[Comparative evaluation of the methods of treatment of dislocations of the clavicle]. / Sravnitel'naia otsenka sposobov lecheniia vyvikhov kliuchitsy.

An analysis of treatment was made in 93 patients divided into three groups: conservative treatment (11 patients), operations by traditional methods (28 patients), surgery using constructions of titanium nickelide (54 operations). It was found that the conservative treatment of complete acromioclavicular end dislocation was followed by a repeated displacement, development of deforming arthrosis and deformity of the area of injury. Transcapticular fixation of acromioclavicular end dislocation resulted in the development of deforming arthrosis (68%), the incidence of this complication depending on the kind of operation. The greatest inclination of the construction to migration was noted after fixation with wires. After the application of a titanium nickelide construction the most frequent process was resorption of the bone around the construction in the shape of a hook (36%) which resulted in some patients in subluxation (11%) and development of deforming arthrosis (4.5%).

[Plasma-modified silicone graft for scleroplasty in progressive myopia]. / Plazmenno-modifitsirovannyi silikonovyi transplant dlia skleroplastiki pri progressiruiushchei miopii.

Plasma-chemical modification of synthetic transplant material (proliferous silicone) intended for scleroplasty in progressive myopia was theoretically substantiated, developed in the experiment and tested in practice. This treatment was shown to enhance the biocompatibility of a graft which tightly joins the sclera through the connective tissue intergrown from the surrounding capsule into the graft. The efficacy of the proposed plasma-modified grafts in stabilizing progressive myopia in 18 patients operated on (33 eyes) aged 6 to 49 years (spherical equivalent myopia degree 3.0-28.0 D) during 3- year followup was 97%. There was an elevation of uncorrected and corrected visual acuity, are active course of the postoperative period.

Refractive tunnel keratoplasty with synthetic implants modified by a gas-discharge plasma.

Various methods of refractive interlamellar tunnel keratoplasty with synthetic implants modified by low-temperature gas-discharge plasma were used for correction of myopia and myopic astigmatism. Experiments carried out with laboratory rabbits revealed that pretreatment of hydrogel, silicon, and polymethylmethacrylate by gas-discharge plasma enhances the tolerance of corneal stroma to these synthetic materials. Clinical studies with hydrogel have shown that gas-discharge plasma treatment of traditional polymer materials is a promising method for achieving improved biocompatibility of synthetic materials to corneal stroma. Forty-four clinical tunnel keratoplasties have been conducted on humans with gas-discharge-plasma-treated hydrogel. The patients had a high degree of myopia (from 7.0 to 28.0 D) and myopic astigmatism (within the range of 5.0 to 11.0 D). Surgical methods were similar to those developed during the experimental stage of work. The patients were followed postoperatively for up to 8 years. According to these observations, circular tunnel keratoplasty with synthetic implants reduced spherical myopia up to 20.0 D. Methods for correcting of both simple and complex myopic types of astigmatism have been developed. Arc-type sectoral tunnel keratoplasty and elliptical tunnel keratoplasty allowed correction of myopic astigmatism up to 11.0 D.

[Scleroplasty with plasma-modified homoslceral grafts: experimental morphological study]. / Skleroplastika s ispol'zovaniem plazmenno-modifitsirovannykh gomoskleral'nykh transplantantov v eksperimente (morfologicheskoe issledovanie).

Healing of homoscleral grafts treated by gas discharge low-temperature plasma has been studied. Such treatment leads to formation of a modified surface layer in scleral tissue; the presence of such a layer improves the hydrophilic properties and biocompatibility of the sclera, thus promoting better adaptation of the graft to further restructuring and healing during the postoperative period. Experiments on 32 eyes of chinchilla rabbits showed that after scleroplasty with thus treated transplants, complete replacement of fibroblasts and collagen carcass of the graft was observed as early as after 7.5 months (vs. 12 months in the control); the graft was stabilized and tightly grown into the sclera to form a solid sclera-graft complex which fortifies the scleral membrane of the eye. Use of plasma-modified transplants may improve the efficiency of scleroplastic operations in progressive myopia and ocular injuries.

Amyloid precursor protein in the cerebral cortex is rapidly and persistently induced by loss of subcortical innervation.

Lesions of the cholinergic nucleus basalis of Meynert elevate the ex vivo synthesis of beta amyloid precursor protein (beta-APP) in the cerebral cortex, a major projection region. We have found that this elevation is reflected by increased levels of beta-APP mRNA. The induction is rapid (occurring 60 min after placement of the lesion) and persistent (remaining for at least 45 days after lesioning). Two other subcortical lesions, which result in reductions of cortical adrenergic and serotonergic innervation, similarly induced cortical beta-APP. The beta-APP induction is reversible and does not require loss of the subcortical neurons. Infusion of lidocaine, a calcium antagonist that disrupts neurotransmitter release, into the nucleus basalis of Meynert leads to the temporary reduction of released acetylcholine in the cortex. In this model, beta-APP mRNA levels are elevated shortly after the infusion of lidocaine (90 min) but return to preinfusion levels 7 days after the lidocaine treatment. However, metabolic stresses of the brain, including chronic physostigmine, glucocorticoid, and diabetogenic treatments, fail to induce the beta-APP response. These results suggest that the induction of beta-APP is a specific response to the loss of functional innervation in the cortex. Importantly, these studies show that cortical beta-APP is induced by lesions that mimic the neurochemical deficits most frequently observed in Alzheimer disease.

Increased biosynthesis of Alzheimer amyloid precursor protein in the cerebral cortex of rats with lesions of the nucleus basalis of Meynert.

The nucleus basalis of Meynert was lesioned by infusion of N-methyl-D-aspartate (NMDA) unilaterally in adult rat brain. Seven days post lesion we observed that polysomes isolated from the cerebral cortex affected by the lesion synthesized 2.6-fold greater amounts of the Alzheimer amyloid precursor protein (AAPP) compared to the nonlesioned side of the same rat brain. This increase exhibited specificity to AAPP in that overall protein synthesis was not altered by the lesion. The increase of AAPP did not alter the ratio of AAPP isotypes in rat brain (in which AAPP 695, which is lacking the protease inhibitor insert remains the predominant form). The increased synthesis did not result in the apparent accumulation of mature AAPP. These results indicate that a cholinergic lesion which models many of the neurochemical changes observed in Alzheimer's disease induces the expression of AAPP in a major projection region, the cerebral cortex.