Potentialities of modern clinical X-ray radiology in the differential diagnosis of tumor and other obstructive diseases of the large bowel

The misdiagnosis rate in defining the cause of obstructive colonic disease is 8.2-24.4%. This is consistent with the fact that every 5 patients with colonic obstruction present difficulties in establishing the nature of a pathological process. The paper provides the results of analysis of clinical and X-ray symptoms in 350 patients with difficult differentially diagnosed cases of narrowing of the rectum and colon. Based on the analysis, the authors identified the basically important X-ray signs that might differentiate tumor stenoses from other obstructive diseases. They also defined the specific X-ray signs of such diseases as infiltrative cancer; extraintestinal cancer involved in the large bowel; inflammatory strictures in ulcerative colitis, diverticulosis, actinomycosis, tuberculosis, intestinal endometriosis, invagination, and other obstructive diseases. The developed differentiated diagnostic criteria could enhance the overall accuracy of X-ray study in this difficult group of patients from 72.7-80% to 93%.     

Conventional X-ray study in the diagnosis of esophageal achalasia and at its treatment stages

The paper deals with one of rather common and clinically urgent diseases of the esophagus--esophageal achalasia (EA). By using 173 cases as an example, the authors show a diversity of clinical symptoms and basic X-ray diagnostic criteria for this abnormality. Analysis of the results of clinical and instrumental studies has enabled the authors to differentiate the complicated and uncomplicated forms of the disease, identification of which determines the choice of an algorithm of complex treatment. The paper provides strong evidence that the classical techniques of a conventional X-ray study ensure a valid differential diagnosis of EA and cardioesophageal cancer and evaluates the efficiency of treatments.     

Current possibilities of X-ray diagnosis of small intestine diseases using the agent Entero-view

The paper analyzes the current capacities of routine (classical) X-ray study in the diagnosis of organ diseases of the small bowel. The distinctive feature of the paper is that in addition to routine barium passage through the small bowel, the new barium contrast agent Entero-view specially designed for its exploration is used. Of the 115 examined patients with various gastroenterological diseases, 76 underwent Entero-view examination that revealed different organ pathology of the small bowel in 28 cases (Crohn's disease in 18, tuberculosis in 3, lymphomas in 5, and cancer in 2). A normal X-ray pattern of the small bowel was diagnosed in 48 cases. The authors highly appreciate this agent. In their opinion, it is essentially helpful in solving one of the most difficult problems in X-ray gastroenterology--present-day X-ray diagnosis of small bowel pathology. The paper describes a procedure for using this agent. It gives a normal X-ray pattern of the small bowel, the agent's use has provided a particularly vivid image of both a normal part of the ileum and its different organ pathology-associated changes.     

Role of digital X-ray study in the current diagnosis of gastric cancer

The authors attempted to assess and provide evidence for the expedience of using a digital radiography CR system in clinical gastroenterology. The prerequisite for this was the results of large-scale diagnostic studies of different organ and systemic diseases. The authors underline the specific features of application of this digital system: the latter allows several analogue X-ray apparatuses to be transformed to digital ones, provides economic efficiency as compared with apparatuses with the direct digitization of an image, shows telemedical prospects, and has low radiation loads as evidenced by research and experimental studies even in comparison with green systems, which makes the use of these digital systems in X-ray gastroenterology highly tempting. Based on a great body of data from 126 studies, the authors could show the effectiveness of the digital radiography CR system in the diagnosis of gastric cancer, demonstrate a modernized approach to formatting an obtained digital image, the possibility of postprocessor treatment that can enhance the validity of existing X-ray symptoms. This all permitted the authors to recommend using the CR systems in the diagnosis of gastric cancer, by taking into account the current obvious predominance of its morphological diffuse and mixed forms and corresponding difficulties of their endoscopic diagnosis.     

Computed tomography in the differential diagnosis of biliary, duodenal and pancreatic diseases]

The paper is concerned with analysis of CT-investigation of 150 patients with diseases of the bilio-pancreatoduodenal area, whose diagnosis was verified histologically or by clinical observation over time, using other methods (USI, RCPG, etc.). The authors have arrived at a conclusion that for increasing the informative value of CT one should use various methods of a contrast study of the duodenum and biliary tract, electron reconstruction of CT images in different projections. They have pointed out the most significant differential-diagnostic CT signs, proposed a table to facilitate the identification of causes and a level of obturation of the bile ducts, the table playing an important role in a choice of adequate therapy.     

Modern radiology in the differential diagnosis of breast diseases accompanied by calcium micromasses

The study was undertaken to enhance the efficiency of diagnosis of breast cancer shown up as calcium micromasses since breast diseases appear as clusters of 50-600-um calciferous inclusions that are not inclined to the formation of conglomerates without a visible node on a X-ray film, may be a manifestation of both sclerosing adenosis and nonpalpable cancer. Of the examined 4500 females aged 15 to 83 years, breast calcium masses were detected in 207. Of them, 39 females were found to have clustered calcium micromasses without a node on a X-ray film; in them cancer and sclerosing adenosis were diagnosed in 28 (71.8%) and 11 (28.2%) females, respectively. Examination was made by using clinical, mammographic, and sonographic studies. Intervention radiology and pathomorphological studies were studied. This has yielded a number of signs that are characteristic of malignant and benign diseases attended by clusters of calcium micromasses in a restricted area without a visible node on X-ray films that assist in making a correct preoperative conclusion with a greater probability in 80%.     

X-ray colonometry in the diagnosis of colonic dyskinesias and inflammatory diseases

Clinical and X-ray studies were made in 316 patients, which revealed intestinal dyskinesia, chronic colitis, and nonspecific ulcerative colitis in 105, 133, and 78 patients, respectively. Irrigoscopy (administration of a contrast enema, examination of the mucosal contour, and double contrasting) was performed in all the patients, by analyzing X-ray planimetric indices. X-ray colonoplanimetry makes it possible to objectify the interpretation of the X-ray pattern in chronic inflammatory diseases of the large bowel and colonic dyskinesia.     

X-ray and ultrasonic diagnosis of noninflammatory benign diseases of the gallbladder]

The author analyzes the results of x-ray (cholecystography) and ultrasonic examinations carried out in patients with noninflammatory benign diseases of the gallbladder (71 with cholesterosis and 28 with adenomyomatosis). X-ray and ultrasonic symptoms of these conditions are presented and the diagnostic potentialities of both methods in the detection of such diseases assessed. The author considers ultrasonic scanning the method of choice for the diagnosis of any forms of gallbladder cholesterosis, whereas an x-ray examination appears to be informative only in a polypous form of the disease. X-ray contrast examination is preferable for the recognition of gallbladder adenomyomatosis, for it presents a clear-cut pattern characteristic of each form of this condition, whereas ultrasonic symptoms of such involvement are nonspecific.     

Probing the origins, diagnosis and treatment of amyloid diseases using antibodies

The deposition of proteins in the form of amyloid fibrils is the characteristic feature of more than 20 medical conditions affecting the central nervous system or a variety of peripheral tissues. These disorders, which include Alzheimer's disease, the prion diseases and type II diabetes, are of enormous importance in the context of present-day human health and welfare. Extensive research is therefore being carried out to define the molecular details of the mechanism of the pathological conversion of amyloidogenic proteins from their soluble forms into fibrillar structures. This review focuses on recent studies that demonstrate the power of using antibodies or antibody fragments to probe the process of fibril formation, and discusses the emerging potential of these species as diagnostic and therapeutic agents.     

A cohort study of thyroid cancer and other thyroid diseases after the Chornobyl accident: objectives, design and methods

The thyroid gland in children is one of the organs that is most sensitive to external exposure to X and gamma rays. However, data on the risk of thyroid cancer in children after exposure to radioactive iodines are sparse. The Chornobyl accident in Ukraine in 1986 led to the exposure of large populations to radioactive iodines, particularly (131)I. This paper describes an ongoing cohort study being conducted in Belarus and Ukraine that includes 25,161 subjects under the age of 18 years in 1986 who are being screened for thyroid diseases every 2 years. Individual thyroid doses are being estimated for all study subjects based on measurement of the radioactivity of the thyroid gland made in 1986 together with a radioecological model and interview data. Approximately 100 histologically confirmed thyroid cancers were detected as a consequence of the first round of screening. The data will enable fitting appropriate dose-response models, which are important in both radiation epidemiology and public health for prediction of risks from exposure to radioactive iodines from medical sources and any future nuclear accidents. Plans are to continue to follow-up the cohort for at least three screening cycles, which will lead to more precise estimates of risk.     

Comparisons of eccrine sweat gland anatomy in genetic, chromosomal, and other diseases, and a suggested procedure for use of sweat gland measurements in differential diagnosis

Statistical analysis of the dimensions of microdissected eccrine sweat glands (duct length, coil volume, ratio of coil volume to duct length, and axis ratio of coil) was performed for several diseases (cystic fibrosis of the pancreas, Werdnig-Hoffmann disease, tetralogy of Fallot, chronic renal disease, and trisomies 13, 18, and 21) using both individual and grouped age-matched control patients. Duct length, coil volume, and the ratio of the two all rise with age. Eccrine gland duct length was found to be significantly large in tetralogy of Fallot and Werdnig-Hoffmann disease and small in chronic renal disease (less so in males than in females, trisomy 13 and trisomy 18). Secretory coil volume was significantly smaller than normal in trisomy 21 (Down syndrome) and in chronic renal disease, and the ratio of coil volume to duct length was low in trisomy 21 and chronic renal disease. The shape of the secretory coil (axis ratio) was possibly abnormal in trisomy 13. Gland dimensions were normal for cystic fibrosis. Using the multivariate procedure of discriminant analysis, it was found that sweat gland measures significantly contributed to the differentiation of diseases, after adjustments were made for variations in age-at-death. This suggested the possibility that criteria for distinction of clinically similar genetic, metabolic, or chromosomal diseases by study of the anatomic properties of eccrine glands obtained by skin biopsy could be developed. A procedure of analysis comparing the "percentage of normal" of gland dimensions for each disease to control values, and thereby differentiating disease categories on the basis of the "percentage of normal" values, is presented.     

Identification of esophageal cancer pathway deviation and construction of a diagnosis model using three kernel genes

The purpose of this study is to better understand the role of interleukin 35 (IL35) in esophageal carcinoma by comparing the mRNA level in Barrett's esophageal mucosa and in matched normal squamous mucosa and to understand how the diagnosis model works with two other genes: hepatocyte nuclear factor 1B (HNF1B) and cAMP responsive element binding protein 3-like 1 (CREB3L1). By comparing carcinoma tissue and normal tissue samples, we extracted all the differentially expressed mRNAs. The bioinformatics analysis resulted in the discovery of three prominent genes. Eventually, the three genes were utilized to train a deep-learning model. An additional wet experiment was conducted to validate the effect of IL35. All the differentially expressed genes were enriched into nine groups, each of which has specific biological functions. Given that the three significant genes HNF1B, CREB3L1, and IL35 as diagnostic features, a deep-learning model was constructed, reaching an accuracy of 93% in the training set and 87% in the test set. Our findings suggest that IL35, along with the other two signatures, can distinguish esophageal tumor samples from normal samples precisely.     

microRNA与食管癌关系的研究进展

肿瘤的发生、发展是多基因共同参与的多步骤的复杂过程,包括癌基因的异常激活和抑癌基因的失活。MicroRNAs(miRNAs)是一组真核细胞内源性产生的单链小RNA分子,研究发现miRNAs的表达异常与人类肿瘤发生有着密切的关系。食管癌是我国常见的恶性肿瘤之一,近来miRNA与食管癌的相关研究也日渐报道,因此本文就此作一综述。