The described clinical case demonstrates the importance of multispiral computed tomography (MSCT) in the diagnosis of early laryngeal cancer using the developed form for assessing tumor resectability. The article presents the case of patient Ts. 68 years old with a verified diagnosis of stage 1 laryngeal cancer.In September 2024, complaints of hoarseness appeared, no treatment was carried out, in February 2025 the patient sought medical help from an ENT doctor. Suspected of malignant tumor, he was referred to GBUZ OOD. According to the results of the patient’s examination in a single diagnostic algorithm, assessment of the course of the tumor process according to MSCT data, with the joint activity of a radiation diagnostician and a surgeon, the option of surgical treatment by endolaryngeal resection (ELR) was chosen. To determine the resectability of the tumor process in the larynx, a detailed assessment of the tumor condition and its prevalence is necessary before surgical treatment in the form of endolaryngeal resection. MSCT makes it possible to quickly perform a study for calculating and performing minimally invasive surgery, improving oncological and functional results.
Background. N-acetyltransferase 2 is an enzyme involved in the detoxification of xenobiotics. The N-acetyltransferase 2 gene is polymorphic and causes variants of the enzyme structure, determining susceptibility to neoplasia, metabolic changes and diseases. The aim. To study the features of the N-acetyltransferase 2 gene polymorphism in blood samples of patients operated on for euthyroid and toxic goiter, and its role in the development of complications of the disease and surgery. Materials and methods. The study included patients living in the Irkutsk region who, during 2021–2023, underwent thyroidectomy for euthyroid and toxic goiter: 11 patients with diffuse toxic goiter, 12 with multinodular toxic goiter and 18 with multinodular euthyroid goiter. The control group is volunteers without thyroid pathology. Single nucleotide polymorphisms in the structural region of the N-acetyltransferase 2 gene (С282Т (rs1041983), T341C (rs1801280), С481Т (rs1799929), G590A (rs1799930), А803G (rs1208) и G857A (rs1799931)) were studied by the polymerase chain reaction method. Results. The frequency of detection of the unchanged nucleotide sequence at position C282T is reduced (up to 45 % in diffuse toxic goiter and 50 % in multinodular toxic goiter) (p <0.0005). The frequency of detection of the T341C polymorphism in the homozygous state in multinodular toxic goiter was 33 % and was not detected in diffuse toxic goiter and in the control (p <0.0005). The frequency of neutropenia development against the background of thiamazole intake was 9 % and did not depend on the C282T polymorphism (p>0.95). In diffuse toxic goiter, a moderate negative correlation was noted between C282T and C481T, T341C (p <0.0005). At the same time, in multinodular toxic goiter, a positive relationship was found between C282T and G590A (p <0.0005). Conclusion. The study demonstrates the features of the N-acetyltransferase 2 gene polymorphism in blood samples of patients operated on for euthyroid and toxic goiter
Postradiation epidural fibrosis is one of the rare complications of cancer treatment in patients receiving radiation therapy, leads to a mosaic clinical picture, including manifestations of polyneuropathy, caudogenic intermittent lameness syndrome and can significantly affect the quality of life of patients. Depending on the type of cancer, the volume of the affected tissues and the level of damage to the spine, radiation fibrosis syndrome is characterized by a diverse clinical picture. The main clinical manifestations of post-radiation fibrosis of the spinal canal at the level of the lumbar spine are pain, numbness, paresthesia in the lower extremities. A thorough history and physical examination, combined with the use of neuroimaging data, help establish an accurate diagnosis and select an effective treatment. When studying the problem of post-radiation fibrosis, it is extremely difficult to predict the time, risk group and specificity of characteristic symptoms, given the development of pathology in elderly and senile patients, against the background of existing degenerative changes in the spine. However, there is a close relationship with dosage, anatomical impact, nature of damage and clinical symptoms. Conservative methods of treating post-radiation fibrosis with spinal canal stenosis include the use of analgesic, antiinflammatory therapy. With a prolonged course of pain syndrome, insufficient effectiveness of conservative treatment, local blockades or epidural injections are carried out. In the absence of the effect of conservative treatment, indications for surgical intervention arise.
Background. Oxidative stress is crucial in the pathogenesis of endogenous intoxication syndrome in acute surgical abdominal pathology. The enzyme systems of oxidative phosphorylation and cytochrome reductase are vital for hepatocyte energy potential. This study aimed to investigate the effects of a p38 MAPK inhibitor on cytochrome b5 reductase 3 (CYB5R3); cytochrome c oxidase; and microsomal oxidation in experimental peritonitis.Methods. A model of peritonitis was used with two groups: a control group without treatment (n = 15) and a main group treated with adezmapimod conjugate on endof-surgery (n = 15). Immunomorphological staining was employed to evaluate CYB5R3 and cytochrome oxidase expression on days 3; 7; and 14. The intensity of staining was scored from 0 to 4; and differences were assessed using multiple comparison tests and the Mann-Whitney criterion.Results. In the control group; CYB5R3 intensity decreased from 2.5 [2.0;3.0] on day 3 to 1.0 [1.0;1.0] on day 14. Conversely; in the main group; the inhibitor maintained high enzyme expression throughout the study. On day 3; cytochrome oxidase levels differed significantly between groups: 1.0 [1.0;2.0] in the control and 4.0 [3.0;4.0] in the main group (p < 0.05).Conclusion. The findings suggest that adezmapimod conjugate positively affects the integrity of enzyme systems; maintaining redox balance and oxidative phosphorylation in hepatocytes during peritonitis.
Long-term outcomes (3–5 years) in 71 patient with the adjacent level lesion syndrome (ALDS) were analyzed. All patients underwent minimally invasive surgical interventions (puncture laser decompression of intervertebral discs and radiofrequency denervation of the facet joints) in the neurosurgical department of Irkutsk Scientific Center for Surgery and Traumatology. The applied technology was chosen after analyzing clinical examination findings, introscopy findings, degeneration coefficient and intervertebral disc height. In the study, there were 37 males, 34 females. Average age 54.1 ± 2.3 years. The time interval between the initial decompression and stabilization surgery and the subsequent minimally invasive surgical intervention was 48 ± 3.8 months. The effectiveness of minimally invasive surgical treatment was assessed after analyzing clinical and neurological findings, radiological findings (MRI, MSCT, overview and functional spondylography) as well as by the visual analog pain scale and MacNab questionnaire.
