[The treatment of osteogenic sarcoma in children].
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Biomedical subjects
Publications and source records attributed to O G Iugrinov.
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After combined treatment of 74 patients for colorectal cancer using preoperative neoadjuvant intraarterial selective polychemotherapy (IAPCT) three-year survival index have constituted (77.0 +/- 5.2)%, the cancer recurrence have occurred in (10.8 +/- 2.8)%, distant metastases were revealed in (17.5 +/- 4.2)%. Using verapamil as a IAPCT modifier in 54 patient three-year survival have increased by 11.8%, the frequency of distant metastases occurrence have reduced by 10.1%.
The combined treatment of 53 patients with colonic cancer, using neoadjuvant intraarterial polychemotherapy (IAPCT), was conducted. The trustworthy lowering of the catheterized artery thrombosis occurrence rate, the tumor recurrence-by 7%, distant metastases-by 13.9%, two-year survival increase-by 15.5% was promoted by verapamil application as a IAPCT modifier.
A complex examination of 1400 patients with pathologies of the lungs and mediastinum was carried out using roentgenologic, endoscopic, bioptic and cytologic methods. Diagnosis was confirmed morphologically in 93.7% of cases. More specific information was obtained by express cytologic examination in 97.9% of cases of malignant growth and in 64.4% with benign tumors. On the basis of the test results, preoperative intratumor chemotherapy technique suggested by the authors may be recommended for clinical use.
The treatment experience of 127 patients with the locally spread rectal cancer was summarized. The combined with preoperative intraarterial chemotherapy course application causes significant injurious effect on the tumor (more than 3 times decrease of the viable tumor tissue part by volume in rectal adenocarcinoma, the appearance of subcapsular necrosis regions in metastatically injured regional lymphatic nodes in 32.2% of observations) and is characterized by low common toxicity.
The complex examination of 1400 patients with pathologic masses of the lungs and mediastinal organs with the use of roentgenologic, endoscopic, puncture bioptic and cytologic methods was carried out. Morphologic verification of diagnosis was performed in 93.7% of the patients. In express cytologic study, histogenesis of neoplasms of the thoracic cavity organs was specified in 97.9% of cases of a malignant tumour, and in 64.4% of those of a benign one.
The results of roentgeno-endovascular intervention in nephroblastoma in 31 child are presented. For chemoembolization, suspension of lipiodol and adriamycin was used, for control of the effectiveness of the intervention--the radiopharmaceutical preparation pyrophosphate. After embolization, the decrease in tumor size was noted. This made easier the performance of nephrectomy, the volume of blood loss reduced. Pathomorphism of neuroblastoma induced by chemoembolization was studied. No complications were noted.
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Results are reported of a study of the content of gonadotropins, prolactin and sex steroids in different regions of the vascular bed in women with Itsenko-Cushing disease. It was found that the content of gonadotropins were similar at all levels of the vascular bed indicating their secretion reduction in the pituitary. At the same time there was an increase of prolactin, testosterone, progesterone and cortisol in the blood of the ovarian, adrenal, peripheral and lower cavernous sinus veins. It is suggested that increased secretion of testosterone, progesterone and cortisol inhibits the production of gonadotropins and prolactin-inhibiting factor in the pituitary and leads to an increased prolactin level.
In patients with gastric cancer, depending on location of a tumor, the left gastric or right gastroepiploic artery was catheterized via a puncture of the femoral artery, the course of polychemotherapy with fluorouracil and adriablastin was carried out, then the operative treatment was performed. In 62.4% of the patients, the complete, in 18.8%--the partial destruction of a tumor was achieved, in 18.8%, the effect was insignificant.
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The selective testicular venography can establish the presence and localization of undescended non-palpable testes in children. The morphofunctional state of non-palpable undescended testes can be estimated on the basis of the data obtained which helps to make a correct choice of the surgical treatment.
To diagnose the Icenko-Cushing syndrome and disease, samples of the venous blood were taken from the inferior vena cava, the renal and adrenal veins of 51 patients to determine hydrocortisone and ACTH. Thirty-nine patients showed a tendency to an increase in the basal level of hydrocortisone in the blood from the inferior vena cava and the renal veins and a significant elevation of its concentration by approximately an equal value in the blood from both adrenal veins. The ACTH content in their blood was elevated, all these indicating the presence of primary disorders in the hypothalamus-hypophysis system and the secondary involvement of the adrenal cortex in the pathological process, i.e. the Icenko-Cushing disease. Different changes of the hydrocortisone content in some places of the venous blood sampling were observed in 12 patients. A significant difference in the hydrocortisone concentration from the left and right adrenal veins and a decrease in the ACTH level in the blood were observed. Such a combination of the signs points to the presence of an autonomous hormone producing adrenal tumor (the Icenko-Cushing syndrome). The results of measurement of the hydrocortisone concentration in the blood within a group of patients with suspicion of corticosteroma recurrence were taken into account to select an appropriate therapeutic method.
The paper is concerned with the results of a study of the aldosterone concentration and renin activity, the general level of catecholamines and their fractions (epinephrine, norepinephrine and dopamine) in the peripheral blood and blood taken at selective venography from the vena cava inferior, renal and adrenal veins of 108 patients with hypertension, aldosteroma and idiopathic hyperaldosteronism, adrenal and extraadrenal pheochromocytoma, renovascular and renoparenchymatous arterial hypertension. The aldosterone concentration and renin activity were determined with radioimmunoassay, and the general content of catecholamines and their fractions with a radioenzymatic method using standard kits. It has been shown that the radioimmunoassay to determine the aldosterone concentration and renin activity in the blood from the vena cava inferior, renal and adrenal veins makes it possible to resort to differential diagnosis of hypertension, aldosteroma, idiopathic and secondary hyperaldosteronism. A considerable increase in the blood plasma renin activity on the affected side was revealed in the patients with renovascular hypertension, and in renoparenchymatous hypertension it was equal in both renal veins. The study of the total content of catecholamines and their fractions in the blood from different parts of the venous system can be used for topical diagnosis of adrenal and extraadrenal pheochromocytoma.
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