Surgical approach for borderline „giant“ osteoma in the frontal sinus. Clinical case. Literature review

Introduction: Osteomas are benign tumors, with slow growth and a long period of asymptomatic development. The paranasal sinuses are often involved, the most affected one being the frontal sinus, followed by the ethmoid, maxillary and sphenoid sinuses. Etiologically, theories of inflammatory, traumatic, genetic genesis should be introduced, but the issue still remains unclear. The diagnosis is very often accidental, when performing radiography or computed tomography (CT). Clinically manifested osteomas with headache, facial deformity, mucocele, intracranial complications are subject to timely surgical intervention. The choice of surgical approach depends on the size of the osteoma and the location, as well as on the professional and technical capabilities given the more specific requirements for the instrument.Materials and methods: We present a clinical case of a 28-year-old man with complaints of headache in the frontal facial area. An X-ray revealed an osteoma in the area of the left frontal sinus, involving more than 2/3 of its cavity. CT was performed and a discussion of the possibilities of endoscopic endonasal surgery, given the borderline „giant“ osteoma with a diagonal size of about 2.75 cm (> 3 cm). An endoscopic endonasal approach was applied.Results: Endoscopic endonasal surgery was performed. The chosen surgical approach was Draf 3 type frontotomy with osteoma extirpation. In early postoperative period– 5 days, there aren’t registreted complications. The patient was followed endoscopically in the second week, first month, sixth month. A month later, a control CT scan was performed with data on residuality on the anterior wall of the frontal sinus, without drainage disturbance. Clinically, the patient has no complaints. There are no late postoperative complications.Conclusion: Symptomatic osteomas of the paranasal sinuses require timely surgery. The choice of surgical approach (open with osteoplastic flap, endonasal or combined) depends on the anatomical location, the size of the tumor, as well as the experience of the surgeon and the technical capabilities of the hospital. Endoscopic endonasal surgery is popular, with highly valued capabilities over time, but in „giant“ osteomas it is debatable given the risk of residuality

Clinical aspects of satellite diseases and cricoarytenoid joint involvement. Arthritis of the cricoarytenoid joint. Clinical case.

Introduction: Laryngeal involvement in rheumatoid arthritis is a rarely mentioned complication in clinical practice. In the literature over the last 10 years, single articles on the subject have been published, presenting a small number of clinical cases. Cricoarytenoid arthritis is a life-threatening condition requiring timely anesthesia and otorhinolaryngological intervention, where the tracheostomy has an important therapeutic place.Aim: With the presentation of our clinical case we aim to expand the knowledge about systemic diseases and their possible acute manifestation in otorhinolaryngological practice. Materials and methods: We present a clinical case of patient M.S., 63 years old, female, with a long medical history of rheumatoid arthritis. She was admitted to the clinic with a tracheostomy cannula placed for acute laryngeal dyspnea. Physical examination with a fibrolaryngoscope revealed bilateral paresis of the vocal folds, in a medial position, without phonatory and respiratory activity. Computer tomography of the neck, chest, with a focus on the mediastinum – without clinical data on tumor processes. Laboratory tests reveal a repeatedly elevated rheumatoid factor.Results: MRI revealed a collapse of the larynx, with pronounced fatty degeneration of the thyroarytenoid and cricoarytenoid muscles. The patient was referred to a rheumatologist to control the chronic exacerbation process, with a definitive tracheostomy cannula.Conclusion: Pathological changes in the cricoarytenoid joint in patients with rheumatoid arthritis, as well as scleroderma, lupus, Felty’s syndrome, Tiez syndrome and other systemic diseases, are a common finding, although diagnosed in the past at autopsy. It can be acute, subacute and chronic, but in otorhinolaryngological practice it occupies an important clinical place in emergencies

Transcription of a β-1,3-glucanase gene in grape berries in a late developmental period, or earlier after wounding treatments

The hydrolytic enzymes β-1,3-glucanases (EC3.2.1.39) an known to be involved in plant defense reactions against pathogens and in developmental events. We have obtained two partial cDNA clones, corresponding to Vitis vinifera β-1,3-glucanase gene sequences (VvGlu1/7 and VvGlu26). The expression of VvGlu1/7 was studied in grape berries at different developmental stages and in wounded berries with or without salicylic acid elicitation. No constitutive expression was observed in young berries, whereas the induction of VvGlu1/7 transcription was detected during fruit ripening. By contrast, synthesis of mRNA coding for this isoform was generated in the first stage of rapid berry growth in response to wounding treatments with and without salicylic acid

GLAUCOMA PROGRESSION. IMPACT OF RISK FACTORS ON THE DISEASE

The aim of the study is to assess the effect of systemic and local risk factors on the rate of glaucoma progression, the specificity and informative nature of ophthalmological studies for assessment of the rate of glaucoma progression.Material and methods. A retrospective analysis of the medical case histories and outpatient charts of 217 patients (268 eyes) for the period from 2014 to 2017 was conducted. The patients with primary open-angle glaucoma having at least 5 Humphrey field-of-view (24-2) studies and optic coherence tomography of the optic nerve disk and retina with a guided progression analysis (GPA) function (SD-OCT) were included in the study. The patients were divided into 2 groups: with rapid progression (more than 1 dB per year, 144 eyes (103 patients)) and slow progression (less than 1 dB per year, 124 eyes (114 patients)). The data of standard ophthalmological methods of investigation (visometry, ophthalmoscopy, biomicroscopy, measurement of intraocular pressure (IOP) according to Maklakov) were additionally analyzed. Demographic and clinical data were assessed: gender, age, cornea central thickness, refraction, IOP, glucocorticosteroid intake, cardiovascular diseases presence, arterial hypertension, arterial hypotension, local hypotensive therapy. Results and discussion. The analysis revealed the main risk factors in glaucoma progression, which include age, cardiovascular diseases presence, high initial IOP values, pronounced functional changes in thevisual fields (lower mean deviation), pseudoexfoliation syndrome

Аcinetobacter baumannii bv Tryptophandestruens bv nov. isolated from clinical samples

The aim of the study was to determine the taxonomic status of a group consisting of atypical strains of Acinetobacter baumannii, outline relevant characteristics and methods necessary for their identification. There were examined 10 strains of A. baumannii (6 of them primary comprised) bearing similar profile of atypical features isolated from clinical samples (urine, sputum) in 2017–2019 at the Military Medical Academy. Сlinical strains of typical A. baumannii (n = 36), Acinetobacter nosocomialis (n = 14), Acinetobacter pittii (n = 9) and 1 strain of Acinetobacter calcoaceticus isolated from the external environment were used in comparative studies. Atypical strains had the characteristics of A. calcoaceticus — A. baumannii (ACB) complex bacteria and were identified as A. baumannii. The utilization of substrates as the only carbon source was studied on a dense synthetic medium added with 0.2 % substrate during incubation for 72 hours at 37°C. Carbohydrate oxidation coupled to acid formation was detected on the Hugh–Leifson medium by using a micromethod. Aromatic amino acid biotransformation was carried out in liquid and dense nutrient media assessed in chromogenic reaction. The rpoB gene was used for strain genetic characterization. Amplification of two 940 and 1210 base pair (bp)-long fragments from the rpoB gene was performed by the routine polymerase chain reaction using primers with previously described sequences. Amplification products were sequenced by Sanger using Big Dye Terminator v3.1 (Applied Biosystems, USA) and capillary electrophoresis on an automatic sequencer ABI PRISM 3130 (Applied Biosystems, USA), followed by using methods for determining the similarity levels of sequenced fragments with the rpoB gene sequences of the reference strain A. baumannii ATCC 17978 (GenBank accession no. CP053098.1). It was found that all strains belonging to atypical A. baumannii spp. had a specific set of features that distinguish them from typical strains of A. baumannii as well as other types of the ACB complex: detected biotransformation of L-tryptophan (via anthranilate pathway) and anthranilic acid under unambiguous lack of such signs in other bacteria; lack of utilized sodium hippurate and L-arabinose being unambiguously evident in other bacteria; lack of utilized L-tryptophan, putrescine, L-ornithine being utilized in the majority of strains of belonging to other bacterial species. Genetic analysis showed that the control strains of typical A. baumannii displayed 99.20–99.21% similarity within the sequenced fragments of the rpoB gene with those from the rpoB gene of the reference strain. All 10 strains of atypical A. baumannii had similar features (99.20–99.21%). At the same time, parameters of control strains from other bacterial species significantly differed: A. nosocomialis (95.10–95.97%), A. pittii (94.63–94.92%), A. calcoaceticus (93.00%). Hence, the strains of atypical and typical A. baumannii are genetically homogeneous and belong to the same species. The data presented allow us to consider this group of atypical A. baumannii strains as a new biovar. We propose the name for this new biovar — tryptophandestruens (tryptophan-destroying) stemming from the Latin word destruens — destroying. Identification of A. baumannii bv. tryptophandestruens bacteria can be carried out in laboratory of any level by using tests for L-tryptophan biotransformation as well as sodium hippurate utilization

A novel KCNA1 mutation in a family with episodic ataxia and malignant hyperthermia.

Episodic ataxia type 1 (EA1) is an autosomal dominant channelopathy caused by mutations in KCNA1, which encodes the voltage-gated potassium channel, Kv1.1. Eleven members of an EA family were evaluated with molecular and functional studies. A novel c.746T>G (p.Phe249Cys) missense mutation of KCNA1 segregated in the family members with episodic ataxia, myokymia, and malignant hyperthermia susceptibility. No mutations were found in the known malignant hyperthermia genes RYR1 or CACNA1S. The Phe249Cys-Kv1.1 channels did not show any currents upon functional expression, confirming a pathogenic role of the mutation. Malignant hyperthermia may be a presentation of KCNA1 mutations, which has significant implications for the clinical care of these patients and illustrates the phenotypic heterogeneity of KCNA1 mutations

The importance of pathogenicity factors of some Streptococcus spp. and Klebsiella spp. in determining their etiological role in the inflammatory processes of the respiratory tract

Together with the known pathogens of inflammatory processes of the respiratory tract in clinical practice are often found representatives of Streptococcus and Klebsiella, previously considered commensals of the mucous membranes of the upper respiratory tract. The exchange of genetic information facilitates the transfer of virulence factors between strains not only within the species but also within the genus. In such cases, the acquisition of virulence genes by nonpathogenic species from representatives of pathogenic species contributes to the manifestation of previously not typical properties. Therefore, the aim of the research was to study the virulence of opportunistic Streptococcus spp. and Klebsiella spp. in inflammatory processes of the respiratory tract and substantiate their etiological role in the development of the disease. We studied 220 strains of Streptococcus spp. and 97 strains of Klebsiella spp., isolated from patients with inflammatory processes in the respiratory tract and from healthy individuals. Strains of Streptococcus spp. were investigated for the presence of virulence genes: sagA, lmb, fapl, ply, lytA. Strains of Klebsiella spp. were examined for the presence of virulence genes: MrkD, magA, kfu. The phenotypic marker of lmb gene expression in Streptococcus and MrkD gene in Klebsiella was the indicator of adhesion of isolated strains to buccal epithelial cells. Expression of the fapl gene was evaluated in a phenotypic biofilm formation test. In individuals with upper respiratory tract inflammation, the most common types of strepto -cocci were: S. mitis, S. anginosus, and S. oralis. Strains of these species isolated from inflammatory processes in the upper respiratory tract had 2—4 times greater adhesiveness than strains isolated from healthy individuals. Phenotypic determination of the ability to biofilm formation showed that strains of Streptococcus containing the fapl gene formed a dense biofilm in contrast to strains without the fapl gene. K. oxytoca strains isolated from people with sinusitis had mrkd, magA, and kfu virulence genes that are characteristic of K. pneumoniae strains. In phenotypic tests, it was found that the value of the adhesion index in K. oxytoca strains isolated from patients is 4 times higher than in strains of this species isolated from healthy individuals. Thus, to confirm the etiological role of an opportunistic microorganism in the development of the infectious process, it is necessary to be guided by data on the genetic and phenotypic markers of virulence of the isolated strain

Assessing <i>Serratia</i> spp. pathogenic potential from cryogenic habitats

The genus Serratia are opportunistic bacteria widely spread in natural environment. At the same time, this bacterial genus consists of the species associated with outbreaks of nosocomial infections. Serratia species are found in extreme habitats, but pathogenic potential of polyextremophilic strains in this genus remains unexplored. The aim of this study was to compare the genomes of two Serratia strains isolated in polar regions, primarily examining genetic factors of virulence and adaptation to cryogenic environment. During the 56th Russian Antarctic Expedition the Serratia liquefaciens 72 strain was isolated from a guano sample of the Adelie Penguin (Pygoscelis adeliae) colony on Tokarev Island (Haswell Archipelago, East Antarctica). The Serratia fonticola 5l strain was isolated from the frozen carcass of moose (Alces alces) fossils found on the Buor-Khaya Peninsula near the Laptev Sea coast (Yakutia Region, Russia). The whole-genome sequencing of such strains allowed to reveal genetic structures evidencing about their successful adaptation to low temperatures. Thus, it was found that both genomes contain genes encoding the main cold shock proteins, phylogenetically close to the corresponding genes in the hypobarotolerant Serratia liquefaciens strain ATCC 27592. Furthermore, both strains bear a cluster of tc-fABCD genes determining the bacterial adhesion to epithelial tissues, and the genes for RTX toxins — adhesins, crucial factors of biofilm formation in pathogenic Gram-negative bacteria. Experimental studies confirmed the ability of Serratia liquefaciens 72 and Serratia fonticola 5l to actively form biofilms in a wide temperature range (from 6°C to 37°C). The results obtained indicate that the examined genus Serratia strains isolated in Arctica and Antarctica exert overall similar adaptation strategies to polar climate, including the ability to produce pili, show active adhesion, and biofilm formation under low temperatures. Genetic adaptive factors may also act as pathogenicity factors allowing extremotolerant Serratia strains to exert traits of opportunistic and nosocomial pathogens and spread via chilled food-borne transmission. The wide use of food technologies, such as cooling and vacuum sealing, can potentially create a new ecological niche favourable for selection of psychrotolerant and hypobarotolerant pathogens. The data obtained allow to raise a question about necessity of further studies to monitor genetic diversity among psychrophilic hypobarotolerant microbial populations possessing pathogenic and epidemic potential

Clinic features perinatal damages central nervous system by undifferentiated connective tissue dysplasia of children

The purpose of work: revealing of clinico-neurologic features of current perinatal damages central nervous system at full-term newborns and children of the first year of a life with a undifferentiated connective tissue dysplasia (UCTD) after the lead analysis ante-intranatal the periods of development, an estimation on L.N.Fominoj's scale, definition of indexes of an arachnodactyly, definition of a hyaluronic acid, products of degradation of a collagen and antinuclear antibodies. 90 full-term children in the period newborn and in the age of 1 ,3 ,6 ,9 and 12 months are surveyed. The clinical condition and the neurologic status of the child, the genealogical anamnesis, a state of health of mother, feature of current of pregnancy was estimated. For revealing fenotipic attributes UCTD L.N.Fominoj’s scale (2000.) was used . Except for the standard laboratory methods (the general analysis of a blood, the general analysis wet, coprogramm, a level of saccharum of a blood, AST, ALT, the general fiber, a calcium and phosphorus of a blood) in Serum of a blood determined the contents of a hyaluronic acid, antinuclear antibodies and products of degradation of a collagen. In the age of 6 and 12 months it was spent US of internal organs and the ECHO-KG, ultrasonic research of a brain. Conclusions. At children with СТД in 1,5 times had the complicated character in comparison with children without attributes those. At estimation UCTD on scale L.N.Fominoj's at children of the basic group parameters exceeded control value (less than 12 points). Clinically children with UCTD were characterized by a delay of a becoming of static functions and vegetative-vascular disturbances. Ultrasonic research has taped at children of the basic group attributes CTD of heart in 100 % and in 36 % of microanomaly of development of internal organs.Цель работы: выявление клинико-неврологических особенностей течения перинатальных повреждений ЦНС у доношенных новорожденных и детей первого года жизни с недифференцированной соединительнотканной дисплазией после проведенного анализа антеинтранатального периодов развития, оценки по шкале Л. Н. Фоминой, определению индексов долихостеномелии, определения гиалуроновой кислоты, продуктов деградации коллагена и антиядерных антител. Обследовано 90 доношенных детей в периоде новорожденности и в возрасте 1, 3, 6, 9 и 12 месяцев. Оценивалось клиническое состояние и неврологический статус ребенка, генеалогический анамнез, состояние здоровья матери, особенности течения беременности. Для выявления фенотипических признаков НСТД использовалась шкала Л. Н. Фоминой (2000 г.). Кроме общепринятых лабораторных методов (общий анализ крови, общий анализ мочи, копрограмма, уровень сахара крови, ACT, АЛТ, общий белок, кальций и фосфор крови) в сыворотке крови определяли содержание гиалуроновой кислоты, антиядерные антитела и продукты деградации коллагена. В возрасте 6 и 12 месяцев проводилось УЗИ внутренних органов и ЭХ0-КГ, НСГ. Выводы. У детей с СТД в 1,5 раза имело осложненный характер по сравнению с детьми без признаков таковой. При оценке НСТД по шкале Фоминой у детей основной группы показатели превышали контрольное значение (менее 12 баллов). Клинически дети с НСТД характеризовались задержкой становления статических функций и вегето-сосудистыми нарушениями. УЗ-исследование выявило у детей основной группы признаки СТД сердца в 100% и в 36% микроаномалии развития внутренних органов

Stability of mRNA/DNA and DNA/DNA Duplexes Affects mRNA Transcription

Nucleic acids, due to their structural and chemical properties, can form double-stranded secondary structures that assist the transfer of genetic information and can modulate gene expression. However, the nucleotide sequence alone is insufficient in explaining phenomena like intron-exon recognition during RNA processing. This raises the question whether nucleic acids are endowed with other attributes that can contribute to their biological functions. In this work, we present a calculation of thermodynamic stability of DNA/DNA and mRNA/DNA duplexes across the genomes of four species in the genus Saccharomyces by nearest-neighbor method. The results show that coding regions are more thermodynamically stable than introns, 3′-untranslated regions and intergenic sequences. Furthermore, open reading frames have more stable sense mRNA/DNA duplexes than the potential antisense duplexes, a property that can aid gene discovery. The lower stability of the DNA/DNA and mRNA/DNA duplexes of 3′-untranslated regions and the higher stability of genes correlates with increased mRNA level. These results suggest that the thermodynamic stability of DNA/DNA and mRNA/DNA duplexes affects mRNA transcription