[Thoracic endometriosis and catamenial pneumothorax].

It was analyzed own experience of diagnosis and treatment of catamenial (menstrual) pneumothorax and thoracic endometriosis and literature review. It is shown that catamenial pneumothorax has specific clinical and instrumental signs allowing to establish the diagnosis before surgery. It was proposed surgical treatment including the removal of trans diaphragmatic way of pneumothorax development, removal of thoracic endometriosis and the establishment of reliable pleurodesis. It was demonstrated that this volume of surgery can be successfully implemented by using of thoracoscopic access. Relapse prevention includes hormonal therapy for the 6 months after surgery under the supervision of an obstetrician-gynecologist.

[Changes in the contents of phosphoinositides in formed elements of blood and endometrial tissue in patients with hyperplastic processes and cancer of the endometrium]. / Izmenenie soderzhaniia fosfoinozitidov v formennykh élementakh krovi i tkani éndometriia u bol'nykh s giperplasticheskimi protsessami i rakom éndometriia.

The levels of phosphoinositides were measured in blood macrophages, platelets, lymphocytes, granulocytes, neutrophils, and red cells, as well as in endometrial tissue of 175 patients with glandular hyperplasia of the endometrium, atypical hyperplasia, endometrial polyps and cancer. A reliable reduction of the content of phosphatidyl inositides and phosphatidyl inositide-S-phosphates was observed in all formed elements of the blood, the most marked decrease being observed in endometrial cancer. On the contrary, the content of phosphatidyl inositide-4-phosphates and phosphatidyl inositide-4.5-diphosphates in the macrophages, lymphocytes, and granulocytes was reliably increased in the patients as against healthy women. The process of phosphatidylinositide phosphorylation run an absolutely different course in pathologically altered endometrial tissue than in comparison with that in blood cells. A new phosphatidyl inositide-signal mechanism was revealed, which is unrelated to inositol-1.4.5-triphosphate, as a result of which the potentiality of appearance of new secondary messengers actively participating in cell growth increases.

[Diagnosis of internal endometriosis of the uterus]. / K voprosu o diagnostike vnutrennego éndometrioza matki.

The authors analyze the informative value of instrumental methods of examination (hysteroscopy, hysterosalpingography, ultrasonic scanning) and measurements of blood phosphatidyl inosites in 50 patients with internal endometriosis and come to a conclusion that it is in proportion with the disease severity, hysteroscopy being the most informative. A reliable reduction (p < 0.001) of blood phosphatidyl inosites were seen in endometriosis patients as against normal subjects. Combined examinations making use of instrumental methods and blood phosphatidylinosite measurements essentially improve the accuracy of internal endometriosis diagnosis and help develop a rational treatment strategy.

[Changes in the phosphoinositide metabolism in the blood and tissues of benign and malignant uterine tumors]. / Izmenenie fosfoinozitidnogo obmena v krovi i tkani dobrokachestvennykh i zlokachestvennykh opukholei matki.

Measurements of phosphoinositide levels in the blood, immunocompetent cells, and tumors of 105 patients with uterine myomas, 24 patients with cancer of the corpus uteri, and 17 ones with uterine sarcoma showed that the parameters of phosphoinositide metabolism in the blood of patients with tumors of the uterus reliably differed from those in healthy women. The content of phosphatidylinosites and other phosphoinositide fractions in patients with uterine myomas reliably differed from those in patients with malignant tumors of the uterus, this permitting the use of such measurements in the differential diagnosis. Phosphoinositide mechanism of development of tumors of the uterus is discussed, which is related to the "new" phosphoinositides and secondary messengers directly participating in transfer of cell growth signals.

[Change in phospholipid content in platelets, immunocompetent cells and myometrial tissue in patients with internal endometriosis]. / Izmenenie soderzhaniia fosfolipidov v trombotsitakh, immunokompetentnykh kletkakh i tkani miometriia u bol'nykh vnutrennim éndometriozom.

A method of flow horizontal chromatography has been developed permitting investigation of blood and tissue cellular phospholipids ruling out lipid peroxidation effects on cellular membranes. Phospholipid levels of blood and myometrial tissue cells were measured by this method in 67 patients with histologically verified internal endometriosis. Phospholipid and phosphatidyl inosite levels in platelets and immunocompetent cells of these patients reliably differed from those in healthy women. Phosphatidyl inosite levels of heterotopic endometrial tissue was increased by 1.4 times vs. the norm on an average. In parallel with this, a reliable change of phosphatidyl cholines and inosites levels in endometriosis foci were detected as against their levels in intact tissue. The authors suggest a method for the diagnosis of internal endometriosis by phosphatidyl inosite levels in blood lymphocytes.

[A clinico-morphological comparison of the ultrasonic criteria of adenomyosis]. / Kliniko-morfologicheskoe sopostavlenie ul'trazvukovykh kriteriev adenomioza.

The authors analyze the data of ultrasonic examinations in 110 patients operated on for adenomyosis and in 50 patients with this condition not exposed to surgery, in whom the diagnosis was made after comprehensive examinations. The accuracy of ultrasonic diagnosis correlated with the disease severity. Diagnostic difficulties are explained by the absence of pathognomonic echographic criteria, frequent associations with myoma, and with false echo signals emerging in the myometrium. Transabdominal and transvaginal methods may be recommended for a more precise diagnosis; it is desirable to single out several echographic criteria and by all means correlate them to clinical data. An attempt at morphologic explanation of the principal echographic criteria of adenomyosis has been made. Echo-negative structures in the myometrium emerge mainly as a result of the signal reflection from the zone of perifocal membranogenic edema of myometrial stroma developing round endometriosis focus.

[A trial of psychotherapeutic action in the combined nondrug treatment of endometriosis interna]. / Opyt psikhoterapevticheskogo vozdeistviia pri kompleksnom nemedikamentoznom lechenii vnutrennego éndometrioza.

A complex of nonpharmaceutical analgetic modalities has been tried in 25 females with internal endometriosis. Each component of the program has a pronounced analgetic action and participates in formation of somatic, vegetative and emotional responses. Aftertreatment pain characteristics proved the complex efficacy in mild, moderate and advanced internal endometriosis. It is emphasized that the patients can be taught to use the complex without help of medical personnel.

[The clinical picture, diagnosis and treatment of the corpus-isthmus location of uterine endometriosis interna]. / Klinika, diagnostika i lechenie korporal'no-istmicheskoi lokalizatsii vnutrennego éndometrioza matki.

The authors analyze the results of comprehensive examinations and treatment of 79 patients with corporal isthmic adenomyosis. Comprehensive examinations making use of clinical, instrumental (hysteroscopy, hysterosalpingography, echography), biochemical (measurements of blood and myometrial phosphatidylinosites), and morphologic methods are needed for a reliable diagnosis of this condition. Blood phosphatidylinosite measurements may be used as an objective test to assess the efficacy of hormonal therapy. Trental and lipostabil forte are advisable for adenomyosis therapy. If amputation of the uterus has to be resorted to, intraoperative histologic express testing of the lower edge of the uterus for endometriosis may help choose the optimal volume of surgical intervention and prevent extirpation of the uterus that is not at all neutral for the body.

[Changes in the content of phospholipids and their metabolic products in the blood and tissues of patients with endometriosis interna and cancer of the corpus uteri]. / Izmenenie soderzhaniia fosfolipidov i produktov ikh metabolizma v krovi i tkani u bol'nykh vnutrennim éndometriozom i rakom tela matki.

Levels of phospholipids, phosphoinosites, phosphatidylinosite-3-phosphates, diacylglycerols, arachidonic acid, prostaglandins E, F, J, and thromboxane A2 in patients with endometriosis and cancer of the corpus uteri were found to differ from those in healthy women. Biochemical parameters of whole blood and myometrial tissue of endometriosis patients differ significantly from those of patients with corpus uteri cancer. The authors suggest that reduction of phosphatidylinosite and phosphatidulinosite-3-phosphate levels in whole blood and their parallel increase in myometrial tissue are conducive to cellular proliferation and malignant degeneration.

[New data on the pathogenesis of endometriosis interna]. / Novye dannye o patogeneze vnutrennego éndometrioza.

Eighty-six patients with histologically verified internal endometriosis were examined using histochemical, morphometric methods, and measurements of blood and myometrial tissue phosphatidyl inosites. Blood levels of phosphatidyl inosites were found reliably decreased in the patients vs. normal subjects, whereas their levels in myometrial tissue were significantly increased. Increased counts of tissue basophils, microcirculation disorders, lymphostasis and membranogenic stromal edema development were observed round endometriosis foci. Changes in the basic substance and fibrous structures of myometrial connective tissue complex were revealed, most marked in the areas adjacent to the endometrium. A possible mechanism of the development of pathologic shifts in internal endometriosis is discussed.

[The dynamics of the rapid changes in the phospholipids of the whole blood and blood cells in patients with endometriosis interna]. / Dinamika bystrykh izmenenii fosfolipidov tsel'noi krovi i kletok krovi u bol'nykh vnutrennim éndometriozom.

Time course of rapid changes in blood phospholipids and blood cells was studied in 44 patients with endometriosis. Rapid reversible blood phospholipid changes were observed when these patients' red cells and lymphocytes were incubated with calcium chloride. Time course of rapid changes in phosphoinosites, sphyngomyelines, phosphatidylserines, phosphlatidylethanolamines of patients' red and white blood cells, whole blood, and myometrial tissue differed significantly from that in healthy women. The authors suppose that cellular proliferation processes in endometriosis are connected with phospholipid homeostasis disorders in blood cells and tissue.