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Introduction The development of carcinoid heart disease (CaHD) is still relatively unknown at present. It is difficult to define an optimal follow-up for patients initially free from cardiac involvement. The aim of this study was to assess the prevalence and the evolution of CaHD using annual echocardiographic follow-up. Method We reviewed from our database 137 patients (61 ± 12 years, 53% men) with histologically proven neuroendocrine tumor between 1997 and 2017. All patients underwent serial conventional transthoracic echocardiographic studies. Right-sided and left-sided CaHD were systematically assessed. We used a previous validated echocardiographic scoring system of severity for the assessment of CHD. An increase of 25% of the score was considered as significant. Results Mean follow-up was 2.6 ± 3.5 years [0;16]. Prevalence of CaHD was 27% (37 pts) at baseline and 36% (49 pts) at the end of follow-up. Among patients with initial CaHD followed for more than one year, disease progression was observed in 28% of cases. Among the patients free from initial cardiac involvement, an onset of the disease was observed during follow-up in 21% of cases. The onset of CHD could be very late, more than 5 years from the initial echocardiographic examination in 42% of our cases ( Figure 1 ). This late occurrence of CaHD was only observed in patients presenting with new resumption of neuroendocrine tumor (symptoms, increased of 5-HIAA, occurrence of new metastasis). Conclusion Our study demonstrated that in patients without initial CaHD, cardiac involvement may occur tardily after a normal initial assessment. Our data suggest the need for prolonged echocardiographic follow-up in patients presenting with a resumption of tumor process ( Figure 1 ).

Pseudomyxoma peritonei is a clinical entity characterized by a gelatinous ascite associated with mucinous tumor deposits spreading on peritoneal surface and potentially invading abdominal organs. It is considered as a tumor process linked, in most of cases, to a mucinous appendiceal neoplasm. Pseudomyxoma peritonei may benefit from a therapeutic strategy combining cytoreductive surgery and intra-peritoneal chemotherapy, which has led to a major prognosis improvement. Different classifications are available and the last one corresponds to the WHO 2010 version, which individualizes pseudomyxoma peritonei in two classes: low grade and high grade mucinous carcinoma. The very low frequency of this entity and its specific therapeutic strategy need specific health care centres, as well as physicians and pathologists collaborating through dedicated networks. The aim of this article is to summarize the pathology, causes, mechanisms and therapeutic approaches of pseudomyxoma peritonei, as well as their interfaces with dedicated networks.

Background Experimental and clinical studies have shown an increase in the level of interleukin-6 (IL-6) in the blood plasma and other cytokines in obstructive jaundice. The combination of a persistent increase in cytokines and an extended acute response phase is associated with a decrease in protein calories, leading to surgical complications and death. Methods The study involved 41 patients treated at the Gastroenterology department in 1st Republic Clinic, Tashkent aged from 33 to 84 years old (62.8 ± 2.14) were studied, of whom 26 (63.4%) were men and 15 (36.6%) were women. The duration of the icteric period by the time of admission to the hospital averaged 28.7 ± 2.18 days. At the same time, in 6 (14.6%) patients the duration of cholestasis was up to 15 days, in 10 (24.4%) - from 15 to 30 days, in 25 (61.0%) - more than 1 month. Percutaneous transhepatic cholangiography (PTCH) with per-cutaneous transhepatic cholangiostomy (PTCHS) was performed for all patients, regardless of the localization of the tumor process. The level of IL-6 in serum and bile was determined by ELISA method. Results The concentration of IL-6 before the overlap of PTCH in the serum was higher than normal, averaging 152.65 ± 16.3 pg/ml. Immediately after the overlaying of PTCH in bile, this indicator was on average 68.58 ± 7.24 pg/ml. The high content of IL-6 in serum and bile testified to a pronounced endogenous intoxication of the body. The concentration of IL-6 in the initial day after the imposition of PTCH in serum decreased to 32.9%. In the following days, this indicator remained virtually unchanged, but on the 6th day of observation, there was a slight increase in his blood. In the bile at the same time, the concentration of IL-6 decreased by 17.1%. These indicators remained virtually unchanged up to 6 days of observation. On the 14th day, the decrease in the level of IL-6 in the blood compared to baseline was 64.4%, and in the bile 54.3% (P Conclusions Thus, the determination of IL-6 in the blood and in the bile makes it possible to more objectively evaluate the tumor process and the cytokine-induced endogenous intoxication to the response of the therapeutic measures taken in biliopancreatoduodenal tumors complicated by the mechanical jaundice. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

In this write-up mathematical model of cell osmotic process is developed. Probability density distribution of interval to administer biostimulant for optimal survival is obtained. The traditional cancer therapy problem is formulated as non zero sum cyclic stochastic game employing behavior strategies for optimal survival. Mathematical model is obtained for ion transmitter for hypothermia therapy. Neural supervised training algorithm employing amorphous model for hypothermia therapy is given. Radiation transport model for tumor growth and procedure for forecasting tumor metastasis process is given. Probability density distribution of tumor process termination time is obtained.

Aim To improve the results of the treatment of patients with locally spread oral cavity tumors, spreading onto neighboring anatomic structures, including skull base. Materials and methods We proposed the variant of combined treatment of patients with head and neck tumors, including expanded operations, intraoperative radiotherapy and reconstruction-at-once in the case of primary and recurrent tumors after surgical, radiation, combined, complex treatment, just as their repeated coalition. We accumulated experience of 55 patients’ treatment, for whom block resections were conducted, together with intraoperative radiotherapy in radiation doze 15 Gray (52 patients) and in radiation doze 25 Gray in the conditions of gas hypoxia (three patients). For all the patients the spread of tumor process corresponded to T4 symbol. In 32 cases for reconstruction-at-once we used the method of microsurgical tissue autotransplantation, in 23 observations locally-relocated flaps were used. Results The complications appeared in 41.2% of cases, the complications predominated in the group of patients with intracranial expansion of a tumor. Total survival rate was for 3 years – 23.3 ± 6.3%; for 5 years – 14.8 ± 7.0%. At the same time, there was observed reliable difference in the survival rate of patients with recurrent and primary tumors. 3 year survival rate with recurrent tumors was 15.6 ± 2.3%; with primary tumors – 39.7 ± 1.7%; 5 year survival rate – 10.41 ± 5% and 23.8 ± 1.4% correspondingly.

The paper examines the biological reasoning of the Gompertz model for tumor growth: the increase and loss rates of the tumor volume are both proportional to the volume itself. The statement is proved mathematically. The theoretical foundation is therefore established, this ensures the application of the Gompertz model as an effective aid for the understanding of the experimental and clinical tumor process.