[FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity]

Tumor induced osteomalacia is a rare paraneoplastic syndrome caused by mesenchymal tumors that secrete fibroblast growth factor 23 (FGF23). Patients complain of progressive bone pain, muscle weakness and brittle fractures. Delayed diagnosis of osteomalacia caused by a tumor is often found in clinical practice. When verifying the exact localization of the neoplasm, radical removal within healthy tissues is recommended. The article considers a clinical example of FGF23 tumor induced osteomalacia with localization of neoplasm in the tympanic cavity.

[New effects of a topical antimicrobial (agent) in the treatment of acute tonsillopharyngitis]

Sore throat is the leading symptom of acute tonsillopharyngitis associated with previous acute respiratory viral infections, including COVID-19. The pathogenesis of these nosologies is based on the cumulative result of the primary direct damaging effect of viruses and secondary alternative inflammatory changes in the mucosal epithelium in the focus of infection, which, against the background of changes in the functions of the regional microbiota, leads to the development of viral-bacterial inflammation that goes beyond the protective-reparative level. In the treatment of acute tonsillopharyngitis after exclusion of GABHS etiology, topical etiotropic drugs are often used. It is desirable to achieve a uniform distribution of active ingredients, and to maximize the use of additional pharmacological capabilities (irrigation-eliminative action, reparative effect). To build up the evidence base for the effectiveness of just such medicines on the basis of the Department of Otorhinolaryngology of the Moscow State Medical University named after. A.I. Evdokimov, an observational prospective comparative study was conducted, using, in addition to the clinical assessment method, cytomorphological approaches (cytomorphometry). The results of the study demonstrated that gargling with a solution of hydroxymethylquinoxylindioxide (Dioxydin 0.25 mg/ml solution for topical application) in adult patients with acute tonsillopharyngitis provides rapid relief of pain, a decrease in the severity of inflammation symptoms, and also makes it possible to achieve limitation of the degree of destruction of the epithelium in the height of inflammation and a more complete and rapid recovery of the damaged mucous membrane by the time of recovery.

[Comparative characteristics of the effectiveness of local therapy in acute tonsillopharyngitis]

Acute tonsillopharyngitis (ATP) is an infectious inflammation of the mucous membrane and lymphadenoid structures of the oropharynx. Sore throat, as the main symptom of ATP, is the most common reason for seeking outpatient medical care or self-medication. Topical therapy of sore throat in the treatment of non-streptococcal ATP is the most effective and safe. In the article, based on their own experience and literature data, the problem of treating patients with sore throat with ATP of non-streptococcal etiology is presented. At the Department of Otorhinolaryngology of the Evdokimov Moscow State Medical University conducted a study to study the clinical features of the course of ATP and improve the results of local treatment of patients with this pathology. In the course of the study, 75 people were examined, in whom subjective and objective symptoms were assessed. Our study showed that the use of the drug Doritricin demonstrated high efficacy in the treatment of patients with ATP, which contributed to an earlier regression of inflammatory-infiltrative changes in the pharynx, as well as a faster decrease in the level of pain syndrome according to the scores of the visual-analog pain scale.

[Modern H1 antihistamines in the treatment of patients with allergic rhinitis and comorbid acute respiratory infections]

Patients with allergic rhinitis (AR) have a predisposition to frequent acute respiratory viral infections (ARVI). Inflammation of the mucous membrane of the nasal cavity and paranasal sinuses in such patients is more pronounced against the background of a combination of allergic and infectious inflammation.

OBJECTIVE

To evaluate the effect of therapy using modern antihistamines on the condition and severity of symptoms in adult patients with exacerbation of AR caused by plant pollen (seasonal) (SAR) and the development of ARVI.

MATERIAL AND METHODS

An observational study was conducted at the Department of Otorhinolaryngology of the Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation from April to August 2021. Included are patients of both sexes aged 18 to 65 years with a previously (at least 1 year ago) verified diagnosis of mild and moderate acute SAR in the acute stage, who sought medical help for ARVI. All patients were prescribed therapy with the inclusion of a drug belonging to the pharmacological group of antihistamines of the 2nd generation (a course of 14 days). In addition, patients received symptomatic ARVI therapy according to indications, including nasal decongestants (as needed), antipyretic and antitussive drugs.

RESULTS

Based on the data obtained, it was possible to prove that the use of modern antihistamines in patients comorbid with AR and ARVI has a pronounced therapeutic effect. Theoritin provides a therapeutic effect at an early stage in relation to nasal and non-nasal symptoms of SAR/ARVI, and also quickly improves the quality of life of patients, which makes its use promising for the treatment of ARVI against the background of AR. The drug has an antihistamine activity comparable to cetirizine and surpasses it in its ability to suppress an allergic inflammatory reaction, for example on the skin, as well as in the duration of preservation of the antihistamine effect.

CONCLUSION

The presented results indicate the effectiveness of theoritin and cetirizine in the treatment of patients with seasonal exacerbation of allergic rhinitis, comorbid for acute respiratory viral infections.

[Sore throat. Recent trends in treatment]

According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.

[The new possibilities for the treatment of chronic cough associated with postnasal drip]

Cough is considered to be one of the leading clinical symptoms associated with the pathological changes in the respiratory system. Notwithstanding a great variety of therapeutic pharmaceutical products possessed of the antitussive action, physicians tend the give preference to the preparations producing the combined effect. The present article reports the results of the clinical study designed to evaluate the effectiveness and safety of the application of rengalin exhibiting the combined antitussive, anti-inflammatory, and broncholytic action in the patients presenting with the postnasal drip syndrome. The comparison of the therapeutic effects of rengalin with those of other therapeutic modalities frequently employed for the management of postnasal drip give evidence of the high efficiency of this product for the optimization of the treatment of this condition and the associated chronic cough.

[15-year experience of moxifloxacin in the treatment of patients with bacterial rhinosinusitis]

The article summarizes 15 years of experience of the use of moxifloxacin (Avelox) in Russia in patients with acute bacterial rhinosinusitis. Emphasize its high bactericidal activity against a broad spectrum of microorganisms- from basic agents to the atypical and anaerobic microflora. The results of these studies suggest the continued effectiveness of the dosage of 400 mg a short course (7 days) over 15 years of practical use of the drug, which in its clinical efficacy is superior to amoxicillin/clavulanate, cefuroxime axetil and levofloxacin. The safety profile of moxifloxacin, studied at the population level is not associated with an increased risk of adverse effects in compliance with the dosing regimen, taking into account the indications and contraindications.

[The causes of the development of cicatrical stenosis of the larynx and trachea in the patients presenting with Guillain-Barré syndrome]

The problem of rehabilitation of the patients presenting with post-intubation stenosis of the larynx and trachea remains unresolved despite the development of new methods for the diagnostics and treatment of this condition. One of the indications for long-term artificial lung ventilation is the severe form of Guillaine-Barret syndrome associated with paralysis of breathing muscles, development of bulbar symptoms, and disturbances of trophic process in the skin and mucous membranes. However, prolonged (mean 26 days) artificial lung ventilation may result in the formation of many-layer stenosis of the larynx and trachea whereas disturbed trophic processes in the skin and mucous membranes coupled to inadequate innervation complicate the postoperative conditions of the patients and promote restenosis of the tracheal lumen.

[Treatment of patients with complicated tonsillogenic infection]

The number of patients with pyo-inflammatory complications associated with chronic tonsillitis has increased in the recent years. The objective of this paper was to analyse the frequency of stenotic conditions caused by purulent complications of tonsillogenic infection. An algorithm is proposed for diagnostic examination and treatment of patients with descending tonsillogenic infection suffering obstruction of the upper respiratory tract.

Stimulation by aurintricarboxylic acid of tobacco mosaic virus-specific RNA synthesis and production of informosome-like infection-specific ribonucleoprotein

It was shown that aurintricarboxylic acid (ATA), a well-known inhibitor of protein synthesis, markedly stimulates the synthesis of tobacco mosaic virus (TMV)-specific RNA species of the intermediate (I) class (apparent molecular weights 1.1-1.3 x 10(6) and 0.6-0.8 x 10(6)). No stimulation by ATA of full-length genomic TMV RNA or the subgenomic TMV RNA coding for TMV coat protein was detected. Informosome-like infection-specific ribonucleoprotein (vRNP) particles different from mature TMV particles were found in the TMV-infected cells (Yu. L. Dorokhov, N. M. Alexandrova, N. A. Miroshnichenko, and J. G. Atabekov, 1983, Virology 127, 237-252). It is shown here that [3H]uridine incorporation into vRNP RNAs was markedly stimulated in the presence of ATA. vRNP can be released from the TMV-specific polyribosomes by EDTA treatment, which suggests that it is involved in the translation process. The results of the pulse-chase experiments (including those in which TMV RNA synthesis is blocked by 2-thiouracil) suggest that vRNP does not serve as a precursor for mature virion.

[Variants of tracheostomy depending on etiology of laryngeal and tracheal stenosis]

The results of tracheostomy and prevention of airway stenosis depend much on preoperative examination, adequate management of postoperative period. Introduction of the treatment algorithm including rational surgical approaches, wide-spectrum antibiotics, drugs improving tissue repair, local and general antihypoxic therapy significantly raises effectiveness of post-tracheostomy rehabilitation.

[Immunological status of patients with juvenile angiofibroma of the skull base]

Immunological status was studied in 20 patients with juvenile angiofibroma of the base of the skull (JABS). An imbalance in the immune system was found, especially in cellular immunity (low number of T-helper and high level of T-suppressor lymphocytes, subnormal index of their proportion). The number of activated T-cells decreased, while that of NK-cells increased. JABS patients have an elevated level of serum IgA.

[Medical ozone in combination with low-frequency ultrasound therapy in the treatment of patients with chronic purulent otitis media]

The authors propose a method of endoural ultrasound therapy in parallel with local introduction of ozonized physiological solution for patients with otitis media purulenta chronica. Locally used was the solution containing ozone in concentration 10 mg/l. Low-frequency ultrasound therapy was conducted using Tonsillor-2 unit with special intraauricular wave guides. Treatment outcomes in 132 patients are analysed for 5 years. The response was registered in the majority of cases.

[Juvenile angiofibroma of skull base: diagnosis and treatment]

227 young men and boys aged 9-22 years underwent treatment for juvenile angiofibroma of the base of the skull (JAFBS) in the ENT clinic of the Russian Academy of the Advanced Medical Education between 1977 and 1998. JAFBS was most frequently diagnosed at the age 15-18 years. An original clinicotopographic JAFBS classification is proposed basing on the disease spread. A complex of tests has established that JAFBS patients develop changes in hormonal and immunological statuses. Indications to ligation of the external carotid arteries and a modified nasomaxillary approach to angiofibroma providing radical removal of the tumor are described. After surgical treatment only 11.5% of the patients exhibited recurrent tumors.

Translation enhancing properties of the 5'-leader of potato virus X genomic RNA

The double-stranded DNA copy corresponding to the 5'-nontranslated alpha beta-leader of potato virus X (PVX) genomic RNA (positions -3 to-85 according to AUG initiator) was chemically synthesized and fused to the transcription plasmids containing three different reporter genes: neomycinphosphotransferase type II (NPT II) gene, Bacillus thuringiensis coleopteran-specific toxic protein gene and beta-glucuronidase (GUS) gene. Expression of the reporter genes in vitro and in plant protoplasts (in the case of GUS gene) reveals that the alpha beta-leader of PVX RNA acts as a translation enhancer despite the presence of the upstream vector-derived sequence and irrespective of the length of the spacer sequence preceding the reporter genes.

Expression strategy of the potato virus X triple gene block

The mode of expression of the overlapping genes of the triple block positioned internally in potato virus X (PVX) RNA was examined. The results of In vitro translation of synthetic RNA transcripts and natural PVX-specific methylmercuric hydroxide-denatured dsRNAs suggest that the 25K protein is expressed as a single translation product of the 2.1 kb subgenomic (sg) RNA and that both the 12K and 8K proteins are expressed from the same 1.4 kb sgRNA.

In vitro membrane binding of the translation products of the carlavirus 7-kDa protein genes

Two double-stranded DNA copies of the genes potentially coding for the 7-kDa proteins of potato virus M (PVM) and potato virus S (PVS) were synthesized and cloned into T7 transcription vectors. Cell-free translation of the corresponding monocistronic transcripts yielded in both cases a single protein of approximately 7-8 kDa that contains a highly hydrophobic N-terminal segment. To analyze their membrane-binding potential, both proteins were synthesized in the membrane-enriched Krebs-2 extract. It was found that the smooth membrane fraction was enriched in the carlavirus 7-kDa proteins. The primary and predicted secondary structures of their N-terminal hydrophobic segments suggest that the latter can function as signals for translocation into the rough endoplasmic reticulum.

Translational efficiency and competitive ability of mRNAs with 5'-untranslated alpha beta-leader of potato virus X RNA

The 5'-untranslated leader sequence of potato virus X (PVX) RNA (63 nucleotides apart from cap-structure) consists of two sub-sequences referred to as alpha-sequence (41 nucleotides with no G) and beta-sequence (42 nucleotides upstream from the first AUG). Computer-based folding predictions suggest that the 5'-proximal region of alpha beta-leader is unstructured. The second structural feature of alpha beta-leader is the presence of the sequences apparently complementary to the 3'-terminal region of 18S rRNA. The alpha beta-leader has been shown to strongly enhance the translation of the contiguous foreign gene (NPT1) transcripts in cell-free translation systems from rabbit reticulocytes (RRL), wheat germ (WG) and Krebs-2 ascite cell extract (KA). In competitive translation PVX, RNA strongly inhibited tobacco mosaic virus (TMV) RNA, in RRL and WG systems. No competition occurred between PVX and TMV RNAs in KA system. There was no correlation between the translational efficiency and competitive ability of PVX RNA in different cell-free translation systems. The competitive ability did not solely depend on the presence of alpha beta-leader in mRNA. We present evidence to suggest that alpha beta-leader together with about 150 bases of the coding sequence is responsible for the translation competitive ability of PVX RNA.

Expression of RNA transcripts of potato virus X full-length and subgenomic cDNAs

Translation of synthetic potato virus X (PVX) RNAs was examined in Krebs II ascite cell extracts and rabbit reticulocyte lysates. Either full-length or subgenomic RNAs produced by in vitro transcription of cDNAs cloned in the T7 promoter vectors were used. Full-length PVX RNA-transcript directed the synthesis of a large polypeptide which was indistinguishable from the translation product (165 kDa) of authentic viral genomic RNA on SDS-PAGE. Translation of the full-length and 3'-truncated RNA species was stimulated by addition of m7GpppG to the T7 transcription system. Subgenomic cDNA transcripts corresponding to the 3'-proximal part of PVX RNA were efficiently translated into the PVX coat protein and 2 as yet unidentified small hydrophobic proteins.

Anomalous electrophoretic behavior of the major potato virus X RNA translation product

The major potato virus X (PVS) RNA translation product migrates in Laemmli's electrophoresis system as a 210 kDa polypeptide ('p210'). If a Tris-phosphate-SDS buffer system is used instead of a Tris-glycine-SDS one, the mobility of p210 is higher than that of the largest TMV RNA translation product, the 183 kDa protein. It is suggested that anomalous electrophoretic behavior of the largest PVX polypeptide during SDS-electrophoresis is due to its primary structure, namely to the presence of hydrophilic domains.

[Use of a cell-free protein synthesizing system from cells of ascites carcinoma Krebs-2 for RNA translation of plant viruses]

Cell-free translation in Krebs-2 extracts was optimized for RNAs of two plant viruses; potato virus X (PVX, potexvirus), and tobacco mosaic virus (TMV, tobamovirus). PVX and TMV RNAs programmed synthesis of similar sets of polypeptides in both the Krebs-2 extracts and the rabbit reticulocyte lysates, major virus-specific products being the same in molecular weight in both in vitro systems. PVX structural protein (p29) was absent among polypeptides synthesized in the Krebs-2 system but was readily identified by immuno-precipitation among the ones synthesized in the reticulocyte lysate system. The "cap" analog, m7Gpp, inhibited the synthesis of all the polypeptides programmed by PVX RNA in the Krebs-2 system. The synthesis of only a few of the most high molecular weight products in the reticulocyte lysate system was inhibited, the synthesis of a number of low molecular weight products (and among them p29) was even stimulated. Thus, the PVX capped messengers derived from PVX genomic RNA due to its fragmentation with endogenous nuclease activities. The use of the Krebs-2 system allows to avoid activation of internal PVX genes.

Characterization of bean mild mosaic virus: particle morphology, composition and RNA cell-free translation

Virions of bean mild mosaic virus (BMMV) are built of 180 subunits of a single protein species of MW 40 x 10(3) [coat protein CP], packed into a T = 3 surface lattice. The capsomers on the five-fold symmetry axes protrude 2-3 nm from the particle surface. The virions encapsidate genome-size [approximately 4,200 nucleotides (nt)] as well as some heterogeneous RNAs of subgenomic size approximately 1,000-2,000 nt. In cell-free systems from Krebs-2 ascites cell extracts and rabbit reticulocyte lysates, genome-size RNA directed the synthesis predominantly of two polypeptides of MW 27 x 10(3) and 79 x 10(3) while the third major BMMV-specific polypeptide (MW 40 x 10(3), putative CP) seemed to be encoded by a shorter messenger RNA. The 'cap' analogue, m7GDP, partially inhibited BMMV RNA in vitro translation, suggesting that at least part of the BMMV-specific RNAs are capped. Oligo (dT)-cellulose column chromatography data suggested that poly(A)-tracts are absent from the BMMV genome. The data obtained confirm the previous classification of BMMV within the carmovirus group.

Translation arrest of potato virus X RNA in Krebs-2 cell-free system: RNase H cleavage promoted by complementary oligodeoxynucleotides

Translation arrest of genomic potato virus X (PVX) RNA promoted by complementary oligodeoxynucleotides in Krebs-2 cell-free system is described. 14-15 mer oligodeoxynucleotides complementary to the 5'-proximal cistron of PVX RNA were shown to induce specific truncation of the major non-structural polypeptide coded by PVX RNA. Evidence is presented that effective translational arrest of PVX RNA in the presence of complementary oligonucleotides results from the site-specific cleavage of RNA by endogenous RNase H intrinsic to the Krebs-2 extract. No similar translational arrest was found in the rabbit reticulocyte lysate cell-free system.

[Analysis of polypeptides of virus-specific informosomes induced by tobacco mosaic virus and potato virus X]

Informosome-like virus-specific ribonucleoprotein (vRNP) of tobacco mosaic virus (TMV) comprise a set of four major polypeptides having molecular weights of 17 500, 31 000, 37 000 and 39 000. Of the minor polypeptides, those of apparent molecular weights 25 000, 55 000, 68 000 and 70 000 had electrophoretic mobilities of polypeptides found in a ribonucleoprotein preparation from uninoculated plants. Polypeptide with mol.wt. 175 000 is TMV coat protein so far as: a) vRNP was precipitated with immunoglobulins against TMV and TMV coat protein; b) it had electrophoretic mobility similar to mobility of TMV coat protein; c) the peptide map of polypeptides with mol.wts 31 000, 37 000 and 39 000 are probably virus-specific-products. This is supposed because they are not present in cell informosomes protein, and they are not revealed in vRNP induced in cells after infection with potato virus X (PVX). Electrophoresis of vRNP-PVX protein reveals polypeptides of 23 000 (PVX coat protein), 55 000, 70 000, 78 000, 95 000, 120 000 and 145 000.

[Virus-specific informosomes in tobacco cells infected with tobacco mosaic virus]

We have previously detected in TMV-infected cells virus-specific informosome-like ribonucleoproteins (vRNP) that differed in the CsCl buoyant density from mature TMV particles. It is shown in the present work that [3H]uridine-labelled TMV-specific structures, when fractionated in Cs2SO4, produce three types of structures, i. e. with a buoyant density of 1.23 g/cm3 (the so-called 1.23 material), 1.29 g/gm3 (mature virus) and 1.34--1.49 g/cm3 (vRNP). The 1.23 material has been investigated. The incorporation of [3H]palmitic acid and the sensitivity of this material to 0.1% Na dodecyl sulphate was interpreted to mean the presence of membrane components. Treatment of the 1.23 material Na dodecyl sulphate induces the release of the mature virus, vRNP and free viral RNA. vRNP was shown to contain genome TMV RNA (mol. weight, 2.0 x 10(6)) and a considerable amount of subgenomic TMV RNA (mol. weight, 1.1--1.3 x 10(6) and 0.6--0.8 x 10(6)). It is demonstrated that RNA isolated from vRNP codes for TMV-specific proteins and is able to hybridize with recombinant plasmid containing DNA-copy of 3'-end RNA TMV fragment (about one half of genome).

[Isolation of protease complexes from Streptomyces griseus by ultrafiltration]

The possibility of concentrating proteases from Streptomyces griseus by the ultrafiltration technique using Soviet membranes of the MB-I-IV type was explored. This method allowed a 3-10 fold reduction of the native solution of enzymes and their simultaneous purification from by-products.