[BRAF-STATUS OF PAPILLARY THYROID CARCINOMAS AND STRATEGY OF SURGICAL TREATMENT].

Analyzed the presence of BRAF V600E mutation in the focal thyroid gland in the preoperative diagnosis of papillary carcinoma (PC). Molecular genetic testing conducted on puncture aspirates from 26 patients before surgery. The diagnosis was verified according to the morphological investigations. Mutations in BRAF V600E detected only in patients with the thyroid PC. Thus, the definition of BRAF V600E mutation may be a marker in the preoperative diagnosis of thyroid PC. Analyzed the presence of BRAF V600E mutation in the focal thyroid gland in the preoperative diagnosis of papillary carcinoma (PC). Molecular genetic testing conducted on puncture aspirates from 26 patients before surgery. The diagnosis was verified according to the morphological investigations. Mutations in BRAF V600E detected only in patients with the thyroid PC. Thus, the definition of BRAF V600E mutation may be a marker in the preoperative diagnosis of thyroid PC.

Fungal Planet description sheets: 320-370.

Novel species of fungi described in the present study include the following from Malaysia: Castanediella eucalypti from Eucalyptus pellita, Codinaea acacia from Acacia mangium, Emarcea eucalyptigena from Eucalyptus brassiana, Myrtapenidiella eucalyptorum from Eucalyptus pellita, Pilidiella eucalyptigena from Eucalyptus brassiana and Strelitziana malaysiana from Acacia mangium. Furthermore, Stachybotrys sansevieriicola is described from Sansevieria ehrenbergii (Tanzania), Phacidium grevilleae from Grevillea robusta (Uganda), Graphium jumulu from Adansonia gregorii and Ophiostoma eucalyptigena from Eucalyptus marginata (Australia), Pleurophoma ossicola from bone and Plectosphaerella populi from Populus nigra (Germany), Colletotrichum neosansevieriae from Sansevieria trifasciata, Elsinoë othonnae from Othonna quinquedentata and Zeloasperisporium cliviae (Zeloasperisporiaceae fam. nov.) from Clivia sp. (South Africa), Neodevriesia pakbiae, Phaeophleospora hymenocallidis and Phaeophleospora hymenocallidicola on leaves of a fern (Thailand), Melanconium elaeidicola from Elaeis guineensis (Indonesia), Hormonema viticola from Vitis vinifera (Canary Islands), Chlorophyllum pseudoglobossum from a grassland (India), Triadelphia disseminata from an immunocompromised patient (Saudi Arabia), Colletotrichum abscissum from Citrus (Brazil), Polyschema sclerotigenum and Phialemonium limoniforme from human patients (USA), Cadophora vitícola from Vitis vinifera (Spain), Entoloma flavovelutinum and Bolbitius aurantiorugosus from soil (Vietnam), Rhizopogon granuloflavus from soil (Cape Verde Islands), Tulasnella eremophila from Euphorbia officinarum subsp. echinus (Morocco), Verrucostoma martinicensis from Danaea elliptica (French West Indies), Metschnikowia colchici from Colchicum autumnale (Bulgaria), Thelebolus microcarpus from soil (Argentina) and Ceratocystis adelpha from Theobroma cacao (Ecuador). Myrmecridium iridis (Myrmecridiales ord. nov., Myrmecridiaceae fam. nov.) is also described from Iris sp. (The Netherlands). Novel genera include (Ascomycetes): Budhanggurabania from Cynodon dactylon (Australia), Soloacrosporiella, Xenocamarosporium, Neostrelitziana and Castanediella from Acacia mangium and Sabahriopsis from Eucalyptus brassiana (Malaysia), Readerielliopsis from basidiomata of Fuscoporia wahlbergii (French Guyana), Neoplatysporoides from Aloe ferox (Tanzania), Wojnowiciella, Chrysofolia and Neoeriomycopsis from Eucalyptus (Colombia), Neophaeomoniella from Eucalyptus globulus (USA), Pseudophaeomoniella from Olea europaea (Italy), Paraphaeomoniella from Encephalartos altensteinii, Aequabiliella, Celerioriella and Minutiella from Prunus (South Africa). Tephrocybella (Basidiomycetes) represents a novel genus from wood (Italy). Morphological and culture characteristics along with ITS DNA barcodes are provided for all taxa.

[Postradial sialozoadenitis in patients with papillary carcinoma of the thyroid gland].

The authors present the results of investigation of 42 patients with salivary gland dysfunction after radioactive iodine-131 ablation therapy concerning papillary thyroid carcinoma. Clinical manifestations of postradial sialodenitis with secretory insufficiency of different degree were revealed. These side effects required an application of the special therapy.

[An endoapparatus for restoration of hip joint].

The possibility of prolonging the anatomic and functional longevity of joints in young patients with coxarthrosis deformans under conditions of long-term unloading using a submersible distraction device is considered. A submersible endoapparatus for restoration of hip joint is described. Its functional capabilities as an unloading device were corroborated by experimental testing. Clinical examples illustrated with X-ray photographs demonstrate the possibility of long-term unloading of the injured joint and postponement of endoprosthesis replacement in young patients by 20-25 years. It is suggested to use the developed method for organ-sparing surgery in young working-age patients.

[Current approaches to analysis of narcotic drugs in biological substances].

A method of analysis of basic narcotic drugs in urine is described. It consists in isolation by solid phase extraction, derivation and identification by gas chromatography with mass-selective detector. The approaches applied in the above method can be used for analysis of narcotic drugs undetectable by preliminary investigations as well as for urine examination for pharmacological or other biologically active substances.

[The role of computer tomography in differential diagnosis of benign and malignant tumors of the adrenals cortex].

Possibilities of computer tomography (CT) application for differential diagnosis of tumors of the adrenal cortex (TAC) were studied. CT was conducted in 157 patients with TAC, including 75--with malignant (MTAC), 82--with benign (BTAC), permitting to revealed MTAC in 76% patients. In 17.1% patients with BTAC false-positive results were noted, reducing, thus, the method diagnostic value. While the trustworthy signs of malignancy are absent, it is necessary to conduct morphological verification of the adrenal tumors nature using puncture biopsy and/or intraoperative express-cytological investigation.

[Using magnetic-resonance tomography in differential diagnosis of the adrenal glands malignant tumors].

Possibilities of application of magnet-resonance tomography (MRT) for differential diagnosis of the adrenal glands tumors were studied up. MRT was conducted to 39 patients with adrenal glands tumors, including 22 - with malignant adrenal gland tumor, 17 - with benign tumor of adrenal gland. MRT constitutes the most effective method of topic diagnosis of the adrenal glands tumor, owes multipurpose possibilities, do not deliver radiation load, permits to visualize the vessels without the contrast media usage. The tumor diameter more than 10,1 cm, irregular form, illegible edges, uneven contours, presence of lymphadenopathy, regional or remote metastases constitutes diagnostic criterions of the adrenal glands malignant tumors. The intensity of MRT signal could not be used for differential diagnosis of malignant and benign tumors of adrenal glands.

[Using ultrasound investigation in differential diagnosis of adrenal malignant tumors].

Possibilities of ultrasound investigation (USI) application for differential diagnosis of the suprarenal glands tumors (SGT) were studied. USI was conducted in 169 patients with SGT, including 95 with malignant tumors of suprarenal glands (MTSG) and 64--with benign SGT. USI constitutes the main method of screening, permitting to reveal SGT in 90.5% of patients. Diagnostic criterions of MTSG were: diameter of tumor exceeding 10.1 cm, incorrect form, irregular edges, presence of invasion, lymphadenopathy, regional and remote metastases. In 45.3% of observations it was possible to establish the MTSG diagnosis, using USI.

[Identification of narcotics in urine by capillary gas chromatography]. / Identifikatsiia riada narkoticheskikh veshchestv v moche metodom kapilliarnoi gazovoi khromatografii.

It is demonstrated that gas chromatography with quartz capillary columns (QCC) and with cross-sewn SE-52 by polysiloxane provides for the possibility to divide and identify, in human urine, 16 narcotic substances of the amphetamine, 1.4-benzodiazepine, morphine and other groups. The suggested extraction method makes it possible to isolate the above compounds from urine simultaneously and, after derivatization, to determine them by gas chromatography (GC) with programmed temperature within one stage analysis session. GC tests were performed on 2 both foreign and Russian QCC with SE-52. There is a description of 2 methods of how to obtain the trifluor-acetyl derivatives (TFA-derivatives) by using trifluor-acetate anhydride and N-methyl-bis-trifluor-acetamide. The limit of detecting the TFA-derivatives was 1-2 ng for the plasma-ionizing detector. The extraction method as well as the positive and negative aspects of using the TFA-derivatives are under discussion. The method of gas-chromatography/mass-spectrometry confirms that the positive results of radioreceptor assay are verified by GC in 92% of cases.

[Results of treatment of parathyroid gland cancer]. / Rezul'taty lecheniia raka parashchitovidnykh zhelez.

Carcinoma of parathyroid glands is characterized by relatively slow course, frequent recurrence after performance of operation. Authors were observed 8 patients, operated in 1967-2001, what had constituted 6% of all quantity of the primary hyperparathyroidism observations. Early diagnosis and performance of adequate surgical intervention promote the efficacy of treatment raising and the prognosis improvement. Most favourable prognosis was noted after performance of primary radical operation. In most observations the performance of reoperation guarantee long-lasting remission, but rarely constitutes the radical measure.

[Analysis of surgical treatment results of primary hyperparathyroidism]. / Analiz rezul'tatov khirurgicheskogo lecheniia pervichnogo giperparatireoza.

For the 1967-2000 period 134 patients with primary hyperparathyroidism (PHPTH) were treated in the clinic. Clinico-morphological characteristics of PHPTH were analyzed. In majority of the patients the mixed form of PHPTH was revealed. In 90% of patients solitary adenoma of parathyroid gland had constituted the morphological substrate of the disease. In 117 (87%) of patients positive result of treatment was noted. In 18 (15%) of patients postoperative permanent hypoparathyroidism occurred. Seven (4.5%) patients died. For the improvement of early diagnosis and effective treatment it is necessary to secure wide screening of the calcium content, peculiarly in patients, constituting the risk group.

[Reflecting the mode of metastasizing of the thyroid gland tumor in TNM classification]. / Otrazhenie v klassifikatsii TNM regionarnogo metastazirovaniia opukholi shchitovidnoi zhelezy.

Essential approaches to the regional metastasizing rubric in TNM system were analyzed. Basing on summary of the results of 466 operations, performed for the thyroid gland cancer including intervention on cervical lymph nodes, the subgroup N alteration in international classification TNM was proposed, permitting to reflect individual clinical situation full to the brim and to achieve significant practical gain in further management of patient. The grading proposed corresponds to general principle, according to which every subsequent rubric must determine more severe affection without combining several types of affection in individual patient.

[Reoperations in thyroid gland cancer]. / Povtornye operativnye vmeshatel'stva po povodu raka shchitovidnoi zhelezy.

Results of reoperation for the thyroid gland cancer (THGC) were analyzed in 189 patients for 1981-2001 yrs period. Majority of patients were primarily operated in other hospitals of Ukraine. Thorough characteristic of the cancer forms, terms of reoperation performance, results of histological investigation of the tumor are adduced. Large frequency (41.2%) of the operation performance for THGC recurrences in term up to one years after performance of primary intervention trusts the necessity of operative intervention performance on thyroid gland (THG) in specialized centre by experienced surgeons. Absence of malignant growth in the THG stump while performance of definitive thyroidectomy in 60% of observations is not the cause to reject of doing it because the conduction of radioiodine therapy is possible after complete excision of the THG tissue. Examination and ultrasonographic investigation of the THG region and of cervical lymphatic nodes after performance of operation for THGC is recommended to conduct no less than once in 6 months.

Thyroid cancer in children of Ukraine after the Chernobyl accident.

The results of treatment of 330 children (< 14 years) and adolescents (15-18 years) with thyroid cancer who were operated on at the Institute of Endocrinology after the Chernobyl accident in 1986 were analyzed. The number of young patients increased after 1986 (1981-1985, 9 cases; 1986-1990, 37 cases; 1991-1995, 177 cases; 1996-1998, 116 cases). Most of these children and adolescents were younger than 8 years at the time of the accident (84.2%). More than half of the children (58.1%) lived in areas receiving the highest radiation exposure. These thyroid cancers developed after a short latent period, were more aggressive at presentation, and expressed regional (57.3%) or distant (14.5%) metastasis. Solid papillary cancers were present in 93.1%. Coexisting thyroid conditions were common (thyroid hyperplasia, 25.1%; nodular goiter, 18.8%; chronic thyroiditis, 10.2%). Most patients were treated by total thyroidectomy with intraoperative visualization of recurrent laryngeal nerves and parathyroid glands. When lymph node metastases were identified, a modified neck dissection was performed. Such operations were done in 277 (84.1%) patients. Postoperatively, the patients were treated with radioiodine and thyroid-stimulating hormone suppressive therapy. Postoperative complications included recurrent nerve palsy in 12.3% and permanent hypoparathyroidism in 6%. Operations for local recurrence of cancer were performed in 2.8% cases and for regional metastasis in 4%. The general mortality was 1. 8%. We anticipate that there will be more patients with thyroid cancer during the next few years. Therefore this high risk population for thyroid cancer must be carefully monitored and evaluated during the next several decades.

[Immune state of patients of various age with the thyroid gland tumor]. / Immunnyi status bol'nykh razlichnogo vozrasta s novoobrazovaniem shchitovidnoi zhelezy.

The comparative analysis of immune state of the various age patients with benign and malignant thyroid gland (TG) tumors is presented. In the TG cancer the immunogenesis insufficiency is more pronounced. The data obtained trusts the perspectiveness of the immunocorrecting therapy application in patients with the TG cancer.

[Surgical treatment of benign tumors of thyroid gland in children and adolescents]. / Khirurgicheskoe lechenie dobrokachestvennykh novoobrazovanii shchitovidnoi zhelezy u detei i podrostkov.

In 1981-1998 years 552 children and juveniles were operated on for benign tumors of thyroid gland (TG). The enhancement of the revelation frequency of solitary and polynodous goiter and lowering of follicular adenoma and cystadenoma was noted. The tactics of children and juvenile patients with benign TG tumors was proposed, which included an early morphological verification of diagnosis, the puncture biopsy performance as well as intraoperative express-histological investigation. While solitary node in TG existence and preoperatively established its benign essence, extrafascial hemithyroidectomy, using original method, is the operative of choice.

[Prophylaxis and methods of correction of the parathyroid insufficiency in surgical treatment of the thyroid cancer]. / Profilaktika i metody korrektsii nodostatochnosti parashchitovidnykh zhelez pri khirurgicheskom lechenii raka shchitovidnoi zhelezy.

The state of calcium metabolism in 249 patients after performance of thyroidectomy was studied up. It was established that precisional technique of the surgical intervention performance directed on the parathyroid glands vascularization preservation, is the main prophylactic method for the parathyroid insufficiency occurrence. Indications for the parathyroid tissue autotransplantation application during the performance of thyroidectomy are substantiated.

[The analysis of the methylenedioxy derivatives of amphetamine]. / ANaliz metilendioksiproizvodnykh amfetamina.

Methods for analysis of narcotics belonging to amphetamine methylene dioxy derivatives (MDD) are reviewed. The characteristics of these agents, their metabolism, and methods used for their detection and identification (TLC, GC, HPLC, GC/MS) are described. Methods for their extraction from biological objects (human urine and hair) are described. Efficacy of MDMA and MDEA from the urine by different extractants is assessed. The data demonstrate different potentialities for detection and identification of amphetamine MDD, including those in biological specimens (human urine and hairs), by numerous chromatographic methods.