[On the new classification of eye burns]. / O novoi klassifikatsii ozhogov glaz.

The currently used classification of eye burns was proposed in 1973 by N.A. Puchkovskaya and V.M. Nepomnyashaya. Recent emergence of the concept of limbal stem cells of the corneal epithelium and its application in clinical practice has significantly expanded the possibilities for diagnosis, treatment, and visual rehabilitation of patients with eye burns. In 1997, Dr. Michael Wagoner proposed a classification of eye burns in which the grade of burn severity is determined by the degree of damage to the limbal stem cells. Considering this approach, the authors conducted a comparative analysis of the classifications of eye burns used in Russia (in different years) and those that have appeared in the Western countries in recent years. In this regard, a new classification of eye burns is being proposed.

[Medical terminology. Blepharorhaphy]. / O meditsinskoi terminologii. Blefarorafiya.

Ophthalmic literature currently lacks definiteness in classifying surgeries aimed at eyelid closure. In Western countries the term tarsorrhaphy is most commonly used, while in Russia another term - blepharorhaphy - is widely accepted. The latter seems more appropriate as the sutures are passed through all palpebral layers, not just the cartilage. It has also been suggested that temporary blepharorhaphy, which implies that we use only sutures to bring the eyelids together, and therefore, the procedure cannot be permanent, should be called simple blepharorhaphy. As to a procedure (temporary or permanent), of which the goal is ankyloblepharon, it is recommended to be called ankylosing blepharorhaphy, instead of permanent. CONCLUSION: Blepharorhaphy is a more appropriate name for eyelid closure surgery than tarsorrhaphy. Blepharorhaphy can be simple or ankylosing and only the latter can be either temporary or permanent. The authors suggest reconsidering classification of this type of surgical procedures.

[The organization of emergency actions for ocular burns in conditions of military unit (of the ship)].

Prehospital services for ocular burns are delivered by servicemen as self or mutual management and also by paramedic. Every case of ocular burn should be considered as severe one. The patient, shortly after the first aid, should be transported to the medical company or medical unit. Under conditions of medical unit military doctor has to organize an ophthalmological working space (ophthalmological comer) with the necessary equipment. Eye irrigation has to be made for chemical ocular burns. Military doctor should consider any previous irrigation as insufficient. For severe ocular burns during evacuation to the hospital it is necessary to perform a simple blepharorrhaphy or (if the condition of lids allows) to make a hermetic seal with aid of aid-band. Doctor's obligations should also include prophylaxis of ocular burns.

[Comparative evaluation of therapeutic efficacy of early amnion covering the cornea, temporary blepharorrhaphy and its combination in severe alkali burns of the eye in the experiment].

In four groups of rabbits on model of a heavy alkaline burn of a cornea and a limbus of various extent character and outcomes of healing of an eye surface as a result of early (it is direct after a burn) applications is investigated: only conservative treatment - group I, conservative treatment + time blepharorrhaphy - group II, conservative treatment + covering of a cornea and a limbus of amnionic membrane - group III, and also combinations of conservative treatment, temporary of blepharorrhaphy and coverings of a cornea and a limbus amnionic membrane - group IV. In all groups conservative treatment included: an instillation of maxitrol within 14 days with transition to a mortgaging of Unguentum Tetracyclini of 1% 3 times a day. Depending on width of sector of the burn measured in circular degrees, each group included 4 subgroups: 60° - a subgroup "A", 120° " " - 180° - "B", 270° "Γ" - (on 4 eyes in a subgroup). Results estimated daily within the first 10 days, and further every 5 days (during 3 months) after a burn with photoregistration at colouring of an eye surface of 1% a solution fluorescein-natrium. On the basis of the received results it is established that the early fortnight time blepharorrhaphy (as addition to conservative treatment) is the most effective and accessible method (from considered) optimisation of healing of an eye surface at heavy burns of eyes with capture to 75% of the area of a cornea and a limbus.

[Improvement of outpatient dental care in the military district].

The paper presents proposals for improving outpatient dental care in the military area. To improve all types of outpatient dental care it is encouraged to use mobile multi-purpose field dental system based on chassis KamAZ, versatile portable dental kit. The construction kit has a modular design that supports rapid deployment of the dental office. For its operation is designed dental kit, which includes modern dental materials, instruments and medicines. Equipping the army medical service data development will help to improve outpatient dental care in the Army.

[To the role of Chlamydia infection in the development of dry eye].

The study deals with the possible etiological role of Chlamydia, Mycoplasma, Ureaplasma, and bacteroid infections in the development of chronic conjunctivitis and dry eye (DE). A hundred and fifty patients with DE and chronic conjunctivitis were examined. Conjunctival scrapes were examined by direct immunofluorescence for evidence of Chlamydia, Mycoplasma, Ureaplasma, and bacteroid infections. DE was verified by the Schirmer test and the Norn test. Ninety-five (63.3%) persons were found to be infected. GE was diagnosed in 84 (56%) of the 150 patients. Analysis of infection rates revealed Chlamydia, Mycoplasma, Ureaplasma as mono- and mixed infection in 63.3, 50.6, and 35.3, respectively, and bacteroids as mixed infection in 32.6%. Chlamydia was detected in the conjunctiva in the vast majority of patients with DE (90.5%). Chlamydia infection of the conjunctiva is one of the causes of artificial DE. Conjunctival Chlamydia affliction is manifested by the clinical picture of chronic slowly progressive inflammation with the progression of DE after a latent period of about 2-3 years.

[Penetrating keratoplasty in combination with limbic transplantation in the rehabilitation of patients with total corneal leukomas of burn genesis].

The paper gives the results of a follow-up of the clinical course and visual outcomes of penetrating keratoplasty (PK) in combination of corneal epithelial stem cell grafting (limbic transplantation (LT)) in 10 patients (10 eyes) in end-stage burn disease. For LT, autologous limbic grafts were used in 5 cases and allogenic ones were applied in 5 more cases. Visual outcomes were assessed in the periods of 2 months to 4 years and 3 months. A rather high visual acuity was obtained in the patients who had undergone PK in combination with autologous LT. The majority of patients with allogenic LT were observed to have a recurrence of keratoleukoma and less significant functional outcomes. Possible tissue incompatibility, followed by lysis of allogenic limbic grafts, and inadequate ocular surface moistening are considered to be main causes of recurrent corneal conjunctivalization. PK in combination with LT substantially increases the possibility of visual rehabilitation in patients with postburn total corneal leukomas. The use of autologous limbic grafts for these purposes is more effective as compared with that of allogenic ones.

[Tactics in rendering of specialized medical care to the casualties with combined maxillofacial trauma].

Basing on the clinic's data obtained during the 5-year period (2000-2004) we observed 653 patients with different traumas of maxillofacial area. Among the patients 69.8% were the casualties with mandible fractures, 6.7--with maxilla fractures and 2.5%--with zygomatic bone fractures. The combined injuries of maxillofacial and other areas were observed in 11.6%. The combined injuries of maxillofacial area with extremities constituted 0.6%, with chest--0.5% and adjacent areas of head--9.5%. The analysis of conducted therapeutic work and previous experience allows suggesting the medical tactics concerning the problems of terms, methods and volume of specialized care rendered to the patients with combined maxillofacial trauma. It implies that combined injury of jaws with other body segments requires rendering of specialized care in whole volume, early periods, just immediately after getting the patient from shock.

[The incidence of stomatologic diseases among the reserve officers: the epidemiological investigation].

The epidemiological study of the incidence of stomatologic diseases was conducted in 1030 reserve officers. The high level of stomatologic diseases among them was detected. The high incidence of diseases is characterized by the following indices: dental caries constitutes 100% with its intensity 14.15 +/- 0.22, parodontium diseases--92.87% (gingivitis--17.66%, parodontitis of mild and moderate degree--12.9%, of severe degree--62.30%), oral mucosa injuries--0.49%, not carious dental injuries--32.14%. 40.29% pensioners of RF Defense Ministry required prosthetics and 55.73%--oral sanitation. The results obtained could be used in scientific substantiation of medical standards, which are necessary for providing the reserve officers with dispensary method (active call) and development of recommendations to improve the staff structure of military medical-and-prophylactic institutions and subdivisions of stomatologic profile.

[Morphopathogenesis of the amniotic membrane after its transplantation in the course of experimental conjunctiva plasty]. / Morfopatogenez amnioticheskoi membrany posle ee transplantatsii v khode kon"iunktival'noi plastiki v éksperimente.

The paper contains the results of an experimental study of the clinical healing of the standard wound defect in the bulbar conjunctiva of rabbit after conjunctiva-plasty involving the use of the human amnion transplant; there is also a description of a histological study of reparative processes in the adjacent tissues and a description of morphological changes occurring in the transplant during the healing process. The study was made on 14 rabbits (28 eyes). It was established that the wound-surface healing occurs, beneath the amnion transplant, without a pronounced inflammation, scarring or immunologic-rejection reaction; its sequence is typical of inflammation and compensatory processes with the formation, in the outcome, of the conjunctiva coating of the eyeball, whose color and composition are ordinary.

[Limbal transplantation in the treatment of and optic rehabilitation of the patients with severe chemical burns of the eyes]. / Limbal'naia transplantatsiia v lechenii i zritel'noi reabilitatsii patsientov s tiazhelymi khimicheskimi ozhogami glaz.

Described in the paper are the results of observations of the autogenous and allogenic limb transplantation (LT) made in 4 patients at exacerbation of severe and extra severe burns of the eyes and made in 8 patients in the remote period after severe chemical burns (4 months and more after trauma). A total vascularized corneal leukoma shaped up in 3 patients with LT made at exacerbation; an intense corneal opacification was observed in 1 more such patient. As for the patients, who were operated on in the remote period, better corneal properties and significantly improved visual acuity were registered in them. Relapsing corneal conjunctivalization were observed only in 3 cases of allogenic LT. Thus, LT was proven to be an effective tool in the remote visual rehabilitation of patients with severe eye burns, whereas, the procedure made at exacerbation and in cases of acute and extra acute burns with extensive lesions in the conjunctiva is low effective or a failure.

[The experience of a clinical trial of bioceramic-based materials in dentistry]. / Opyt klinicheskoi aprobatsii materialov na osnove biokeramiki v stomatologii.

Bioceramics-based materials manufactured in Russia were experimentally and clinically tried with the aim of optimizing repair osteogenesis of the jaws. Powder, granules, and porous blocks of hydroxyapatite alone and mixed with tricalcium phosphate may be effectively used for plastic repair of osseous pouches and post-operative defects of the jaws in surgical treatment of periodontitis, periradicular cysts of the jaws, and for filling the wells after removal of teeth.