Most infectious complications in the bed of the implant are due to colonization of methicillin-resistant flora and are very difficult and high material costs for treatment. More than 50% of infectious complications occur during the first 14 days after the implantation. There are several treatments, which include a mandatory component - the antibiotic therapy. The main goals of surgical treatment of infectious complications are preventing mortality in this group of patients and limb salvage. The scheme of diagnosis and treatment based on evidence of etiological factors, pathogenesis of complications, risk factors contributing to their development and data on the stability of the prosthesis, the indicators of aspirate and of time after surgery. So far a holistic approach to the therapy is not developed because of lack of data and prospective, randomized clinical trials. Our study proposes a new algorithm for the diagnosis and treatment of infectious complications after joint replacement.

This is a review and discussion of possibilities and indications of VATS metastasectomy in the treatment of soft tissue and bone sarcomas. Thoracotomy is still a standard approach for the patients with sarcoma lung metastasis. Our point shifted forward and thoracoscopic resection should be a method of choice for the treatment of sarcoma solitary lesions. Miniinvasive technic leads to less complications, less admission time and faster rehabilitation time. Thoracoscopic resections decreases future thoracotomy trauma and give the possibilities for faster further conservative treatment.

Inflammatory fibrosarcoma is very uncommon low grade myofibroblastic tumor. We report the pathologic features of inflammatory fibrosarcoma and outcomes of the 6 patients. The age ranged from 12 to 64 years; 3 patients were younger than 25 year. The diagnosis of inflammatory fibrosarcoma was made by autopsy in 4 patients. 2 patients had local recurrences and 4 patients had distant metastases. Follow-up showed the death of 4 patients during 7-14 month after diagnosis. The tumors were 7-12 cm; sites included the mediastinum (4 patients), pelvis and liver. All tumors showed predominantly the hypercellularity and atypical cytologic features of inflammatory myofibroblastic tumor, however, areas of nuclear enlargement and necrosis were identified. Immunohistochemically, cytoplasmic ALK1 reactivity was seen only in 1 patient. The ALK rearrangement was confirmed by FISH in same case.

Aim of the study was to evaluate efficacy and safety of 24-hour 3 weekly CI infusion of trabectedine in patients with specific soft tissue sarcomas subtypes as a second or more treatment option. Materials and methods. 21 patients with PD after one or more lines of chemotherapy were enrolled. 12 pts. with leiomyo, 7 -synovial and 3 myxoid liposarcoma. Detailed toxicity profile evaluation was performed and the obtained data almost equals STS 201 trial. Patients received 2-9 cycles with median 4 cycles. Results. 20 patients were available for the response assessment: CR - 0, PR - 3 (15%), SD - 11 (55%), PD - 6 (30%) with the control rate (CR+PR+SD) of 70%. Conclusion. Trabectedine is effective second or more line treatment option for advanced specific STS subtypes with acceptable toxicity profile.

The aim of this study was to investigate the cutaneous malignant melanoma (CMM) in individuals aged under 20 years in Russia. We consider both temporal and geographical variations. The Annual reports of Ministry of health and Federal State Statistics Service were used to extract information on cases (1990-2009) and deaths (1999-2009) including gender, age and geographic information. Population data were also obtained and analyses included descriptive summaries, rates, and trend detection tests. During 20 fiscal years, 1860 children and adolescent were diagnosed with CMM. Significant temporal variation of incidence was observed: increase in 1990s (AAPC=9,5%; [95%HR 7,1% ь -12%]) following by decline in 2000s (AAPC= -13,4% [95%HR -17,9% - -12%]). There were a doubling of average Russia incidence rates in some areas. Mortality from childhood CMM was sufficiently high in 1999-2009 (0,25 per 1000,000). Conclusion: although a relatively rare number of children and adolescent in Russia were diagnosed with CMM during the study period, significant temporal and geographical variations were found. Further study is required to explain higher rate areas.

Aim of the study. To investigate the comparable value of acute toxicity and antitumor activity of new water soluble salt of decocine - preparation Decovine. Materials and methods. The study was carried out on 516 mice Balb/c, C57Bl6 or SHK without or with transplanted tumours AKATOL, AKATON, sarcoma S180, B16 and Ehrlih carcinoma (ACE). Decovine at the single doses of 50 or 75 mg/kg was administrated i.p. daily for 10 days; comparable drugs were administrated with well known schedules of treatment. All results were calculated with according to standard criterion: DL₅(MTD) and DL₅₀ or TGI and ILS. Sstatistically significant effects were calculated for p<0.05. Results. Decovine was low toxic for mice (MTD=230 mg/kg, DL50=417 mg/kg), and high effective against 3 from 5 strain of tumors AKATOL, AKATON and ACE at the same time by the developed tumors, TGI=56-98% or ILS=95% (p<0,05). In comparison of decocine, ^diamine or cyclophosphamide Decovine was on 20-30% more effective for TGI and in 3 times for ILS, especially by the treatment of developed tumor. Conclusion. New water soluble salt of decocine Decovine with comparable low toxicity and high antitumor activity can be considered as the candidate for clinical evaluation. This drug can be useful as for mono or combined chemotherapy.

The aim of the study was to appreciate the influence of local ultrasonic hyperthermia on toxicological properties of cisplatin and doxorubicin. Material and methods. The experiments were performed on a total of 90 female outbreed rats (280-300 g) cisplatin (2,5 mg/kg/day) and doxorubicin (1,5 mg/kg/day) were injected intravenously into the caudal vein for 5 days with 24 h intervals 15 min before local ultrasonic hyperthermia. The site of thigh muscle of animals was heated for 10 min at mean 41,5 (±0,3) °C. Parameters for evaluation of toxicity: clinical signs including behavioral reactions, body weight, clinical and biochemical blood tests, urine analysis, electrocardiographic examination. Statistical analysis was performed by Microsoft Excel using Student's test. Internal organs and muscle of thigh from the site of local ultrasonic hyperthermic exposure were examined microscopically. Results. Local ultrasonic hyperthermia in regiment was used practically doesn't influence on clinical parameters of animals. Morphological changes of internal organs have, basically, reactive nature. Local tissue reactions are moderate. Combination of local ultrasonic hyperthermia with cisplatin or doxorubicin does not increase the toxicological properties of antineoplastic agents. Histopathological effects are equivalent in rats given anticancer drugs or their combinations with local ultrasonic hyperthermia. Conclusion. Combination of cisplatin or doxorubicin and local ultrasonic hyperthermia doesn't result in unexpected toxicities. By clinical application the control of combination toxicity, apparently, add up to the control of doxorubicin or cisplatin toxicity. The toxicity of cisplatin, while it combines with local hyperthermia, may become apparent later.

This is case report about the metastasis of osteosarcoma in the kidney. The patient is 18 years old with ostesarcoma of the thighbone received combined therapy with surgery. A year later, metastasis of osteosarcoma in the left kidney were diagnosed.

Soft tissue sarcomas (STS) are rare mesodermal tumors represent approximately 1% of malignant neoplasms in adults. The pattern of growth, clinical behaviour and prognosis refer soft tissue sarcomas to one of the most malignant tumors. The survival rate of the patients with STS mostly depends on the effective and early started treatment. Over the past decades, the success in the treatment of STS was reached due to development and use of neoadjuvant chemotherapy. That is why grows the necessity in evaluation of efficiency of chemotherapy to modify the initial therapeutic approach. A newer functional imaging technique, such as dynamic contrast-enhanced MRI (DCE MRI), is being developed for better evaluation of response to preoperative treatment. Review of the literature identifies a high potential of DCE MRI in detection of highly vascularized zones in tumor, which correlate with zones of residual viable tumor on pathologic examination. In this preliminary report of a clinical trial of DCE MRI is shown a high informativeness of the method in assessing of response to chemotherapy in a patient with clear cell sarcoma of soft tissues.