[Evaluation of the effectiveness of the compression method for infiltration anesthesia of the mandibular molars]. / Otsenka effektivnosti primeneniya kompressionnogo metoda pri infil'tratsionnoi anestezii dlya obezbolivaniya zhevatel'nykh zubov na nizhnei chelyusti.

AIM: To study the depth of analgesia and the electrical excitability dynamics of the pulp of the tooth under local anesthesia without and with compression on the depot of local anesthetics. MATERIALS AND METHODS: 87 men and 93 women took part in the study, the average age of men was 36.8±5.02 and the average age of women was 30.43±2.14. According to the indications, local anesthesia of infiltration type with and without compression at the depot of local anesthetics was performed. The injection was carried out with a solution of 4% articaine with epinephrine1:100000 or 1:200000. Patients were divided into 2 groups depending on the used concentration of the vasoconstrictor with 4% articaine. The target area thermometry and electroodontometry (EOD) of the first mandibular molar were performed. The criterion for the onset of pulp analgesia was the value from 92 to 100 mA. RESULTS: Dynamics of change in pulp electrical excitability of the first molar with the use of 4% articaine with epinephrine 1:200000 without a compress showed that in the latter case the reduction of pulp electrical excitability to 96.6 µA, which is optimal for painless treatment, was developed by the 5th minute of the study and remained at the limit of 92.2-92.1 µA for 20 minutes. When using 4% articaine 1:100 000 it was noted that also the compression technique allowed to reach the necessary reduction of EOD indices to 93.5 µA by the 5th minute of the study, and to 97.2 µA by the 10th minute. Increased hypothermia in the injection depot area was noted thermographically, especially when high concentrations of epinephrine were used. CONCLUSION: Our own studies reflect the dynamics of change in the electrical excitability of the pulp of the first molar with the use of 4% articaine by compression method more intensively reduces the electrical reacrivity of the dental pulp depending on the concentration of the epinephrine: with the use of 1:100000, the advantage of the pressure technique is 19.3% and 1:200000 - 21.8%.

[Objective assessment of mental nerve local anesthesia]. / Ob''ektivnaia otsenka urovnia mestnogo obezbolivaniia podborodochnogo nerva.

AIM: To study the reaction of the mental nerve to selective stimulation of thin nerve fibers by thermal stimuli during conduction anesthesia. MATERIAL AND METHOD: The pilot study involved 24 healthy volunteers: 13 subjects were injected with a 4% solution of articaine-containing anesthetic with a vasoconstrictor in a ratio of 1:200 000 (pH 4.8-5.4) and 11 subjects - a 3% solution of mepivacaine-containing local anesthetic without a vasoconstrictor (pH value 5.8-6.4). The registration of evoked potentials was performed twice: before local anesthesia and 5 minutes after anesthesia. With the help of disposable carpal dental injectors, local anesthesia was performed near the mental foramen in order to anesthetize the innervation region of the mental nerve through a conductive type. The evoked potentials (VP) were recorded on a Nicolet instrument (USA) with Bravo evoked potentials software. The study of thermal EPs was performed using a Contact heat evoked potential stimulator (CHEPS) device ('Medoc Ltd, Ramat Yishai', Israel). The base and peak temperature were set at 33 and 54 °C, correspondingly. RESULTS: The evoked potentials for thermal stimulation demonstrated a significant decrease in the amplitude of all components and the elongation of the LP of the main negative-positive N2-P2 complex after anesthesia compared with the initial thermal EP. The complete disappearance of thermal responses was observed in 14 (58%) of 24 study participants, minor changes were seen in 3 (12.5%) cases only. The total response disappearance was observed in 10 (77%) of 13 participants after articaine and in 3 (27%) of 11 - after mepivacaine (p<0.05), weak changes were registered in 2 (15%) cases in the articaine group and in 1 (9%) case in the mepivacaine group. CONCLUSION: A 4% solution of articaine is somewhat more effective for pain relief of teeth and bone since it often causes deeper anesthesia, and a 3% solution of mepivacaine without a vasoconstrictor is physiologically more suitable for working with soft tissues.

[Possibilities of thermographic rating the level of microcirculation with local anesthesia in dentistry]. / Vozmozhnosti termografii dlia otsenki urovnia mikrotsirkuliatsii pri mestnom obezbolivanii v stomatologii.

It is known that the reduction of blood vessels by epinephrine that are part of the local anesthetic leads to a decrease in oxygen intake and the development of hypoxia, which has a significant effect on the excitability of nerve fibers. This is due to the fact that epinephrine is present in the local anesthetic cartridge, which helps to reduce, until termination, microcirculation in the depot area, which leads to local hypothermia. With the introduction of local anesthetics, the temperature of which is significantly lower than the depot temperature, the patient experiences severe discomfort, which is associated with unsuccessful local anesthesia. The goal of the study was the need to analyze the feasibility of using the thermography method in assessing the degree of ischemia of the soft tissues of the maxillofacial region against the background of local anesthesia with a different concentration of epinephrine in dentistry. MATERIAL AND METHODS: In the pilot study, 22 healthy volunteers aged between 29-35 years of both sexes participated. To assess the degree of external vasoconstriction, a buccal region was chosen near the maxilla. Infiltration anesthesia was used with a 4% solution of articaine with epinephrine 1: 100 000 and 1: 200 000 at a dosage of 0.5-0.7 ml. The temperature distribution in the study area was estimated using a thermal imager Nec InfReC Thermo Gear G30. RESULTS: The study showed that the use of epinephrine in local anesthetics naturally has a moderate effect on hemodynamics in areas adjacent to the anesthesia depot. When using a low concentration of epinephrine (1:200 000), the projection hyperthermia of the skin is determined. Perhaps this is due to the activation of microcirculation due to an increase in capillary blood flow in the region above the zone of action of the epinephrine. From the point of view of physiological arterial hyperemia, this mechanism carries positive properties, since leads to an increase in tissue oxygenation. When using a high concentration of epinephrine (1:100 000), the zone of hypothermia of the skin is determined, which corresponds to the phenomenon of angiospastic ischemia.

[Systemic toxicity of local anesthetics]. / Sistemnaia toksichnost' mestnykh anestetikov.

The paper presents characteristics of local anesthetics used in dentistry and maxillofacial surgery taking into account their effectiveness and toxicity. We described the main clinical symptoms of manifestation of systemic toxicity and measures for prevention of local anesthesia complications, as well as the detailed protocol of 'lipid rescue' and resuscitation at manifestation of systemic toxic reaction of local anesthetics with the mechanism of the fatty emulsion action.

[Functional cardiovascular assessment in dentists performing local anesthesia in out-patient settings]. / Otsenka funktsional'nogo sostoyaniya serdechno-sosudistoi sistemy vrachei-stomatologov pri provedenii mestnogo obezbolivaniya v ambulatornykh usloviyakh.

The article presents the results of the cardiovascular changes assessment using electrocardiography (ECG) monitoring during local anesthesia in GP dentists. Selective ECG monitoring was carried out in 60 dentists aged 25-55 years (1 group - 25-34 y.o.; 2 group - 35-44 y.o.; 3 group - 45-55 y.o.) by means of portable «Valens¼ system. The study of stress index or the index of regulatory systems tension (IT) was conducted for 6 hours in the first day half within 1 working day. IT from 50 to 150 relative units was considered normal. In the first group IT peak was observed at the time of expectation of clinically relevant anesthesia in upper and lower jaw, while in the second and third groups it was associated with pain reaction in the course of treatment despite of clinical signs of anesthesia in the maxilla (IT=20±5.3 and 231±1.4, correspondingly) and mandible (IT=213±2.7 and 223±2.6, correspondingly). In all groups greater IT correlated more with mandible anesthesia events.

[Choice of local anesthetic volume at the infiltration anesthesia on the upper jaw].

The aim of this study was to investigate the effect of volume and pressure, at which the solution of local anesthetic is injected into the tissue, on the effectiveness of infiltration anesthesia of the periosteum on the upper jaw. We used the technique of tooth pain sensitivity thresholds. According to the rate of development and the duration of the maximum analgesia effect, the optimum volume for different levels of pressure was determined. The influence of the tissue density at the injection site on the effect criteria of analgesia was demonstrated.

[Pharmacological and physiological specificities of local anesthesia in dentistry]. / Farmaco-fiziologicheskie osobennosti mestnogo obezbolivaniia v stomatologii.

Described in the paper are the specificity of local analgesia at the medical dental procedures and the effect produced by local anesthetics and vasoconstrictive agents on the induction of nervous fibers and peripheral blood circulation. The pharmacological-and-physiological mechanisms of local analgesia by a 2% artikain solution (with adrenalin, concentration 1:100,000) and by a 2% mepivakain solution (with adrenalin, concentration 1:100,000) exerted on the pain sensitivity and blood circulation in the tooth pulp are analyzed.

[Culture of Plasmodium berghei with the short life span in mouse erythrocytes: evaluation of chloroquine resistance in three strains of the malaria parasite]. / Korotkozhivushchaia kul'tura Plasmodium berghei v éritrotsitakh myshei: opredelenie ustoichivosti k khlorokhinu u trekh shtammov maliariinogo parazita.

This comparative study was made to examine chroloquine inhibition of C14-hypoxanthine incorporation (preferably nucleic acid precursor for plasmodium) in the short-living red blood cell cultures in mice infected with P. berghei strains differently sensitive to the agent 24 hours after incubation. These included 1) chloroquine-sensitive H strain; 2) LNK-65 strain having a spontaneously 2-3-fold decreased sensitivity to the agent; 3) strain LNK-65 ChR selected for high resistance to chloroquine. IC50 (chloroquine concentrations that ensure 50% inhibition of the incorporation of nucleic acid precursor into the cells of the parasite) was estimated for 3 P. berghei strains that were differently sensitive to chloroquine. These in vitro values adequately reflect the sensitivity of these strains to the agent in vivo.

[Ca++ ion transport blockers as reversants of the drug resistance of malarial parasites. 2. The effect of praziquantel on the resistance to chloroquine and compound R-70-Zh of Plasmodium berghei]. / Blokatory transporta ionov Ca++ kak reversanty lekarstvennoi ustoichivosti maliariinykh parazitov. Soobshchenie 2. Vliianie prazikvantelia na ustoichivost' k khlorokhinu i soedineniiu R-70-Zh u Plasmodium berghei.

The reversing action of anthelminthic praziquantel (P) on the effect of chloroquine (C) and compound R-70-Zh (styrylquinazoline) was revealed on a Plasmodium berghei model (white inbred mice), using a LNK65 isolate with naturally reduced sensitivity to chloroquine and its polyresistant line LNK65CHLFR with acquired resistance to chloroquine/fansidar (selected in our laboratory). P (125 mg/kg) in combination with C showed a potentiating effect not only on the LNK65 isolate, but also on the LNK65CHLFR line, while investigated separately on this line, both drugs were not effective in tested doses. Moreover, the similar effect of C on the LNK65CHLFR line was achieved in the dose that was 4 times higher than that of P/C combination. P in a standard dose on the LNK65 isolate showed a more marked activation of compound R-70-Zh that on C. The potentiating effect was manifested in combination with R-70-Zh in the dose half as high as that of C; this phenomenon was also reflected by the efficiency index (5.0 against the 4.0) accepted in our laboratory and may be associated with the higher sensitivity of the LNK65 isolate to R-70-Zh. P showed some antimalarial action which manifested itself only by morphological changes on P. berghei parasites similar to those observed under the action of some dihydropholate reductase inhibitors, such as pyrimethamine.

[Ca++ ion transport blockers as reversants of the drug resistance of malarial parasites. 1. The effect of verapamil on the resistance to chloroquine in vivo of Plasmodium berghei and in vitro of Plasmodium falciparum]. / Blokatory transporta ionov Ca++, kak reversanty lekarstvennoi ustoichivosti maliariinykh parazitov. Soobshchenie 1. Vliianie verapamila na ustoichivost' k khlorokhinu in vivo u Plasmodium berghei i in vitro u Plasmodium falciparum.

The reversing action of verapamil on the effect of chloroquine was found in in vivo experiments by using a model P. berghei resistant to chloroquine, an LNK65 isolate having a naturally lower resistance to the agent, and its polyresistant strain with the acquired resistance to chloroquine and fansidar, as well as by employing the chlorine-resistant P. falciparum isolates from the south of the Socialist Republic of Vietnam. The magnitude of this effect was related to the dose of verapamil, the frequency of administration of a combination of the agents in vivo, while that was associated to the concentration of verapamil and the level of isolate resistance to chloroquine in vitro which was the most pronounced. Taking into account the dose-dependent effect of verapamil, it can be suggested that increasing its concentration in combination with chloroquine can provide a more marked reversing action with lower chloroquine concentrations. The parameters accepted by the authors in evaluating the combined effect enable the effect of the verapamil/chloroquine concentration to be regarded as potentiation.

[The search for new antiparasitic agents. 10. The synthesis, toxicological and antimalarial properties of nitrogen-containing heterocycles with a 4-(4-alkylpiperazinyl-1) phenylamine substituent (the preparation quinoprazine)]. / Izyskanie novykh protivoparazitarnykh sredstv. 10. Sintez, toksikologicheskkie i protivomaliariinye svoistva nekotorykh azotsoderzhashchikh geterotsiklov s 4-(4-alkilpiperazinil-1)fenilaminnym zamestitelem (preparat khinoprazin).

Synthesis is described and acute toxicity and antimalaria action is studied in new derivatives of quinoline and benzo(g)quinoline containing a 4-(4-alkylpiperazinyl-1)phenylamine substitute. Only the derivatives of benzo(g)quinoline were found to have a high antimalaria effect and to have advantages over the standard agent chloroquine on their tolerance and protective action. One of the compounds, 4-[4-(4-ethylpiperazinyl-1)phenylamino] benzo(g)quinoline, named QUINOPRAZINE, showed some action against Plasmodium berghei chloroquine--resistant infection (isolate LN-K65). This agent was elected for further tests.

[The modelling of the multiple drug resistance of the malarial parasites. 1. The combined resistance of Plasmodium berghei to chloroquine and fansidar]. / Modelirovanie mnozhestvennoi lekarstvennoi ustoichivosti maliariinykh parazitov. Soobshchenie 1. Sochetannaia ustoichivost' Plasmodium berghei k khlorokhinu i fansidaru.

Using a recurrent technique, P. berghei isolate resistant to chloroquine-fansidar combination is formed in golden hamsters. The isolate resistant to chloroquine-fansidar combination was 4 times less sensitive to chloroquine, 2 times less sensitive to fansidar and its combinations, 2 times less sensitive to sulfadoxine, 31 times less sensitive to pyrimethamine, as compared to the baseline isolate LNK65 P. berghei characterized by naturally reduced sensitivity to chloroquine.