Radiation diagnosis of bronchioloalveolar cancer

The paper analyzes the results of examination of 260 patients with bronchioloalveolar cancer (BAC) who were followed up at the Russian Research Center of Radiology and Roentgenology for 30 years. It provides its clinical, X-ray, and morphological manifestations and classification and the methodological aspects of differential diagnosis. An optimum radiation diagnosis programme has been drawn up, which involves currently available procedures, including computed tomography. The morphological forms of BAC are given in detail.     

Radiation diagnosis of venous angiodysplasias

The paper proposes an original procedure for diagnosing venous dysplasias of different sites. The procedure is based on the analysis of the capacities of currently used invasive and noninvasive techniques of radiation visualization. The practical aspects of conduct of routine studies, their potentialities and shortcomings are outlined. The principle of the proposed procedure is a result of a complex use of the capacities of ultrasound visualization and interventional X-ray contrast studies of the vascular system. The procedure has been successfully used in 8 patients. It is concluded that it is promising to examine venous angiodysplasias by means of direct puncture made under ultrasound guidance, followed by mass contrasting and angiography which may be supplemented by sclerosing therapy.     

Double-energy X-ray absorptiometry in the diagnosis of osteopenia in ancient skeletal remains

Bone mineral density (BMD) assessed by double-energy X-ray absorptiometry (DEXA) accurately estimates the bone mass in living individuals, and is thus the method usually employed in the diagnosis and follow-up of osteopenia. It is preferred, in clinical settings, to the more invasive and destructive histomorphometrical assessment of trabecular bone mass in undecalcified bone samples. This study was performed in order to examine the value of DEXA-assessed BMD at the proximal end of the right tibia, either alone or in combination with the cortico-medullary index at the midshaft point of the right tibia (CMI), in the diagnosis of osteopenia in a prehistoric sample composed of 95 pre-Hispanic individuals from Gran Canaria. Age at death could be estimated in 34 cases. Diagnosis of osteopenia was performed by histomorphometrical assessment of trabecular bone mass (TBM) in an undecalcified bone section of a small portion of the proximal epiphysis of the right tibia. A high prevalence of osteopenia was found among the population of Gran Canaria. Both TBM and BMD were significantly lower in the older individuals than in younger ones, and BMD was also significantly lower in female individuals. BMD was moderately correlated with TBM (r = +0.51); the correlation was higher if CMI was included (multiple r = +0.615). BMD values lower than 0.7 g/cm2 showed a high specificity (>93%) at excluding normal TBM values. These methods were prospectively applied in a further sample of 21 right tibiae from Gran Canaria, Tenerife, and El Hierro. The results were similar to those obtained in the larger sample. Thus, DEXA-assessed BMD combined with CMI (noninvasive procedures) may be useful in detecting osteopenia in ancient populations.     

Radiation and endoscopic diagnosis of pneumonia

The authors analyze the results of different types of radiation and endoscopic studies of 151 patients with pneumonia with an established etiological agent. There is a correlation of X-ray semiotics and endoscopic changes with the clinical manifestation and causative agent of the disease. When the studies are combined, emphasis is laid on the role of endoscopy in verifying the diagnosis, in specifying an etiological agent, and in implementing therapeutical measures to prevent complications. An algorithm of radiation imaging techniques is proposed to examine patients with pneumonia and of their purpose-oriented use according to the task set.     

Radiation diagnosis of abdominal aortic aneurysms

Four hundred and forty seven patients with aneurysms of the abdominal aorta (AAA), including 238 patients with aneurysmal rupture, were admitted to the Research Institute of Emergency Care in 1990 to 2000. The results of studies in 225 patients (ultrasonography in 197, computed tomography in 59, and angiography in 104), including 155 patients with aneurysmal rupture were analyzed. Computed tomography (CT) has proved to be the most accurate technique in the detection and estimation of the size of aneurysms, as well as in the identification of ruptures (83.9%) and inferior to angiography (AG) in the study of involvement of the branches of the abdominal aorta. Ultrasound study (US) ranks below CT in its accuracy (US detects ruptures in 67.8%); however, US surpasses CT and AS in screening, particularly valuable at an admission unit and an intensive care unit, which permits repeated studies. AG has turned out to be the most valid method in identifying the involvement of renal and iliac arteries in aneurysm and in detecting aortocaval anastomoses; yet it is inferior to US and CT (the former revealed rupture and dissection in 18.6% of cases) in solving other diagnostic tasks. Based on the analysis, the optimal sequence of studies in the patients is US, CT, and AG.     

Radiation diagnosis of interstitial lung diseases

The authors analyzed the results of complex radiation study of 1192 patients with various interstitial lung diseases (ILD). An algorithm of differential diagnosis of diffuse and disseminated lesions of the lung was derived by using the findings. The X-ray morphological principle underlies the algorithm. The level of structural lesions of the lung and tissue reactions and the presence of granuloma shadows are the governing criteria for evaluating the gross structure in the differential diagnostic complex. Great emphasis is laid on the significance of computed tomography (CT), high performance CT in particular, which is becoming the priority radiation diagnostic technique in pulmonology. Morphofunctional studies, 99mTc AMA and 67Ga citrate pulmonary scintigraphy in particular, specify the magnitude of changes in the microcirculatory bed and the activity of intrathoracic lymph nodes.     

Radiation diagnosis for tuberculous gonitis in children

Tuberculous knee joint lesion in children is the most common form of articular pathology. The high sociomedical significance of this disease in modern society is determined by not only its prevalence, but also economic losses caused by high disability rates in children. The purpose of the study was to determine the possibilities and place of a comprehensive radiation study in the diagnosis of tuberculous gonitis in children. Sixty patients aged 10 months to 18 years were examined. Clinical studies were comprehensively assessed, by taking into account the collected history data and orhthopedic and laboratory findings. Surgery was made in 26 children. All the patients underwent mutiprojection X-ray study, knee joint ultrasound study being made in 48 patients. Knee joint X-ray study was performed on Siregraph (Siemens) apparatuses. Real-time ultrasonography was conducted on Aloka SSD-1100 and Aloka--3500+ apparatuses, by employing a 7.5-MHz linear transducer. According to P.G. Kornev (1971), three phases were identified in the course of tuberculous gonitis. These included prearthritic (the development of primary ostitis); arthritic (articular cartilage destruction, followed by the development of secondary arthritis; and postarthritic (sequels of prior tuberculous osteomyelitis) phases. Analysis indicated that the use of the routine X-ray study in combination with ultrasound scanning in the diagnosis of tuberculous gonitis in children yielded more adequate information on tissue and knee joint structural changes and made it possible to define further policy treatment and to predict the outcomes of the disease.     

Radiation diagnosis of diffuse lung diseases: Part I

Based on the data on 150 patients with diffuse lung diseases, the authors present the X-ray and computed topographic semiotics of changes in lung tissue in a number of diseases from this group. The differential diagnosis of diffuse lung diseases has certain difficulties whose solution is association with the application of complex radiation studies (digital fluorography, classical X-ray study, X-ray computed tomography, and magnetic resonance imaging). These techniques not only assess the status of the parenchyma of the lung and the extent of a process, but also permit a follow-up monitoring and evaluation of the efficiency of the therapy performed.     

Radiation diagnosis of uncomplicated compression spinal fractures in children

Experiments on rabbits compared the X-ray, morphological, and magnetic resonance imaging of compression fractures of the vertebral body. Edema of the bone marrow of the vertebral body was ascertained to be a basic morphological substrate that evokes a modified MR signal. The data on 178 children with suspected compression fracture of the vertebral body were used to consider the potentialities of MRI and X-ray study in this pathology. The MRI semiotics of uncomplicated compression fractures of vertebral bodies is presented. The sensitivities of MRI and spondylography in the diagnosis of compression fractures of vertebral bodies were 100 and 62.5%, respectively.     

Heparin-induced osteopenia in pregnancy.

Multiple vertebral compression fractures occurred in a pregnant woman receiving heparin over nine months. This phenomenon may be more common than is clinically recognised and warrants careful re-examination of the indications and method of administration of anti-coagulants during pregnancy.     

Modified operative technique for involutional lower lid entropion

The paper presents a modified operative technique for involutional lower lid entropion. The prospective noncomparative study of 101 lower eyelids of 88 patients undergoing surgery for involutional lower lid entropion was conducted in period from September 2005 until March 2012. Indication for the surgery was entropion, previously untreated, with moderate to severe horizontal lid laxity and no clinically relevant medial and lateral canthal tendon laxity. The operative technique is our modification of Quickert and Jones procedures. Photo was taken preoperatively and one month after surgery. Clinical follow-up was at 7th postoperative day, one month and six months after surgery and in case of the recurrence. Long-term follow-up was obtained via telephone interviews. There were 44 male (50%) and 44 female (50%) patients included in the study. The age of patients was in average 73.27 +/- 8.1 years (range 53-90 years). Early postoperative complication was localized lid swelling found in two patients starting 4-6 weeks postoperatively at the area of absorbable suture. It resolved spontaneously in two and three weeks respectively. There was recurrence of entropion in 11 eyelids (10.89%) of 10 patients. The mean interval between primary surgery and the recurrence was 17.45 +/- 14.84 months (range 4-48 months). In these eyelids Jones procedure was performed. However in four eyelids of four patients from the recurrent group an additional surgery needed to be performed after 6, 12, 12 and 17 months respectively. Our modification of surgical treatment for involutional lower lid entropion was effective in 89.11% of eyelids. Complications of the procedure were scarce.     

Differential diagnosis of enterococci]

The most stable differential signs of enterococci are: growth in the medium at pH 10.2, growth in broth containing 40% bile, citrate utilization, resistance to 0,05% potassium tellurite, 2, 3, 5-triphenyltetrazolium chloride (TTC) reduction, the staining of colonies (plaques) on a medium with manganese, iron and zinc salts, glycerine fermentation under anaerobic conditions, mannite fermentation, the presence of hemolysin, of the proteolytic enzyme, and mobility. Combined differential-diagnostic nutrient medium permits to determine simultaneously 5 enterococci signs--resistance to nalidixic acid and to crystal violet, TTC reduction, hemolytic and proteolytic activity. The suggested scheme of enterococci laboratory diagnosis including a set of hard nutrient media poured into multisection Petri dish is simple reliable and accessible for any bacteriological laboratory.     

The use of conchal cartilage graft in involutional entropion

A simple and stable technique for repairing involutional entropion is described. Through a transconjunctival incision between the lower border of tarsus and the lower lid retractor, the eyelid is divided between the tarsus and the orbicularis oculi muscle into external and internal layers. The internal layer is moved upward until the eyelashes turn outward, and then through-and-through sutures are placed to fix it in this corrected state. The resultant defect between the lower end of the tarsus and the retractor is filled with a conchal cartilage graft. The raw surface of the cartilage is epithelialized from the surrounding mucosa within 1 to 2 weeks without shrinkage. This technique is more stable than any other technique that we have performed.     

Low oxygen [correction of oxygene] tension may defence the bone tissue from unloading simulated osteopenia

The main task of the present study is to investigate the influences of normobaric gas mixture with lowered PO2 (90-110 mm Hg) on the bones metabolism in rats after hind limb unloaded (HLU). We observed increased the glycosaminoglicans (GAG) concentration in blood serum rats with hind limb unloaded in atmospheric air (AA). An increased activity of acid phosphatase (AcP) and tartratresistant acid phosphatase (TRAcP) in blood serum of rats after HLU was observed. The activities of the alkaline phosphatase (AIP) in blood serum did not change. An increased osteocalcin (OST) and C-terminal Propeptide of type I Collagen (CICP) concentration in blood serum, but parathyroid hormone (PTH) decrease comparatively with the control. The above mentioned biochemistry markers in animals after 28 days unloading in normobaric gas mixture (NGM) were more stable and in spite of the same procedure in AA, all dates were near to the controls.