[Study of blood flow in uterine vessels by Doppler-metry in patients with cervical cancer].
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Biomedical subjects
Publications and source records attributed to I I Semenov.
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The feasibility of application of indirect lower lymphoscintigraphy (ILLSG) was assessed in 202 patients with Hodgkin's disease. Its high diagnostic potential was demonstrated by comparison with direct X-ray contrast lymphography: ILLSG's sensitivity was 91.5%, specificity--76.1% and overall accuracy--88.4%. The procedure used for topometric preparation prior to exposure of paraaortal and ileaco-inguinal lymph nodes proved instrumental in designing individual irradiation fields: their boundaries were altered in 21.6% on the basis of ILLSG data.
125 suspects for endometrial pathology were examined to evaluate clinical significance of color Doppler sonography for comprehensive diagnosis of endometrial carcinoma. This pathology was identified in 114; atypical hyperplasia--11. The data on combined application of traditional ultrasound and color Doppler sonography were compared with those on clinical and postoperative histological examinations. The combined method proved the most informative both in primary diagnosis of endometrial carcinoma and assessment of invasion into the myometrium. The specific features of blood supply to carcinoma are discussed.
Pulmonary and pleural involvement was identified in 17% (42.2% at the debut of the disease, while 57.8%--in the course of tumor progression) out of 264 children with Hodgkin's disease. Basing on X-ray evidence, pulmonary lesions were classified as perinodal, focal-infiltrative, disseminated, nodular, mixed infiltration and lobitis, while those of the pleura--exudative pleurisy and tumor masses involving the pleura. Focal-infiltrative pattern was most common (53%). The best results were reported in the treatment of perinodal infiltration, whereas the worst--disseminated and mixed infiltration as well as pleural lesions.
Bacteriological examination of angiocardiac system, biocenosis of the intestine and upper respiratory tracts was made in 3473 patients who were to be operated or reoperated for congenital or acquired valvular defects in the presence of chroniosepsis and chronic septic endocarditis, complicated IHD. 375 patients with other diseases served control. 74 of them have undergone surgery for varicose veins of the legs. Preoperative contamination with opportunistic microflora was found in the heart, major vessels, veins of the majority of the patients. There was also dysbiosis of natural biotops. Patients with valvular defects to be reoperated 2-20 years after the initial operation on the heart had infection in the angiocardiac structures, severe dysbiosis of natural biotops, i.e. advanced dysbiosis--severe persistent condition with permanent source of endogenic infection complicated the underlying disease and bringing postoperative septic complications.
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A clinico-ultrasound description of presentation of melanoma metastases to the gallbladder in 8 patients is discussed. Secondary lesions to the bladder presented as exophytic outgrowths extending from the bladder wall into the lumen. Echo generated by the lesions was of medium intensity and low intensity around the edge of the elastic wall. They revealed dopplergaphic signs of blood flow. Complex application of echo- and dopplergraphy offered a means of differential diagnosis of metastatic lesions and other pathologies of the gallbladder presenting as exophytic outgrowths in the bladder wall in melanoma patients.
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Since 1992, there has been a rise in tuberculosis mortality and morbidity among adults and children in the Kaliningrad region. By 1995, tuberculosis morbidity and mortality have increased by 88 and 92%, respectively. Mortality among children has shown a 2.2-fold increases. The pattern of clinical pulmonary tuberculosis types has become worse.
The study group included 104 patients with soft-tissue sarcoma and metastases into the lung, treated at the Institute Clinic in 1960-1992. Surgery for lung metastasis was given to 10 and chemotherapy-to 48 patients; the remaining 48 cases received treatment for symptoms only. Overall 5-year survival was 13.5% (after surgery-30.0%; chemotherapy-19.1%). All the 46 patients treated for symptoms died within two years after detection of lung metastasis. Chemotherapy proved effective in the treatment of multiple metastasis when detected shortly after removal of the first lesion.
The data on clinico-sonographic examination of 603 patients with Hodgkin's disease and non Hodgkin is disease are presented. Involvement of abdominal lymph nodes was recorded in 186 (30.8%) cases. The diagnostic procedure specificity and sensitivity in Hodgkin's and non-Hodgkin's disease were 98.5; 64.5 and 99.6; 86.1%, respectively. The results of sonography application in detecting malignant lymphomas in the liver and spleen proved uninspiring because only foci could be identified which accounted for not more than 6-10% of all lesions of different organs. Diffuse lesions were detected in a few cases only.
The clinico-echographic data on 91 cases of angiomyolipoma of the kidney are presented. This pathology appears to be the most frequent renal tumor in women. It usually has no clinical signs. Echographic examination typically produces images of formations having distinct contours; image quality is basically determined by fat level. More often than not, the image densitometric characteristics are rather low. The signs of a spontaneous rupture of tumor are discussed. Angiomyolipoma grows slowly--0-5 mm within 3 years. Check-ups (chiefly, echography) should be carried out every 12 or 24 months.
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The paper deals with results of complex diagnosis of intrathoracic lymph node involvement in 194 patients with malignant lymphoma (85 cases), cancer (11), sarcoidosis (95) or lymphadenitis (3 cases). All the patients underwent complex roentgenologic and radionuclide examination. Tumor tissue sampling aimed at morphologic verification was carried out by transthoracic puncture, mediastinoscopy, parasternal mediastinotomy or diagnostic thoracotomy. The following diagnostic algorithm was suggested: in patients with involvement of the anterior mediastinum, diagnosis should start with transthoracic puncture (efficacy--71%) which should be followed, if it fails, by parasternal mediastinotomy (100%). Mediastinoscopy proved the best procedure for diagnosing central mediastinal lymph node involvement (efficacy--96%). Patients with lymphadenopathy in the anterior central mediastinum should undergo mediastinoscopy (efficacy--67%) or parasternal mediastinotomy (90%). Diagnostic thoracotomy was performed in 7 (3.6%) patients in whom the other methods had failed.
The frequency of aseptic necrosis of femoral head was evaluated on the basis of 1066 case histories of Hodgkin's disease of all stages in patients aged 15 and more. The lesions were found in 14 patients (1.3%). Nine of them had received combined treatment for tumor, four--combination chemotherapy alone, and one--radiation alone. All had been given prednisolone. No significant correlation between treatment modality and osteonecrosis development was established. It is suggested that the effect of synergism of such damaging factors as ionizing irradiation, cytostatic drugs and glucocorticoids may be responsible for aseptic necrosis in cases of Hodgkin's disease.
The results of therapy of 152 patients with stage III Hodgkin's disease (106--IIIA, 46--IIIB) were studied. The administration of 2-4 cycles of polychemotherapy (MOPP scheme including embichin, vincristine, procarbazine and prednisolone) followed by large field irradiation after a radical program in 2-4 weeks was envisaged in the therapeutic plan. Cox's multifactor regression analysis made it possible to determine the values of some indices for the outcome of disease. The main prognostic factors in chemo- and radiotherapy were a histological type and mediastinal lymph node involvement. The fact of the involvement of the mediastinal lymph nodes in a tumor process rather than a degree of their enlargement played a decisive role. Such prognostic factors as male sex and the age over 40 were regarded as unfavorable, however their role was not as important as that of a histological type and mediastinal lymph node involvement. The above program of chemo- and radiotherapy made it possible to reduce the effect of general symptoms and signs of "biological activity" of a process.
Clinico-roentgenologic and thermographic signs of bone involvement were studied in 53 cases of Hodgkin's disease. Although radionuclide and X-ray procedures were found to be diagnostically superior over thermography, the latter is complication-free, time-saving and can be used repeatedly. It, therefore, may be recommended as the first diagnostic procedure when bone involvement is suspected. As a result of the treatment, regression was observed in 50% and stabilisation--in 30.6% of pathologic foci. Radiation-induced hyperthermia accounts for low reliability of thermography in evaluating response.