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In 1998-2003 yrs in the clinic there were treated 360 patients with the thyroid gland diseases, 147 (40.8%) of them were operated. In 19 (12.9%) of patients various kinds of complications had occurred.

The article is devoted to actulal problem of endocrinology and surgery-treatment of severe diseases of the thyroid gland. Results of plasmapheresis application in complex preoperative preparation in 90 patients, aged from 20 to 60 yrs, in severe course of the disease, were adduced. After plasmapheresis preparation conduction the reduction of the autoimmune processes in the patients organisms, the antibodies titer lowering were noted, witnessing the stable remission achievement. Plasmapheresis application in complex of treatment of patients with autoimmune thyroiditis and diffuse toxic goiter causes significant positive influence on hormonal and immune state.

The paper presents a retrospective analysis of long-term follow-ups (from 1959 to 2000) of 86 patients with acute pro-myelocytic leukemia, a rare type of hemoblastoses. The specific features of this form of leukemia is that blast cells of the bone marrow and peripheral blood have a specific granularity that plays a decisive role in the development of the severe hemorrhagic syndrome leading to patients' death. The morphological, cytochemical, cytogenetic, electron microscopic, and biochemical features of blast cells in this disease and its pathogenesis, clinical presentation, and treatment are considered. An extract from the records of a female patient who has had a complete clinical and hematological remission for 22 years is given. The follow-up of such a prolonged remission has not been covered in the Russian literature.

The increase in HIV-infection incidence in the RF Armed Forces requires the study of modern epidemiology of this infection, the improvement of prophylactic and antiepidemic measures to prevent the contamination of units and ships and to eliminate the epidemiologic foci in time. The epidemiological situation connected with HIV-infection in Russia and the Armed Forces has the general patterns. The maximal incidence is registered in servicemen living in HIV unfavorable territories of the country. In 2001 the structure of HIV transmission in the military collectives was the following: sexual--51%, parenteral (drug addiction)--45%, parenteral (use of one shaving set)--1%, parenteral (tattooing)--1%, uncertain--2%. The high military epidemiological significance of HIV-infection requires the improvement of preventive forms and methods taking into account the main causes and factors that determine the epidemiological situation in Army and Navy.

Excretion of catecholamines has been studied in patients with opium narcotic and alcoholic dependence in developmental dynamics of the opium and alcoholic abstinence syndrome and in the postabstinence period. It has been revealed that 8-10 h after cessation of the psychoactive substances (the preabstinence period) the level of excretion of adrenaline [A], dioxyphenylalanine [DOPA], dopamine [DA] and, to the greatest extent, of noradrenaline [NA] especially in patients with alcoholic dependence decreases in comparison with the control variant. As compared to the control variant the acute form of abstinence syndrome (1-3 days after cessation of the psychoactive substances is characterized by the higher level of the A and DA excretion and the lower level of the NA excretion (especially in patients with opium narcotic dependence). As compared to the preabstinence period under conditions of the acute abstinence syndrome there is an essential increase in the level of the A, NA, DOPA and DA excretion. As compared to the control variant the postabstinence period (10-20 days after cessation) is characterized by the lower level of the NA excretion, especially in patients with alcoholic dependence, and of DOPA. The level of DA decreases in patients with alcoholic dependence. As compared to the acute abstienence syndrome the postabstinence period differs by the lower level of the A, NA (especially in patients with alcoholic dependence), DOPA (only inpatients with alcoholic dependence) and of DA excretion.

Radiowave hemostasis was used for endoscopic stopping of bleeding from gastric and duodenal ulcers in 96 patients. Primary single radiowave hemostasis permitted to achieve stable effect in 80 (83.3%) patients. After repeated radiowave hemostasis bleeding was completely stopped in 14 (14.6%) patients, 2 (2.1%) patients of this group underwent urgent surgery. On day 10 after radiowave hemostasis 95% of mucosal defects epithialized.

The paper deals with the influence of glutaminic acid on the functional activity of the sympatho-adrenal system and the concentration of calcium in urine under conditions of the alcoholic abstinence syndrome development. Changes in the functional activity of sympatho-adrenal system and in the concentration of calcium in the process of the abstinence syndrome development are shown to be of the phase character. It is established that in the period of the developed abstinence syndrome glutaminic acid produces a normalizing action on the excretion of adrenaline and dopamine and also facilitates a decrease in the level of calcium in urine.

The previous data (Zheleznova et al., 2001) did not enable the authors to conclude which particular wortmannin sensitive PI-3-kinase--p85/p110 (I class PI-3-K) or hVPS34 (III class PI-3-K)--may be involved in the regulation of EGF-receptor endocytosis. In the present work, we have shown that upon stimulation of EGF-receptor endocytosis additional structures stained with antibody against p85 appear in A431 cells, but the p85-positive compartment never co-localized with EGF-receptor-containing compartments either in control or in wortmannin-treated cells. At the same time, wortmannin treatment prevented association of hVPS34 with endosomal membranes. We have also found that early endosomal markers--Rab5 and EEA1 (membrane association of the latter depends on Rab5 and hVPS34)--co-localized with EGF-receptor in the juxtranuclear region during late stages of endocytosis, both in control and upon wortmannin treatment. These observations favor our suggestions that the transition of EGF-receptors from early to late endosomes may occur directly in this juxtranuclear region and be tightly associated with the formation of so called multivesicular bodies (MVB), which are late endosomes per se. We suggest that wortmannin may have no effect on early EEA1-dependent stage of the receptor endocytosis but blocks a transition of EGF-receptor complexes into the late endosomes by inhibiting activity of hVPS34 and removing it from membranes. The hVPS34 product PI-3-K, according to the known data, is involved in the formation of internal vesicles of MVB. Accumulation of EGF-receptors in these vesicles is believed to be necessary for the receptor degradation.

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%.

Breast fibroadenomas are a common disease in females, mainly in those aged 20-40 years. For differential diagnosis of fibroadenomas, it is expedient to apply a comprehensive approach whose leading role is played by mammography. The histological structure of fibroadenomas determines their X-ray and sonographic signs. Indications for choosing a surgical treatment are identified by X-ray and sonographic manifestations of fibroadenomas of various histological structure and by typical changes at a follow-up.

Based on results of comprehensive examination of 20,000 females with different breast diseases in a specialized mammological room, the paper presents the most informative invasive techniques that combine diagnostic and therapeutical potentialities, such as ductography, cystography using various sclerosing solution, various types of needle biopsies under X-ray guidance, stereotactic computer devices, ultrasound study, and various labeling modes for nonpalpable formation before surgery. It shows in expedient to make a comprehensive examination under the conditions of a mammological room where the advantages of this or that invisable intervention, including those without a dosage load, are rationally, without duplicating, used depending on the diseases detected, which increases the significance of preoperative diagnosis up to 95-98%, including that of nonpalpable formations by substantially reducing the proportion of surgical interventions into the breast.

The paper deals with the diagnosis of demyelinating diseases of the central nervous system, including multiple sclerosis, by means of magnetic resonance imaging (MRI). The low-magnetic induction tomographs "Obraz" ("Image") and "Ellips" ("Ellipse") made in Russia were used to perform MRI of the brain in 255 patients diagnosed as having multiple sclerosis. Whether low-magnetic induction MRI can detectfocal changes in the brain in the presence of multiple sclerosis was assessed; the tomographic signs of the disease were clarified and classified. There was a relationship between the detection of focal changes in the brain and the duration of the disease. Particular emphasis is laid on the cases of various abnormalities at MRI, which clinically mask multiple sclerosis. The cases are summarized and a list of conditions to be particularly emphasized while making a differential diagnosis is drawn up.

Hypertonic sucrose and amiloride or derivatives of the latter are commonly used to selectively inhibit clathrin-dependent (usually considered as a synonim of receptor-mediated endocytosis) or clathrin-independent endocytosis. Though these approaches are widely used in experimental practice, their limitations have not been studied in detail. In the present work, an attempt was made to evaluate possible side effects and selectivity of these agents towards the type of endocytosis. It was found that the incubation of A431 cells in 0.4 M sucrose resulted in a decrease in both intracellular accumulation and surface binding of the RME marker 125I-EGF. However, while the binding drops by about 3 times, the internalization of EGF in low concentrations was inhibited by more than 30 times, and that of high EGF concentrations by 5-10 times. It may evidence that at high EGF concentrations about 10-20% of ligand-receptor complexes can enter the cells through clathrin-independent pathway. Nevertheless, these results cannot be interpreted so unambigously, because we found that at the incubation longer than 30 min a significant portion of cells became dead or damaged, yielding about 50% of the whole population. By immunofluorescent assay, 5-(N,N-hexametylen)-amiloride commonly used to inhibit fluid phase endocytosis was demonstrated to reduce the staining of fluorescein-containing pinocytic vesicles, but it did not inhibit totally the entering of this marker. Under simultaneous stimulation of fluorescein and EGF endocytosis in the presence of the amiloride derivative, such a residual fluorescence shifted with time to the juxtranuclear region, which is characteristic of the late steps of RME. We suppose that a significant portion of extracellular fluid phase can be included in clathrin-dependent vesicles, whose formation is not disturbed by amiloride. It means that conclusions about the degree of pinocytosis inhibition are to be corrected, taking into account the constitutive clathrin-dependent endocytosis.

The data on 25 cases of histologically verified bronchioloalveolar carcinoma and papillary adenocarcinoma are discussed. Reliable differential diagnostic cytological features of both diseases were established using a statistical, program and fine-needle biopsy findings. Statistical analysis data pointed to the sets of cytological features: "serial pattern--clear cell boundaries" and "serial pattern--presence of macrovacuoles" as a major factor of accuracy of bronchiolo-alveolar carcinoma and papillary adenocarcinoma diagnosis. These cytological features may be used for reliable diagnosis of the diseases.

The study deals with a complex radiation diagnosis of mass lesions of the distopic thyroid. Forty five patients with mass lesions of the anterior mediastenum were examined. They were 28 with retrosternal and intrathoracic goiter, 6 with teratodermoid tumors, 11 with cysts of the anterior mediastenum. A complex radiation study included serial routine X-ray tomography in 2 standard projects, sonography, computed tomography. The diagnosis was verified on the basis of transthoracic and transbronchial needle biopsy with compulsory morphological confirmation. An intergroup comparison has shown that X-ray study is a screening method to detect a tumor, to define its site and its relationship with the adjacent organs. Ultrasound study reveals pathognomonic signs of the distopic goiter. Of the greatest informative value is X-ray CT which allows one to state about the structure of a tumor and its densitometric signs.

Gastroduodenal disorders were studied endoscopically for 5 years in 159 Chernobyl wreckers and were compared to subjects unexposed to ionising radiation. Upper gastroduodenal tract was examined with esophagogastroduodenoscopy to avoid additional radiation load. It was found that 8-12 years after irradiation, many examinees had gastroduodenal mucosa erosions the rate of which was persistently high. Incidences of malignant and benign tumors in the study and control groups did not differ significantly.

Modern definition, classifications, diagnosis and treatment of irritable bowel syndrome (IBS) are presented together with results of treatment of 30 patients with irritable bowel syndrome with the new selective calcium-channel blocker dicetel.

The chief factors of aggression are discussed together with mechanisms of protection of gastric and duodenal mucosa. Results of treatment of 30 patients with gastritis (Helicobacter pylori negative) with a cytoprotective drug smecta are presented.

The shape of thoracic physiological kyphosis was studied based on data obtained through the examination of 120 patients who had presented no complaints regarding thoracic spine. As a result, a quantitative description of a normal curvature for thoracic kyphosis was elaborated. The study addressed such issues as the impact of separate segments on the development of kyphosis, with the identification of relevant quantitative parameters. In addition, sex-related differences of the quantitative parameters describing the form of thoracic spine were determined. The study analyzed tendencies in the curvature transformation during the life period of 16-30 years of age.

Non-steroid antiinflammatory drug (NSAID)-related gastropathy is regarded as the most important NSAID-induced complication. The above term is used to signify erosive and ulcerous injuries to the stomach and duodenum, having a characteristic clinical picture.

A substantial effect of geomagnetic storms on human health with a confidential probability P = 0.95 was revealed. The quantitative estimates of the biotropic effect are presented. For example, the frequency of occurrence of bursts exceeding the average number of hospitalized patients with mental and cardiovascular diseases during magnetic storms increases approximately 2 times compared with quiet periods (based on the data on 1983-84). The frequency of occurrence of myocardial infarction, angina pectoris, violation of cardial rhythm, acute violation of brain blood circulation during storms increases 2.1; 1.6; 1.6; 1.5 times, respectively compared with magnetically quiet periods (based on the data of 1992-96). A similarity of the seasonal distribution of the magnitude of the biotropic effect is revealed in the case of myocardial infarction and the number of magnetic storms: a maximum in the equinox and a minimum in summer.

Results are submitted of bacteriological investigations in those persons with duodenal peptic ulcer who had been called up. The presence of regional strains of H. pylori is ascertained together with their sensitivity to certain antibacterial drug preparations. A rational antihelocobactertherapy schedule is proposed.

The nosologic and etiopathogenetic structure of the cholestatic syndrome encountered both in surgical and therapeutical practice is described.

Groups of patients suffering alcoholism and narcomania were examined for the effect of intoxication on the blood serum enzymes of mainly liver origin: alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as on thymol test. It has been shown that in patients with the first stage of alcoholism one could observe only functional disturbances in the liver: the increase of ADH activity which evidences for the induction of its synthesis. In patients with the first stage of opium narcomania one can record total hyperenzymenia, decrease of de-Rimis coefficient at the expense of more considerable increase of ALT activity than that of AST, as well as the sharp increase of thymol test--these are the signs of destructive and metabolic disturbances in the liver. In patients with the second stage of alcoholism one can observe the decrease of ALDH activity under the increase of ADH, AST, ALT activity and high thymol test-these are the signs of toxical hepatitis. Destructive and metabolic changes increase in the liver in the patients with the second stage of narcomania.

The data on the surgical and combined treatment of 35 cases of lung cancer associated with pleural effusion detected during surgery have been evaluated. Mean 5-year survival was 68.5%, pleural effusion--70%.

Scanning osteodensitometry helped to study mineral saturation of lumbar vertebra in individuals who liquidated Chernobyl accident consequences. Bone mineral density appeared to depend on radiation dose obtained by the examinees. High risk of osteoporosis revealed in the examinees who participated in the liquidation in 1986. The authors stress that the examinees should be covered by the skeletal state monitoring possible only with osteodensitometry. The article justify that biphotonic scanning osteodensitometers are expedient in Health Care Centers for individuals who liquidated Chernobyl accident consequences.

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.

The end-results of extended radical radiotherapy for stage II-III Hodgkin's disease with apparent factors of risk of relapse in the lung and/or liver are presented. The procedure included prophylactic irradiation of both organs. Ten-year relapse-free survival in the lung-irradiation group was 85.9%, overall 10-year survival--94.0%; the liver-irradiation group--90.0 and 94.7%, respectively. Preventive irradiation was shown to significantly decrease the influence of such risks as extended lesions of the mediastinum and spleen. Relapse in the lung was recorded in one case (1.6%) only, with no tumor progression defected in the liver. Significant increase in 5- and 10-year relapse-free survival was established in the lung-irradiation group, as a result of a comparison of the study group and that of controls who showed characteristic signs of intrathoracic risk. Significant difference in overall survival was recorded for the first three years only. As far as the liver-irradiation factor is concerned, the rise in both categories of survival was significant for the 10 years. It is suggested that patients with stage II-III Hodgkin's disease receive prophylactic irradiation whenever they reveal significant signs of risk of relapse in the lung and/or liver.

The history of radiation application for breast cancer diagnosis in Russia is illustrated by an experience gained at the Center. It was concerned with designing specialized X-ray equipment as well as development of Standards to be used at mammographic stations. Teaching programs were devised for training X-ray diagnosis specialists with all necessary qualification to operate high-tech equipment of a mammographic station and to use a wide range of radiation and invasive procedures.

A CT-examination of 87 patients with various types of central cancer of the lung was carried out. Computed-tomography scanning is a highly-sensitive method of radiodiagnosis which detects respiratory system lesions, stage, predominant area of involvement and condition of adjacent tissues. On the basis of CT-related features of tumor, type and stage can be identified to choose optimal therapy and follow-up.

A relationship between the dynamics of growth and pathological response of tumor cells and the number of neoadjuvant chemotherapy courses was established. As a result, there was no correlation between increase in overall and disease-free survival, on the one hand, and stage, on the other. An interval between neoadjuvant chemotherapy and surgery longer than 4 weeks had a negative effect on overall tumor response and duration of disease-free period.

336 patients with locally-advanced breast cancer underwent neoadjuvant chemotherapy or chemoradiotherapy. Increase in T- and N-indices (change of stage after neoadjuvant chemotherapy) proved an important prognostic factor. Survival rates correlated with clinical effect and dropped as it diminished. This tendency was clear in both groups. There was no relationship between stage and overall and disease-free survival rates at early stages but later they declined as T- and N-indices decreased.

The report discusses the data on the complex radiation examination of 40 lung cancer patients at different stages of postoperative follow-up. Standard X-ray procedures and CT of thoracic organs were carried out. Considerable advantages offered by CT were recorded in the assessment of the pleural cavity, the remaining part of the lung and mediastinal organs. CT evidence played an important role in making differential diagnosis of relapse and other postoperative changes.