[Diagnostics of the primary multiple forms of the colorectal cancer].

The issue analyses the diagnostics of the repeated malignant lesions of the colorectal region. The study covers the two decades period (1992-2011 yy). Of the observed patients with primary colorectal tumors, 238 showed the repeated lesions of the region. The article focuses on the on-time diagnostics and differential approach to the repeated malignancies of the colorectal region.

[Diagnosis of odontogenic maxillary sinusitis by spiral computed tomography using a dental program].

Genyantrum mucosal changes and the upper jaw ridge were analyzed in different forms of periodontitis and in cases of endodontic treatment failure with the dental filling material being in maxillary sinus cavity. Spiral computed tomography using the Denta Scan software could confirm the odontogenic nature of the changes found in 57 (85.0%) patients with suspected maxillary sinusitis.

[Comparative trial of efficacy of trimethasidine MB and 3-(2,2,2-trimethylhydrasine) propionate dihydrate in chronic heart failure].

AIM: To study efficacy of the myocardial cytoprotector trimethasidine MB and metabolic drug 3-(2,2,2-trimethylhydrasine) propionate dihydrate (3-TMHP) in the treatment of chronic cardiac failure (CCF). MATERIAL AND METHODS: Sixty-five patients with CCF after myocardial infarction (> 6 months) with left ventricular ejection fraction (LV EF) <40% were randomized into 3 groups: group 1 (n=28) received basic therapy plus trimethasidine in a daily dose 70 mg; group 2 (n=25)--basic therapy plus 3-TMHP in a daily dose 1000 mg; control group (n=12) received basic therapy with ACE inhibitors, beta-blockers and diuretics. Before and after 6-month treatment all the patients have undergone stress echocardiography with dobutamine. Perfusion and myocardial metabolism were determined in 34 patients with single photon emission computed tomography of the myocardium (SPECT) with 99m-Tc-technetril and positron-emission tomography of the myocardium (PET) with F-18-fluorodesoxyglucose. RESULTS: Groups 1 and 2 significantly reduced functional class of CCF and prolonged the distance of a 6-min walk. Significant improvement of life quality was observed only in the treatment with trimethasidine. According to PET, treatment with trimethasidine MB and 3-TMHP has an anti-ischemic action manifesting with a significant attenuation of glucose hypermetabolism in the ischemic segment to normal values. However, significant improvement of systolic thickening in hybernated segments by SPECT as well as a significant rise of LV EF were recorded only in the treatment with trimethasidine MB. Stress echocardiography with dobutamine had high specificity (85.7%) but low sensitivity (50.4%) in detection of hybernated myocardium. CONCLUSION: Trimethasidine MB (preductal MB) has advantages over 3-TMHP, so it is preferable in ischemic CHF.

[Possibilities of myocardial cytoprotection in complex treatment of patients with chronic heart failure].

Efficacy of metabolic therapy with trimetazidine MR and 3-(2,2,2-trimethylhydrazyn) propionatodihydratum (3-TMHP) was compared in patients with chronic heart failure (CHF) of ischemic genesis. Clinico-functional examination included dobutamine stress echocardiography single photon emission computer tomography (SPECT) with 99mTc-technetril, and positron emission tomography (PET) with 18F-Fluoro-2-deoxyglucose. Clinical course of CHF improved during therapy with both trimetazidine MR, and 3-TMHP. According to PET data therapy with trimetazidine MR and 3-TMHP exerted antiischemic action which appeared as significant diminishment of glucose hypermetabolism in ischemic segments down to normal values. However significant improvement of regional systolic thickening in hibernating segments according to SPECT data, significant increase of left ventricular ejection fraction at rest and peak load according to data of stress-echocardiography took place only during therapy with trimetazidine.

[Spiral computed tomography with functional tests in diagnosis of chronic obstructive diseases of the lungs]. / Spiral'naia komp'iuternaia tomografiia s funktsional'nymi probami v diagnostike khronicheskikh obstruktivnykh boleznei legkikh.

The potential of spiral computed tomography (SCT) and high resolution computed tomography (HRST) in diagnosis of chronic obstructive pulmonary diseases (COPD) is described. Semiotic sings of bronchial asthma (BA) and chronic obstructive bronchitis (COB) are specified. Informative value of SCT in differential diagnosis of BA and COB including early stage of the diseases is analysed. An updated technique of SCT and HRCT of the lungs in COPD patients is presented.

[Computed tomographic densitometry in the diagnosis of chronic obstructive lung diseases]. / Komp'iuternaia tomograficheskaia densitometriia v diagnostike khronicheskikh obstruktivnykh boleznei legkikh.

The capacities of spiral computed tomography (CT) synchronized with a patient's respiration in the diagnosis of chronic obstructive lung diseases (COLD) were studied. Normal lung parenchymal density was clarified in different parts. The densitometric changes typical of bronchial asthma (BA) and COLD were studied in relation to the severity of an obstructive process. The differential diagnostic criteria of BA and COLD, including those at the early stage of the disease, are proposed. The optimized procedure of spiral CT synchronized with the patient's respiration is presented.

[Spiral computed tomography in the diagnosis of ankle and foot injuries]. / Spiral'naia komp'iuternaia tomografiia v diagnostike travmaticheskikh povrezhdenii golenostopnogo sustava i stopy.

The data on 187 patients with traumatic lesions of the ankle joint and foot were used to analyze the capacities of computed tomography (CT) in the diagnosis of this pathology. The efficiency of CT versus X-ray study was evaluated. Specific guidelines are given to make spital CT. CT is shown to be of the most informative value in the diagnosis of lesions of the tibial plateau, undisplaced fractures of the internal malleolus, small marginal comminuted fractures, and lesions of the distal tibiofibular syndesmosis. There is evidence for that CT plays a dominant role in the diagnosis of lesions of the talus and calcaneus. Emphasis is laid on the great value of secondary multi- and three-dimensional image reconstructions.

[Magnetic resonance imaging of the ankle joint and foot: possible diagnostic errors]. / Magnitno-rezonansnaia tomografiia golenostopnogo sustava i stopy: vozmozhnye oshibki v diagnostike.

The paper deals with the visualizing study of the ankle joint and foot by MRI and with the problems in the interpretation of magnetic resonance images in health. For this, 50 healthy volunteers without diseases and lesions of the ankle joint and foot were examined. The study was performed by using flexible superficial coils and T1-, T2-, and proton-weighed pulse-sequences in the orthogonal projections. The articular surfaces and cavity of the ankle joint were evaluated. The specific features of visualization of the muscles and tendons of this area and the pattern of fluid under their membranes were explored. The typical location of the "magic corner" phenomenon was revealed. The individual specific features of identification of the ligaments of the ankle joint and foot and plantar aponeurosis were defined. The features of visualization of bones simulating abnormalities were studied. A category of normalcy in the MRI of the ankle joint and foot was formulated.

[Radiodiagnosis of acute appendicitis]. / Luchevaia diagnostika ostrogo appenditsita.

Sixty acute appendicitis suspects with unclear clinical picture were examined with high-frequency ultrasound and native CT. The results of the examinations were compared with clinical data, surgical findings and histological evidence. Acute appendicitis was in 39 patients, other diseases of abdominal cavity and small pelvis--in 21. Sensitivity of CT was 95%, specificity--91.3%, accuracy--96.6%. Sensitivity of US was 92.3%, specificity--100%, accuracy--95%. The above parameters for non-invasive diagnostic methods were similar to ones for laparoscopy. Native CT and US are highly precise methods for diagnosis of acute appendicitis. They are preferable in unclear clinical situations, atypical location of the appendix, in children, elderly and aged patients, and in patients with mental disorders.

[The role of intravertebral disk protrusion in pathogenesis of lumbosacral radiculopathies in flying personnel]. / Rol' protruzii mezhpozvonkovykh diskov v patogeneze poiasnichno- kresttsovykh radikulopatii u letnogo sostava.

The significance of x-ray computer tomography in determining the mechanisms of pathogenesis of lumbar-sacral radiculopathy in patients with protrusions of intervertebral disks of the lumbar-sacral backbone is demonstrated. Pilots with the protrusions (n = 135) and the intervertebral disk herinas (79) have been examined. The clinical course of the sickness was reviewed in both groups of patients. The computer-tomographic semiotics of various protrusions was elaborated and expanded and their clinical implications demonstrated. The fresh paradigm of pathogenesis of radiculopathy at various forms of protrusions is presented. The roentgenomorphologic classification of arthrosis of archiprossesed joints was studied and proposed.

[Clinical and X-ray diagnosis of initial degenerative changes in the lumbar section of the spine in flight personnel]. / Kliniko-luchevaia diagnostika nachal'nykh degenerativnykh izmenenii poiasnichnogo otdela pozvonochnika u letnogo sostava.

The paper demonstrates the diagnostic validity of X-ray computerized and magnetic/resonance tomographies in detecting early degenerative/dystrophic processes in the lumbar compartment of vertebrae in flying personnel. Examination of 215 aviators with varying degrees of impairment of the vertebrae-pelvis-lower extremity biokinematic system allowed to relate protrusions of the intervertebral disks. Correlation between the neurologic pattern of disease and different forms of protrusions was studied. Pathogenesis of the radiculopathy syndrome was made more clear. Potentials of the X-ray computerized and magnetic/resonance tomographies were given a comparative analysis. As was established, the two methods are not mutually exclusive. MRI is more advantageous in the diagnosis of degenerative/dystrophic changes in soft a tissue structures. On the other hand, the X-ray computerized tomography is preferable for visualization of changes in highly dense tissues. Semiotics of processes articularis arthrosis was studied. Discovered were X-ray detectable morphological signs of arthrosis which had never been discussed in literature. Main strategies of medical treatment of patients with various forms of protrusions are proposed.