Objective: to determine the importance of a symptom of Schatzki ring.

Material and methods. The results of examining 95 patients aged 62–92 years with the symptoms of dyspepsia in the Netanya State Geriatric Center (Israel) in 1994–2004 were analyzed. Standard X-ray study of the upper digestive tract was complemented by provocation tests. The length of an X-ray-negative area (XNA) between barium in the esophagus and stomach and the width in the lower esophagus were measured.

Results. Only 2 (2%) of the 95 patients were found to have normal function of the gastroesophageal junction (GEJ). Two patients with a drastic esophageal narrowing due to reflux esophagitis were excluded. The remaining (91) atients were divided into 2 groups. The width of the esophagus was less than 2 cm and 2 cm or more in 64 (70%) and 27 (30%) patients, respectively. In weak GEJ, there was esophageal dilatation above the XNA. When in a horizontal position, this portion of the esophagus evacuates its contents into the tomach as a result of ampullary function. It is proximally closed by ontracting the functional proximal sphincter (PS). When the ampulla contracts, its pressure increases up to the threshold. This causes the XNA to be closed and the ampulla to inject its contents into the stomach. The wider was the ampulla, the shorter the XNA was. Schatzki ring was detected in 20 (22%) of the 91  patients with gastroesophageal reflux disease (GERD). It was always at the level of the PS.

Conclusion. The so-called sliding esophageal hernia is an esophageal  mpulla measuring more than 2 cm in wide. The presence of the esophageal ampulla despite its size suggests that the GEJ is incompetent and GERD is present. Schatzki ring occurs at the level of the PS due to reflux esophagitis.

 

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Objective: to investigate the diagnostic value of 18F-FDG positron  emission tomography (PET) in the diagnosis and staging of marginal zone non-Hodgkin lymphomas (NHLs).

Material and methods. Twenty-four patients with new-onset NHLs were examined. Extranodal MALT lymphoma, splenic marginal zone  lymphoma (MZL), and nodal MZL lymphoma were diagnosed in 18, 3, and 3 patients, respectively. 18F-FDG PЕT was carried out by the standard protocol via whole-body examination, by estimating the  standardized tracer uptake value (SUVmax) in the abnormal foci.

Results. Most (83.3%) of the examinees were found to have abnormal tracer hyperfixation foci. The mean SUVmax was 5.05±0.9. There was no correlation between SUVmax in the tumor foci and their metabolic sizes (r = 0.1; p = 0.7). No significant differences between the mean SUVmax were found in patients with different histological types of MZL (p > 0.05). Disease staging by PET and other diagnostic methods yielded  contradictory results in three patients. The final analysis suggested that the stage had been correctly determined in all the 3 patients from PET findings.

Conclusion. The results of 18F-FDG PET suggest that it is of high diagnostic value in imaging marginal zone NHLs. The major advantage of PET is that it can accurately stage the disease, which can provide a rationale for optimal treatment policy.

 

Objective: to calculate Z scores for different age groups of women in the Kemerovo region, by relying on the developed database for two-dimensional bone mineral densities (BMD) of the lumbar vertebra and proximal femoral bone.
Material and methods. This given investigation analyzed 1504 results of dual-energy X-ray absorptiometry of the lumbar vertebra and proximal femoral bone in healthy  women from the Kemerovo Region.
Results. The performed investigation revealed that the peak bone mass of the lumbar spine and proximal femoral bone in the Kuzbass women corresponded to that of 20–29-year olds. In the women of the Kemerovo Region, the population-based lumbar vertebral BMDs significantly differed from those available in the NHANES III database starting from 30 years of age. Thus, the developed BMD database has regional features and must be used to calculate a Z score for the female population of Kuzbass. By taking into account the fact that were no differences in the peak body mass values of the women in the two compared groups in accordance of the guidelines of the International Society for Clinical  ensitometry; the NHANES III database may be used to estimate a T score.

The authors analyze the MEDLINE publications in the past 20 years on the treatment of diffusely growing brainstem tumors in children and adolescents. Radiation and  chemoradiation are main treatments for these diseases. The use of different radiation
dose fractionation modes and different combinations of cytotoxic drugs has caused no significant changes in long-term results. Whatever the used treatment option is, most patients die within the next 1–2 years after tumor progression. Prognosis mainly depends on the biological properties of a tumor and patients with low-grade glioma generally survive longer. The late effects of radiotherapy make quality of life worse in long-term survivors
after treatment. Hopes to enhance therapeutic effectiveness are placed on the development of targeted therapy options based on molecular biological markers.

The paper gives information on current approaches to diagnosing and treating intrahepatic cholangiocarcinoma (IHC), its microscopic and macroscopic varieties. It details the specific
features of images of IHC by ultrasonography, X-ray computed tomography, magnetic resonance imaging (MRI), including those by diffusion-weighted MRI. Dynamic intravenous contrast enhancement and analysis of tumor hemodynamic features are emphasized to play a crucial role in different examination (arterial, venous, and delayed) phases. Diffuse heterogeneous enhancement of the whole volume of the tumor in the arterial phase with
pronounced peripheral and progressing centripetal enhancement in ensuing phases is considered to be the most common type of an IHC image, which can recognize with  confidence this comparatively rare neoplasm.

Acute traumatic aortic rupture is associated with extremely high mortality rates and requires emergency diagnosis and treatment. This clinical example shows the role of multislice spiral computed tomography in the emergency diagnosis of rupture of two large arterial vessels in severe concomitant injury. It presents the benefits of this rapid and noninvasive imaging technique, an algorithm of the study and the semiotics of injuries in patients
with suspected traumatic aortic rupture. The paper also shows the importance of this method in defining treatment policy and then in the assessment of the results of the performed correction.

The paper describes a patient admitted to the Emergency Cardiology Department, A.L. Myasnikov Institute of Clinical Cardiology, for diagnosed ST-segment elevation acute coronary syndrome. At the prehospital stage, the patient received ineffective thrombolytic therapy; percutaneous coronary intervention was made at the Department of X-ray  Endovascular Diagnostic and Treatment Methods of the Institute 3.5 hours after disease onset. Repeated thrombus aspirations from the infarction-related artery were carried out, which could have a good angiographic pattern. His medical record shows that the
patient has been suffering from persistent atrial fibrillation for a long time. There is also evidence for transient ischemic attacks in 2010 and 2011. The fact that there are no coronary artery stenoses after thrombus removal could suspect the thromboembolic
genesis of myocardial infarction.

The paper reports a clinical case of Jeune syndrome in a baby, in whom the diagnosis was established immediately after his birth. He was also diagnosed as having multiple  congenital malformations, such as Dandy–Walker anomaly, hexadactyly of the left hand, cleft palate, choroidal colobomas in both eyes, and atrial septal defect and he also had interstitial nephritis and hepatitis.