[Comparison of results of elastography with hormonal and metabolic status in patients with the diagnosis of thyroid neoplasms].

In order to assess the effectiveness of compression elastography of the thyroid gland as a method for differential diagnosis to studies conducted in the pre-operative period, there were involved 34 patients with a mean age 46.6 +/- 2.7 years. Elastography in the real time was characterized, according to the method of estimating, by a relatively high sensitivity (85.2-92.5%) and accuracy (70.6-79.4%), but low (30%) specificity. The specificity of the method, as it turned out, could be improved by taking into account the level of thyroid stimulating hormone (TSH) in the blood or body mass index (BMI) of the patients and, therefore, reducing the number of false-positive findings. Further improvement in the pre-operative diagnosis of malignant tumors of the thyroid gland and the formation of appropriate risk groups could be based on a combination of cytologic, hormonal, genetic and instrumental methods, including the so-called shear wave elastography.

[Direct results of endovascular prosthetics of aneurysms of the infrarenal part of the aorta in patients with a severe concomitant pathology].

From May 2007 to March 2009 under observation there were 58 patients aged from 52 to 79 years (mean age 68) with the diagnosis of abdominal aortic aneurysm (AAA). Selection of patients for endoprosthesis was performed by the data of spiral computed aortography. The endovascular exclusion ofAAA from blood flow was performed in 15 patients. All the patients had high risk of surgery because of multiple concomitant pathologies. In 14 (93%) patients bifurcational and in 1 patient aortofemoral unilateral prostheses of AAA were made with the application of femoro-femoral bypass. All implantations were technically successful without complications. Shorter time of operation, less intraoperative blood loss, shorter tine of staying in hospital and time of rehabilitation were found to be 1.5-3 times as compared with classical surgical intervention. Implantation of bifurcational stent-graph seems to be the method of choice in treatment of AAA patients with severe concomitant pathology.

[Evaluation of coronary bed function by positron emission tomography using 13N-ammonium during cold stimulation].

The purpose of the present investigation was to study the time course of changes in myocardial blood flow (MBF) in response to cold stimulation. Thirty-eight patients having risk factors of cardiovascular complications were examined. The time course of MBF changes was estimated by positron emission tomography (PET) using 13N-ammonium at rest and during a cold test (CT). Endothelium-dependent vasodilation of the brachial artery was determined from the results of a reactive hyperemia test, by applying ultrasound duplex scanning. No significant MBF increase in response to the cold test was an indicator of coronary arterial endothelial dysfunction at cardiac 13N-ammonium PET. Agreement of the results of brachial arterial ultrasonography during reactive hyperemia and cardiac 13N-ammonium PET in the presence of the cold test suggests that endothelial dysfunction is generalized. Cardiovascular risk factors, such as left ventricular hypertrophy, smoking, dyslipidemia, and diabetes mellitus, substantially affect coronary arterial function. Left ventricular hypertrophy is an independent factor that influences the amount of the coronary reserve and, in combination with endothelial dysfunction, worsens coronary microcirculation.

[Modern diagnostic technologies in determination of the strategy of treatment of patients with obliterating atherosclerosis of the lower artery vessels].

The authors analyzed results of surgical treatment of 332 patients in whom 410 reconstructive operations were performed on the lower extremity arteries. During 12 months after operation on the aorto-femoral segment with high peripheral vascular resistance reocclusions were noted in 61% of the cases, with normal resistance--in 11.8%, after operation on the femoro-popliteal segment--in 77.1% and 28.3% respectively. According to the findings of computed tomography and magnetic resonance imaging, densitometry the indices were established allowing prognosis of high peripheral resistance in the lower extremity arteries at the preoperative stage. Such indices are considered to be indications to femoro-profundoplasty on the aortofemoral segments or arterio-venous fistula on the femoro-popliteal segment. Such effectively fulfilled interventions could reduce the frequency of reocclusions to 3.1% on the aorto-femoral segment and to 11.8% on the femoro-popliteal segment.

[Evaluation of coronary bed function by positron emission tomography using 13N-ammonium during cold stimulation].

The present investigation was to study the time course of changes in myocardial blood flow (MBF) in response to cold stimulation. Thirty-eight patients having risk factors of cardiovascular complications were examined. The time course of MBF changes was estimated by positron emission tomography (PET) using 13N-ammonium at rest and during a cold test (CT). Endothelium-dependent vasodilation of the brachial artery was determined from the results of a reactive hyperemia test, by applying ultrasonic duplex scanning. No significant MBF increase in response to the cold test was an indicator of coronary arterial endothelial dysfunction at cardiac 13N-ammonium PET. Agreement of the results of brachial arterial ultrasonography during reactive hyperemia and cardiac 13N-ammonium PET in the presence of the cold test suggests that endothelial dysfunction is generalized. Cardiovascular risk factors, such as left ventricular hypertrophy, smoking, dyslipidemia, and diabetes mellitus, substantially affect coronary arterial function. Left ventricular hypertrophy is an independent factor that influences the size of the coronary reserve and, in combination with endothelial dysfunction, worsens coronary microcirculation.

[Cytological diagnosis and prognosis in Ewing's sarcoma in children].

143 cytological studies of the material obtained from 98 children aged from 2 to 18 years with tentative diagnosis of Ewing's sarcoma were made. Histocytological correlations showed 96.2% cases to be of informative value, 87% of them with precise cytological diagnosis of the above sarcoma. The analysis of images specified mean values of square (S) and ploidity (P) of tumor cell nuclei in 21 children with a good (10), and bad (11) outcome of the disease. It was established that if ploidy is higher than expected one (p = 0.0357 S), bad prognosis can be supposed and a good prognosis in the opposite case. In case of good prognosis differentiated tumor cells with large clear nuclei are seen in the smears, and poorly differentiated cells with hyperchromic nuclei are observed in cases with bad prognosis.

[Correlation of cytologic and DNA ploidy evidence and prognosis in childhood Wilm's tumor]. / Sopostavleniia dannykh tsitologicheskogo issledovaniia i opredeleniia ploidnosti DNK s iskhodom zabolevaniia pri opukholi Vil'msa u detei.

A retrospective evaluation of the clinical features, cytological, biological (DNA) and histological data on 29 children with Wilms' tumor. Two prognosis-related groups were identified: (1) good outcome (17)--all children, aged 4-15, had survived by end of follow-up; (2) bad outcome (12)--all children died within 4 months--4 years. Cytological examination by fine-needle biopsy of smears was carried out prior to preoperative neoadjuvant therapy in all 29 patients; in addition, print smears from resected tumor were taken from 21. Blastemal, stromal, epithelial and anaplastic cells levels were estimated by the semi-quantitative procedure (0, 1+, 2+, 3+). DNA ploidy was determined by image cytometry after destaining slides and re-staining them according to Feulgen. It was shown that favorable outcome could be expected when fine-needle biopsy of print smears identified DNA diploidy and marked drug-related pathomorphosis involving fewer blastemal cells and signs of cell dystrophy and tumor necrosis. When anaplastic and aneuploid cells were detected, matched by the absence of therapeutic pathomorphosis, outcome was poor.

[Ultrasound diagnosis of angiopathy in antitumor therapy]. / Ul'trazvukovaia diagnostika angiopatii pri protivoopukholevoi terapii.

The ultrasound characteristics of arterial walls were assessed in 78 young and middle-aged male (42) and female (36) cancer patients (mean age 36 +/- 0.9) receiving radiation and/or polychemotherapy. The study was specifically concerned with quantitative and qualitative changes in the "intima-media" complex and the vasoactive dysfunction of the endothelium. We established the ultrasound characteristics of arterial walls, in particular, the damage done to the complex in the arteries in exposed sites, and angiopathies as a systemic manifestation of vasoactive dysfunction (polychemotherapy) or the combined effect on the vascular wall radiopolychemotherapy, vis-a-vis each therapeutic modality, separately and in combination.

[The results of cytologic diagnosis of bone tumors]. / Rezul'taty tsitologicheskoi diagnostiki opukholei kostei.

The results of bone tumor cytological diagnosis in 968 patients examined and treated at the Institute Clinic (1988-1997) were analyzed. Histological examinations were performed in 479 cases. The share of cytologically inconclusive findings was significantly higher with benign lesions (17.5%) than malignant tumors (9.0%; p(0.05). The sensitivity and specificity of cytological analysis were 94.7 and 93.4%, respectively; positive predictive value--96.7, negative--89.8 and overall diagnostic accuracy--94.3%. Histological pattern of tumor was correctly identified in 73.7% of malignancies.

[Results of cytologic diagnosis of breast tumors]. / Rezul'taty tsitologicheskoi diagnostiki opukholei molochnykh zhelez.

The data on the cytological diagnosis of breast cancer in 4.410 patients tuated at the Clinic of the Institute in 1993-1996 are presented. There was histological evidence on 1,479 patients. The sensitivity of cytological examination was 97.2, specificity--92.4, predictive value of positive test--97 and that of negative test--93%. Correlations between cytological evidence, histological pattern, stage and size of tumor are discussed.

[Cytologic diagnosis of retroperitoneal tumors in children]. / Tsitologicheskaia dignostika zabriushinnykh opukholei u detei.

Cytological diagnosis of retroperitoneal tumors in 173 children (1985-1996) has been evaluated, using aspiration biopsy (165), imprint smears (84) and cytohistological examination (128). Fine-needle biopsy data were confirmed in 99%; histological examination--97.3%.

[The results of cytologic diagnosis of thyroid diseases (20 years experience)]. / Rezul'taty tsitologicheskoi diagnostiki zabolevanii shchitovidnoi zhelezy (20-letnii opyt)

The data on fine-needle aspiration biopsies and imprint smears for thyroid nodules and regional lymph nodes carried out in 1129 patients at the Institute Clinic (1976-1995) were reviewed. Histological examination was performed in 340 cases. The cytological procedure showed a diagnostic sensitivity of 92.3% and a specificity of 75.8%.

[Cytological characteristics of the bronchial epithelium in lung cancer and chronic lung disease]. / K tsitologicheskoi kharakteristike bronkhial'nogo épiteliia pri rake i khronicheskikh zabolevaniiakh legkikh.

Cytological patterns of bronchial epithelium were studied in 204 cases of lung cancer and 131 cases of chronic non-specific lung lesions and tuberculosis. The material under study included bronchial washings and smears. Reactive changes in bronchial epithelium in certain forms of lung cancer, chronic non-specific lesions and tuberculosis appeared to be different. Reactive changes are of no diagnostic value unless cellular background, pattern of sputum, and clinical course and case history data are taken into account.

[Prognosis of the incidence of hemorrhagic fever with the renal syndrome in the Primorsk region]. / Prognozirovanie zabolevaemosti gemorragicheskoi likhoradkoi s pochechnym sindromom v Primorskom drae

A study was made of a possibility of prognostication of the number of patients (morbidity per 100 000 residents) with hemorrhagic fever with the renal syndrome in conditions of the Primorsk region. The main factors characterizing this disease were analyzed with the use of the "Minsk-22" computer; these were dynamics of the populations of murine rodents, metereological data, morbidity. A method of prognostication of the number of patients (morbidity) with hemorrhagic fever and a renal syndrome in the Primorsk region for the current year was elaborated.