[Characteristics of the sympathoadrenal system response to psychoemotional stress under hypoxic conditions in aged people with physiological and accelerated aging of the respiratory system].

The peculiarities of the response of the sympathoadrenal system to psychoemotional and hypoxic stress in healthy young people and in aged people with physiological and accelerated aging of respiratory system were studied. It was shown that in aging a more pronounced response of the sympathoadrenal system to psychoemotional stress. At the same time, elderly people with different types of aging of the respiratory system did not demonstrate a difference in the response of the sympathoadrenal system to psychoemotional stress. Unlike in young people, in aged people, combination of psychoemotional and hypoxic stresses resulted in further activation of the sympathoadrenal system. The reaction of the sympathoadrenal system was more expressed in elderly people with accelerated ageing of the respiratory system.

Successful percutaneous endovascular treatment of a ruptured femoral aneurysm.

Popliteal and femoral aneurysms account for about 70% of the incidence of peripheral aneurysms. Only 4% of aneurysms run their course with the clinical evidence of rupture. The ruptured aneurysm is dangerous because of a potential limb loss as well as due to the threat of lethal outcome in patients at a high surgical risk. Presented herein is a successful experience (first in this country) gained with the treatment of a ruptured femoral aneurysm by means of endoprosthetics using a new stent graft with PTFB coating in a patient at a high risk for traditional surgical treatment.

[Peculiarities of the influence of chemical and physical factors on cytogenetic indices of root meristem in Pisum sativum L]. / Osoblyvosti vplyvu khimichnykh ta fizychnykh chynnykiv na tsytogenetychni pokaznyky korenevykh merystem Pisum sativum L.

The results of comparative analysis of cytogenetic effects of various chemical and physical factors on meristemic cells of field pea (Pisum sativum L.) are presented. Cytogenetic effects of aluminum, cadmium and selenium compounds as well as X-ray irradiation were studied. Cytogenetic indices were investigated for different doses of the above factors and peculiarities of their influence on the ratio of mitotic phases were analyzed. The increasing in the proportion of cells at the specific mitotic stage was revealed. There were anaphase stage for aluminum chloride, prophase stage for cadmium chloride, meta- and anaphase stages for sodium selenate, and telophase stage for X-rays. Investigated chemical elements may be ranged according to their ability to induce the aberrant anaphase frequency in the row: Se (from 3.75 x 10(-6) M) > A1 (from 3.86 x 10(-5) M) > Cd (from 8.44 x 10(-5) M). Maximal experimental dose of X-ray irradiation (9.03 x 10(-3) C/kg) induces the frequency of chromosome aberration similar to those induced by maximal experimental doses of aluminum and selenium (3.86 x 10(-4) M and 8.34 x 10(-6) M).

[Changes in the dynamic surface tension of urine in lupiform glomerulonephritis]. / Zminy dynamichnogo poverkhnevogo natiagu sechi pry vovchakovomu glomerulonefryti.

As many as 54 patients with systemic lupus erythematosis presenting with the kidney damage and thirteen damage-free patients were studied for the dynamic surface tension (ST) of the urine with the aid of the computerized tensiometer MPT2. The condition is characterized by a drop in ST with the surface time equal to 1 second and a slope in the curve of tensiograms. The above findings have been secured in 53.7 and 71.6 percent respectively. In lupiform glomerulonephritis there is noted further lowering of the parameters. The proposed technique will, we believe, help in carrying out the differential diagnosis of the condition, assessment of the clinical course and degree of activity of the pathological process as well as in exercising control over efficiency of the therapeutic measures adopted.

[Comparative clinical pathology of encephalopathy with circulatory dysfunction in those who participated in the clean-up after the Chernobyl accident and in non-irradiated patients]. / Porivnial'na kharakterystyka klinichnogo symptomokompleksu pry dystsyrkuliatornii entsefalopatiï u likvidatoriv naslidkiv avariï na ChAES i neoprominenykh khvorykh.

A comparison was done of incidence and degree of main symptoms and syndromes of dyscirculatory encephalopathy (DE) in liquidators of the aftermath of the Chernobyl accident and in those patients who have not come to be exposed to radiation. Established in the study were statistically significant differences suggesting that in liquidators injuries in the hypothalamic, truncal and cochlear zones of the brain occur 2 to 4 times as frequently as in unexposed patients. The incidence of the most severe variants of a third-degree DE comes up to 19.4 and 8.9 percent in liquidators and unexposed patients respectively. The severity of the disease course correlates in liquidators with the blood content of medium-molecular weight peptides and is of a significantly higher degree than in unexposed patients and in essentially healthy persons. This suggests a progressive endogenous intoxication in the body of DE liquidators of the Chernobyl accident.

[Dynamic interphasic tensiometry of the blood in chronic hepatitis and liver cirrhosis]. / Dynamichna mizhfazna tenziometriia krovi pry khronichnomu hepatyti ta tsyrozi pechinky.

Studied with the aid of the computerized tensiometer MPT2-Lauda (Germany) was dynamic surface tension (ST) of blood serum in patients with chronic hepatitis (ChH), hepatic cirrhosis (HC), and in essentially healthy people, with n = 44, 32, and 68 respectively. ChH was shown to be accompanied by a significant increase in ST indices in the region of short (t = 0.01 sec) times of the surface life as well as by a decrease in that of medium (t = 1 sec) and long (t-->infinity) times. Rise in parameters of interphase tensiograms is a prognosis-negative sign with respect to the development of HC. Correlations have been established of indices of blood ST to its content of protein, lipid, and inorganic substances and to morphological signs of affection of the liver as well.

Full-thickness macular hole formation in eyes with a pre-existing complete posterior vitreous detachment.

BACKGROUND: Tangential macular traction by the posterior vitreous cortex has been widely accepted as the major causative factor in the development of idiopathic macular holes. Separation of the posterior cortical vitreous should relieve this vitreoretinal traction. METHODS: The authors report five patients with idiopathic full-thickness macular hole formation that occurred in the presence of a well-documented pre-existing complete posterior vitreous detachment. RESULTS: Of five eyes, three underwent pars plana vitrectomy and instillation of transforming growth factor-beta. No residual prefoveal cortical vitreous was present at the retinal surface at the time of surgery. Additionally, clinically identifiable epiretinal membranes were present in three of five eyes, but these epiretinal membranes were extremely thin, transparent, induced minimal traction, and did not warrant surgical peeling. CONCLUSION: It is likely that, in these five patients, some mechanism other than tangential traction by prefoveal vitreous cortex is responsible for idiopathic full-thickness macular hole formation.

Transforming growth factor-beta 2 levels increase following retinal laser photocoagulation.

To determine if the levels of transforming growth factor-beta 2 (TGF-beta 2) in ocular tissues change following laser photocoagulation, pigmented rabbit eyes underwent panretinal photocoagulation using laser indirect ophthalmoscopy. The rabbits were followed for a period of either 2 or 14 days after the procedure. The eyes were then removed and samples of vitreous and aqueous humor were collected. TGF-beta 2 levels were measured using an immunoassay. When compared to control eyes, TGF-beta 2 levels in the vitreous humor of treated eyes at day 2 and day 14 were increased. Changes in TGF-beta 2 levels were also seen in the aqueous humor of the treated eyes, with increased levels seen at day 2 and day 14 compared to control eyes. The increase in both vitreous and aqueous humor in treated eyes compared to control eyes was shown to be statistically significant (p < 0.05). Our results show that intraocular TGF-beta 2 levels increase significantly following laser photocoagulation. This preliminary study suggests that TGF-beta 2 may be involved in the process of chorioretinal wound healing.

Indocyanine green angiography in multiple evanescent white-dot syndrome.

Using indocyanine green angiography we examined two patients with multiple evanescent white-dot syndrome. Both patients had unilateral loss of vision and a fundus appearance typical of multiple evanescent white-dot syndrome. Fluorescein angiography in both patients disclosed a patchy hyperfluorescent pattern at the level of the retinal pigment epithelium. Using indocyanine green angiography, we observed multiple deep, small, round hypofluorescent lesions that appeared early and persisted into the late phases. The spots appeared to block the underlying choroidal pattern. These hypofluorescent spots were clearly visible and present throughout the posterior pole. Many more spots were seen on indocyanine green angiography than were visible by clinical examination or angiography. After follow-up examinations, there was a rapid resolution of the spots over four to six weeks with return of vision. Our findings show that indocyanine green angiography can be a valuable tool in the recognition and further understanding of multiple evanescent white-dot syndrome.

The use of perfluoro-octane in the management of giant retinal tears without proliferative vitreoretinopathy.

PURPOSE: A technique for managing giant retinal tears without proliferative vitreoretinopathy (PVR) is presented, and visual outcome, anatomic reattachment, and postoperative complications are discussed. METHODS: A total of 25 consecutive cases of retinal detachment from giant retinal tears in eyes without PVR that had not previously undergone surgery were reviewed. A surgical technique combining pars plana vitrectomy, perfluoro-octane, and fluid-gas exchange was used. Scleral buckling was performed in 23 (92%) of 25 eyes, and pars plana lensectomy was performed in 11 (69%) of the 16 phakic eyes. A minimum follow-up period of 6 months was documented in each case. RESULTS: Of the 25 eyes, redetachment occurred in 3 (12%) after the initial procedure, and further surgery was necessary to successfully reattach the retina. A total of 9 secondary procedures were performed in 7 (28%) of the 25 eyes. Final retinal reattachment was achieved in all 25 eyes. Final Snellen visual acuity was 20/80 or better in 18 (72%) patients and 20/200 or better in 21 (84%) patients. CONCLUSION: The anatomic and visual results of this method of surgical treatment of giant retinal tears without PVR compare favorably to those achieved with techniques that use a nonbuckling approach, but with reduced ocular morbidity.

Retreatment of full-thickness macular holes persisting after prior vitrectomy. A pilot study.

PURPOSE: Vitrectomy with fluid-gas exchange has been shown to close more than one half of full-thickness macular holes, with improvement in visual acuity. By adding the appropriate dose of transforming growth factor-beta 2, a higher success rate has been reported. However, there still remain cases of macular holes that fail to close after vitreous surgery. The current pilot study is designed to determine whether reoperation may have a role in the management of cases that fail after vitreous surgery. METHODS: Twelve eyes with persistent full-thickness macular holes that failed to close after an initial vitrectomy underwent reoperation using 1330 ng transforming growth factor-beta 2. RESULTS: After the second operation, closure occurred in 12 (100%) of 12 eyes. Follow-up ranged from 8 to 16 months. Visual acuity also improved by two or more lines in 5 (42%) of 12 patients. Increased nuclear sclerosis occurred in nine (90%) of the ten phakic eyes. Of the five eyes showing visual improvement, four required cataract extraction and intraocular lens implantation. CONCLUSION: Retreatment of persistent full-thickness macular holes with transforming growth factor-beta 2 appears to have a beneficial effect on both neurosensory retinal flattening and visual outcome.

Subretinal exudative deposits in central serous chorioretinopathy.

The presence of subretinal exudation in a patient with neurosensory detachment of the macula frequently suggests the diagnosis of choroidal neovascularisation. A retrospective chart review of newly diagnosed cases of central serous chorioretinopathy revealed 11 patients, seven men and four non-pregnant women, who had plaques of subretinal exudate, which presumably were fibrin. Each of these patients had a solitary plaque that ranged in size from 300 to 1500 microns in diameter. These patients had no signs or a clinical course suggestive of choroidal neovascularisation. In each case the subretinal plaque was overlying an exuberant leak in the retinal pigment epithelium. The exudate was generally present at the initial examination, and usually showed dissolution before or coincident with the resolution of the neurosensory detachment. After resolution of the central serous chorioretinopathy, patients were left with subtle alterations in the retinal pigment epithelium in the areas of the subretinal plaque. These findings are important for two reasons. Firstly, the presence of subretinal exudation does not necessarily rule out the diagnosis of central serous chorioretinopathy. Secondly, pathophysiological theories of central serous chorioretinopathy must explain how the plaques are deposited behind the retina.

[The clinico-diagnostic significance of the general antiprotease capacity of the blood in assessing endotoxicosis in suppurative-inflammatory diseases of the abdominal cavity organs]. / Kliniko-diahnostychne znachennia zahal'noï antyproteaznoï iemnosti krovi v otsintsi endotoksykozu pry hniino-zapal'nykh zakhvoriuvanniakh orhaniv cherevnoï porozhnyny.

The views upon the value of general antiprotease capacity of the blood in evaluation of endotoxicosis in purulent-inflammatory processes of the abdominal cavity are presented. One hundred and thirty one patient with diffuse peritonitis, acute pancreatitis and obstructive jaundice was examined. A role of bacterial proteases in exhaustion of the inhibitors at the example of Pseudomonas aeruginosa strain has been established. Use of protease inhibitors (contrykal etc.) only for strict indications is substantiated.

Microrips of the retinal pigment epithelium.

We describe six patients with exudative age-related macular degeneration who had retinal pigment epithelial detachments with associated overlying neurosensory detachments. During fluorescein angiography, each patient demonstrated a solitary, intense, central serouslike leak at the edge of the retinal pigment epithelial detachment with passage of fluorescein into the subretinal space. In patients in whom the location of associated choroidal neovascularization was evident, the leakage site was remote to the area of neovascularization. Our observations suggest that these leaks result from small retinal epithelial rips, which we termed "microrips," that differ from conventionally described retinal pigment epithelial rips in clinical course and response to laser treatment. We hypothesize that the mechanisms and forces that generate these microrips are different from those producing conventionally described retinal pigment epithelial rips.