[Changes of blood rheological properties and its correction under surgical and drug treatment in patients with phlegmons of maxillofacial area].

Blood theological properties in patients with phlegmons of maxillofacial area before treatment, immediately after surgical treatment and after surgical treatment combined with reamberin therapy were examined in the study. Negatively changed theological profile values somewhat improved after operation, mainly because of blood and serum viscosity decrease by 10-11% and blood transport capability enhancement. But significant positive macro- and microrheological changes was only received by surgical treatment combined with reamberin. Reed blood cells (RBC) incubation with reamberin proved direct microrheological effect of reamberin due to RBC deformability increase (by 10%, p < 0.05) and aggregation decrease (by 11%, p < 0.05). Positive theological changes associated with favorable clinical outcome.

[Clinics, diagnostics and treatment of parotid salivary gland adenomas].

Clinical data of 252 patients with parotid gland adenomas (PGA) were produced. Pleomorphic adenoma (PA) was found in 81.3% of PGA cases, adenolymphoma (Warthin's tumor) - in 13%, canalicular adenoma - in 2.8%, other adenomas - in 2.9% of observations. PA more often was met in women, adenolymphoma - in men. PGA diagnostics sometimes was difficult. In the minimum of additional analyses in cases of PGA it was desirable to include aspiration puncture by thin needle and sonography, but other methods (computer tomography, magnet resonance tomography) - according to restricted indications, mainly for differential diagnostics with malignant growth, determination of PGA position to peripharyngeal space and skull base. 2 cases of myoepithelioma and cystadenoma of parotid gland were described. The following operations were performed: extracapsular tumorectomy - in 13 patients, adenomectomy with limited gland resection - in 152 patients, subtotal gland resection with nervus facialis separation - in 62 patients, parotidectomy with nervus facialis preservation - in 25 patients. When treating all PGA it is advisable to determine individually the volume of surgical intervention and to keep up to the same tactics as for PA operations.

[Mucoepidermoid carcinoma of parotid and submandibular glands: diagnostics and treatment].

Data were presented about 48 patients with mucoepidermoid carcinoma (MEC) of parotid gland and 4 patients with MEC of submandibular gland. Peculiarities of MEC clinical course depending upon differentiation stage of tumor cells, its localization etc. were noted. Diagnostic value of a number of additional analyses (cytologic, ultrasonic study, X-ray and others) was appreciated. Possibility of preserving facial nerve without any detriment for treatment efficacy in a number of cases was verified. In conditions of thorough checkup and dispensary observation of the patients it was often possible to refrain from preventive interventions on neck lymphatic apparatus.

[Clinical picture, diagnosis, and therapy of adenolymphoma of the parotid gland]. / Klinika, diagnostika i lechenie adenolimfomy okoloushnoi zhelezy.

Clinical data on 33 patients with adenolymphoma (AL; Warthin's tumor) of the parotid gland are presented, including a case with development of mucoepidermoid carcinoma in the presence of AL. Specific features in the clinical course of AL are described, which depend on the tumor location, probable suppuration of the contents of the cystic cavities, etc. The diagnostic significance of some accessory methods of examination is evaluated: ultrasonic method, sialoscintigraphy, single-photon emission computer-aided tomography, cytological method, etc. High accumulation of (99m)Tc pertechnetate in AL was observed in some cases. The ratio of the glandular and lymphoid components in AL, which can vary, is clinically significant. The treatment strategy in AL is the same as in surgery for pleiomorphic adenoma of the parotid gland.

[Comparative sonographic, x-ray and morphological studies of the salivary glands in Sjögren's syndrome]. / Sravnitel'nye sonograficheskie, rentgenologicheskie i morfologicheskie issledovaniia sliunnykh zhelez pri sindrome Shegrena.

AIM: To define diagnostic value of parotid gland (PG) sonography in Sjogren's syndrome (SS) as compared to sialography and morphological changes of labial salivary glands (LSG). MATERIALS AND METHODS: Examination of 50 females with primary (20 patients) and secondary (30 patients) SS consisted of clinical, ultrasonic, x-ray and morphological investigations. RESULTS: Sonographically, PG in SS is characterized by nonhomogeneity of parenchymal picture detected in 75% of patients with primary and 50% of patients with secondary SS. Moderate and severe nonhomogeneity of PG parenchyma was seen in the stage of marked manifestations of chronic parenchymatous parotitis. CONCLUSION: Relationship between PG sonographic image in SS and morphological changes in LSG need further study. PG sonography may help in combined examination of SS patients.

[The clinico-morphological characteristics of sarcoid sialoadenitis]. / Kliniko-morfologicheskaia kharakteristika sarkoidnogo sialoadenita.

Eight patients with sarcoidosis of the parotid salivary gland and submandibular area were examined. Primary involvement of the intra- or intra- and extraglandular lymph nodes with a probable secondary involvement of the salivary gland parenchyma was detected. Clinical, x-ray, and cytological findings were nonspecific, typical rather of a tumor of chronic sialadenitis. Histological findings were decisive for the diagnosis of sarcoidosis.

[The comparative clinico-morphological characteristics of chronic parotitis in sarcoidosis and primary Sjögren's syndrome]. / Sravnitel'naia kliniko-morfologicheskaia kharakteristika khronicheskikh parotitov pri sarkoidoze i pervichnom sindrome Shegrena.

Common and differential clinical and morphological signs of chronic parotitis, parotid gland sarcoidosis and Sjögren's disease are outlined. 5 cases of sarcoidosis and 28 cases of Sjögren's disease served as illustration.

[The x-ray changes in the parotid salivary glands of patients with Sjögren's disease]. / Rentgenologicheskie izmeneniia okoloushnykh sliunnykh zhelez u bol'nykh bolezn'iu Shegrena.

The data obtained upon sialography of the parotid glands (PG) in 28 patients with Sjogren's disease (SD) were compared to clinical SD manifestations, PG regional circulation and histological picture of the labial salivary glands. 24 patients exhibited classical sialography characterized by sialoectasias, enlarged ducts, obscure outlines of the latter. 4 sialograms displayed the duct narrowing, noncontrast parenchyma outlines, unclear images of sialoectasias. Severe xerostomia, marked dryness of the vermilion border, rare enlargement of the salivary glands and parotitis recurrences occurred more frequently in patients with narrow efferent PG ducts. These changes are attributed to vascular sclerosis, devascularization, stromal sclerosis and parenchymal PG atrophy.

[The diagnostic significance of biopsy of the labial salivary glands in Sjögren's disease and chronic parenchymatous and interstitial sialoadenitis]. / Diagnosticheskoe znachenie biopsii gubnykh sliunnykh zhelez pri bolezni Shegrena, khronicheskom parenkhimatoznom i interstitsial'nom sialoadenite.

Histologic methods were used to examine biopsy specimens of minor (labial) salivary glands obtained to verify Sjogren's disease in 14 patients with this condition, 12 ones with chronic parenchymatous parotitis, and in 4 subjects with chronic interstitial parotitis. Sjogren's disease, chronic parenchymatous parotitis, and, to a lesser degree, chronic interstitial parotitis were found to be associated with development in the minor salivary glands of an immune inflammation with the predominance of features characterizing delayed-type hypersensitivity reaction presenting as mainly lymphoid macrophagal infiltration of tissue first near the ducts and then near the end portions. This or that degree of glandular lymphoid macrophagal infiltration is present during all periods of disease and it therefore cannot be considered as a process secondary in relation to extension of the secretory portion of the gland. These data may be useful in interpretation of morphologic changes in the minor salivary glands in various forms of chronic sialadenitis.

[The clinico-morphological characteristics of the regional blood circulation of the parotid glands in patients with chronic parenchymatous parotitis]. / Kliniko-morfologicheskaia kharakteristika regionarnogo krovoobrashcheniia okoloushnykh sliunnykh zhelez u bol'nykh s khronicheskim parenkhimatoznym parotitom.

Regional circulation in the parotid glands was studied in 34 patients with chronic parenchymatous parotitis (CPP) with the use of clinical (rheography and coagulography) and morphologic methods. A relationship has been revealed between regional circulation changes and the inflammation severity, CPP stage, type of concomitant diseases.

[The regional blood circulation of the parotid gland and the correction of its disorders in chronic interstitial parotitis]. / Sostoianie regionarnogo krovoobrashcheniia okoloushnoi zhelezy i korrektsiia ego narushenii pri khronicheskom interstitsial'nom parotite.

Elevated vascular tone, lengthened time of intraglandular arterial bed filling, fibrinogenemia, elevated plasma tolerance to heparin were detected in 32 patients with chronic interstitial parotitis (CIP) during exacerbation and in a number of CIP patients with the remission of the disease. Correction of microcirculation disturbances is advisable during CIP exacerbation; in remission it may be effective in patients with the late stage of parotitis, in those with parotitis coursing along with diabetes mellitus, essential hypertension, or against the background of prolonged oral drug therapy (e. g. clofelin). Drugs correcting the microcirculatory disorders are conducive to a sooner alleviation of the inflammation and better and longer preservation of the function of the parotid glands.

[The effect of drugs that correct regional blood circulation on the function of the parotid salivary glands in the combined treatment of patients with Sjögren's disease]. / Vliianie lekarstvennykh sredstv, korrigiruiushchikh regionarnoe krovoobrashchenie, na funktsional'noe sostoianie okoloushnykh sliunnykh zhelez pri kompleksnom lechenii bol'nykh bolezn'iu Shegrena.

A study was made of the effect of some drugs that correct microcirculatory disorders (dimethylsulfoxide (DMSO), heparin, novocaine) on the function of the auricular salivary glands (ASG) in combined treatment of 20 patients suffering from Sjögren's disease (SD). It has been established that the use of the indicated remedies is conducive to a more rapid counteracting of the inflammatory process in the ASG, making it possible to stabilize their function for a long time in persons with the initial and marked stages of chronic parotitis (CP) but not preventing repeated exacerbations of CP. In order to maintain the therapeutic level of the response of the vascular bed of the ASG to DMSO, it is desirable that compresses with DMSO in a "pure" form be applied in 6 hours, using a 1% hydrocortisone ointment "laying" 1 to 2 times a day.

[The microsurgical transplantation of skin-fascia autografts in maxillofacial surgery]. / Mikrokhirurgicheskaia peresadka kozhno-fastsial'nykh autotransplantatov v khirurgii cheliustno-litsevoi oblasti.

The authors analyze the results of 6 transplantations of dermofascial rear flaps from the sole and of a radial transplant from the forearm, made to replace maxillofacial defects after tumor removal and injuries. Radial artery-based grafts were found preferable, the possibility of taking a skin-and-bone transplant being among the advantages of such transplantations. The authors recommend a wide use of radial grafts from the forearm for elimination of head and neck defects, oral cavity defects included.

[The regional circulation of the parotid gland in Sjögren's disease]. / Sostoianie regionarnogo krovoobrashcheniia okoloushkoi sliunnoi zhelezy pri bolezni Shegrena.

Morphological methods, rheography and coagulography were used to study regional circulation in the parotid salivary gland (PSG) in 20 patients with the primary dry syndrome (Sjögren's disease). It has been established that in the presence of immune inflammation with the predominance of traits characteristic of delayed-type hypersensitivity, the vascular bed of the PSG undergoes transformation (changes in the tone, elasticity of vessels, blood flow rate, dystonia of resistive and atonia of capacitance microvessels, lymphostasis, and so forth). The changes in regional circulation are not infrequently coupled with a high concentration of fibrinogen and low fibrinolytic activity of the blood tending towards hypercoagulation.

[The use of a supersonic-frequency current in treating inflammatory periodontal diseases]. / Primenenie toka nadtonal'noi chastoty pri lechenii vospalitel'nykh zabolevanii parodonta.

The impact of supersonic-frequency current (SFC) on the periodontium was investigated in 76 patients with chronic catarrhal gingivitis and light to mild periodontitis. SFC was shown to promote the disappearance or reduction of the size of inflammatory focus due to normalization or improvement in periodontal microcirculation. Clinical improvement was noted in 86% of the patients with chronic catarrhal gingivitis and in 88% of light periodontitis and 96% of mild periodontitis patients.

[Blood vessels of the periodontium of incisors and molars of the lower jaw of the white rat]. / Krovenosnye sosudy periodonta reztsov i moliarov nizhnei cheliusti beloi krysy.

By means of injective and noninjective methods, the structural organization of the incisor and molar blood bed has been studied in the white rat mandible. For the periodontal blood bed, distinguishing by a pronounced organo-specificity, distribution of arterial and venous vessels between collagenous fiber bundles and a reticular arrangement of the capillaries is peculiar. A definite connection is clearly seen between angioarchitectonics of different segments of the periodontium, its structure and function. Unequal density of the capillary networks in the area of the epithelial dental organ and difference of the periodontal angioarchitectonics with the lingual and labial surfaces of the incisors are noted. The area of the epithelial dental organ, having a peculiar functional importance, is characterized by multiple pathways of blood inflow and outflow, by concentration of structural-functional adaptations which increase expansiveness, capacity and diffusive surface of metabolic microvessels, by a small critical thickness of the tissue layer between neighbouring capillaries.

[Functional anatomy of the blood vessels of the dental pulp in the white rat]. / Funktsional'naia anatomiia krovenosnykh sosudov pul'py zubov beloi krysy.

Applying a complex of modern microangiological techniques, the organization of the blood bed in the incisor and molar pulp has been studied in the white rat mandible. Production of the dental tissue components in the zones of dentinogenesis is ensured by an increased density of the capillary and venular bed of the pulp, a tight connection of the capillaries with predentin. The morphometric data obtained make it possible to prognosticate a high intracapillary pressure and the hydratation degree of the interstitial gel in the incisor pulp, which is close to maximal figures. Differences in angio-architectonics of the incisor pulp and the molar pulp depend on the peculiarities of the histostructure and functional state of the pulp, on the geometry of the dental cavity and the radicular canals. The pulp blood bed possesses a complex apparatus that ensures the blood stream regulation (duplication of the nutrition sources, arteriolar and venular area, various types of anastomoses, precapillary sphincters and others).