[Treatment of postoperative macular edema (a clinical case study)]. / Lechenie posleoperatsionnogo makuliarnogo oteka (klinicheskoe nabliudenie).

Pseudophakic cystoid macular edema (CMO) known to appear in 0.1-2.35% of patients after phacoemulsification is one of the common causes of vision decrease during the postoperative period. The authors analyze a case of CMO development in a pseudophakic patient diagnosed 7 months after uncomplicated phacoemulsification. Optical coherence tomography (OCT) was suggested for patients with low vision and a sensation of shroud before the eye for early diagnosis of pathological process. Intravitreal injection of the 0.7 mg dexamethasone micro-implant performed soon after establishing diagnosis was proved to be viable for postoperative CMO arrest in patients without previous treatment. One month after intravitreal implant injection the visual acuity in the patient's eye improved from 0.4 to 0.7, and retinal thickness in the macular area decreased from 705 to 255 µm. The result remained stable for 10 months. Intravitreal micro-implant appeared to have higher efficiency in contrast with traditional treatment methods (according to literature data), which was attributed to direct drug delivery to the area of pathological process. The use of 0.7 mg dexamethasone implant did not increase the intraocular pressure indicating its potential viability for patients with compensated glaucoma.

[Treatment of postoperative macular edema (a clinical case study)]. / Lechenie posleoperatsionnogo makuliarnogo oteka (klinicheskoe nabliudenie).

Pseudophakic cystoid macular edema (CMO) known to appear in 0.1-2.35% of patients after phacoemulsification is one of the common causes of vision decrease during postoperative period. The authors analyzed a case of CMO development in a pseudophakic patient diagnosed 7 months after uncomplicated phacoemulsification. Optical coherence tomography (OCT) was suggested for patients with low vision and a sensation of shroud before the eye for early diagnosis of pathological process. Intravitreal injection of the 0.7 mg dexamethasone micro-implant performed soon after establishing the diagnosis was proved to be viable for postoperative CMO arrest in patients without previous treatment. One month after intravitreal implant injection, the visual acuity in the patient's eye improved from 0.4 to 0.7, and retinal thickness in the macular area decreased from 705 to 255 µm. The result remained stable for 10 months. Intravitreal micro-implant appeared to have higher efficiency in contrast with traditional treatment methods (according to literature data), which was attributed to direct drug delivery to the area of pathological process. The use of 0.7 mg dexamethasone implant did not increase the intraocular pressure indicating its potential viability for patients with compensated glaucoma.

New algorithms for multi-class cancer diagnosis using tumor gene expression signatures.

MOTIVATION: The increasing use of DNA microarray-based tumor gene expression profiles for cancer diagnosis requires mathematical methods with high accuracy for solving clustering, feature selection and classification problems of gene expression data. RESULTS: New algorithms are developed for solving clustering, feature selection and classification problems of gene expression data. The clustering algorithm is based on optimization techniques and allows the calculation of clusters step-by-step. This approach allows us to find as many clusters as a data set contains with respect to some tolerance. Feature selection is crucial for a gene expression database. Our feature selection algorithm is based on calculating overlaps of different genes. The database used, contains over 16 000 genes and this number is considerably reduced by feature selection. We propose a classification algorithm where each tissue sample is considered as the center of a cluster which is a ball. The results of numerical experiments confirm that the classification algorithm in combination with the feature selection algorithm perform slightly better than the published results for multi-class classifiers based on support vector machines for this data set. AVAILABILITY: Available on request from the authors.

Using global optimization to improve classification for medical diagnosis and prognosis.

Global optimization-based techniques are studied in order to increase the accuracy of medical diagnosis and prognosis with data from various databases. First, we discuss feature selection, the problem of determining the most informative features for classification in the databases under consideration. Then, we apply a technique based on convex and global optimization for classification in these databases. The third application of this technique is a method that calculates centers of clusters to predict when breast cancer is likely to recur in patients for which cancer has been removed. The technique achieves high accuracy with these databases. Better classifiers will lead to improved assistance in making medical diagnostic and prognostic decisions.

[Morphofunctional state of ischemically damaged kidney transplant in preservation and reperfusion (an experimental study)]. / Morfofunktsional'noe sostoianie ishemicheski povrezhdennogo pochechnogo transplantata pri prezervatsii i reperfuzii (éksperimental'noe issledovanie).

In cadaveric renal transplantation with simple cold storage, pretransplant evaluation of allograft viability creates an important problem. To assess the degree of ischemic damage and microcirculation of the renal allograft, experiment comparing parameters, like median perfusate flow and median intrarenal resistance, with histological findings was made. Kidney harvesting was performed from three groups of New Zealand rabbits by keeping warm ischemic time zero, thirty, sixty minutes for each group. Following perfusion with Euro-Collins solution and 24 and 48 hours of hypothermic preservation, perfusion was repeated. Perfusion parameters were measured and histopathological examination of the kidneys was made with light microscopy. In arterioles and glomerular, peritubular capillaries, red blood cell trapping was seen. It was also observed that an increase of warm ischemic time aggravates the erythrocyte aggregation and tubular degeneration. Following reperfusion, resistance measured from renal arteries by Protocol Propaq 106 manometer was named as terminal intrarenal resistance. It is noticeable that this simply measured parameter shows correlation with other parameters and histopathological findings.

[Vascular complications of kidney transplantation]. / Sosudistye oslozhneniia pri peresadke pochki.

584 kidney transplantations (208 from cadaveric donors, 376 from living relative donors) were performed in Medical Faculties of the Istambul University in 1986-1997. Thrombosis of the renal artery was observed in 2 patients (0.35%). One of them had diffused arterial atherosclerosis 4 months after the kidney transplantation. In spite of two successful thrombectomies, the patient died 3 months after the last surgical procedure from cerebral thrombosis. The other patient underwent nephrectomy. Hypertension was observed in 63 patients. In 5 of them about 50% stenosis of the anastomotic area was detected by doppler duplex scan and selective angiogram. Transluminal angioplasty was performed in one patient, open surgical correction in one case. Renal vein thrombosis took place in 1 (0.2%) patient. In 2 cases (0.35%) 5 and 12 years after the transplantation aortic aneurysmal dissection was observed.

[Rendering qualified medical services to patients with fractures of long tubular bones]. / Okazanie kvalifitsirovannoi meditsinskoi pomoshchi postradavshim s perelomami dlinnykh trubchatykh kostei.

The conditions for rendering aid to and treatment of the injured in extreme situations require insistantly the development of new methods for skilled medical service. From analysis of treatment of 114 patients with fractures of the long tubular bones the authors conclude that the use of various types of pin apparatuses for this purpose is expedient because they possess advantages over the nail apparatuses. Analysis of treatment of 90 patients showed the expediency of using some auxiliary devices for immobilization of peripheral erimetaphyseal fractures and oblique and spiral diaphyseal fractures.

[Electroacupuncture and laser puncture in the early postoperative period of urological patients]. / Elektroakupunktura i lazeropunktura v rannem posleoperatsionnom periode u urologicheskikh bol'nykh.

To provide an objective assessment of the analgetic effect obtained at electric or laser acupuncture early after operative treatment of 117 uronephrological patients, the study was performed of a general vegetative and psychoneurological responses and blood levels of some hormones. There were positive effects on psychoemotional postoperative stress, pain impulses from the wound reflected by higher pain thresholds and lowered levels of contrainsular hormones against higher insulin and C-peptide concentrations. These changes were dependent on a nociception degree and agreed with the analgetic action of the reflex anesthesia modalities.

[A physiological method of annuloplasty of the mitral valve]. / Fiziologicheskii metod annuloplastiki mitral'nogo klapana.

The work deals with an anatomo-functional substantiation of plastic repair of the mitral valve. Isolated annuloplasty was carried out in 20 patients with mitral incompetence, annuloplasty with aortic prosthetics was conducted in 13 patients. The method allows a prosthesis with a larger diameter to be used in the last named group of patients. A fatal outcome which was not connected with the operative method was encountered in 2 cases. The clinical and hemodynamic effect was good in all patients.

[Hemodynamic support of physical loads in patients with ischemic heart disease and a permanent artificial pacemaker]. / Gemodinamicheskoe obespechenie fizicheskoi nagruzki u bol'nykh ishemicheskoi bolezn'iu serdtsa s postoiannym iskusstvennym voditelem ritma.

A study, using noninvasive monitoring during bicycle ergometry, was carried out to assess hemodynamic support of physical stress in coronary patients with implanted pacemaker (IPM). Heart contractility of IPM-carrying coronary patients was reduced, with capacity for compensation diminished even at rest, while exercise contributed to further deterioration of those. Adequate hemodynamic support of stress was only observed in patients belonging to the second functional class.