[A modified technique for expanding the attached keratinized gingiva zone using a free gingival graft "Danilov`s medallions"]. / Modifitsirovannaya metodika rasshireniya zony prikreplennoi keratinizirovannoi desny s pomoshch'yu svobodnogo desnevogo transplantata «medal'ony po Danilovu¼.

On a clinical example a modified technique for increasing the width of the attached keratinized gingiva zone is presented by taking medallions of a free gingival graft 1.5-2 mm thick from the hard palate using 5 mm mucotomes and transplanting them into the gum defect zones with a simultaneous vestibular deepening in the lateral regions of the jaws. This technology has been tested over a 5-year period with long-term clinical results.

[Microbiological analysis as effective tool for optimization of empirical antibiotic therapy in the urological clinic].

AIM: to study the features of microbiota in patients of urological departments and to optimize the schemes of antibiotic therapy. MATERIALS AND METHODS: Data of microbiological studies in patients of urological departments in 2017 years were analyzed. Isolation of pathogens was carried out using standard techniques. A disk diffusion test using Mueller-Hinton agar with BioRad disks was used to determine the sensitivity. The statistical analysis was performed using the WHONET 5.4 program. In addition, a comparison with the results of the PCR study was done. RESULTS: A total of 672 etiological pathogens were isolated in whole clinic in 2017 year. From those, 173 pathogens were found in the urological clinic, which accounted for 25.7% of the total number. Gram-negative bacteria predominated and its proportion was 59.23%. Gram-positive bacteria were isolated in 24.4%, and fungi were found in 16.37% of cases. The structure of pathogens isolated from stoma or obtained by catheterization was not significantly different. Most frequently isolated pathogens included @K. pneumonia (22.8%), @E. coli (21.2%), @C. albicans (17%), @P. aeruginosa (11%), @E. aerogenes (6%) and @S. aureus (3 %). @K. pneumonia usually had an unfavorable resistance pattern. E. coli isolated from urine samples had more favorable resistance pattern in comparison to pathogens obtained from stoma. The bacteria which were found in intensive care unit had the increased level of resistance. CONCLUSION: Gram-negative bacteria predominate in the urological clinic with a relatively high proportion of extended-spectrum beta-lactamase-producing organisms. Risk factors for the emergence of multi-resistant pathogens are the treatment in the intensive care unit and the presence of stomas or catheters. The PCR method, carried out in parallel with routine microbiological studies and regular analysis of the overall bacterial spectrum, allows to optimize the starting antibiotic therapy from the first day of the disease. The use of cephalosporins is not justified in the most cases. Aminoglycosides and fluoroquinolones remain effective. The use of either -Lactamase-protected penicillins or fosfomycin is possible only after obtaining the results of bacteriological study. When prescribing carbapenems, the risk of inefficiency is especially high in patients with stomas/catheters and transferred from the intensive care unit.

[Pharmacological PI 3-kinase inhibitors induce radioprotective effect in Drosophila melanogaster imago].

Phosphatidylinositol 3-kinase (PI3K) signaling cascade is involved in many cell processes that are required for radioresistance, including proliferation, survival, growth, metabolism, and death. At the whole organism level PI3K signaling cascade is involved in lifespan control. In this study the contribution of PI3-signaling cascade to radioresistance of Drosophila melanogaster imago was investigated. It is shown that pretreatment with Pl3-kinase specific inhibitor LY294002 (5, 100 micromol/l) and wortmannin (5 micromol/1) leads to increase of male and female survival after acute irradiation in dose of 30 Gy. The obtained results demonstrate that PI3K specific inhibition induces radioprotective effect on Drosophila melanogaster imago.

[Experimental study of optical characteristics of homogeneous highly-dispersive biological medium].

Specific features of the process of short laser pulse propagation through a highly-dispersive biological medium are considered. Two models are used for the theoretical description of propagation of optical radiation through a highly-dispersive medium: diffusion approximation and non-stationary axial model. Physical characteristics of the dispersive medium are determined in both models. The obtained theoretical dependences are found to be in qualitative agreement with the results of experimental study.

[Experimental determination of radiation scattering and absorption coefficients in a homogeneous layer of highly-dispersive biological medium].

A method for experimental determination of optical characteristics of a highly-dispersive medium (radiation scattering and absorption coefficients) is described. The method is based on two mathematical models of ultrashort laser pulse propagation through a highly-dispersive medium (HDM), an axial model and a diffusion model. Milk dissolved in water was used as HDM. Dependences of optical characteristics of HDM on the concentration of milk in water are obtained. The limits of applicability of the axial and diffusion models to media with different scattering and absorption characteristics are determined.

[Renin-angiotensin-aldosterone system and vasopressin in adult and aged patients with acquired mitral valve defects]. / Renin-angiotenzin-al'dosteronovaia sistema i vazopressin u bol'nykh zrelogo i pozhilogo vozrasta s priobretennym mitral'nym porokom serdtsa.

Seventy four patients aged 35-74 years who had mitral valvular disease were examined for renin, angiotensin II, aldosterone, and vasopressin, of whom 49 patients were diagnosed as having a mitral valve defect with prevalent stenosis, 25 presented with a mitral valve defect with prevalent heart failure. Circulatory disorders, Stages I-II, were found in 41 patients, Stage IIB in 23, and Stage III in 10 patients. There were no significant differences in the parameters of the renin-angiotensin-aldosterone system (RAAS) and vasopressin in untreated adult and elderly patients with mitral valvular disease at rest. As circulatory disorders progressed, the RAAS parameters significantly increased in all the groups. However, the patients with prevalent stenosis showed higher blood renin levels than did those with prevalent heart failure, irrespective of its severity. In refractory heart failure, the significant differences remained to a greater extent only for renin. The treatment with peripheral vasodilators (isosorbide dinitrate and corinfar) resulted in compensatory activation of the neurohumoral vasoconstrictive system, thereafter the RAAS parameters significantly increased after the drugs.

[Osteosynthesis in hand bone fractures in children]. / Osteosintez pri perelomakh kostei kisti u detei.

At 12 preparations of the upper extremities of still-born fetuses has been studied microcirculatory channel of long bones of a hand. Clinical confirmation of the experimental results is based on the analysis of data obtained in process of treatment of 54 children with instable fractures of phalanges and metacarpal bones. An arterial channel of long bones of a hand is formed by the branches of finger arteries and vessels of the surrounding tissues. Epiphysis, metaphysis and growth cartilage have common circulatory system. The types of phalanx epiphysiolysis determine the terms of the open reposition realization. Comparison of morphological data and clinical observations demonstrated that the optimal methods of fixation of instable fractures of long bones of a hand are as follows: diafixation by means of wires, intramedullary osteosynthesis and perosseous compressive-distractive osteosynthesis.

[Effects of digoxin on ventricular arrhythmias in patients with mitral valve defects]. / Vliianie digoksina na zheludochkovye narusheniia ritma u bol'nykh mitral'nymi porokami serdtsa.

A study was undertaken to examine 55 (27 females and 28 males) patients aged 25 to 74 years who had ventricular arrhythmias. Twenty five patients were diagnosed as having mitral valvular disease concurrent with predominant stenosis, 30 presented with prevalent mitral dysfunction. Twenty eight patients showed Stages I to IIA circulatory failure, and 27 had Stages IIB to III heart failure. All the patients displayed perpetual ciliary arrhythmia of various duration. More frequent and severe ventricular arrhythmias were recorded in mitral valvular disease patients with predominant mitral dysfunction than in those with stenoses. When the plasma digoxin concentration was less than 1.1 ng/ml in patients with a low end-diastolic volume and initial signs of circulatory failure, the agent produced an antiarrhythmic effects on ventricular arrhythmias in many cases, in mitral valvular disease patients with predominant stenosis in particular. The arrhythmogenic effect of digoxin was found in 47.6% patients with prevalent mitral dysfunction concurrent with Stages IIB-III circulatory failure. The agent may show arrhythmogenic action in mitral valvular disease patients with prevalent mitral dysfunction who had larger cardiac volumes and plasma digoxin concentrations of no more than 1.6 ng/ml in the absence of clinical signs of digitalis intoxication.

[The sympathetic-adrenal system in mitral heart defects in patients of different ages studied by the use of a specific L-DOPA test]. / Izuchenie simpatiko-adrenalovoi sistemy pri mitral'nykh porokakh serdtsa u bol'nykh raznogo vozrasta s primeneniem spetsificheskogo testa s L-DOFA.

As many as 59 patients aged 35 to 74 years suffering from mitral valvular disease (MVD) were examined for excretion of dopamine (DA), noradrenaline (NA) and adrenaline, parameters indicating the activity of the sympathoadrenal system. Administration of L-DOPA brought about a significant increase of excretion of all catecholamines in all the patients under 59 years and in those aged 60 to 74 years. In patients with stage I and IIA heart failure, DA excretion rose 50-fold in response to L-DOPA administration, in those with stage IIB and III, 17-fold (p less than 0.001). In patients suffering from MVD, no age-associated differences were revealed in the levels of catecholamines and ICM. In patients suffering from MVD with the predominance of stenosis and in those with stage I and IIA heart failure, background excretion of NA was significantly higher than in patients suffering from MVD with the predominance of heart failure (p less than 0.01). Administration of L-DOPA was followed by an appreciable increment of NA exactly in patients suffering from MVD with the predominance of stenosis (p less than 0.001). In the majority of patients with stage III heart failure refractory to multimodality treatment, the L-DOPA test revealed the smallest increment of DA; its excretion rose only 12-fold. Therefore, the progress of heart failure entails a decrease of the reserve potentialities of the sympathoadrenal system, marked by less output of its mediators.