Gene expression analysis to identify mRNA markers of cardiac myxoma.

cDNA expression arrays were used to identify mRNA expression markers for cardiac myxoma. The RNA profile analysis suggests that cardiac myxoma should be considered as a stand-alone tissue rather than a pathological modification of particular normal tissue. The analysis reveals a set of genes which are highly and steadily expressed in cardiac myxomas and can serve as an mRNA expression markers of the tumour. Marker status of selected genes was confirmed by reverse transcriptase polymerase chain reaction analysis. Genes MIA (melanoma inhibitory activity) and PLA2G2A (phospholipase A2, group IIA) show the highest specificity as cardiac myxoma markers, since they have more than 10-fold higher RNA level in cardiac myxomas than in any one of 15 normal tissues tested. Among markers of myxoma at least three are participants of phospholipid metabolism: ANXA3, PLA2G2A, and phospholipid transfer protein. Tissue inhibitor of metalloproteinase 1 and secretory leucocyte protease inhibitor are inhibitors of proteases degrading extracellular matrix proteins and participating in cell proliferation regulation. MIA, SPP1, fibromodulin are modulators or participants of the interaction between extracellular matrix proteins and their cell surface receptors. SOX9 is a transcription factor required for chondrocyte differentiation. Calretenin (CALB2) is an intracellular calcium-binding protein with poorly understood function.

[Arterial pulmonary thromboembolism as a cause of mortality in thoracic surgery]. / Tromboémboliia lëgochnoi arterii kak prichina letalnosti v torakalnoi khirurgii.

Analysis of hospital mortality showed that thromboembolism of the pulmonary artery was a cause of lethal outcomes in thoracic surgery in 0.4% of hospitalized patients, in 0.7% of those who underwent operation, in 14.8% of all patients who died, and in 15.6% of those who died in the postoperative period. The principal causes of death in thromboembolism of the pulmonary artery were various diagnostic errors (79.5%), severity of the patient's initial condition (14.1%), and defective treatment (6.4%). Prevention of thromboembolism of the pulmonary artery is based on timely detection of its sources by wider use of ultrasonic and radionuclide methods, rarer application of invasive diagnostic methods, and the use of anticoagulant therapy after operations in the risk groups.

[Primary heart neoplasms]. / Pervichnye opukholi serdtsa.

The work analyses the anatomomorphological characteristics of primary tumors of the heart in 106 patients; in 101 patients the tumor was benign (myxoma, neurinoma, rhabdomyoma) and in 5 malignant (angiosarcoma, liposarcoma). Surgical treatment was conducted in 99 patients; hospital lethality was 7.1%. Six patients who refused an operation died at other therapeutic institutions, one patient died on admission to the clinic from occlusion of the left atrioventricular orifice by the tumor. It is pointed out that the diversity and the various degree of the clinical manifestations of the disease are predetermined by the localization and morphological characteristics of the new growths, their size, and mobility. The authors emphasize that knowledge of the anatomomorphological features of primary tumors of the heart and their early diagnosis are conducive to a differential approach in each concrete situation and to the choice of the optimal volume of an urgent surgical intervention.

[Bleeding as a cause of mortality in thoracic surgery]. / Krovotechenie kak prichina letalnosti v torakalnoi khirurgii.

Analysis of hospital lethality showed that hemorrhage was the cause of lethal outcomes in thoracic surgery among 0.5% of all hospitalized patients, 0.8% of those who underwent operation, and 17.3% of all patients who died. Among all fatal hemorrhages 28.6% were surgical and 71.4% were erosional. Surgical hemorrhage was due to injury inflicted to the large vessels (atria) during the operation. Erosional hemorrhages were caused by postoperative infectious-septic complications, progressive malignant tumors and pyo-purulent diseases, and exacerbation of peptic ulcer or the formation of an acute gastric ulcer. Among the principal causes of fatal hemorrhages are defective treatment (32.9% of cases), methodical and technical errors during the operation (28.6%), erroneous diagnosis (25.3%), initially severe condition of patients (6.6%), and progressive malignant tumor (6.6%). Intraoperative prevention of fatal surgical hemorrhage is based on personal experience, knowledge and skill of surgeons, and the use of modern technology in the control of blood loss. The prevention of erosional hemorrhage in patients who are not operated on consists in timely surgical treatment and early diagnosis in the postoperative period and active treatment of infectious-septic complications.

[Benign cystic tumors of the pancreas]. / Dobrokachestvennye kistoznye opukholi podzheludochnoi zhelezy.

Benign pancreatic cystic tumors (BPCT) is a rare and little studied pathological condition. By the end of the eighties approximately 500 registered cases of BPCT were described in the world literature, which were those of different morphological variants of cystadenomas (CA). Many scientists note the high probability of malignant degeneration of some CA types. The diagnostic signs and surgical tactics in BPCT are treated ambiguously. The authors systematized the most characteristic signs of pancreatic CA and revealed the possibility of accurate preoperative recognition of these tumors. From rich clinical material (21 cases) the authors show that complications resulting from an erroneous choice of the operation are inevitable. Postoperative complications occurred in 8 patients. The late-term results of the operation were followed-up in 11 patients and were found to be good and satisfactory in complete removal of the tumor. According to foreign authors, cystic carcinomas of the pancreas account for 1-2% ot all primary carcinomas of the organ. Timely radical operation dictated by the specific features of pancreatic cystadenoma is one of the measures of carcinoma prevention.