Responses of Blood System to Doxorubicin/Docetaxel Chemotherapy in Patients with Breast Cancer.

We studied the effects of combined chemotherapy with doxorubicin/docetaxel on erythroid and granulocytic hematopoietic lineages with particular attention focused on their recovery in patients with stages III-IV breast cancer. Intensification of differentiation of erythroid and granulocytic CFU (even under conditions of their suppressed proliferation) provided the increase in the content of mature and morphologically differentiated elements in the bone marrow and peripheral blood. High proliferative activity of erythroid and granulomonocytic precursors resulted from enhanced production of hematopoiesis-stimulating activities by microenvironment elements.

[The possibilities for the prevention of incompetent tracheorrhaphy]. / Vozmozhnosti preduprezhdeniia nesostoiatel'nosti shvov trakhei.

The present review of the literature is focused on the methods designed for the prevention of incompetent tracheorrhaphy. The main cause that dictates the necessity of strengthening the sutures is the risk of the development of the complications during the postoperative period following the surgical interventions. The incompetence of the tracheal anastomoses is known to occur in 3.6-26.3% of the patients which leads to the development of such complications as neck phlegmon, mediastinitis, and pleural empyema. The mortality rate amounts to 18.2%. The authors describe the methods employed for the prevention of incompetent tracheorrhaphy following the circular resections and suturing of the linear traumatic defects. The advantages and disadvantages of individual methods are discussed.

Nanostructure changes in the intervertebral discs after experimental laser irradiation.

Laser-induced changes in the intervertebral discs were studied by the method of atomic force microscopy. Alteration of the proximal caudal intervertebral discs was modeled in rats: puncture and exposure to diode laser (2, 3, or 5 W) in constant or pulse regimens or only puncture (control). Nanostructure of disc surface was estimated by surface skewness, root mean square and average roughness, and coefficient of kurtosis. Maximum positive effect and signs of regenerative changes in the surface microstructure of the intervertebral discs were found after exposure to laser (2-3 W) in constant or pulse regimens.

High-speed extra-intracranial bypass combined with an assisting low-speed anastomosis: surgical technique and a clinical example.

Described herein is the technique of performing assisting low-speed and high-speed extra-intracranial bypass, followed by a clinical case report concerning successful application of this technique in trapping of a giant aneurysm of the cavernous portion of the internal carotid artery in a female patient after endured transitory ischaemic attack during the test with temporary balloon-mediated occlusion of the internal carotid artery.

[Factors affecting the outcome of surgical management for extramedullary spinal cord tumors: a multicenter study].

UNLABELLED: Extramedullary spinal cord tumors (ESCTs) are relatively rare neoplasms requiring surgical treatment. This paper presents a study of outcomes in patients with ESCTs treated at Irkutsk region hospitals with different facilities. AIM: To identify factors affecting the outcome of surgical treatment of ESCTs. MATERIAL AND METHODS: The disease stage before surgery was evaluated according to the I.Ya. Razdol'skiy and McCormick classifications. Features and extension of the approach, the extent of blood loss, surgery duration, and the equipment used were analyzed. Treatment outcomes were assessed according to the MacNub and McCormick neurological outcome scales. RESULTS: ESCTs were removed totally in 84 (95%) patients and subtotally in 4 (5%). Tumor recurrence was detected in 8 patients. No deaths were observed. No correlation was found between the treatment outcome, according to the McCormick scale, and factors such as gender, tumor location, histological type, tumor grade, disease duration, and type of a surgical approach and the equipment used. Factors having medium and high correlations with the disease outcome are a neurological disease phase and an initial neurological deficit: sensory deficit, r=0.32; motor deficit, r=0.33; pelvic disturbances, r=0.35; McCormick grade before surgery, r=0.74; disease phase r=0.41 (p<0.05). CONCLUSION: The disease phase is the most significant factor affecting the outcome of surgical treatment in patients with ESCTs. Despite this, important aspects of surgical treatment of ESCT include the approach that is adequate to the tumor size and localization, as well as combination of different surgical techniques.

[Investigation of bacterial translocation regularities in diffuse peritonitis using labeled radionuclide colibacillus].

The investigation of the regularities of translocation of opportunistic pathogenic microflora from the small intestine lumen and abdominal cavity in diffuse peritonitis using labeled radionuclide colibacillus has shown that in normal condition the intestinal barrier is not permeable for bacteria. Under conditions of diffuse peritonitis the bacterial translocation and peritoneal resorption are developing since the first minutes of the disease. During the development of the pathological process the priority of the foci of bacterial toxemia is changed from peritoneal to intestinal. Relaparotomy with manipulations on the intestine in peritonitis induces sharp activation of bacteria translocation into the portal blood flow and systemic circulation.

[Peculiarity modification mechanical property of a pulmonary tissue in the period of physiological pregnancy].

In the period of pregnancy are reduced elastic of property of a pulmonary tissue. More than in 2 times is enlarged an extensibility, as at the expense of participation of the surface active agents, and some factors of parenchyma. The conditions for augmentation of the size of alveolus's, delay in them of air and infringement of a bodily machinery of respiration are framed. Obviously, as a result of rising a hydrophilic nature the effective viscosity plasticity of system of a pulmonary tissue is reduced, that causes infringement of alveolar ventilation (close-effect) and hypercarbondioxide in respiratory ways. The combined influence of the factors of pregnancy at some women promotes formation dynamic hyperinflation mild, development of respiratory failure and hypoxia to complications on the part of a fetus.

[Colonic serrated adenoma and its clinical significance].

Serrated adenoma as an immediate precursor of colorectal cancer is included in the WHO classification (2003). Nevertheless, diagnosis of this tumour and hyperplastic polyps encounters serious difficulty. Enhanced awareness of endoscopists and morphologists about this pathology may help to improve diagnostic efficiency and modify approaches to the treatment of hyperplastic polyps.

[Pathophysiological mechanisms of bacterial endotoxicosis in disseminated peritonitis].

Using methods of nuclear medicine in experiment, we studied pathophysiologic mechanisms of bacteriemia in disseminated peritonitis in various laboratory animals. The results give grounds to consider regularities revealed to be universal.

[Structural and functional disorders of erythrocyte cell membrane in patients with Crohn's disease].

Investigation of erythrocyte membrane in patients with Crohn's disease detected the changes in asymmetry of its molecular components, abnormalities in normal functioning of membrane-associated enzymes and energy-dependent processes in the cell. The mechanism of damaging effect on the cell membrane was caused by the excessive blood accumulation of a composite complex of low-molecular substances, compounds of quinone and carbohydrate nature, peptides, modified forms of nucleotides. The revealed changes make it possible to assess the severity of endogenous intoxication and cell membrane disorder, which take place not only in the course of the disease acute attack, but also retain during the period of incomplete clinical and endoscopic remission.

[The specific features of diagnosis of latent small airway obstruction].

Latent obstruction of the small airway is a preclinical stage of chronic obstructive pulmonary disease (COPD), has no specific signs and it is a risk factor of respiratory failure. Its mechanism is unknown; it is likely to be caused by rearrangement of lung tissue, its increased hydrophicility due to the influence of various endogenous factors, which ultimately causes a change in the mechanical omechanics. The new sensitive functional integral index (the latent small airway obstruction coefficient) has been proposed for timely diagnosis. Body plethysmography was used to comparatively study the health status of 152 women during a gestational period by a special program; of them 66 suffered from COPD. It was found that 26 (16.1%) patients who considered themselves healthy had latent obstruction of the small airway and there was a considerable increase in the number of cases of fetal hypoxic complications.

[Lieutaud's triangle lesion and urodynamic disorders in bladder cancer according to magnetic resonance imaging data].

OBJECTIVE: To estimate the capabilities of magnetic resonance imaging (MRI) in revealing bladder tumor in relation to its sizes and location and in diagnosing concomitant urodynamic disorders. MATERIAL AND METHODS: A total of 93 patients (78 men and 15 women; mean age, 62.1 ± 12.2 years) with bladder cancer were examined. Examinations were made using 1.5 T MRI according to an extended protocol with a mandatory inclusion of diffusion-weighted images; dynamic contrast-enhanced MRI was carried out in 86 patients. RESULTS: There were single nodules in 48.7% of the patients and multiple bladder wall lesions in 51.3%. Bladder wall injury involving the functional area of Lieutaud's triangle was revealed in 67.5% of the patients. Single and multiple tumors in Lieutaud' triangle were observed in 58.9 and 80.5% of cases. Ureteral orifice involvement led to secondary ureterectasia in 68.2%. CONCLUSION: As the number of tumors detected in the bladder increases, the risk of tumors in Lieutaud's triangle injury rises. The involvement of the triangle into the pathological process is accompanied by impaired urodynamics as uretere- ctasia in every four cases (26.8%; p < 0.008). It is shown that dynamic contrast-enhanced MRI must necessarily be performed to better visualize a tumor and to determine its relationships to the underlying wall and basic structures of the bladder.

[Intravascular laser irradiation of blood in the treatment of patients with lung abscess]. / Vnutrisosudistoe lazernoe obluchenie krovi v lechenii bol'nykh s abstsessami legkikh.

Intravascular blood laser irradiation has been introduced into a multimodality treatment of pulmonary abscesses in 47 patients. Intracavitary laser irradiation of the abscess or pleural empyema was performed in 10 cases. A suggested detoxication and immunostimulation related to the laser therapy was confirmed. The highest efficacy of the treatment was found for chronic pulmonary abscesses, the least one in decompensation associated with multiorgan failure.

[Liver abscesses of the right hepatic lobe after cholecystectomy]. / Abstsessy pravoi doli pecheni posle kholetsistéktomii.

The authors discuss the results of the diagnosis and treatment of abscesses of the right hepatic lobe which were consequent upon ischemic necrosis; they were encountered after cholecystectomy in 0.15% of cases. Ultrasonography and angiography are the main diagnostic methods suggested. The optimal results of treatment were produces in combination of percutaneous drainage and puncture of the destruction cavities under control of ultrasonography and endovascular regional infusion therapy.

[Minimally invasive method in the treatment of liver trauma complications]. / Miniinvazivnyi metod v lechenii oslozhnenii travm pecheni.

78 patients aged from 14 to 73 years (57 men, 21 women) with complications after trauma of the liver were studied. Minimally invasive operations (puncture, drainage, puncture + drainage) were performed in 62 (79%) patients. 8 patients with small bilema received conservative treatment under visual follow-up. 8 patients with middle and big posttraumatic lesions not treated with minimally invasive surgery entered control group. Intracavitary prolonged proteolysis with immobilized proteinases (imosimase Literum, Novosibirsk) was used. Imosimase injection led to lysis of thick inflammation products, intensified sanation of focus. There were neither complications nor lethal outcomes. 2 (2.6%) patients were operated. Tissue sequestrum and bleeding were indications for surgery. Efficacy of minimally invasive treatment of posttraumatic lesion of the iver was 96%.

[Puncture-drainage sanation of abdominal abscesses: is it sufficient treatment?]. / Punktsionno-dreniruiushchaia sanatsiia gnoinikov briushnoi polosti: ischerpyvaiushchii li metod lecheniia?.

Some anatomical grounds of postoperative extravisceral abscess formation, methods and results of their treatment, therapeutic policy in abscesses of parenchymatous organs are presented. 681 patients with abdominal abscess of various location were examined. Detailed analysis of ultrasonic and computed tomographic semiotics of postoperative extravisceral suppurative focus was carried out in 164 patients. The risk zones of extravisceral abscess formation in the conditions of changed visceral syntopy and destroyed ligamentic structures were determined. The efficiency of puncture-drainage treatment in different variants of subdiaphragmatic abscess was 89.4%, in abscess of omental bursa--83.3%. Intracavital prolonged proteolysis by immobilized proteinases (imosimase) was applied. The injection of imosimase in abscess cavity led to its content lysis, including the thick products of inflammation, improving their secretion through the drainage. In the majority of the patients, the puncture-drainage treatment of abscesses of various etiology and pathogenesis is an adequate method of sanation.

[Programmed cleansing of abdominal cavity in postoperative generalized suppurative peritonitis]. / Programmirovannye sanatsii briushnoi polosti pri posleoperatsionnom rasprostranennom gnoinom peritonite.

Programmed cleansing of the abdominal cavity was performed in 54 patients in the management of postoperative generalized purulent peritonitis. Indications for stage inspection of the abdomen in different variants are discussed. The results were best in the group of patients (42 cases) treated by programmed relaparotomy and poor in patients (10 cases) in whom laparostomy had to be established. Total mortality in the analysed group was 46.3%. Polyorganic insufficiency was the main cause of death.

[Staged correction of surgical pathology of the stomach ("Damage Control") in conditions of decompensated hypovolemic shock]. / Etapnaia korrektsiia khirurgicheskoi patologii zhivota ("Damage Control") v usloviiakh dekompensirovannogo gipovolemicheskogo shoka.

Based on an analysis of results of treatment of 184 patients the authors make a conclusion that staged surgical correction is an expedient method for traumas of the abdomen and acute intestinal obstruction with necrosis of the bowel.