Relevance of the problem. The difficulties of diagnostics of orbital diseases are well known. Especially difficult is intraspecies differentiation among the multitude of tumour, pseudotumour, inflammatory, vascular, endocrine and other diseases occurring here, manifested by the symptom complex of unilateral exophthalmos [Beradze I.N., 1978; Brovkina A.F., 1993].
Malignant intraocular neoplasms are the main cause of death of patients with diseases of the organ of vision, with 45-48% of patients dying from metastases in the first 5 years after enucleation [Alekseeva I.B., 1990, Barkhash S.A.1978, Brovkina A.F..1991, 1997; Keizer R.W.. Viclvoyc G.L.,1986],
Retinoblastoma is the most frequent malignant neoplasm in children. According to different authors, the frequency of its occurrence is 1 case per 14000 - 35000 newborns. [Bobrova N.F. and Vit V.V., 1993; Brovkina A.F., 1997; Provenzale J.M., et al., 1995; Skulski M., et al., 1997; Weber A.L., Mafee M.F, 1992; Wilms G., et al., 1989]. The frequency of patients with the most malignant intraocular tumour in adults - uveal melanoma has recently reached 7-9 people per 1 million population [Brovkina A.F., 1997; Kotslyansky E.O., 1989; Yushko N.A., Peskova L.I., Kalenich L.A., 1989; Peyster R.G., Augsburger J..I., Shields J.A., 1988; Romani A.. Baldeschi L., ct al 1998; Scott I.U., 1998].
The fundamental difference in treatment tactics, depending on the stage of development, size and topography of the tumour, as well as the seriousness of the prognosis in retinoblastomas and melanomas sharply increase the requirements for the accuracy of their differential diagnosis. At the same time, the number of diagnostic errors in ocular tumours continues to be 10-30% even when complex clinical and instrumental examination is applied in specialised ophthalmological centres [Ternovoy S.K., Panfilova G.V., Rogozhin V.A., 1979; Friedman F.E., Malyuta G.D., Kodzov M.V., 1995; Song G.X., 1991].
Widely used in ophthalmological practice traditional diagnostic methods (ophthalmoscopy, gonioscopy, diaphanoscopy, fluorescence angiography, laboratory tests) are insufficient to obtain comprehensive information about the localisation, nature of growth and prevalence of volumetric pathological formations of the eye and orbit. This circumstance and not quite satisfactory results of surgical treatment are the causes of high mortality of patients [Muratova T.T., Nigmanova N.H., Kozlovskaya G.M.. 1989, Naches A.I., 1980; Cheremisin V.M., Trufanov G.E., Kholin A.V., 1991]. Untimely or erroneous recognition of pathological processes of the orbit leads to a sharp deterioration of visual functions, up to blindness, and in some cases to the death of the patient [Yuzhakov A.M., Travkin A.G., Kiseleva O.A., 1991]. All this determines the importance of timely and accurate diagnosis of diseases of the orbit, on the one hand, and the difficulty of such diagnosis - on the other [Gabunia R.I., Kolesnikova E.K., Tumanov L.B., 1982].
The fact that the orbit is closed from direct inspection and palpation by bone walls and the eyeball, indicates the advantage of radial diagnostics in comparison with other methods of examination. In the arsenal of clinicians there is a great variety of methods of clinical-radial diagnostics of orbital pathology, however, at present the information in the literature about their resolving capabilities and significance in comparative aspect is incomplete and not fully studied. The priority of using one or another instrumental investigation, their sequence and expedient combination have not been determined yet. This makes it difficult to choose the optimal standardised approach for diagnosis and adequate treatment [Cheremisin V.M., Trufanov G.E., 1993, Weber A.L., Sabates N.R., 1996; Wenig V.M., Mafee M.F., 1998].
Thus, the study of these and other questions, contributing to the improvement of diagnostics and treatment of patients with neoplasms of the eye and ocular cavity, should be recognised as urgent urgent.
Purpose of the study. Comparative evaluation of magnetic resonance tomography capabilities and development of algorithms for complex radial diagnostics of volumetric formations of the visual organ. To solve this goal we set the following tasks.
1. To study the normal picture of the magnetic resonance image of the visual organ in comparison with other methods of visualisation.
2. To find out the possibilities of magnetic resonance tomography, ultrasound and computed tomography in detection and evaluation of intraocular neoplasms.
3. To determine the role and place of magnetic resonance tomography in differential diagnostics of volumetric pathological formations of the eye cavity in comparison with other radial methods of research.
4. To determine the indications and to develop an algorithm for the complex application of radiography, ultrasound, computer and magnetic resonance tomography for diagnostics of volumetric formations of the eye organ.
Scientific novelty.
The present work is the first to give a detailed and detailed description of the complex clinical and radiation examination, with generalisation and standardisation of magnetic resonance, computer and ultrasound semiotics of volumetric pathological formations of the eye and eye cavity. The conducted clinical and instrumental investigations allowed to determine the diagnostic value and resolving capabilities of each of the applied methods. The ultrasound, CT and MRI signs of volumetric formations of the eye organ were studied, clarified and supplemented taking into account the use of low-field magnetic field and general-purpose ultrasound apparatus. The developed standardised diagnostic algorithm of examination of patients with this pathology is new, thanks to which the pre-oppositional diagnosis of tumour and other diseases of the visual organ is improved and the total radiation load on the patient is reduced.
Conclusions
1. MPT will provide an opportunity to study the weight of the soft tissue and anatomical components of the ocular cavity, up to the optic nerve sheath and perineural liquor space, the orbital apex and chiasmal-sellar region, as well as to assess the condition of adjacent structures of the brain and facial skull. The method is limited in the evaluation of changes in the bony walls of the orbital cavity.
2. MRI is inferior in detecting characteristic signs of retinoblastoma (presence of calcification). The sensitivity of MRI was 66.6%, while for ultrasound and CT these values were 96.1 and 100%, respectively. But when the tumour spreads rstrobulbarly outside the eyeball (at 3-4 stages) the informativeness of MRI increases significantly. In uveal melanoma the sensitivity and specificity of MRI reaches 100%.
3. Both MRI and CT have a high detection rate (98.1% and 95.8% respectively) of benign orbital tumours of both primary and secondary origin. However, MRI is the preferred method of investigation. MRI is especially informative when a cranioorbital tumour and pseudotumour are suspected. The sensitivity of the method is 90.9% and 91.6%, respectively
4. In some cases ultrasound can be used to differentiate between encapsulated and diffuse neoplasms, which facilitates the diagnosis. However, when the pathological process is localised near the orbital apex, the diagnostic value of ultrasound decreases. In such cases it is advisable to use MRI.
5. In detection of primary and secondary malignant tumours of the orbital cavity both MRI and CT are quite informative (sensitivity 97,2% and 95,4% respectively), but the most comprehensive information about the state of bone walls will be provided by CT. When the process spreads intracranially, the value of MRI increases significantly, especially with the use of contrast enhancement.
6. The developed algorithm of complex clinical and radiation examination of patients with the use of ultrasound, CT and MRI is the most effective in the diagnosis of volumetric pathological formations of the eye and eye cavity, allowing to reduce to an adequate minimum the total radiation load on the patient and diagnostic period, excluding duplication of research techniques and choosing the most informative in each case, which in turn allows to develop appropriate treatment tactics and reduce the level of disability of the patient.
Subject of the inquiry: 148 patients with degenerative dystrophic diseases of the hip joint, of them 103 with osteoarthritis and 45 with avascular necrosis of the femoral head.
Aim of the inquiry: improvement of the diagnosis of degenerative-dystrophic diseases of the hip using possibilities of ultrasonography and magnetic resonance imaging.
Methods of research: X-ray, ultrasonography and magnetic resonance imaging.
The results achieved and their novelty: For the first time, the role of ultrasonog-aphy and magnetic resonance imaging in osteoarthritis and avascular necrosis of the hip was established in comparison with conventional X-ray. The result have shown that sensitivity of ultrasonography in osteoarthritis was low (57.7%) in the detection of femoral head deformation. In avascular necrosis of the hip detection of femoral head deformation was revealed better - 89.7%, which can be explained by differences in the mechanism and localization of deformation in these diseases. Ultrasonography was quite sensitive to changes of the joint capsule both in osteoarthritis and avascular necrosis, the sensitivity 86.0% and 84.6% respectively. MRI was superior to X-ray in the assessment of space orientation of the joint surfaces, necrosis zone, synovitis, subchondral cysts, structural changes and joint effusion. X-ray was more preferable for the detection of ostephytosis, subchondral sclerosis and changes of the joint space in osteoarthritis.
Practical value: of the work consisted in the concretization of sonographic and MRI signs of degenerative dystrophic diseases of the hip joint and in the suggested algorithm of using radiological methods for establishing the nature of hip joint pathology.
Degree of inculcate: the results of research were introduced in the Radiology Department of First Tashkent Medical Institute and the Department of Large Joint Pathology Department of the Traumatology and Orthopedy Research Institute.
Sphere of usage: radiology, traumatology and orthopedy, rheumatology.
Topicality and demand of the subject of dissertation. Development of science and intensification of all branches of national economy and also introduction of new technogenic processes of production have resulted in antropogenic influence of industrial activity of man on the environment and ecological equilibrium According to the data of regional evaluation of stable toxical compounds in the countries of the European Counsel the highest concentrations of Pb, Cd and Hg in the environment have been noted in the Ukraine (Pb-31,02; Cd-54, Hg-36 ton/year).Release of heavy metals to the environment for Russia equaled Pb-50%; Cd-66%; Hg-37% and in some others countries: Pb-10%,Cd-21%,Hg-58%,.Short analysis of the situation interms of these tree toxical metals has shown the level of antropogenic throwings of heavy toxical metals(HTM).The biggest part of HTM finding with throwings released to the atmosphere thrown out on soil and in waters of the country being the-surce the release and then they accumulate in neighbouring countries .
At presente time in the Republic of Uzbekistan the level of manufacture is rapidly growing and this results in the increase of the concervation of HTM compared with global scale of some natural processes. The most dangerous for the health of population are the non-essencial elements (Hg, Cd, Pb, As) . For this reason the monitoring of pollutions of objects of environment especialy HTM has acquired special importance and actuality. Qualitative and quantitative determination of ions of HTM has acquired important and necessary demands and has pulled out before analysts and ecologists the task of elaboration of express sensitive and selective methods of determination of microquantities of these elements which are dangerous toxicants, cancerogens and mutagens.
In this regard in the process protection of objects of the environment it is important and necessary to determinetion precise concentrations of HTM by different physical, chemical and physico-chemicals methods. For the practical realization of this problem at chemical analysis it is necessary to improve perfection existing methods analysis and elaborationof new modern methods ecotoxicants monitoring (espessially HTM). In the aspect of realization of theoretical prerequisites and practical confirmation of analytical determination of ecotoxicants concentrations it is necessary to elaborate some new hybrid methods with immobilization of different complexe-forming reagents on polymeric bearers and matrixes differing by high meteological and operation parameters.
Existing actual problems can be solved by introducing to the analytical practices of the methods of HTM determination of some new selective and specific organic reagents.The most perspective way of their solution is the purposeful synthesis and immobilization of new organic reagents with some definite analytical characteristics with following forecast of their properties with the aim of the optimal solving of the given tasks.
Elaboration of methods and approaches of prognosis as method of further development of sorbtion-spectroscopical method of analysis is an actual problem .In this range of theoretical and applied analytical chemistry there are considerable achivments bonding with investigations of home and forcing investigators ,but row of questions of problematical character has demanded of deep investigation and knowledges of new approaches and methods of their decision.
It is known that theory of action of OR is characterized as “system of ideas” allow ing to construct of some analytical system to find optimal by nature reagent and medium in which analytical reaction will carried out .In decision of some taskes of development of theory of OR action the fallowing stages neussarg to take into acconnl:”esplantion of observe processes and phenoments:prediction and direction works by synthesis of reagents with given properties .’’Thus the elaborated methodology and predication of properties of immobilized analytical reagents can be consider as definite seintific contribution in development of theory of action of IMOR for their using in analytical chemistry and ecology.
Purpose of research is elaboration of express, high-sensitive sorbtion-spectroscopical methods and test-systems of HTM determination with using of IMOR. Elaboration on the base of these methods some general approach to prognosis of properties and construction of specifical analytical grouos in organic reagents immobilized on different types of bearers synthesis of new organic reagents with given up properties on the base of our theretical prognosisesand introduction of them in practice of analysis of different analytical and ecological laboratories.
To achieve this goal the following tasks of research is solved: -optimization of immobilization conditions of organic reagents with preservation of their analytical properties; determination of mechanism of coloured reactious of complex-formation of immobilized organic reagents with ions of HTM;
-determination of connection between structure of OR and their analytical characteristics; prognosis of some perspective ways of their modification and directed synthesis of new specifical reagents on the base of nitronaphtols;
-analytical groups (EAG): (6-methyl-pyridil-2-azo-aminophenol; l-(5-methyl -2-pyridilfzo )-5-diethglaminophenol ;l-(4-antipyridilazo) -2-napthol sulphoacid; 1-(2-pyridilazo)-2-oxynaphtalin-6-sulphoacid sodlium; 3-hydroxy-4-nitrozo-2-naphtoic acid;2-hydroxiy -3-nitrozo naphtaldehyde and others);
-determination of influence of different factors and parameters on value of the analytical signal ;wing of elaborated methods in analysis of different by nature model binary ,triple and more complex mixtabiological objects industrial materials
-comparison of obtained results with results obtained by existing methods of determination of the investisated metals in solution.
Scientific novelty of disscrtational research consists in the following:
-Immobilization of different by nature reagents for prognosis and prediction of optimal construction of some OR based on quantum-chemical value of changing of analytical characteristics in dependence on structure of the functional and analytical-active groups has been theoretically based and practically has been realized;
-Chemico-analytical properties of OR immobilized on bearers on the base of polyacrylonitrile (PAN) and polypropylene (PP) for apriory prediction of structure of different OR and elaboration on their base an optical chemical sensors on the base PAN and PP-matrixes having some necessary analytical parameters;
Conclusion
1. Litrature date about using fiber sorbents and ion-exchanging on their base for determination of HTM cations at analysis objects of environment have been summarized. Advantages of using of fiber sorbents in comparison with their using as granule and powder have been shown. Necessarily of search of new immobilized reagents for determination metals in different objects was ground.
2. New scientific trend in analytical chemistry based on the sorbtion-spectroscopical determination of HTM in different objects of enviroment with using immobilized on fiber material organical reagents of different nature with aim of improvment of metrological parameters, exploitational and analytical parameters was developed.
3. Pysico-chemical and analytical properties of immobilized reagents on the base of reagents Arsenaza and threephenylmethan row and also synthesized on the department of organical chemistry NUUz sorbited on the fiber “Nitron” were systematically investigated. Optimal conditions of immobilization of new reagents on some polymeric bearers with preservation of theirspecifical analytical properties were determined.
4. 1R- spectroskopical investigation of immobilized reagents of fiber sorbents and their complexes with cations of HTM was carriedout. It was proved that in complex-formation of HTM ions with immobilized reagents the same functional analytical groups participated as in case of native solutions.
5. Results of investigations of interaction of reagents group Arsenazo and theephenylmethanic raw and also reagents synthesized on the derailment of inorganical and analytical chemistry of chemical faculty ofNUUz immobilized on marix on the base of PAN and PP-fibers with ions of HTM have shown that their immobilization was carried out owing to ionic changing and also formation of strong intermolecular hydrogenous bonds with bearers.
6. Using of calculating quant- chemical methods such as EMN, MNDO, RMZ and AM-1 has allowed in apriori to predict the structures of different rengents having some necessary analytical parameters (sensibility, contrastion of reactions and conditions of their carring out).
7. On the base on comparison optimal conditions of immobilization, sorbtion, degree of extraction of metals ions, coefficients of distribution, sorbtion capasity of fiber sorbents, data about sensibility of the analytical action occording to ions Cd, Hg, Cu and Fe in presence of accompanying elements, possibilities of quantitative desorption by small volumes of mineral acids and accessibility of initialcompounds it is shown an perspective of practical using of synthesized reagents and fiber sorbents. Immobilized reagents quantitativly have extracted ions of metals during 20-30 min at temperature 20-25°C in pH diapazone 3-7 (R=90-99%).
8. Coplex of methods of solidphase - spectroshopical and visually-testing determination of HTM in natural objects and samples of sewage and also new effective method of sorbtion - spectroskopical determination of Co,Cu, Cu, Ni, Fe and Hg in drinking and natural waters with using of immobilized organical reagent has been elaborated . This sorbtion - spectroskopical method has allowed to determine abovementioned metals in drinking and natural waters on the level n x 10-6 - n x 10'3 % and also to decrease the limitof their determination . Rightness of elaborated methods was proved by method “introduced - determined” at analysis of some real abjects and also by comparison with data obtained by atom -absorbtion method.
9. Elaborated methods were aprobated at analysis of real objects and were introduced in practics of laboratories by investigation of surface waters NYSMY; SES (sanepidemic station) of Tashkent region and Bekabad; department of radiopreparates of INP (Institute of nucleur physies) and others. Some obtained experimental data have been introduced in educational process at reading of lectures , carring out seminars and labaratory works with bachelors and masters by courses : “Analysis of environment objects”; “Optical methods of analysis “ ; “Physical methods of analysis “ ; “ Metrology statistics and computer in analytical chemistry” on the departments ofNUUz ; SamSU; Term.SV Tash.Pharm.1.
Maqolada bolalarni maktab taʼlimiga tayyorlashda talab qilinadigon asosiy jihatlar nimalardan iborat ekanligi haqida gap ketadi. Maktab hayoti bolalarga yangi bir dunyoni ochib beradi, bu davrida bolalarning asosiy faoliyatlari o’zgaradi, maktab taʼlimiga tayyorlash muammolari, tayyorlashning jismoniy, shaxsiy (ruhiy), aqliy, maxsus tayyorgarlik bosqichlari haqida so‘z yuritiladi
The article provides information on the importance of adhering to the rules of targeted diet and rational nutrition, which are important elements of a healthy lifestyle in the prevention and treatment of arterial hypertension, and the implementation of the DASH diet program. Dietary approach and rational nutrition, which is one of the foundations of a healthy lifestyle, is widely used as a non drug treatment in many diseases of the cardiovascular system, including arterial hypertension. In the development of arterial hypertension, an excess of the recommended amount of salt increases the sensitivity of the resistive vascular wall to pressor factors. The result is an increase in peripheral resistance as well as arteriola tone. As a result, a steady increase in the level of arterial hypertension leads to an increase in the incidence of injuries to the target organs and the occurrence of hypertensive crises.
Особенностью лечения туберкулеза является одновременное и длительное назначение нескольких противотуберкулезных препаратов с учетом лекарственной чувствительности, что в условиях высокой частоты сопутствующей патологии не редко осложняется развитием нежелательных явлений от химиотерапии. Частота нежелательных явлений от противотуберкулезных препаратов первого и второго ряда колеблется от 17% до 72,8%.
Важную роль в диагностике воспалительных заболеваний кишечника и мониторинге их активности играют биомаркеры, такие как дефензины, кателицидины, лактоферрин, остеопротергин, кальпротектин. В современных исследованиях показана их высокая чувствительность, специфичность и прогностическая ценность.
Перинатальная инфекционно-воспалительная патология (ИВП) у новорожденных является одним из актуальных проблем неонатологии, что связано с высоким уровнем заболеваемости, показателями неонатальной смертности при данной патологии. В этой связи особую значимость приобретают сведения о региональных особенностях распространенности, нозологической структуры перинатальных возбудителей инфекционно-воспалительных процессов у новорожденных
Ushbu tesizda biblioterapeyaning insonning rivojlanishiga ta‘siri, kitobning shaxsni o‘z-o‘zini aanglab yetishdagi muhim roli, insonlardagi induvidial xususiyatlarning shakllanishi haqida yoritib berilgan.
Maqolada kreativlikni o‘rganish va tushunishga bo‘lgan tizimli yondashuvlar, kreativlikning rivojlanishiga ta’sir qiluvchi omillar va tadqiqotchilarning asarlarida kreativlik tushunchalarining mohiyati ko‘rsatib o‘tilgan.