Diagnostics and surgical treatment of isolated and associated injuries of the liver

The authors have analyzed results of treatment of 388 patients with open and closed injuries of the liver and the diagnostic potential of different instrumental methods. The optimal diagnostic algorithm is proposed. The validity of using videoscopic interventions in injuries of the liver were studied as well as the indications for using them. A differentiated approach is proposed to the decision on the kind of surgery in patients with a severe isolated or combined trauma of the liver. The expediency of two-stage interventions is shown. A strategy of treatment for central ruptures of the liver and hemobilia is substantiated. It was shown that the application of minimally invasive and traditional technologies of treatment of patients with injuries of the liver allowed the incidence of postoperative complications and lethal.     

Surgical tactics in treatment of osteomyelitis of long bones

The new osteomyelitis classification was worked out on the strength of treatment results of 361 patients. Four types of long bones lesions are marked out: medullar, superficial, focal and diffuse. The kind of surgical treatment is determined according to the lesion type. Authors worked out a modification of osteoplastic trepanation--a "grip-sack" technique, which is used for medullar and focal femoral and tibial osteomyelitis. Long term follow-up results are obtained in 271 (77,7%) cases. The developed classification eases the standardization of follow-up results and permits treatment planning.     

Tissue microarray analysis of EGFR and HER2 oncogene copy number alterations in squamous cell carcinoma of the larynx

Purpose To evaluate EGFR and HER2 copy number changes and to assess their significance to tumor progression in a large group of patients with larynx cancer through the construction of a tissue microarray (TMA) consisting of 1,385 biopsies.Methods Fluorescent in situ hybridization (FISH) was applied to analyze the tumors. FISH was successful for EGFR in 1,080 (77.98%) and for HER2 in 683 (49.31%).Results HER2 was amplified in 1.02% of cases. Amplification did not correlate with the tumor phenotype-clinical stage, and grade. The low frequency of amplification of HER2 oncogene in larynx tumors showed that the mechanism responsible for the high level of receptor overexpression still remains unclear in the majority of cases. Amplification of EGFR was found in 10.37% of cases. The analysis revealed a lack of correlation between amplification of the oncogenes and the tumor phenotype. We observed a lack of difference between the samples of primary tumors and advanced disease carcinomas—tumors with regional/distant metastases and recurrent tumors regarding oncogene amplification.Conclusion These results suggest that EGFR amplification is a relatively rare event in larynx carcinogenesis that obviously does not predispose to tumor progression.     

Skeletal muscle regeneration in very old rats

This study was undertaken to assess the regenerative capacity of skeletal muscle in rats near the end of their normal life span. Two experiments were performed. In the first, extensor digitorum longus (EDL) muscles were cross-age transplanted from 32-month-old male inbred Wistar (WI/HicksCar) rats in place of an EDL muscle in 4-month-old hosts. The other EDL muscle in the hosts was autotransplanted. After 60 days, the old-into-young muscle transplants regenerated as well as the young-into-young autotransplants. In the second experiment, EDL muscles in young adult (4 months) and old rats (32 and 34 months) of WI/HicksCar and Brown Norway (BN) were injected with a local anesthetic, bupivacaine, and allowed to regenerate for 41 days. In all cases, the masses and absolute maximum tetanic force of the regenerates equaled or exceeded those of untouched contralateral control muscles. These experiments showed that under appropriate conditions, very old muscles can regenerate to equal or exceed the contralateral control values, which in old rats are much less than those in muscles of young rats.     

Differential pattern of DNA-aneuploidy in human malignancies

The differential pattern of DNA-aneuploidy, detected by flow cytometry (FCM) regarding its frequency, grade and multiclonality, was investigated and correlated to tumor type, malignancy grade, tumor stage and prognosis in a multi-institutional study at the University of Münster. High resolution measurements using admixed normal blood reference cells were undertaken in 2413 cases of 13 different malignant diseases and in 776 benign lesions or samples. The incidence of DNA-aneuploidy was highest in melanomas, carcinomas, testicular tumors, sarcomas (75%-95%) and myelomas (65%). Acute leukemias showed an intermediate DNA-aneuploidy rate of 40% with special subgroups represented by common ALL (44%), p less than 0.05) and myelomonocytic/monocytic AML (47%, p less than 0.01). The lowest DNA-aneuploidy-rate was found in basal cell skin carcinomas (19%) and congenital melanocytic nevi (9%). No case of DNA-aneuploidy was observed in the 776 benign lesions or samples.--DNA-indices giving the grade of DNA-aneuploidy with 1.0 for normal diploid G1/0 cells were found distributed predominantly between 1.0 and 2.0 in the solid tumors, except testicular tumors, clustering around a triploid maximum at 1.5. DNA-indices of myelomas and acute leukemias generally ranged below 1.25 with lower DNA-aneuploidy grades in AML than in ALL (p less than 0.01).--In melanomas the aneuploidy rate was higher (86%) in metastases than in the primary tumors (54%, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

新肺结核患者中与不依从相关的危险因素以及六个俄罗斯地区的社会支持

背景:六个俄罗斯地区的结核病服务机构实施的结核病(TB)患者社会支持项目.目的:检出病人不依从治疗的危险因素并评价社会支持的可能影响.方法:回顾研究2003年2～3季度期间登记的涂片阳性和阴性的新结核病人.通过病例--对照研究,包括不依从治疗病人作为病例组、成功治疗病人作为对照组进行的资料分析,采用多变量logistic回归模型分析.结果:共纳入1805例肺结核(PTB)病人.病人不依从治疗的概率为2.3%-6.3%.经多变量分析,不依从治疗的独立相关危险因素有:失业(OR=4.44;95%CI:2.23-8.86),酗酒(OR=1.99;95%CI:1.04-3.81),无家可归(OR=3.49;95%CI 1.25-9.77).社会支持降低了不依从结果(OR=0.13;95%CI:0.06-0.28).该分析控制了年龄、性别、地区、居住地和痰涂片抗酸染色因素的影响.结论:失业、酗酒和无家可归是增加新结核病患者不依从治疗风险的相关因素,相反,社会支持降低了不依从.在俄罗斯为了评估和确定最佳成本--效益的社会支持对改善结核病人治疗结果的作用进一步进行前瞻性随机研究是必须的,尤其在有较高不依从治疗风险的人群.