[The role of neovascularization in the formation of an unstable human atherosclerotic plaque]. / Rol' neovaskulyarizatsii v formirovanii nestabil'noi ateroskleroticheskoi blyashki u cheloveka.

MATERIAL AND METHODS: The study material was 20 autopsy samples obtained from males aged 65 to 72 years who died from acute atherosclerotic cardiovascular insufficiency. Aortic segments (from the arch, thoracic and abdominal regions), coronary arteries and the arteries of the base of the brain (a. basilaris) were investigated; these totaled 45 tissue segments. Neovessels and cellular responses in the arterial wall were examined by hematoxylin and eosin staining. VEGF was immunohistochemically detected using a highly sensitive two-stage streptavidin-biotin method. RESULTS: In unstable atherosclerotic lesions, there were active neovascularization processes in both the fibrous cap and the underlying parts of the adventitia. These changes are usually combined with a pronounced cellular inflammatory response that can contribute to their development. Endothelial growth factor may be one of the causes of neovascularization in unstable atherosclerotic lesions. CONCLUSION: A comparative immunomorphological study in the human aorta, coronary arteries, and a. basilaris revealed active neovascularization processes in the cap and the underlying parts of the adventitia in unstable atherosclerotic lesions. The cause of this neovascularization is probably endothelial growth factor and cellular inflammatory responses.

Spectrum and resistance determinants of oral streptococci clinical isolates.

The profiles of oral streptococci sensitivity to antibacterial drugs may reflect information about the presence of macroorganism resistance determinants. The aim of the work was to isolate the spectrum of oral streptococci from the microbiota of the oral cavity of patients and to determine their sensitivity to a wide range of antibiotics. A total of 342 microbial streptococcal isolates were isolated from saliva samples and a periodontal pocket and tested for antibiotic sensitivity. Species identification of streptococci was carried out using biochemical API test systems. Evaluation of antibiotic resistance was performed using E-tests. Real-time PCR was used to identify the presence of tetracycline and macrolide resistance genes. The study identified six types of oral streptococci: S. oralis, S. salivarius, S. mitis, S. sanguinis, S. anginosus and S. mutans. All streptococci were sensitive to linezolid and meropenem. The proportion of penicillin-resistant streptococci in the subgroup S. oralis / mitis / mutans was 47,8% versus 23,5% in the subgroup S. salivarius / sanguinis / anginosus (p = 0.020). Significant levels of resistance were revealed to macrolides (erythromycin) - 47,9%, tetracyclines (tetracycline) - 44,4% and quinolones (ofloxacin) - 41%. Multiple drug resistance (MDR) was detected in 31,9% of oral streptococcal isolates, a combination of erythromycin, tetracycline and ofloxacin resistance was prevalent in 79 isolates (23,1%). The most common genotypes of macrolides and tetracycline resistant oral streptococci (in 127 streptococcal isolates with combined resistance) were ermB-mefE + and tetM + tetQ-, respectively. Thus, S. oralis / mitis / mutans group streptococci predominated in the structure of antibiotic-resistant oral streptococci, including MDR. So, being in one of the most densely populated biotopes of a macroorganism, oral streptococci can mediate the transfer of resistance determinants to more pathogenic and clinically significant microorganisms, which requires careful monitoring of their level of susceptibility to antimicrobial agents.

[Endothelins and dopamine levels in tears for assessment of neurovascular disorders in glaucoma]. / Éndoteliny i dofamin v sleznoi zhidkosti v otsenke neirovaskuliarnykh narushenii pri glaukome.

PURPOSE: To estimate the possibility of detection of neurovascular ocular disorders in glaucoma by assessing the content of catecholamines and endothelins in lacrimal fluid. MATERIAL AND METHODS: The study included 47 patients with primary open-angle glaucoma (POAG). Tear eluate was analyzed by high performance liquid chromatography (HPLC) for catecholamines concentrations, and enzyme-linked immunoassay (ELISA) was used for evaluation of endothelins content. RESULTS: Endothelin-1 (ET-1) and big endothelin (bET) content in tears of patients with POAG was higher than in healthy controls. Concentration of dopamine (DA) in tears was lower and concentrations of L-dioxyphenylalanine and dihydroxyphenylacetic acid had a tendency for decrease. Noradrenaline content was equal in patients with POAG and controls. Adrenaline was not detected in any tear samples. CONCLUSION: Multidirectional changes of endothelins and DA levels in tears of patients with POAG was found. The increased concentration of ET-1 and its precursor bET promote vasoconstriction and decrease of aqueous humor outflow. The decrease of DA concentration is typical for neurodegenerative processes. Estimation of DA and endothelins concentrations in tears can enable early detection of neurovascular disorders in glaucoma patients and help evaluate their severity.

Chlamydia Pneumoniae and Immunoinflammatory Reactions in an Unstable Atherosclerotic Plaque in Humans.

Comparative study of the walls of the aorta, coronary artery, and a. basilaris detected for the first time intra- and extracellular depositions of Chlamydia pneumoniae in unstable atherosclerotic plaques. No chlamydia were detected in the intima of normal sites of the vascular wall and just negligible levels thereof in stable atherosclerotic plaques. An unstable plaque with intra- and extracellular colonies was characterized by infiltration of the cap and intima adjacent to the atheromatous core with mononuclear cells, primarily T cells. These data suggested that Chlamydia pneumoniae could play an important role in the development of immunoinflammatory processes in the vascular wall and promote destabilization and progressive development of atherosclerotic plaques in humans.

Role of interleukin-18 in destabilization of the atherosclerotic plaque in humans.

Precise location of IL-18 in cell and tissue elements of the atherosclerotic lesions in humans and its role in destabilization of the atherosclerotic plaque were detected. The data suggested a hypothesis on indirect involvement of IL-18 in destruction of the elastic and collagen fibers in an unstable plaque due to this cytokine capacity to induce the production of IFN-γ in T cells and macrophages, this eventually leading to inhibition of collagen and elastin synthesis in smooth muscle cells of the vascular wall and to loosening of the plaque cap.

[Antioxidant agents in neuroprotection treatment of glaucoma].

Purpose was to study efficiency and safety of mexidol in combined therapy in patients with primary open-angle glaucoma (POAG). 94 patients (185 eyes) at the age of 18-75 years old with POAG I-III stages were divided into 3 groups: 50 patients received combined therapy of mexidol 100 mg and picamilon 150 mg, 22 patients received combined therapy of mexidol 300 mg and picamilon 150 mg, 22 patients received only picamilon 150 mg. All medicine was administered qd during 14 or 21 days. Examination included standard ophthalmologic methods, perimetry, electroretinography, retinal and optic nerve heard arterial blood flow. Improvement of visual acuity, perimetric, electrofisiological indicies and increased blood flow velocity of central retinal artery were registrated. Combined mexidol therapy allows improving results in treatment of patients with POAG.

[Effect of the nitric oxide donors Na nitroprusside and L-arginine on the course of uveitis, the antioxidative and antiproteolytic potential of tear and blood in the experiment].

The nitric oxide (NO) donors Na nitroprusside and L-arginine were tested for their effects on the course of experimental immunogenic uveitis, antiproteolytic and antioxidative activities in the rabbit tear and blood. With the use of the NO donors, the course of uveitis was shown to be more severe and prolonged. In uveitis, there was a change in the activity of the antiproteinases--alpha1-antitrypsin and alpha2-macroglobulin and the antioxidative enzymes superoxide dismutase in both tear and blood. The magnitude of changes in the biochemical parameters under study suggested that the course of uveitis was more severe in the rabbits given the NO donors. Thus, the inclusion of the NO donors in the active phase enhances an inflammatory reaction in immunogenic uveitis.

[Effects of nootropic agents on visual functions and lacrimal antioxidative activity in patients with primary open-angle glaucoma].

The paper presents the results of an investigation of the effect of the nootropic agents pantogam and nooclerine on visual functions in patients with primary open-angle glaucoma. These agents have been found to have a beneficial effect on the functional activity of the retina and optic nerve, light sensitivity, hemo- and hydrodynamics of the eye.

[An experimental substantiation of nitric-oxide containing gas flow in the treatment of eye traumas]. / Eksperimental'noe obosnovanie primeneniia oksida azota v gazota v gazovom potoke dlia lecheniia travm glaza.

The hypothesis on the biostimulating effect of exogenous nitric oxide (NO) was made use of to develop a new method to stimulate the healing of wounds through treating them by a NO saturated gas flow. The above gas flow is generated by air-plasma unit "Plazon". The experimental and clinical studies confirmed that the NO-therapy is a highly effective treatment method for different lesions of the skin and soft tissues. We tried to use the above method in ophthalmology. A comprehensive experimental study was carried out to assess the impact of the NO-containing gas flow on the eyeball structures. An optimal mode was designed, which does not exert any influence on the intraocular pressure, Ph of the lachrymal fluid, antioxidative activity and on the proteinase-inhibitor balance in tears; no morphological changes occurred in the ocular tissue structures. The mentioned morphological and biochemical studies confirmed that the application of the NO-containing gas flow speeds up the healing, process of both an experimental cornea erosion and penetrating corneal wounds. Optimal modes of NO-therapy were defined for both types of lesions.

[Effect of pantogam on visual function and hemodynamic of eyes in patients with primary open-angle glaucoma]. / Vliianie pantogama na zritel'nye funktsii i gemodinamiku glaz bol'nykh pervichnoi otkrytougol'noi glaukomoi.

The complex therapy in patients with primary open-angle glaucoma, with normalized intraocular pressure but with declined visual functions included the use of the Russian neurometabolic preparation pantogam. The improvement of the visual function appeared as enlargement of the borders of visual fields, decreased area and sensitivity deficit (according to computer perimetric data). Doppler ultrasonography has demonstrated an increase in the mean blood velocity in the orbital vessels and a decrease in eyeball blood supply defects after pantogam therapy which is a favourable sign of a glaucomatous process. The authors consider the use of pantogam to be rational in the complex therapy of patients with glaucoma.

[Problems of dental diseases among young residents of the Archangelsk region]. / Problemy stomatologicheskoi patologii molodezhi Arkhangel'skoi oblasti.

Dental examinations (according to WHO methods) were carried out in 447 youths aged 18-19 years, residents of Northern Russia, in Archangelsk before army service, and 500 students of Northern Medical University. Dental health of young people was characterized by high incidence and prevalence of caries (9.4.31%, CDL = 5.94), periodontal diseases, maxillodental abnormalities (72.18%), high percentage of lost teeth (8.75) in the CDL structure, poor oral hygiene (OHI-S index 3.68), and high level of need in all types of dental care, this demonstrating poor organization of health improving measures for young people before military service. Poor dental health in young people aged 18-19 years is one of the causes making them unfit for army service or fit with limitations (47 subjects for categories C, D in 1996-1998, 100-198 subjects annually for category B).

[Effects of gaseous flow containing nitric oxide on the eyeball structures (an experimental study)]. / Vliianie gazovogo potoka, soderzhashchego oksid azota, na struktury glaznogo iabloka (éksperimental'noe issledovanie).

Nitric oxide is one of the main factors of intra- and intercellular regulation in the organism. Its vasodilating, antiaggregant, antithrombogenic, antibacterial, anticarcinogenic, and immunogenic effects are well known. It stimulates the reparative processes in soft tissue injuries. We failed to find reports about the role of NO in the wound process in the eyes. The source of NO in our experiments was medical air-plasma device Plason. Exposure of the eye to NO-containing gaseous flow did not cause changes in the lacrimal pH; NO penetrated through the cornea and sclera, exerted no appreciable cytotoxic effect on the surface epithelium of the eye, did not change the intraocular pressure, and caused no morphological changes in ocular tissues. On the other hand, NO-containing gaseous flow had an appreciable lasting effect on the diameter of the conjunctival vessels, this effect being dose-dependent. The doses of NO-containing gaseous flow which can be used in the treatment of eye wounds were determined.

N-Acetylcarnosine, a natural histidine-containing dipeptide, as a potent ophthalmic drug in treatment of human cataracts.

A study was designed to document and quantify the changes in lens clarity over 6 and 24 months in 2 groups of 49 volunteers (76 eyes) with an average age of 65.3 +/- 7.0 enrolled at the time of diagnosis of senile cataracts of minimal to advanced opacification. The patients received N-acetylcarnosine, 1% sol (NAC) (26 patients, 41 eyes = Group II), placebo composition (13 patients, 21 eyes) topically (two drops, twice daily) to the conjunctival sac, or were untreated (10 patients, 14 eyes); the placebo and untreated groups were combined into the control (reference) Group I. Patients were evaluated upon entry, at 2-month (Trial 1) and 6-month (Trial 2)-intervals for best corrected visual acuity (b/c VA), by ophthalmoscopy and the original techniques of glare test (for Trial 1), stereocinematographic slit-image and retro-illumination photography with subsequent scanning of the lens. The computerized interactive digital analysis of obtained images displayed the light scattering/absorbing centers of the lens into 2-D and 3-D scales. The intra-reader reproducibility of measuring techniques for cataractous changes was good, with the overall average of correlation coefficients for the image analytical data 0.830 and the glare test readings 0.998. Compared with the baseline examination, over 6 months 41.5% of the eyes treated with NAC presented a significant improvement of the gross transmissivity degree of lenses computed from the images, 90.0% of the eyes showed a gradual improvement in b/c VA to 7-100% and 88.9% of the eyes ranged a 27-100% improvement in glare sensitivity. Topographic studies demonstrated less density and corresponding areas of opacification in posterior subcapsular and cortical morphological regions of the lens consistent with VA up to 0.3. The total study period over 24 months revealed that the beneficial effect of NAC is sustainable. No cases resulted in a worsening of VA and image analytical readings of lenses in the NAC-treated group of patients. In most of the patients drug tolerance was good. Group I of patients demonstrated the variability in the densitometric readings of the lens cloudings, negative advance in glare sensitivity over 6 months and gradual deterioration of VA and gross transmissivity of lenses over 24 months compared with the baseline and 6-month follow-up examinations. Statistical analysis revealed the significant differences over 6 and 24 months in cumulative positive changes of overall characteristics of cataracts in the NAC-treated Group II from the control Group I. The N-acetylated form of natural dipeptide L-carnosine appears to be suitable and physiologically acceptable for nonsurgical treatment for senile cataracts.

[Experimental validation of licopin-containing drug tomatol use in combined therapy of patients with diabetic retinopathy]. / Eksperimental'noe obosnovanie ispol'zovaniia likopinsoderzhashchego preparata "tomatol" v kompleksnom lechenii diabeticheskoi retinopatii.

Effects of tomatol on metabolic changes in the blood and lacrimal fluid and ocular capillaries of rabbits with alloxane diabetes were studied. Tomatol is a drug containing licopin carotenoid characterized by a high biological activity. The intensity of lipid peroxidation was notably decreased, antioxidant activity of the blood increased, lipid metabolism parameters in the blood and some parameters of proteinase inhibitory balance in the blood and lacrimal fluid normalized in diabetic rabbits treated with tomatol in comparison with untreated rabbits. Changes in perilimbic capillaries were less expressed in treated vs. untreated animals. Hence, tomatol is recommended for combined therapy of patients with diabetes as a drug normalizing metabolism and probably decelerating the development of diabetic retinopathy.

[Clinical use of "Pericom"--a Russian automated perigraph]. / Opyt klinicheskogo ispol'zovaniia otechestvennogo avtomaticheskogo staticheskogo perigrafa "Perikom".

Analyzes the potentialities of clinical application of a new Russian automated computer-aided perigraph Pericom in studies of the central and peripheral visual fields in patients with different ocular diseases. The authors consider that Pericom is not inferior to foreign analogs Peritest, Perimat, etc., is simple to handle, and reliable.

[Lipoic acid as a means of metabolic therapy of open-angle glaucoma]. / Lipoeva kislota kak sredstvo metabolicheskoi terapii otkrytougol'noi glaukomy.

A total of 45 patients (90 eyes) with stages I and II open-angle glaucoma (OAG) were examined, 26 of these were administered lipoic acid in a daily dose of 0.075 g for 2 months and 19 were given 0.15 g daily for 1 month. Control group consisted of 31 patients with OAG who were administered only local hypotensive therapy. Vision acuity and visual field were checked up, tonometry, tonography, and campimetry carried out, and levels of nonprotein SH-groups and activity of gamma-glutamyl transpeptidase measured in the lacrimal fluid. Improvement of the biochemical parameters, visual function, and of the coefficient of efficacy of liquid discharge was more expressed in the patients administered lipoic acid in a daily dose of 0.15 g. Color campimetry results indicate improved sensitivity of the visual analyzer under the effect of treatment. Improvement was attained in approximately 45-47.5% of examined eyes, and was more often seen in patients with stage II OAG: in 57-58% eyes. The effect of lipoic acid may be explained by its antioxidant properties and direct influence on ocular tissue metabolism.

[The effect of lipoic acid on the components of the glutathione system in the lacrimal fluid of patients with open-angle glaucoma]. / Vliianie lipoevoi kisloty na komponenty sistemy glutationa v sleznoi zhidkosti bol'nykh otkrytougol'noi glaukomoi.

Nonprotein SH groups and gamma-glutamyl transpeptidase were detected in the lacrimal fluid of patients with open-angle glaucoma and senile cataract and in controls (in 82 and 100% of the examinees, respectively). In stage II glaucoma SH group level was found reduced vs. that in stage I or control. Intake of lipoic acid by patients with stage II glaucoma resulted in a reliable increase of lacrimal SH group level. Measurements of lacrimal fluid nonprotein SH groups may be used to monitor antioxidant therapy of patients with open-angle glaucoma.

[The effect of antiaggregants on the course of diabetic microangiopathy]. / Vliianie antiagregantov na techenie diabeticheskoi mikroangiopatii.

As shown by conjunctival biomicroscopy, 6-month administration of ticlid and gliclazide induced a statistically significant increase in the frequency of less severe microcirculatory disturbances compared to conventional hypoglycemic therapy. The drugs also restricted plasmatic impregnation and cell proliferation in skin biopsy microvascular wall. Following 2-year antiaggregation treatment (gliclazide, trental, dipiridomol) 48.9% of diabetes mellitus patients achieved regression of morphological manifestations of diabetic microangiopathy, 16.2% stabilization against 34.9% of progressive disease cases. Conventional sugar-reducing therapy fails to stop diabetic microangiopathy progression in 73.4-93.3% of the diabetics.

[Results of the use of ticlid in the treatment of patients with post-thrombotic retinopathy]. / Rezul'taty primeneniia tiklida dlia lecheniia bol'nykh posttromboticheskoi retinopatiei.

Presents 22 case histories of patients with postthrombotic retinopathy (n = 20) and fresh thrombosis (n = 2), treated with ticlid, a new drug. Demonstrates the disaggregating and antithrombotic effects of the drug, a positive time course of microcirculatory changes in the fundus oculi and improvement of blood rheology.

[Results of the use of betoptik (betaxolol) in the treatment of primary glaucoma]. / Rezul'taty primeneniia preparata betoptik (betaksolol) v lechenii pervichnoi glaukomy.

Effect of instillations of 0.5% betaxolol solution (Alcon) on intraocular pressure, ocular hydro- and hemodynamics, function, systemic arterial pressure, and pulse was studied in 35 patients (57 eyes) with primary open-angle glaucoma. The effects of betoptic and arutimol on the eyes are compared. Betoptic is characterized by a marked hypotensive effect explained by depression of aqueous humor production. The drug does not influence ocular function and hemodynamics. Comparison of the hypotensive effects of betaxolol and arutimol has shown that arutimol more effectively reduces intraocular pressure.