Portable microfocal radiographic devices for medical diagnosis

After the operation peritonitis have occurred in 19 patients, in 40--postoperative period course was without complications. The informativity of the laboratory investigations indexes for the postoperative course prognosis and early peritoneal cavity inflammation was revealed.     

Laparoscopic pelvic lymph node dissection for prostate cancer: comparison of the extended and modified techniques

PURPOSE: We compared the results of extended (obturator, hypogastric, common and external iliac nodes) to modified (obturator and hypogastric nodes only) laparoscopic pelvic lymph node dissection in patients with clinically localized prostate cancer. MATERIALS AND METHODS: A total of 189 patients with stage T1 to T3 prostate cancer underwent modified (150) or extended (39) laparoscopic pelvic lymph node dissection for pelvic nodal assessment before definitive treatment. RESULTS: Twice as many lymph nodes were removed via extended than modified laparoscopic pelvic lymph node dissection (mean 17:8 versus 9.3). The overall positivity rate was 23 of 189 lymph nodes (12.2%), including 14 of 150 (7.3%) for modified and 9 of 39 (23.1%) for extended dissection (p = 0.02). Two patients (22%) who underwent extended dissection had positive lymph nodes in the external iliac area. Patients who presented with the high risk features of prostate specific antigen (PSA) greater than 20 ng./ml., Gleason score 7 or greater, or stage T2b disease or greater had a 26.5% (p = 0.0002), 22% (p = 0.0006) or 16.4% (p = 0.003) likelihood of positive lymph nodes, respectively. For extended versus modified laparoscopic pelvic lymph node dissection node positivity in high risk patients was 27% versus 18.8% (p = 0.4), 30 versus 26.4% (p = 0.8) and 25.4 versus 14.6% (p = 0.17) for Gleason score 7 or greater, PSA greater than 20 ng./ml. and disease stage T2b to T3a, respectively. Patients who underwent the extended procedure had a higher complication rate (35.9 versus 2%, p < 0.0001). No laparotomy was required. CONCLUSIONS: Despite yielding a 2-fold higher node count and higher node positivity rate, extended laparoscopic pelvic lymph node dissection offers no advantage over modified laparoscopic pelvic lymph node dissection for diagnosing positive lymph nodes when results are analyzed by prognostic factors. The extended procedure is associated with a much higher complication rate. In patients with the high risk features of PSA greater than 20 ng./ml., Gleason score 7 or greater and stage T2b to T3a disease modified laparoscopic pelvic lymph node dissection can be performed safely and effectively to help identify those who may benefit most from curative therapy.     

The clinical significance of phasic duodenal intubation and ultrasonic monitoring of the gallbladder in healthy subjects

Hypoxic and low-temperature effects on the thermal regulation and the content of catecholamines (epinephrine--E and norepinephrine--NE) in mice have been compared. Continuous and repeated hypoxia brought about a significant drop of the rodent body temperature and heat content. Found was a significant elevation of catecholamines in the pituitary and adrenal tissues, and blood plasma with E prevalence after the continuous exposure. Repeated stimulus resulted in a more pronounced effect. Exception was the adrenal tissue where enhanced E and NE secretion into blood was noted. The uninterrupted and repeated cold conditions were also responsible for heat release. Continuous exposure to low temperature increased NE and decreased insignificantly E in blood and adrenal. Multiple stimulation increased sharply catecholamines concentration in blood plasma with the dominance of epinephrine in the pituitary gland, and norepinephrine in the adrenal.     

Physico-chemical properties of a protein-inhibitor of serine proteinases from the potato]

Serine proteases inhibitor with pl-7.3, isolated from potatoe tubers by isoelectric focusing procedure as described previously (V.V. Mosolov et al., Bioorganic Chem., 1, 1449, 1975), was homogeneous under ultracentrifugation, having sedimentation coefficient S20,w 2.8S. Its molecular weight, investigated by sedimentation equilibrium and gel filtration through Sephadex G-100, was found to be 32500 and 31500 respectively. The Stokes radius R and frictional ratio f/fo were found to be 24 A and 1.14. The molecular weight of the inhibitor as determined by sodium dodecylsulfate polyacrylamide electrophoresis was twice as low as determined in ultracentrifuge and by gel filtration procedure. It is suggested that the inhibitor is dimer and consists of two protomers of equal molecular weight.     

Stable chronic disease: a behavioral model

A three-year study was undertaken in the general medical clinic of a private community hospital, to assess the health behavior, health status, and profile of function of stable chronic disease was developed and tested. It was shown that these patients used a disproportionate amount of health care services. Half of the group was treated by a nurse practitioner/physician team and half by a house officer/preceptor team. Patients in both groups behaved similarly. These patients: 1) made frequent demands for outpatient services but did not need more than average hospital care; 2) tended to have problems of socio-economic indigency; 3) were likely to have hypertension, obesity, arthritis, and functional disease; 4) were chiefly women; 5) required special visits 9 percent of the time, usually for exacerbations of illness or intercurrent health problems; 6) made greater demands if they had functional complaints as a primary or secondary health problem; and 7) viewed their health more positively and functioned at a higher level if they were over 65 years of age. It was also found that the nurse practitioner, working in consultation with a physician, was able to provide high-quality health care.     

The mechanism of the development of the synapse as the basis for its involution

The electron microscopic investigation of human brain synaptic organization in normal aging and in ischemic heart pathology in different life periods was performed. A significant quantity of desmosome-like and mixed contacts was shown. Their ultrastructural organization was similar to that of developing synapses during prenatal ontogenesis and in newborn rats. The analysis of the experimental results suggests that an appearance of desmosome-like contacts in the human brain results from synapse involution. This is supported by the observation of formation of mixed contacts which may be a transitional stage between symmetrical or asymmetrical specialized synapse and desmosome. Thus, the mechanism of synaptic involution appears to be a mirror reflection of the mechanism of its development.