collection ipp

8/12/2019 Collection Ipp

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The collection of proceedings of Institute of Practical Psychophysics

Topical problems of NLS-diagnostic

(theoretical and clinical)

(Moscow !!")

#omputer non-linear diagnostics

$%I% Nestro&

The Non-linear 'iagnostic System (NLS)has been etensi&ely used lately and are

gaining e&er growing popularity% &en in the few cases* where the clinical symptomsloo+ &ery typical the NLS diagnostics method pro&ides etra information about the

etent of the affection and allows to consider a prognosis% In most cases it is of &ital

importance for diagnostics and ,uently for the right choice of treatment%

In !!! it was ! years since Theodore $an o&en had de&eloped the theory of

,uantum entropy logic that underlies this method% So non-linear diagnostics appears

to be most up-to-date of all methods of the hardwarebased diagnostics% .t any rate* his

disco&ery became a significant landmar+ in diagnostic medicine%

Non-linear analysis was originally employed in organic chemistry to determine thecomposition of comple compounds%

S&iatosla& Pa&lo&ich Nestero& who introduce a trigger sensor in /011 and thus

framed the concept is acceptably considered as a originator of NLS-diagnostics

de&ices (metatron) .cti&e wor+ was immediately started to de&elop and impro&e the

NLS-diagnostics systems% #linical testing of the early e,uipment too+ the period from

/00! through /002% The late 0!s saw a fast growth of commercial production of the

de&ice and a sudden surge in the ,uality of the results produced%

The non-linear diagnostics is still in its de&eloping stage% The diagnostical techni,ues

are impro&ing so fast* that the system &ersion ha&e to be updated e&ery si months%

'ue to the introduction of some of new de&ices e,uipped with digital trigger sensor*

the NLS-diagnostics has become not only far more time-efficient but also ,uiet

different in terms of ,uality% It is ob&ious that some runtime techni,ues* for instance

tree-dimensional &isuali3ation of in&estigation results will soon become a daily

practice% The &egeti&e testing is 4ust an eample of a ready implementation% The

method is employed so widely that we should rather spea+ about a definite rang of

indication for its use than 4ust about populari3ation%


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5esearch centers continue their ,uest for some new in&estigation methods based on

the non-linear analysis system% So far the result appear to be ,uiet promising%

6nli+e NM5 and computer tomography* the NLS-analysis does not need strong

fields% The method seems to ha&e good prospect for metabolism studies* particularly

on a cellular le&el%

The NLS-method ad&ances along the path not only of technical inno&ation but also of

new application% Some minor surgical operations* biopsy for one* ha&e been long

monitored using ultrasound* fluoroscopy or computer tomography% Today we ha&e

opportunity to hae biopsy monitored by NLS% 7y the way* many surgeons focus on

using this method to assist ma4or surgeries%

The cost of e,uipment for NLS-diagnostics is still &ery low as compared to some

other hardware-based methods% This is supposed to promote more etensi&e use of the

method in countries with low li&ing standards% 8f all methods of hardware-based

diagnostics the NLS pro&ides representations most proimate to the

pathologicoanatomic picture% This feature of the method along with its harmlessness*

promotes rapid de&elopment of the NLS-diagnostics%

#LINI# T# IN#% - ascending into the 99I century

'%$% :osholen+o* S%.% Letun

The de&elopment of the new generation of non-linear computer scanners (metatrons)

ma+ing use of multidimensional &irtual imaging of the body of interests* had allowed

to substantially impro&e the efficiency of the NLS-method and e&en epand its fieldsof application despite the M5T competition% The originally &olumetric pattern of

scanning is a distincti&e feature of the multidimensional NLS imaging% The data thus

ac,uired are an integral array* which facilitates reconstructing multidimensional

&irtual images of anatomical structures of the body of interest% In this connection the

&irtual NLS is widely used especially for angiographic in&estigation with the tree-

dimensional reconstruction of &ascular formations%

.nother promising field of application of the three-dimensional image reconstruction


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based on the data ac,uired by means of multidimensional NLS is the study if hollow

organs with a ;&irtual-NLS-scopy; in&ol&ed% This +ind of system was de&eloped by

Medintech #ompany for their high-rate multidimensional s latest de&elopment is a con&enient tool for planning inter&entional

procedures monitored by NLS% The Pincers comprises a controlled stereo tactic


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manipulator (;mar;)* a flat gentry-mounted monitor* a cable system and software% The

system pro&ides the physician with the means of simulating and performing

inter&entional procedures through an interacti&e lin+ between the &irtual NLS and the

real operational field%

MT8' 8 ? #8MP6T5 N8N-LIN.5

.N.L@SIS .N' ITS 58L IN 'I.AN8STI#%

$%'%.rtyu+h* 6%. Sho&+oplyas* .%. Aa&rio&

The computer-based non-linear analysis (NLS) as a dynamic non-in&asi&e informati&e

method is increasingly used to eamine the status of health affected by pathologies of

different origin% The NLS can be applied both in &i&o ( to ac,uire an NLS-spectrum of

one or another part of any organ or tissue) and in &itro ( to obtain an NLS-spectrum of

etracts from tissues* biological fluids or cells)B while* rather often both approaches

can be combined for a more accurate data interpretation% The usage of NLS at a clinic

re,uires de&ices production an at least !-"! mT eddy magnetic field% The

proceedings of the latest International #ongress of Medical 'octors (!! and !!/)*

that dealt with new methods of diagnostics gi&e e&idence of of a growing number of

NLS-in&estigations used for the diagnostics purposes - the !!! summit heard /C

presentation ion the sub4ect* while in !!/ there were twice as many%

S%'% Tutin et%al% informed of the possibility to use the NLS to diagnose abscesses in

the encephalon% It appears* that at an abscess in the encephalon in the NLS-spectrum*

during the biochemical homeostasis e&olution some signals from lactate and amino

acid are detected* which disappearing the course of treatment% The NLS data in &i&o

correlated well with the result of abscess sample tests made by means of M5# with

the high resolution in &itro%

6sing the NLS-method the dynamics of metabolic change in the encephalon when

treating epilepsy can be traced% Some data are a&ailable* that indicate a possibility to


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register a decline in oidati&e phosphorylation in the lower limbs muscles with

constriction of the &essels caused by arteriosclerosis% In the course of treatment the

muscles metabolism appears to impro&e% .nother trend in the application of the NLS

method is detection of metabolic disturbance of phosphoregic compounds at muscular

atrophy related to pathology in the musculos+eletal system% some promising prospects

for myocardial infraction diagnosis by means of the NLS method were describe by

6%.%Sho&+oplyas et% al%* who studied the .TP echange in the myocardium% .t the

myocardial infraction its le&el was pro&en to decrease%

The NLS-analysis method was employed to study the dynamics of change in the

metabolism of lipids in the li&er affected by cirrhosis% The NLS -in&estigation of the

pancreas affected by malignent degeneration allows diagnosing tumor progression*

4udge of the efficiency of radiation or chemotherapy and also ad4usting indi&idual

dosage schemes for inoperable patients%

Moreo&er* NLS is reported to be used to diagnose #NS disorder* cardio&ascular

discase* muscular system disorder* prostatic tumor* mammary gland tumors* and in

addiction to monitor radiation - and medicinal 6S therapies% The researches ha&e

demonstrated the diagnostic importance of NLS for arteriosclerosis* apopley*

encelophalomyclitis and &acuities% NLS allows estimating the phase of a pathology

and acti&ity of the nidus* determining a relationship between genetic characteristics*clinical symptoms and metabolic de&iations in the encephalon% NLS helps to

differentiate bengin and malignant tumors in the mammary gland% The studies of

abnormal changes in the prostate gland by means of the NLS showed that the method

allowed to identify an incipient change in the gland tissue and pic+ out the appropriate

therapy in good time%

:%.%:&aso& et% al* presented some data about diagnosing prostate discases (including

histologically confirmed bengin hypertrophy and .den carcinoma) by combining

NLS and dynamic M5T with artificial ;Magne&ist; contrasting% .ccording to the

deri&ed results* this +ind of combination allows to define the pattern of the prostate

pathology and substantially increase the diagnostic accuracy% In the recent years

special attention has been focused on a study of li&er metabolism by means of NLS

necessitated by a growing number of transplantation of the organs ( in urope the

annual number of li&er transplantation is around !! and in the 6S. it is /!!!) and

due to this method>s nonin&asi&e e&aluation of the li&er function in the course of

implantation% The result indicate appropriateness of using the NLS-analysis in this


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case since the .TP le&el in the li&er mirrors an integrate picture of sell homeostasis%

There is a close correlation between the disturbed metabolism of phosphorergic

compounds and etend of li&er decompensation%

.part from diagnosing li&er disorders in &i&o* the NLS allows to 4udge on the state on

the transplanted li&er in &itro by ac,uiring spectral characteristics of the organs

meta3odes% This is based on a good correlation between the pathology change in the

li&er but also monitor the biochemical responses to treatment%

Summing up the abo&e it can be concluded that the e&er growing use of NLS-analysis

in different fields of clinical medicine* including its combination with M5T with

contrast amplification in&ol&ed* increases the efficiency and diagnostic accuracy and

its indicati&e of a continuous progress in the field of internal organ &isuali3ation

techni,ues based on the NLS -analysis phenomenon

Potential of NLS method in diagnosing gastric and

calonic cancers%

P%.%S&etlo&a* N%. Soro+ina* T%A% :u3netso&a* $%I% Nestero&a* L%.%@an+ina*

N%$% Tatiso&a

The non-linear diagnostics method (NLS) use in the 8beron de&ice has been acti&ely

practiced lately as many medical institutions% The most tangible results were achie&ed

by using the NLS method as a means of dispensary obser&ation% In the course of its

de&elopment and ad&ancement the method the method has become a foremost tool of

diagnostic and obser&ation with respect of widespread digesti&e organs diseases D it

allows to promptly collect detailed information about the lesion and its pattern and

asses the treatment efficiency% That +ind disease include gastrodoudenal ulcer* chronic

gastritis* and also benign and malignant gastric and colonic tumors% The specific

character and wor+ing conditions of the therapeutic an dlEclinical institutions in

5ussia allow etensi&ely employ the NLS method not only for diagnosing disease


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with some symptoms but also for dispensary obser&ation and what is more* practically

all the patients in need of eamination can be placed under obser&ation% So physician

now can co&er patients with the changes that are latent and can only be &erified by

means of NLS% Specifically* such patients include those ha&ing precancerous disease

or mucous disturbances in the upper andFor lower sections latent in a certain phases%

.ccording to the data ac,uired by some medical specialists* using the de&ices for

NLS-diagnostics* and based on annual research in thousands of cases* the fre,uency

of detecting focal or diffuses changes* typical for chronic atrophic gastritis in patient

o&er 2! years old* is within "!-=!G%the analysis of the spectral eamination of

pattern-different section of focal changes in stomach mucosa shows that different

symptoms of diseases including intestinal metaplasia and epithelia dysplasia can be

detected in them 4ust as often% 'uring the NLS analysis symptom of gastric ulces

where recorded in about 2G of cases* polyps in stomach in HG* and polyps in colons

in =2G of cases% Thus* e&en NLS analysis result alone* without other ris+ factors

ta+en into account* include the most of the patients in the respecti&e age group appear

to be among those who need dynamic obser&ation because of potential gastric cancer

(A#) or colonic cancer (##)%

.ccording to the cancer register for /000-!!!* the &alues of gastric an colons cancer

cases were 1!%0 and 2"%/ respecti&ely per /!!!!! patients and the death according to

the mortality statistics was =H%"2 and /0%2G% .ccording to conclusion of the therapy-

diagnosis unit* with about H!G patients under acti&e dispensary obser&ation* the

pathologies of this +ind are li+ely to be detected as often as in !%=-!%1G of cases%

Therefore* the NLS screening would allow to detect A# or ## in about e&ery /2th-

!th eaminee%

#onsidering that emergence of clinical sings is one of the incenti&es for a patient to

ta+e medical ad&ices and a reason for hardware-based eamination* some clinical

implication and their pattern were e&aluated in the case of the abo&e mentioned

diseases% .s fallow in the results*H! patient affected by #A or ## the condition

appeared to be symptoms free in =G and "G of cases respecti&ely or there were

some sings characteristic of pre&ious chronic digesti&e trac+ diseases that was a case

in HHG and 0G for the / phase* 2CG and C1G for the nd phase* "G and "G for

the "rd phase* and 1G for the =th phase of this diseases% The clinical implication at a

gastric cancer were of a point-dyspepsia syndrome nature typical for the lesion in the

upper section in digesti&e trac+% .t a colonic cancer subgroups were segregated with


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dominating sings of intestinal hemorrhage* disturbed e&acuation or abdominal pain% .

certain interrelationship was pro&en between the pattern of the clinical implications

lasted less than " months in CG of patients the ## de&eloped actually within a few

days% It should be noted that so-called ;minor sing syndrome; correspond to some

later phases of the disease% The same was true fro lab eamination data where the

change became e&ident during phases III and I$ ()%

The result for NLS!daignostics for the initial phases of gastric cancer in a series of

/!= eamination showed that in H of cases the physicians on the assumption of the

spectral similarity to the reference standard* regarded the lesion as benign and

indicati&e of focal mucosa hyperplasia* polyp* and area of local information* wall

deformation or small ulcer% The probability for detection sings of malignant changes

found out in the elimination mode was under /G% 8f /"= cases of colonic cancer in

phase / malignant adenomas were detected in 21G of patients% The rest of the patients

were found to ha&e the so-called ;minor; changes of cancer* li+e polyps* atrophic

gastritis or atrophic-hyper plastic gastritis% The endoscopic &erification of A# and ##

with reference to the diacrisis of phases II*III and I$ of the discases completely

confirmed the results of the NLS-in&estigation%

/H patients were found to ha&e to ha&e A# or ## disco&ered by NLS eamination

conducted within a less than a year inter&al% among them CG of patients% .mong

CG of patients had an initial phase of gastric cancer and "1G of the patients during

pre&ious obser&ation were found to ha&e some or other sings of chronic gastritis in the

form of focal mucos hyperplasia* local inflamination or wall deformation% .ccording

to morphological in&estigation* the said sections were of a benign nature and cancer

de&elopment therein o&er the last year only% In the rest of the patients the macroscopic

changes corresponding to malignant affection (spectrial similarity to ;gastric

carcinoma; reference standard 'J!%=2) occurred in the span between the last

eamination% This preceding endoscopy detected atrophic gastritis free focal changes

in the area of the de&elopment tumor% Similar NLS data were ac,uired for "1 patients

who during a year>s obser&ation were diagnosed to ha&e de&eloped a tumor

corresponding to phases II and III%

The NLS of the colon and straight intestine was performed a year before tumors were

diagnosed in / patients affected by malignant polyps* of whom /H had been under


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acti&e obser&ation because of polyposis* while no formation of that +ind was in

e&idence during the initial eamination% In addition* within the same time span /"

patients were eamined who were diagnosed with precancerous condition (spectral

similarity to straight intestine carcinoma* reference standard 'K!%H) an minor form of

cancer% In C of the patients the tumor de&eloped in area of endoscopic polypectomy

after they had a large &illous adenoma remo&ed% Thus* in "= (HG) of // patients*

who were diagnosed to ha&e a malignant polyp conditions in phase I or a small si3e

tumor* colonic cancer de&eloped within a year%

"C patients eamined within the same time inter&al were found to ha&e the condition

in phase II and II 4ust as fre,uently% 1 of them were sub4ected to medical regular

chec+ -ups with no clinical sings of the disease of e&idence in any of them% 1 patients*

within "-H months prior to tumor diagnosis* began to shows sings of growly anemia or

progression stool retention% This dispensary obser&ation data for these patients* with

the NLS method employed a year before the cancer was de&eloped* had indicated the

tumor%

There are two indicated factors +nown to be paramount importance for malignant

disease diagnosis hey are the ,uality of clinical and diagnostic techni,ues and the

specific pattern of the disease progress which actually determine the dynamic of the

disease progression% #onsidering capabilities and wor+ing condition in the therapeuticinstitutions* the presented data on gastric and colonic diagnoses may to certain etent

be regarded as optimum% It implies* that e&en if all the patients were readily diagnose

with the disease during the dispensary obser&ation (actually it is a matter of C!G)* the

phase I condition could been detected only in =!G of them% The analysis of causes of

the late diagnosis cases suggests that such cases could pre&ented by impro&ing

organi3ational and methodical wor+%

?urthermore* the focus should be placed on the specific features of the diseases

progress which are of great* and possibly of &ital importance for tumor detection% The

analysis of the a&ailable data allows to assume that tumor may de&elop within the

short time inter&al reaching the si3e of either ;minor cancer; or etensi&e lesion% .ll

that confirms the idea that the tumor growth dynamics in different patients and in the

different phases of the diseases id li+ely to &ery and be both continuous and discrete

pattern% So a possible scenario of tumor de&elopment could be the emergence of

;early; gastric cancer against the bac+ground of precancerous gastric diseases with

the subse,uent prolonged period of eistence in the initial phase of the condition in


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ad&ance% The colonic cancer de&elopment through the benign phase and then through

a malignant adenoma is not the only possible scenery it can processed% Tumor can

de&elop de no&o and here too% a &ariant of comparati&ely slow or fast growth in

potential% This pro&ides an eplanation for an ;accidental; detection of patients with

fairly large tumors during dispensary obser&ation and a great number of patients with

short clinical anamnesis and late phases of the diseases%

Thus* NLS can be considered as an ade,uate method for diagnosis gastric and colonic

cancers% The difficulties in dealing with NLS interpretation largely concern the initial

phases were the fre,uency of diseases detection depends in the long run on any focal

changes in the mucosa in the case of chronic gastritis and on +eeping the patient under

dynamic obser&ation on the gi&en modes of elimination and NLS analysis in&ol&ed%

The submitted results allow to segregate two principal &ariants of the diseases

diagnosis% The first one suggest ;accidental; tumor detection during NLS-

in&estigationB neither clinical nor other familiar sings of disease are in e&idence or

their intensity ia an insufficient reason for the patient to see the doctor% The second

&ariant occurs the patient de&elop clinical implications which impel physician to carry

out the respecti&e in&estigation for them% The result of diacrisis of gastric or colonic

cancers indicate that for most patient the problem of early diagnosis can not be

sol&ed* not only because of certain organi3ation factors but also and primarily becauseof the specific pattern of the disease process and its manifestation% owe&er* the

actual opportunities for impro&ing the well-timed diseases diagnosis in practical

public health conditions lie* primarily* in increasing the number of patients to be

eamined by means of the NLS-method within the framewor+ of health sur&ey and

also in a timely and complete eamination of the patients who are suspected to ha&e

the disease%


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Malignant Tumor

New potentials of NLS-method in colonic neoplasm

diagnostic%

$%I%Nestero&a* T%A%:u3netso&a* $%I%Metlush+o* N%L%8glu3dina

Introduction

#olonoscopy is successfully used to diagnose colon new growths% 7ased on the

number of indications endoscopy in&estigation allows to get reliable information

about the colonic growth surface in order to correctly classify its pattern and ta+e a

sample for morphologiacal identification% @et* colonoscopy does not gi&e an idea of

the +ind of internal structure the new growth has* nor does it allow to assess the depthof the in&asion of the colon wall by a malignant tumor* determine its proliferation to

ad4acent organs or metastases to regional lymph nodes% 7eside* colonoscopy does not

pro&ide information about etra intestinal new growths unless they ha&e already

permeated the intestinal wall%

The NLS-in&estigation of the colon using =%0 A3 high fre,uency nonlinear sensor

can help clear up all of these issues%

The NLS-in&estigation allows to eamine intestinal wall layers and the adrectal


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cellular tissue%

The research aimed to define the potential of the NLS-method in a more specific

diagnostics of straight-and segmented intestine tumor%

The matter and in&estigation methods

In order to achie&e the set goal 1H patients were eamined by in whom 0/ new

growths were in&estigated by means of the NLS-method% The eaminees included =/

men and =C women age from "/ to 1" with most of them (1G)aged from 2! and

o&er% .ll the patient affected by colon new growths were gi&en one or another +ind of

surgical treatment depending on the pattern* si3e and locali3ation of the growth%

.mong them in " cases endoscopic polypectomy was performed* in C/ cases a

resection was done on different parts of the colon and in " patients transanal

endomicrosurgery was performed% .ll of the NLS-in&estigation results were &erified

by a pathomorphological eamination of macro preparation according to which the

colonic ne growths were represented by simple tumors in "! cases and by glandular

cancers with different degrees of differentiation in C/ cases%

The stage of the malignant process were defined according to TNM classification

adapted by International .nticancer .ssociation in /00H (the 2th re&ision) Phase T/was diagnosed in /" patients (/G)* phase T -in C patients (="G)* phase T" in /H

patients (1G) and phase T= in2 patients (1G)%

.ccording to a pathomorphological eamination* metastases into regional lymph

nodes were detected in // of C/ cases%

.ll the patient underwent NLS-in&estigation and ultrasound colonoscopy to diagnose

and locali3e new growths* define their si3e* growth patterns and approimate

morphological characteristics* and also ultrasound scanning of the abdominal ca&ity

and small pel&is organs to assess the condition of the organs ad4acent to the colon and

diagnose distant metastases%

The NLS-in&estigation used the 8beron-=!// de&ice e,uipped with a =%0 A3

nonlinear sensor manufactured by the Institute of Practical Psychophysics (5ussia)

and #linic Tech Inc% (6S.)% The endoscopic ultrasonography made use of the

endoscopic ultrasonographic system 6M-! complete with the ultrasonie colonoscope

#?-6M! (8lympus* apan)% The echographia of the abdominal ca&ity made use of

the diagnostic unit SS'-C"! (.lo+a* apan) and Logi,-H!! (Aeneral lectric* 6S.)


13/33

'iscussion of results

e +now from eperience that e&ery NLS-in&estigation should be preceded by

diagnostic colonoscopy* which e&aluates anatomic characteristic of the colon and

defines the number* locali3ation and macroscople characteristic of the new growths*

and by ultrasound scanning of the abdominal ca&ity aw well% . through

transabdominal ultrasound scanning is re,uired to assess the condition of the organs

ad4acent to the colon and diagnose remote metastasi3es%

. comparison of the NLS results with those of pathomorphological in&estigation was

made in order to define the potentials of the NLS-method in differential diagnostics of

benign and malignant colonic new growths%

The result of the NLS-in&estigation coincided with the apthomorphological

in&estigation in 1H of 0/ cases% Most of the errors occurred in diagnosing colon

adenomas% In C of "/ cases the patient was suspected of ha&ing cancer% The analysis of

the obser&ation noted that the difficulties in diagnostics were related to the

deformation of intestinal wall layers due to the pressure of a nodal &illous tumor

rather than to a genuine in&asion% To false-negati&e results were obtained in the case

of malignant adenoma and cancer decreases*

Thus the accuracy of the NLS method in differential diagnostics of malignant and

benign colon tumors amounted to 1/%""G and sensiti&ity to H0%1G* while thespecificity made HC%=G%

The method of treatment to be chosen for patients affected by colon cncer depends on

the tumor process phase% . comparison was made to he pathomorphological

in&estigation data in C/ cases in order to assess the diagnostic efficiency of the NLS-

method in classifying the colonic cancer phase%

The correct definition of the phase of tumor process was possible in C1%=G of the

obser&ations% The best results were obtained in defining phases T" and T=* where the

diagnostic accuracy was H1%G and 1/%G respecti&ely% It should be noted that most

of the errors occurred in determining phases T/ and T* were the data of NLS and

pathomorphological in&estigations coincided only in 2=%G and =H%=G of the

obser&ations respecti&ely%


14/33

In diagnosing phase T/ mista+es were made in = cases with " of the errors toward

o&erstating the phaseB in once case sings of intestinal wall in&asion were not found

and the tumor was ta+en for adenoma% In the analysis of phase T diagnostic errors in

o&erstated phases were noted in H of 0 casesB an understatement of phase of the tumor

process occurred in one case and yet in one case no e&idence of in&asion pro&ed to be

fond% The analysis of the post surgical morphological conclusions made it clear that in

C of H false positi&e result pathomorphological in&estigation of macro preparation

detected a deeper infiltration into the intestinal wall% owe&er according to

microscopy eamination* the filtration was on inflammatory rather than of a tumorous

+ind% It should also be noted that in all of the cases it had to do with an infiltrati&e

tumorous process in the inferior ampullar section of the straight intestine free of

serous membrane while the inflammatory infiltration area was located in adrectal

cellular tissue%

To find out the causes the present difficulties for diagnosis the efficiency of the NLS

method was analy3ed in function of the si3e* locali3ation and form of germination of

neoplasms% The best results were obtained in diagnosing new growths si3e under cm

and o&er 2 cm%

The epithelia tumor o&er 2 cm in si3es is represented by phases T" and T= in / of /H

cases% It has to be noted* that the large neoplasms the data of NLS essay did notcoincide with pathomorphological data only in phase T where the process phase was

o&erestimate because of the presence of the inflammatory infiltration in deeper layers*

than the layers where the tumoral in&asion occurred% Thus* at neoplasms larger than 2

cm in si3e the diagnostic of the in&asion degree of the intestinal wall is feasible in

H1*G of obser&ation% igh result was also obtained at the estimation of depth of

tumoral in&asion by neoplasms si3ed up to cm% most of them are represented by a

tumor in phases T/ and T% The results of ultrasonic colonoscopy ha&e coincided with

those pathomorphologic conclusions in HC%HG of the obser&ation% It should also benoted* the tumours up to cm are most con&enient for eamination since they ha&e

the least number of artefacts%

.t this essay the greatest groups were the tumours si3ed from to 2 cm* where the

result pro&ed to be lower* than in two first groups% The NLS data and those of the

pathomorphological essays coincided in CC%HG of cases% .n appreciable share of

mista+e (C!G) occurred in phase T* where the intestinal wall in&asion depth was

o&erestimated in all obser&ation%


15/33

The great &alue has the fact* according to the pathomorphologic essay* in 2 of C cases

of hyperdiagnostics apart fro the tumoral infiltration an epressed inflammation was

detected in deeper layers of the intestinal wall% The relati&ely low accuracy of

diagnosed depth of the intestinal wall in&asion by tumor si3ed from to 2 cm is due

to the fact that = of "! obser&ations of this group corresponded to phases T and T"%

The differential diagnostics of the tumoral infiltration depth in this phases is comple%

.t the net research stage we made comparati&e analysis of the effect of the form of

growth of the neoplasm for accuracy of defining the phase of the tunoral in&asion in

the intestinal wall% .ll neoplasms were classified into three groups* in function of the

shape otf the tumor growthD polipiform* saucer shaped and infiltrati&e%

The highest results were obtained when diagnostic the phases of the caucer-shaped

growth cancer process where the accuracy of the defining the tumoral in&asion in the

intestinal wall was H1%"G%

It seems howe&er impossible to fully estimate the accuracy ot the NLS method in

defining the depth of a tumoral in&asion at neoplasms with saucershaped growth

because of its dismall occurrence among other forms n patients sur&eyed by us%

The polipiform of the growth was noted in "! neoplasms% The growths had a distinct

interface with unaltered sections of the intestinal wall and did not bloc+ the intestinelumen by more than half* which created fa&orable condition conditions for the sur&ey%

The accuracy of NLS method in defining the depth of tumoral in&asion in the intestine

wall was as high as C2G% It has to be noted* that half if all cases di&ergent with the

pathomorphologic conclusions is due to the o&erestimate depth of tumoral infiltration

at defining the phase T* which is connected with the presence of perifocal

inflammation%

This fact suggest difficulties in defining the phase of cancer process in cases where

the tumoral in&asion is compounded by the inflammatory component penetrating

deeper layers of the intestinal wall and beyond its limits%

The neoplasms with in infiltrati&e growth shape ha&e pro&ed to be most difficulty in

defining the degree of the tumoral in&asion in to the intestinal wall% tn this group the

result of NLS-method and those of the pathomorphologic essays coincided only in

=0%1G of obser&ations% It was due to the fact that these neoplasms* as a rule* had a

large si3e and occupied more than a half of the intestine wall circle%


16/33

In the net in&estigation phase was estimated the accuracy of the NLS method in

defining the degree of the intestinal wall in&asion depending on the tumor location in

the colon%

In =! cases the tumor was locali3ed in the rectum and in / cases in the segmented

intestine% The accuracy of diagnosing the phase of the tumoral process in the colonic

intestine is significantly height that at finding the tumoral in&asion depth with the

neoplasms located in the rectum and amounts to H/ and C%2G respecti&ely% This high

result can be most li+ely eplained by the fact* that this department of colon contains

a serious membrane* which distinctly separates the muscular layer from the abenteric

organs and tissues% .lso is noted that the serous membrane of the intestine is less

sub4ected to penetration of the inflammatory infiltration* than the pararectal cellular

tissue% The ma4ority of mista+e falls on the cases o&erestimated depth of the in&asion

at defining Phase T%

These researches ha&e noted that accuracy of diagnosing the phase of a tumoral

process was higher in colonic intestine than in rectum% The greatest number of

abscesses* inflammatory infiltration or radial therapy in the neoplasm area%

'amage regional lymph glands are an important prognostic factors in diagnosing

rectum cancer% To define the capabilities of the method in diagnosing metastases inregional lymph glands* the results of the NLS method were damage with those of the

pathomorphologic essay% In the letter the malignant damage to the regional lymph

glands was detected in// obser&ation from cases%

The analysis of the deri&ed data pro&ed that the NLS essay had correctly defined the

pattern of damage to the lymph glands in C"%CG of cases%

The metastatic pattern of damage to the lymph nodes was defined in H=%1G of cases*

and an inflammatory changes the results of ultrasonic colonoscopy and those of the

pathomorphologic essay coincided only in =2*2G of obser&ation% In C from // of

cases the presence of metastasi3es in lymph nodes was assumed (false-positi&e result)%

Such mista+e s can be attributed to oncologic &igilance of the researcher and

compleity of differential diagnostic of inflammatory and metastatically -altered

lymph glands

#onclusion


17/33

/ NLS diagnostics is a highly efficient method of diagnosing the neoplasm of the

colon* allowing to diagnose neoplasms and regional lymph glands%

The NLS method allows to detect the colon adenoma and cancer by presence or

absence of the tumoral in&asion in the intestinal wall%

" The diagnostic efficiency of NLS method in defining the phase of tumoral process

in the rectum is lower then in segmented intestine%

= The diagnostical accuracy of the cancer phase in colon depends as much on the si3e

as on the anatomic shape of the tumor growth% The best results were obtained at

defining depth of in&asion of the intestinal walls be a tumor si3ed under cm and

co&er 2 cm%

NLS-method in &ascular pathology diagnosis

S%M% Patrushe&

.%'% Slu3+y* $%M% $agulin

Today the world faces a constant trend of a growing rate of morality caused by

occlusi&e &ascular diseases* especially by cerebro&ascular disorders which are in the

third place among death causes% 8n the one hand the trend is caused by a growing

number of elderly and aged patients% 8n the other many men e&en already at =2 ha&eatherosclerotic damage of main head arteries E* causing the need for a dispensary

obser&ation%

The most simple and at the same time informati&e method of nonin&asi&e diagnosis of

occlusi&e damage of peripheral &essels appeared to be the NLS-method with has been

used in clinical practice not long since% The first NLS de&ices e,uipped with analog

trigger sensors* operating in /%= A3 fre,uency mode and used in clinical practice

since the late 0!-s ha&e not their importance yet% They can determine the condition of


18/33

certain sections of the main &essels in the lower limbs and that of the brachiocephalic

&essels%

Not only can the condition of the &essels but also of the &al&ular system of deep &enis

can be studied% /! patients were eamined in /000H-/001 to detect &al&ular

insufficiency of deep &enis affected by &aricosis% The patients were from / to CH

years old% The eamined patients included 2 men (=%2G) and HH women (H=%2G)%

The study was carried out by means of the 8beron de&ices using a /%=A3 analog

trigger sensor% In " patients a &al&ular insufficiency of the femoral &ein was detected*

in == patients failure of both femoral and popliteal &enis% NLS allows s to asses the

condition of the &al&ular system of deep &enis in low limbs on a nonin&asi&e and

ob4ecti&e basis which is &ery important point for the surgery tactic to be selected* and

can be used an alternati&e to phlebography analysis%

The NLS-signal spectral analysis method has no counterindications and in terms of

informational content is comparable angiography% It cn be used to perform screening

in the course of polyclinical eamination with the &iew to detect early or latent forms

of &ascular pathology and also as a preliminary method of selecting patient for

angiosurgical treatment* since according to some angiologists* angiography should

only be performed on candidates for surgery pic+ up after a preliminary NLS

in&estigation% owe&er the method does not allow to asses bul+ inde of thebloodstream* because NLS does not allow to pro&ide &essel>s image and hence to

measure the &essels diameter% This +ind of information can be ac,uired with the help

of 'oppler system with '-imaging* that offer duple and triple scanning (the so-

called 'oppler chromatic charting)%

The NLS-method was de&eloped in the mid 0!-s played an essential role in in

&ascular pathology diagnosis% The main ad&antage of the NLS-method was that

differentiate &essels from non&ascular structures* arteries from &enis and &ery

accurately detect sings of disturbed &ascular permeability caused by stenosis or

occlusion of the &essel lumen by an atheroscierotic patch or thrombus which are

generally not &isible on screening in 7-mode alone%

In addition the NLS-method allows to diagnose portal hypertension* the etant of its

intensity* and permeability of Porto systemic bypasses% NLS is &ery sensiti&e in

defining the etend of peripancreatic &essel in&ol&ement with pancreas cancer which


19/33

is essentially important for choosing the approach for surgical treatment% NLS allows

to detected the damage renal &essels (both &eins and arteries)* which is &ery important

for the correct choice of a hypotensi&e drug at arterial hypertension%

Some efficient hypertensi&e drugs* i%e% inhibitors of angoitensin-con&ering en3yme

(.#) such as capoten* enalapril* berliptil* cet%* became &ery popular lately* but they

ha&e counter-indications at renal artery stenision% So physicians should bear in mind

that chec+ing for stension is a must before prescribing this +ind of medicine% NLS-

method is li+ely to be the choice method in such cases%

The NLS-method is indispensable fro differential diagnostics of benign and

malignant hepatic diseases% Its sensiti&ity is comparable with the potential of

con&entional or digital angiography and computer assisted amplified

tomography% In addition* the NLS-method is much cheaper* simpler and

more intelligible% In can be employed directly at the patient>s bedside if

re,uired% The NLS-method can be used in ophthalmology to chec+ ocular

hemodynamics before or after surgical inter&ention* in obstetrics to detect

the disturbed blood current in umbilical cord arteries with a &iew to

diagnose a retarded fetus de&elopment and predict a negati&e perinatal

produce%

@et another potential of NLS method lies in cranial scanning which allows

to detect intracranial hematomas* ancurisms* cysts and tumors in the

encephalon%

These are far from potential of the NLS method%

Summing up, the NLS-method is one of the most dynamic techniques

and within the next few years it is bound to bring some new discoveries%

NLS-diagnostic of lung abscess

S%N% Ma+aro&a


20/33

. screening NLS-in&estigation detected two cases of lung abscess in fe&erish patients

who were complaining of pain in the right hypochondriac region% The patient were

sub4ected in order to preclude an abdominal ca&ity pathology%

The NLS eamination was conducted by means of ;8beron-=!!0; de&ice e,uipped

with digital trigger sensor% (/*=A3)%

Patient N%* age 2H* was admitted to therapeutic department% e was complaining of a

wee+-long fe&er with the temperature of up to =!#* a moderate non-producti&e

cough and pain in the right hypochondriac region as a result of catching a cold% e

came to see the doctor tan days after falling ill% The anamnesis read a bilateral

pneumonia /= days before% The clinical blood analysis indicated an increased

leu+ocyte content- up to /1%H /!0 with a flush left leucogram% The common

urinalysis showed no de&iation% Physical eamination &esicular pulmonary

respiration* wea+ened in lower section on the right with no rhonchi%

Tong drt* with furred% 7elly soft* with fran+ painfulness in the right hypochondriac

region% No symptoms of peritoneum irritation in e&idence% Pasternats+i symptom

negati&e on the right and left%

The NLs-in&estigation on the abdominal ca&ity did not detect any sings of pathology

in the li&er* gallbladder or pancreas% 8n the right there are &isuali3ed blac+ening inthe diaphragramatic pleura (=-2 points according to ?landler>s scale) and an image of

&oluminous formation in the right lung was ac,uired (2-C points)% 8n the dorsal

thoracic wall there was an image of a enhanced chromogenic formation (C points) of a

heterogeneous internal structure* si3ed 1!C22= cm% the lung tissue around the nidus

had a higher chromogenic density (=-2 points) on account of infiltration% . spectral

simillirality to the ;lung abscess; reference standard ('E!%"/) was detected% The

in&estigation of the left lung and pleural ca&ities did not detect any structural changes%

NLS conclusionD certain sings of de&eloping abscess in the right lung%The chec+ radiological in&estigation arri&ed at the conclusionD abscess in the lower

lobe of the right lung in progress%

. repeated NLS eamination was conducted /! days later% It &isuali3ed a rounded

hyporchromogenic formation with une&en outlines with some hyporchromogenic

3ones inside* si3ed 1/C!2/ mm%

The chromogenic density of the lung tissue around the nidus was somewhat higher

( due to infiltration)* and the folia of the &isceral and parictal pleuras were blac+ened


21/33

in the lower section of the right lung%

The patient was offered the further therapy in the speciali3ed surgical department*

which he turned down% " wee+s later* after some anti -inflammatory therapy a chec+

NLS eamination was performed% 'uring the eamination the patient complained of

coughing with a profuse sputrum discharge% is temperature was normal* the clinical

blood analysis indicated a leucocytecount of 1%C/!0* and the differential blood count

was within the standard and S5 grew up to "H mmrFh% the NLS-in&estigation

&isuali3ed rounded formation with e&en outlines* increased chomogenic density and

heterogenous internal structure si3ed =H="% The chromogenic density of the lung

tissue around the perimeter decreased (because of reduced infiltration)%

.t the patient>s urgent appeal he was discharged from hospital from further outpatient

treatments% Later he underwent two chec+ eaminations conducted%

Patient M% age C"* was eliminated by means of the NLS method in order to preclude a

li&er or gall bladder pathology%

.n LNS-i&estigation of the lung and pleural ca&ities was carried out% In the left lung

and pleural ca&ites it found no sings of pathology in e&idence% In the right lung in the

I9* 9 .N' 9I hypochondria (from the para&ertebral line to the scapular one) it

parietally &isuali3ed a formation ha&ing an increased chromogenic density and si3ed

12C! mm une&en outlines and heterogenous structures (due to inclusions of adecreased chromogenic density! si3ed "-= mm% the chromogenic density of the lung

tissue was not increased% NLS conclusionD sing o abscess in the right lung

#linical conclusionD abscess in the lower lobe of the right lung%

The patient had chec+ NLS-in&estigation conducted against bac+ground of anti-

inflammatory therapy%

ith the NLS-in&estigation performed /! day later the formation loo+ed rounded* had

e&en outlines* and increased chromogenic density ("-= points) because of infiltration%

The formation measured H"2!C! mm%

The NLS-in&estigation wee+s later did not detected any positi&e dynamies from the

administered anti-inflammatory therapy%

The submitted the clinical obser&ations once again confirmed the NLS-in&estigation

with lung diseases is not used in clinical practice as often as it deser&es%

7eside* the dynamic NLS-obser&ation of the patient affected by lung diseases allow to

assess the efficiency of the employed therapy and reduce the radiation load both on

patient and the medical personnel


22/33

NLS-diagnostics of the degenerati&e changes in the

spine%

.%A% 7ruso&a* P%.% Mano+hin* T%:% Pu3no&s+aya* T%.%

Shysh+o&etes%

#omputer Nonlinear 'iagnnostics (NLS) is a new highly informati&e method

pro&ided to eamine the spine and the spinal morrow% The NLS ad&antages are

nonin&asi&eness* scalability of the image field* a capability to obtain section of any

orientation and &irtual imagining of reticular canals and para&ertebral 3one%

6ndoubtedly the use of NLS in diagnostic of degenerati&e spine diseases has apparent

prospects%

Sub4ect and methods

The in&estigation was conducted by means of ;8beron =!!0; metatron e,uipped with

a /%2 A3 digital trigger sensor% //H patient affected by degenerati&e changes in the

lumbar region of the spine was in&estigated% The NLS of the spine and spinal marrow

was performed for all patients* // patient had NLS and #T and myleography was

performed for /! patients%

.nalysis of result

In 1HG of cases in the eaminee group we found dis+s affectes by degenerati&echanges% The elierst degenerati&e change in inter&ertebral dis+s (I') was a

hyoerchromous lesion (Cp point on ?landler>s scale) in 3one between the pulpous

nucleus and the fibrous annulus% .longe with the degenerati&e changes NLS has

detected an increased chromogenic density of the spinal from the bone marrow in the

ad4acent regions of the &ertebral bodies (=-2 points according to ?loander>s scale)% "

degrees of the degenerati&e changes could be distinguished depending on the process

intensity%


23/33

'egree/* a hyperchromous 3one apprised at =-2 on ?landler>s scale* was detected in

0! patients% #on&entional radiograph did not display any changes% ?ormation of

fibro&ascular tissue followed by its penetration into the bone marrow is belie&ed to

underline the changes% Some author relate these changes ro the lac+ of stability in the

segment%

The histogram displayed a spectral similarity to the reference standard ;inter&ertebral

osteochondrosis; (' !%"0C to !%=2)

'egree * a hyperchromous response in the affected 3one at 2-C points in ?landler>s

scale was detected in /2 patients% #on&entional radiograph did no showed any

changes% .ccording to some literary e&idence* in this phase the histology detects a

substitution of the fat bone marrow for the red bone marrow often accompanied by

enlarged trabeculae% This phase generally precedes an osteochondrosis de&elopment

which can be diagnosed a little while later by con&entional radiographs%

The spectral similarity to the references standard ;inter&ertebral osteochondrosis; was

fran+ ('!%=C to !%"C!)

'egree"* a fran+ hyperchromous response (C points)* which corresponds to a far

ad&ance &ertebral body sclerosis* was detected in "/ patients% Some secondarysymptoms* li+e local bulging and &ertebral asteophytes* were detected with a far

ad&ance degenerati&e lesion of the dis+ and substantial similarity to the references

standard ;osteochondrosis; (' from !%/2 to !%/1)% NLS allowed to differentiate

between a protrusion and prolpse of the dis+ and eistence of rupture of the fibrotic

ring and condition of longitudinal and other ligaments%

. protrusion is defined as a bulging of dis+ tissue beyond the posterior out line of the

&ertebral body into the spinal canal% The fibrotic ring tissue endures through becomes

&ery thin and NLS only re&els 3one of slight destructi&e changes in the structure ("-=

points!% ith compression it gi&es an actually fran+ hyperchromous response(C

points)%

Protrusion may be accompanied by slight caudal shift which is ,uiet often defined by

means of the NLS-method at L2-S/ inter&ertebral dis+ le&el% NLS detected protrusion

in H0 patients%


24/33

The rupture of the fibrotic ring fibers result in the prolapsed of the pulpous nucleus on

a subligamentary le&el and the ligaments rupture results in the prolapsed inside the

cerebrospinal canal% .s can be seen from NLS* the longitudninal ligaments loo+ well

delimited and are represented as hyperchromous band-li+e structures (2-C points)

which ad4oin the bones and fibrotic ring% The etraligamentary prolapsed can shift

either in a caudal or cranial direction% The etraligamentary prolapses of the dis+ that

lost contact with the host dis+ become se,uesters% 8ccasionally* we obser&e some

&ery small etraligamentary se,uesters which shifted far into the cerebrospinal canal*

which made it hard to detect them%

The NLS in&estigation detected prolapsed in ==2 patients% In C12 of cases the hernias

of inter&ertebral dis+ was combined with other degenerati&e dystrophic spinal

changes on this le&el% The hernia of the inter&ertebral dis+ was detected at /%= -2 le&el

in 1"G and /%"-= le&el in G of cases% . lesion of se&eral dis+ was found in 2!

patients% /0C underwent surgery* among the //= had lateral hernias* HC patients had

median lateral hernia and C had median hernia% 2 patient had surgery for hernia

recurrence% The NLS diagnosed etraligamentary se,uestrated hernia in "1 patients

and intradural hernia was diagnosed in " patients% Multiple se,uesters were detected

in 2 patients%

The clinical symptomatology for the prolapsed of inter&ertebral dis+ was &ariable anddid not always depend on their si3e% In some case we obser&ed median protrusions

which did not result in any clinical implication% The clinical symptomatology for

small se,uestrated hernia was no less then for large se,uesters%

In e&aluating the NLS data not only the si3e of hernia but also the reser&e area of the

cerebrospinal canal and their preposition should be ta+en in to account%

ith a suspected hernia the NLS-in&estigation should be performed at least in two

planes* sagittal and paraial* i%e%* parallel to the dis+ plane* and the sagittal

in&estigation in T/w-S can be combined with others se,uences%

The median prolapses of inter&ertebral dis+s in sagittal shots could be seen ,uiet

clearly% The signal content of the hernia predominantly corresponded to the NLS

signal content of the pulpous nucleus% The eternal part of the fibrotic ring* posterior

longitudinal ligament and the dura matter gi&e a fran+ hyperchromous response and

did not differentiate from one another% Thus** the NLS method sometimes fails to

present a direct proof of a rupture in the eternal and aial pro4ections%


25/33

Sagittal shots ha&e an ad&antage in deciding on the dis+ prolapsed* the si3e of

inter&ebral foramina and the condition of the cerebrospinal canal and bones% These

shots are not significant for detecting an intradural process with the cone especially

poorly in&isible in them% ?rontal shots ha&e drawbac+s in determining the condition

of the pulpous nucleus and fibrotic ring% To that and paraial &irtual models are used*

for they allow to differentiate the process between the fibrotic ring rupture and

protrusion free of the rupture% Than+s to &irtual dimensional scaling sagittal shots

allow to delimit the subarachnoid space%

NLS-diagnostics of diffuse infiltrati&e lung diseases

$%I%Nestero&a* T%A%:u3netso&a* N%L%8glu3dina

.mong different +inds of lungs disorders special attention has been paid o&er the last

years to diffuse infiltrati&e lung diseases ('IL')* which is largely accounted or by

some problems in their timely diagnostics and treatments%

Most diffuse lung diseases in&ol&ed in the pathological process both the interstitial

tissue and the respiratory tract and al&eola% In this connection this type of pathological

processes should be defined rather diffuse infiltrati&e than as interstitial diseases%

'espite of the polymorphism of clinicomorphological manifestation of 'IL'* most of

them star off with producti&e al&eolitis (in contrast to the eudati&e al&eolitis in thecase of pneumonia) with fairly stereotyped changes in the lung interstice in the form

of inflammatory infiltration with different degrees of intensity% Subse,uently fibrosis

de&elops that can ha&e differen rates of progression% . ;cellular lung; pattern is the

final phase of de&elopment% It should be noted* that some infection diseases of certain

etiology (li+e tuberculosis* histoplasmosia* etc%) and particular malignant tumors

(lymphogenous* carcinomatosis* brioncholoal&eolar cancer) do not directly belong to

interstitial lund diseases but are similar to them in terms of manifestation%


26/33

The clinical e&aluation of patients which are suspected 'IL' is a comple problem%

Nonspecific symptoms and in some cases sing detected during chest eamination may

be characteristic of a multitude acute or chronic diseases that in&ol&e interstitial

tissue* respiratory tract or al&eola% 'IL' are represented by etremely heterogeneous

group of diseases% The 'LI's ha&e been describe in o&er than a hundred possible

&ersions * howe&er in clinical practice only about /! or /2 condition are the most

common and it should be noted that sarcoidosis and &arious cases of lung fibrosis

occur in clinical practice in "2-2!G of all 'IL's% 7esides* acute diffuse lung

processes in patients with reduced immunity (also in combination with I$-infection)

are li+ely to ha&e a great number of infectious and non-infectious &arieties* which 9-

ray e&aluation is forum to be difficult%

6nfortunately* the capabilities of con&entional peonthenography for patient with a

suspected 'IL' appear to be limited for the sensiti&ity and specificity of the method

pro&e to be insufficient% The data on =21 patients with a histological confirmed 'IL'

were studied% The chest radiographs for /!G of the cases turned out to be normal%

.mong 1C patients affected by 'IL' no pathological change was detected in 2!G of

the patients with histologically pro&en bronchiectasia and o&er !G of the patients

with emphysema shown on 9-ray shot% 5adiography may e,ually show false positi&e

results of the in&estigation% e ha&e disco&ered that /!-!G of the patients with the-ray-confirmed sings of 'IL' no changes were detected during the lung biopsy%

The computer nonlinear diagnostics (NLS) is one of the promising methods of

diagnosing lung disease of today% NLS appreciably impro&es the communication of

the fine morphological elements in the lungs tissue and opens up new opportunity for

recogni3ing interstitial discases of the bronchol&eolar system% NLS has a high

sensiti&ity in detecting fine interstinal lesions of the parenchyma and small nodules%

The result of in&estigations pro&e that NLS has a better sensiti&ity in detecting both

acute and chronic diffuse lung diseases% The sensiti&ity of NLS diagnosis in detecting

lung disease ma+e 12G as compared to H0G in chest radiography%

The accumulated eperience too* gi&e additional grounds to assert that NLS is a

highly efficient method for diagnosing a wide range of &arious diffuse lung diseases*

'IL' included* and ecels the classicD chest radiography by sensiti&ity%

It should be noted that the high sensiti&ity of the NLS-method is achie&ed without


27/33

sacrificing the specific and diagnostic accuracy of the method% In patients affected by

'IL' the NLS specificity amounted to 1CG as opposed to HCG in radiography% In

particular* the high sensiti&ity (1H!11G) and specificity (1"-10G) of NLS were

demonstrated in bronchiectasia diagnostic%

.lthough* NLS is a more sensiti&e method as compared to the chest radiography* its

sensiti&ity in lung diseases diagnostic is not absolute and the fact that no radiological

changes were detected by NLS may lead to precluding lung disease in patients who

actually suffer from 'IL'% /!! patients were eamined by means of the NLS with 1C

of them affected by 'IL' and /= ha&ing no pathological changes in the lungs%

'espite the high &alue of NLS sensiti&ity and specificity* for =G of the patients with

biopsy-detected lung disease the result were interpreted as being normal% 8n other

hand* the NLS was pro&en to high-accuracy techni,ue for precluding acute lung

disease in patients with immunodeficiency% Some eamination data were studied for

patients with a bone marrow transplant and clinical symptoms of fe&er of obscure

genesis% The authors demonstrated high reliability of the NLS in determining fungal

infection in ! of = cases% 7eside* the fact that no changes were detected during NLS

lung eamination allows to assume that the fe&er was caused by bacterial or fungal

infection of etra pulmonary genesis%

It is also a pro&en fact that the sensiti&ity with NLS is higher than with standardcomputer tomography% e eamined /2! patients% 6sing con&entional #T (/! mm

collimation) and NLS we found that NLS had higher sensiti&ity in recogni3ing

pathology changes in the lung tissue%

'ue to its high sensiti&ity* NLS should be used to define lung diseases in patients with

a normal or obscure aspect of disease who ha&e a pulmonary disturbance or

symptoms that suggest acute or chronic diffuse lung disease%

&en with certain clinical sings in e&idence the diagnostic accuracy of classic

radiography in patients affected by 'IL' apperes to be limited% The reason is both

superposition of the image in the radiograph and low contrast of minute lung

structure% NLS is fee of these aspects* which is why it is reputed to be a more

efficiency method for recogni3ing lesions of lung tissue as compared to both

radiographic sur&ey and con&entional computer tomography%

7eside ha&ing a higher sensiti&ity* specificity and diagnostic accuracy* the NLS


28/33

method can become a determining factor in e&aluating the acti&ity of a pathological

process in patient affected by 'IL'% In certain cases NLS can be used not only to

define the presence of a pathological process or the etent to which it has spread* but

also to collect information about the re&ersibility of changes (in acute or acti&e phase)

as compered to irre&ersible (fibriotic) changes in the lung tissue% Moreo&er* since

NLS can accurately identify the imponderable acti&ity of a pathological process in the

lungs* it can be employed to e&aluate the efficiency of the treatment gi&en to the

patients%

The con&entional methods for e&aluating disease acti&ity* such as transbronchial lung

biopsy (T7L7)* bronchoal&eolar la&age (7.L)* chest radiography* galliumlung

scanning and functional lung tests are insufficient reliable I e&aluating the acti&ity and

in terms of prognostication% So the open lung biopsy (8L7) is still the choice method

for both diagnosing and e&aluating the process acti&ity% e were able to pro&e* that

sings detected in patients by means of NLS can pro&ide some &aluable information

and be significantly important in defining the acti&ity of a pathological process%

In terms of this prognostic &alue NLS is ad&ancing to the foreground lea&ing behind

functional lung tests* 7.L and e&en 8L7* because it allows to assess a lesion of

actually the whole lung paranchymes as compared to a separate biopsy sample%

Moreo&er* NLS can become an accurate nonin&asi&e method for e&aluating theefficiency of the administered treatment%

Sarcoidosis is one of the most common interstitial lung disease of un+nown etiology%

In typical cases granulomas are formed in fine lymph &essels or beside them*

afterwards the granulomas self organi3e which causes lung tissue fibrosis%

. number of researches considered the NLS potential in defining the procsess acti&ity

in patients affected by sarciodosis% The main acti&ity indicator is the presence of small

nodules and to lesser degree their distribution and occurrence in the lung tissue%

6nfortunately* despite the difference between re&ersible and irre&ersible changesdetected by NLS for patients ha&ing sarcoidosis* the potential of NLS is assessing the

process acti&ity ha&e not been studied well enough%

.mong differential indications in fa&or of NLS application* the use of this method in

lung biopsy is porbable the most important one% 7iopsy is &ery essential diagnostics

techni,ue which allows to define the nosology of lung disease* its acti&ity le&el and

phase% The diagnostic &alue of biopsy to a certain degree depends on its method and

the type of 'IL'% The authors pro&ed that T7L7 was diagnostically informati&e for


29/33

only ! patients of 2" ("1G) who had 'IL' in e&idenceB in "" such patients (CG)

T7L7 displayed normal lung tissue or nonspecific changes%

.t the same time 8L7 made a specific diagnosis of 'IL' in 0G of cases% In 'IL'-

affected patients T7L7 pro&ed to be most informati&e for patients ha&ing sarcoidosis

or lymphogenous carcinomatosis* because this lesions ha&e largely peribronchical

tissue in&ol&ed and are therefore most accessible to T7L7% 'iagnostically 8L7

appears to be more accurate* but it also has certain compleities because lung tissue is

sampled from a small sector of the lung which might not reflect the changes occurring

in the rest of the lung tissue% Many diffuse diseases affect lung tissue irregularly so the

pathologically altered parts of the lung may contine both actibe manifestations of te

disease and fibriotic changes of long standing% ?or any accurate diagnostis and

assessment af the clinical progres of the disease the rifht choice of a biopsy smaple is

&ery important% 'uring biopsy NLS helps to collect moere accurate data indicating

acti&e areas of a pathological process% 7y using NLS* the areas affected by lung

fibrosis in its final phase* with honeycomb lung formed* could be s+ipped during

biopsy sampling% In addition* NLS may pro&e to be &itally important for choosing the

most effecti&e techni,ue ( T7LS* 7.L* 8L7) for ma+ing a histological diagnosis%

#onclusion% 5adiography still remines the mostFaccessiable method for diagnosing

'IL' yet its informational content apperes to be not sufficient%

Ma+ing correct diagnosis necessitates a combination of laboratory* functional and

radiological in&estigations as well as some in&asi&e methods* cach of them ha&ing it

sown substantial limitations%

NLS-diagnostics is the method that greatly improves identification of diffuse

infiltrative lung disease and as such it should become a part and parcel of an

integrate investigation.


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NLS-'I.AN8STI#S 8? P58ST.T 'IS.SS

$%.% Toropo&a* S%N% Petren+o

.n e&er growing number of physicians en4oy an opportunity of screening NLS

diacrisis of prostate gland and urinary bladder% This article attempts ti consider some

particular of morphological changes occurring in a prostate affected by pathology*

based on the results of NLS-in&estigations%

In the est prostate cancer ma+es !G of the total cancer diseases and ran+s secondto lung tumors as a depth cause%

.ccording to some autopsy finding with a histological in&estigation of the prostate*

/-=HG of men aged o&er 2! appeared to ha&e cancerous nidi% #linically* cancer is

diagnosed moer rarely because a high percentage of that number corresponds to

;minor forms; of cancer that ha&e low in&asi&eness* so the patients suffering from it

die of another +ing of pathology%

The enhance the ,uality of prostate disease diagnostics it is important to comprehend

to specifics of topographic and 3onal anatomy of particular organ

The prostate gland is located in a small pel&is between the bladder and anterior

abdominal wall* anterior rectum wall and secondary urgenital diaphragm% The gland

has a chestnut shape and tightly en&elops the bladder cer&i and prostatic urethra% The

gland base is tightly connected with the bladder into a coherent mass% Its anterior

surface is directed to the symphisis* and the posterior one - to the rectum ampulla% The

posterior surface of the gland has an epressed sulcus* which allow to con&entionally

subdi&ide the gland into the left and right lobes% 7eside* there is a protruding middle

cone-shaped lobe confined anteriorly by the prostatic urethra and by the spermatic

duets posteriorly%

.ccording to 3onal anatomy theory usually = glandular 3ones are distinguished in the

prostate% The correct interpretation of NLS data largely depends on the +nowledge of

their topical pattern% !G of the glandular tissue correspond to the central 3one (#


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Peruretharal glands (P6A) ta+e a relati&ely small amount if the tissue howe&er

eactly this area of the gland is &ery important for eplaining changes at a benign

hyperplasia%

.part from the glandular area* = fibro muscular 3ones can be disconnectedD

/) .nterior fibro muscular stoma (.?S)%

) 6nstriated muscular fibers of the urethra (6M?6)

") Preprostatic sphineter (PPS)* which is an etension of the musculature of the

inferior part of the urecter and pre&ents in&erse emission of semifliud

=) Postprostatic sphincter (PPS)* which is responsible for retain urine in the bladder

and bloc+s incontinent micturition

The gland can be con&entionally subdi&ided into partsD

-eternal part consisting of #


32/33

nlarged lateral lobes s,uee3e P< and #< causing their atrophy% ith proliferation of

the paraurethral 3ones a massi&e fibro muscular PPS layer restricts of their

hyporplasis* so with this +ind of pathology the gland proliferates along the urethra

forming a middle dar+ened 3ones pushing bac+ the bladder wall% $isrtual scanning

ma+es this pathology clearly &isible in longitudinal sections% .t the beginning of the

proliferation a relationship between the internal and eternal glandular parts id

disturbed% .part from some distinctions in the 3one of principal proliferation* the

clinical sings will be different as wee% In the case where a globe-shaped gland is

formed (T< prolification) the gland is chiefly hyperchromogenic and the dysuric

manifestations are minimal while with a ;middle 3one; formed the gland is slightly

dar+ened and dysuria appears to be fran+% Sphincter decompensation leads to the

de&elopment of urinary incontinence and dilation of the upper urinary trac+ fallowed

by the atrophy of the cortical layer of +idneys* which gradually adds to fre,uent

urination* nycturia* reduced pressure of the urine or slowed-down urination occurring

in the initial phase of the disease%

In case of s,uee3ed cer&i of the bladder an NLS-graph allows to &isuali3ed sings of

an infra&esical obstruction* that causes some morphological and functional changes in

the lower and upper urinary trac+s% Specifically% In the initial phases of benignhyperplasia a dar+ened wall in the bladder can be obser&ed% 'ar+ patches result from

compensatory hyprthropy of the detrusor%

These " phases of benign hyperplasia of the prostate can be distinguished depending

on the intensity of the changesD

/% yperchromogenic density of the gland with no residual urineB

% 5esidual urine presentB

"% .ll of the abo&e-mentioned plus dilatation of the upper urinary tract with the

cortical layer of +idneys in&ol&ed in the process%'iagnosis of the acute prostatitis is made in the basis of histograms (similarity to the

reference standard process ;prostatitis; 'J!%=2)% diagnostication should be done in

combination with dactylar rectal eamination ( painfulness during papation) with

clinic lab data ta+en into account%

In this case oc abscessed lesion a still higher hyprchromous area (C points) is &isible

against the general da+ patch ( =-2 point according to ?landler>s scale)% .reas of fran+

blac+ening correspond to necrotic changes% hich an abscess in progress one can


33/33

notice a reduced infiltration of the tissue around the ca&ity with the dar+ patch

gradually lighter in the course of dynamic obser&ation ( up to "-= pints)% ith

ade,uate therapy employed the postinflamentory cyst may fall into regression%

.s can been seen from NLS-in&estigation * chronic prostatits dose not gi&e a common

characteristic picture* howe&er the morphological processes in different phases of the

disease are reflected in histograms% ith a long-lasting diseases the chromogenetic

density tends to rise due to a postinflammatory substitutions mode destructing of the

fibrous component starts to predominate%

ith an oncological pathology analysis of the gland picture helps locate the process in

different pro4ections and assess the etent of pre&alence and in&ol&ement of ad4acent

organs% The minimum si3e of tumor determinate by means of NLS-in&estigation is

about 1-/! mm% 1!2 of the timorous nodes are represented by mar+edly

hyperchromogenic structures (C points on ?landler>s scale)

.nalysis of histogram of the nidid helps differentiate an oncoprocess% The method>s

sensiti&ity becomes higher with both >elimination> and NLS-anaysis>modes in use%

Peripheral 3one shape first place as far as cancer incidence rate s concerned% Their

shape ma+e H!-1!G of cases% In transitory 3ones (T

collection ipp

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