[Soft tissues volumes changing in malar and cheek area after fat grafting].

To improve the predictability of facial soft tissues fat grafting results tissue thickness dynamics before and 1 year postoperatively was assessed by means of ultrasonic method in 58 patients under standardized position of the ultrasonic transducer, physical and technical scanning conditions. The study revealed direct correlation of soft tissues thickness increase after fat grafting with the initial thickness of recipient area tissues. One year after fat grafting 60-65% of additional thickness remained in the lower regions of malar-cheek area (with the greatest soft tissues thickness), and only 25-27% preserved in the upper regions with the minimal initial thickness of soft tissues. I.e. to achieve necessary correction volume in a zone with small initial soft tissues thickness it is necessary to increase the amount of fat grafting stages. As the rates of soft tissues thickness in correction area change during 3-4 months after fat grafting remaining stable after this period it is expedient to assess postoperative results and to carry out repeated fat grafting not earlier than 4 months after operation.

[Primary reconstruction in a case of total eyelid avulsion].

Authors took clinical case of primary surgical reconstruction in total eyelid avulsion as an example to discuss possible mistakes of surgical technique and implant choice. Besides, prognosis for different eyelid tissues retention in total eyelid avulsion and subsequent reconstruction are analyzed. Laser Doppler flowmetry is a method for dynamic evaluation of retention and prognosis of autotissue rejection, it clearly demonstrates decrease of microcirculation in the sites of worse tissue retention.

[Aging eyelid: clinical, morphological manifestations and peculiarities of microcirculation].

Morphological study of eyelid biopsy tissues with varying degrees of age-related changes revealed sclerosis, infiltration, expansion and the convoluted configuration of the walls of blood vessels, stasis, reflecting microcirculation disturbance in the skin. Decrease in elasticity, elasticity and skin turgor in aging eyelids is largely due to the thinning, randomly distributed bundles of collagen and a decrease in the number or total absence of elastic fibers. In 31 patients with blepharohalasis laser Doppler flowmetry revealed a failure in the neuromuscular regulation of vascular tone, which is a manifestation of chronic stagnation in the microcirculatory bed. Revealed changes in the morphological structure of eyelid skin and microcirculatory bed confirm the trophic disturbances and congestion occurring in the skin of eyelids with aging.

[Experience in the use of frontal flap for reconstructive surgery of eyelids].

Results of the use of classic Indian and petalous frontal flaps for surgical treatment of 52 patients of the age from 11 till 58 years with congenital and acquired eyelid defects were presented. In all cases eyelid form and function it was possible to restore, reduce the number of operations and achieve maximal esthetic rehabilitation in the terms to 1 year from the patient addressing to clinic and in patients with congenital oblique face clefts - before achieving the age of 14-16 years. Frontal flap use on medial, paramedical and lateral pedicles considerably widened reconstructive blepharoplastics possibilities and increased efficacy of treatment of the patients with congenital and acquired limited total and subtotal eyelid defects.

[Efficient correction of posttraumatic lower lid retraction].

The paper describes pathogenesis of posttraumatic or postoperative lower lid retraction and selective approach for its correction. Temporary lid retraction caused by edema, massive hematoma or scar tissue traction should be managed conservatively by means of modern physiotherapy and cosmetic techniques. Permanent retraction requires combination of several surgical methods: free grafts and local tissue reconstruction, pedicle flap, canthopexy, canthoplasty, miopexy, lower lid support with grafts and implants. Each method addresses certain aspects of the deformation.

[Changes of humoral and cellular immunity in chronic hepatitis C patients of different staging]. / Izmenenie pokazatelei gumoral'nogo i kletochnogo immuniteta u patsientov s khronicheskim gepatitom C pazlichnoi tiazhesti.

The purpose of the present study was to investigate the influence produced by viral proteins in the hepatic cells and RNA of hepatitis C virus (HCV) on the indices of T- and B-cell response in 52 patients with chronic hepatitis C (CHC). A relative count of peripheral-blood lymphocytes (PBL), expressing antigens CD3+, CD4+, CD8+, CD16+, CD20+ and CD95+ was estimated. The repertoire of antibodies to HCV proteins was specified. The thus obtained data were compared with an activity and a disease stage by using the histological diagnosis and alanine-amino-transferase (ALT) level as well as with the presence of HCV RNA in the serum and viral protein of the liver. Such comparison of data and the use of the correlation analysis made it possible to establish that the antibodies to NS5 protein were detected reliably more often in patients with a more pronounced hepatic fibrosis, with a higher ALT activity and with expression of HCV proteins in the liver. At the same time, the presence of proteins in the liver and of RNA in the serum were accompanied by a more active humoral response to the non-structure proteins of NS4 and NS5 as well as by more profound discrepancies of the immunity T-cell chain (a lowered ratio of CD4+/CD8+ and a smaller content of CD95+). There were no differences between PBL of the studied populations in patients with various activities and an HCV stage. A relatively bigger quantity of CD95(+)--positive PBL was found to be reliably higher in patients with viremia but lower in those cases, in which HCV proteins were detected in the liver. This confirms the inhibiting ability of HCV proteins to the Fas-mediated apoptose of PBL in CHC patient.

[Effect of mesodiencephalic modulation on peripheral blood immunocompetent cells in viral-bacterial infections]. / Vliianie mezodiéntsefal'noi moduliatsii na immunokompetentnye kletki perifericheskoi krovi pri virusno-bakterial'noi infektsii.

The effect of mesodiencephalic modulation (MDM) on peripheral blood immunocompetent cells during a mixed viral/bacterial infection was studied in 10 patients aged 15 to 35 suffering from acute respiratory diseases complicated by lacunar tonsillitis. Control group consisted of 10 patients aged 16 to 42. A course of MDM consisted of 4-5 daily 10-min sessions. MDM alleviated the course of respiratory diseases complicated by lacunar tonsillitis at the expense of activating body response to inflammation and due to immunomodulating effect of electropulse exposure on lymphocyte subpopulations.

[The interferon reaction of the leukocytes and the natural killer activity in patients with acute viral hepatitis B undergoing interferon treatment]. / Interferonovaia reaktsiia leikotsitov i aktivnost' estestvennykh killerov u bol'nykh ostrym virusnym gepatitom B pri lechenii interferonom.

The interferon response of leukocytes (IRL) alpha and gamma as well as the functional activity of natural killers (NK) were studied in patients with the verified diagnosis of acute viral hepatitis B (AVH-B) treated with leukinferon (a preparation of natural interferon-alpha and cytokines) and reaferon (recombinant alpha 2 interferon). The effect of therapy with LF and RF in patients with AVH-B manifested by an increase in the functional activity of NK up to complete normalization after termination of the course of therapy. In the group of patients treated with LF as a result of therapy IRL-alpha increased by the end of the treatment and in the convalescence period. The observed activation of NK and the IF-alpha system under the effect of IF preparations in patients with AVH-B correlated with enhanced elimination of HBsAg.

[A study of the effect of thymotropin on immunologic indicators and excretion of virus in women with chronic cytomegalovirus infection]. / Izuchenie vliianiia timotropina na immunologicheskie pokazateli i ékskretsiiu virusa u zhenshchin s khronicheskoi tsitomegalovirusnoi infektsiei.

Thymotropic hormone was given subcutaneously in a dose of 100 mg twice a week for 3 months to 10 women with verified chronic cytomegalovirus infection. After termination of the treatment, in 8 women the virus excretion was decreased and this was accompanied with some improvement in immunological parameters: increased activity of natural killers, enhanced interferon-producing activity of lymphocytes, higher theophylline-resistant lymphocytes, and lower theophylline-sensitive T-cells. The above results confirm the association between the activity of cytomegalovirus infection and the state of immunity and allow thymotropic hormone to be recommended for treatment of other groups of patients with cytomegalovirus infection.

[Natural killer activity in influenza patients]. / Aktivnost' estestvennykh killerov u bol'nykh grippom.

The activity of natural killers (NK) for K-562 target cells (human myeloleukemia cells) was determined in 20 patients with influenza complicated with pneumonia and in 11 patients with uncomplicated influenza. The influence of the autologous blood serum and recombinant alpha 2-interferon (reaferon) on NK activity was studied in vitro. In uncomplicated influenza, the activity of natural killers in the acute period of the disease was higher, and in patients with influenza complicated by pneumonia lower than in normal subjects. In the convalescent period, the activity of natural killers increased or approached the norm in complicated cases, and the average values showed no significant difference from those in normal subjects. The stimulating effect of the autologous blood serum and reaferon on the activity of natural killers in patients with complicated influenza was demonstrated in vitro.

[Correlation between the indices of immunity and virus elimination in cytomegalovirus infection]. / Izuchenie korreliatsii mezhdu nekotorymi pokazateliami immuniteta i éliminatsiei virusa pri tsitomegalovirusnoi infektsii.

Correlations between titres of complement-fixing antibody, levels of E-RFC, Ea-RFC, EAC-RFC, EA-RFC, and the intensity of virus excretion in the saliva and urine of women with chronic form of cytomegaly, as well as the effect of decaris in vitro on the level of E-RFC were studied. The highest antibody titres were found in subjects with generalized infection (virus excretion in the saliva and urine) and in cases where high concentrations of the virus were found in the salivary gland cells. In these subjects, total levels of E-RFC and their active subpopulations were decreased. The lowest antibody titres were found in women excreting no virus in the study period. Relative amounts of E-RFC and Ea-RFC in them were within normal ranges. No correlation between the levels of EAC-RFC, EA-RFC, and virus excretion was found. Decaris in vitro normalized the reduced values of E-RFC. Theoretical substantiation of the possibility of using this drug for treatment of patients with cytomegalovirus infection is presented.

[Results of combined therapy using levamisole for patients with influenza complicated by pneumonia]. / Rezul'taty kompleksnoi terapii bol'nykh grippom, oslozhennnym pnevmoniei, s ispol'zovaniem levamizola.

The results of combined therapy of patients with influenza complicated with pneumonia using levamisole (decaris) as an interferon inducer are presented. The study group included 39 subjects, the control 35. The group of patients receiving the drug showed in the convalescent period a higher titre of the antiviral activity of serum interferon (1 : 24) than the control group (1 : 17). The antiviral activity of interferon in the blood serum was determined in patients with different degrees of severity of the disease course, and comparative clinical observations in relation to the levels of its antiviral activity and its content in the blood serum were carried out. No rise of interferon content was observed in the protracted course of the disease. In severe forms ending lethally there was a considerable decline of interferon levels (down to 0 units). A rise in its concentration in the blood serum was conducive to a more rapid recovery and favourable outcome of the disease. The drug is recommended for combined therapy of complicated forms of influenza, particularly those with a severe course.