Localization Of Pathological Process Research Articles

COMBINED NANOCHEMOTHERAPY USING DOXORUBICIN AND CURCUMIN AS AN EXAMPLE

The aim of the work was to review literature data on combined nanochemotherapy using the example of two drugs ̶doxorubicin and curcumin. Special attention was paid to the use of substances with synergistic properties in one nanoparticle, capable to penetrate into living cell. The method of combined chemotherapy of nanopreparations improves processing efficiency. The technique of using nanocontainers with synergistic drugs in combination with ligands reduces the side effects of chemotherapy drugs. Results. Literature data indicate that the use of nanopreparations contributes the rapid creation and use of synergistic combinations that were purposefully delivered to target cells, reducing dosage due to precise targeting. A promising direction of nanomedicine is the creation of multifunctional nanomaterials based on several active drugs having synergistic properties, with the simultaneous use of their enhancers and the strategy of active targeting. These structures enabled targeted and controlled penetration of medicinal compounds into the localization of pathological processes, reducing drugs toxicity for normal cells. Conclusions. Combined chemotherapy using polymers and nanoparticles with ligands, in which synergistic drugs are included, ensures to reduce side effects and doses of chemotherapy drugs, and helps to overcome multiple drug resistance as well.

Modern complex treatment of microsporia of smooth skin

Objective — to determine clinical efficacy of antifungal agent 2 % sertaconazole nitrate cream in complex treatment of microsporia of smooth skin mainly affecting the vellus hair in children and adults.Materials and methods. We observed 80 patients with microsporia of smooth skin aged from 2 to 53 years including 9 adults and 71 children (49 girls and 22 boys). There were injured vellus hair in 75 patients presented. All patients were divided into 3 groups depending on treatment assigned. All patients of 3 groups were prescribed terbinafine depending on body weight: for less than 20 kg of body weight — 62.5 mg/24­hour period (1/4 of pill); 20 to 40 kg — 125 mg/24­­hour period (1/2 of pill), more than 40 kg — 250 mg/24­­hour period (1 pill). System therapy was combined with on skin treatment. Patients of the 1st group were prescribed 2 % sertaconazole nitrate cream, patients of the 2nd group — ketoconazole cream, patients of the 3rd group — terbinafine cream. Treatment duration in the 1st group ranged from 1 to 5 weeks depending on localization of pathological process. Treatment duration in the 2nd and 3rd groups ranged from 2 to 6 weeks. Results and discussion. All 80 patients with microsporia have clinically and etiologically recovered as a result of treatment. Treatment duration for all three groups ranged from 1 to 6 weeks depending on localization of the pathological process. Treatment duration in the 1st group ranged from 1 to 5 weeks. The inclusion of 2 % sertaconazole nitrate cream in complex treatment of patients with microsporia allowed to improve treatment results and to shorten treatment duration by 7—14 days. There was good tolerability in adults and children without changing the general and biochemical blood and urine tests after completion of therapy. Conclusions. Antifungal agent 2 % sertaconazole nitrate cream is effective and safe in case of microsporia of smooth skin in children. Complex treatment of patients with microsporia by means of antimycotic terbinafine and 2 % sertaconazole nitrate cream has contributed to improvement of treatment results, reduction of treatment duration, acceleration of clinical and mycological recovery. This complex treatment method showed its effectiveness in treatment of patients with microsporia of smooth skin mainly affecting the vellus hair in children and adults.

Peculiarities of values of acetylcholine concentration and cholinesterase activity in serum of patients with alcoholic chronic pancreatitis and duodenal ulcer

Introduction. There are a lot of pathogenic factors involved in development of polyetiologic diseases. Acetylcholine (AC) is known as first-order mediator as it plays an important role in development and maintenance of pathological processes. In this article we provide data on AC concentration in blood serum of patients with duodenal ulcer, alcoholic chronic pancreatitis and control group as well as activity of cholinesterase.
 The aim of this study was to identify a role played by AC in pathological process during disease, which may complicate a course of the disease as a bad prognostic factor.
 Results and discussion. We divided AC concentration into three types in the control group: low — 0.46–1.0 mmol/l (60% of individuals), moderate — 1.02–1.5 mmol/l (30%) , and high — more than 1.5 mmol/l (10%).
 Conclusion. We suppose that cholinesterase activity and AC concentration depend on localization of pathological process.

Clinical forms of the pathology of distal limbs of the pigs

Spread and clinical character of course of different forms of surgical pathology of distal limbs of the pigs are shown in the materials of the article. For clear differentiation it is proposed classification of surgical diseases of the limbs of the pigs which is based on principle of anatomical-topographical localization of pathological process. Degree evaluation of lameness in diseases of distal limbs of the pigs is presented

The use of liposomal solutions of antibiotics in treatment of infected and festering wounds in children

Aim of research. To study the use of liposomal solutions of antibiotics in the complex treatment of infected and festering wounds in children.Materials and methods of research: The results of clinical and laboratory examinations of 77 children 3-18 years old with infected and festering wounds were analyzed. All children were distributed into groups of observation by the character of the treatment: in 37 sick children (the main group) liposomal preparations were used in the complex treatment. Patients of the control group (40 children) get the generally accepted complex treatment. The groups of comparison were statistically similar by the character and localization of pathological process, age, prescription of disease. In the main group an antibacterial-liposomal mixture was injected into the wound alongside with the generally accepted methods. The dynamics of the clinical, laboratory, cytological, bacteriological and morphological indicators was defined using the generally accepted technics. The general condition of patient’s organism was assessed with a help of laboratory methods of research (general clinical and biochemical analyses).Results. In the main group it was observed a persistent tendency to normalization of leukocytal formula and of the number of leukocytes in peripheral blood that reached normal values (p < 0,05) on 7th day. In 36 patients of the control group leukocytosis remained for 7 days. Evident differences of indicators of leukocytal index of intoxication and of an index of the shift of leukocytal formula in the main and the control groups were observed on 3-4th day. In addition its decrease was combined with diminution of an intensity of clinical symptoms and with decrease of manifestations of the local pathological process.Bacteriological examination of the nidus of inflammation in patients of examined groups revealed that in the main group the diminution of the degree of infectious contamination passed faster (p<0,05 – on first 3 days, p<0,01 – from the 4 day of observation. On the 3 day the number of microbial cells in 1 ml. of the wash from infected and festering wounds was 103 – 106 CFU/ml, on the 4–6 day was lower than 103 CFU/ml.Conclusions. After 3 days of treatment wounds with liposomal solution of antibiotics the faster rates of normalization of clinical and laboratory and cytological indicators were reliably fixed in 67% of patients from the main group in comparison with the control one. The use of liposomal solutions of antibiotics in the complex treatment of infected and festering wounds in children results in intensification of biosynthetic activity of cells, reparative processes in the wound area, fastens formation of granulation tissue

Combined Atherosclerotic Lesions of Cerebral and Coronary Blood Vessels: Risk Factors

Data is presented specifying the extent of influence of traditional and novel (C-reactive protein (CRP), fibrinogen, intima-media complex (IMC)) risk-factors of atherosclerotic lesions upon cerebral blood vessels in case of isolated variant vs. combined lesions of coronary and cerebral blood vessels. The role of CRP and fibrinogen as atherosclerotic process development markers is discussed. The most significant risk factors of combined and isolated atherosclerotic lesions of coronary and cerebral blood vessels are discussed important for understanding of this pathology ethiology and pathogenesis. Pathogenetic interrelation of cerebral and cardiac pathology is specified manifesting itself by mutual aggravation in case of atherosclerotic process. Pathophysiologic mechanisms of cerebral and coronary blood vessels’ atherosclerotic lesions are common, hence the risk factors are also analogous, however their import is not identical in case of isolated and combined variants and this feature should be taken into account while working out the approach to this ailment treatment and prophylaxis. Atherosclerotic lesions of arteries from various vascular basins alongside with common pathophysiologic mechanisms also possess a score of peculiarities that predetermine different approaches to their treatment and prophylaxis. Separate risk factors determine predominant localization of pathologic process in certain vascular basins thus identification of isolated and combined coronary and cerebral principal blood vessels atherosclerotic lesions’ risk factors is a subject of profound studies. Thus working out new approaches to cerebrovascular ailments risk prognosis on the basis of cardiovascular ailments risk factors as well as existing prophylactic measures monitoring is actual for contemporary medicine.

PERIOPERATIVE SUPERVISION OF CHILDREN WITH ADRENAL NEOPLASMS

Aim. To optimize the perioperative safety and to improve the results of surgical treatment of children with adrenal neoplasms. Materials and methods. The perioperative supervision of 18 patients (children aged 2 months to 15 years) with adrenal neoplasms who underwent laparoscopic adrenalectomy for different adrenal neoplasms was analyzed. The following two groups of patients were formed depending on the hormone activity of neoplasm originating from the adrenal gland: children with hormonally inactive adrenal tumors (14 cases) and patients with hormone-producing neoplasms (4 cases). Patients underwent complex examination confirming the character and localization of pathological process. Operative intervention - endoscopic adrenalectomy - was performed in conditions of multicomponent anesthesia and perioperative replacement steroid therapy. Results. The study indicated that the applied methods of general anesthesia are adequate anesthetic measures. So as to ensure safety of patients during operative intervention, uninterrupted monitoring of electrocardiography, noninvasive arterial pressure, pulsoxymetry, carbonic acid concentration in the expired gas-narcotic mixture, control of glycemia level, monitoring of blood gas composition and acid-base balance, temperature control, hourly diuresis were used. An obligatory condition for adequate perioperative supervision of children is replacement steroid hydrocortisone therapy in the perioperative period by the age dosage scheme irrespective of hormonal activity of neoplasms. The postoperative period in all cases, except one, was smooth, on the days 1-2 patients were transferred from resuscitation unit to the ward. Conclusions. For the purpose of preventing development of hypoadrenal crisis in the postoperative period after unilateral adrenalectomy irrespective of presence or absence of hormonal activity of adrenal neoplasm, it is necessary to carry out replacement steroid therapy since before the surgery it is not possible to assess the function of contrlateral adrenal gland.

Opportunities postmortem multislice computer tomography

Objective Compare the data from postmortem multislice computer tomography (MSCT) and autopsy to determine the diagnostic capabilities of dead fetus and neonatal MSCT. Methods Postmortem MSCT was performed on 5 fetuses (gestational age 20-21 weeks), 3 stillbirths (22-34 weeks) and 11 newborns who died 2 hours to 36 days after birth. The results were compared with the clinical and the autopsy data. Results There is a correspondence between the ante-mortem clinical, MSCT and autopsy data: in cases of congenital anomalies of the long bones (7 of 7 cases), genitourinary system (2 of 5), brain (5 of 6), in cases of congenital diaphragmatic hernia (3 of 4), cerebral hemorrhage (6 of 6), hypoplasia of the heart (2 of 4), pneumonia (2 of 5), and pneumothorax (3 of 3). MSCT has revealed additional abnormalities that are not listed in the childbirth and disease protocols, but diagnosed at autopsy: malformation of the vertebras (2), forearm, hands and skull bones (4), brain hemorrhage (3), pneumothorax (4), subcutaneous emphysema (2). Conclusions Postmortem MSCT is an important complement to traditional autopsy, because it allows clear identification of the kind and localization of pathological processes and contributes to a more effective carrying out of the autopsy.

Endorectal ultrasound (ERUS) in pelvic disorders

Endorectal ultrasound (ERUS) imaging is a complex process using electronic devices to control ultrasound waves and produce images of anatomic structures. It is a simple, cheep and well-tolerated procedure that provides excellent images of rectal and anal canal wall and pelvic floor muscles together with surrounding organs and tissues. The direct imaging of anal canal and pelvic floor muscles with surrounding tissues allows one to identify sphincter defects, anorectal abscesses and fistulas as well as great variety of benign and malignant pathology of the pelvis. Basically, techniques for ERUS are very similar, but there are some slight modifications regarding equipment, indications, and localization of pathologic process. We describe the technique, indications, results and pitfalls of ERUS with the Bruel and Kjaer type 1850 endosonic probe with 7 and 10 MHz transducers in benign pelvic disorders.

Clinical and Roentgenologic Semiotics of Long Bone Pathologic Fractures

During 1965-2002 one thousand two hundred thirty patients with bone tumors and tumor-like diseases were treated at Astrakhan Medical Academy, Clinic of Traumatology and Orthopaedics. Out of them 163 (13.3%) patients had pathologic fractures. One hundred eight fractures were localized within long bones: humerus (61), femur (37), tibia (29), fibula (6), radius (5). Long bones fractures were commonly resulted from destructive lesions: solitary bone cyst - 48 cases, fibrous dysplasia - 26, giant cell tumor - 24, aneurismal bone cyst - 18, metaphyseal fibrous defect -11. Clinical and roentgenologic semiotics was studied and complex of roentgenologic signs of long bone pathologic fractures was systematized. Peculiarities of fractures (injury mechanism, typical localization of pathologic process, pattern of destruction focus) in various nosologic forms of primary disease were detected. The data obtained simplify diagnosis and allow trustworthy making prehistologic diagnosis as well as to choose optimum treatment tactics.

Sonography of the internal capsule and basal ganglia in infants. Part II. Localization of pathologic processes in the sagittal section through the caudothalamic groove.

Sagittal sonograms through the caudothalamic groove routinely display a gangliothalamic ovoid delimited by the lateral ventricle, the perimesencephalic cistern, and the radiations of the corpus callosum. The caudothalamic groove divides the superior surface of the ovoid into an anterior caudate arc and a posterior thalamic arc. The cerebral peduncle divides the inferior surface of the ovoid into an anterior ganglial arc, a middle peduncular arc, and a posterior thalamic arc. The genu of internal capsule constantly courses from the anterior end of the caudothalamic groove down to the peduncular arc and is easily identified. The gangliothalamic ovoid exhibits four obliquely oriented bands of increased and decreased echogenicity. The anteriormost hyperechoic band 1 corresponds to the head of the caudate nucleus. Hypoechoic band 2 corresponds to the globus pallidus, genu of the internal capsule, and cerebral peduncle. Hyperechoic band 3 corresponds to the ventral and lateral thalamic nuclei (exclusive of the pulvinar). Hypoechoic band 4 corresponds to the pulvinar. Lesions of the medial nucleus of the globus pallidus appear as hyperechoic foci that abut on the anterior surface of genu just above the peduncle and that have a narrow convex caudal margin. Lesions of the lateral nucleus of globus pallidus abut on the genu distant from the peduncle, spare the medial nucleus adjacent to the peduncle, and have a broad caudal border. Lesions of the head of caudate nucleus affect the anterior pole of the ovoid; those of the body affect the caudate arc superior to the caudothalamic groove. Thalamic lesions increase the echogenicity of bands 3 and 4.

Neurological Examination in Clinical Practice.

The examination is a time-consuming one, often ignored or omitted, frequently abbreviated and inadequate, or incomplete and misleading. While detailed, it is logical and, when it is performed well and interpreted correctly, it yields important information concerning localization of pathological processes. When it is coupled with a good history, a precise diagnosis or an approach to diagnosis is established. This book is an attempt to help the clinician elicit and interpret neurological signs, stressing the traditional approach. As such, it is classical and, like an old friend, reliable and well done. However, it is of limited appeal, being too simple for trainees and not really sufficient by itself for the occasional traveler in problems—he needs additional help in anatomical and clinical correlation not available in this small volume. It is fine for medical students and house officers to read during their first week of a