No 2 (2010)

Background. The past decades have been marked by a rise in the incidence of polyneoplasia (PNP), including that of the breast, which necessitates a more in-depth analysis of its manifestations.
Materials and methods. The study was based on the results of a complex radiological and postmortem examination in 120 women with different types of breast PNP (BPNP) and 6 with metastatic breast lesion.
Results. The procedure for radiological and postmortem studies in BPNP was improved; the optimal diagnostic complex developed; and the radiation semiotics of different types of BPNP clarified.
Conclusion. Overall, the comprehensive approach to the examination to be made by one specialist who can use a broad spectrum of vari- ous procedures and competent in allied specialties has allowed the objective criteria for BPNP to be defined.

The current surgical treatment strategy for breast cancer is to fulfill two tasks: a reliable cure for cancer and solution of esthetic problems. The former task is successfully solved by radical mastectomy whereas it is rather difficult to restore the breast because a specialist has to compensate for the whole volume of its tissue and to form a nipple-areolar complex (NAC) and a submammary fold. Subcutaneous mastectomy with and without NAC preservation optimally solves both tasks: its performance, by simultaneously maintaining the high level of radicalism, substantially makes primary breast repair easier and yields a better esthetic result.

The study was undertaken to improve breast cancer (BC) staging by the criterion N ex vivo, by applying the up-to-date ultrasound and microsurgical technologies. A LySonix 3000® with PulseSelectTM system was used to expose lymph nodes and vessels. Axillary adipose tissue classically exposed was examined in 70 patients with Stages II-III BC. Lymph vessels and nodes were separated by the sonolipodestruction technique. The findings permit sonolipodestruction to be used for ex vivo total lymph dissection for BC as a method that improves its N-staging. Sonolymphodissection opens up fresh opportunities for studying the anatomic structure of the lymphatic apparatus.

The paper analyzes and presents the clinical and laboratory data of 978 female patients, including 268 (27.4%) control women having no reproductive organ tumors, 478 (48.8%) and 232 (23.7%) patients with slowly and rapidly growing uterine myoma (UM), respec- tively. A new procedure has been developed and tested to diagnose rapidly growing UM, including the latter concurrent with endometrial hyperplastic processes, which is based on the comparison of the levels of lipid peroxidation products in the biomolecules in the study biological fluids (endometrial lavages) and on the analysis of their morphostructural features. A mathematical model to calculate uterine volume has been proposed to objectify the estimation of tumor growth rates. The proposed multimodal approach makes it possible to detect UM, to determine its growth rate and endometrial status, and to assess the likelihood of a recurrence occurring after conservative surgery.

The paper characterizes paranoic hypochondriacal development, that is comparable with expan-sive paranoia, in patients with a >5-year history of malignancies at examination. A study sample comprised 8 treated out- and inpatients (mean age 55.7±7.02 years) diagnosed as having repro-ductive organ malignancies. Their examination was made by the clinical catamnestic technique. Psychopathological disorders in the described cases of expansive paranoia are associated with the development of abnormal querulant activity that is aimed at having the medical care volume inadequate to the somatic status of patients with malignancies.
The described variant of development of paranoid disorders enables their determination within the framework of cancer-induced chang- es in personality disorders with the formation and further reinforcement of the psychopathological manifestations of mainly the hy- poparanoia type. The constitutional predictors of hypochondriacal development via expansive paranoia type, which include not only certain types of personality disorders (paranoic, 50%; schizoid–expansive pole, 12.5%; icteric, 37.5%; sensitive, 12.5%), but also ac- centuations (segmental depersonalization accentuation) against which the study reactions manifest themselves as a continuation of but ab-normally transformed constitutional properties.