[Changes in the elemental composition of the temporal bone in patients with chronic suppurative otitis media]. / Izmenenie elementnogo sostava visochnoi kosti u patsientov s khronicheskim gnoinym srednim otitom.

TO STUDY: The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. PATIENTS AND METHODS: The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. RESULTS: A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. CONCLUSION: X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.

[Evaluation of structural changes of bone in chronic purulent otitis media]. / Klassifikatsiia strukturnykh izmenenii kostnoi tkani pri khronicheskom gnoinom srednem otite.

Fragments of bone tissue of the temporal bone, obtained during reconstructive-sanitizing operations in patients with chronic purulent otitis media, were studied by light and electron microscopy. An analysis was made of the degree of structural changes in bone tissue in chronic inflammation at the cellular and tissue levels after a histomorphological study in microwave decalcification. The method of diagnosis reliably allowed to differentiate the diseases characterized by the rarefaction of bone tissue, due to chronic inflammation, and also to determine the processes of transformation of bone tissue. The method of diagnosis reliably allows to differentiate diseases characterized by the rarefaction of bone tissue due to chronic inflammation, as well as to determine the processes of bone tissue transformation, however, the study is time-consuming, long-lasting and expensive.

[Autonomous cardioneuropathy in patients with coronary heart disease].

This paper reports the results of an electron microscopic study of the sinoatrial node in deceased patients with CHD in whom high-resolution rhythmocardiography revealed autonomous cardioneuropathy. Non-specific morphological changes in pacemaker cells of the sinoatrial node (swelling and disintegration of mitochondria, incorporation of calcium and accumulation of lipofuscin in mitochondria) can be regarded as manifestations of ischemic insufficiency of cardiac tissue perfusion. The rhythmocardiograms of such patients showed signs of autonomous cardioneuropathy manifest as the sharply decreased amplitude of all vegetative waves. The spectral power pattern was dominated by inefficient humoral-metabolic regulation due to suppression of protective parasympathetic regulation.

[Myoclonic epilepsy of Lafora: a case report].

Myoclonic epilepsy of Lafora (EPM2) is a severe autosomal recessive disorder. The onset in adolescence, generalized seizures, severe myoclonus, dementia and a rapid malignant course with death in 4-8 years after the onset are characteristic features of EPM2. The disease has a specific pathological feature, intracellular polyglucosan inclusions (Lafora bodies) in the brain, liver, skin and muscles. Two genetic forms are known, one of which (EPM2A) is caused by mutations in the laforin gene and another (EPM2B)--by mutations in the malin gene. We report a case of EPM2A in a 17-year-old girl of mixed Russian-Ukrainian ethnicity. The disease lasted for almost four years by the time of the examination but the girl still had no dementia. A previously described laforin mutation Tyr86Stop in the homozygous state was detected and Lafora bodies were found in the skin and muscles. Various anticonvulsants produced no effect or a slight and unstable effect. In the following several months, the disease progressed quickly, the girl became severely disabled and demented and died in 19 years old, 5.5 years after the disease onset. This is a first Russian case confirmed by DNA testing.