[Anesthesia for dental care management in children with dystrophic epidermolysis bullosa]. / Anesteziologicheskoe obespechenie stomatologicheskikh vmeshatel'stv u detei s distroficheskim bulleznym epidermolizom.

THE AIM OF THE STUDY: Was to summarize our experience in dental treatment of children with dystrophic epidermolysis bullosa (DEB) under deep intravenous sedation. MATERIAL AND METHODS: The study comprised 11 DEB patients aged 2-17 years who received full oral rehabilitation under deep sedation in Hospital Pediatric Dentistry department of the Central Research Institute of Dentistry and Maxillofacial Surgery in 2021-2022. Intravenous induction was used if a child already had venous access installed or it was feasible before sedation. If not the case inhalation induction with sevoflurane was performed for vein catheterization. Sedation was sustained by propofol infusion up to aimed concentration. Both dental treatment and extractions were carried out. RESULTS: In 11 children 37 teeth were treated and 14 extracted. Mean duration of the procedure under deep sedation was 53 min (30-190 min). In two children multiple dental extractions resulted in extensive oral mucosa injury with bullae and erosions formation in vermillion, cheeks, and hard palate areas. No skin injuries, airway obstruction or long-term complications of both anesthesiologic an dental procedure were observed. The paper describes main preventive measures minimizing risks of skin and mucosa adverse events. CONCLUSION: Intravenous sedation with spontaneous respiration allows full oral rehabilitation in DEB children with minimal risks of skin and mucosal injury associated with intubation techniques when performing described preventive measures. Use of cofferdam is crucial for success and safety of the procedure as it prevents water, dust and dental fragments contamination of oropharynx which is especially important in case of sedation with spontaneous respiration.

[Nonenzymatic covalent modification of human hemoglobin by pyridoxal-5-phosphate under the effect of visible light]. / Neénzimaticheskaia kovalentnaia modifikatsiia gemoblobina cheloveka piridoksal'-5-fosfatom pod deistviem vidimogo sveta.

Under the action of visible light, PLP with apo-, oxy- and deoxy-Hb at 4-20 degrees C and neutral pH produced adducts stable to dialysis and Sephadex gel filtration. The stable adduct formation enhanced with an increase in radiation intensity and/or irradiation time. Under light, production of stable adducts occurred most effectively for apo-Hb and was significantly slowed down in the case of met-Hb as well as in the presence of an electron acceptor, methylene blue. PLP-Hb adducts possessed intense fluorescence coinciding in properties with the fluorescence of stable PLP adducts obtained after Schiff base reduction by NaBH4. Stable adduct formation is assumed to proceed owing to Schiff base aldimin link reduction by photoejected electrons. During isoelectrofocusing of hemoglobins which had formed stable adducts with PLP under light or after NaBH4 treatment of solutions, essentially the same pictures were observed as to the number of new bands and their position in the isoelectroforegram, with the band intensity being different. This is related to the distinctions in the electron seeking properties of the Schiff bases produced by PLP with alpha-NH2 groups of Val-1 and epsilon-NH2 groups of lysine residues of the protein alpha- and beta-chains.