[Anatomical and morphometric features of anterior eye segment structures in hyperopia and the risk of developing primary angle-closure glaucoma]. / Anatomo-morfometricheskie osobennosti struktur perednego segmenta glaza pri gipermetropii i risk razvitiya pervichnoi zakrytougol'noi glaukomy.

PURPOSE: To study features of anatomical and morphometric parameters of the structures of anterior eye segment in young patients with moderate and high hyperopia in order to identify the signs of an increased risk of developing primary angle-closure glaucoma (PACG) and its acute attack. MATERIAL AND METHODS: The study included 160 eyes (80 patients) with axial length (AL) of less than 23 mm. Patients with moderate or high hyperopia were divided into two groups according to their age ranges (the 1st - 27 patients (54 eyes) under 40 years old; the 2nd - 27 patients (54 eyes) of 41-50 years old, the comparison group - 26 patients (52 eyes) of 42-50 years old with the initial stage of PACG. AL of the eyes, anterior chamber (AC) depth in the central zone, lens thickness (LT) in the optical zone were measured using IOL Master 700 («Carl Zeiss Meditec AG¼, Germany). AC volume and peripheral AC depth were measured using rotating Scheimpflug camera Pentacam («Oculus¼, Germany). RESULTS: While the average values of AL in patients of the 1st and 2nd groups were comparable, a statistically significant decrease in AC depth and a significant increase in LT were revealed in the 2nd group. There was a statistically significant increase in LT, a decrease in peripheral AC depth and AC volume in the comparison group relative to the 2nd group. In the 1st group: in 2 eyes of one 38-year-old patient the maximum proximity of all 3 indices to the median values of the group of patients with PACG was found; in 4 eyes of two other patients (35 and 38 years old), a combination of small AC volume with increased LT or small AC volume with small AC on the periphery was noted. CONCLUSION: Significant differences in terms of LT, peripheral AC depth and AC volume were found between age-comparable (41-50 years old) healthy individuals with short eyes and patients with initial PACG. In 11% of the eyes of healthy patients with hyperopia aged 21 to 40 years, there was a combination of two or three of the studied morphometric signs, which may indicate the risk of developing PACG.

[Phacoemulsification in prevention of acute angle-closure glaucoma attack]. / Fakoemul'sifikatsiya v profilaktike ostrogo pristupa zakrytougol'noi glaukomy.

Analysis of the effectiveness of preventative phacoemulsification (PE) in anatomically short eyes with an increased risk of an acute glaucoma attack in thickened lens can help in choosing the optimal management tactics for these patients. PURPOSE: To study the changes in morphometric parameters of the anterior segment of anatomically short eyes with an increased risk of acute glaucoma attack before and after preventative PE. MATERIAL AND METHODS: The study included 70 patients (70 eyes) with a high risk of acute glaucoma attack in short anatomical axial length and thickened lens, with posterior and middle positions of the ciliary body. They were divided into 2 groups: the main group consisted of 45 patients who agreed to undergo PE; the comparison group consisted of 25 patients who refused to undergo PE due to good visual functions and no complaints about vision. B-mode ultrasound examination of the anterior segment of the eye was used to evaluate the cross-sectional surface area of the lens (CSAL) and the cross-sectional surface area of the anterior chamber (CSAAC). RESULTS: In the main group, on day 2-3 after PE the anterior chamber depth increased in all eyes, the CSAAC index increased, the anterior chamber angle (ACA) widened to Schaffer grade to II-III. After 1-3 years and 4-5 years, the anterior chamber depth, the CSAAC index and the width of the ACA remained stable. In the comparison group, after 1-3 years the anterior chamber depth and the CSAAC index significantly decreased, the ACA narrowed, and the intraocular pressure increased; after 4-5 years, there was a progressive increase in the CSAL index, the ACA was completely closed (0°). CONCLUSION: In all cases of timely performed preventative PE, already on days 2-3 after surgery there was a statistically significant improvement in the main morphometric parameters of the eye, which remained stable for 4-5 years.

Seasonal Dynamics of Testosterone and Corticosterone in Predatory Birds as Exemplified by the Northern Goshawk (Accipiter gentilis).

Testosterone and corticosterone are steroid hormones that regulate various aspects of bird behavior. The dynamics of blood level of these hormones depending on the stage of the life cycle have been studied in many species. It has been shown for both sexes that the levels of both hormones rise during the breeding season. We have studied changes in the level of these hormones in the northern goshawk (Accipiter gentilis) during a year. This has been the first study of this type on northern goshawk. We collected blood samples from 16 adult northern goshawks kept in pairs in aviaries in the VITASFERA Rare Bird Species Breeding Center. The testosterone level rises in males during the period of lekking and mating (March-June); however, there is no synchronous increase in females. The corticosterone level generally remains high throughout the year in both sexes. Since these are the only data on the northern goshawk, it cannot be concluded whether this is characteristic of the species as a whole or only for captive birds.

[Diagnostics and treatment of patients with giant leiomyoma of the esophagus]. / Diagnostika i lechenie bol'nykh s gigantskoi leiomiomoi pishchevoda.

Diagnostics and surgical treatment of 2 patients with giant esophageal leiomyoma are reported. The diagnosis was confirmed by chest computed tomography, MRI of the mediastinum, endoscopic ultrasound. Resection of tumor with mucosa suturing and Nissen fundoplication was performed in 1 case. There were no intraoperative complications. Postoperative partial failure of the seams of the esophageal wall occurred in 1 case. Drainage of posterior mediastinum was performed. Treatment resulted closure of the esophageal wall defect. Control postoperative examination confirmed patent esophagus and preserved passage through the esophagus. Multidisciplinary approach to diagnosis and treatment of these patients results favorable outcomes.

[Effectiveness of the system for predicting the risk of developing an acute angle closure glaucoma attack]. / Éffektivnost' sistemy prognozirovaniia riska razvitiia ostrogo pristupa zakrytougol'noi glaukomy.

One of the most severe urgent conditions of the eye capable of leading to untreatable blindness is an acute attack of glaucoma. This condition is an acute decompensation of eye hydrodynamics, which develops with primary angle-closure glaucoma (PACG). Detectability of PACG is only high at the sudden development of an acute attack, which can cause a sharp decrease or even irreversible loss of vision. PURPOSE: To assess the effectiveness of predicting the development of PACG in eyes with short anterior-posterior axis. MATERIAL AND METHODS: The study included 69 patients (90 eyes) aged 46 to 80 years with short anterior-posterior axis. We used our own mathematical formulas for calculating the risk of PACG development. According to these formulas, two groups of patients with high risk of PACG were selected. Patients of the main group underwent cataract phacoemulsification for preventive purposes, while patients of the comparison group did not undergo any operative treatment. RESULTS AND DISCUSSION: In the long-term, PACG did not develop in the patients of the main group. Patients of the comparison group refused to undergo cataract phacoemulsification, and had PACG develop in 38% of cases in the long-term follow-up. CONCLUSION: The high efficiency of the developed screening model for estimating the risk of PACG developing in eyes with short anterior-posterior axis has been proved. Preventive cataract phacoemulsification in the eyes with a high risk of PACG development in all cases helped to avoid it, retaining and even improving visual functions.

[An open safety pin in the oesophagus of an one-year old child]. / Otkrytaia angliiskaia bulavka v pishchevode u godovalogo rebenka.

The objective of the present work was the description of the observations documented in the clinical practice concerning the cases of detection of the foreign bodies in the internal organs of human patients. This publication is devoted to the case of the child's accidental swallowing the safety pin. The presence of the open safety pin in the esophagus of the one-year-old child created a serious threat to its health. This case highlights the risk of the child's accidentally swallowing the safety pin and the similar objects which can lead to severe complications.

[Surgical decision-making during treatment of a patient with multifocal atherosclerosis based on intraoperative epiaortic scanning]. / Vybor taktiki khirurgicheskogo lecheniia patsienta s mul'tifokal'nym aterosklerozom na osnove intraoperatsionnogo épiaortal'nogo skanirovaniia.

The article deals with a clinical case report regarding surgical management of a patient presenting with multifocal atherosclerosis. Taking into consideration critical stenoses of the anterior interventricular artery (80%) and circumflex artery (80%), as well as subocclusion of the left internal carotid artery and stenosis of the right internal carotid artery (60%), there were high risks for intraoperative cerebral circulation impairment. It was decided to perform a two-stage operation on the coronary and carotid beds. The envisaged scope of the intervention comprised: carotid endarterectomy on the left and coronary bypass grafting of the anterior interventricular and circumflex arteries in conditions of assisted circulation. The intraoperative epiaortic scanning revealed atheromatosis of the ascending portion of the aorta, thus making it impossible to cross-clamp the aorta for establishing distal anastomoses on the non-beating heart and proximal anastomoses on the aorta. A decision was made to change the treatment policy. The patient was subjected to endarterectomy from the left internal carotid artery and mammarocoronary bypass grafting of the anterior interventricular artery on the beating heart with the help of the Octopus myocardial stabiliser. The second stage consisted in stenting of the circumflex artery. This clinical case report demonstrates the necessity of precision diagnosis of an atherosclerotic lesion of the aorta by means of epiaortic scanning in order to prevent perioperative acute impairments of cerebral circulation.

[An analysis of postoperative cognitive dysfunction in different methods of coronary artery bypass]. / Analiz posleoperatsionnoi kognitivnoi disfunktsii pri razlichnykh metodakh operatsii aortokoronarnogo shuntirovaniia.

AIM: To evaluate changes in cognitive functions in patients with coronary heart disease before and after coronary artery bypass grafting (CABG) in a planned manner. MATERIAL AND METHODS: The study included 192 patients divided into 3 groups: in group 1 patients (n=88) underwent standard CABG; in group 2 (n=61) different methods of CABG were used; a control group consisted of 43 people. MMSE, FAB, Clock drawing test, Shultz tables, semantic verbal fluency, Wechsler adult intelligence scale were used for neurological testing. RESULTS AND CONCLUSION: Postoperative cognitive dysfunction develops 3.2 times more often in patients after standard CABG. Patients in the group with a differentiated approach show a trend towards the improvement of cognitive functions after surgery.

[Prevention of cerebrovascular complications in coronary artery bypass grafting]. / Profilaktika tserebrovaskuliarnykh oslozhnenii pri koronarnom shuntirovanii.

The authors carried out a comparative analysis of the incidence rate of cerebrovascular complications following coronary artery bypass grafting performed using either a differentiated approach to surgical policy depending on the findings of epiaortic ultrasonographic scanning or the standard conventional approach. A total of 3,454 operations of coronary artery bypass grafting were performed. All patients were divided into two groups. Patients of the Study Group (n=765) were subjected to obligatory intraoperative epiaortic scanning, with the variant of further surgical intervention depending on the obtained findings of the examination. The Control Group patients (n=2,689) underwent standard coronary artery bypass grafting in the conditions of artificial circulation (AC). In the Study Group patients, depending on the degree and localization of the atherosclerotic lesion of the aorta, determined by the findings of epiaortic scanning, one of the following techniques of coronary artery bypass grafting (CABG) was chosen: cases with no lesion were managed by CABG with AC (585 patients); a local solitary lesion was managed by altering the site of cannulation and application of the clamp (92 patients) or by the operation according to the 'single clamp' technique (43 patients); cases of manifested atherosclerosis of the ascending aorta were treated by the 'on-pump beating-heart' technique in the conditions of AC without placing clamps (27 patients); cases of massive involvement of the ascending aorta and aortic arch were managed by CABG performed according to the 'no-touch aorta' technique (18 patients). The total mortality rate amounted to 1.1%. Thirty-three (0.96%) patients in the postoperative period were found to have ischaemic stroke. The mortality rate in the Control Group amounted to 1.4% and that in the Study Group equalled 0.3%, with the number of cases of ischaemic strokes amounting to 33 (1.4%) and 0, respectively. Perioperative infarction was diagnosed in 16 (0.6%) cases in the Control Group and in 5 (0.7%) patients in the group treated using the differentiated approach. A conclusion was drawn that the differentiated approach to choosing the technique of CABG based on the findings obtained by means of epiaortic scanning was associated with a statistically significant decrease in both the number of ischaemic strokes and the mortality rate after CABG operations.

[Methods of substance abuse prevention in the Armed Forces].

Dynamics of substance abuse morbidity in the Armed Forces of the Russian Federation during the last 10 years (2002-2012) was analyzed. Results of performed analysis showed decreasing tendency since 2007 in conscripts (0.07% in 2012) and in contract soldiers (0.3% in 2012). Alcoholism prevailed in the structure of substance abuse in conscripts (0.05%), drug abuses were diagnosed 2,5 times less often (0.02%). In contract soldiers non-alcohol abuses were diagnosed in 0.004% of cases. It is stated that the major aims of substance abuse prevention are qualitative recruiting of military units (especially in troops maintaining the combat readiness) and departments (subunits) of military education, creating conditions for propaganda for healthy lifestyle, prohibition of drugs and psychopharmaceuticals in military units. For early detection of persons liable to substance abuse and facts of drug consumption it is necessary to perform a medical examination with the help of special program apparatus complex (such as "Addicts") and take into account clinical signs of addiction. Besides, it is necessary to introduce planned and unexpected medical examinations of servicemen. Algorithm of measures in case of detection of serviceman with alcohol or drug intoxication is given. In conclusion the main organizational principals of substance abuse prevention in the Armed Forces are given.

[Neurophysiological monitoring of the efficacy of the complex therapy of vascular and posttraumatic encephalopathy].

Authors have studied the efficacy of adaptol and neyromidin in the combined treatment of patients with chronic cerebral circulation insufficiency and consequences of closed head injury using neurophysiological monitoring which included dynamic evaluation of central conductivity, neuropsychological tests and analysis of blood BDNF levels. Severe autonomic disorders, anxiety and low level of learning observed in all patients are correlated with neurophysiological (increased central conductivity time) and neurotrophic (decreased blood BDNF levels) profiles. These indicators may change throughout the treatment. The combination of adaptol and neyromidin enhanced greatly the efficacy of combined treatment. The received data allow recommending neurophysiological monitoring for treatment optimization of numerous neurological diseases that demand neuroplasticity stimulation.

[Computer modeling of parametric structures of water].

The algorithm for the arrangement of hydrogen atoms in twist-hexacycle parametric structures of bound water is developed. The calculation of energetic properties is carried out using the TIP3P and Poltev-Malenkov potentials. Optimization of energy for these structures is fulfilled.

Urethral compliance in hypospadias operated by tubularized incised urethral plate (TIP) with and without a dorsal inlay graft: an experimental controlled study.

OBJECTIVE: Abnormal uroflowmetries are common after tubularized incised plate urethroplasties (TIP), perhaps due to low compliance. We hypothesized that (1) abnormal uroflowmetries after TIP might be caused by segmental lower compliance; (2) by adding a graft to the raw area in the incised plate (TIPG), compliance might be improved by preventing secondary intention healing of the dorsal incision. METHODS: A standardized penectomy was performed in 27 adult male rabbits: 9 normal non-operated controls (G1), 6 weeks after TIP (G2: n = 9) or TIPG (G3: n = 9). A standardized isolated segment (including the whole urethroplasty in G1 and G2) was progressively distended with air (1, 2 and 3 ml) in the 3 groups. The respective intraluminal pressures were measured with a tensiometer. RESULTS: Pressure measurements were feasible and reproducible for this model. Mean pressures tended to be higher in the experimental groups (G1: 59.7 mmHg vs. G2: 79.6 mmHg vs. G3: 100.1 mmHg for 1 ml injections; G1: 233.1 mmHg vs. G2: 241 mmHg vs. G3: 308.4 mmHg for 2 ml injections and G1: 457.3 mmHg vs. G2: 429 mmHg vs. G3: 520 mmHg for 3 ml injections) without reaching the statistical significance. CONCLUSION: In this model, the elasticity of the TIP or TIPG neourethras tended to be reduced when compared to controls. The placement of an inlay graft on the dorsal incised area did not increase the compliance. This model allows the measurement of segmental intraluminal urethral pressures generated by controlled air distension and may be a useful tool to evaluate the experimental urethroplasty models.

[The prognostic significance of brain-derived neurotrophic factor (BDNF) for phobic anxiety disorders, vegetative and cognitive impairments during conservative treatment including adaptol of some functional and organic diseases of nervous system].

We have studied the efficacy of adaptol in the treatment of 45 patients with somatoform dysfunction of the autonomic nervous system and 30 patients with closed head injury. The condition of patients during the treatment was evaluated with clinical and neuropsychological scales. The serum level of BDNF before and after the treatment has been studied as well. Adaptol has been shown to enhance the production of BDNF, reduce significantly the intensity of anxiety, autonomic disorders and improve intellectual processes. The dose-dependent effect of the drug has been demonstrated. In conclusion, adaptol can be recommended for treatment of diseases that demand stimulation of neuroplasticity in the CNS.

[Comorbide somatic pathology in servicemen with neurotic disorders].

Prevalence and structure of comorbidity a somatic pathology in military men with neurotic disorders was studied. It was established that 40,4% of surveyed noted concomitant somatic pathology, the structure of which was dominated by gastro-intestinal tract (26,8%), and pathology of the cardiovascular system (21,6%). It is shown that concomitant somatic pathology provided aggravating effect on clinic neurotic disorders in serviceman, making it difficult to diagnose mental disorders. The greatest risk concomitant a somatic pathology was marked in patients with depressive and somatoform disorders. Indicates the need for specialized standards of care for persons with comorbid mental and somatic disorders.

[Prevention of tobacco addiction in the Armed Forces].

The problems of tobacco smoking among servicemen are analyzed from the position of their interrelations with the quality of service duties performance. On the basis of received data the conclusion is drawn that the servicemen with tobacco dependence are characterized by lower level of mental resilience, adjustment capacities and are related to lower category of fitness for duty. Based on analyzes of the world and own country experience the program of tobacco smoking prevention among servicemen is proposed.

[Peptide inhibitors of myosin light chain kinase. Development of peptidase resistant analogues].

Myosin light chain kinase (MLCK) is the key regulator of various forms of cell motility including endothelial and epithelial permeability in particular. One of the potential MLCK inhibitors to be used in humans is a membrane permeable peptide H-RKKYKYRRK-NH2 (L-PIK). In present work we used solid phase peptide synthesis and Fmoc-technology to produce five modifications of L-PIK. Based on (1)H NMR analysis revealed that these peptides demonstrated improved resistance to degradation in blood plasma. One of de novo synthesized peptides, L-[MeArg(1)]PIK inhibited MLCK activity in vitro with the same efficiency as L-PIK whereas other modified peptides showed reduced inhibitory activity. D-amino acid analog of PIK was the least active inhibitor. Thus, we have demonstrated the possibility to produce an effective MLCK peptide inhibitor with increased resistance to biodegradation that is suitable for further pharmacological development.

[Pathomorphism of neurotic disorders among military servicemen].

There were analyzed changes in popularity, structure and clinical peculiarities of neurotic disorders among military servicemen for the period 1986-2006. There were used epidemiological, clinical-archival and clinical-psypathological methods. It was established, that that internosological pathomorphosis of neurosis came out in reduction of their rates in general structure of psychological pathology. Internosological pathomorphosis has found reflection in narrowing of syndromes spectrum and its drift from hypochondriac to anxiety and depressive pole. Dynamic pathomorphosis consisted of less favorable indices of course and outcomes of these disturbances in 1992-1999, and also in reduction of the period of the period from the beginning of illness to hospitalization to a specialized department.

[Novel peptide inhibitors of the myosin light chain kinase suppress hyperpermeability of vascular endothelium].

The ability of novel cell-permeating peptide molecules derived from the peptide inhibitor of the myosin light chain kinase (MLCK) L-PIK (Arg-Lys-Lys-Tyr-Lys-Tyr-Arg-Arg-Lys) to inhibit this kinase in vitro and attenuate the thrombin-induced hyperpermeability of endothelial cell monolayer in culture has been studied. It was found that the compounds [NalphaMeArg1]-L-PIK and [Cit1]-L-PIK possess the inhibitory activity towards MLCK comparable to that of L-PIK and the ability to suppress the hyperpermeability of endothelium, whereas other modifications of L-PIK were less effective. Thus, among de novo synthesized peptides, [NalphaMeArg1]-L-PIK and [Cit1]-L-PIK demonstrate the inhibitory properties of the original peptide L-PIK and additionally surpass it by stability in blood plasma. These peptides may be used in the design of novel antiedemic drugs.