplasty using our own technique. We applied eye drops Kombinil-Duo during postoperative period.Results: 25 patients had clear corneas whole period of observation. Graft rejection occurred in 1 eye. Mean BSCVA was 0.47±0.21.Conclusion: Kombinil-Duo has been allowed to avoid infectious complication and to increase efficiency of the operative interven-tion during postoperative period.</p

MAGNETIC RESONANCE SEMIOTICS OF BREAST CANCER

Breast cancer (BC) that is the most common malignancy in women presents an indubitable threat to their life and health. The basis for this investigation was magnetic resonance imaging (MRI) data of 203 women with histologically verified malignan- cies. The patients' mean age was 53±10.2 years. The paper describes the magnetic resonance semiotics of BC; the authors have developed criteria for dynamic contrast-enhanced magnetic resonance mammography used in the differential diagnosis of nodules.Due to high soft-tissue contrast, the use of thin sections, and the possibility of examining in any projection, MRI allows one not only to accurately visualize a pathological mass as compared with X-ray mammography or ultrasound study, but also to characterize its vascularization, which is a major criteria for the differential diagnosis of benign and malignant breast nodules

Оценка влияния сопутствующей глаукомы на результаты эндотелиальной кератопластики при буллезной кератопатии

PURPOSE: Evaluate the influence of concomitant glaucoma on the ultra-thin Descemet’s stripping automated endothelial keratoplasty (UTDSAEK) outcome. METHODS: 64 patients (67 eyes) with bullous keratopathy underwent UTDSAEK. The average age of the patients was 71.7±5.4 years. The average preoperative visual acuity equaled 0.04±0.04. 19 patients (19 eyes) had a history of glaucoma (stages II-III). 45 patients (48 eyes) didn’t have glaucoma. Bullous keratopathy was detected in 47 of the studied eyes, Fuchs dystrophy - in 20. Prior to the operation mean intraocular pressure (Р0) in eyes with glaucoma was 13±2.3 mmHg, in eyes without glaucoma - 14±3.1 mmHg. Intraocular pressure before and after the operation was measured by Tonopen-XL tonometer. RESULTS: In 1 year after endothelial keratoplasty mean IOP for patients with concomitant glaucoma was higher than before surgery and equaled 16±2.8 mmHg (pЦЕЛЬ. Оценить влияние сопутствующей глаукомы на результаты автоматизированной эндотелиальной кератопластики с удалением десцеметовой мембраны и использованием тонких трансплантатов (UTDSAEK). МЕТОДЫ. 64 пациентам (67 глаз) с буллезной кератопатией произвели UTDSAEK. Средний возраст пациентов составил 71,7±5,4 года. Средняя дооперационная острота зрения равнялась 0,04±0,04. Не страдали глаукомой 45 больных (48 глаз), у 19 пациентов (19 глаз) в анамнезе имелась глаукома II-III стадии. Вторичная буллезная кератопатия была выявлена на 47 глазах, дистрофия Фукса - на 20. Среднее внутриглазное давление (ВГД, Р0) на глазах с глаукомой до кератопластики составляло 13±2,3 мм рт.ст., на глазах без глаукомы - 14±3,1 мм рт.ст. ВГД до и после операции измеряли апланационным тонометром Tonopen-XL. РЕЗУЛЬТАТЫ. Через 1 год после эндотелиальной кератопластики среднее ВГД у больных с сопутствующей глаукомой было достоверно выше, чем до операции, и равнялось 16±2,8 мм рт.ст. (

Evaluation of myocardial damage in different types of rheumatoid arthritisduring disease-modifying antirheumatic drug or biological therapy (with infliximab)

Objective. To estimate the extent and pattern of myocardial damage in different types of rheumatoid arthritis (RA) during disease-modifying antirheumatic drug (DMARD) or biological therapy. Subjects and methods. Seventy-one patients with RA were examined; some of them received biological therapy with infliximab, while the others took DMARDs. A group of patients with incipient RA was also identified. B-type brain natriuretic peptide levels were estimated and electrocardiography, echocardiography (EchoCG), and cardiac magnetic resonance imaging (MRT) using the contrast medium Dotarem were conducted in all the patients. The follow-up totaled 6 months. A control examination was made at the moment of randomization and 6 months posttreatment. Results. Tn the bulk of patients, the level of B-type brain natriuretic peptide did not differ from the reference values, however, its lower level was observed in the incipient RA group, which was associated with the absence of cardiovascular diseases and with a younger age group. There were no negative EchoCG changes in myocardial viability values. Cardiac MRT demonstrated that the majority of patients had the similar changes that failed to affect myocardial kinetics and ejection fraction. These changes were not found in incipient RA patients without cardiovascular diseases. No improvement in myocardial viability was recorded in the patients receiving the biological therapy. Conclusion. Thus, cardiac MRT showed the similar changes that failed to affect myocardial kinetics and ejection fraction in patients with RA during both methotrexate and infliximab therapy

Возможности усовершенствованной методики однофотонной эмиссионной компьютерной томографии головного мозга с 99mTc-метоксиизобутилизонитрилом в определении степени злокачественности глиальных опухолей

99mTc-MIBI Brain SPECT results of 79 patients with glial brain tumors are presented in the issue. The new technique of brain SPECT with 99mTc-MIBI was discovered and its oppotunities in characterization of tumor grade is shown in his study.В статье представлена усовершенствованная с методика проведения однофотонной эмиссионной компьютерной томографии головного мозга с использованием радиофармпрепарата 99mTc-метоксиизобутилизонитрила при выявлении и определении степени злокачественности глиальных опухолей головного мозга. В результате обследования 79 пациентов с различными глиальными опухолями головного мозга показано, что применение данной методики позволяет не только определить наличие анапластической ткани опухоли, но также охарактеризовать ее по степени анапластической активности и отнести к той или иной степени злокачественности

IDENTIFICATION AND STUDY OF LEPTOSPIROSIS FOCUS IN IRKUTSK REGION

Due to examination of animal breeding workers at the Irkutsk Region a case of human leptospirosis was identified. at the cattle farm of Tugutuy settlement. Due to epizootological-epidemiological study a mixed, leptospirosis focus in Ekhirit-Bulagat district was established, the agent circulation among commensal and wild, small mammals was demonstrated. Continuous pathogenic Leptospira DNA detection during the second, half of 2011, as well as the positive tularemia laboratory results require further study of the focus

Evaluation of fetal absorbed doses from computed tomography examinations of pregnant patients: A systematic review

BACKGROUND: Currently, no systematic data are available on fetal radiation exposure as a result of radiographic studies during pregnancy. Consequently, there are no approved methods of its calculation that can be used in clinical practice. It is especially relevant for computed tomography scans as it is a widely used and highly informative method of diagnostic imaging associated with high exposure levels. AIM: to systematize currently available data on radiation dose absorbed by the fetus from computed tomography scans in pregnant women. MATERIALS AND METHODS: The search for publications in Russian and English was conducted in PubMed/Medline, Google Scholar and еLibrary. The final analysis included 12 papers including 8 studies using human body phantoms, 3 retrospective studies and one prospective clinical study. RESULTS: Abdominal and pelvic computed tomography scans as well as whole-body scans were found to be associated with the highest fetal radiation exposure. However, in none of the publications the fetal exposure limit was exceeded. CONCLUSION: Clinically indicated non-contrast-enhanced computed tomography scans in pregnant women are not likely to be associated with the fetal absorbed doses that exceed the limit of 100 mGy regardless of the scanned area. However, this limit might be exceeded in case of performing multiple studies or if multiphase abdominal or pelvic computed tomography scans, or whole-body computed tomography scans are performed in patients with multiple trauma. In these cases, a decision regarding the need for these investigations should be made by a multi-disciplinary team (including radiation safety specialists, diagnostic radiologists and clinicians) based on the results of additional risk assessment

Three-dimensional pattern formation, multiple homogeneous soft modes, and nonlinear dielectric electroconvection

Patterns forming spontaneously in extended, three-dimensional, dissipative systems are likely to excite several homogeneous soft modes ($\approx$ hydrodynamic modes) of the underlying physical system, much more than quasi one- and two-dimensional patterns are. The reason is the lack of damping boundaries. This paper compares two analytic techniques to derive the patten dynamics from hydrodynamics, which are usually equivalent but lead to different results when applied to multiple homogeneous soft modes. Dielectric electroconvection in nematic liquid crystals is introduced as a model for three-dimensional pattern formation. The 3D pattern dynamics including soft modes are derived. For slabs of large but finite thickness the description is reduced further to a two-dimensional one. It is argued that the range of validity of 2D descriptions is limited to a very small region above threshold. The transition from 2D to 3D pattern dynamics is discussed. Experimentally testable predictions for the stable range of ideal patterns and the electric Nusselt numbers are made. For most results analytic approximations in terms of material parameters are given.Comment: 29 pages, 2 figure

Магнитно-резонансная морфометрия головного мозга при различных вариантах мультисистемной атрофии

Introduction. Neurodegenerative diseases occupy a significant place in the structure of diseases of the Central nervous system and have a high social and economic significance. One of the methods of more accurate neuroimaging assessment of the neurodegenerative process is magnetic resonance morphometry using specialized software. Purpose of research. To evaluate the possibilities of magnetic resonance morphometry as a method of differential diagnosis of parkinsonism syndromes and to investigate the characteristic of volumetric changes of individual brain structures in different variants of Multisystem atrophy. Materials and methods. Morphometric markers of Multisystem atrophy variants development using postprocessing processing of native MRI on Freesurfer software are analyzed. 24 patients with striatonigral degeneration and 20 patients with olivopontocerebellar degeneration were examined. Patients without relevant neurological pathology of appropriate age were examined as a control group. Magnetic resonance imaging was performed on a magnetic resonance tomograph of Siemens with magnetic field induction of 1,5 T. 240 structures from the right and left hemispheres of the brain were subjected to statistical analysis. There were significant differences in the distribution of atrophy among the structures of the brain stem and hemispheres in patients with olivopontocerebellar and striatonigral degeneration. Сonclusions. The obtained data of the study on the atrophy of cortical areas involved in the realization of cognitive functions showed the difference between the variants of Multisystem atrophy. Thus, striatonigral atrophy is characterized by a decrease in the thickness of the structures of the frontal cortex, while olivopontocerebellar degeneration reveals a decrease in the thickness of the parahippocampal zone. Methods of postprocessing processing of MR morphometry data allow to confirm the clinical diagnosis instrumentally, as well as to clarify the pathogenesis of neurodegenerative diseases and to clarify the distribution of the brain structures most susceptible to neurodegeneration.Введение. Нейродегенеративные заболевания занимают значительное место в структуре болезней центральной нервной системы и обладают высокой социальной и экономической значимостью. Одним из методов более точной нейровизуализационной оценки течения нейродегенеративного процесса является магнитно-резонансная морфометрия с использованием специализированного программного обеспечения. Цель исследования: оценить возможности магнитно-резонансной морфометрии в качестве метода дифференциальной диагностики отдельных синдромов паркинсонизма и исследовать характерные волюметрические изменения отдельных структур головного мозга при различных вариантах мультисистемной атрофии. Материалы и методы. Проанализированы морфометрические маркеры развития вариантов мультисистемной атрофии с помощью постпроцессинговой обработки нативных МР-изображений на программном обеспечении Freesurfer. Обследовано 24 пациентов с стриатонигральной дегенерацией и 20 пациентов с оливопонтоцеребеллярной дегенерацией. В качестве контрольной группы были обследованы пациенты без актуальной неврологической патологии соответствующего возраста. Магнитно-резонансная томография выполнялась на магнитно-резонансном томографе фирмы «Siemens» с индукцией магнитного поля 1,5 Тл. Статистическому анализу подвергались 240 структур из правого и левого полушария головного мозга. Получены достоверные различия в распределении атрофии среди структур ствола головного мозга и полушарий у пациентов с оливопонтоцеребеллярной и стриатонигральной дегенерацией. Выводы. Полученные нами данные об атрофии зон коры головного мозга, участвующих в реализации когнитивных функций, показали отличие между вариантами мультисистемной атрофии. Так, для стриатонигральной атрофии характерно уменьшение толщины структур лобной коры, в то время как при оливопонтоцеребеллярной дегенерации выявляется уменьшение толщины парагиппокампальной зоны. Методики постпроцессинговой обработки данных МР-морфометрии позволяют инструментально подтвердить клинический диагноз, а также уточнить патогенез нейродегенеративных заболеваний и уточнить распределение наиболее подверженных нейродегенерации структур головного мозга