Сell clusters isolation in glioblastomas and their functional and molecular characterization using new morphometric approaches.

BACKGROUND: Digital pathology has come a long way in terms of creating tools to improve existing diagnostic approaches. However, several pathology fields, such as neuropathology, are still characterized by low coverage from machine learning tools and neural network analysis, which may be due to the complexity of the internal cellular and molecular structure of the corresponding neoplasms, including glioblastomas. METHOD: In the framework of this study, using advanced proprietary tools for obtaining images of histological slides and their deep morphometric analysis, we studied samples of 198 patients with glioblastoma with the selection of morphometric cell clusters. Also, cells of each cluster were isolated, and their proliferative, migratory, invasive activity, survival ability, aerobic glycolysis activity, and chemo- and radioresistance were studied. RESULTS: Four morphometric clusters were identified, including small-cell cluster, paracirculonuclear cluster, hypochromic cluster, and macronuclear cluster, which significantly differed in morphometric parameters and functional parameters. Hypochromic cluster cells demonstrated the highest proliferation activity; macronuclear cluster was the most active glucose consumer; paracirculonuclear cluster had the most prominent migratory and invasive activity and hypoxia resistance; small-cell cluster demonstrated predominantly average values of all parameters. Moreover, additional analysis revealed the presence of a separate subcluster of stem cell elements that correspond in their molecular properties to glioma stem cells and are present in all four clusters. It also turned out that several key molecular parameters of glioblastoma, such as mutational modifications in the EGFR, PDGFRA, and NF1 genes, along with the molecular GBM subtype, are significantly correlated with the identified cell clusters. CONCLUSIONS: Thus, the results represent an up-and-coming innovation in the practical field of digital pathology and fundamental questions of glioma carcinogenesis.

EXPERIENCE OF TREATMENT OF CONGENITAL DIAPHRAGMATIC HERNIA AMONG BABIES.

The article presents our experience of treatment of congenital diaphrogmatic hernia at newborns and hernia of an esophageal opening of a diaphragm among children of early age. Since 2010 surgical tactics has been changed: the prolonged preoperative preparation with use of the device of high-frequency ventilation of lungs, correction of symptoms of pulmonary hypertensia is carried out, operation is carried out according to plan after stabilization of the patient in parameters of oxygenation and an acid-base state, operative treatment is executed by method of low-invasive endosurgery. Over the last 5 years 25 children with good functional and cosmetic results have been operated. The lethality in the case of congenital diaphragmatic hernia at newborns decreased to 12%, it was noted generally among patients with the expressed hypoplasia of lungs which died during preoperative preparation. In recent years we place emphasis on antenatal diagnosis of pathology and prenatal diagnostics of degree of a hypoplasia of a lung on indicators of a pulmonary and head index at a fetus. It wasn't noted a postoperative lethality.

[The accessibility of high-tech medical care of newborns with surgical pathology in conditions of Far North].

The actual stage of development of public health rendering of specialized medical care is based on principles of generality, accessibility, addressness, qualitativeness, and effectiveness. However, the problem of rendering specialized medical care to population is one of most critical targets in district centers and requires immediate solution. The main mean of resolving this problem is re-hospitalization of patient in more large-scale medical institutions. The rendering of high-tech medical care, surgery care included, to newborns in the Republic of Sakha (Yakutia) is possible only in conditions of metropolitan health institutions i.e. medical institutions of third level. Annually, almost half of newborns with surgical pathology is transported from central district hospital. The organization of reanimation counseling center, maintenance of remote monitoring of newborns and development of telemedicine and means of sanitary aviation play main role in supporting accessibility of high-tech medical care in conditions of this region.

[Computerized tomography of spinal injuries]. / Komp'iuternaia tomografiia pri povrezhdeniiakh pozvonochnika.

The authors have presented their experience of computer roentgen tomography application in 127 patients with complicated and noncomplicated spine damages, attained during 1987-89 in the clinic of the Byelorussian research institute of traumatology and orthopaedics. Computer tomography examinations allowed to determine spine fractures in 12 patients for the first time, reveal additional damages of the spine frontal sections in 35 patients and of the rear support complex in 30 patients. The causes of neurological disorders have been defined more precisely in 74 observations. Computer tomography possibilities as to the spine and spinal cord damage diagnosis are represented in the offered observations with demonstration of pictures obtained with/without subarachnoid space contrasting, in different hardness modes, formed according to the assigned programs.

[The surgical treatment of dislocations and fracture-dislocations of cervical vertebrae 3-7]. / Operativnoe lechenie vyvikhov i perelomovyvikhov III--VII sheinykh pozvonkov.

The authors have analysed the results of the treatment of 131 patients with dislocations and dislocation fractures of C 3-7. The stabilization of the injured segment by posterior surgical approach with a fixative draw was performed in 64 cases of dislocations of the cervical vertebrae when the compression of the spinal cord and its roots was eliminated by the setting of the dislocation. Anterior compression of the dural sac and disturbances in the supportability of the spinal column was an indication for anterior decompression and corporodesis in 67 cases.