Saratov JOURNAL of Medical and Scientific Research

Siberian State Medical University

The effect of intraoperative application of Cyclisporin A on the regeneration of the tissues of the anterior segment of the eye in experimentally induced glaucoma

Year: 2018, volume 14 Issue: №4 Pages: 833-837
Heading: Ophtalmology Article type: Original article
Authors: Zhigalskaya Т.А., Krivosheina O.I., Dzyman A.N.
Organization: Siberian State Medical University
Summary:

Purpose: to study in vivo the features of regeneration of a conjunctiva and sclera after surgery with application of a 0.05% Cyclosporin A against the background of experimentally induced glaucoma. Material and Methods. The experiment was performed in 29 rabbits. At the first stage, the animals were induced with a steroid model of glaucoma by subconjunctival injections of 0.5 ml 0.4% Dexamethasone 1 time per week for 3 months. At the second stage rabbits (24 animals) were subjected to a through incision of the conjunctiva and an incision of the surface layers of the sclera of one of the eyes. Depending on the course of the operation, the animals were divided into the main group and the comparison group. Rabbits of the main group (16 animals) were subjected to local application of a 0.05% Cyclosporin A fora duration of 3 minutes in subgroup "a" (8 animals) and 6 minutes in subgroup "b" (8 animals). In rabbits of the comparison group (8 animals), wasn't used cytostatic. Results. In animals of the comparison group, the inflammatory and reparative reaction, despite the presence of dystrophic changes due to an increase in intraocular pressure, proceeds with the stereotypic dynamics of the change of cellular phases. Using a 0.05% Cyclosporin A suppresses the migration of cells from different populations to the surgical zone, increasing the duration of the macrophage reaction phase and slowing down the transition to the regeneration phase. Conclusion. Using of 0.05% Cyclosporin A during surgical intervention slows down the repair of the tissues of the conjunctiva and sclera, preventing pronounced fibroblation in the area of surgical trauma, which can be an effective way to prevent scarring during antiglaucoma operations.

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Clinical efficacy of using autocytokines in surgery for bullous keratopathy

Year: 2018, volume 14 Issue: №4 Pages: 805-808
Heading: Ophtalmology Article type: Original article
Authors: Denisko M.S., Krivosheina O.I.
Organization: Grand Retina LTD, Siberian State Medical University
Summary:

Purpose: to study clinical efficacy of a surgical modality of treatment for bullous keratopathy (BK), which is based on cell technology and involves intrastromal injection of autologous mononuclear leukocytes suspension, in comparison with medical therapy. Material and Methods. All patients with BK in this study were divided into two groups: treatment group, which consisted of 14 subjects who underwent intrastromal injection of autologous mononuclear leukocyte suspension; and control group, which included 13 subjects who received conservative treatment. Results. In treatment group corneal edema significantly subsided 1 month after treatment, which was accompanied by a decrease in corneal thickness by 24% and a 3.4-fold increase in visual acuity. After 6 months pachymetry index decreased by 32.8% from the initial value, visual acuity increased 10-fold from the initial value as well, and these parameters remained stable for 8 months. In control group, biomicroscopic pattern and pachymetry index had unstable dynamics, which was accompanied by only a 2.7-fold maximum increase in visometry after 1 month with a gradual decrease observed later on. Conclusion. Our method of surgical treatment for BK which involves injection of suspension of autologous mononuclear leukocytes into a posterior third of corneal stroma leads to a faster relief of corneal syndrome symptoms, restoration of normal corneal thickness within reference values and to a significant and stable increase in visual acuity when compared to a course of medical treatment.

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Evaluation of expenses for treatment of patients with different forms of psoriasis in the conditions of round-the-clock hospital

Year: 2017, volume 13 Issue: №3 Pages: 595-599
Heading: Dermatovenerology Article type: Original article
Authors: Nelyubova O.I., Sazanova G.Yu., Utz S/R.
Organization: Siberian State Medical University
Summary:

 Objective: to evaluate the structure and volume of expenditures on treatment of patients with different clinical forms of psoriasis using the method of analysis of "cost of illness". Material and Methods. The study was conducted on the basis of the Clinic for Skin and Venereal Diseases Medical University of the Saratov State Medical University n.a. V. I. Razumovsky. To determine the costs of treating patients with different clinical forms of psoriasis, 702 medical records of a stationary patient have been analyzed. To assess and analyze the costs of treating patients with psoriasis, one of the methods of clinical and economic analysis was used-the "cost of illness". In the analysis of costs, the costs of inpatient treatment were included, which included direct medical costs, including the payment of medical personnel, the costs of diagnostic, medical manipulation, medicines, the use of medical equipment, inventory, etc.; indirect costs, including the costs of ensuring the activities of the medical institution. The comparative characteristic of the evaluation of the cost of treatment of patients with different forms of psoriasis in accordance with the program of state guarantees and the actual costs of the clinic. Results. It was revealed that the actual cost of the treatment for the completed case of patients with severe forms of psoriasis is 3 times higher than the cost of the treatment under the state guarantees program. The study of the structure of expenditures showed that the main costs are for the purchase of medicines and supplies in severe forms of psoriasis. Conclusion. The difference between the cost of treatment for patients with different forms of psoriasis according to the territorial program of state guarantees of the Saratov region and the actual costs is explained, because the state guarantees program does not take into account comorbid pathology and concomitant diseases, patient's age, which requires additional diagnostic and treatment methods. Analysis of the structure of actual expenditures showed that the maximum share of costs is accounted for by medicines and supplies in severe forms of psoriasis.

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Morphological changes in urinary tract wall after direct electropulse effect: in vitro study

Year: 2011, volume 7 Issue: №4 Pages: 937-941
Heading: Urology Article type: Original article
Authors: Gudkov А.V., Boshchenko V.S., Nedosekov V.V.
Organization: Siberian State Medical University
Summary:

The research goal is to study morphological changes after direct electropulse effect (DEPE) on the wall of urinary tract. Materials and methods: Materials of renal pelvis (25 fragments, n), ureter (n=33) and urinary bladder (n=20) from open surgeries were used. During the surgical intervention a few small fragments were resected to study the organ, immersed on a Petri-dish with solution of 0.9% NaCI. Mucosa was subjected to 1-20 single nanosecond electric impulses of intensity 0.8-1.0 J using probe of electropulse lithotriptor «Urolith-105M». The fragments were fixed in formalin, and then tissue sections were made. Results: Wall of renal pelvis was the most resistant to DEPE. Epithelial desquama-tion, basal disorganization, capillary dilatation and edema were observed within submucosal layer on application up to 10 impulses of intensity 1.0 J in the same point of mucosa. Walls of ureter and urinary bladder were less resistant to the DEPE, where just 5 impulses of intensity 1.0 J caused similar disorders, and 10 impulses of intensity 1.0 J caused damage to the entire thickness of the muscular layer up to adventitia. Conclusion: DEPE of urinary tract mucosa with a number of electric impulses from 1 to 20 with intensity of 0.8 to 1.0 J is a safe method. It causes morphological disorders within the muscular layer but it does not lead to wall perforation

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