[Determination of the presence of an antibiotic in implant-bone biopsy specimens by Raman spectroscopy in experiment]. / Opredelenie nalichiya antibiotika v implantato-kostnykh bioptatakh metodom ramanovskoi spektroskopii v eksperimente.

THE AIM OF THE STUDY: Was to determine the presence of an amoxicillin-based antibiotic in bone implant biopsies by Raman spectroscopy in an experiment. MATERIALS AND METHODS: Experimental animals (n=10, a miniature pig of the Svetlogorsk breed) were divided into 2 groups of 5 animals. Groups 1 and 2 were injected with amoxicillin 2 ml per 20 kg of body weight 30 minutes before dental implantation surgery, then group 2 was additionally injected with 1 ml per 20 kg of body weight for 5 days. Each animal has 6 implants installed. On the 1st, 3rd, 7th, 14th day, an implant-bone biopsy was removed from each animal, micro-preparations were made and Raman spectroscopy was performed to assess the peak matching of the Raman spectrum. RESULTS: In animals of the 1st and 2nd groups, the main peak of the Raman spectrum, which is closest to the values of the antibiotic spectrum of interest to us, is located closer to 1448 cm-1 and 1446 cm-1, respectively. At the same time, in both observations, the peaks relate to the spectrum of bone tissue, which cannot indicate the content of an antibiotic in the drug. CONCLUSION: No scattering spectra corresponding to the antibiotic molecule were found in any animal from both groups, regardless of the mode of administration and dosage of amoxicillin. The detected peaks corresponded to bone tissue without an antibiotic.

Experimental Model for the Study of Reparative Bone Regeneration in the Reconstruction of the Lower Jaw.

An experimental in vivo model has been developed on the rabbit mandible to study reparative regeneration of alveolar bone after intercortical split osteotomy and the role of the periosteum in the process of reparative osteogenesis. The peculiarity of this model is fixation of the periosteum over the reconstruction zone, which allows preserving the bone block displaced during surgery and leads to the formation of an organotypic structure of the regenerate with cortical and spongy bone.

[The improvement of cognitive rehabilitation of persons of older and senile age].

The article presents results of study of patients of elderly age within the framework of pilot project on the basis of the geriatric department of the State Budget Institution of the Rostov Oblast "The Hospital for War Veterans". The specially questionnaire was developed with participation of the charitable foundation "Memory of Generations" and the public movement "Medics-Volunteers". The social hygienic characteristics of studied contingent was analyzed. The statistical processing of obtained data was carried out considering subjective status of patients.

[The impact of masticatory muscles hypertonicity on the bite formation]. / Vliyanie gipertonusa zhevatel'noi muskulatury na formirovanie okklyuzii.

THE AIM OF THE STUDY: Was to assess the impact of masticatory muscles hypertonicity on the bite formation. MATERIALS AND METHODS: The study comprised 60 patients aged 7-14 years. Group 1 consisted of 20 individuals with Angle class 1 occlusion without masticatory muscle hypertonicity. Group 2 comprised 20 patients with class II malocclusion with hypertonicity of the masticatory muscles, group 3 - 20 patients class II malocclusion and no hypertonic masticatory muscles. All patients were examined according to common diagnostic protocol that included electromyography of the temporal and masticatory muscles at rest and in dynamics). RESULTS: In group 1 the mean IMPACT at rest was 242.8±133.6 µV, IMPACT during contraction was 880.50±201.5 µV; in group 2 - 797.9±413.0 and 1561.23±568.0 µV; in group 3 - 236.7±93.5 and 955.60±295.5 µV, correspondingly. The ratio of the activity of the temporal muscles to the masticatory muscles with neutral occlusion at rest correlates as 1:09, with compression 1:1. In patients with distal occlusion and the presence of hypertonicity at rest, the temporal muscles correspond to the chewing proper as 1:0.8, and with compression 1:09. CONCLUSION: The estimated ratio can contribute to the retroposition of the mandible, as well as inhibition of the growth of the mandible in the sagittal direction.

Micro X-ray Spectral Analysis and Comprehensive In Vivo Study of Modified Titanium Implants.

We developed a technique for the complex modification of the surface of dental implant made of VT1-0 titanium that included sequential mechanical treatment and irradiation with powerful ion beams. The chemical composition and physical properties of the surface of titanium implants (VT1-0 grade) sandblasted with subsequent acid etching, as well as subjected to complex treatment (sandblasting and irradiation with powerful ion beams) were evaluated using micro-X-ray spectral analysis. In in vivo experiments, osseointegrative properties of the implants subjected by these treatments were compared. Microrentgenospectral analysis of dental implants subjected to irradiation with powerful ion beams revealed higher indicators of surface cleanliness; in in vivo experiments, morphometric analysis also demonstrated high osseointegrative properties.

Halophilous Vegetation of the Southern Coast of the Pechora Bay.

Geobotanical studies of the coastal halophilous vegetation are carried out on the southern coast of the Pechora Bay (the Barents Sea region). The ecological-phytocenotic approach is applied for classification; in total, 11 plant associations (including 2 subassociations) belonging to 10 formations are described. The syntaxa are identified considering 94 original geobotanical descriptions. In the article, the classification is limited to two leading syntaxonomic units: (1) formation, distinguished by the type of phytocenosis edificator species and (2) association, distinguished by the dominant species of the upper and lower tiers, which are defined as the diagnostic category. The vegetation cover differed in composition and structure in the habitats with different ecological conditions, such as beaches and foredunes, salt and brackish marshes, brackish water bodies on the marshes, ecotone zones between marshes, and shrub tundra. On the beach sands, there were communities of two associations: Leymetum arenarii honckenyosum diffusae and Leymetum arenarii latirosum japonici. The salt marshes were covered with the halophilous vegetation of the four associations: Caricetum subspathaceae potentillosum egedii, Caricetum glareosae potentillosum egedii, Festucetum rubrae potentillosum egedii, and Caricetum mackenziei. In the brackish marshes, there were communities of associations of Rumexetum aquaticus, Glycerietum fluitantis subpurum, and Arctophiletum fulvae. The small brackish lakes were occupied by the communities of Hippuridetum tetraphyllae. The communities of Salicetum reptantis parnassiosum palustris association are described in the ecotone zones between the marshes and shrub tundra. The original data on the marshe syntaxa described by the ecological-phytocenotic approach are compared with the previously published data on those from the Bolshezemelskaya tundra, but identified using the ecological-floristic approach. For the first time, the vegetation of marshes and beaches at the mouth of the Dresvyanka River is described. The article expands the information about the distribution of beach communities of the Leymeta arenaria formation, and the communities of marshes of the Caricetum subspathaceae, Caricetum glareosae, Festucetum rubrae potentillosum egedae, Hippuridetum tetraphyllae, Rumexetum aquaticus, and Arctophiletum fulvae associations. New information about the composition and structure of the Glycerietum fluitantis subpurum association is presented; these communities are first described earlier by the authors outside the northern border of the range of the coenose-forming plant Glyceria fluitans, in the south of the Pechora Bay, at the mouth of the Khylchuyu River. These communities together with the coenose-forming plant Glyceria fluitans require protection in the Nenets Autonomous Okrug.

[Soy protein as part of a low-protein diet is a new direction in cardio- and nephroprotection in patients with 3B-4 stages of chronic kidney disease: prospective, randomized, controlled clinical study].

BACKGROUND: It has been established that the use of a low-protein diet (LPD) in combination with ketoanalogues (KA) of essential amino acids can contribute to cardio- and nephroprotection in chronic kidney disease (CKD). Moreover, it has been shown that replacing part of the animal protein with soy protein (SP) in the diet contributed to more pronounced nephro- and cardioprotection in CKD, however, the data, available in the literature, are mainly represented by experimental studies. AIM: To compare the effects of 2 types of diets on the main parameters of nephro- and cardioprotection in patients with CKD. MATERIALS AND METHODS: We have conducted a prospective, randomized, controlled clinical study which included 85 patients with 3B4 stages of CKD, compliant to LPD (0.6 g of protein/kg body weight) + KA (1 tablet/5 kg body weight). 43 patients (Group 1) received LPD with replacing animal protein with soy (60% soy protein + 40% another vegetable proteins) + KA, and 42 patients (control group, Group 2) received LPD (60% animal protein + 40% vegetable protein) + KA, within 12 months. RESULTS: The dietary substitution of animal protein with SP to a greater extent delayed the decrease in glomerular filtration rate (-5.9% vs -13.3%; p=0.048), the increase in left ventricular hypertrophy (+4.7% vs +12.3%; p=0.042), as well as the increase in central systolic blood pressure (+2.6% vs +13.0%; p=0.021), augmentation index (+7.6% vs +23.3%; p=0.010), slowed down the decrease in lean body mass in men (+0.9% vs -11.2%; p=0.017) and women (-1.8% vs -10.3%; p=0.024), increase in phosphorus (-10.3% vs +13.0%; p=0.029), cholesterol (-10.7% vs -3.4%; p=0.047) and urea (+6.3% vs +19.6%; p=0.035) serum levels. CONCLUSION: The use of LPD with substitution of animal protein with soy protein + KA provides a more pronounced effect on nephro- and cardioprotection as well as maintenance of nutritional status, than conventional LPD + KA in patients with 3B4 stages of CKD.

[Dedicated to the memory of Yuri Nikolaevich Volkov]. / Pamyati Yuriya Nikolaevicha Volkova posvyashchaetsya.

One of the brilliant representatives of medicine of the XX century is Yuri Nikolaevich Volkov. His results of scientific and practical activities are impressive in their scale. They are represented in numerous printed works devoted to the most important theoretical and practical aspects of otorhinolaryngology. Yuri Nikolaevich Volkov also created some inventions. His works are included in a four-volume guide to otorhinolaryngology and textbooks for medical students.

The tellurium-based immunomodulator, AS101 ameliorates adjuvant-induced arthritis in rats.

Despite undeniable improvement in the management of rheumatoid arthritis (RA), the discovery of more effective, less toxic and, ideally, less immune suppressive drugs are much needed. In the current study, we set to explore the potential anti-rheumatic activity of the non-toxic, tellurium-based immunomodulator, AS101 in an experimental animal model of RA. The effect of AS101 was assessed on adjuvant-induced arthritis (AIA) rats. Clinical signs of arthritis were assessed. Histopathological examination was used to assess inflammation, synovial changes and tissue lesions. Very late antigen-4 (VLA-4)+ cellular infiltration was detected using immunohistochemical staining. Enzyme-linked immunosorbent assay (ELISA) was used to measure circulating anti-cyclic citrullinated-peptide autoantibody (ACPA) and real-time polymerase chain reaction (PCR) was used to measure the in-vitro effect of AS101 on interleukin (IL)-6 and IL-1ß expression in activated primary human fibroblasts. Prophylactic treatment with intraperitoneal AS101 reduced clinical arthritis scores in AIA rats (P < 0·01). AS101 abrogated the migration of active chronic inflammatory immune cells, particularly VLA-4+ cells, into joint cartilage and synovium, reduced the extent of joint damage and preserved joint architecture. Compared to phosphate-buffered saline (PBS)-treated AIA rats, histopathological inflammatory scores were significantly reduced (P < 0·05). Furthermore, AS101 resulted in a marked reduction of circulating ACPA in comparison to PBS-treated rats (P < 0·05). Importantly, AS101 significantly reduced mRNA levels of proinflammatory mediators such as IL-6 (P < 0·05) and IL-1ß (P < 0·01) in activated primary human fibroblasts. Taken together, we report the first demonstration of the anti-rheumatic/inflammatory activity of AS101 in experimental RA model, thereby supporting an alternative early therapeutic intervention and identifying a promising agent for therapeutic intervention.

IVIG ameliorate inflammation in collagen-induced arthritis: projection for IVIG therapy in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease that leads to joint destruction and disability. Despite a significant progress in administration of biological agents for RA patients, there is still a need for improved therapy. Intravenous immunoglobulins (IVIG), a pooled polyspecific immunoglobulin (Ig)G extracted from 5000 to 20 000 healthy subjects, showed beneficial therapeutic effect in patients with immune deficiency, sepsis and autoimmune diseases. The current study aimed to investigate the beneficial effect of treatment with IVIG in established collagen-induced arthritis in DBA/1j mice. Murine arthritis was induced in DBA/1j mice. Treatment with IVIG began when the disease was established. The clinical score was followed twice a week until day 48. The mice were bled for plasma and the paws were hematoxylin and eosin (H&E)-stained. Cytokine profile in the plasma was analyzed by Luminex technology and titers of circulating anti-collagen antibodies in the plasma was tested by enzyme-linked immunosorbent assay. Our results show that treatment with IVIG in murine significantly reduced the clinical arthritis score (P < 0·001). Moreover, mode of action showed that IVIG significantly reduced circulating levels of inflammatory cytokines [interferon (IFN)-γ, interleukin (IL)-1ß, IL-17, IL-6, tumor necrosis factor (TNF)-α, P < 0·001], inhibiting anti-collagen antibodies (P < 0·001) in the plasma of collagen-induced arthritis mice. Importantly, histopathological examination revealed that IVIG treatment prevented the migration of inflammatory immune cells into the cartilage and synovium, reduced the extent of joint damage and preserved joint architecture. Our results proved for the first time the valuable anti-inflammatory treatment of IVIG in experimental RA. We propose IVIG therapy for a subgroup of patients with rheumatologically related diseases.

An interplay of various damage channels in polyethylene exposed to ultra-short XUV/X-ray pulses.

Polyethylene (PE) irradiated with femtosecond extreme ultraviolet or X-ray laser pulses in a single-shot damage regime is studied theoretically. The employed microscopic simulation tool XTANT-3 traces nonequilibrium electron kinetics, energy exchange between electrons and atoms, nonthermal modification of interatomic potential, and the induced atomic response. It is found that the nonthermal detachment of hydrogen atoms in bulk PE starts at the threshold deposited dose of ∼0.05 eV per atom. With an increase in the dose, more hydrogen atoms detach from the carbon backbone. At a dose of ∼0.3 eV per atom, hydrogen behaves like a liquid flowing around carbon chains. It is accompanied by the appearance of defect energy levels within the band gap. At a dose of ∼0.5 eV per atom, carbon chains actively bend and cross-link. In the range of doses from ∼0.5 eV per atom to ∼0.9 eV per atom, the electronic excitation induces formation of new carbon structures embedded in the hydrogen liquid, such as benzene-like rings. The band gap collapses at such doses, merging the valence and the conduction bands. Finally, at doses above ∼0.9 eV per atom, the carbon subsystem also melts into liquid. All of these damage mechanisms are mainly nonthermal, triggered by promotion of electrons from the valence into the conduction band of PE. At high doses, however, thermal electron-ion coupling is extremely fast causing equilibration of the electronic and the ionic temperatures within a hundred femtoseconds.

Biocompatibility and Bioresorption of 3D-Printed Polylactide and Polyglycolide Tissue Membranes.

We studied biocompatibility and bioresorption of 3D-printed polylactide and polyglycolide tissue membranes. Ultrasound microscopy and histological examination showed that membranes fabricated of a copolymer of lactic and glycolic acids in a mass ratio of 1:9 are bioresorbed and have good biocompatibility with soft tissues (connective tissue, adipose tissue, and epithelium). An important feature of the copolymer membranes, which differs them from pure polylactide membranes, is the formation of a thin fibrous capsule that did not interfere its destruction by the mechanism of hydrolytic resorption.

Growth of Mesenchymal Stem Cells on Poly(3-Hydroxybutyrate) Scaffolds Loaded with Simvastatin.

We studied the effect of porous composite scaffolds based on poly(3-hydroxybutyrate) (PHB) loaded with simvastatin on the growth and differentiation of mesenchymal stem cells. The scaffolds have a suitable microstructure (porosity and pore size) and physicochemical properties to support the growth of mesenchymal stem cells. Scaffold loading with simvastatin suppressed cell growth and increased alkaline phosphatase activity, which can attest to their osteoinductive properties.

[Laparoscopic ONLAY ureteroplasty using buccal mucosa graft for long recurrent stricture of the upper third of the ureter].

Long strictures of the upper third of the ureter are most often recurrent and occur after endourological and reconstructive procedures. The lack of native tissues and an impossibility of substitution by bowel segment in some cases dictates the use of alternative surgical techniques. Our first experience of laparoscopic onlay ureteroplasty using buccal graft for long stricture of the upper third of the ureter is described in the article. The length of the stricture was 6 cm. The operation time was 210 minutes, while blood loss volume was less than 100 ml. The patient did not have any surgical complications. Drains were removed in timely manner. The patient was discharged from the hospital in a satisfactory condition on the 8-th day. The ureteral stent was removed after 4 weeks. Kidney ultrasound was performed on a monthly basis. According to IVU after 4 months, the anastomosis was completely patent. This method can be considered as an alternative to more complex procedures in selected patients.

[Active surgical approach for retroperitoneal liposarcoma]. / Rol' aktivnoi khirurgicheskoi taktiki pri zabryushinnoi liposarkome.

OBJECTIVE: To assess the influence of active surgical approach on the long-term postoperative outcomes in patients with retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. The effect of malignancy grade, adjuvant chemotherapy, number of separate tumor nodes in primary neoplasm and the first relapse, as well as the number of previous total resections on survival rate was analyzed. RESULTS: Overall and relapse-free survival is significantly worse in patients with high-grade retroperitoneal liposarcoma (G2-3) compared to low-grade (G1) tumor (plog-rank=0.000). Multifocal growth of primary tumor (p=0.869; plog-rank=0.607) and multiple (>1) separately located nodes in abdominal cavity and retroperitoneal space at the first relapse (plog-rank=0.158 to 0.985) did not significantly impair prognosis after total resection of all types of retroperitoneal liposarcoma regardless malignancy grade. Adjuvant chemotherapy does not significantly improve relapse-free survival. Overall survival was significantly higher in patients who underwent ≥4 previous total resections compared to 1 surgical treatment for all types of retroperitoneal liposarcoma regardless malignancy grade (p=0.000; plog-rank=0.001). CONCLUSION: The only potentially radical treatment for patients with retroperitoneal liposarcoma is surgery. We reported the advantages of active surgical approach for improvement of long-term outcomes in patients with retroperitoneal liposarcoma.

[Differentiated surgical approach for retroperitoneal non-organ liposarcoma]. / Differentsirovannyi podkhod v khirurgii zabryushinnykh neorgannykh liposarkom.

OBJECTIVE: To determine the indications for combined and organ-sparing surgery depending on malignancy grade of retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. Influence of malignancy grade, lesion of adjacent organs and resection/excision of adjacent organs on the overall and recurrence-free survival was studied. Moreover, we analyzed the issue of kidney-sparing surgery and nephrectomy. RESULTS: Overall and recurrence-free survival were significantly worse in high grade (G2-3) compared to low-grade tumors (G1) (p=0.0001; log-rank test). Visceral invasion was revealed in 23% of patients with low-grade (G1) tumors and 53% of patients with high-grade (G2-3) neoplasms. Visceral invasion significantly impairs overall and recurrence-free survival in both low grade (G1) and high-grade (G2-3) tumors (p=0.0001; log-rank test). In case of low grade (G1) retroperitoneal liposarcoma, overall and recurrence-free survival was similar after combined surgery without histologically confirmed visceral invasion of liposarcoma and organ-sparing surgery (p=0.006; p=0.053; log-rank test). On the contrary, high grade (G2-3) tumor was followed by significantly better overall and recurrence-free survival after combined surgery without histologically confirmed visceral invasion compared to organ-sparing surgery (p=0.006; p=0.053; log-rank test). Recurrence-free survival was similar after kidney-sparing surgery and nephrectomy among patients with low-grade (G1) tumor (p=0.456; log-rank test). In case of high-grade retroperitoneal liposarcoma (G2-3), recurrence-free survival was significantly worse after kidney-sparing surgery compared to nephrectomy (p=0.039; log-rank test). CONCLUSION: Surgery is the only potentially radical treatment of patients with retroperitoneal liposarcoma. Organ-sparing including kidney-sparing surgery is advisable for low-grade liposarcoma (G1). On the contrary, organ-sparing surgery impairs long-term results and prognosis in patients with high-grade tumors (G2-3). Combined operations including nephrectomy are justified for high-grade retroperitoneal liposarcoma (G2-3).

[Surgical and combined treatment of patients with duodenal stromal tumors]. / Osobennosti khirurgicheskogo i kombinirovannogo lecheniya bol'nykh stromal'noi opukhol'yu dvenadtsatiperstnoi kishki.

OBJECTIVE: To evaluate the immediate and long-term results of surgical and combined treatment of patients with duodenal stromal tumors. MATERIAL AND METHODS: There were 47 patients with duodenal stromal tumors for the period 2002-2019. All patients underwent treatment at the Blokhin National Cancer Research Center. Six patients had metastatic disease, 2 ones - a rare syndrome of duodenal stromal tumor associated with neurofibromatosis type 1, other 39 patients had a localized and locally-advanced disease. Surgical treatment was performed in 37 patients (limited resections (LR) in 24 cases and gastropancreaticoduodenectomy in 13 cases).Incidence of postoperative complications was significantly lower after limited resections compared to gastropancreaticoduodenectomy (22.2% (6/24) vs. 61.5% (8/13), respectively). Severe complications (Clavien-Dindo grade 3) occurred in 4.2% (1/24) vs. 15.3% (2/13) of patients, respectively. Postoperative mortality was absent in both groups. We observed no significant differences in long-term results. Overall 5-year survival was 91% and 70% (p=0.5960), 5-year recurrence-free survival - 65 and 70% (p=0.6226), respectively. CONCLUSION: Considering similar survival rates, lower postoperative morbidity and better quality of life, limited duodenal resections are preferred for duodenal stromal tumors.

[Rationale for the use of bioactive cements by in vitro simulation of accidental pulp opening]. / Obosnovanie primeneniya bioaktivnykh tsementov dlya sokhraneniya zhiznesposobnosti pul'py pri ee sluchainom vskrytii.

OBJECTIVE: To study the features of reparative dentinogenesis when using biomaterials during accidental opening of the pulp in an experiment. MATERIAL AND METHODS: In an experiment on 3 dwarf pigs of the Svetlogorsk breed a traumatic opening of the tooth cavity was carried out in 18 teeth (6 molars, 6 premolars, 6 incisors), then Biodentin (9 teeth) and Aurosil (9 teeth) were applied on the opened pulp horn. After 14, 30 and 60 days, dwarf pigs were euthanized, and jaw blocks taken. Histological examination of the teeth was carried out using the method of embedding in methyl methacrylate (OsteoBead, Sigma, USA). Thin sections of 35-50 microns were made from the samples and stained using the «Heavenly Trichrome¼ method. Documentation was carried out using a Leica DM100 microscope and an EC3 digital camera in reflected and transmitted light. RESULTS: Histological examination of the thin sections of teeth stained according to the «Heavenly Trichrome¼ method revealed that 2 weeks after the pulp opening and applying of Aurosil and Biodentin, comparable processes occurred in the tooth cavity. Thus, the proliferation of odontoblasts was noted on the lateral surfaces of the chamber. New dentin layers and odontoblasts spread over the lower surface of the material with the formation of dentinal bridges by 4 weeks of observation in both groups. By week 12, there was a decrease in the proliferative activity of odontoblasts and dentin maturation in all cases. At the initial stages of the experiment, some pulp edema and moderate plethora were noted, which was no longer observed at 4 weeks. By 12 weeks, because of the proliferation of odontoblasts, the volume of the tooth cavity was reduced by a third. By the 6th month in the experiment, no significant changes in the structure of dentin and pulp were revealed. CONCLUSION: According to morphological data the studied biomaterials (Aurosil and Biodentin) contribute to dentin regeneration equally.

[Organ changes found by postmortem examination in COVID-19 patients]. / Izmeneniya organov, vyyavlennye pri posmertnom issledovanii patsientov s COVID-19.

The postmortem study results presented in 20 sources of literature on 186 COVID-19 patients were analyzed. Pathological changes were noted in multiple organs, by involving predominantly the respiratory, circulatory, and excretory systems. The changes in the lungs were characterized by an increase in organ weight (59.3%), a dark red color of the parenchyma (47.4%), compaction of lung tissue (56%), and signs of lung congestion (37.3%). The histological characteristics found during postmortem lung tissue examination, which were indicative of diffuse alveolar damage, were proliferation of type II alveolocytes in 65.2% of cases, the appearance of hyaline membranes lining the alveoli in 64.4%, and interstitial edema in 54.2%. In the analyzed sources, 22% of cases were noticed to have severe thrombosis and pulmonary artery branch embolism that was associated with lower extremity deep vein thrombosis. In all the sources of literature, acute tubular necrosis, tubular luminal dilatation, and interstitial edema were detected in the kidneys.

[Retroperitoneal dedifferentiated liposarcomas: semi-quantitative assessment of the dedifferentiated component and prognosis]. / Zabryushinnye dedifferentsirovannye liposarkomy: polukolichestvennaya otsenka dedifferentsirovannogo komponenta i prognoz.

OBJECTIVE: To evaluate the impact of malignancy grade and the proportion of the dedifferentiated component (DC) in retroperitoneal dedifferentiated liposarcomas (DDLS) on the course and prognosis of the disease. MATERIAL AND METHODS: The retrospective study enrolled 74 patients with primary retroperitoneal DDLS who underwent radical surgical treatment in the N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia. Histological surgery specimens from all cases of DDLS were reexamined and reclassified. According to malignancy grades and the proportion of the dedifferentiated component in the tumor, the patients were divided into the comparison groups included in the intergroup analysis of overall and relapse-free survival (OS and RFS) rates. The authors also analyzed the relationship between the proportion of the dedifferentiated component in DDLS and the frequency of adjacent organ invasion. RESULTS: Patients with a more than 15% dedifferentiated component had significantly lower OS rates than those with a less than 15% one (p=0.0001; log-rank test). The median OS in the DDLS group with a less than 15% dedifferentiated component was 91 months (95% CI, 82-100); that in the DDLS group with a more than 15% dedifferentiated component was 29 months (95% CI 17-41). The 5-year overall survival rates in the groups with less than 15% and more than 15% dedifferentiated components were 69% and 2%, respectively. The group with a more than 15% dedifferentiated component had significantly lower RFS rates than that with a less than 15% one (p=0.0001; log-rank test). In the DDLS groups with less than 15% and more than 15% dedifferentiated components, the median RFS rates were 25 months (95% CI 23-27) and 13 months (95% CI 8-18), respectively. In these groups, the 2-year RFS rates were equal to 50% and 9%, respectively. In the DDLS groups with less than 15% and more than 15% dedifferentiated components, pathologically confirmed invasion into the adjacent organs was observed in 32% and 63% of cases, respectively. There were no statistically significant differences in the OS and RFS of patients with DDLS according to tumor grade (p=0.069; p=0.102). CONCLUSION: This investigation suggests that DDLS have a more aggressive course with an increasing proportion of the dedifferentiated component in the tumor. Considering the histological variability in the dedifferentiated component, which is demonstrated in the research and scientific literature, as well as lack of a prognostic impact of histological grade, the authors believe that semi-quantitative assessment of the proportion of the dedifferentiated component in DDLS is able to serve as a simple and efficient morphological marker for the course of the disease and prognosis in retroperitoneal DDLS.