[Analysis of lymphatic drainage pathways using infrared fluorescence in patients with lung cancer]. / Izuchenie putei regionarnogo limfoottoka pri rake legkogo s pomoshch'iu infrakrasnoi fluorestsentsii.

OBJECTIVE: To develop a method for analysis of lymphatic drainage pathways from the lobe of the lung affected by non-small cell lung cancer (NSCLC) using infrared fluorescence. MATERIAL AND METHODS: A study enrolled patients with NSCLC who underwent anatomic resection of the lung with systematic lymph node dissection and preliminary intraoperative peritumoral injection of indocyanine green conjugate with human albumin. Registration of fluorescence in regional lymph nodes (LN) was carried out immediately after excision of specimen using the FLUM-808 instrumental system. RESULTS: Infrared fluorescence was observed in 117 hilar and mediastinal lymph nodes from 43 patients (2.7 nodes per a patient). Comparison of localization of fluorescent LN with localization of tumor in various lobes established significant variability of lymphatic drainage pathways. CONCLUSION: The developed method of infrared fluorescent evaluation of lymphatic drainage in patients with NSCLC confirms the necessity of systematic lymph node dissection for adequate staging.

[Radiation therapy for medullary thyroid carcinoma].

The paper analyzes the effectiveness of external beam radiation therapy of medullary thyroid cancer in 38 patients. The radiation therapy of the first phase combined therapy was performed in 9 (24 %) patients: after treatment, 5 patients had a partial response, 4--stabilization. The radiation therapy of the second phase combined therapy was performed in 27 (71%) patients: after treatment, 2 patients had a complete response (booster method), 5--partial response, 4--stabilization. External beam therapy has been performed in 2 (5 %) patients with palliative and symptomatic goals. Additionally has been estimated level of calcitonin in patients after combined treatment. The calcitonin level becomes normal without radiation therapy. Therefore, exposure for medullary thyroid carcinoma is questionable (exception for cases gain exposure to the rest of the tumor).

[Application of damper craniofixators from nitinol in plasty of skull defects].

An overview of the methods of fixation of the skull bones is presented,as well as discussion and characterization of different methods of fixation. A new system of fixation of the skull bones was used in osseous-plastic trepanation and reconstructive operations using nitinol craniofixators. Results of cranioplasty using craniofixators were analyzed in 62 patients with craniocerebral injuries and its consequences, vascular and oncological diseases of the brain. There were no complications in the postoperative period. Articles made of nitinol are very strong, elastic and have the effect of thermo-mechanical memory of the form.

[Significance of determination of lipid-oxidizing catalytic antibodies in patients with ischemic heart diseases].

From the previously examined patients with ischemic heart disease (IHD), the authors formed two groups in whom an original method was used to detect the abnormal lipid-oxidizing anti-Chlamydia antibodies abzymes that increased the serum concentration of malondialdehyde. The effects of the statin rosuvastatin and the antioxidant licopin on abzymes were comparatively studied. Despite the positive impact of therapy with rosuvastatin on lipid metabolism of IHD patients, the agent exerted no effect on the rate of lipid peroxidation and the activity of lipid-oxidizing antibodies. Licopin intake caused statistically significant lipid metabolic changes in patients with IHD. The antioxidant activity of licopin neutralized the pathogenic effect of lipid-oxidizing anti-Chlamydia abzymes.

[Clinical studies of transpedicular system using TiNi rod with functionally optimal rigidity].

Transpedicular metal systems are very widely applied in surgical treatment of spinal pathology. Recently TiNi constructions were introduced into practice. This material is characterized by shape memory, superior elasticity and cyclic durability. Adequacy of mechanical interactions of tissues and TiNi-based alloys allows to suggest that TiNi systems are more physiological and functional in comparison with steel and titanium alloys. This enabled development of transpedicular TiNi system with good safety and stability properties in combination with physiologic compatibility and high functional value of TiNi connections. We performed computer modeling of different spine lesions treated by transpedicular systems using ANSYS program kit. Statistic and cyclic tests of transpedicular systems were made using test machine 'Terotest' according to international standards. Results of studies allowed to formulate guidelines for application of transpedicular systems with different level of rigidity in treatment of injuries and degenerative lesions of the spine. The authors performed 53 operations in patients with lesions of lower-thoracic and lumbar spine using TiNi rod with functionally optimal rigidity and obtined good postoperative results.

[The application of modern module hip and knee endoprostheses "mati-cito" in patients with tumors and postresectional femur and shin bone defects].

In the paper data concerning the use of new module hip and knee endoprostheses "MATI-CITO" in the course of conservative surgery in patients with large defects of femur and proximal shin-bone, arising during removal of tumors or developing as a result of side effects of preceding management, are presented. In given category of patients the causes of high-risk of complications diminishing an efficiency of operations are discussed. It was shown that sophistication of fabrication technologies and practical application of new endoprostheses gives an opportunity to significantly improve the functional results of treatment and to decrease of number of complications. The development such new medical technologies, as X-ray endovascular surgery, intraoperational reinfusion of own blood allows to decrease operational lethality, improve the performance status of patients and accelerate their rehabilitation

[RET and GFRA1 germline polymorphisms in medullary thyroid cancer patients].

The role of RET and GFRA1 germline polymorphisms in predisposition to sporadic medullary thyroid cancer (MTC) and polymorphisms' modulation effect on clinical features of inherited and sporadic MTC were investigated. Blood samples from 67 MTC patients (22 hereditary and 45 sporadic), 3 asymptomatic mutant RET gene carriers and 178 ethnically matched healthy control individuals were tested. Screening of RET exons and portion of introns 1, 8, 10, 13, 14, 15, 16 and GFRA1 5'-UTR was performed by means of direct sequencing and PCR-RFLP. 8 polymorphic variants of RET gene (exons 11, 13, 14, 15 and introns 1, 8, 13, 14) and 4 GFRA1 polymorphisms in GFRA1 were detected. Linkage disequilibrium was found between RET variants G691S and S904S, L769L and IVS8, S836S and IVS13. In sporadic MTCs, allelic frequency of only one polymorphic RET variant, L769L, was significantly decreased versus control group. In hereditary MTCs, a significant over-representation of S836S and under-representation of S904S sequence variants were observed as compared to sporadic MTCs and controls. No co-segregation was found between individual polymorphisms and phenotype of sporadic MTC. In patients with inherited MTC whose genotype was presented with polymorphic L769L and wild-type S836S, disease onset occurred 20 years later than in individuals with polymorphic L769L and S836S or wild-type L769L (p = 0.01) suggestive of a possible protective role of L769L in MTC development and modulating effect of a combination of L769L with wild-type S836S on clinical outcome of inherited MTC.

[Familial well-differentiated thyroid carcinoma].

Medical Research Institute of Radiology, Russian Academy Forty-eight cases of familial disease (24 families) (4.3%) were identified among 1,118 patients with well-differentiated thyroid carcinoma who had been either examined or treated at the Clinic of Medical Research Institute of Radiology (1995-2004). In 86% of the study group, papillary thyroid carcinoma (PTC) was associated with tumor of the identical histological pattern while the remaining families revealed association with follicular or medullary thyroid cancer. Carcinoma inheritable from mother was the most frequent (75%). No differences in manifestation, histological pattern, stage or clinical course were established following a detailed evaluation of clinico-morphological data on 43 familial and 172 sporadic (control) cases in both groups. The analysis pointed to a significantly higher incidence of concomitant thyroid pathology in the familial thyroid cancer group. Molecular-genetic study of RET-protooncogene and gene BRAF in 6 blood samples from PTC-bearers established RET-mutation (mother and daughter) in codon 891 (exon 15) G2673A (TCG->TCA). No mutation in BRAF was found.

[Frequency of RET/PTC rearrangement and somatic BRAF mutation in papillary thyroid cancer].

Frequency of RET/PTC rearrangement and somatic BRAF mutation was investigated in patients with papillary thyroid cancer (PTC) vis-a-vis relevant demographic and clinico-pathological features. The study group included 76 patients with a female/male ratio of 4.8:1; mean age - 45.7 +/- 9.7 yrs. BRAF mutation was identified in 49 (65%) (V600E--47, KSRWS600--1 and E585K--1). RET rearrangement was detected in 9 (12%): RET/PTC1--5, RET/PTC3--2, unspecified RET/PTC--1 and delta RET/PTC--1. It was age at diagnosis alone that proved to be consistently associated with BRAF mutations (p = 0.017). Younger tumor patients were mostly prone to RET/PTC rearrangement (p = 0.08). No correlation between mutation and clinico-pathological features was established.

[Molecular analysis of structural abnormalities in papillary thyroid carcinoma gene]. / Molekuliarnyi analiz strukturnykh narushenii genoma papilliarnykh kartsinom shchitovidnoi zhelezy.

Rearrangements of the RET proto-oncogene (RET/PTC) and BRAF gene mutations are the major genetic alterations in the etiopathogenesis of papillary thyroid carcinoma (PTC). We have analyzed a series of 118 benign and malignant follicular cell-derived thyroid tumors for RET/PTC rearrangements and BRAF gene mutations. Oncogenic rearrangements of RET proto-oncogene was revealed by semiquantitative RT-PCR of simultaneously generated fragments corresponding to tyrosine kinase (TK) and extracellular RET domains. The clear quantitative shift toward the TK fragment is indicative for the presence of RET rearrangements. The overall frequency of RET/PTC rearrangements in PTC was 14% (12 of 85), including 7 RET/PTC1, 2 RET/PTC3, 1 deltaRFP/RET and 2 apparently uncharacterized rearrangements. The most common T1796A transversion in BRAF gene was detected in 55 of 91 PTC (60%) using mutant-allele-specific PCR. We also identified two additional mutations: the substitution G1753A (E585K) and a case of 12-bp deletion in BRAF exon 15. Moreover, there was no overlap between PTC harboring BRAF and RET/PTC mutations, which altogether were present in 75.8% of cases (69 of 91). Taken together, our observations are consistent with the notion that BRAF mutations appear to be an alternative pathway to oncogenic MAPK activation in PTCs without RET/PTC activation. Neither RET/PTC rearrangements nor BRAF muta-tions were detected in any of 3 follicular thyroid carcinomas, 11 follicular adenomas and 13 nodular goiters. The high prevalence of BRAF mutations and RET/PTC rearrangements in PTCs and the specificity of these alterations to PTC make them potentially important markers for the preoperative tumor diagnosis.

[Assay of thyrocalcitonin in cervical lymph node using fine-needle washings for the diagnosis of disseminated medullary thyroid carcinoma]. / Opredelenie soderzhaniia tireokal'tsitonina v punktate limfaticheskikh uzlov shei dlia diagnostiki metastazov medulliarnogo raka shchitovidnoi zhelezy.

Fine-needle aspiration biopsy of cervical lymph nodes was carried out in 22 patients with suspected metastatic involvement with medullary thyroid carcinoma (MTS). It was followed by cytopathological examination of aspirates and assay of of thyrocalcitonin (TCT) in fine-needle washings. TCT determinations proved highly informative as well as significantly high in all seven cases of MTS involvement (26-8,484.87 pg/ml, mean 2,208 +/- 1,722 pg/ml).

[Experimental and clinical substantiation of the functional transpedicular stabilization of the vertebral column]. / Eksperimental'no-klinicheskoe obosnovanie funktsional'noi transpedikuliarnoi stabilizatsii pozvonochnika.

Metallic construction for transpecular stabilization (transpedicular constructions T-TPC). Titanium nickelide (TiNi) alloys have come into existence in the surgical treatment of diseases of the vertebral column and spinal cord. The properties of these alloys are the storage of a shape, superelasticity, and cyclic longevity. The adequate mechanical behavior of live tissues and TiNi-based alloys suggests that metallic constructions made from TiNi are more physiological and functional than those made from steels and titanium alloys. The foregoing makes it possible to consider the design of metallic constructions to be promising for transpedicular spinal stabilization involving the latter's reliability and stability with the physiological and functional capacities of TiNi fixing arms. The study performed computer-assisted simulation of surgical treatment for different spinal diseases by using TPC by means of the programme package ANSYS and statistical and cyclic studies of TPC up to the international standards on a Terotest testing machine. The experimental findings were used to formulate recommendation to use TPC of varying rigidity to treat spinal injuries and diseases. Eight operations were performed to treat patients with diseases of the lower thoracic and lumbar parts of the vertebral column, by using TiNi rod of the optimum rigidity, which yielded good clinical results.

[Technique of X-ray computed arthro-tomography in the diagnosis of internal disorders of the temporomandibular joint]. / Metodika rentgenovskoi komp'iuternoi artrotomografii v diagnostike vnutrennikh narushenii visochno-nizhnecheliustnogo sustava.

141 patients suffering by internal derangements temporomandibular joint are surveyed with the help x-ray computed arthrotomography. The opportunity of reception of precise intra-articular elements after introduction of contrast substance allows treat results of researches with high reliability. X-ray's data received with the help CT are investigated and systematized. The features of x-ray's picture TMJ, capable to affect tactics of spent treatment, are revealed.

[Magnetic resonance tomography of temporomandibular joint]. / Magnitno-rezonansnaia tomografiia visochno-nizhnecheliustnogo sustava.

The paper shows the place of magnetic resonance imaging among other radiation diagnostic techniques in detecting abnormal changes in the temporomandibular joint. The authors' own data were based on the results of 315 examinations. The paper describes the technical features of examination of the joint and shows it possible to visualize different anatomic structures on T1-, T2- and Pd-weighted images. It also indicates the diagnostic potentialities of magnetic resonance imaging in identifying abnormal changes in the joint in its diseases and lesions. This has allowed the authors to show what is indicated for magnetic resonance imaging of the temporomandibular joint and that it is necessary to develop an algorithm of radiation diagnosis for patients with different clinical forms of joint diseases.

[The classification of diseases of the temporomandibular joint]. / Klassifikatsiia zabolevanii visochno-nizhnecheliustnogo sustava.

There were 2040 patients with temporomandibular joint (TMJ) diseases in the investigation including clinical, physiological, X-ray methods of research, contrast arthrotomography, computer arthrotomography and magnetic resonance tomography. The changes of structure in different lesions were estimated. The result of received data was elaboration of classification of TMJ internal derangements with estimation of clinical forms in according with structural changes and characteristics of syndromes.

[Relationship of the size of the thyroid gland and anthropometric parameters of physical development]. / Sviaz' velichiny ob"ema shchitovidnoi zhelezy s antropometricheskimi parametrami fizicheskogo razvitiia.

The size of the thyroid was determined in 10,839 individuals (5074 males and 5765 females) aged 3-25 years from life-time echography. The correlation analysis was used to examine the relationship between the size of the thyroid and the anthropometric values of their physical development (body weight, length, and surface area). The relationship was found for males and females by using the regression analysis.

[An evaluation of various methods for arthrography of the temporomandibular joint]. / Otsenka razlichnykh sposobov artrografii visochno-nizhnecheliustnogo sustava.

In 130 patients with temporomandibular joint dysfunctions several arthrographic techniques were applied, and their advantages and drawbacks pointed to. Indications to different joint contrasting techniques were established. Contrast arthrotomography combined with computerized tomography showed major diagnostic value in detection of internal joint disorders.