[The use of digital radiography in the morphological evaluation of tumor response to neoadjuvant treatment of breast cancer]. / Primenenie tsifrovoi rentgenografii pri morfologicheskoi otsenke otveta opukholi na neoad"yuvantnoe lechenie raka molochnoi zhelezy.

OBJECTIVE: To optimize the morphological assessment of tumor response to neoadjuvant therapy in breast cancer. MATERIAL AND METHODS: A retro- and prospective cohort study was conducted. The object of the study was the surgical material. Macroscopic parameters of residual tumor without and with the use of digital radiography (digital X-Ray) are described and analyzed. PathVision Faxitron imaging system was used for digital X-ray samples. An analysis of dynamics of clinical characteristics was carried out. Two methods of tumor bed examination were compared. RESULTS AND DISCUSSION: The study cohort included 32 women, mean age 45.5±14 years. The correlation of the results of instrumental methods was 0.66 ([95% CI: 0.28; 1], p=0.0002). Microcalcinates were detected by digital X-Ray in 29 (90.6%) cases. Tumor bed sizes determined macroscopically (mean maximal size 6.1 (3.3) cm, median 5.2 (3.4-8.0) cm) and by using digital X-ray (mean maximal size 4.8 (2.6) cm, median 4.1 (2.7-6.2) cm), had statistically significant differences (p<0.0001). The agreement between the two methods of studying the tumor bed was 96.9%. The Cohen's kappa value was 0.95 (p<0.0001). CONCLUSION: Morphological study is an integral part of clinical trials of drug efficacy. With the help of digital X-Ray, the identification of metal markers placed in the tumor bed and microcalcinates is facilitated by the morphologist, and the visibility of the boundaries of the tumor bed is also improved. The results obtained showed that the use of digital X-Ray can improve the accuracy of assessing the degree of morphological regression of breast cancer in response to treatment.

[The clinico-morphological characteristics of psoriatic nephropathy]. / Kliniko-morfologicheskie osobennosti psoriaticheskoi nefropatii.

Based on studying the data obtained during examination of patients with psoriasis combined with the urinary syndrome possible varieties of psoriatic nephropathy, namely chronic glomerulonephritis (CGN) and amyloidosis were distinguished. CGN combined with psoriasis was mainly represented by latent glomerulonephritis (GN) and morphologically, it was mostly represented by the mesangio-proliferative variant, with IgA and C3 being fixed on the basal membrane of the capillaries and in the mesangium. The clinicomorphological feature of that form of psoriatic GN is combination of the signs of both associated CGN and hyperuricemia and IgA-nephritis. Special emphasis is laid on the diagnosis of rapid-progressing GN which is of paramount importance for institution of early etiopathogenetic therapy. Amyloidosis associated with psoriasis is characterized by the signs of acquired disease (AA-amyloidosis) and does not differ in its course from amyloidosis coupled with other diseases.

[Morphological characteristics of hyperuricemic variant of chronic latent glomerulonephritis]. / Morfologicheskaia kharakteristika giperurikemicheskogo varianta khronicheskogo latentnogo glomerulonefrita.

The study of a hyperuricemic variant of chronic latent glomerulonephritis in asymptomatic hyperuricemia and gout suggested that relevant pathologic lesion can be morphologically represented by immune-complex glomerulonephritis and reactive mesangial changes as well as secondary tubulointerstitial nephritis. The underlying pathogenetic mechanism in the development of immune-complex glomerulonephritis and secondary tubulointerstitial nephritis is formation of antibodies to antigens of basal glomerular membrane and to alkaline edge of the proximal nephron, respectively. Reactive mesangial changes of the glomeruli reflect mesangiocyte sensitization to the antigens.

[Immune complex hyperuricemic nephritis: aspects of its morphology and pathogenesis]. / Immunokompleksnyi giperurikemicheskii nefrit: nekotorye aspekty morfologii i patogeneza.

The authors described the results of an immunohistochemical, electron microscopic and morphometric study of the kidney bioptates of 45 patients with latent glomerulonephritis with hyperuricemia, 8 patients with primary gout and 12 patients with latent glomerulonephritis without hyperuricemia. Two possible variants of the involvement of the renal glomerula were revealed against a background of purine metabolism: typical immunocomplex glomerulonephritis and the so called "reactive" mesangial changes. The expression of interstitial changes (by the results of histometric investigation) was maximum in gout, slightly less in latent nephritis with hyperuricemia and minimum in nephritis without hyperuricemia. The authors emphasized the possibility of immunocomplex nephritis as one of the variants of renal lesion in gout and hyperuricemia and the necessity of specifying therapeutic modalities to be used in this condition including general nephrological approaches to the treatment of latent nephropathies.

[Beta 2-microglobulin in the blood serum and urine of patients with interstitial kidney lesions]. / Beta 2-mikroglobulin v syvorotke krovi i moche u bol'nykh s interstitsial'nym porazheniem pochek.

A study of the level of beta 2-microglobulin (beta 2-MG) in the blood serum and urine was conducted in 67 patients: 22 with chronic pyelonephritis, 13 with gout with renal lesion, 25 with chronic glomerulonephritis (5 without hyperuricemia, 20 with hyperuricemia) and 7 with amyloidosis accompanied mainly by renal lesion. A raised level of beta 2-microglobulin was found in the patients with chronic pyelonephritis, gout, latent glomerulonephritis with hyperuricemia, and in over half of the cases its raised level was found in the urine. The results obtained indicate a frequent and in some cases predominant involvement of the tubules as well as interstition in the patients with hyperuricemia.

[Hyperuricemic variant of latent glomerulonephritis]. / Nekotorye osobennosti giperurikemicheskogo varianta latentnogo glomerulonefrita.

The authors describe the data of a comparative clinicomorphological analysis made in 40 patients with associated latent nephritis and hyperuricemia and 43 patients suffering from latent nephritis without hyperuricemia. No substantial differences in the disease clinical picture or in the structure of the morphological variants of glomerulonephritis (GN) were found in the above groups of patients. A more detailed morphological study made it possible to reveal a higher incidence of tubulostromal-vascular changes in patients with hyperuricemia. It is assumed that excess uric acid is likely to play an etiological role in the development of latent GN. Emphasis is laid on the necessity of early diagnosis of purine metabolism disorders in patients with latent nephritis whose goal-oriented therapy may improve the characteristics of the uric acid syndrome and renal function.

[Clinical characteristics of myxoma of the heart]. / Klinicheskie osobennosti miksomy serdtsa.

The authors describe 3 cases of left atrial myxoma confirmed by two-dimensional echocardiography and at operation. One patient had the symptoms of embolisms to the cerebral and renal vessels in the absence of heart disease, 2 patients presented with the symptoms of congestive heart failure. In one patient, loud first sound as well as systolic and diastolic murmur at the heart apex were documented. The nonspecific manifestations (weight loss, fever, high ESR, dysproteinemia, and rheumatoid factor) were observed in all the cases. The difficulties encountered in the clinical diagnosis of heart myxoma are discussed. The differential diagnosis is made between valvular heart disease and infective endocarditis, systemic vasculitis, cardiomyopathy, etc. Echocardiography to exclude myxoma should be performed in patients with thromboembolism, rheumatic valvular disease, subacute endocarditis (particularly in the absence of the classical symptoms) and in those with fever of unknown origin.

[Role of tissue glycolysis in combined exposure to hypercapnia, hypoxia and hypothermia]. / Znachenie glikoliza v tkaniakh pri sochetannom vozdeistvii giperkapnii, gipoksii i gipotermii.

The amount of metabolites of the glycolytic way of carbohydrates transformation and the enzymatic activity were studied in the tissues of brain, myocardium, liver, skeletal muscles, and the blood serum of rats subjected to cooling in conditions of gradually increasing concentrations of CO2 and decreasing concentrations of O2. Single as well as repeated actions of these factors entailed changes of the substrates under study and of some enzymatic activity which revealed a moderate intensification of the glycolysis within the general rearrangement of metabolism during adaptation to sharp hypoxia under the above conditions.