The prevalence of polymorphism -1486T/C of the TLR-9 gene was studied in 44 patients with chronic Epstein-Barr virus infection (CEBV). The control group for the study of the polymorphisms prevalence of -1486T/C of the TLR-9 gene was 40 healthy donors. Three main genotypes of -1486T/C of the TLR-9 gene were identified based on the obtained results – TT, TC, CC. Investigation of the occurrence frequency of individual genotypes revealed the dominance of the TC genotype, compared with the homozygous TT and CC genotypes. The study of -1486T/C of the TLR-9 gene polymorphism frequency distribution for different genotypes demonstrated the specificity of changes in the TC genotype in patients with CEBV and the absence of such for the TT and CC genotypes. These results confirm the important role of the TLR-mediated signaling in the pathogenesis of the disease, which is necessary to determine the genetic background associated with the course of the disease and its possible consequences. These are the aspects that will further enable the identification of risk groups among such patients and provide timely therapy. The analysis of the results of the -1486T/C polymorphism of the TLR-9 gene revealed three main genotypes –TT, TC, CC. Investigation of the occurrence frequency of individual genotypes revealed the dominance of the genotype TC, compared with the homozygous genotypes of TT and CC. The study of frequency distribution of the polymorphism -1486T/C of TLR-9 for different genotypes demonstrated the specificity of changes in the TC genotype and the absence of suchin the TT and CC genotypes in patients with CEBV.Our study for the purpose of determining the 1486T/C polymorphism of the TLR-9, that is associated with chronic forms of CEBV infection, confirms the important role of TLR-mediated signaling in the pathogenesis of this disease, which is necessary to determine the genetic background associated with the course of the disease and possible consequences of CEBV. These aspects will further enable the identification of risk groups among such patients and provide timely therapy.Analysis of the results allowed establishing the following:1. The 1486T/C polymorphism of the TLR-9 gene is significantly more frequent in patients with CEBV than in the control.2. The frequency distribution of the -1486T/C polymorphism ofthe TLR-9 gene allowed the establishment of the association of the genotype TC with chronic forms of the EBV infection, which is very specific for this group of patients.

Paraganglioma is one of the tumors that is rarely found in the practice of an otorhinolaryngologist. Approximately 90% of tumors from nonchromaffin paraganglia occur in the adrenal glands. Nevertheless, 5 – 10 % of paragangliomas have different localization: 85 % - in the abdominal cavity, 12 % - in the chest, 3 % - on the head and neck. Paraganglioma grows slowly, but there is a risk of its degeneration into a malignant neoplasm. Diagnosis of paraganglioma includes CT, MRI; Ultrasound scintigraphy, arteriography, biopsy, histological examination. The main treatment for this education is surgical. As this tumor occurs rather rarely, we present a clinical observation of a paraganglioma of the nasal cavity. Purposes. The purpose of this article is to describe a rare clinical case of paraganglioma of the nasal cavity to determine diagnostic measures and treatment tactics to help a practical doctor. Materials and methods. On 01/18/2019 patient M., 52 years old, with complaints of recurrent nosebleeds, difficulty breathing in the right half of the nose was received at the ENT Center «V. T. Lisovets Dynasty». Bleeding from the nasal cavity has been disturbing the patient twice a week for 6 months, for no apparent reason. An increase in the frequency of bleeding up to 4–5 times a week has been noticed for the last month. On a series of MRI tomograms dated 12.24.2019, in the front sections of the nasal concha, on the right, a volumetric pathological formation with dimensions of about 10 × 12 mm, with tuberous contours, an inhomogeneous MR structure was determined. Bone structures were not affected. The neoplasm narrowed the lumen of the nasal cavity on the right. Conclusion: MR-picture of the pathological volumetric formation (of blastomatous nature) of the nasal cavity on the right. Results. On 01/21/2019 the patient underwent surgical removal of the neoplasm within healthy tissues using a radioknife. An anterior nasal tamponade with a hemostatic preparation was performed. The postoperative period was without complications. A morphological examination of surgical material N 330/2019 yielded the following results: a microscopic examination determined a tumor with the same histological picture in the form of alveolar and solid areas, a branched network of blood vessels of capillary type, fibrous tissue of various thicknesses. Tumor parenchyma was represented by epithelioid morphology cells with pronounced eosinophilic cytoplasm, a large nucleus with granular chromatin. Cells with a weakly expressed eosinophilic cytoplasm, with small monomorphic nuclei were also found. Conclusions. The patient was diagnosed with a rare tumor of neuroectodermal nature, which in most cases has a benign nature, slow growth and develops from nonchromaffin ganglia, which are scattered throughout the body. As the formation grows, the arterial and venous network of vessels develops. The clinical picture of a neoplasm of the nasal cavity is often masked by the symptoms of chronic polypousrhinosinusitis, vasomotor and chronic hypertrophic rhinitis. Based on the foregoing, this clinical cases valuable for the practitioner in terms of the features of localization, diagnosis and these lection of the correct therapy for this category of patients.

The problem of frequently ill children has extreme relevance in medical practice. A special group is FIC with autonomic dysfunction syndrome, born prematurely with perinatal damage of the central nervous system (CNS). In previous studies, we found that FIC who were born prematurely with perinatal damage of the central nervous system exhibit lower immunoreactivity than their healthy peers. Purpose of the work – to study the biochemical indicator of immunocompetent cells (the study of the phospholipid composition of granulocyte membranes) of the frequently ill children with autonomic dysfunction syndrome, born prematurely with perinatal damage to the central nervous system (CNS). Materials and methods. 68 children in the age of 6-7 years who are belonging to the group of frequently ill were examined. Out of 68 children, there were 36 children with autonomic dysfunction syndrome (SVD) born prematurely with perinatal hypoxic-ischemic damage to the central nervous system (group 1) and 32 children without autonomic dysfunction syndrome born on time without central nervous system damage (group 2). Results. A study of the phospholipid composition of blood granulocyte membranes of patients of the studied groups revealed significant differences comparison with the control group. The revealed changes in granulocyte biomembranes were more pronounced for FIC with SVD born prematurely with perinatal CNS damage than for children born on time without CNS and SVD damage. Conclusions. The obtained data allow us to conclude that FIL who were born preterm with perinatal damage of the central nervous system, changes in the biochemical characteristics of membranes are observed to a slightly greater extent than for children who were born on time without central nervous system damage. The revealed changes in immunocompetent cells are characterized by an increase in the polarity of the lipid component of biomembranes and a decrease in the relative content of neutral lipids in them. These violations lead to a change in protein-lipid interactions, which, as a result, leads to a change in the microviscosity of biomembranes and their structural and functional properties. At these children forme an inferior immune response to an infectious agent.

Today, about 85-95 % of the population is infected with EBV, therefore, the study of the nature of clinical and laboratory changes in patients with chronic EBV infection and the characteristics of the disease is an urgent problem of our time. According to the results of the study, it was found that in patients with chronic EBV infection, chronic tonsillitis, chronic fatigue syndrome and peripheral lymphadenopathy were more often observed among the clinical manifestations. In laboratory studies, it was found that patients with chronic EBV infection are characterized by a significant increase in ESR, an increase in the relative content of lymphocytes and monocytes, as well as a decrease in the absolute and relative content of neutrophils compared with the control group of patients, which indicates the presence of a shift in the leukocyte blood count, characteristic of the disease of viral etiology associated with EBV.

Study of the role of lipid peroxidation and antioxidant system in patients with infectious diseases is of great interest to researchers. Numerous studies have led to a common understanding of their contribution to the pathogenesis of infectious diseases, as well as to the complications development. However, the state of lipid peroxidation and antioxidant protection in patients with chickenpox (varicella) has not been sufficiently studied which is important for the development of new targeted treatments. The aim of the research - to assess the state of lipid peroxidation (LPO) and the antioxidant system (AOS) in the dynamics in patients with chickenpox, depending on the severity of the disease. Materials and methods. We selected for participating in the study 240 chickenpox patients (142 women and 98 men) aged 18-40 years. Chickenpox was diagnosed using clinical, serological, and molecular genetic methods. The state assessment of LPO in chickenpox patients was based on the determination of serum diene conjugates (DC), malondialdehyde (MDA) levels and the total oxidative activity (TOA) of blood plasma. Results. Study showed that the process of lipid peroxidation increases and the activity of the antioxidant system decreases in patients with chickenpox during the acute period of the disease. The extent of these processes becomes greater as the severity of chickenpox increases. A decrease in the activity of antioxidant enzymes and a disruption in the functioning of the glutathione system in patients with moderate to severe hypertension leads to disruption of protective mechanisms and, as a result, to an increase in the free radical chain reactions, the uncontrolled growth of which causes irreversible damage to the membranes of various cells, which underlies visceropathy in chickenpox patients. Conclusions. Antioxidant system is activated in the acute period in patients with mild chickenpox. It is evidenced by an increase in the overall antioxidant activity of blood plasma (p=0.045) and red blood cells (p=0.00087), in the activity of catalase (p=0.001), superoxide dismutase (p=0.0093), glutathione peroxidase (p=0.036), glutathione reductase of plasma and red blood cells, and an increase in the concentration of oxidized and reduced glutathione in blood. Lipid peroxidation is hyperactivated in the acute period in patients with a moderate and severe course of the disease and an excess amount of primary and secondary hydroperoxides of fatty acids accumulates in the blood. This is accompanied by indicates a developing imbalance between the oxidative and antioxidant systems in group of patients with moderate and severe chickenpox. Our findings confirm the usefulness of antioxidants in the treatment of chickenpox.