Влияние лазерной иридэктомии на анатомо-функциональные показатели при первичной закрытоугольной глаукоме с относительным зрачковым блоком

PURPOSE: To research the effect of laser peripheral iridectomy (LPI) on anatomical, topographical and functional indicators in primary angle-closure glaucoma with relative pupillary block. METHODS: We examined 20 patients (34 eyes) with primary angle-closure glaucoma (PACG) and relative pupillary block. Stages of glaucoma: I - 28 eyes, II - 3 eyes and III - 3 eyes. Ophthalmologic examination included viso- metry, biomicroscopy, gonioscopy, tonometry, perimetry, ophthalmoscopy, ultrasound biometry. All patients underwent a single-stage LPI with the use of laser Nd:YAG SYL-9000 Premio (“LightMed”, Taiwan). To investigate the depth and volume of the anterior chamber we used Pentacam HR (“Oculus”, Germany). To investigate anatomic and topographic relationships of anterior chamber angle and iridocilliary zone structures we used ultrasound biomicroscopy (UBM) on UBM Hi-scan (“Optikon”, Italy). Obtained measurements included the anterior chamber depth (ACD), trabecular-iris angle (TIA), trabecular-iris distance at 500 micrometers (TID), trabecular-ciliary process distance (TCPD), iris-ciliary processes distance (ICPD), cross-sectional area posterior chamber. We measured viscoelastic properties of the corneoscleral capsule of the eye and intraocular pressure with Ocular Response Analyzer (“Reichert”, США). RESULTS: LPI in patients with relative pupillary block in PACG leads to an increase in anterior chamber volume by 19.57 mm3 on average and practically doesn’t change its depth. According to UBM an increase in the TIA was noted in all cases after LPI, on average by 17.49° temporally, and 16.52° nasally; TID increased on average by 0.21 microns from the temporal and 0.18 microns from the nasal side; TCPD increased on average by 0.09 microns from the temporal and 0.07 microns from the nasal side; ICPD decreased on average by 0.08 microns from the temporal and 0.12 microns from the nasal side. After LPI posterior chamber cross-sectional area decreased by 0.25 mm2 temporally and 0.27 mm2 nasally. LPI lead to intraocular pressure lowering of 3.29 mm Hg on average. CONCLUSION: UBM revealed specific anatomic and topographic features of the iridocilliary zone structures, inherent relative pupillary block in PACG, and their change after LPI. Increase of TIA and TID values, decrease of ICPD and the posterior chamber cross-sectional area values explain the increase in anterior chamber volume and the invariance of its depth reference value. LPI carried out in at patients with PACG and relative pupillary block, leads to an improvement of the functional space of the iridocilliary zone structures and a decrease in perfusion pressure.ЦЕЛЬ. Изучить влияние лазерной иридэктомии на анатомо-топографические и функциональные показатели при первичной закрытоугольной глаукоме с относительным зрачковым блоком. МЕТОДЫ. Обследовали 20 пациентов (34 глаза) с первичной закрытоугольной глаукомой (ПЗУГ) и относительным зрачковым блоком: 1-я стадия - 28 глаз, 2-я - 3 глаза, 3-я - 3 глаза. Офтальмологическое обследование включало визометрию, биомикроскопию, гониоскопию, тонометрию, периметрию, ультразвуковую биометрию. Всем пациентам выполняли одномоментную лазерную ирид- эктомию (ЛИРЭ) с использованием излучения Nd:YAG лазера SYL-9000 Premio («LightMed», Taiwan). Для исследования глубины и объема передней камеры глаза использовали Pentacam HR («Oculus», Germany). Для исследования анатомо-топографического взаимоотношения структур угла передней камеры и иридоцилиар- ной зоны проводили ультразвуковую биомикроскопию (УБМ) с использованием прибора UBM Hi-scan («Optikon», Italy). Измеряли следующие параметры: глубину передней камеры, угол передней камеры (УПК), дистанцию «трабекула - радужка» 500 мкм, дистанцию «трабекула - цилиарные отростки», дистанцию «радужка - цилиарные отростки», площадь сечения задней камеры. Исследование вязко-эластических свойств фиброзной оболочки глаза и внутриглазного давления (ВГД) выполняли с помощью динамической двунаправленной пневмоаппланации роговицы Ocular Response Analyser («Reichert», США). РЕЗУЛЬТАТЫ. Профилактическая ЛИРЭ у пациентов с относительным зрачковым блоком при ПЗУГ приводит к увеличению объема передней камеры в среднем на 19,57 мм3 и практически не влияет на изменение её глубины. По данным УБМ, во всех случаях после ЛИРЭ отмечали увеличение УПК с височной стороны в среднем на 17,49°, с носовой - на 16,52°; дистанция «трабекула - радужка» увеличилась в среднем на 0,21 мкм с височной и на 0,18 мкм с носовой стороны; дистанция «трабекула - цилиарные отростки» в среднем увеличилась на 0,09 мкм с височной и на 0,07 мкм с носовой стороны; дистанция «радужка - цилиарные отростки» уменьшилась в среднем на 0,08 мкм с височной и на 0,12 мкм с носовой стороны. После ЛИРЭ площадь сечения задней камеры уменьшилась на 0,25 мм2 с височной и на 0,27 мм2 с носовой стороны. ЛИРЭ приводит к снижению ВГД в среднем на 3,29 мм рт.ст. ЗАКЛЮЧЕНИЕ. Выявленные методом УБМ специфические анатомо-топографические соотношения структур иридоцилиарной зоны, присущие относительному зрачковому блоку при ПЗУГ, и их изменение после проведения профилактической ЛИРЭ: открытие УПК передней камеры и увеличение дистанции «трабекула - радужка», уменьшение дистанции «радужка - цилиарные отростки» и площади задней камеры - позволяют объяснить увеличение объема передней камеры при сохранении исходного значения ее глубины. Профилактическая ЛИРЭ, выполненная при относительном зрачковом блоке у пациентов с ПЗУГ, приводит к улучшению функционального пространства структур иридоцилиарной зоны и к снижению ВГД

Effect of the Nature of Deposited Metal on the Morphology of Electrolytic Deposits

Установлено, что природа ионов металла, разряжающихся на катоде, оказывает значительное влияние на морфологию осадка. Осадки никеля обладают характерной структурой пены: на них присутствуют крупные поры (каналы эвакуации водорода), вокруг которых кристаллизуется металл в форме дендритов. Осадки сплава Ni–Co по своей морфологии близки к рыхлым порошкообразным металлам.It was found that the nature of metal ions discharged at the cathode has a significant effect on the deposit morphology. Pure nickel deposits have a typical foam structure with large pores composed of dendrites. The Ni-Co alloy deposits are characterized by morphology close to loose powder metals

Muon `Depth -- Intensity' Relation Measured by LVD Underground Experiment and Cosmic-Ray Muon Spectrum at Sea Level

We present the analysis of the muon events with all muon multiplicities collected during 21804 hours of operation of the first LVD tower. The measured angular distribution of muon intensity has been converted to the `depth -- vertical intensity' relation in the depth range from 3 to 12 km w.e.. The analysis of this relation allowed to derive the power index, $\gamma$, of the primary all-nucleon spectrum: $\gamma=2.78 \pm 0.05$. The `depth -- vertical intensity' relation has been converted to standard rock and the comparison with the data of other experiments has been done. We present also the derived vertical muon spectrum at sea level.Comment: 7 pages, 3 figures, to be published on Phys. Rev.

The use of lysozyme to prepare biologically active chitooligomers

International audienceTwo types of crustacean commercial chitosans (CS1, CS2) were dissolved in lactic acid solutions, hydrolysed by lysozyme and finally fractioned by methanol solutions into two parts containing chito-oligomers (CS-O1, CS-O2). The antioxidant power and antimicrobial properties of both fractions were studied and compared with non-hydrolysed CS1 and CS2. The antioxidant properties were determined by the ferric ion reducing antioxidant power (FRAP) method while the bioactive properties were evaluated against a strain of Listeria monocytogenes. CS-O obtained from the solid fraction of the chito-oligomers solid fractions treated with 90% methanol showed the highest reducing power. Microbiological tests showed that CS-O exhibit higher antilisterial activity than CS

DIAGNOSIS AND TREATMENT POLICY FOR SEVERE CONGENITAL CYSTIC ADENOMATOID MALFORMATION OF THE LUNG IN NEWBORN INFANTS

Objective. To present the diagnosis of and treatment policy for severe cystic adenomatoid malformation (CAM) of the lung in newborn infants, allowing one to rule out a fatal outcome and to ensure good quality of life in the future. Material and methods. The authors describe their own 12 clinical cases in newborn infants with the histologically verified diagnosis of type 1 CAM with a pronounced mass effect, as well as pregnancy management tactics, the time and algorithm of postnatal radiation examination, a treatment method and give long-term results. Results. The traced long-term results are predominantly good (77.8%); there are no poor outcomes or mortality in this patient group. Conclusion. The prognosis for life in severe forms of CAM with a high risk of antepartum fetal demise can be favorable if there is a correct pregnancy management tactics, early examination, and surgical treatment. Computed tomography and computed tomographic angiography are main postnatal diagnostic techniques that determine the further tactics of a neonatal surgeon. Emergency surgery is indicated after the diagnosis of type 1 CAM with a pronounced mass effect is confirmed

Clinical and paraclinical manifestation COVID-19 in different age children

COVID-19 is an infectious disease caused by a new coronavirus first discovered in 2019. The infection has spread rapidly throughout the world and affects people of all ages. Thus, 12.7% of all SARS-CoV-2 patients are children. Purpose — to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease’s manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4–6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7–12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child’s age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors

DIAGNOSTICS AND TREATMENT OF CONGENITAL MALFORMATIONS OF THE LUNG AND MEDIASTINUM IN NEWBORN CHILDREN AND INFANTS

The article presents the experience of treatment of newborn children and infants with congenital malformations of the lung and mediastinum, which required a surgery. Children (138 cases) were treated during recent 18 years. There was a prevalence of full-term infants (73%). Fetal malformations were diagnosed in prenatal period in majority of cases. Computed tomography was the main method of diagnostics after delivery. Children (110 cases) were operated out of 138. Children with extrapulmonary sequestration didn’t undergo surgery in case of absence of clinical manifestations. The authors made a conclusion that malformations of the lung and mediastinum should be included in number of differentiated diseases in case of respiratory distress syndrome in newborn children. The indications to early surgery should be the danger of contamination and malignant transformation, presence of intrathoracic tension syndrome in neonatal period