High-Intensity Focused Ultrasound Thermotherapy for Scar Treatment.

The formation of pathological scars is a common medical and aesthetic problem worldwide. Surgical interventions, burns and injuries are the most common cause. Treating these scars is a challenge for any surgeon. The Clinic of Plastic-Reconstructive and Aesthetic Surgery with Thermal Trauma and Imaging Diagnostics applied an innovative method of thermotherapy with high-intensity, focused ultrasound in 20 patients with hypertrophic scars and keloids of different age, etiology and parameters. After a series of procedures, we got excellent results, reducing scar size, pigmentation, pain and itching. This type of thermotherapy is successfully applied to pathological scars. In this way, a change in scar density is achieved by converting hard collagen into a gelatin-like mass.As a subsequent procedure, moderately compressive massages are applied for faster resorption of the pathological collection. Our results show that high-intensity focused ultrasound thermotherapy of pathological scars is a non-invasive method of treatment with reasonably good results as regards both aesthetic and functional aspects.

Les cicatrices pathologiques sont un problème médical et esthétique ubiquitaire, rencontré principalement après traumatisme, brûlure ou intervention chirurgicale, dont le traitement est un défi pour tout chirurgien. Le service de chirurgie plastique, reconstructrice et esthétique a utilisé une méthode innovante de thermothérapie par ultrasons à haute intensité focalisés pour traiter les cicatrices hypertrophiques ou chéloïdes, d'origine variée, de 20 patients. Après une série de procédures, nous avons obtenu d'excellents résultats sur la taille, la pigmentation, la douleur et le prurit. Cette technique permet de transformer les fibres collagènes en une masse gélatineuse, qui se résorbe plus rapidement après massages. La thermothérapie ultrasonique focalisée à haute intensité est une méthode non invasive de traitement des cicatrices pathologiques qui donne des résultats corrects, tant du point de vue esthétique que fonctionnel.

Delayed evacuatory function due to specific smooth muscle reactivity in the gastrointestinal tracts of tacrine-treated rats.

Most of the side effects induced by tacrine are associated with the gastrointestinal (GI) tract. The aim of the study was to analyze the nature of radiographically registered, tacrine-induced changes in evacuatory function, as well as to find a possible correlation with the immediate in vitro action of the drug on smooth muscles from the GI tracts of rats. The tacrine dose we used reliably delayed GI passage: contrast matter was not fully evacuated, predominantly from the stomach and cecum. The delay resulted from changes in tone and peristaltic activity, specific for the various regions of the tract. These changes were associated with a superposing of the responses due to the anticholinesterase and noncholinergic action of tacrine.

The cellular nuclear matrix regulatory protein YY1 does not directly interact with the mouse polyomavirus large tumor antigen.

The transcription factor Yin-Yang 1 (YY1) is a multifunctional protein involved in repressing and activating many promoters of cellular and viral genes. YY1 functions via protein-DNA but also protein-protein interactions. The latter has been documented between YY1 and early gene products of adenoviruses (Lewis et al., J. Virol. 69, 1628-1636 (1995)) and papillomaviruses (Lee et al., Virol. 72,4911-4917 (1998)). In this study, first of this kind on mouse polyomavirus (Py), we report that YY1 and the main viral regulatory protein, large tumor antigen (LT), do not interact directly in vivo. This evidence was obtained by use of two separate methods, immunoprecipitation (IP) and a yeast two-hybrid system.

[Intra-arterial therapy as a treatment method in acute pancreatitis]. / Intraarterialnata terapiia kato metod za lechenie pri ostriia pankreatit.

Intra-arterial therapy has a definite place in the complex management of pancreatitis. Drug infusion into the celiac trunk and a. mesenterica superior is a procedure bringing about the highest concentration (16-18 times) in the pathological focus (Briskinikol), inactivation of vasoactive and toxic products, interference with autolysis of the gland, allowing in turn the administration of smaller drug amounts. Intraarterial therapy (IT) is carried out in 18 patients presenting destructive pancreatitis: total necrosis--2, focal necrosis--8 and hemorrhagic pancreatitis--8, with ages ranging from 25 to 65 years, in a poor general condition. IT is conducted after catheterization of truncus celiacus and celiacography, with infusion effected through single time introduction of 0.5 per cent novocain solution, heparin, kontrikal, Petphtoruracil, antibiotic and atropine.

Roentgenographic study of ethosuximide-induced functional changes in rat gastrointestinal tract and their modulation by Nivalin in a chronic experiment.

Ethosuximide, a typical antiabsence drug, causes gastrointestinal complaints in the drug-treated patients. In the present study we investigated in an experimental model the functional disturbances occurring in rat gastrointestinal tract (GIT) after a 100-day chronic administration of ethosuximide. Contrast radiographic study of rat gastrointestinal tract was used. The mechanical activity of GIT smooth muscle (SM) preparations was measured using an in vitro isometric technique. The 100-day ethosuximide treatment induced atonia, disturbed peristalsis, and lead to a delay of the contrast material evacuation from the gastrointestinal tract combined with a reduction of the acetylcholine effect on the contractions of GIT smooth muscles in ethosuximide-treated rats. Nivalin cannot eliminate the ethosuximide-induced disturbances in the gastrointestinal tract after a 100-day administration of ethosuximide to the rats. It is thus assumed that Nivalin is not capable of compensating the inhibiting effect of ethosuximide. The authors assume that desensitization of acetylcholine receptors may occur and this reduces the effect of Nivalin action.

Our experience in the diagnostics of liver and spleen hemangiomas.

We studied the potentials of conventional imaging methods (sonography, computed tomography) and invasive imaging methods (digital subtraction angiography, fine needle biopsy under sonographic guidance) in diagnosing liver and spleen hemangiomas. 384 patients underwent ultrasound investigation for suspected focal lesions of liver and spleen. Hemangioma was diagnosed in 83 patients. Computed tomography with contrast enhancement was performed on 62 of these 83 patients. The diagnosis of hemangioma was confirmed in 38 (61.3%) patients. In 22 patients the combination of sonography and computed tomography failed to provide indubitable diagnosis. Digital subtraction angiography was performed in 11 of them; the remaining 11 patients underwent fine needle biopsy under sonographic guidance. The authors achieve precision in the diagnosis of liver and spleen hemangiomas by employing combinations of above mentioned imaging methods.

Our experience in the imaging diagnostics of abdominal aortic aneurysms.

The present study focuses on the use of imaging methods for diagnosing aneurysms of the abdominal aorta. We performed ultrasound tomography, computed tomography and digital subtraction angiography in 42 patients (17 men, 45 women, aged 25 to 64 years) with clinically suspected aneurysm of the abdominal aorta. The results obtained are discussed determining the proper sequence in using these imaging methods in the overall diagnostic approach. The high percentage of true positive results (100%) achieved in digital subtraction angiography makes it the leading diagnostic method. It is recommended that ultrasound and computed tomography examinations should precede the digital subtraction angiography.

Effects of ethosuximide on the cerebral vasculature and hemodynamics of rats.

The development of epileptogenic activity has been proven to be closely related to changes in cerebral blood flow. This study was designed to examine the effects of ethosuximide, a widely used anticonvulsant drug, on cerebral hemodynamics. White Wistar rats were treated (p.o.) with 100 mg/kg b.w. ethosuximide. Three hours after administration, changes in cerebral blood flow due to vasodilation were recorded by means of angiography. Using the single sucrose gap method it was found that ethosuximide caused hyperpolarization of smooth muscle sample from rat internal carotid artery by 5.4 +/- 1.6 mV. The hyperpolarization was related to relaxation of smooth muscle tissue of vessels, which was recorded isometrically. Ethosuximide significantly depressed vascular reactions to the vasoconstrictive agents noradrenaline and serotonin. Ethosuximide-induced reaction was not significantly influenced by the Ca2+ antagonist verapamil, but was reduced by caffeine (10(-4) M) and apamine (5.10(-6) M), the latter being a blocker of Ca2+ -dependent K+ channels. The experimental data strongly suggest that changes in bioelectric and contractile activity of arterial smooth muscle samples are a result of Ca2+ -dependent K+ efflux, provoked by calcium which has been derived from intracellular Ca2+ store. These results show that ethosuximide-induced changes in cerebral blood flow are caused by reduced reactivity of smooth muscle tissue and vascular dilatation.

Quantitative analysis of digital subtraction renal vasography in patients with autosomal dominant polycystic kidney disease correlated with clinical and paraclinical data.

Digital intravenous subtraction angiography (DSA) of the kidneys provides an alternative means to achieve better screening of suspected, symptomless and unclear forms of autosomal dominant polycystic kidney disease (ADPKD). The method's capabilities for a quantitative analysis makes it particularly useful in patients with arterial hypertension. We report our experience in using DSA in 36 patients of whom 11 were with proven ADPKD and 15 with suspected ADPKD. The results analysed were correlated with laboratory data obtained in 28 healthy subjects. The importance of the intravenous DSA is underscored as a possible investigation modality for a quantitative analysis in relatively normal haemodynamic conditions of imaging the two kidney's symmetrically and normal conditions for comparison.

Digital subtraction angiography in renal tumours.

By their nature, more than 98 percent of renal tumours are malignant. Clinically, early symptoms of malignancy are difficult to detect. Because of this, treatment of tumorous formations in the kidneys still is unsatisfactory. In general diagnostic terms, angiographic study can play an important role as a preoperative method that more accurately defines the degree of the spread of cancer as well as the extent of renal vessel involvement in this process. The authors report their experience in performing digital subtraction angiography (DSA) in 39 patients with renal tumours. The advantages of the method are emphasized by a comparison of 38 intra-arterial digital subtraction renal vasographic studies and 11 cavographic studies with respect to reduced irradiation doses and contrast material. In addition, the method allows qualitative image processing and the performance of therapeutic procedures such as embolization, which was done in 17 patients.

Radiologic methods used in the diagnostics of vasculogenic erectile dysfunction.

Contemporary methods of assessing erectile dysfunction include instrumental registration of nocturnal penile erections, the penile brachial index, Doppler sonography, use of vasoactive substances and various contrast radiologic methods along with studies of the hormonal profile, the neurologic status, examination of prostate excrements, etc. These methods are still not widely used in Bulgaria although their scope of application is quite well known. We report here our own experience in using the contrast radiologic methods for studying this pathological condition, in particular, the technique of digital subtraction pharmacocavernosography with cavernosometry introduced by us and used for this purpose. In some of the cases we used it in combination with digital subtraction angiography of pelvic arteries. Using these methods we can detect not only morphological but also functional disorders. On the basis of the data obtained we determine the particular therapeutic approach, specify the nature of the disorder and the effect of eventual surgical intervention.

Digital subtraction angiopulmography in children.

The digital subtraction angiography has revealed the great potential of the angiographic diagnostics of children lung diseases with its intravenous introduction of contrast material, greatly reduced amount of the contrast agent used and the irradiation dose applied. Angiopulmography is one of the basic methods for proving the presence of malformations, their characteristic and degree of development. We did 29 digital subtraction angiographies in 13 children aged 2 months to 7 years. We found the following malformations: hypoplasia of one of the branches of a. pulmonalis with the other branch aneurysmally dilated, hypoplasia and agenesis of a lobar branch, confirmed also by digital bronchoradiography, lobar emphysema, mediastinal and pulmonary hemangiomatosis. In addition to the advantages given above the digital subtraction angiography reduces the trauma rate due to the possibility of avoiding catheterization by using peripheral venous pathways. It also allows both qualitative and quantitative processing of the image.

[A congenital vascular anomaly--arteriovenous shunt to the right kidney with an aneurysm of the inferior right branch of the renal artery as a cause of asymptomatic hematuria and vasorenal hypertension]. / Vrodena sudova anomaliia--arterio-venozen shunt v desen bubrek s anevrizma na dolen desen klon na renalnata arteriia kato prichina za bezsimptomna khematuriia i vazorenalna khipertoniia.

A case of a 19 years old man with a congenital vascular anomaly is presented: arteriovenous shunt in the right kidney with an aneurysm of the inferior right branch of the renal artery as a cause of asymptomatic hematuria and vasorenal hypertension. The diagnosis was determined with the help of subtraction angiography. The method is recommended for the precise diagnosis of asymptomatic hematuria caused by arteriovenous malformations of the kidneys in order to help for a correct therapeutic decision.