VARIANT ANATOMY OF THE MAXILLARY SINUS BASED ON MULTISPIRAL COMPUTED TOMOGRAPHY DATA.

The structural features of the paranasal sinuses play a key role in the development of pathological processes within them. The aim of our study was to examine the variations in the anatomical structure of the maxillary sinus based on Multispiral Computed Tomography (MSCT) data. MATERIAL AND METHODS: The study involved 400 individuals aged 18 to 44 years, both male and female. During the study, attention was given to the following topographical and structural indicators: linear dimensions of the maxillary sinus2. The position relative to the nasal cavity, which is also important for reconstructive surgeries and cosmetic procedures. For planning surgical interventions in plastic surgery, the location and prevalence in height of the sinuses were also parameters studied in this work; pneumatization features, which deserve special attention from both researchers and practicing physicians; the average volume, wall thickness, and density, measured as key structural indicators of the sinus. Additionally, these data can indirectly indicate potential risks of complications; the study also determined the dependence of the calculated indicators on gender and age. RESULTS AND DISCUSSION: The maximum average sinus volume was found in men aged 60-74 years and women aged 18-44 years. This measure was 19.05±2.33 x10⁻6m³ and 19.3±2.9 x10⁻6m³, respectively. The minimum average volume was observed in men aged 45-59 years, where it was 13.02±2.3 x10⁻6m³. In the corresponding age group of women, the minimum average volume was slightly higher, at 11.9±2.1 x10⁻6m³. In other groups studied, the average volume values were intermediate between the maximum and minimum values. CONCLUSIONS: The results of this study provide insights into the variations in the structure of the human maxillary sinus based on MSCT data. The average sinus volume indicators were calculated, with a maximum of 19.05±2.33 x10⁻6m³ and a minimum of 11.9±2.1 x10⁻6m³. Additionally, the study identified features of the topographical location of the maxillary sinuses in relation to the external nose.

PECULIARITIES OF THE ORGANS OF THE REPRODUCTIVE SYSTEM OF WOMEN OF REPRODUCTIVE AGE WITH LIVER DYSFUNCTION UNDER THE INFLUENCE OF EXOGENOUS POLLUTANTS.

The widespread use of chemicals by modern society and the prevalence of harmful habits (alcoholism, tobacco smoking, drug addiction) leads to an unnaturally high intake of exogenous pollutants in the human body, which can cause damage to internal organs, including the reproductive system. The aim of this study was to determine the peculiarities of the reproductive system of women of reproductive age with liver dysfunction under the influence of exogenous pollutants, namely, due to harmful working conditions and tobacco smoking. Estimation of activity of liver enzymes was determined by the level of activity of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamate transaminase. The first group (control group) included women with no changes in liver enzyme activity and no history of harmful working conditions or bad habits. The second group (comparison group) - women with no history of harmful working conditions and bad habits, but with laboratory data showing changes in liver enzyme activity. The third group included women who have been working with harmful substances for more than 10 years. The fourth group included women who have smoked for more than 10 years. Changes in objective indicators of women's reproductive system have been studied (vaginal discharge, elasticity of the vaginal wall, epithelial integrity, mucous membranes moistness, pH of the vaginal contents, cytological type, vaginal contents) for all groups. Gynecologic examination and evaluation revealed changes indicating the presence of candidiasis and bacterial vaginosis (caused by anaerobic microbiota) in women who worked in harmful working conditions and smoked, both with and without signs of inflammation. During the objective examination, changes in vaginal discharge were observed in women. Only in 20% of women with smoking habits and 10% of women with harmful working conditions there was no vaginal discharge, while in the control group, such women were the majority. In the group with signs of impaired liver function, the absence of discharge was observed in 30% of women. According to the results of cytological studies, a quarter of women who smoked and one in five women who worked in hazardous conditions had estrogen deficiency, apparently as a result of dysregulation disorders under the influence of pollutants. The inflammatory or cytolytic type of smear, which is a consequence of restructuring, was observed in most women from the smoking group. Also, in the two study groups, there was an increase in the number of cases of fungal or Gardnerella vaginal lesions. Disorders of the genital organs in women under the influence of exogenous pollutants are associated with hepatic and endocrine disorders. Obviously, the mechanisms of formation of the pathological condition cause these disorders, and since women working in harmful conditions and smoking have more developed gynecological manifestations, they have more developed symptoms. Inflammatory changes have been revealed in the cervix for up to 30% of women with the influence of xenobiotics. The relationship between the activity of liver enzymes and epithelial integrity has been revealed as the most significant correlation in study parameters (r=0.71 for alanine aminotransferase and epithelial integrity).

THE INFLUENCE OF IMMUNODEFICIENCY ON THE LEVEL OF CD34-POSITIVE CELLS IN THE CERVIX.

There are many studies on changes in cervix, however, there are no data about property of cervical tissue to keep potential for regeneration under influence of immunodeficiency, which is very important since it allows escaping severe irreversible changes in tissue. CD34 stem cells are one of significant indicator for property of tissual regeneration. So, the purpose of our study was to identify amount of CD34 stem cells in the cervix under influence of immunodeficiency of infectious and non-infectious origin. Sectional material of reproductive women was studied. All subjects were divided into 3 groups: women who were diagnosed with HIV infection; women who have identified anamnestic and postmortem signs of alcohol abuse; group of comparison. After routine testing and immunohistochemical (IHC) staining to CD34, morphometric measure was performed. We evaluate presence activities of stromal cells for detection of connection and relationship between expression of CD34 and the thickness of the cervical epithelium, relative volumes of condyloma, cervical dysplasia severity, degree of infiltration of the mucosal lamina propria by immunocompetent cells. The obtained digital data were statistically processed. Morphological investigation revealed changes of thickness of the cervical stratified squamous nonkeratinized epithelium up to 714.23±59.21 x 10-6 m in group of HIVinfected women. Relative volumes of condylomas were 44 increased in both investigated groups with presence of pointed, flat and inverted types. Both low- and high-grade squamous intraepithelial lesions were detected more often in investigated goups. Assessment of the degree of infiltration of the mucosal lamina propria by immunocompetent cells was changed unevenly with reducing in HIV-group and increasing in alcohol group. Results of ICH reaction CD34 realized in cytoplasmic staining with membranous accentuation in all cases of control group with strong, but reduced level in investigated groups. Most close connection was observed for cervical dysplasia severity and CD34 expression. HIV infection and alcohol abuse have pronounced pathological effects with cervical changes. The expression of CD34 is present in 96% of women with immunodeficiency mainly with strong reaction. It is statistically likely that it does not depend on such morphological indicators as thickness of the cervical epithelium, relative volumes of condyloma, degree of infiltration of the mucosal lamina propria by immunocompetent cells. The expression of CD34 has statistically close negative connection with cervical dysplasia severity (r=-0,81) and can be used for detection of early potential of tissual transformation in women with immunodeficiency.