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This article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. The study involved 110 patients. The study began with intravesical administration of 50 ml of 0.2% solution of 5-ALA HE, the exposure time was 1 hour, after which the drug was removed from the organ. During the next hour, the mucous membranes were examined in two cystoscopy modes, followed by a standard transurethral resection of all urothelium sites with suspicion for tumor lesion based on white light and visible red fluorescence, and a control blind biopsy from the visually unchanged and non-fluorescent mucous tissue in each patient. The results of the study indicate the high effectiveness of the developed FD methodology with 5-ALA HE in detecting non-muscularinvasive bladder cancer during intravesical administration of the drug, due to selective accumulation of hexasens-induced PPIX in the tumor tissue compared with healthy mucosa. Compared with the results of standard cystoscopy, fluorescence diagnostics significantly increased diagnostic sensitivity by 24.4% (from 75.1% to 99.5%), diagnostic accuracy – by 15.8% (from 82.4% to 98.2%) and a negative predictive value – by 33.2% (from 65.8% to 99%) (p≤0.05). Additionally, a total of 37 (33.6%) patients was found to have 63 foci of fluorescence with a diameter of 2.5 to 3.0 mm. 59 of these were morphologically confirmed to contain cancer cells.

Currently, reconstructive-plastic surgery is becoming the standard for surgical and combined treatment of breast cancer (BC) patients.With a one-stage reconstruction of the breast, the use of biological implants that can replace muscle autografts and, consequently, reduce trauma, blood loss and operation time, and also to avoid defects in the donor zones is becoming topical. From 2014 to 2017, 151 reconstructive operations on 121 patients with BC (average age 41.5 years) using synthetic and biological materials were carried out in P.Herzen Moscow Oncology Research Institute. 0 stage of BC TisN0M0 was diagnosed in 11 (9.1%) patients, I stage – in 52 (42.9%), IIA – in 41 (33.9%), IIB – in 9 (7.4%), IIIA – in 4 (3.3%), IIIB – in 2 (1.7%), IIIC – in 2 (1.7%). To strengthen the lower slope, a biological implant – Permacol acellular dermal matrix, was used in 34 cases. Cosmetic result was rated as excellent in 20 (58.9%) cases, good in 11 (32.3%), unsatisfactory in 3 (8,8%). Biological materials are an important addition to various options for breast reconstruction. The criterion for selecting the material for strengthening the lower slope of the breast with subcutaneous or cutaneous mastectomy for cancer with a one-stage reconstruction using a silicone endoprosthesis is the pinch-test value.

The article presents a clinical observation of the patient of 38 y.o. with cancer of the left breast stage IIIC урТ4bN3М0L1V1. On the 1st step of the treatment the patient had 2 courses of CAF neoadjuvant chemotherapy, on the 2nd step – extended radical mastectomy on the left with intraoperative photodynamic therapy and closure of the defect with ТRАМ-flap, on the 3rd step – continuation of the chemotherapy (8 courses), on the 4th step – radiation therapy to the chest wall on the left and zones of regional lymph drainage, targeted therapy with herceptin a (1 year). Four years later a silicone implant was inserted into the left breast. Corrective surgery (reduction mammoplasty on the right side) was performed in april, 2017. Currently, the patient has remission of the disease of the left breast, the period of remission accounts for 8 years.

Clinical observation of a patient with an orphan disease (mucinous peritoneal carcinomatosis) after 2 courses of intraoperative photodynamic therapy with photogem photosensitizer is presented. During the first course of photodynamic therapy, photogem was administered at a dose of 2.5 mg/kg, the energy density of the laser radiation was 10 J/cm2. The duration of stabilization after the first course of treatment was 2 years, after which the progression of the disease was registered. The second course of photodynamic therapy was carried out in the same way. The duration of stabilization after the first course of treatment was 2.5 years. The patient died as a result of an accident unrelated to the disease.

The investigators analyzed the world literature on and the immediate and late results of 14 total small pelvic exenterations with different urinary tract reconstruction modalities. Postoperative complications occurred in 57.1 % of patients; postoperative mortality was 7.1 %. Late results were followed up in 12 patients. Overall survival at 10 to 48 months after surgery (median 26 months) was 83.3 %; relapse-free survival was 75 %. Urine derivation was made via orthotopic bladder plasty in 5 patients, Bricker operation in 6, and bilateral ureterocutaneostomy in 3. Functional results were regarded as good in all the patients after orthotopic bladder plasty. Thus, adequate urinary tract reconstruction allows one to expect the quality of life to be better without a negative impact on oncological results.

Renal cell carcinoma (RCC) is one of the most urgent topics in modern oncourology. This is attributable to the high morbidity and mortality rates associated with this pathology. Renal dystopia is a rather rare developmental anomaly. The literature data describing cases of the diagnosis and treatment in patients with dystopic kidney malignancies are scarce. Moreover, if a tumor is present in the solitary dystopic kidney, it is often extremely difficult to perform an organ-saving operation for a number of features of the anatomic structure of the dystopic kidney and its vascular architectonics. The paper describes a clinical case of S-shaped crossed dystopic kidney resection in a patient with RCC.

Severe postoperative complications and critical conditions caused by profuse hemorrhage, pulmonary thromboembolism, anaphylactic shock in response to drugs, as well as circulatory arrest, pyoseptic processes are accompanied by significant activation of free radical lipid oxidation along with progressive depletion of the antioxidative defense system, i. e. the development of oxidative stress underlying the development of acute multiple organ dysfunctions (MOD) of posthypoxic or toxemic genesis, and they require special treatment policy. The active antioxidants Ceruloplasmin and Laprot based on natural human protein antioxidants are the drugs of choice in correcting oxidative stress. Their use as part of traditional intensive care restores imbalance of oxidative-antioxidative processes in the body and significantly enhances the efficiency of therapy for critical conditions and it should be regarded as an essential pathogenetic component of complex intensive care. The developed tactics of effective antioxidant therapy promotes optimization of the course of a rehabilitative period in patients after prior critical conditions and reduces the need for invasive hardware methods of correcting endotoxemia and MOD, which determines its economic expediency in addition to therapeutic one. Key words: critical conditions, oxidative stress, the antioxidants Ceruloplasmin and Laprot.

The calcium antagonist verapamil, a P-glycoprotein inhibitor, affects the growth of human tumor transplants under the capsule of the animal kidney with an oscillating-type dose-effect dependence. The maximal positive effect of verapamil is tumor regression and the maximal negative effect stimulation of transplant growth. In 3 out of 6 cases (gastric adenocarcinoma) verapamil at 9 mg/kg injected 0.5 h prior to vincristine inhibited tumor resistance to the latter. These data offer promise for increasing the effectiveness of chemotherapy in patients with cancer of the stomach by means of chemotherapy combined with P-glycoprotein blockers in doses determined for each individual.

Effects of γ-irradiation in a dose of 6 Gy and platidiam in a total dose of 16 mg/kg on the growth rate of transplants of 20 human pulmonary carcinomas under the renal capsules of immunodepressed mice were studied. Ten out of 11 tumors resistant to radiation were found to be resistant to platidiam as well. On the other hand, only 10 out of 15 carcinomas resistant to platidiam were resistant to radiation.