1Научно�исследовательский институт комплексных проблем гигиены и профессиональных заболеваний, г. Новокузнецк, 2 Городская больница №11, г. Новокузнецк Реферат Приведено описание редкого случая многолетнего наблюдения больной с опухолью краниовертебрального перехода. Представленный клинический случай содержит ряд заслуживающих внимания особенностей. Дебют заболевания с появления симптомов опухоли носоглотки, необычное распространение опухоли спереди в про-свет носоглотки с муфтообразным охватыванием тел позвонков С I -С II и сзади -в просвет позвоночного канала, наличие у больной признаков дизонтогенеза и органического перинатального поражения центральной нервной системы создали значительные сложности в определении характера и структуры опухолевого процесса, что в свою очередь повлияло на выбор тактики лечения. Проанализированы результаты обследования больной по поводу «рака носоглотки с распространением в ротоглотку». Показаны недостаточные возможности для диагностики опухоли краниовертебрального перехода таких методов, как реоэнцефалография, электроэнцефалография, эхоэн-цефалография, дуплексное сканирование брахиоцефальных артерий, транскраниальная магнитная стимуляция. Обнаружены сложности интерпретации результатов гистологического и иммунохимического исследований био-птата вне клинического контекста и данных лучевой диагностики. Уточнить характер и распространённость опухолевого процесса в краниовертебральном переходе позволили спиральная компьютерная и магнитно-резо-нансная томография с контрастированием.Ключевые слова: опухоли краниовертебрального перехода, спиральная компьютерная томография, магнитно-резонансная томография. Municipal hospital №11, Novokuznetsk, Russia A rare case of the long-term observation of a patient with craniovertebral junction tumor is decribed. The presented case report includes a number of noteworthy features. The onset of the disease as the nasopharyngeal tumor symptoms, unusual anterior tumor growth towards the nasopharyngeal lumen with cuff inclusion of С I -С II vertebral bodies and posterior growth towards the spinal canal, signs of development disorder and perinatal organic brain damage were the factors creating considerable difficulty in determining the tumor nature and structure, which in turn influenced the treatment choice. Results of the patient's examination for «nasopharyngeal carcinoma extending into the oropharynx» were analyzed. Insufficient capabilities of such methods as rheoencephalography, electroencephalography, echoencephalography, brachiocephalic arteries duplex scanning, transcranial magnetic stimulation for the diagnosis of craniovertebral junction tumor are shown. The difficulties of the biopsy histological and immunochemical study results interpretation out of clinical context and radiological data are discovered. Contrast spiral computed tomography and magnetic resonance imaging allowed to clarify the craniovertebral junction tumor nature and spreading. CLINICAL CASE OF CRANIOVERTEBRAL JUNCTION TUMOR SIMULATING NASOPHARYNGEAL
Introduction. Despite the signifi cant reduction in the production of electrolytic aluminum, the frequency of fl uorosis is a leader in this industry. In this pathology, fi rst of all, bone tissue actively reacts to the impact of factors of the working environment. The aim of the study was to study the eff ect of chronic fl uoride intoxication on the morphofunctional state of bone tissue. Materials and methods. Th e analysis of bone mineral density, structural rearrangement of skeletal bones was evaluated by x-ray method using photon densitometry. Biochemical status of blood of workers with fl uorosis included determination of parameters of mineral homeostasis (level of calcium, phosphorus) and genetic markers (COL1A1, IL1β, IL6, VEGF). Histological analysis of bone tissue was carried out in an experiment on white rats.Results. A comprehensive clinical and experimental study of bone tissue under chronic fl uoride intoxication is presented. A signifi cant correlation of GG COL1A1, TT IL1β, GC IL6, GC VEGF genotypes with the development of osteosclerosis was revealed. Th e study showed the relationship of combined signs of fl uorosis, confi rmed by experimental data on persistent bone destruction.Conclusions. Th e leading clinical and radiological syndrome of industrial fl uorosis is the defeat of the musculoskeletal system against the background of gross violations of the morphological and functional structure of the bones of the skeleton, due to the osteotropic mechanism of action of fl uorides and the genetic status of the body.
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