Method for predicting ophthalmoherpes
FIELD: medicine, ophthalmology.
SUBSTANCE: one should detect the content of tumor necrosis factor alpha in acute period, moreover, the above-mentioned factor should be determined in lacrimal liquid on the 11th - 15th d against the onset of herpetic ophthalmoinspection, at its content ranged 176-250 pcg/ml prediction is considered to be favorable, and from the value of 300 pcg/ml and higher - as unfavorable.
EFFECT: higher accuracy of prediction.
The invention relates to medicine, in particular to ophthalmology, and can be used in medical practice for predicting the course of ophthalmic herpes.
Methods of prediction of ophthalmic herpes based on the study of immunopathological changes in this disease involving abnormalities in the number and range of subpopulations of lymphocytes and cytokine changes the status of the patient (Webmachine, 1997; A.Biglino, 1996).
There is a method of prognosis of ophthalmic herpes (Webmachine, Tonkonogov, Anabuki. Ophthalmological journal, 1981, No. 3, p.142-143) by defining subpopulations of lymphocytes method rosethorne with sheep erythrocytes. The disadvantages of this method are its complexity, subjectivity in the evaluation of the results and the small number of simultaneously ongoing research.
About the nature of the flow and its forecast judged on functional activity of blood cells, determined by the level of their synthesis of cytokines, one of which is tumor necrosis factor α (TNF-α). This cytokine exerts pyrogenic properties, portrays the response of acute phase of inflammation and affects the induction of autoimmune reactions.
The closest in technical essence is "the Way to prevent postoperative complications of penetrating corneoscleral wounds of the eye" (Ossipova et al. In the party of ophthalmology, 1998, No. 3, pp.28-32), the authors of which is shown pathogenetic role of one of the cytokines TNF-α single determination of its contents in serum and tear fluid of patients with corneoscleral wounds.
The disadvantage of this method is that the authors predicted infectious complications of penetrating corneoscleral wounds eye on the content of tumor necrosis factor α in the serum of patients, which is an invasive method. According to this method in the determination of tumor necrosis factor α in the serum of patients prognosis complications after corneoscleral wounds is carried out at a later date (up to 1.5 years), and the frequency efficiency of the forecast is 25-75% of cases.
The technical result of the invention is increasing the frequency and reducing the time of predicting the course of ophthalmic herpes on the basis of the determination of tumor necrosis factor α in the tear fluid of patients during the acute period (11-15 day of onset) of herpetic keratitis.
The technical result is achieved by determining the content of tumor necrosis factor α in tears in the acute period of the disease, characterized in that the identification of the content of tumor necrosis factor α in the tear fluid at 11-15 days from the beginning of Zabol the cation within 176-250 PCG/ml, is assessed as favourable prognosis of the ophthalmic herpes, and when its concentration from 300 PCG/ml and more unfavorable.
The advantage of the proposed method for the prognosis of herpes of the eye is the definition of the content of TNF-α in tears in the acute period (11-15 days) ophthalmic herpes. Confirmation of the proposed method is coincident indicators concentrations of these cytokines in the tear fluid with the clinical course of ophthalmic herpes on average, more than 92% of cases.
The method is as follows.
Lacrimal fluid is picked up by the introduction of the conjunctival SAC in the amount of 1 ml.
Determination of the level provospalitelna TNF-αin the tear fluid of patients spend enzyme-linked immunosorbent method with the use of horseradish peroxidase as indicator enzyme using test systems ProCon (LLC “Protein component”, St. Petersburg).
In the microplate with immobilized antibodies contribute 100 ál of standards TNF-α and 100 μl samples of tear fluid. The tablet is incubated for 1 hour at +37°With continuous shaking, then washed three times with buffer and twice with distilled water. Conducts a full aspiration of the remaining fluid.
In each of the wells of the microplate make 100 ál conjugate with streptavidin horseradish peroxidase, diluted with buffer. The Board is incubated for 30 min at +20-25° With continuous shaking. Fluid from the cells were removed and washed three times with buffer, then twice with distilled water. The tablet is dried by tapping the surface of the lab table covered with a filter paper.
All wells contribute 100 ál of substrate solution with the dye. The microplate incubated for 10-15 minutes at room temperature protected from the direct rays of the place on the shaker. There is the development of blue color. The reaction is stopped by adding 50 μl of sulfuric acid to each well. The total time of production research 2.5-3 hours.
Analysis is carried out with the use of automatic photometer “Multiscan” at a wavelength of 450 nm, set the zero absorbance in the hole with standard 0. The results are expressed in PCG/ml Normal levels of the studied cytokines in the tear fluid in healthy individuals (control group), as a rule, does not exceed 125 PCG/ml
In 63 patients with ophthalmic herpes was studied content provospalitelna TNF-α in tears in the acute period of the disease. Tear fluid was taken by the introduction of the conjunctival SAC in the amount of 1 ml.
Determining the level of TNF-α in the tear fluid of patients was carried out by enzyme-linked immunosorbent method with the use of horseradish peroxidase as indicating the enzyme.
In the microplate with immobilized antibodies contributed 100 ál of standards TNF-α and 100 μl samples of the lacrimal fluid of patients. Tablet incubated for 1 hour at +37°With continuous shaking, then washed three times with buffer and twice with distilled water. Undergoing a complete aspiration of the remaining fluid.
In each of the wells of the microplate made of 100 ál conjugate with streptavidin horseradish peroxidase, diluted with buffer. Tablet incubated for 30 min at +20-25°With continuous shaking. Fluid from the cells was removed and washed three times with buffer, then twice with distilled water. The tablet was dried by tapping the surface of the lab table covered with a filter paper.
All wells were made in 100 µl of substrate solution with the dye. The microplate was incubated for 10-15 minutes at room temperature protected from the direct rays of the place on the shaker. Watched the development of blue color. The reaction was stopped by adding 50 μl of sulfuric acid to each well.
Analysis was performed using an automatic photometer “Multiscan” at a wavelength of 450 nm, setting the zero absorbance in the hole with standard 0. The results were expressed in PCG/ml
34 (53,9%) of 63 patients the content of TNF-α in the tear fluid at 11-15 days from N. the beginning of the disease was identified within 176-250 PCG/ml However, 31 (91.2 per cent) of them clinically, the disease was progressing favorably, and by the end of the 3rd week of the inflammatory process was docked. 3 (8,8%) patients for ophthalmic herpes was characterized as unfavorable, since within 3 weeks remained inflammatory response with gradual transition into the deeper layers of the cornea. Only towards the end of the 4th week was marked subsidence of the inflammatory process in the eye.
29 (46,1%) of 63 patients with ophthalmic herpes concentration of TNF-α in tears in the same period of the disease was 300 PCG/ml or more. Negative for herpes ophthalmopathy (more than 30 days) was observed in 27 (93.1%) are of them, 2 (6,9%) reported short (up to 14 days) favorable course.
Thus, the proposed method for prediction of ophthalmic herpes was correct in 58 out of 63 patients, which was significantly in 92% of cases.
Example 1. Patient U. the hospital treatment for herpes tree keratitis. Determination of cytokines in the tear fluid were carried out on the above-described method. In the midst of disease for 12 hours, the content of TNF-α in the tear fluid was equal 376,2 PCG/ml on the basis of which predicted an unfavorable course. Indeed, in the development of the disease, in spite of antiviral treatment, it was noted by agenie the deep layers of the cornea with involvement in the inflammatory process of the choroid. Was delivered the final clinical diagnosis: corneal ulcers (herpes), acute iridocyclitis. The patient was hospitalized for 27 days. Thus, the high content of TNF-α in tear fluid (376,2 PCG/ml) in the acute stage indicates an unfavorable prognosis, course of ophthalmic herpes.
Example 2. Patient K. Diagnosis: regional herpetic keratitis. Determination of cytokines in the tear fluid and serum were carried out according to the above-described method. On the 15th day from the onset, the concentration of Pro-inflammatory TNF-α in the lacrimal fluid - 185 PCG/ml On the basis set within the above-specified interval (176-250 PCG/ml) values of TNF-α in the tear fluid of the patient is predicted favorable for ophthalmic herpes. Subsidence of the inflammatory process, resorption of infiltration of the cornea, were noted to 19 days after onset of the disease, deep optical medium eyes were calm, which indicates the confirmation of the previously suggested a favorable prognosis of development of ophthalmic herpes.
Thus, the proposed method for prediction of ophthalmic herpes allows to evaluate the clinical course of this disease by changing the content of TNF-α in the tear fluid of patients. The prognosis of the disease is favorable when the level of TNF-αin the lacrimal fluid is STI within 176-250 PCG/ml and an unfavorable when its concentration from 300 PCG/ml and above.
The method of prediction of ophthalmic herpes by determining the content of tumor necrosis factor α in the acute period of the disease, characterized in that the tumor necrosis factor α determine in tear fluid on the 11-15 day from the beginning of herpetic ophthalmopathy, when its content within 176-250 PCG/ml, the prognosis of the disease is assessed as favourable, and from 300 PCG/ml and more unfavorable.
FIELD: medicine, ophthalmology.
SUBSTANCE: in lacrimal liquid one should detect the content of interleukin 8 (IL-8) and that of interleukin 1 beta (IL-1β) to calculate prognostic coefficient (PC) due to dividing the first value by the second one by the following formula: At PC value being below 10.0 one should predict favorable disease flow, and at PC value being above 10.0 - unfavorable flow.
EFFECT: higher accuracy of prediction.
SUBSTANCE: method involves collecting morphological and functional signs describing patient health condition and then calculating integral values describing morphological and functional patient state and its belonging to diagnosis group. Mass-to-height index, life index, torso pulling force index, hand dynamometry force index, double product index and relative working capacity are studied. The obtained values are standardized for reducing them to common form by subtracting mean value and dividing each sign values by mean square deviation. Then, cluster analysis approach is applied to calculate partial clustered membership coefficients using k-means method. The values are interpreted on the basis of their belonging to one of estimation scale types as follows. Mass-to-height index data are treated using sigmoid scale. life index, force index, and relative working capacity data are treated using direct proportionality scale and summed for calculating general clustered membership coefficient. The general clustered membership coefficient is repeatedly subjected to cluster analysis using k-means method to detect really statistically distinguished groups of testees assigned to basic, preparatory and special medical groups.
EFFECT: higher objectivity in classifying sportsmen into groups.
SUBSTANCE: method involves introducing lymphotropic dyes into lymphatic vessels and studying the stained lymphatic vessels next to it. Lymphosurine preparation is subserously administered in the amount of 1-2 ml in 5 points of space surrounding the tumor. Then the stained nodes are marked with ligatures and nodes of interest are sent for making histological express study.
EFFECT: high accuracy in detecting lymphogenous metastases.
SUBSTANCE: method involves carrying out clinical and endoscopic examination of a patient with risk factors being evaluated in points and sum of points being calculated. The sum being equal to or greater than 0, bleeding recurrence risk exists. The sum being less than 0, no bleeding recurrence risk is predicted. Sex, age, liver and pancreas disease availability or absence, hypertension availability or absence, non-steroid anti-inflammatory means and/or anticoagulants, and/or antiaggregants consumption within the last month period, disease duration, frequency of ulcer disease exacerbations, time lost from the hemorrhage beginning to the moment the patient is admitted in hospital, availability of hemorrhagic shock sings in prehospital period, pain syndrome localization characteristics, Alhover index value, general blood circulation deficiency degree, blood hemoglobin content, packed cell volume value, blood group, ulcer defect localization, ulcer defect diameter, ulcer defect depth and ulcer bottom changes nature are taken as the risk factors. Points are assigned separately in the cases of chronic gastric ulcers and chronic duodenal ulcers.
EFFECT: high risk prognosis accuracy.
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: one should determine blood activity of antithrombin III (Aat-III%), total antioxidizing plasma activity (Aaoa%), concentrations of serotonin (Cst%), T-suppressors (Ccd8+%), adrenaline (Cad%), a2-macroglobulin (Ca2mg%), malonic dialdehyde (Cmda%), T-helpers (Ccd4+%) expressed in % against control values. One should calculate coefficient of activity of syntactical programs of adaptation (CASPA) by the following formula:
Moreover, CASPA value ranged 0.8 - 1.0 characterizes light degree of climacteric syndrome, within 0.6-0.8 - average severity degree, and below 0.6 - severe degree of climacteric syndrome.
EFFECT: higher accuracy of diagnostics.
SUBSTANCE: method involves applying biological indicator as mixture composed of 0.1% aqueous solution of amino acids: leucine, glycine, proline, serine, phenylalanine, histidine, oxyproline, arginine, glutamic amino acid and aspartic amino acid, 0.5% aqueous solution of neuromediators like dopamine and histamine, 12% aqueous solution of magnesium sulfate in proportion of amino acids : neuromediators : magnesium sulfate = 4:1:5. Indicator kept on neck surface in thyroid gland projection during 3-5 min. It is dried at T=+35-40°C, studied in polarized light. Degraded polygonal chambers and relict polygonal chambers being observed, autoimmune thyroiditis is to be diagnosed. Striated aggregates of various sizes and ring-shaped fuzzy aggregates being detected, hyperplasia is considered to be the case. Transformed polygonal chambers with processes being observed, thyroid gland nodes are to be diagnosed.
EFFECT: high accuracy of diagnosis.
SUBSTANCE: method involves applying biological indicator as mixture composed of 0.1% aqueous solution of amino acids: leucine, glycine, proline, serine, phenylalanine, histidine, oxyproline, arginine, glutamic amino acid and aspartic amino acid, 0.5% aqueous solution of neuromediators like dopamine and histamine, 12% aqueous solution of magnesium sulfate in proportion of amino acids : neuromediators : magnesium sulfate = 4:1:5. Indicator kept on neck surface in thyroid gland projection during 3-5min. It is dried at T=+35-40°C, studied in polarized light with quartz compensator. Columnar, columnar-and-striated, sheaf-like crystals and discharged polygonal variegated chambers being observed, thyroid gland hyperfunction is to be diagnosed.
EFFECT: high accuracy of diagnosis.
FIELD: medicine, operative gynecology.
SUBSTANCE: at final stage of laparoscopic operation for 5-7 min one should introduce 16 U lidase in 1 ml 2%-lidocaine solution into uterine mesentery from both sides, and then, by not removing a needle - a half of single dose of antimicrobial preparation in 1 ml 2%-lidocaine solution, then in postoperational period - an antimicrobial preparation applied during laparoscopy lymphotropically under mucosa of lateral vaginal arch from both sides for 5-7 d once daily and one antimicrobial preparation - intravenously for 5-7 d, moreover, as antimicrobial preparations one should apply gentamicin, metrogyl and other preparations permitted for intravenous application. The present innovation stimulates lymphatic drainage in area of inflammation and activates interstitial humoral transport of antimicrobial preparations that, in its turn, favors complete sanitation of inflammation foci and prophylaxis of disease relapses.
EFFECT: higher efficiency of therapy.
1 cl, 1 ex
FIELD: medical engineering.
SUBSTANCE: device has bottom and cover joined in inseparable way so that no chance is available to mismatch covers belonging to different containers. The bottom and internal part of cover are lined with sponge so that the allergenic disks are kept in uniformly wetted state. Grate with holes is attached to lower sponge, the holes narrowing downward as cones so that the allergenic disks are kept in stable vertical position.
EFFECT: simplified access to disks using forceps; excluded misidentification risk.
5 cl, 6 dwg
SUBSTANCE: method involves measuring radio signals and low frequency spectra of signals emitted by oral cavity organs and tissues in maxillofacial area. Decoding and comparison of the spectra to healthy organs and tissues spectra is carried out. Then, modulated information signals in infra-low frequency bandwidth corresponding to healthy organs and tissues signals are applied. Low frequency radio signals and spectra are measured. Treatment with modulated signals in infra-low frequency bandwidth is applied directly to organ or its location zone via skin.
EFFECT: enhanced effectiveness in diagnosing and treating oral cavity organs and tissues in maxillofacial area.
5 cl, 3 tbl
SUBSTANCE: method involves determining homeostasis values and absolute number of neutrophils and lymphocytes in particular. Low neutrophil number being determined in a child during a number of years and low number of lymphocytes in the persons from the nearest child surrounding, the persons are to be examined for given psychosomatic pathology availability with following medical treatment to be applied to eliminate the detected pathology and to normalize homeostasis values and lymphocyte number among others.
EFFECT: enhanced effectiveness of prophylaxis.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl