[Endolaryngeal laser-assisted microsurgery of benign pharyngeal neoplasms: objective evaluation of functional outcome].

A new technique for endolaryngeal microsurgery is proposed. It based on the irradiation of benign laryngeal tumours using Ho:YAG and potassium-titanyl-phosphate (KTP) lasers. A total of 198 patients of either sex aged from 2 to 77 years with a variety of benign laryngeal neoplasms were treated by this method between 2004 and 2007. Its application allowed the results of the treatment to be optimized as confirmed by the statistically significant improvement of the external respiration function, acoustic characteristics of the voice, and positive dynamics of laryngeal endoscopic imaging data.

[Treatment of chronic tonsillitis: prognostic criteria of efficacy].

An original method of wedge dehydration of biological fluids assessing the ability for separation of organic and mineral constituents was for the first time used in patients with different forms of chronic tonsillitis (CT). The method was used in 102 patients aged 8-68 years with chronic inflammation of the palatine tonsils out of exacerbation. A dehydrated drop of tonsillar lacuna discharge (TLD), facia, was studied morphologically under microscope at small magnification (x10--x50). Three types of TLD facia were identified in CT patients. These types characterized severity of the pathological process in the palatine tonsils. Changes of facia type in patients with different CT forms were compared. Basic regularities in the disease progress were determined. This enabled prognosis of a further course of CT in an individual patient and, therefore, planning treatment policy for each case.

[Therapeutic exercise in combined treatment of patients with laryngo- and tracheostenosis].

It is shown that staged individual special respiratory exercises targeted at nervous-muscular apparatus of the pharynx and trachea improve external respiration function, activate blood flow and venous-lymphatic outflow in the neck area with stimulation of reparative processes in combined postoperative treatment of patients with cicatricial stenoses of the pharynx and trachea.

[The problem of treatment in patients with laryngeal and tracheal stenoses, as viewed by an ENT specialist].

Based on their 40 years' clinical experience in treating patients with laryngeal and cervical tracheal stenoses of various etiology, the authors consider that circular trachectomy, by anastomosing laryngeal cartilages, may be performed by highly skilled specialists only at specialized and well-equipped institutions. In cases of chondroperichondritis of cartilages of the larynx or trachea in the presence of paralysis of the vocal folds, it is necessary to make stepwise reparative and plastic operations that can be performed at the ENT clinics having experience in laryngeal surgery.

[Clinico-anatomic characteristics of the tip of the nose].

The anatomy of the tip of the nose is reviewed with description of clinical manifestations in different variants of anatomical structures of the tip of the nose. Thick skin problem and specific features of surgical treatment of nasal tip deformities in thick, porous skin are considered.

[Long-term surgical outcomes in congenital malformations of the floor of the auricle].

The authors analyse long-term outcomes of surgical treatment of congenital defects of the floor of the auricle. They came to the conclusion that surgical techniques used in the correction of the defects need some modification. In the presence of a wide, elastic ascending crus of the helix, when creating the anthelix, the crus should be made finer. In the presence of a large and wide scaphoid fossa it should be made smaller. After reduction of the floor of the auricle the margin of the auricle should be shortened.

[Differentiated approach to medicine phonophoresis in complex treatment of cicatrical deformations].

135 patients aged 18 to 55 years with cicatrical alterations in the larynx were under observation. The treatment included phonophoresis of contractubex, colitin and elastolytin. The study found the necessity to take into account the age of cicatrical deformations when treating them. The most effective in treatment of formation cicatrices (6 to 12 days old) are medicines containing heparin (contractubex), which prevent the formation of pathologic cicatrices (keloid and hypertrophic ones). After the formation of the cicatrice is completed, medicines containing enzymes are more effective, because these "garnet" collagen and thus favor the mechanism of the reversion of pathologic cicatrical formation.

[Clinicofunctional parallels in posttraumatic deformities of the nasal tip].

The analysis of different posttraumatic deformities of the nasal tip gave evidence for a close correlation of internal nose deformities with nasal breathing ranging from common changes in the internal nose (hypertrophy of the inferior turbinated bone) to atresia when nasal breathing is completely blocked. Because of tissue edema, respiration improved and normalized only 1 and 3 months after surgery. It is concluded that functional examinations before and after surgery are beneficial for patients and warrant optimal terms of surgery.

CD20 and CD5 expression in B-chronic lymphocytic leukemia.

In order to quantitate a previously noted decrease in CD20 fluorescence intensity (FI) on B-CLL lymphocytes, binding capacities [BC x 10(3) +/- 1SD = number of antibodies bound per cell] were calculated. The mean (N = 5) BC x 10(3) +/- 1SD of CD20 reagents for normal B-PBL and B-CLL lymphocytes confirmed this observation. B-PBL and B-CLL were 56 +/- 11 and 61 +/- 14, and 19 +/- 15 and 18 +/- 16, respectively, for Leu 16 and B1. Although adequate compensation standards for the determination of CD5 and CD20 coexpression are not available, qualitatively, the density of CD5 on both normal B-PBL and B-CLL is less compared to the expression of CD5 by normal T cells. CD5 expression on B-CLL seems to be linked to the lower levels of CD20, whereas CD5 expression may appear to be absent on CLL lymphocytes expressing normal levels of CD20. Levels of CD20 in B-CLL suggest involvement of one or two genes (alleles) whose decreased expression may be linked to CD5 expression.

Antigenic expression of B-cell chronic lymphocytic leukemic cell lines.

A flow cytometric analysis of five B cell chronic lymphocytic leukemic (B-CLL) cell lines was undertaken using 129 unknown reagents from the blind panel (BP) and 72 reagents from the known CD panel obtained from the Fourth International Leucocyte Differentiation Conference and Workshop, B cell section (Vienna, 1989). The five cell lines examined were: SeD (PNAS 75, 5706, 1978), B-CLL-LCL (BLOOD 71, 9, 1988), JVM-HH and JVM-2(INT J CAN 38, 531, 1986), and WR#1 (TH and BD). The reagents were #1-129 (blinded panel) and reagents 1-44 and 53-84 (CD panel with CD23 reagents missing). Positivity was defined as greater than 30% of the cells having a three fold increase or more in mean channel fluorescence. Fourty-three reagents of the blinded panel were negative by these criteria while all remaining reagents were positive on all five lines. SeD showed the lowest reactivity; B-CLL-LCL and JVM-2 showed the most reactivity; JVM-HH and WR#1 were intermediate. The known CD panel confirmed the reactivity of the blinded panel. An average immunophenotype was constructed and compared to published normal EBV lymphoblastoid cell lines and several differences were noted. There was an absence or significant decrease in the expression of CD19, CD21, CD22 and CD37 while there was an increased expression of CD38, CD54, CD74 and CD76. The heterogeneity observed between the B-CLL lines may in part be due to polymorphisms but is more likely to represent the underlying heterogeneity seen in common and familial B-CLL.2+öff

No adaptogen response of mice to ginseng and Eleutherococcus infusions.

There was no significant difference in mortality, weight gain, liquid consumed, or pathogenesis between mice ingesting four different ginseng infusions for up to 96 days, and control mice drinking distilled water. These results suggest no toxicity or tea selectivity of mice subjected to such regimens. Mice that drank concentrated Siberian ginseng wuchaseng extract with sugar showed significantly more aggressive behavior than those drinking other infusions or distilled water. However, there was no significant difference in stamina or longevity between mice drinking infusions of two preparations of Siberian ginseng, Oriental ginseng, or American ginseng, and control mice when subjected to swimming trials in cold water 38, 46 and 96 days after treatment began. Consequently, ingestion of adaptogenic glycosides did not significantly affect the survival of mice under major environmental stress.

[Interrelations of lysosomal enzymes of leukocytes in patients with cicatricial stenosis of the larynx]. / Vzaimosviazi lizosomal'nykh fermentov leikotsitov u bol'nykh s rubtsovym stenozom gortani.

Activities of acid and alkaline phosphatases, cathepsin B, leucine aminopeptidase, N-acetyl-beta-D-hexosaminidases, beta-D-galactosidase and beta-D-glucuronidase were studied in leukocytes of two groups of patients with normal and pathological healing of wounds after surgical treatment of scar stenosis of larynx. Analysis of the enzymatic activity, calculated by means of Student's test using the data of a single estimation of the activity in leukocytes before surgical treatment, did not exhibit any distinct differences in these two groups of patients. The study of interrelationship between the activities of individual enzymes by means of principles of regression analysis enabled to show that the enzymes studied were in the positive regressive relation. Pattern of enzymatic activity in leukocytes of patients with pathological wound healing was distinctly different from that of patients with normal healing in the shape of regression and, especially, in relaxation of the interrelations between phosphatases and other enzymes. The principle of regression enabled to evaluate the prognosis of postoperative development of wound healing using the preliminary estimation of enzymatic activity in leukocytes of patients with scar stenosis of larynx.

[Post-traumatic rehabilitative treatment of hollow neck organs]. / Puti sovershenstvovaniia vosstanovitelnogo lecheniia posledstvii travm polykh organov shei.

The attention of the reader is focused on the errors and shortcomings in rendering urgent emergency care for patients who underwent traumas of the neck hollow organs. The 30-year experience with 1000 patients managed by the authors convinced him of the necessity to consider more carefully the medical history of the patient, to use more frequently Killian's and Brunings's examinations, microlaryngoscopy, fibroendoscopy, x-rays. Restorative treatment becomes more effective under ultrasound and laser separation of the tissues, laryngochioido plexy, tracheopexy with establishment of the laryngeal patency and that of trachea. The technique is proposed for broadening the lumen of the cervical trachea in cicatricial stenosis and in going-on scarring in the thoracic trachea. The progress in the surgery of the neck hollow organs depends on adequate facilities and treatment policy.

[Surgical treatment of children with cicatricial stenoses of the larynx and trachea]. / Opyt khirurgicheskogo lecheniia detei s rubtsovymi stenozami gortani i trakhei.

The present authors recommend a modification of Ivanov's method suggested by their treatment of 41 children, aged 4 to 15 years; 12 patients suffered from stenosis and 29 patients from atresia of the larynx and trachea, which resulted from surgical intervention required by the complications of extended nasotracheal intubation and subsequent tracheotomy. The modified procedure is as follows. In order to enlarge the laryngeal or tracheal lumen, skin is cut and one or two triangle-shaped skin flaps are dissected; their tops are sutured to the anterior wall of the above organs cut along the median line. In order to distend the larynx, redressment of the cricoid cartilage is needed. He-Ne laser irradiation (of 20 mW/cm2 with a wavelength of 632.8 nm) and collagenase and elastase enzymes stimulate repair and prevent secondary cicatrization of post-operative wound. The lumen is formed using a T-shaped silicon tube. Out of 4 patients followed-up during the last 5 years, 21 were decannulated, 12 developed good laryngotracheostoma, 5 of which required suture of wound. Only 8 patients who had laryngotracheostoma needed surgical intervention due to repeated cicatrization. In 4 of these patients, allogenic cartilage was used for support, and polymer paste Polytel was applied to eliminate laryngeal, tracheal or esophageal fistulas.

[Contemporary status of the issues in the treatment of children with respiratory papillomatosis]. / Sovremennoe sostoianie problemy lecheniia detei s respiratornym papillomatozom.

For 15 years the authors treated 205 children aged 9 months to 15 years with respiratory papillomatosis. Besides surgical endolaryngeal removal of the papillomas, they applied immunomodulators, plasmapheresis and antiviral drugs. Of different methods of artificial lung ventilation, the best is thought to be transcatheter high-frequency artificial lung ventilation. As shown by the studies of infection resistance, the combined treatment should incorporate such drugs as zovirax and leukomax. Ultrasound disintegration and laser photodestruction with Ho laser were introduced in surgical removal of the papillomas. The combined treatment shortens the treatment duration and prolongs recurrence-free period.

[Assessment of changes in the course of nasal and paranasal inflammation]. / Otsenka dinamiki vospalitel'nogo protsessa v polosti nosa i okolonosovykh pazukhakh.

Direct joulemetry, a method of diagnosis of nasal and paranasal mucosa condition, is based on measurement of electric current work (CW) by electrochemical dissociation of biological fluids on the mucosa of the frontal sinus and its aperture. 27 patients had CW characteristics in three forms of inflammation: purulent, serous-fibrinous, exudative. The effectiveness of the method in follow-up of patients with frontal sinusitis is shown.

[Differential approach to the use of drug ultraphonophoresis for scars]. / Differentsirovannyi podkhod k naznacheniiu lekarstvennogo ul'trafonoforeza pri rubtsakh.

A differential approach to administration of drug ultraphonophoresis (gel contractubex, collitin, elastolitin) in scarry deformations is proposed. The analysis of 82 treatment outcomes has shown that early after trauma (on day 6-12) it is more beneficial to use ultraphonophoresis (UPP) of heparin-containing compounds improving blood rheology, e.g. lidase. This prevents development of pathological scars. Later, when the scar tissues has already formed, more effective is UPP of enzyme medicines with fibrinolytic properties (collitin, elastolitin). Differentiated choice of UPP in scar therapy reduces the time of rehabilitation considerably.

[Correction of congenital of the lateral nose deformities]. / Korrektsiia vrozhdennykh deformatsii kontsevogo otdela nosa.

Immediate and remote results of perennial use of most popular correction methods in different types of congenital deformations of nose end (wide end -- according to J. Converse; prolonged end -- according to D. Armstrong and protruded end -- according to F. Burian) were analyzed and their drawbacks disclosed. The authors presented their own new techniques.

[Current aspects and prospects of the combined treatment of respiratory papillomatosis in children]. / Sovremennye aspekty i perspektivy kompleksnogo lecheniia respiratornogo papillomatoza u detei.

Treatment methods and outcomes have been analyzed for 313 children aged 9 months-14 years with respiratory papillomatosis (RP) admitted to ENT clinic in 1950-1995. Beginning from 1982 papillomas were removed by means of ultrasonic disintegration. A novel approach included extracorporeal detoxication and immunocorrection. 85% of patients responded to treatment with discrete plasmapheresis and T-activin. It is concluded that best treatment results were achieved in combination of conventional methods with advanced modalities such as extracorporeal detoxication and immunocorrection.

[Use of transcatheter high-frequency artificial ventilation of the lungs in surgical treatment of obturating papillomatosis of the larynx and trachea in children]. / Primenenie chreskateternoi vysokochastotnoi iskusstvennoi ventiliatsii legkikh pri operativnom lechenii obturiruiushchego papillomatoza gortani i trakhei u detei.

Investigations of transcatheter high-frequency artificial ventilation of the lungs (THFAVL) in surgical treatment of obturating papillomatosis in children led the authors to the conclusion that this method is optimal in assisting breathing in operative intervention on the larynx. THFAVL is not feasible unless adequate expiration is provided. Hence, the high-frequency regimen must be acquired gradually under control of blood gases in parallel with reopening of rima glottidis with consideration of individual clinical situation. The most effective parameters of the above surgery are: P-1 kgs/cm 2; heart rate under 80 per minute; inhalation/expiration ratio 1:3, 1:4. The emergence of side effects can be prevented in coordinated actions of the surgeon and anesthesiologist.