[MALT-lymphomas in Sjogren's disease].

AIM: To develop algorithm of early diagnosis of extranodal lymphoma arising in patients with Sjorgen's disease (SD). MATERIAL AND METHODS: SD diagnosis was made in 457 patients treated in Rheumatology Institute clinic in 1999-2004, 38 (8.3%) females aged 19-82 had lymphoproliferative diseases. MALT-lymphomas were diagnosed in 15 (42.2%) patients. All the patients have undergone morphological, immunomorphological investigations of the salivary glands, postoperative material was analysed in some patients. In addition, the following investigations were made: ultrasonography of the salivary glands, lymph nodes, viscera; scintigraphy; trephine biopsy of the bone marrow; myelograms; CT of the chest, abdomena and brain; tests for monoclonal immunoglobulins in the serum and light chains in urine; biopsy of the parotid gland. Clinical, morphological and immunophenotypical characteristics of MALT-lymphomas were assessed by WHO classification. Lymphoma stages were classified according to Ann Arbor. RESULTS: Parotid glands were affected with MALT-lymphoma most frequently. Predominant were extranodal lymphomas of the parotid submandibular, minor salivary glands of the lip and lacrimal glands of stage I E-II E. Extranodal lymphoma with nodal lesion of stage IV occurred less frequently. Untreated long existing MALT-lymphomas of the parotid glands may transform into B-large cell lymphomas deteriorating SD prognosis. The presence of long-term (> 12 months) massive enlargement of parotid/submandibular salivary and lacrimal glands, massive infiltration, monoclonal immunoglobulins in blood serum and their light chains in the urine predict development of MALT-lymphoma in SD. CONCLUSION: In SD, MALT-lymphomas develop primarily in target organs--salivary and lacrimal glands. SD patients with persistent enlargement of the parotid glands need biopsy for early detection of malignant lymphoproliferation.

[Spiral computed tomography in the diagnosis of limb osteomyelitis]. / Spiral'naia komp'iuternaia tomografiia v diagnostike osteomielita konechnostei.

The results of radiation studies in 121 patients of different age (4 to 75 years) examined for limb osteomyelitis are analyzed. All the patients underwent routine X-ray study and computed tomography (CT), 26 patients had X-ray fistulography; 8, linear tomography; 10, CT fistulography; 6, scintigraphy, and 15, ultrasound study. Acute hematogenous osteomyelitis (AHO), chronic hematogenous osteomyelitis (CHO), and atypical (here Garre's sclerosing osteomyelitis and Brodie's abscess) osteomyelitis were ascertained in 10.6, 26.4, and 10.1% of cases, respectively. Posttraumatic osteomyelitis was diagnosed in almost 50% of the patients. CT defined the phase of chronic limb osteomyelitis. Spiral CT has proven to be the most effective technique for diagnosing limb osteomyelitis as compared with routine X-ray study: the accuracy of X-ray study was 81.8%, its sensitivity, 84.9%, and specificity, 60.0% and those of computed tomography were 96.7, 99.1, and 80.0%, respectively.

[Bone tissue morphological structure in congenital deformations of the jaws]. / Gistostruktura kostnoi tkani pri vrozhdennykh deformatsiiakh cheliustei.

Morphological structure of bone tissue was studied in various types of congenital deformations of the jaws. Morphological changes in the bone with deformations and the severity of these disorders depended not so much on the type on the deformation, but mainly on its severity, which can be explained by a drastic increase of functional exercise because of impaired occlusion and impossibility of proper chewing. Decelerated weak restructuring of bone tissue and imperfect osteogenesis in deformed bone, similar in various types of deformations, were demonstrated on morphological material. These changes can affect the regenerative potential of the bone in operated zones.

[Comparative assessment of 5-year survival with cancer of the buccal mucosa treated by different methods]. / Sravnitel'naia otsenka piatiletnei vyzhivaemosti bol'nykh rakom slizistoi obolochki polosti rta pri razlichykh metodakh lecheniia.

We analyzed case histories of 495 patients with oral cancer treated in the Head and Neck Tumor Clinic of the Russian Cancer Research Center RAMS from 1985 to 1998. 88 patients were included in the study out of which 50 reserved combined (radiotherapy + surgery) and 38--complex (chemotherapy + radiotherapy + surgery) treatment. On assessing the clinical results we got the following results: after combined treatment 5-year survival was 45.9 +/- 7.0%, while after the complex method--37.2 +/- 7.8%. The inclusion of chemotherapy to the treatment does not significantly influence long-term results.

[The effect of hyperbaric oxygenation on the urea content of the saliva in acute and chronic soft-tissue inflammation in the maxillofacial area]. / Vliianie giperbaricheskoi oksigenatsii na soderzhanie mocheviny v sliune pri ostrom i khronicheskom vospalenii miagkikh tkanei v cheliustno-litsevoi oblasti.

Urea levels were measured in the saliva of 30 patients with acute and chronic maxillofacial inflammation treated with multiple modalities including hyperbaric oxygenation (HBO). Urea concentrations were evaluated before, in the course of and after HBO session. A total of four 40-min sessions were made (1 session a day, 1.5 atm). Elevated concentrations of urea after HBO are thought adaptive, serving for elimination of ammonia overproduction in hyperoxia. Urea measurements in the saliva can be used for prediction of oxygen intoxication in the HBO-exposed patients.

[The psychological assessment of patients with congenital and acquired maxillofacial deformities in the pre- and postoperative periods]. / Psikhologicheskaia otsenka bol'nykh s vrozhdennymi i priobretennymi cheliustno-litsevymi deformatsiiami v do- i posleoperatsionnom periodakh.

Complex rehabilitation of 20 patients with congenital and acquired maxillofacial deformations included psychological examinations using the finish-the-sentence test, Taylor's, Eysenck's [correction of Isenk's], Leonhard-Smisek, and Dembo-Rubinstein tests. Depressive states were detected in 4, neurotic reactions with depressive incorporations in 16 examinees. After surgery the manifestations of depression decreased in 60% of patients. Psychological studies helped improve the efficacy of surgery due to a favorable impact on the personality.

[The use of tactivin in the combined treatment and prevention of complications in reconstructive operations on the bones of the facial skeleton]. / Primenenie taktivina v kompleksnom lechenii i profilaktike oslozhnenii pri rekonstruktivnykh operatsiiakh na kostiakh litsevogo skeleta.

Sixty-three patients with congenital and acquired defects and deformations of facial bones without concomitant diseases were examined. Twenty-eight of them were operated on; auto- and alloplasty was resorted to in 18 patients, and to 10 patients tactivin was administered after common protocols for immunocorrection before or after surgery. Immunologic and clinical studies showed that immunodeficiency states are the most probable causes of postoperative complications following repair surgery on the facial bones. Tactivin normalized the immunity parameters and prevented the development of postoperative complications.

[Immunological and biochemical indices during the use of hyperbaric oxygenation for treating patients with jaw deformities]. / Immunologicheskie i biokhimicheskie pokazateli pri ispol'zovanii giperbaricheskoi oksigenatsii dlia lecheniia bol'nykh s deformatsiiami cheliustei.

Analysis of changes in immunological and biochemical parameters in patients operated on for congenital deformations of the jaw bones and improperly grown fractures showed that postoperative therapy including hyperbaric oxygenation sessions was conducive to increase of immunological reactivity in patients with initially reduced immunological reactivity. No changes in urinary excretion of hydroxyproline were observed in the patients with deformations of the jaws.

[A clinico-genetic study of patients with congenital deformities of the jaw bones]. / Kliniko-geneticheskoe izuchenie bol'nykh s vrozhdennymi deformatsiiami cheliustnykh kostei.

Clinical and genetic examination of 78 patients, 43 of these women with jaw bone deformations aged 16 to 30, has revealed that inferior macrognathia combined with superior macrognathia were the most incident in jaw bone deformations. The share of familial cases was 23.9%, this proving a hereditary predisposition to such conditions. These data indicate an etiologic and pathogenetic heterogeneity of patients with deformations of the jaw bones.

[Immunological and biochemical indices during the use of hyperbaric oxygenation for treating patients with jaw deformities]. / Immunologicheskie i biokhimicheskie pokazateli pri ispol'zovanii giperbaricheskoi oksigenatsii dlia lecheniia bol'nykh s deformatsiiami cheliustei.

Analysis of changes in the immunologic and biochemical parameters in the patients operated on for congenital deformations of the maxillary bones and poorly joined fractures has shown an increase of the immunologic reactivity under the effect of hyperbaric oxygenation therapy administered after surgery to patients with initially reduced levels of these parameters. Urinary excretion of hydroxyproline was found unchanged in patients with maxillary deformations.

[The biological effectiveness of the proteins in the specialized product "Ovolact" in the nutrition of patients following reconstructive surgery on jaw bones with congenital deformities]. / Biologicheskaia éffektivnost' belkov spetsializirovannogo produkta "Ovolakt" v pitanii bol'nykh posle rekonstruktivnykh operatsii na cheliustnykh kostakh pri vrozhdennykh deformatsiiakh.

Postoperative feeding with a special-purpose foodstuff Ovolact proved superior to tube feeding in patients on after treatment following surgical correction of congenital jaw defects. This was evident from assessment of anthropometric and protein metabolism parameters. Nitrogen metabolism underwent positive changes reflecting the product value for maintenance of protein status of the above patients. Therefore, Ovolact can make more effective postoperative rehabilitation in jaw reconstruction.

[The bone tissue of the jaws in congenital and acquired deformities]. / Sostoianie kostnoi tkani cheliusti pri vrozhdennykh i priobretennykh deformatsiiakh.

Biophysical parameters of the jam bones were examined in patients with congenital and acquired deformations. Ash content, density, mineral content, and microhardness were estimated in 58 patients aged 17 to 28. The mean values of these characteristics were found to be unrelated to the individual features and the type of the changes in the bone tissue, associated with deformations of the jaws. Frequency ranging of the individual values helped obtain a more objective picture of the bone tissue status. Bone tissue density was found increased in congenital maxillary and mandibular deformations. These data evidence a lowered plasticity of the bone tissue in the patients with congenital deformations of the jaw bones.

[The psychological rehabilitation of patients following reconstructive operations in congenital deformities of the jaw bones]. / Psikhologicheskaia reabilitatsiia bol'nykh posle rekonstruktivnykh operatsii pri vrozhdennykh deformatsiiakh cheliustnykh kostei.

Various methods of psychotherapeutic correction, used in patients with congenital deformations of the jaw bones, are described. Individual and group psychotherapy before, immediately and in late periods after surgery was used. Good results were achieved, confirmed by objective psychologic tests.