[Cytological puncture diagnosis of thymomas].
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Biomedical subjects
Publications and source records attributed to V L Ganul.
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Routinely stained cytological preparations of puncture biopsy specimens of mediastinal tumors from 870 patients are examined. Diagnostically informative material is investigated in 759 (87.3%) cases; malignant tumors are diagnosed in 538 (62%) cases, benign in 221 (25.2%). In 59 (6.8%) cases the cytological answers were descriptive, and in 52 (6%) puncture biopsy material was not informative for cytological verification. Diagnostic sensitivity of the cytological method is 94%, diagnostic specificity 71%, and diagnostic efficacy 91%.
Antimicrobal preparation Unazin, combining sodium sulbactam and sodium ampicillin, characterized by broad antibacterial spectrum and potency to overcome the microorganisms stability, was applied in 15 patients in the early postoperative period after operations for pulmonary, esophageal, cardial cancers and mediastinal tumor. In these patients purulent-septic complications were not noted. According to the retrospective analysis data, of 846 patients, operated earlier, the complications have occurred in 131 (13.2%).
The authors have developed and approbated a methodology involving the use of copper sulphate as a radio sensitizer. The methods permit the enhancement of the immediate efficiency of treatment up to the level comparative with the best results of radiosensibilization at the expense of cytostatic agents. The incidence of complete regression of the tumor came up to 43.3%, partial one to 53.3%, stabilization to 3.3%. The advantages of the use of copper sulphate include low toxicity, practical availability, and exceptional cheapness, which facts suggest superiority of the proposed methods to other methodologies.
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Total triboluminescence, i.e. optic radiation induced as a result of mechanic activation of venous blood in a TPA-2 triboluminometer, was measured in patients with cancer of the gastric cardia and esophagus, and in healthy subjects. The parameter was assessed in control water samples, too. In the 252-649 nm range, five bands of emission were registered with peaks at 262, 280, 360, 422 and 649 nm subject to variation in certain segments of blood spectrum. Triboluminescence of the venous blood at 280 nm determines for the total triboluminescence registered in the entire spectrum. The triboluminescence of capillary blood at 302 and 418 nm calculated using K coefficient facilitates differentiating between inflammation and cancer. This express test takes less than 1 minute and requires a small blood sample (0.02 ml). The accuracy proved 88%.
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The study including 414 patients aged over 60 years suffering lung esophageal, gastric and colorectal cancer was carried out to assess the possibility of preventing postoperative complications. Preoperative preparation, anesthesiologic medication and drug treatment in the early postoperative period included vitamins, eleutherococcus, sodium oxybutyrate, retabolil, splenin, curantyl, heparin, panangin, sulfalen and trichopol. In that group, the overall postoperative complication rate was 1.5 times lower and that of purulent complications, cardiovascular disorders, pneumonia and pancreatitis--2 times lower than those in 642 controls. The duration of postoperative stay in the hospital was shorter and the postoperative lethality tended to decrease. Topical treatment with methylsiloxane-immobilized gentamycin and 5-fluorouracil was shown to prevent development of purulent complications and pancreatitis.
Local intracavitary hyperthermia and simultaneous intensive-concentrated irradiation were used in 23 patients with esophageal cancer and 64 cases of cardioesophageal malignancy prior to surgery. The procedure for thermometry is described. Hyperthermia was carried out after the second and fifth (out of six) radiation fractions, thermotolerability being taken into account. Complete and partial response rate was 72.7% in the study group compared to 56.5% in controls. The volume fraction of viable parenchyma dropped to 2.1 +/- 0.2% (16.6 +/- 1.5% in controls) whereas the injury index according to Lavnikova rose to 95.0% (58.7% in controls).
The factor analysis of qualitative parameters carried out in 968 patients with lung cancer helped identify certain features which may play the key role in the development and, consequently, diagnosis of various types of the disease. In workers of major industries, smoking proved a significant factor of higher incidence of lung cancer. Formation of the habit at an earlier age, its intensity and concomitant occupational hazards were found to increase the risk of cancer, particularly, in males. Mass screenings and questionnaire--based interviewing of smokers are suggested. Young age and heavy smokers should be included in groups at risk irrespective of occupation.
An analysis of the activity of pituitary-adrenal and sympathetic-adrenal systems in patients with cancer of the digestive canal and lungs with consideration of age, sex and stage of the disease indicates that not age but the development of the tumour process is the leading factor in disorders of the neuroendocrine homeostasis. Therapeutic measures are discussed.
The optimal approaches to the choice of the surgical treatment of carcinoma of the thoracic esophagus are discussed from analysis of 425 operations. Louis' operation providing for a convenient approach for a rather high resection of the esophagus with one-stage esophagogastric anastomosis is recommended in localization of the tumor in the inferior third of the esophagus. Garlock's operation is indicated only in low localization of the carcinoma (diaphragmatic and supradiaphragmatic segments). In carcinoma of the middle third of the esophagus Dobromyslov-Torek's operation is indicated only for elderly and debilitated patients; in the remaining cases a one-stage intervention (Louis' operation) is recommended. An original modification of esophagogastric anastomosis is suggested.
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The levels of tumor markers--CEA, ferritin and prolactin (the hormone of the anterior pituitary gland) were studied in the blood serum of 178 breast cancer patients in the menopause during combined therapy using a radioimmunoassay. This combination was shown to be informative for assessment of prognosis of disease and efficacy of antitumor therapy which was confirmed by clinical and x-ray findings and observation of a tumor process in breast cancer patients over a 5-year period.