[Left ventricular noncompaction: A clinical and morphological study].

The data of clinical, macro- and micrometric, histological, and immunohistochemical studies of the heart were analyzed in patients with left ventricular noncompaction (LVNC). Materials from 7 patients: 5 hearts of recipients after heart transplantation, one heart of a dead patient, and one endomyocardial biopsy specimen were investigated. The investigations showed that this disease was accompanied by a preponderance of a noncompact layer with its ratio to a compact layer (2.4:6.6) in the left ventricle and by myocardial hypertrophy and fibrosis in all cases, by endocardial fibroelastosis and discomplexation of muscle fibers by more than 15% of the specimen area in 6 of the 7 cases, by right ventricular hypertrabeculation and myocarditis in 5 cases, and by lipomatosis and impaired connexin 43 expression in 4 cases. Only one of the four patients was found to have MYH 7 gene mutation. The results of MRI of the extracted heart coincided with morphological findings in 100% of cases. The comparative study demonstrated that this disease had simultaneously morphological features of both LVNC and restrictive, hypertrophic, dilated cardiomyopathy. The findings may suggest that the LVNC phenotype may be formed under the influence of various modifying factors (hemodynamic and inflammatory ones).

[Intravital and postmortem morphological studies and magnetic resonance imaging of arrhythmogenic right ventricular dysplasia].

The authors conducted histological, immunohistochemical, and morphometric studies of 47 endomyocardial biopsies and 33 hearts with a high morphological criterion for the diagnosis of arrhythmogenic right ventricular dysplasia after F.I. Marcus et al. (2010), as well as intravital and postmortem cardiac magnetic resonance imaging (MRI). The average residual cardiomyocyte area was 39.7 +/- 12.8%, and the average cardiomyocyte diameter was 10.4 +/- 1.5 microm. Muscle fiber atrophy, lipomatosis, and fibrosis in the right ventricle were detected in all cases, myocarditis in 44%, mitral valve prolapse in 42%, and muscle fiber dyscomplexation in the right ventricular in 33%. The most informative signs for the diagnosis of arrhythmogenic right ventricular dysplasia using MRI are right ventricular contraction dyssynchrony and those using a morphological study are a residual cardiomyocyte area and muscle fiber atrophy in the right ventricle. A decrease in or focal absence of gamma-catenin expression in the muscle fibers was observed only in 60% of the patients.

[Spinal osteochondrosis, mesenchymal dysplasia and herpes infection].

36 intervertebrate disks (IVD) were studied in spinal osteochondrosis concurrent with herniation. Expression of herpes simplex types 1 and 2 (HSV-1 and HSV-2) antigens, which was absent in IVD of the control group (autopsy cases without disk hernia). The similarity of herniation in osteochondrosis and cardiac mesenchymal dysplasia, a frequent concomitance of these processes and the presence of HSV-1 and HSV-2 antigens in the IVD cells and cardiac valves may indicate the same nature of these diseases.

[Liver pathology in patients with primary hemochromatosis--homozygous carriers of C282Y mutation ]. / Patologiia pecheni u bol'nykh pervichnym gemokhromatozom--gomozigotnykh nositelei C282y-mutatsii.

Liver pathology was studied in 3 patients with primary chemochromatosis. In two cases so-called iron free foci with signs of hepatocytes with feature of dysplasia were found. Many siderosomes were found ultrastructurally in the cytoplasma of hepatocytes. Histological markers of virus infection were absent in a patient with positive serum HbsAg and HCV-Ab. Alcohol did not produce typical histological changes. In this case grave liver reticuloendothelial hemosiderosis typical for secondary hemochromatosis and overloading with iron of spleen pulp according to MR imaging were observed.

[Computerized and magnetic resonance tomography in the staging of lung cancer]. / Komp'iuternaia i magnito-rezonansnaia tomografii v stadirovanii raka lëgkogo.

CT (157) and MRI (74) potential in lung cancer staging was studied. Central form was identified in 195 patients (75%). The data were compared in 34. Comparison with surgical evidence was carried out in 47 (CT) and 35 (MRI). Both procedures proved valuable. Use of CT cut down the gap between the results of clinical and surgical evaluation to 17%. Higher precision was achieved by MRI application which was demonstrated by a comparison of the sensitivities of both procedures attained in evaluating the three parameters. The sensitivities of MRI (96%) and CT (90%) in the detection of intrathoracic lymphadenopathy were almost identical. MRI was superior to CT in detecting large vessel involvements (sensitivities--91 and 42%, respectively) as well as those of the pleura, pericardium and thoracic wall.

[Ultrasonic tomography of the mediastinum in the staging of lung cancer]. / Ul'trazvukovaia tomografiia sredosteniia v stadirovanii raka legkogo.

Results of standard X-ray tomography, computed tomography and ultrasonic tomography (UT) used for detecting mediastinal metastases from lung cancer were compared in 50 patients who were later operated on. UT sensitivity in the diagnosis of paravasal lymph node involvement proved superior to that of X-ray tomography and only slightly yielded to that of computed tomography. As regards bifurcation lymph node assessment, results of the radiation imaging techniques were similar to those obtained by surgery. Ultrasonographic signs of tumor spreading to the mediastinum were observed in cases of stage IIIa-IIIb tumors only. UT assured detection of metastases in normal-sized lymph nodes of the upper mediastinum. Combined application of standard X-ray and ultrasonic tomography of the mediastinum assured better staging of tumor roughly in half the patients. Absence of X-ray signs of mediastinal lymph node enlargement is considered a direct indication for UT.

[Magnetic resonance tomography in the diagnosis of lung metastases in the mediastinum and thorax]. / Magnitno-rezonansnaia tomografiia v diagnostike rasprostranennosti raka legkogo na sredostenie i grudnuiu kletku.

The results of MRI in 81 patients with morphologically verified lung cancer, mainly Stages IIIA and IIIB, were analyzed. They were compared with CT data in 37 cases and surgical findings in 28. MRI was performed by using Magnaview 0.04 T and Vectra 0.5 T apparatus in the T1- and T2-weighted SE and PC sequences as well in the fat-suppression mode. Thoracic metastases were evaluated from the direct signs tumor spread into the adjacent tissue and vessels. The criteria for the involvement of lymph nodes were their over 1-cm enlargement and characteristic changes in the intensity of signals from them. CT was found to yield less information on pleural, pericardial, and vascular invasion (66-75% sensitivity). MRI detected this type of cancer spread (88-94% sensitivity). Both techniques have nearly equal sensitivities in revealing intrathoracic lymphadenopathy. The interpretation of MRI data did not depend on the voltage of a magnetic field. It is recommended that MRI should be made after CT when there is a need for assessing large vessels or for making clear the data that remain open to question following CT.

[Significance of computerized, magnetic resonance and ultrasound tomography in the diagnosis of spreading of pulmonary cancer to the mediastinum]. / Znachenie komp'iuternoi, magnitnoi rezonansnoi i ul'trazvukovoi tomografii v oprededelenii rasprosteranennosti raka legkogo na sredostenie.

In 232 patients predominantly with the central type of lung cancer underwent echotomography (ET) (n = 16), CT (n = 142) and MRT (n = 55) in order to evaluate their possibilities in the diagnosis of the spread of a tumor process to the mediastinum and their impact on disease staging. The results of the techniques and the data of surgical interventions were compared: CT in 55 patients, CT in 70 and MRT in 22. The sensitivity of each method was determined by 3 parameters: 1) detection of intrathoracic lymphadenopathy; 2) diseased mediastinal large vessels; and 3) cancer spread to the pleura, pericardium, heart, and chest. Routine tomography is of informative value in the diagnosis of metastases into a peritracheo-bronchial group of lymph nodes (its sensitivity, 66%), ET, for paravasal (91%), CT and MRT for any groups of mediastinal lymph nodes (89-100%). MRT and ET (with sensitivities of 80 and 100%, respectively) were the methods of choice in the assessment of vascular lesions. MRT and CT are the most potent in evaluating the pleura, pericardium, and chest. The application of new techniques allows the clinical disease stage to be changed in 520 patients. Only X-ray and bronchological studies of patients with suspected lung cancer are not sufficient. ET either CT or MPR should be supplemented.