[Use and outcomes of antioxidant therapy in ophthalmic practice]. / Vozmozhnosti i rezul'taty primeneniya antioksidantnoi terapii v oftal'mologicheskoi praktike.

Advances in medical diagnostic technologies, particularly in ophthalmology, help researchers understand histological characteristics of the human eye and study vision at the cellular level. In addition to its role in the ocular function associated with the control of movements, senses and protective responses, the nervous system plays a key role in regulation of the visual process. Neurodegenerative disorders hold a special place among systemic diseases. Presently, the development of such pathologies are associated with neuroinflammation, which has been proven to also contribute to the glaucomatous process. For this reason, achieving target intraocular pressure does not always guarantee stabilization of the degenerative process. In this context, neuroprotective agents are recommended for glaucoma management to all patients taking into consideration pathogenetic characteristics of the disease. Based on its antioxidative and neuroprotective effects, ethylmethylhydroxypyridine succinate (Mexidol) is commonly used in ophthalmic practice, specifically in the treatment of patients with glaucomatous optic neuropathy and retinal diseases. The results of studies demonstrate that Mexidol is effective in slowing down neurodegeneration and stabilizing visual functions in patients with primary open-angle glaucoma due to its antihypoxic, antioxidant and membrane-stabilizing properties, as well as its positive impact on the neuromediator balance and ocular blood flow.

Grape breeding is a key link in the development of the grapes and wine-making industry.

The article considers the legislative and regulatory acts that specify the tasks in the implementation of breeding processes. The results of the creation, variety testing, patenting and introduction of grape varieties and clones into the State Register of the Russian Federation for 2010-2020 are presented. The article analyzes the relationship between the indicators of industrial development with the production volumes of planting material, the use of domestic varieties that are included in the State Register of the Russian Federation. The characteristic of ampelographic collections - the genetic resources of grapes - is given. A comparative analysis of many years' worth of data on the assessment of the adaptive potential of domestic varieties and introduced varieties is presented. The article describes domestic varieties, from which premium wines are produced, which not only competes with European varieties, but also surpasses the organoleptic properties and biochemical parameters of grape must and wine material. The main problems hindering the wide demand for domestic varieties on the market, including a substantial amount of imported European varietal planting material, are described. The necessity of accelerating breeding processes is actualized, modern methods are identified, including those of generative and genomic selection, transgenic technologies, cellular, mutational, and clone selection, and priority areas in breeding are presented. The numerical and qualitative analyses of the composition of breeding scientists is given, the trends of increasing the number and qualitative composition of breeders, the influx of young people, the growing need for training qualified personnel are noted. The number of bachelor's, master's and post-graduate students specializing in viticulture in general and in selection in particular as well as the number of defended dissertation studies on grape breeding has been found to be insufficient. The main scientific and practical problems in the organization and implementation of breeding processes in ensuring the development of the industry are updated, including a low share of domestic varieties in the produced planting material and planting, the lack of a systemically implemented varietal and technological policy, the imperfection of the legal system for the protection of intellectual property, a low availability of instrumentation and analytical equipment for the implementation of breeding by modern methods.

[The influence of long-term retinal protective therapy on glaucoma progression according to structural and functional tests]. / Vliyanie dlitel'noi retinoprotektornoi terapii na progressirovanie glaukomy po dannym strukturno-funktsional'nykh issledovanii.

PURPOSE: To evaluate the influence of prolonged neuroprotective therapy on disease progression in patients with primary open-angle glaucoma (POAG) with compensated intraocular pressure (IOP). MATERIAL AND METHODS: The study included 147 patients with stages I-II POAG (249 eyes) who were randomized into the main (69 patients, 119 eyes) and control groups (78 patients, 130 eyes). Patients of the main group underwent retinalamin treatment course every 6 months. Patients were examined before enrolling and then every 3 months during the 24-months follow-up including optical coherence tomography (OCT; RNFL - retinal nerve fiber layer, NRR - neuroretinal rim, GCL - ganglion cell layer) and static perimetry (MD - mean deviation, PSD - pattern standard deviation). RESULTS: Visual acuity and refraction did not change in either group (p>0.05). IOP increased in the control group (p=0.033). There was no difference between the groups by the 24th month (p=0.87). No MD changes were noted in the main (p=0.45) and control groups (p=0.27). PSD changed in the main (4.84±3.21 and 6.01±2.584 dB in the beginning and the end, respectively, p=0.0004) and the control groups (3.46±2.23 and 5.86±2.26 dB, respectively; p<0.0001). The groups differed in MD and PSD initially (p=0.15; p=0.02) and became equal by the end (p=0.59; p=0.53). RNFL did not change significantly in the main group (p=0.078) and decreased from 83.5±22.47 to 76.7±20.7 µm in the control group (p=0.001); no differences between the groups were noted in the beginning (p=0.276) or in the end of the study (p=0.524). NRR increased in the main group from 222±88.94 to 231±99.3 (p=0.012), and decreased in the control group from 248±87.09 to 234±96.2 (p=0.0006); no differences were found between groups in the beginning or in the end of the study (p=0.109; p=0.909). GCL thickness did not change either in the main, or in the control group (p=0.211; p=0.16), with no difference between the group noted in the beginning or the end of the study (p=0.44; p=0.51). CONCLUSION: Regular treatment with retinalamin arrests the development of glaucomatous optic neuropathy. Longer-term research is required to study its influence on the visual function and the quality of life.

[Structural and functional changes in the retina of patients with primary open-angle glaucoma and compensated intraocular pressure while undergoing retinoprotective therapy]. / Strukturno-funktsional'nye izmeneniia setchatki u patsientov s pervichnoi otkrytougol'noi glaukomoi pri kompensirovannom vnutriglaznom davlenii na fone retinoprotektornoi terapii.

PURPOSE: To evaluate the efficacy and safety of intramuscular Retinalamin for retinoprotection in patients with open-angle glaucoma and normalized intraocular pressure (IOP). MATERIAL AND METHODS: The study included 180 patients (355 eyes) randomized into the main (n=90) and control groups (n=90). The patients of the main group received intramuscular Retinalamin injections; the course was repeated 6 months later. Patient examination was performed at 1, 3, 6, 7, 9 and 12 months. RESULTS: Vision acuity did not change in the main group after the treatment courses (p=0.3732, p=0.6862), nor in the control group (p=0.7751). IOP didn't have significant changes during the whole course of the study neither in the main group (p=0.7632), nor in the control group (p=0.3921). MD index in the main group has increased from -5.52±2.76 to -4.82±2.73 dB (measurements from 6 visits: p=0.0391, p=0.0201, p=0.0302, p=0.3708, p=0.0151, p=0.0353). Control group showed negative MD trend (from -3.51±1.84 to -4.60±2.61 dB; p=0.0012). PSD index has changed from 4.63±1.60 to 4.05±1.43 dB (p=0.0081) in the main group, and from 3.73±1.19 to 4.29±1.53 dB (p=0.0027) in the control group. Average thickness of retinal nerve fiber layer (RNFL) and the volume of neuroretinal rim were stable in both the main (p=0.8039, p=0.9005) and the control groups (p=0.7448, p=0.9620). Ganglion cell complex (GCC) thickness remained stable in the main group (p=0.0377), but has decreased in the control group (p=0.0250). P50 amplitude and latency were stable in the main group (6.54±2.61-6.53±2.64 µV, p=0.0479; 48.39±3.69-50.86±4.09 ms, p=0.0271), while in the control group P50 amplitude has decreased (p=0,0031) and the latency has increased (p=0,0194). In the main group, N95 amplitude has stabilized (p=0.0141) with worsened latency (p=0.0492). N95 amplitude in the control group has worsened (p=0.0195), while latency has stabilized (p=0.3401). CONCLUSION: Systemic use of Retinalamin has significant retinoprotective effect confirmed by the dynamics of morphological and functional parameters in patients with POAG and IOP compensation.

Personalized Clinical Diagnosis in Data Bases for Treatment Support in Phthisiology.

The decision-making is a key event in the clinical practice. The program products with clinical decision support models in electronic data-base as well as with fixed decision moments of the real clinical practice and treatment results are very actual instruments for improving phthisiological practice and may be useful in the severe cases caused by the resistant strains of Mycobacterium tuberculosis. The methodology for gathering and structuring of useful information (critical clinical signals for decisions) is described. Additional coding of clinical diagnosis characteristics was implemented for numeric reflection of the personal situations. The created methodology for systematization and coding Clinical Events allowed to improve the clinical decision models for better clinical results.

Reactive oxygen species and high-nitrogen compound in the mechanism of protection and damage in white blood cells in pulmonary tuberculosis.

The purpose: The aim of the study was to determine changes in the level of reactive oxygen species (ROS) and high-nitrogen compounds (HNC) of white blood cells of patients with various forms of pulmonary tuberculosis, and attempt to identify the pathogenic importance marked disturbances in protection mechanisms and damaged by the disease. Methods: A prospective study of 92 people, who were divided into 4 groups: I - 25 patients with newly diagnosed infiltrative tuberculosis and localization process within the same lobe of the lung, II - 42 patients with newly diagnosed pulmonary tuberculosis with a limited process (tuberculoma), III - 15 patients with fibrosis - cavernosis pulmonary tuberculosis with disease duration of less than 2 years old and group IV - healthy people - 10. Results: It has been found that chronic TB infection suppresses the phagocytes activity of leukocytes in any form of study of its development. However, in more severe forms of tuberculosis with a predominance of exudative tissue reactions (infiltrative) levels of these metabolites in the white blood cells increases and they become damaging significance. With limited forms of pulmonary tuberculosis - tuberculoma - levels of these metabolites (especially ICA) in white blood cells is reduced, which may have a protective value. Conclusion: The obtained results allow to claim that in the diagnosis and assessment of the nature of the tuberculosis process may be used definition of functional and metabolic characteristics of blood leukocytes and plasma (phagocytosis, peroxide, total lipid, BURST TEST, AFC, ICA and their derivatives), as well as the number of amino acids, taurine and arginine in plasma and leukocytes.

[On pathogenesis of primary open-angle glaucoma].

The article comprises data on the pathogenesis of primary open-angle glaucoma. Accepted theories and risk factors of glaucoma development are considered from a historical perspective as well as in the light of modern understanding of the essence of glaucomatous optic neuropathy. The impact of different independent factors on particular pathogenetic events and their interrelation is shown. Data on possible mechanisms involved in the neurogenerative process that yet lack substantiation are presented.

[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.

[Efficacy of vision correcting system "focus" for prevention and treatment of dry form of age macular degeneration].

The results of comparative study of efficacy and safety of vision correcting system "Focus" and Picamilon in patients with dry form of age macular degeneration are presented. 60 patients were enrolled into the study, follow-up was 3 months. Routine examination revealed positive impact of "Focus" on dynamics of main visual functions (visual acuity and field). In terms of impact on dynamics of main visual functions "Focus" is comparable with Picamilon, though it is better tolerated. Intake of vision correcting system "Focus" promotes visual functions improvement and prevents progressing of retinal degenerations.

Reviving an old idea: can artificial pneumothorax play a role in the modern management of tuberculosis?

OBJECTIVE: To determine the usefulness of artificial pneumothorax (AP) in the management of pulmonary tuberculosis (PTB) patients when anti-tuberculosis treatment is ineffective. DESIGN: We evaluated the outcome of therapy in 214 patients with cavitary PTB bacteriologically confirmed by culture treated during 1998-2004, 78.9% of whom had multidrug resistance. AP was applied in 109 patients (56 newly diagnosed TB and 53 retreatment cases). A control group consisted of 105 patients (respectively 55 and 50) treated without AP. The average period of AP application was 4.5 months for newly diagnosed patients and 9 months in retreatment cases. Anti-tuberculosis treatment regimens in both groups were based on drug susceptibility test results. RESULTS: Culture negativity was achieved in patients treated with AP in all new cases and in 81.1% of retreatment cases. Cavity closure occurred in 94.6% and 67.9% respectively. In the control group, culture negativity was achieved in respectively 70.9% and 40.0%, and cavity closure occurred in respectively 56.3% and 24.0%. CONCLUSION: AP considerably improved the treatment outcome in both newly diagnosed and retreatment patients. This procedure can be considered a useful addition in managing certain patients with cavitary TB, particularly those with drug resistance.

[Artificial pneumothorax in the treatment of destructive pulmonary tuberculosis complicated by its drug-resistant pathogen].

A hundred and nine patients with complicated destructive pulmonary tuberculosis who had received chemotherapy with reserve drugs, artificial pneumothorax (AP), pneumoperitoneum (PN), physiotherapy, and resection surgery were followed up. The application of video thoracoscopy made it possible to eliminate any types of pleural adhesions. Individualization of therapeutic measures considerably increases the efficiency of treatment. AP is the method of choice in therapy of newly detected patients who have undergone ineffective routine treatment regimens.

[Photodynamic therapy in the treatment of diseases of the anterior and posterior eye segments]. / Primenenie fotodinamicheskoi terapii v lechenii zabolevanii perednego i zadnego otrezka glaza.

The article deals with the use of photodynamic therapy with regard for the modern choice of photosensitizing preparations and with regard for new-generation lasers, which reveal, to a full extent, the possibilities of the above treatment method. Examples of using the photodynamic therapy in the treatment of some oncology pathologies of various localizations, including the ocular pathologies, are depicted in the article. The use of photodynamic therapy at retinal diseases, caused by the onset of new-vascular membranes due to the age-related degeneration of the macular, is under discussion. The application of photodynamic therapy in the treatment of cystic filtration cushions, involving the technique offered by the authors, is described.

[Treatment of inflammatory conditions of the iris and ciliary body, accompanying fibrin exudation]. / Lechenie vospalitel'nykh sostoianii raduzhki i tsiliarnogo tela, soprovozhdaiushchikhsia fibrinoidnoi ékssudatsiei.

The paper presents a description of a new method for treatment of iris and ciliary body inflammation accompanied with fibrin exudation. We used low-level blue laser destroying a fibrin clot in its initial stage of formation. We also used herapin and ascorbic acid. In the absence of the greatest impact urokinase was additionally administered.

[Effects of trans-scleral laser cyclo-coagulation on intraocular pressure and visual function in patients with far advanced open-angle glaucoma]. / Vliianie transskleral'noi lazernoi tsiklokoaguliatsii na vnutriglaznoe davlenie i zritel'nye funktsii u bol'nykh otkrytougol'noi dalekozashedshei glaukomoi.

Transscleral diode laser cyclocoagulation was modified so that laser coagulants (20-25 applications) were applied not only to the ciliary crown, but to the flat part of the ciliary body as well. Inflammation modulators forming after coagulation thus enter aqueous humor and the vitreous body and penetrate into the retina and optic disc, causing dilatation of capillaries and stimulating the blood stream in them. Forty patients (40 eyes) with far advanced glaucoma and pronounced concentrical narrowing of the visual field were operated on and observed for 6-12 months postoperation. One month after the intervention intraocular pressure decreased by 9-21 mm Hg and was below 22 mm Hg in 38 eyes; visual acuity increased by 0.1-0.3 in 11 cases; visual field widened in all patients. These results did not appreciably change till the end of the period of observation.

[Therapy of primary open-angle glaucoma by oftan-dipivefrin]. / Preparat "Oftan-dipivefrin" v lechenii pervichnoi otkrytougol'noi glaukomy.

Choice of optimal hypotensive therapy with the minimal side effects remains a serious problem in therapy of glaucoma. The efficacy and safety of oftan-dipivefrin (Sante, Finland) and glaucon (Alcon, USA) are compared in a controlled balanced randomized open parallel study preceded by a period for discharge of the previous drugs. The period of discharge was 7 days, active treatment was administered for 8 weeks. Sixty patients aged 61-69 years were treated. Thirty-one patients were treated by oftan-dipivefrin (group 1) and 29 by glaucon (group 2). In parallel with this, a 1% pilocarpin solution was administered in both groups. The examinations carried out during all consultations included measurements of intraocular pressure before instillations every day at the same time, evaluation of visual acuity, tonography, and study of the central and peripheral visual fields. The time course of hypotensive effects of both drugs showed a sufficient decrease in intraocular pressure in both groups; the effect of oftan-dipivefrin was more pronounced, while glaucon caused the least number of side effects.

[The separate and combined use of timoptic depot]. / Izuchenie razdel'nogo i kombinirovannogo primeneniia timoptika-depo.

Study of the efficacy of a new long-acting drug timoptic depot (timolol maleate) in 15 patients demonstrated its manifest hypotensive effect. Its administration once a day regulates the level of ophthalmic tone. If additional therapy was needed during treatment with timoptic depot, the best results (more pronounced effect on ophthalmic tone and best tolerance) were observed with combinations of the drug with trusopt or glaucone. Like other nonselective beta-blockers, timoptic depot may cause intraventricular conductivity of the myocardium and sinusoidal bradycardia.

[Histochrome, a new antioxidant, in the treatment of ocular diseases]. / Novyi bioantioksidant "Gistokhrom" v klinike glaznykh boleznei.

The efficacy of a new bioantioxidant histochrome is studied in 92 patients (98 eyes). The drug was injected subconjunctivally or parabulbarly in a dose of 0.5 ml 0.02% solution daily, 7-10 injections per course. The clinical effect of histochrome is determined by the localization, duration, and extent of the process. The drug was the most effective in the treatment of intraocular hemorrhages which occurred no more than 7 days before. Electroretinography demonstrated pronounced retinoprotective properties of the drug which improved the electrophysiological parameters in degenerative processes in the retina and optic nerve. Hence, histochrome is characterized by hemoresorption, retinoprotective, and antioxidant properties and is recommended for the treatment of ocular diseases involving metabolic disorders in the retina, vascular membrane, and cornea.

[New stimulants of corneal reparative regeneration]. / Novye stimuliatory reparativnoi regeneratsii rogovitsy.

The efficacy of corneregel, a drug containing pantothenic acid, a component of coenzyme A, in healing of corneal wounds has been evaluated. The study was carried out on 19 rabbits (38 eyes) with standard corneal defect made with a 5-mm trephine for lamellar transplantation of the cornea, divided into 2 groups: 1) instillations of corneregel (10 eyes) and 0.25% levomycetin solution (10 eyes) and 2) 20% solcoseryl gel (9 eyes) and 0.25% levomycetin (9 eyes). Time course of changes were evaluated by biomicroscopy (fluorescent test), histologically (hematoxylin-eosin staining), and immunohistochemically after 1, 2, 4, 7, 30, and 90 days. Proliferative activity was studied by expression of the proliferating cell nuclear antigen and the migration capacity of cells by expression of alpha-smooth muscle actin. The terms of epithelialization were as follows: corneregel 10 +/- 7 h, 20% solcoseryl gel 108 +/- 10 h, levomycetin 124 +/- 6.93 h. Earlier epithelialization in the corneregel group was apparently due to increased expression of alpha-smooth muscle actin and increase in the cell migration capacity. Hence, corneregel is recommended for practical use as a stimulant of reparative regeneration of the cornea.