[The first experience in using elastography in combination with endobronchial ultrasonography for mediastinal pathology: Preliminary assessment of feasibility and comparison of characteristics via different approaches].

OBJECTIVE: To preliminarily assess the feasibility of elastography in endobronchial ultrasonography and to compare characteristics via different accesses. MATERIAL AND METHODS: The investigation enrolled 3 patients (malignant, benign mediastinal adenopathy, paratracheal tumor). Elastography was carried out using a Pentax EB-1970UK echobronchoscope with a Hitachi Noblus ultrasound scanner. All the patients underwent fine-needle aspiration biopsy of mediastinal and pulmonary lymph nodes/masses with 22G needles (Cook, Medi-Globe). Sequential study of the same group of lymph nodes through different approaches through the esophagus and trachea was conducted, and its characteristics were compared in one patient. RESULTS: A total of 8 lymph nodes and one paratracheal mass (Group 4L-7-4R-2R) were assessed in three patients. Reproducible images acceptable for visual assessment were obtained in all cases. The wall of the trachea and bronchi had no significant negative impact on the quality of an obtained image. Both malignant lesion of lymph nodes and paratracheal mass was accompanied by decreased tissue elasticity in the area of interest. Assessment of the same benign lymph node through different approaches revealed a clear discordance between elastographic findings with a drastic decrease in elasticity values via an endobronchial approach. CONCLUSION: Endobronchial ultrasonography elastography is technically feasible. The wall of the trachea and bronchi has no significant impact on the quality of an obtained image; elastographic data are reproducible during re-measurements. Comparison of elastographic characteristics through different approaches suggests that there is a tendency to overestimate data on lymph node density during endobronchial examination versus a transesophageal approach. Thus, the direct transfer of the accumulated data and patterns of elastographic diagnosis to an endobronchial approach is impossible and likely to require a revision of criteria to estimate malignancy-associated changes during its application.

[Transesophageal ultrasonography in the diagnosis of malignant tumors of the mediastinum].

AIM: To assess transesophageal ultrasonography capabilities in diagnosis of mediastinal malignant tumors. MATERIALS AND METHODS: Technique of radial transesophageal ultrasonography was used to diagnose mediastinal malignancy in 157 patients. Method of amplitude hystography was employed to assess lymph nodes. In 84 cases diagnosis had histological confirmation. RESULTS: In 61 case out of 84 (73%) diagnosis was true. In of lymph nodes without primary tumor in the lung diagnosis was true in 72% (26 cases out of 36) and with primary tumor in 73% (35 cases out of 48). Assessment of lymph nodes sized 30 mm and more was correct in 92% (11 cases out of 12) and much higher than for lymph nodes sized less 30 mm in diameter (69%, 50 out of 72 [p < 0.001, chi2]). Correct diagnosis for lymph nodes less than 10 mm in diameter was achieved in 65% (13 out of 20) [p = 0.44, chi2], for diameter 10-20 mm accuracy was 71% (22 cases out of 31) [p = 0.96, chi2] and similar to the one for diameter 20-30 mm assessment. Location of lesion proved to be important. For lymph nodes of 3, 7, 8, 9 zones (ATS classification) precision was much higher than for other locations. There were no adverse events during the study. CONCLUSION: Transesophageal ultrasonography with the use electronic radial detector is effective an safe method of mediastinal lymph nodes and primary tumors assessment.

[Methods of medical and surgical correction of atherosclerotic aorto-arterial pathology in management of malignant neoplasms].

The article deals with 6 -year experience of the Centre of Oncoangiosurgery of the Chelyabinsk Regional Oncological Dispensary in treatment of patients with concomitant malignant neoplasms and atherosclerotic lesions to the aorta and arteries. The authors analyze therapeutic outcomes in a total of 158 patients. Of these, 81 patients were subjected to surgical correction of the blood flow. The presence of a clinically significant atherosclerotic lesion of the aorta and peripheral arteries in a patient should not be interpreted as an absolute or relative contraindication to contraindication combined treatment of the tumour concerned. In the majority of cases, atherosclerotic occlusion of femoral and tibial arteries was treated conservatively, using <>. In manifestation of an atherosclerotic lesion to the carotid arteries, aorta and iliac arteries, surgical correction of the blood flow was used more often. Usually, vascular reconstruction was carried out first. Simultaneous interventions were performed in 16 patients; three patients died. The technique of operations on the aorta and arteries was traditional, while for revascularization in peripheral lesions to the arteries of the limbs more frequently compromising methods were used (sympathectomy, profundoplasty, local endarterectomy) on the background of prostaglandin E1 infusions.

Immunity to diphtheria among children in Northern Norway and North-Western Russia.

In 1990, diphtheria re-emerged in Russia and during the following four-year period the resulting epidemic reached all the Newly Independent States (NIS) of the former Soviet Union. Several neighbouring countries of NIS, Norway included, have experienced sporadic imported cases. A sero-epidemiological study among children in Northern Norway and North-Western Russia was performed in order to evaluate protection against diphtheria and how differences in vaccination programmes affect immunity. A total of 664 sera, 400 from Norwegian and 264 from Russian children, were examined for antibodies against diphtheria, using an in vitro toxin neutralisation method. The Russian children studied had satisfactory protection in all age groups examined. The Norwegian children had poor protection against diphtheria from the age of 7 years until they received the booster dose at the age of 11. Therefore, a revision of the Norwegian vaccination programme, including a booster dose at school-entry age, seems warranted.

[Two-step exposure of biological objects to infrared laser and microwave radiation]. / Dvukhstupenchatoe vozdeistvie na biologicheskie ob''ekty infrakrasnogo lazernogo i mikrovolnovogo izluchenii.

The effect of two-step exposure of bacterial objects to infrared laser and microwave pulse radiations was studied. The effect is determined by the time interval between two excitation steps and pulse duration. It was shown that the biologically active dose of microwave radiation is much lower than that of infrared laser radiation; however, laser radiation induces a stronger cellular response. It was found that microwaves enhance the efficiency of infrared laser radiation.