[Otorhinolaryngological symptoms of tumors of the pharyngeal process of the parotid saliva (clinical case with literature review)]. / Otorinolaringologicheskie simptomy opukholei glotochnogo otrostka okoloushnoi slyunoi zhelezy (klinicheskii sluchai s obzorom literatury).

The parotid gland is the largest salivary gland. Tumors of the salivary gland account for 5% in the structure of oncological morbidity, and up to 80% of tumors affect the large salivary glands with tumor localization in 20% of cases in the pharyngeal process of the parotid salivary gland. The main clinical sign of a tumor of the parotid salivary gland is the presence of a slowly growing mass in the area of the gland. Often, underestimation of the clinical symptoms of salivary gland tumors is the reason for the late diagnosis of this disease and the initial manifestations of the process remain unnoticed for a long time. In order to increase the efficiency of clinical diagnostics of salivary gland tumors, the staff of the Department of Maxillofacial Surgery, Otorhinolaryngology and Topographic Anatomy with Operative Surgery of the Burdenko Voronezh State Medical University studied the clinical and anatomical parallels of changes in the ENT organs in lesions of the pharyngeal process of the parotid salivary gland. Using the previously obtained results of interdisciplinary interaction of otorhinolaryngologists and maxillofacial surgeons made it possible to increase the efficiency of diagnosis and treatment of patients with tumors of the pharyngeal process of the parotid salivary gland.

Thrombotic microangiopathy, DIC-syndrome and COVID-19: link with pregnancy prothrombotic state.

For last months, humanity has faced a formidable unknown enemy, which is presented as a new coronavirus infection. Despite the fact that the causative agents of new diseases appear at a certain frequency and that the virus SARS-CoV-2 has certain common properties with its predecessors, at the moment we are dealing with a new unknown pathogenesis of the development of severe complications in patients with risk factors. A final understanding of pathological process mechanisms is the goal of the scientific community. Summarizing research data from different countries, it became obvious that in severe cases of viral infection, we are dealing with a combination of the systemic inflammatory response syndrome, disseminated intravascular coagulation and thrombotic microangiopathy (TMA). Thrombotic microangiopathy is represented by a group of different conditions in which thrombocytopenia, hemolytic anemia, and multiple organ failure occur. The article reflects the main types of TMA, pathogenesis and principles of therapy. The main participants in the process are described in detail, including the von Willebrand factor and ADAMTS-13. Based on the knowledge available, as well as new data obtained from patients with COVID-19, we proposed possible models for the implementation of conditions such as sepsis, TMA, and DIC in patients with severe new coronavirus infection. Through a deeper understanding of pathogenesis, it will be possible to develop more effective diagnosis and therapy.

[A clinical observation of laryngeal ossifying fibromyxoid tumor]. / Nablyudenie ossifitsiruyushchei fibromiksoidnoi opukholi gortani.

A rare observation of ossifying fibromyxoid tumor of the larynx in a 23-year-old young man is presented. Surgical intervention, performed in two stages, provided a positive result. With dynamic observation of this patient for three years, continued growth and tumor recurrence were not observed. Due to the fact that ossifying fibromyxoid tumor is rare, differs in the complexity of differential diagnosis and an uncertain prognosis of the course of the disease, registration and dispensary observation of patients with this pathology is necessary.

[On the 100th anniversary of the Department of Otorhinolaryngology of Burdenko Voronezh State Medical University]. / K 100-letiyu kafedry otorinolaringologii Voronezhskogo gosudarstvennogo meditsinskogo universiteta im. N.N. Burdenko.

The article is dedicated to the 100th anniversary of the Department of Otorhinolaryngology of Burdenko Voronezh State Medical University.

[Dynamics of free-radical oxidation in suppurative otitis media]. / Dinamika svobodno-radikal'nogo okisleniia pri gnoino-vospalitel'nykh zabolevaniiakh srednego ukha.

The dynamics of indicators of free-radical oxidation in various purulent-inflammatory diseases of the middle ear in 280 patients was studied. Significant violations of the processes of free radical oxidation in the serum of blood were taken for the patients, the degree of which depends entirely on the severity and nature of the inflammation. A complex treatment with the use of antioxidant therapy in 280 patients was carried out. Positive results were obtained, confirmed by clinical and laboratory indicators. The pathogenetic significance and dependence of the course of purulent-inflammatory diseases of the middle ear on the processes of free radical oxidation was established, which was reflected in the determination of the duration of treatment of various forms of both acute and chronic otitis media.

[Treatment with anti-cancer agents results in profound changes in lncRNA expression in colon cancer cells].

Using real-time RT-PCR in combination with bioinformatics, we have shown for the first time that the treatment of HCT-116 and HT-29 colon cancer cells with two anti-cancer agents (doxycycline or 3,3'-diindolylmethane) results in profound changes in the intracellular content of several lncRNAs (by up to 100 times). Since many of these RNAs are secreted by tumors into the bloodstream, the obtained results provide a basis for developing more sensitive protocols for serological monitoring of tumor relapse and metastasis, as well as for search of new anti-cancer drugs.

[The role of a leukotriene receptor antagonist in the restoration of the nasal breathing in the patients presenting with polypous rhinosinusitis]. / Rol' blokatora leikotrienovykh retseptorov v vosstanovlenii nosovogo dykhaniia u bol'nykh polipoznym rinosinusitom.

The present study was designed to investigate the clinical. laboratory, and morphological characteristics of the nasal obstruction process. It included 87 patients presenting with polypous rhinosinusitis. The dynamics of the serum leukotriene C4 (LTC4) level in the patients and the morphological changes in their polypous tissue suggested the existence of the pronounced exudative phase of allergic inflammation and provided a basis for the use of the leukotriene receptor antagonist in the form of the sodium montelucast tablets for the treatment of nasal obstruction.

[Abnormal expression of genes that regulate retinoid metabolism and signaling in non-small-cell lung cancer].

Retinoids are signaling molecules that control a wide variety of cellular processes and possess antitumor activity. This work presents a comprehensive description of changes in the expression of 23 genes that regulate retinoid metabolism and signaling in non-small-cell lung cancer tumors compared to adjacent normal tissues obtained using RT-PCR. Even at early stages of malignant transformation, a significant decrease in ADH1B, ADH3, RDHL, and RALDH1 mRNA levels was observed in 82, 79, 73, and 64% of tumor specimens, respectively, and a considerable increase in AKR1B10 mRNA content was observed in 80% of tumors. Dramatic changes in the levels of these mRNAs can impair the synthesis of all-trans retinoic acid, a key natural regulatory retinoid. Apart from that, it was found that mRNA levels of nuclear retinoid receptor genes RXRγ, RARα, RXRα, and gene RDH11 were significantly decreased in 80, 67, 57, and 66% of tumor specimens, respectively. Thus, neoplastic transformation of lung tissue cells is accompanied with deregulated expression of key genes of retinoid metabolism and function.

[The multidisciplinary approach to diagnostics and treatment of hypervascular masses in ENTstructures].

The objective of the present work was to improve the quality of diagnostics and treatment of hypervascular masses in ENT structures based on the multidisciplinary approach. The study involved 51 patients presenting with hypervascular masses in ENT structures. All of them underwent comprehensive medical examination including fibrolaringoscopy, multispiral computed tomography, magnetic resonance tomography, ultrasound dopplerography, selective carotid angiography, and/or various combinations of these techniques. The patients were given surgical, endovascular, and combined treatments. The study has demonstrated the advantages of application of the multidisciplinary approach to combined diagnostics and treatment of hypervascular masses in ENT structures as exemplified by neck hemangioma.

[The role of regional intra-arterial chemotherapy in the combined treatment of locally advanced laryngeal cancer].

The objective of the present study was to estimate the possibilities and prospects for the use of regional intra-arterial chemotherapy in the combined treatment of locally advanced laryngeal cancer. The results of the chemoradiotherapeutic treatment of 26 patients presenting with locally advanced laryngeal cancer were analysed. The chemical agents were selectively administered intra-arterially three times from the right-hand femoral access by the standard procedure at a total focal dose (TFD) of 26 and 50 gram prior to the onset of and during of radiotherapy. The very first administration of the chemical agent resulted in the 30% decrease the tumour size. It further decreased by 70% on the average after the TFD of 50 gram was achieved. It made possible the continuation of gamma-therapy up to the total therapeutic dose. As a result, complete regression of the tumour was documented. The dynamic endoscopic control study and CT of the larynx revealed recurrent laryngeal cancer in 1 of the 26 patients (3.8%). The remaining patients did not develop metastases during the 18 month follow-up period. It is concluded that the results of the present study confirm high (96.2%) effectiveness of the method employed in this study which allows it to be recommended for the organ-preserving treatment of locally advanced laryngeal cancer.

[Expression of genes involved in retinoic acid biosynthesis in human gastric cancer].

All-trans-retinoic acid (ATRA) is the main biologically active metabolite of retinol (vitamin A) that is required for the regulation of such processes as embryogenesis, tissue differentiation, proliferation, and others. Multiple alcohol, retinol and retinaldehyde dehydrogenases (ADHs, RDHs and RALDHs) as well as aldo-keto reductases (AKRs) catalyze the biosynthesis of retinoic acid in humans. For many normal and neoplastic tissues, the key ATRA-synthesizing enzymes remain unknown. We identified ATRA-generating genes that are expressed in normal and malignant gastric tissues using the transcriptomic database analysis. Quantitative changes in the expression levels of these genes in gastric cancer were determined by semi-quantitative RT-PCR and real-time PCR. Significant decreases in the mRNA levels of genes encoding enzymes that catalyze the reversible oxidation/reduction of retinol and retinaldehyde (ADH4, ADH1B, ADH1C, RDHL, AKR1B10, AKR1B1, and RDH12), as well as the oxidation of retinaldehyde (RALDH1) were revealed in most of the tumor samples. The sharp reduction in the expression levels of genes encoding the key enzymes that convert retinol and retinaldehyde to retinoic acid could lead to a significant decrease in the content of ATRA--the transcriptional regulator of many genes, which in turn can lead to a dysregulation of cell proliferation/differentiation and initiate cancer development.

[Bulla ethmoidalis uncinata: theoretical and practical implications].

The authors describe the previously unknown morphological structure, bulla ethmoidalis uncinata, located at the medial plate of ethmoidal labyrinth that forms the upper part of the lateral wall of the nasal cavity in the region of middle nasal meatus. It was shown that the absence of semilunar hiatus in the nasal cavity may be responsible for fronto-nasal communication through the infundibular opening or the crooked fronto-nasal duct. The discovery of bulla ethmoidalis uncinata substantially extends our knowledge of the structure of human nasal cavity.

[Clinical and morphological aspects of diagnostics and treatment of exudative frontitis].

The present work is based on the examination of 37 sagittal sawcut sections through the heads of human corpses of either gender. Evacuation paths for the contents of frontal sinuses were studied experimentally in different types of fronto-nasal communication. Two variants of infundibular fronto-nasal communication are described, lateral and medial, formed by the bony septum between uncinate process and bulla ethmoidalis uncinata. It was shown that the direction of evacuation of the contents of a frontal sinusis and the possibility of their rhinoscopic identification are directly dependent on the type of the naso-frontal communication. Cannulas have been developed that optimally match the shape of the naso-frontal communication. An approach is proposed to the choice of the most adequate instrument for endonasal probing frontal sinuses.

[Comparative analysys of immunocorrective effect of ultraviolet irradiation of autoblood and plasmapheresis in patients with recurrent polypous rhinosinusitis].

The objective of the present study was to evaluate the immune status of patients with chronically recurring polypous rhinosinusitis (CRPS) for the identification of the key markers of immune disorders. Assessment of the efficiency of traditional therapy during the postoperative period demonstrated that it was very low in terms of beneficial effect on the major components of the immune system, T and B lymphocytes. Determination of the frequency of immune disorders during irradiation of autoblood with ultraviolet light and plasmapheresis in the postoperative period and evaluation of "true" effects of these treatments revealed their significant quantitative immunostimulating action. Integral evaluation (rank-sum analysis) demonstrated similar therapeutic efficiency of the two methods.

[Comparative characteristic of different methods of conservative treatment of exudative rhinosinusitis].

The objective of the present study was to evaluate effectiveness of secretolytic, secreto-stimulating therapy in 40 patients presenting with acute rhinosinusitis. It was confirmed that acute inflammation results in suppression of local protective mechanisms acting in nasal cavity mucosa. Secretolytic and anti-inflammatory activity of Sinuforte was shown to induce these mechanisms; there is correlation between this effect and clinical picture of the disease. Parallel analysis of the results of traditional treatment of sinusitis and secretolytic, secretion-stimulating therapy has demonstrated high efficiency of the latter modality in patients suffering acute rhinosinusitis.

[Potential of fibrolaryngoscopy for the improvement of diagnosis of laryngeal diseases].

The objective of the present study was to analyse results of fibrolaryngoscopic examination of pretumorous and tumorous laryngeal structures in 75 patients aged from 17 to 78 years who underwent repeated laryngeal biopsies to confirm suspected diagnosis of cancer. Vital staining of affected mucosal areas with a 1% methylene blue solution was used for the purpose. It was found that malignant tumours coloured violet as they readily absorbed the dye while its fixation by dysplastic tissue produced all shades of blue depending on the degree of dysplasia. It is concluded that the method employed in this study increases the informative value of clinical and histological diagnosis and thereby permits to avoid the use of additional diagnostic procedures.

[Improved diagnosis of the severity of chronic decompensated tonsillitis].

Results of examination and treatment of 111 patients were used to evaluate the severity of chronic decompensated tonsillitis based on the following parameters of endotoxicosis: leukocytic intoxication index, content of medium molecular-weight peptides in blood, and erythrocyte sorption capacity. These results provided additional information about the functional state of palatine tonsils and severity of tonsillogenic intoxication; moreover they made it possible to evaluate efficiency of conservative treatment and determine indications for surgical intervention. Taken together, these data may be used to avoid subjective conclusions as regards the degree of decompensation in patients with chronic tonsillitis.

[Specific features of surgical anatomy of the subhyoid region with special reference to tracheostomy].

Peculiarities of thyroid gland linear dimensions, volume, shape, and topographical features were investigated using the morphological material obtained from 426 human corpses of either gender with a view to using this information for planning and performing tracheostomy in residents of the Central Chernozem region, Russia. The study yielded new data on surgical anatomy of additional muscles of the subhyoid region, thyroid isthmus and pyramidal lobe. Rare and previously unknown variants of anatomical structure of the anterior cervical area are described that may play the role of risk factors of postoperative complications of tracheostomy. Relevant recommendations are provided for practicing otorhinolaryngologists.

[Morphological substantiation of surgical sanation of the ethmoidal labyrinth in patients with inflammatory pathology of frontal sinuses].

This study had the objective of evaluating intraoperative characteristics of sanation surgery for the correction of structural elements of ethmoid bone in 131 patients presenting with frontitis. Moreover, it included histological examination of the resected tissues. It was shown that chronic frontitis is associated not only with serious morphological changes in mucous membrane of the respective frontal sinusis and along the entire length of ethmoidal labyrinth but also with necrobiotic processes in the ethmoid bone plates, depending on the state of the ostiomeatal complex. It is supposed that these findings may account for irregular or low effect of conservative therapy of chronic frontitis and confirm the necessity of surgical sanation of ethmoidal labyrinth with due regard for the state of the ostiomeatal complex.

[Diagnostic criteria for surgical correction of exudative otitis media in children].

A total of 118 children with exudative otitis media were available for observation in this study. Pneumatization of the mastoid process was evaluated by the roentgenoplanimetric technique. A large fraction of patients (48%) with acute exudatived otitis media showed pneumatic type of pneumatization whereas sclerotic pneumatization predominated in children with chronic exudative otitis media (68%). Retractions significantly more frequently developed in ears with the sclerotic type of pneumatization of the mastoid process (91%) than in case of pneumatic pneumatization. Based on these data, the children were divided into two groups, one comprising 25 patients with acute exudative otitis, the other 35 ones with recurrent disease. It is concluded that children with the symptomocomplex characterized by low level of pneumatization of the mastoid process, conductive or mixed hearing loss with a bone-air interval of 30-50 dB, and type B tympanogram are in need of early surgical intervention.