[Mesenchymal chondrosarcoma of the lung].

The authors present the data available in the literature and their observation of mesenchymal chondrosarcoma of the lung a 68-year-old female patient. Histologically, the tumor is exhibited by the fields of monomorphic round and oval cells with hyperchromic muclei and a scanty cytoplasm, with the hemangiopericytoma-like structures being formed here and there. There are foci of chondroid cells, portions of necrosis, and an ample quantity of mitoses. Immunohistochemical study has revealed that the tumor cells show the expression of vimentin, S-100 protein, neuron-specific enolase and the cytoplasmic expression of CD 99. The tests using CD 31, CD 34, factor VIII, desmin, total cytokeratin, or synaptophysin are negative.

[Surgical treatment of chronic osteomyelitis of the sternum and the ribs]. / Khirurgicheskoe lechenie khronicheskogo osteomielita grudiny i reber.

Transsternal approach is commonly used in majority of operations in heart surgery. In 0.5-5.9% of patients after median sternotomy osteomyelitis of the sternum and the ribs develops. The authors set forth their experience in surgical treatment of 182 such patients. In 97% of them total resection of the sternum was combined with simultaneous resection of costal cartilages which were involved in pyogenous inflammatory process. Costal cartilages were resected during subtotal resection of the sternum in 95% of cases and ribs--in 25%. Limited resection of the sternum was used only in patients with suppuration in the area of sutures in the sternum. Radical one-stage resection of the pyogenous site at the anterior thoracic wall was carried out in 62 patients. In 120 patients in poor condition and who previously underwent an opening of the abscess, staged surgery (2 or more operations) was performed. The authors suggest that in patients with cardio-pulmonary and hepato-renal insufficiency it is advisable to repair the defect, developed after resection of the thoracic wall, by split and perforated cutaneous flap. Muscular flap (32 patients) and greater omentum flap (30 patients) with vascular pedicles or local tissues (28 patients) were used for plastics of the thoracic wall defects. In 98 patients for the closure of the defect autodermoplasty with free split perforated cutaneous flap was used, otherwise the wound of the thoracic wall in them recovered by secondary intention type. 168 (92%) patients have recovered, 4 patients developed recurrence of osteomyelitis, 10 patients died. The authors suggest that the treatment of such serious patients should be carried out in specialized departments which have experience in thoracic, purulent and plastic surgery.