Telemicroscopic conferences for children of the Perm territory with suspected or proven malignant solid tumors.

BACKGROUND: Malignant solid tumors are rare events in childhood and adolescence. Therefore central review of the histology and standardized grading are requested for accurate risk estimation and facilitate a tumor risk adapted treatment. AIMS OF THE STUDY: To abandon the time consuming transportation of tumor material over long distances to the specialized institution by implementation of an internet based consultation system. METHODS: A microscope combined with a videocamera (situated in Perm) and the personal computers of each of 4 cooperating institutions (in Perm, Kiel, Koeln, Duesseldorf) has been equipped with the special software Mikroskopkonferenz. Additional videocameras allow the transmission of the cooperators to each other. Headsets are used to avoid reecho. As a prerequisite an internet connection with a 54 KBits capacity has to be provided. RESULTS: Between January and December 2009, 26 children (median age 2; 5 years, 12 females and 14 males) with suspected or proven malignant solid tumors have been discussed in 11 telemicroscopic conferences by international cooperators. CONCLUSION: This cooperation demonstrates the proof of principle to obtain second opinions in short time over far distances for seldom diseases on a scientific level.

[Day tuberculous exudative pleurisy: morphological and morphometric aspects].

Visceral pleural pathomorpholodical changes were studied in 50 patients. Group 1 included 25 patients with isolated tuberculous pleurisy; Group 2 consisted of 7 patients with tuberculous exudative pleurisy in the presence of a specific process in the lung; a comparison group comprised 18 who had not died from diseases of the lung and pleura. The exudative productive type of specific pleural inflammation was prevalent in 15 (60%) and 4 (57.1%) patients, respectively. In Group 1, the pleural thickness was 144.0 +/- 3.3 microm, which was 8.3 times greater (p < 0.01) than that in the comparison group (17.35 +/- 4.78 microm). In Group 2, the visceral pleural thickness was 151.1 +/- 3.4 microm, which was 8.7 times greater (p < 0.01) than that in the comparison group and 1.05 times greater than that in Group 1. The study has established that in both Group 1 and Group 2, exudative pleurisy is accompanied by early visceral pleural fibrosing with a tendency to be more pronounced in Group 2 patients, which raises the question as to whether it is necessary to use resolution therapy at the early stages of treatment, to inject isoniazid lymphotropically, and to apply physical methods to prevent pleural cavity obliteration.

[Pathomorphology of specific inflammation in silicotuberculosis].

Silicotuberculosis is an independent disease that arising in patients with silicosis from exacerbation of old tuberculous foci in the lung, less frequently in the lymph nodes and other organs. In silicotiberculosis, there are common secondary tuberculosis forms that are located mainly in the lung, which are rarely accompanied by a rapid progression. Characteristic morphological signs of early, nodal and nodular silicosis are observed. Silicotuberculosis is an independent disease that arises in patients from an exacerbation of old tuberculous foci in the lung, less frequently in the lymph nodes and other organs. In silicotuberculosis, there are usually secondary tuberculosis forms that are located mainly in the lung, which are rarely accompanied by a rapid progression. The characteristic morphological signs of early, nodal, and nodular silicosis are observed. Thoracic and abdominal lymph nodes, lymphatic and blood vessels, the bronchi and pulmonary surfactant system were explored. In silicosis, tuberculosis, and silicotuberculosis, silicon levels and spodograms of some visceral organs were studied and trace elements were determined in the lung.

[Effectiveness of treatment and working ability disseminated pulmonary tuberculosis patients, working at enterprises, hazardous for developing pneumoconiosis]. / Effektivnost' lecheniia i trudosposobnost' bol'nykh s disseminirovannym tuberkulezom legkikh, rabotaiushchikh na pnevmokoniozoopasnykh predpriiatiiakh.

The outcomes of treatment of disseminated pulmonary tuberculosis in 62 patients of "dust" occupations and 82 individuals unexposed to dust were studied. All the patients were treated with antituberculous drugs for, on average, 162.9 +/- 3.25 days in a hospital. The analysis of long-term results of their treatment revealed that those with "dusty" occupations had an unfavourable course of the specific process and developed complications and relapses of the disease as their length of service in the quartz-containing dusty environment increased. The death of the patients in the main group was frequently caused by a progressive course of destructive tuberculosis.

[The status of the external respiratory function in patients with tuberculosis of the lungs and pre-roentgenologic pneumoconiosis changes]. / Sostoianie funktsii vneshnego dykhaniia u bol'nykh tuberkulezom legkikhs dorentgenologicheskimi pnevmokonioticheskimi izmeneniiami.

The ventilation function was studied in 103 pulmonary tuberculosis patients of pneumoconiosis-risk occupations in the absence of pneumoconiosis and in 51 patients who were not exposed to dust. Patients of "dust" occupations were found to have a decrease in the parameters of external respiration and bronchoscopic findings more often showed chronic bronchitis. The initial signs of pneumoconiosis were revealed in the histological examination of surgically removed lung segments in 83.4% of the patients.