[Mast cells in the microenvironment of uveal melanoma]. / Tuchnye kletki v mikrookruzhenii uveal'noi melanomy.

OBJECTIVE: To study the morphological features of the microenvironment of a tumor nodule in the eyes with uveal melanoma, focusing on mast cells. MATERIAL AND METHODS: A total of 43 enucleated eyes with uveal melanoma (260 histological specimens) were examined. The patients' age averaged 54±2.7 years. The morphopathological types of tumors were as follows: epithelioid-cell (n=9; 20.9%), spindle-cell type AB (n=15; 34.9%), and mixed-cell (n=19; 44.2%). The tumor prominence was 4.7±1.3 mm; the base diameter was 13.5±3.3 mm. Statistical methods, such as Microsoft Excel, Statistica 10.1, Spearman's rank correlation coefficient (rs), were applied. RESULTS: Mast cells in the microenvironment of uveal melanoma were present in 18 (41.9%) of the 43 eyes. There was a significantly higher correlation between the mixed-cell type of tumor and the accumulation of mast cells (rs=0.636). The correlation coefficient (rs) of the number of mast cells with the degree of tumor pigmentation in terms of densely and weakly pigmented forms was 0.571 and 0.717, respectively. Tumor invasion through the sclera was detected in 7 (16.3%) eyes with mast cells (rs=0.395). Tumor growth in the emissarium in the presence of mast cells was determined in 8 (18.6%) cases (rs=0.469). Comparison established a correlation between the number of mast cells and the sections of tumor blood vessels (rs=0.21). Granulated cells were noted in 15 (34.9%) cases; degranulated ones were seen in 3 (7%) cases of the 43 examined eyes. with an ejection of granules around the tumor cells, which may be evidence of their interaction. Granules were ascertained to be released around the tumor cells, which may be suggestive of their interaction. CONCLUSION: The study of the mast cell population as one of the components of the tumor microenvironment can be used to elaborate novel approaches for the targeted treatment of uveal melanoma, in particular for its impact on tumor angiogenesis, by using mast cell inhibitors. Therefore, it is relevant and promising to conduct further investigation of mast cells in uveal melanoma.

[Single-stage open tympanoplasty in the form of tympanosclerosis with fixation of the stapes]. / Odnoétapnaia timpanoplastika pri otkrytoi forme timpanoskleroza s fiksatsiei stremeni.

We used several variants of one-stage tympanoplasty, including our own method, according to which, in the absence of an anvil and malleus after mobilisation of the stapes, ossiculoplasty with partial or complete ossicular prosthesis and myringoplasty simultaneously preventively created a support (neo-malleus) in the thickness of the neotympanic membrane. To assess the effectiveness of different variants of single-stage tympanoplasty, the long-term functional results were compared in terms of 6 to 12 months after the intervention with preoperative indicators. Standard methods of statistical estimation with calculation of descriptive statistics and methods of statistical hypothesis testing based on nonparametric Wilcoxon criterion for related samples were used. All the variants of one-stage tympanoplasty used in the fixation of the stapes are effective and, in general, make it possible to achieve an improvement in auditory function. In the present study, this result was achieved in 61 of 86 patients with tympanosclerosis (71% (65%; 74%) of 95% CI). The functional results of tympanoplasty according to the developed method do not differ from the results of traditional variants with the use of prostheses, but the implementation of this variant of tympanoplasty in the absence of an anvil and hammer allows for the fixation of the stapes during the reoperative stapedotomy using a prosthesis of the piston type without additional surgical stage of the formation of the neomaleus.

[Tactics of conservative treatment of chronic adenoiditis in children]. / Taktika konservativnogo lecheniia khronicheskogo adenoidita u detei.

The purpose of this study was to investigate the effectiveness of the use of natural preparations Tonsilotren and Cinnabsin (T & C therapy) in the complex treatment of chronic adenoiditis in children. In the control group, children received standard anti-inflammatory therapy. The high efficacy of the combined intake of Tonzilotren and Cinnabsin drugs (T & C therapy), the use of which led not only to the disappearance of signs of chronic adenoiditis, but also to a significant decrease in the size of the pharyngeal tonsil, which allowed to avoid surgical treatment.

[The question about the topical antibiotic therapy of acute rhinosinusitis]. / K voprosu o topicheskoi antibakterial'noi terapii ostrykh rinosinusitov.

Presented the results of the clinical study of 30 patients with moderate rhinosinusitis (13 (43.3%) men, 17 (56.7%) women, age from 18 to 68 years). Among those patients, the inflammation of one paranasal sinus was observed in 7 (23.3%) cases, polysinusitis was observed in 23 (76. 7%) cases. All patients were randomized into 2 groups of 15 people. In both groups, patients received systemic antibiotic therapy, nasal irrigation therapy, and NSAIDs. In the control group, topical decongestants were used; in the experimental group the antimicrobial drug Polydexa with phenylephrine was used as a local therapy. The purpose of the study was to evaluate the clinical efficacy of Polydexa with phenylephrine in the complex treatment of moderate acute rhinosinusitis. The evaluation criteria were statistically significant comparison of clinical and laboratory parameters of both groups. Confirmed the anti-inflammatory, antimicrobial effects of the drug, made conclusions about the significant clinical efficacy, tolerability, positive effect on mucociliary clearance and safety of nasal spray Polydexa with phenylephrine.

[Skull base defects multilayer plasty in patients with spontaneous cerebrospinal fluid leak: our experience]. / Opyt primeneniia mnogosloinykh transplantatov v plastike defektov osnovaniia cherepa u bol'nykh so spontannoi nazal'noi likvoreei.

Spontaneous cerebrospinal fluid (CSF) leak is one of the types of non-traumatic CSF leaks in which the etiologic factor is unknown. Skull base defects transnasal endoscopic plasty is the initial method of surgical repair of spontaneous cerebrospinal fluid leaks. METHODS: Forty-five patients with spontaneous CSF leaks were managed using multilayer transplant technique. The basic choice criteria of endoscopic transnasal surgical approach and materials to reconstruction of skull base defects were the size of defect and its localization. In all cases pediculated flaps in combination with free graft were used. RESULTS: In 43 (96%) cases CSF leaks was successfully managed in primary surgery, which indicates high efficiency of the described surgical interventions.

[The choice of the treatment strategy for the patients presenting with chronic tonsillitis of streptococcal etiology and subfebrility of long duration]. / Vybor lechebnoi taktiki u bol'nykh khronicheskim tonzillitom streptokokkovoi étiologii i dlitel'nym subfebrilitetom.

The objective of the present study was to develop the optimal therapeutic strategy for the management of the patients with chronic tonsillitis (CT) of streptococcal etiology accompanied by subfebrility of long duration (LDS). The clinical characteristic of the patients presenting with this condition is presented together with the results of their treatment by different methods. It is shown that bilateral tonsillectomy is the most efficient approach to the management of the patients presenting with chronic tonsillitis of streptococcal etiology and subfebrility of long duration.

[Malignant medulloepithelioma mimicking retinoblastoma - clinical and morphological case analysis and cell culture experience]. / . Zlokachestvennaya medulloepitelioma, simuliruyushchaya retinoblastomu ­ kliniko-gistologicheskii analiz sluchaya i opyt polucheniya kletochnoi kul'tury.

The paper presents clinical and morphological case analysis of primary intraocular malignant medulloepitelioma (medulloblastoma) of rare localization (central part of the retina with optic nerve involvement) that simulated retinoblastoma in a 2-year-old child. Histological features of the tumor are given in details (tubular and mesh structures of the tumor, rosettes, ribbons, cells with hyperchromic nuclei, and cellular polymorphism). An experience of creating a primary intraocular malignant medulloepitelioma cell culture, as yet exclusive in the Russian Federation, is described. Culture sensitivity for particular drugs (oxaliplatin, irinotecan, ifosfamide, and ascorbic acid at different concentrations) was evaluated by MTT-assay. Of the four products, IC50 (3.3 mg/ml) was obtained only for ascorbic acid. Despite the relative rarity of primary intraocular malignant medulloepitelioma, its differential diagnosis should be carried out, with retinoblastoma in mind in the first place. The obtained data on the effectiveness of ascorbic acid against intraocular malignant medulloepitelioma cells can be used to supplement the existing chemotherapeutic protocols in pediatric ocular and neuro-oncology.

[Viral infections and retinoblastoma in children].

In this work, the results of a comprehensive laboratory examination of 37 children with retinoblastoma were described. The presence of Igm-, IgA, - IgG- antibodies to the herpes simplex virus types 1 and 2, cytomegalovirus (СMV), epstein-Barr virus (eBV), human herpes virus (HHV) type 6, Toxoplasma gondii, mycoplasma hominis and ureaplasma urealyticum in the serum was tested using ELISA. In the polymerase chain reaction the DNA of these pathogens were detected in the blood plasma of 18 patients and tumor biopsy specimens from 10 eyes. The results showed that children with RB were predominantly infected by the herpesviruses, among which prevailed CMV. in 4 of 5 enucleated eyes the DNA of herpesvirus [CMV (2 eyes), EBV (1 eye), HHV 6 (1 eye)] and ureaplasma urealyticum (1 eye) were also present in tumor tissue. Nucleic acid of infectious microorganisms were considerably more often detected in the tumor tissue than in plasma (5 of 10, 1 of 18, respectively; p = 0.023), suggesting thereby the presence of the virus in the eye and its adverse role in the pathogenesis of the RB.

Testing patients with uveal melanoma for herpesvirus infections.

Results of comprehensive ELISA tests of blood serum for the presence of IgM-, IgA-, and IgG-antibodies to herpes simplex virus types 1 and 2, cytomegalovirus, Epstein-Barr virus, human herpesvirus 6, human herpes virus 8 type, Chlamydia trachomatis in 38 patients with uveal melanoma are presented. The polymerase chain reaction was used to detect DNA of these pathogens in tumor biopsies, vitreous body of 10 enucleated eyes, as well as in plasma IgG-antibodies to HHV 6 were revealed in 50% of patients; IgG-antibodies to HHV 8, in 5.3% of patients. Among the 16 patients with uveal melanoma at advanced stages, 6 patients had antibodies indicative of EBV reactivation (1.2-3.3). Chlamydia trachomatis genome was detected in both biopsies; in one of them, in conjunction with EBV and CMV DNA . Tissue samples from the identified infectious agents were related only to the spindle-cell histologic type AB of uveal melanoma. In plasma, genomes of pathogens were not determined. The results indicate the presence of infectious agents in patients with uveal melanoma and require further study of the pathogenetic role of infections in the pathogenesis of uveal melanoma.

[Non-Hodgkin lymphoma (a case of simultaneous ocular and orbital involvement)].

The paper presents an integrated analysis of clinical, instrumental, and morphological data on a very rare pathological condition-- simultaneous ocular and orbital involvement in a lymphoproliferative disorder.

[Intraocular schwannoma case report: clinical and pathomorphological analysis].

The paper presents a complete clinical, instrumental, histopathological, immunohistochemical, cytological, and molecular-genetic testing of intraocular schwannoma in a 13-year-old girl.

[Histological studies of carbon felt (carbotextim M) in late periods after its orbital implantation].

The authors performed histological studies of a grown carbon felt implant and its adjacent tissues in late postoperative studies. During planned operations (cavity or stump correction), pieces of a grown implant with its adjacent tissues were taken for examination from 25 patients in whom carbon had been earlier implanted during enucleation and delayed stump plastic repair. Morphological studies indicated that mature connective tissue had grown between the fibers of the implant, that a connective tissue capsule had formed around the whole implant, and that there was no inflammatory reaction in both the implant itself and its adjacent tissues. By taking into account the fact that there is a good tissue basis and vascularity, the authors present the results of additional simulation of an implant in late postoperative periods and those of additional correction of the implant's volume.

[Ultrastructure of nasal and paranasal mucosa in patients with chronic polypous rhinosinusitis]. / Ul'trastruktura slizistoi obolochki nosa i okolonosovykh pazukh u bol'nykh khronicheskim polipoznym rinosinusitom.

Electron microscopic study of operative samples of nasal and paranasal mucosa from patients with chronic polypous rhinosinusitis has discovered changes in the mucosa typical for inflammation and ultrastructural changes. Epithelial layer underwent destruction. Adequate function of the remaining ciliary cells is doubtful even in minimal changes of their ciliary apparatus. The absence of the specialized contacts between the epithelyocytes indicates dysfunction of the selective ionic permeability. There was overgrowth of the reticular fibers of the basal membrane. Plasma cells exhibited marked dilation of the cysterns of the rough endoplasmic reticulum probably because of active accumulation of immunoglobulins or their precursors.

[Current methods for assessing mucociliary transport disorders in the diagnosis of chronic rhinosinusitis]. / Sovremennye metody otsenki narushenii mukotsiliarnogo transporta v diagnostike khronicheskikh rinosinusitov.

Mucociliary transport of nasal and paranasal sinus mucosa was assessed in 30 healthy subjects and 40 patients with chronic purulent rhinosinusitis. Clinical, biophysical, mathematical, histological and electron microscopic methods were employed. Biophysical investigation comprised life-time TV microscopy of the specimens. Mucociliary transport investigation and sparing sampling of the ciliary epithelium from mucosa surface of the nose and paranasal sinuses were performed by means of a special apparatus. The computer program modelled vibration of the cilia and estimated their movements (total waving frequency, duration of the impact and raising phases, their correlation). The study discovered prominent structural and functional impairment of the mucociliary system manifesting as ciliary dyskinesia and epithelium converting into the stratified squamous one.

[Sympathetic ophthalmia 21 years after penetrating eye injury]. / Simpaticheskaia oftal'miia cherez 21 god posle pronikaiushcheí travmy glaza.

Sympathetic ophthalmia developed 21 years after penetrating wound during a relapse of posttraumatic uveitis 10 days after enucleation of the injured eye and discontinuation of dexamethasone. The diagnosis was confirmed histologically. The authors believe that enucleation and discontinuation of steroids provoked the development of inflammation in the paired eye.

[Pseudotumors of the orbit and their relationship to granulomatous inflammation]. / Psevdoopukholi orbity i ikh vzaimosviaz' s granulematoznym vospaleniem.

Postoperative material of 225 orbitotomies studied in Helmholtz Research Institute of Eye Diseases for 5 years with the pathohistological diagnosis of chronic inflammation of the orbit tissues was analysed. Granulomatous inflammation was found in 28% of cases and its detailed description in 63 cases is given. Sarcoidosis, Wegener's granulomatosis and other forms of allergic vasculitis and idiopathic forms of "mixed" granulomas are observed around foreign bodies apart from ordinary granulomas. Granulomatous inflammation as a primary manifestation in the orbit of such systemic conditions as Wegener's granulomatosis and sarcoidosis was observed in some cases.