[Justifying standards of workup in patients with occupational polyneuropathy caused by physical overload].

The authors examined algorithm of investigations in occupational pathology centers for suspected occupational polyneuropathy due to physical overload. Suggestions included a procedure to investigate the patients, including medical specialists consultations, set of laboratory and instrumental studies divided into obligatory and by special indications.

[Evaluation of risk factors for neurosensory deafness in workers engaged into gas transport enterprise in Far North].

Complex study of health state covered 666 workers of gas transport enterprise situated in Far North of Russian Federation, revealed risk factors of neurosensory deafness. Neurosensory deafness risk depends on intensity of occupational noise and length of service under exposure to noise, on worker's age, presence of arterial hypertension and type of lipid metabolism disorders. The study found no correlation between neurosensory deafness risk and duration of residence in Far North. The authors suggested a mathematic model to evaluate risk of neurosensory deafness.

[Changes in clinical indices in patients in predisposition for pathological cicatrices formation].

Prophylaxis of ocurrence of pathological cutaneous cicatrices is one of actual problems of plastic surgery of head and neck. Cicatricial changes of tissues, as a consequence of operative interventions and various damaging causes (mechanical, thermal and chemical impact, ionizing irradiation, deep destructive inflammation), were depicted. Propensity for formation of pathological cicatrices we consider as the organism state, in which cicatricial changes occur as an answer for minimal trauma or spontaneously. Detailed analysis of fundamental issues and periodical scientific publications witness the insufficient substantiation of this issue.

[Evaluating dependency of medical rehabilitation results in occupational polyneuropathy patiens on treatment strategy and work conditions].

The authors evaluated efficiency of rehabilitation in patients with upper limbs occupational polyneuropathy, in accordance with length of service under physical overstrain. The study was based on follow-up of 268 patients. Treatment was initiated after the patients discontinued work hazardous for health. Drug and sanatorium treatment was effective in 67-86% of patients (with differences in occupational groups). The effect was only transitory (for 15-60 days) decrease of the disease clinical manifestations. Rehabilitation prognosis was reliably better in patients who worked during the disease development in conditions with number of stereotypic working movements of hands within hygienic norms. The treatment efficiency is reliably higher when started at younger age, regular drug and sanatorium treatment for many years. Placement of the patients on jobs avoiding physical overstrain enabled nowadays to prevent progression of occupational polyneuropathy.

[The risk factors and analysis of complications after regenerative interventions in surgery of oral cavity].

Most spreaded risk factors in reconstructive and plastic surgery of oral cavity were analyzed. Trustworthy monitoring of rate of the complications occurrence in augmentation of the jaws bones was conducted, depending on the risk factor.

[Comparative description and retrospective analisis of modern methods of surgical wounds closure for intraoperative prophylaxis of development of pathologic cutaneous cicatrices].

The experience of application of various methods of closure was presented for the head and neck cutaneous wound surfaces after elective operative interventions. The variant of the postoperative results estimation and optimization of the wounds healing by primary closure was proposed.

[Legal and methodologic problems of assessing relationships between diseases and occupational activities].

The article covers improvement of examination methods aimed to assess relationship between disease and occupation. The authors describe the most topical problems of this examination, not considered by operating regulatory acts, and possible ways to improve: unify the regulations determining criteria of relationships between disease and occupation, give arbitration functions to some occupational centers for resolving conflict and ambivalent examination situations about relationships between disease and occupation, presumption of employer's guilt principle to be implicated into examination concerning relationships between disease and occupation in the case of the employer's inability to justify safe working conditions for the diseased worker who has probable occupational disorder signs.

[Methodology of occupational fitness examination: problems and ways to solutions].

The article covers improvement of occupational fitness examination methodology in workers exposed to occupational hazards, based on longstanding experience of practical work in industrial medicine. The authors examined main causes of controversies and conflict situations in occupational fitness examination, possible ways to solve the problems in accordance with contemporary evidence-based medicine principles.

[Enamel structure of atypically formed human teeth].

Using light and scanning electron microscopy thin epoxide processed sections of 12 impacted third molars, one molar developed in odontogenic follicular cyst and one tooth-like teratoma were studied. It was established that the 4 impacted teeth and the tooth developed in odontogenic follicular cyst had obvious signs of enamel damage in the form of erosion in the crown fissures. The features of enamel alteration make it possible to interpret the changes as carious process which apparently has endogenous origin. Tooth-like teratoma extracted from ovarian dermoid cyst looked like canine and incisor "hybrid" coronal portion of which is covered with thin enamel layer, marked by obvious signs of multiple erosive lesions of endogenous nature. But unlike alterations in impacted teeth it resembles either fluorosis or enamel hypoplasia.

[On results of operative conference of pulmonologists and occupational therapists in St. Petersburg and Leningrad region, concerning the topic "Justifying changes in "Occupational Diseases list" according to respiratory disease classification and global strategies of diagnosis, treatment and prevention of chronic obstructive pulmonary diseases (COLD) and bronchial asthma (GINA)"].

Results of operative conference of North-West Russia pulmonologists and occupational therapists were summarized and covered improvement of current list of occupational diseases. Resolution of the operative conference on the problem is presented.

[Evaluating efficiency of rehabilitation in patients with occupational vegetative sensory polyneuropathies caused by physical overstrain].

Analysis of medical and occupational rehabilitation efficiency in patients with occupational polyneuropathies caused by physical overstrain revealed that most patients show persistent symptoms and ineffective occupational rehabilitation in spite of regular medical and sanatorium-and-spa treatment.

A method for making histological preparations equivalent to semithin sections with large examination areas for multipurpose morphological studies.

Effective methods for making semithin sections of large surface area are not currently available. An alternative solution to this problem, without actual histological section preparation, is proposed. This is a modification of a combination of methods for fixing tissues and embedding them in epoxide resin using known technical methods. This method for making preparations for microscopic examination of biological objects with large surface areas has additional valuable potential, as it allows investigations of a variety of complexes of soft and hard (cartilaginous and bony) tissues without prior decalcination.

[Method of producing histological preparations, equivalent to the large-area semithin sections, for multipurpose morphological studies].

The effective methods for producing large-area semithin sections are presently still unavailable. The method is suggested to alternatively solve this problem without the very procedure of histological sectioning. It includes a modified combination of the methods of tissue fixation and embedding in epoxy resin with the known technique of preparing the ground sections. This method of slide preparation for the microscopical study of large area biological objects gives an additional valuable opportunity, since it allows to study heterogeneous complexes consisting of soft and hard (cartilaginous and bone) tissues without their prior decalcination.

[Dental enamel structure and its relation to dentine].

New information on microscopic and ultrastructural architectonics of human dental enamel and its relation to dentin is presented. Enamel consolidation with dentin is mediated by borderline layer of calcificated substance having fibrous structure.

[Analysing results of rehabilitation of patients with occupational diseases in St Petersburg].

The authors studied rehabilitation of patients with occupational diseases. Rehabilitation of such patients via treatment courses with additional sick payment appeared ineffective. Most cases of occupational diseases are persistent. Even without disability group assigned, the patients remain with reduced occupational abilities for a long time.

[Medical strategy in municipal institutions for workers' health care management].

The authors stress increasing role of doctor in municipal medical institutions, with occupational medical service limited nowadays. The article contains typical medical defects in diagnosing occupational diseases and in their medical management. Suggestions cover measures to better those medical activities.

[Scientific activities of Occupational Medicine Department with St Petersburg Medical Academy for Postgraduate Education]. / Nauchnaia deiatel'nost' kafedry meditsiny truda Sankt-Peterburgskoi meditsinskoi akademii poslediplomnogo obrazovaniia.

The article deals with materials devoted to 80th anniversary of scientific activities of Occupational Medicine Department with St Petersburg Medical Academy for Postgraduate Education. Theoretic, scientifical and practical data on achievements on various stages of longstanding history are presented. The authors prove the research carried by the Department to be important and promising for occupational hygiene and industrial medicine.

[Results of epidemiological research in occupational morbidity]. / Rezul'taty épidemiologicheskikh issledovanii professional'noi zabolevaemosti.

The authors present materials on real prevalence of occupational diseases, calculate the diseases' share per economically active population, demonstrate thorough analysis of occupational morbidity in major industrial city, prove positive role of Occupational Pathology Center.

Quantitative nuclear morphometry by image analysis for prediction of recurrence of ductal carcinoma in situ of the breast.

Clinical management of ductal carcinoma in situ (DCIS) remains a challenge because significant proportions of patients experience recurrence after conservative surgical treatment. Unfortunately, it is difficult to prospectively identify, using objective criteria, patients who are at high risk of recurrence and might benefit from additional treatment. We conducted a multi-institutional, collaborative case-control study to identify nuclear morphometric features that would be useful for identifying women with DCIS at the highest risk of recurrence. Tissue sections of archival breast tissue of 29 women with recurrent and 73 matched women with nonrecurrent DCIS were stained for DNA, and nuclei in the DCIS lesions were evaluated by image analysis. A clear correlation between mean fractal2_area (FA2) and nuclear grade was observed (P < 0.001), allowing an objective determination of nuclear grade. Several nuclear morphometric features, including mean and variance of variation of radius, mean area, mean and variance of frequency of high boundary harmonics (FQH), and variance in sphericity, were found to be useful in discriminating recurrent from nonrecurrent DCIS subjects. However, the nuclear features associated with recurrence differed between high- and low-grade lesions. For lesions with high FA2 (nuclear grade 3), mean variation of radius, mean FQH, and mean area alone yielded recurrence odds ratios of 4.55 [95% confidence interval (CI) 0.45-45.96], 3.86 (95% CI, 0.88-16.98), 2.90 (95% CI, 0.31-27.2), respectively. Using a summed feature model, high-FA2 lesions showing three poor prognostic features had an odds ratio of 15.63 (95% CI, 1.22-200), compared with those with zero or one poor prognostic feature. Lesions with low mean FA2 (nuclear grade 1 or 2) showing high variances in sphericity and FQH had an odds ratio of 7.71 (95% CI, 1.77-33.60). Addition of other features did not enhance the odds ratio or its significance. These results suggest that nuclear image analysis of DCIS lesions may provide an adjunctive tool to conventional pathological analysis, both for the objective assessment of nuclear grade and for the identification of features that predict patient outcome.