[Childhood hearing screening: achievements, difficulties, and possible ways to improve]. / Audiologicheskii skrining v detskom vozraste: dostizheniya, problemy, vozmozhnosti povysheniya effektivnosti.

Hearing impairment is the most common sensory impairment that is seen among adults and children. The frequency of congenital hearing loss is well-known due to implementation of newborn hearing screening. Hearing may change throughout a lifetime due to different factors and, therefore, the number of hearing impaired children increases with age. Introduction of universal newborn hearing screening has enabled earlier detection of hearing loss including unilateral and minimal disorders. Nevertheless, despite significant progress made in this field, there is still a group of hearing impairments that stay undiagnosed timely. Auditory neuropathy spectrum disorders, late-onset hearing loss, low-frequency and minimal hearing impairment are sometimes missed in newborn hearing screening or they manifest later. These types of hearing disorders are covered in detail in this review as well as possible ways of increasing the effectiveness of early diagnosis.

[Right ventricular myocardial infarction in a patient with infectious endocarditis]. / Infarkt miokarda pravogo i levogo zheludochka serdtsa u bol'nogo infektsionnym éndokarditom.

A case of right and left ventricular myocardial infarction in infectious endocarditis of the aortic valve in an injected drug abuser is reported. The infarction was diagnosed only in autopsy. Diagnostic difficulties are discussed. The literature on the problem is listed.

[Clinico-anatomic characteristics of pancreatic cancer]. / Kliniko-anatomicheskaia kharakteristika raka podzheludochnoi zhelezy.

340 autopsy cases of pancreatic carcinoma from hospitals of St. Petersburg (1990-1991) and Petrozavodsk (1981-1990) have been studied (male/female proportion 1.1:1). The pancreatic head was involved in 75% of cases, including the head only in 61.3%, head and body in 12%, total organ involvement in 2.7%. Pancreatic carcinoma was combined with other tumors in 7 cases, including 4 cases of simultaneous combination. Histological types of carcinoma were represented by: adenocarcinoma (75.2%), undifferentiated carcinoma (10.9%), solid cancer (5.8%), mucosal (4.1%), squamous cell carcinoma (1.7%), glandular-squamous cell carcinoma (0.6%). Metastases occurred most frequently in the liver (52.6%) and lymph nodes (44.7%). Jaundice was registered in 39.1% of cases, primarily in cases of carcinomatous head involvement, and in 12.8% without such involvement (most frequently with metastases to the portal lymph nodes of the liver). Diabetes mellitus was diagnosed in 18 (5.3%) patients, but only in 4 of them as a consequence of pancreatic carcinoma. The diagnosis was found missed in 48% of patients.

[The clinico-morphological characteristics of cancer of the extrahepatic bile ducts (an analysis of 52 autopsy cases)]. / Kliniko-morfologicheskaia kharakteristika raka vnepechenochnykh zhelchnykh protokov (analiz 52 autopsiinykh nabliudenii).

Autopsy records have been analysed for 52 fatal cases of extrahepatic bile ducts cancer. Primary cancer most frequently involved common bile duct (37 cases). Histologically, skirr was found in 1 case, small-cell cancer in 1 case, adenocarcinoma in 50 cases. Radical and palliative surgery was performed in 4 and 24 cases, respectively. The invasion into the adjacent tissues and organs occurred in 34.6%, metastases were found in 32.7% of cases. Another primary lesion arose in 2 patients (sigmoid, thyroid cancer). 92.3% of patients developed jaundice with hepatic or hepatorenal insufficiency. Purulent hepatic disorder, impairment of intrahepatic bile ducts were seen in 40.4%. Focal pneumonia emerged in 32.7% of patients. Accurate lifetime diagnosis was made in 30 of 52 patients only.

[Dynamics of blood lymphocyte blast-transformation parameters during hemosorption in patients with gastric ulcer]. / Dinamika pokazatelei blasttransformatsii limfotsitov krovi v protsesse gemosorbtsii u bol'nykh iazvennoi bolezn'iu.

The influence of autotransfusions of hemosorbent-treated blood on parameters of DNA-synthetic activity of blood lymphocytes was studied in 114 patients with gastric ulcer. A statistically significant increase in parameters of DNA-synthetic activity of lymphocytes was recorded simultaneously with the appearance of morphological signs of blast transformation on electrograms. A conclusion has been made on association of lymphocyte blastogenesis under the influence of autotransfusions with the process of ulcerous sanagenesis acceleration.

[The gastrostoma in esophageal cancer: complications and the times and causes of fatal outcomes]. / Gastrostoma pri rake pishchevoda: oslozhneniia, sroki i prichiny letal'nykh iskhodov.

Data of esophageal cancer patients autopsies for 1977-1986 were collected from hospitals of Leningrad and Petrozavodsk and subjected to analysis. Gastrostomy had been carried out in 255 out of 847 (29.1%) cases studied. 83.4% of the operated patients died within one month whereas only 2.1% survived over one year. The majority of patients were evidently operated too late in the course of disease. 148 (58.1%) operated cases died due to progression and the other 107 (41.9%) died of complications of the surgical procedure and postoperative period, mainly pneumonia and peritonitis. 106 cases of the latter group died during the first month following gastrostomy.

[Changes in the perineurium in experimental allergic polyneuritis]. / Izmeneniia perinevriia pre éksperimental'nom allergicheskom polinevrite

The perineurium performs the role of a diffuse neurotissue barrier, protecting the nervous fibres from extra neuronal pathological processes. The changes in the cellular layers of the perineurium in experimental allergic polyneuritis appear secondarily and are directly connected with the severity and localization of the demyelinating process. As a result of a developing demyelinization in the foci of allergic inflammation there is an accumulation of biologically active substances which lead to disturbances of permeability and the intactness of cellular layers of the perineurium. In its turn this leads to the proliferation of a protein exudate from the endobeurium into its intracellular spaces. The dystrophic changes were in the form of large vacuoles, spaces, lacunes of an incorrect form filled with proteins and a large amount of lysosome-like bodies. The cell nuclei were subjected to pycnosis and perinuclear swelling. In the other 3-5 layers there were only processes of a reactive character: a swelling of the cytoplasma, an enlargement of the cysterns in the endoplasmatic reticulum, an increase of the amount of free ribosomes and pynocytic vesicles.

[Hippocampus morphology in tissue culture]. / Morfologiia gippokampa v kul'ture tkani

Explants of the hippocampus of newborn rats were studied neurohistologically and with electron microscope within 5--35 days of explantation. Two zones are found in the culture of the hippocampus: a zone of explant, and a zone of outgrowth. Neurons, glial cells and a network of their fibres are compactly arranged in the center of the former, whereas, the latter involves a layer of migrated glial cells. The explant is surrounded by glia limiting cells. Three types of neurons are identified in the long living culture of the hippocampus: pyramidal, polymorphic and granule cells. Numerous nerve endings observed in the hippocampic explant can be recognized as axodendritic, axosomatic and glomerular synapses. The availability of several types of neurons, a variety of synapses and their complication during outgrowth of the culture are suggestive of a formation in the hippocampic explant of a functional reflex activity.