UJR 2001, vol IX, # 4
THE CONTENTS
2001, vol 9, № 4, page 370
R.YA. Abdullayev
Influence of the stage and localization of myocardial hypertrophy on systolic and diastolic function of the left ventricle in patients with post-infarction cardiosclerosis
Annotation
Objective: To study and compare the influence of the stage and localization of myocardial hypertrophy (MH) on systolic and diastolic function of the left ventricle (LV) inpatients with postinfarction cardiosclerosis (PIC).
Material and Methods: The parameters of systolic and diastolic function were studied using two-dimensional and pulsed Coppler ultrasound in 154 patients with PIC. In 5Э patients, arterial hypertension (AH) preceded myocardial infarction. Chronic cardiac failure (CCF) I - III FC according to NYHA was noted in 75 (48.7%) cases, of them in 41 (69%) with hypertrophy and in 34 (36%) without hypertrophy of the left ventricle (LV) .
Results: Significant enlargement of the end-diastolic volume (EDV) in patients with hypertension was noted at slight hypertrophy (141=6ml; p<0.05). Reduction in the ejection fraction (EF) (p<0.05) was observed when total thickness of the interventricular septum (IVS) and the posterior wall was higher 26 mm.
The smallest EDV and EF parameters were determined in hypertrophy of the PWLV, hut in this case the difference was significant only for EF (43=2%; p<0.05) .
Abnormal relaxation of the IV myocardium was revealed in 4 6 of the 59 (73%) patients with LV hypertrophy, of them in 32 patients with CCF and in 14 without it. The lowest indices of E/A were observed in apical hypertrophy. In 14 patients with MHLV, pseudonormal diastolic filling m was detected, of them in 9 patients in CCF and in 4 without CCF. Mean indices of the time of isovolune relaxation (TIR) were significantly higher when compared with the controls (p<0.13) only inmoderate and in slight hypertrophy and when it was localized in the PWLV. Significant increase in E time of deceleration (T2) (134sec) was noted at the most prominent hypertrophy of the PWLV.
Inpatients with CCF, significant increase of ECV (1=3=4 ml; p<0.05) was observed in slight MHLV and CCF while EF was reduced (42=2%). E/A ratio, ТІR and ETC in patients with CCF were significantly lower than the respective parameters in healthy subjects and patients without CCF. The lowest CTE indices were observed in patients with CCF without LF hypertrophy (129 sec) .
Conclusion: Diastolic dysfunction is registered mall patients with PIC against a background of MHLV: the lowest E/A ratio is observed in apical hypertrophy (0.73±1.13); the lowest TIR and the highest ЕСТ are noted in total thickness of the IVS and PWLV more that 2 6 mm as well as in hypertrophy of the PWLV (62±=3 and 233±4 msec) . Pseudonormal diastolic filling in of the LV is mainly noted in patients with CCF against a background of MHLV. In PIC patients without CCF, significant increase of ECV is observed only in slight hypertrophy of the LV, reduction in EFis noted in marked LV hypertrophy. Systolic dysf'unction in PICpatients prevails in absence of MHLV and in CCF.
Key words: myocardial hypertrophy, systolic and diastolic dysfunction, left ventricle, post-infarction cardiosclerosis.
2001, vol 9, № 4, page 375
R.M. Spuzyak, V.V. Demyanenko, O.M. Tarasova, G.S. Yefimova
Radiographic investigation for evaluation of efficacy of treatment for bone metastases and myeloma using bisphosphonates
Annotation
Objective: Bisphosphonates as an element of treatment for bone metastases are promising due to their capability to inhibit resorption of the bone tissue, which delays the bone destruction and, respectively, prevents development of pathological fractures as well as reduces clinical manifestations of metastatic involvement of the skeleton. The purpose of the present work was to study the findings of radiographic investigations of the skeleton for evaluation of the bone involvement in cancer patients during radio- and chemotherapy with the use of bisphosphonates.
Material and Methods: Clinical laboratory and radiographic investigations were carried out in 13 patients aged 45 – 64 who were administered bisphosphonates. Of them, 8 suffered from breast cancer, 3 lung cancer, 2 myeloma with generalized skeleton involvement. Radiographic investigation included plain x-ray study, bone scan, x-ray CT and MRI which were performed before and after the treatment. Besides, the amount of blood serum calcium during the treatment was studied.
Results: Main clinical sign of metastatic involvement of the skeleton was pain syndrome which was observed in all patients. After the treatment the complaints of pain disappeared (or decreased) almost in all patients, in 2/3 the function of the extremities became normal. The amount of calcium in the blood serum reduced to its normal values in 10 patients.
X-ray study performed before and after the treatment demonstrated dense structure of the involved bones in 9 patients, in one case consolidation of pathological fracture was observed. In 2 patients the x-ray picture was not changed significantly. In 2 patients elevated degree of compression of the involved ventricles was noted.
In 2 patients with breast cancer, bone scan failed to demonstrate pathological accumulation of the radiopharmaceutical in the involved zones after the course of treatment. CT performed after the treatment in 7 patients revealed positive dynamics (diffuse or focal sclerosis) in 6 patients. MRI performed in 2 patients demonstrated decreased MR signal in T2 weighted image of the involved vertebrae in 1 patient (when compared with the previous MR study), in the other there were no changes, though CT demonstrated the structures undergoing sclerosis.
Conclusion: Radiographic techniques allow to evaluate objectively the dynamics of the bone metastases during the treatment. Taking into consideration a small number of observations we can only make a preliminary conclusion about sufficiently effective radio- and chemotherapy with the use of bisphosphonates for treatment of bone metastases.
Key words: bone metastases, bisphosphonates, bone scan, CT, MRI.
2001, vol 9, № 4, page 378
S.S. Makyeev, O.A. Tsimyeiko, O.I. Goncharov, R.Ye. Danilets D.V. Shcheglov
Changes in cerebral blood flow in patients after endovascular exclusion of arteriovenous brain malformations
Annotation
Objective: Arteriovenous malformations (AVM) influence considerably cerebral blood flow volume. The purpose of the work was to evaluate the changes of the latter in patients with AVM after their endovascular exclusion.
Material and Methods: Brain vessel scan (BVS) and emission tomography with Tc-99m HMPAO (SPECT) were performed in 22 patients with brain AVM before and after partial or complete exclusion of the malformations. Repeated investigations were performed 7 days after the surgery, the volume was calculated according to N. Lassen (1988).
Results: Brain vessel scans allowed determining if the AVM was completely excluded. Elevation of cerebral blood flow volume in the hemisphere with AVM from 40.6±0.3 to 42.1±0.27 ml/100g/min (p < 1%), while in the other from 45.05±0.23 to 45.06±0.23 ml/100g/min (p < 5%). Asymmetry of the blood flow volume after the surgery decreased from 4.5±0.23 to 3.03±0.18 ml/100g/min (p < 0.1%).
Conclusion: Brain vessel scan can be recommended for evaluation of the completeness of AVM exclusion, after which in the majority of the patients general increase in the cerebral blood flow volume is observed in the both hemispheres. Asymmetry of the blood flow after the surgery weakens as the volume increases in the hemisphere with AVM.
Key words: arteriovenous malformation, cerebral blood flow, single photon emission computed tomography.
2001, vol 9, № 4, page 383
T.A. Litovchenko, O.K. Zinchenko, O.M. Sheptun, L.M. Shevchenko
The characteristics of cerebral blood flow disturbance in epilepsy
Annotation
Objective: To study the state of cerebral hemodynamics in epileptic patients depending on the frequency and type of seizures as well as the treatment efficacy.
Material and Methods: Cerebral blood flow was studied in 40 patients with epilepsy. Cerebral hemodynamics was studied using MB-9200 gamma-camera (Hungary) with Tc-99m pertechnetate. Brain CT (and/or MRI), transcranial Doppler study, rheoencephalography, electroencephalography were also used. The findings of the examinations were processed statistically.
Results: Brain scan was the most informative technique for investigation of cerebral blood flow; its findings demonstrated that the disturbances of brain circulation correlated with the type and frequency of the seizures. In primary generalized seizures, general reduction in the blood flow, perfusion rate as well as slowing down in the venous phase more pronounced on the side of the focus were observed. The study performed immediately after the seizure demonstrated marked reduction in all phases of cerebral blood flow, which depended on the frequency and duration of the seizures as well as the efficacy of the treatment. In focal seizures, significant disturbance in the blood flow on the side of the epileptic focus was observed. Absence did not cause significant disturbance in the blood flow in the majority of cases.
Conclusion: Brain scan is the most informative technique for investigation of cerebral blood flow. Disturbances of the blood flow depend mainly on the frequency and type of epileptic seizures and aggravate in ineffective treatment. It is possible to recommend the preparations which improve brain blood flow and metabolism in complex treatment for epilepsy.
Key words: epilepsy, brain blood flow, pathogenesis.
2001, vol 9, № 4, page 386
V.V. Boiko, I.A. Krivoruchko, YU.B. Grigorov, YA.Ye. Vikman, YU.V. Avdosev
Treatment results in patients with portal hypertension caused by liver cirrhosis with phenomena of cholestatic hepatic failure
Annotation
Objective: To study the results of complex treatment of the patients with portal hypertension caused by cirrhosis of the liver with phenomena of cholestatic hepatic failure with account of the changes of volumetric blood flow and biochemical parameters.
Material and Methods: Complex treatment of 56 patients with the phenomena of cholestatic hepatic failure caused by cirrhosis of the liver in various stages of dysfunction of the liver was carried out. In 6 patients the compensated stage of the disease, in 11 patients - subcompensated, in 39 - decompensated stage was revealed. The patients underwent endovascular embolization of the splenic and hepatic artery, devascularization of the esophagus and stomach, against a background of complex infusional and intraportal therapy with the use of antioxidants, hepatoprotectors, antispasmodics and angioprotectors. In 4 patients in the complex of treatment extract of embryonic cells was applied. The complex investigation was carried out 30 days and 60 days after beginning the treatment.
Results: It was established that application of combination of mini-invasive procedures and intraportal therapy, administration of extract of embryonic cells promoted normalization of the functional state of the liver, parameters of volumetric blood flow and improving general condition of the patients, in comparison with application of endovascular procedures alone, which was confirmed by the findings of biochemical analyses, blood flow parameters in the portal vessels.
Conclusion: Portal hypertension is accompanied by development of hepatic failure, which demands pathogenetic approaches to treatment. Optimal in treatment of the patients with cholestatic hepatic failure is application of combination of mini-invasive procedures with intraportal therapy and infusional complex treatment.
Key words: portal hypertension, cholestatic hepatic failure, ultrasonography.
2001, vol 9, № 4, page 390
A.O. Protopopov, V.B. Shabelyanskom, O.P. Andrusenko, YU.I. Malimon V.L. Suprunets
Experience of radical treatment for soft tissue sarcoma
Annotation
Objective: To study the survival of the patients with soft tissue sarcoma (STS) depending on the stage of the disease and the applied modalities of radical therapy.
Material and Methods: The study involved 121 patients with STS, of them 40 cases (33.1%) of stage I A, B; 54 (44.6%) stage II A, B, C; 20 (16.5%) stage III; 7 (5.8%) stage IV. Tissue characteristics of the tumor were determined in 83.5% of cases, 16.5% of cases were of unclear origin. Surgical treatment was performed in 43 (35.5%) patients; surgery + radiotherapy were applied to 78 (64.5%) cases; polychemotherapy was administered in 15 (12.4%) cases.
Results: During a five-year period total mortality of the patients with STS was 47.1%; during 10 and 15 years – 64.5 and 71.1%, respectively. Eighteen patients died of the causes which were not associated with the progress of the tumor. Five-year survival of the patients treated surgically was 47.4±8.7%; 10-year – 28.9±7.1%; 15-year – 28.9±7.1%. Five-, 10-, and 15-year survival of the STS patients treated with surgery and radiotherapy was 70.8±5.4, 49.2±5.9, 36.9±6.4%, respectively. Tumor relapses were noted in 26 (21.5%) patients, of them12 (27.9) cases after the surgical removal of the tumor; 14 (17.9%) cases after multimodality treatment. They were chiefly observed in the tumors with unclear origin (40%). Of the patients with relapses, 61.5% died within 3 – 5 years of observation.
Conclusion: Corrected with the account of death due to other causes total survival of the patients with STS was: 5-year – 62.1±4.8%; 10-year – 41.7±5.4%; 15-year – 33.9±6.1%. The life span did not differ in cases of stages I A, B and II A, B, C (p>0.05), in stage III they were considerably lower when compared with the two former parameters (p<0.05). Five- and 10- year survival of the patients administered multimodality treatment is significantly higher when compared with that in surgery only (p<0.05). In patients who survived 10 years after radical treatment for STS the further prognosis depends to a less degree on the stage and methods of treatment. The study proves the opinion that in 2/3 of patients the relapse coincides with the process generalization.
Key words: soft tissue sarcoma, treatment modalities, survival.
2001, vol 9, № 4, page 394
G.S. Yefimova, N.A. Nikiforova
The influence of Lipochromin on the immune state of patients with uterine cervix cancer at combined radiotherapy
Annotation
Objective: To study the influence of Lipochromin, a carotenoid-containing drug, on the immune state of the patients with uterine cervix cancer undergoing combined radiotherapy.
Material and Methods: Immunological study was performed in 30 patients with uterine cervix cancer who were administered Lipochromin as a part of combined radiotherapy and 30 patients from the reference group.
Results: The analysis of the immunity state in patients with uterine cervix cancer before radiotherapy demonstrated that mean level of the peripheral blood lymphocyte population was significantly lower than the respective indices in the group of healthy subjects but was within the lower limits of confidence interval for the physiological norm for T-lymphocytes and the higher limits for B-lymphocytes both in absolute amount and percentage. In the middle of the course of combined radiotherapy, reduction in the relative and absolute amount of thymus-dependent lymphocytes was observed in the both groups, but in the patients taking Lipochromin their level exceeded 1.5 times that in the women from the reference group.
By the end of combined radiotherapy, normal percentage of T-lymphocytes was registered in 75.9% of the patients from the main group while in the controls this value was 45.8%.
Significant, when compared with the group taking Lipochromin, reduction in IgG level and elevation of that of total CIC with simultaneous inhibition of digestive ability of the peripheral blood neutrophils was observed at the same time.
Conclusion: The use of combined radiotherapy for uterine cervix cancer induces development of immune reactions with humoral factors prevailing over cellular ones. Administration of Lipochromin together with combined radiotherapy provides the increase in the amount of T- and B-lymphocytes, digestive ability of the peripheral blood neutrophils and reduction in the level of CIC to the limits of physiological norm.
Key words: uterine cervix cancer, combined radiotherapy, immunity, Lipochromin.
2001, vol 9, № 4, page 399
N.O. Maznik, V.A. Vinnikov
Dependence of changes of chromosome aberration parameters in peripheral blood lymphocytes in participants of Chornobyl accident clean-up from irradiation dose
Annotation
Objective: To study the dynamics of chromosomal aberration level depending on the documented doses in Chornobyl clean-up workers exposed protractedly to low-dose radiation.
Material and Methods: The follow-up cytogenetic survey was carried out in 65 liquidators with documented doses from 24 to 978 mGy in terms 0.03-11.67 years after the end of their duty at the Chornobyl zone. The unstable chromosome type aberration yields were measured in metaphases of 50-hrs peripheral blood lymphocyte cultures using the routine cytogenetic technique. The “time-effect” regressions for mean aberration frequencies were built in liquidators groups with doses Ј250 mGy and >250 mGy.
Results: The common direction of the cytogenetic damage yield dynamics in liquidators was the decreasing of the aberration frequencies from significantly increased level in terms before 1 year after exposure to the subcontrol level 6-12 years after staying at the Chornobyl zone. There were some differencies in acentric fragments yield dynamics in dose groups during the first 2.5 years after exposure at the Chornobyl zone, but similar parameters were shown in later terms. The elimination of lymphocytes carrying dicentrics and centric rings was monotonously exponential and its rate appeared to have no dependence from the radiation dose mentioned in the liquidators’ documents.
Conclusion: The absence of the dose influence on the parameters of dicentrics and centric rings yield dynamics in liquidators indicates the possibility of individual cytogenetic data pooling in similar terms after exposure and using the unified rate of the aberrant cell elimination for extrapolative assessment of the aberration yield on the “time-effect” scale in the groups of persons exposed protractedly to low-dose radiation.
Key words: сhromosome aberrations, cytogenetic effect dynamics, low-dose radiation, Chornobyl liquidators.
2001, vol 9, № 4, page 404
G.A. Zubkova, T.I. Davydova V.N. Slavnov, N.A. Kovpan, V.V. Markov, Ye.V. Luchitskiy
Influence of Thymogen on T-cell suppressor activity and the level of lymphocyte gamma-interferon in irradiated CBA mice
Annotation
Objective: To study the influence of Thymogen on the suppressor activity of T-lymphocytes and the level of lymphocyte gamma-interferon in mice after total irradiation.
Material and Methods: The experiment was performed on CBA mice exposed to single total x-ray irradiation at a dose of 5 Gy using РУМ-17 unit (voltage 200 kV, amperage 10mA, filters 0.5 mm Cu + 1.0 mm Al, focal distance 50 cm, dose rate 0.48 Gy/min). Thymogen was administered 5 week after the exposure, 7 intramuscular injections in a dose of 0.1 µg. The study was done on the 5th and 15th days after the exposure (3 days after the last injection of the preparation).
Results: The results of the study suggested that total irradiation of the animals caused significant disturbances in the functional activity of T-suppressors and considerably reduced the ability of lymphocytes to produce gamma-interferon in response to the mitogen. The course of immune therapy restored suppressor activity of T-lymphocytes and the level of lymphocyte gamma-interferon.
Conclusion: On the 5th and 15th days after x-ray exposure of the mice, suppressor activity of Kon-A-induced T-lymphocytes as well as the capability of blood lymphocytes to produce gamma-interferon in response to mitogen decrease. Administration of Thymogen restores cellular suppressor activity and the level of lymphocyte gamma-interferon.
Key words: total irradiation, suppressor activity of T-lymphocytes, gamma-interferon, Thymogen.
2001, vol 9, № 4, page 407
T.M. Vorob'eva, A.M. Titkova, YU.V. Pavichenko, A.G. Derbeneva
The role of biogenic amines in effects of low-dose ionizing radiation and their correction with activation of positive support system
Annotation
Objective: To reveal the changes which develop in central and peripheral catecholamine and serotoninergic systems as a result of the effect of low-dose ionizing radiation and to correct them by activation of intracerebral system of positive support.
Material and Methods: Fifty-six mongrel male rats were exposed to single total x-ray irradiation at a dose of 50 cGy. On the 8th and 30th days after the exposure, the amount of catecholamines and serotonin in the brain structures (somatosensor region of the neocortex, amygdaloid complex, hypothalamus, hippocampus, reticular formation of the oblong and midbrain) and the blood of the animals was investigated using spectro-fluorimetry. Some rats underwent a stereotaxic operation (implantation of electrodes in the positive emotiogenic regions of the lateral hypothalamus) after the exposure; after which they were trained using electric autostimulation of the brain 60 min daily for the whole period of the experiment.
Results: Activation of catecholamine-ergic processes in the area of the somatosensor cortex against the background of reduction of biogenic mоnoamine amount in the structures of the limbic system was noted on the 8th day after the exposure to the dose of 50 cGy. Inhibition of chatecholamine-ergic processes in the neocortex with increase of biogenic monoamine amount in the structures of the limbic system and elevation of blood adrenaline, noradrenalin and serotonin concentration were noted 30 days after the exposure. Multiple autostimulation of the area of the lateral hypothalamus caused the changes in biogenic monoamine amount similar to those observed in the rats 30 days after the exposure to x-rays.
When the positive support system was active in response to the irradiation, restoration of biogenic amines amount in the structures of the brain and absence of increased adrenalin and noradrenalin amount in the blood were observed.
Conclusion: Single x-ray exposure to a dose of 50 cGy causes long-term phase changes of catecholamines and serotonin in the structures of the brain and blood of the rats. The changes in the structures of the neocortex and limbic system show opposite tendencies. Activation of the positive support increases catecholamine-ergic energizing influence in the subcortical structures of the brain, that performed after the exposure normalizes the amount of biogenic monoamines in the central nervous system and reduces the strain of the function of sympathoadrenal system.
Key words: ionizing radiation, low doses, auto-stimulation, system of positive support, brain structures, blood, biogenic monoamines.
2001, vol 9, № 4, page 413
A. G. Kostenko A. V. Mishchenko
The influence of chronic exposure to increased doses of sodium fluoride and ionizing radiation on antioxidant state and energy metabolism in the liver of animals
Annotation
Objective: To study the influence of chronic fluoride intoxication and ionizing radiation on antioxidant state and energy metabolism in the liver of animals.
Materials and Methods: The investigation involved 50 white Wistar male rats. Sodium fluoride was introduced orally in the daily dose 10 mg/kg of the body mass. Gamma-rays were generated with cobalt unit AGAT-2 at a total dose of 7 Gy. Concentration of malonic dialdehyde, catalase activity, superoxide dismutase concentration of cAMP, cGMP, ATP, RNA of globulins and gistons were determined. Tissue respiration was evaluated according to Chance.
Results: In the experimental animals at combined action of sodium fluoride and radiation the growth of malonic dialdehyde concentration, reduction of catalase and superoxide dismutase activity, ATP, ADP amount as well as increase of AMP and inorganic phosphate concentration were observed. The coefficient of effectiveness of phosphorylation (ADP/0) was reduced.
Conclusion: Combined action of increased doses of NaF for 6 months and repeated massive g-irradiation causes intensification of free radical oxidation and weakening of antioxidant protection.
Combined action of NaF and g-irradiation reduces the concentration of high-energy compounds (ATP, ADP, creatine phosphate), cAMP, RNA, globulins and gistons as well as control of breathing and oxygen consumption; the concentration of inorganic phosphate in the liver is increased.
g-irradiation and increased consumption of NaF disturb synthesis of RNA, globulins and gistons, decrease the concentration of cAMP in the liver. All this disturbances are due to the action of g-irradiation as well as NaF, but the action of g-irradiation is more pronounced.
Key words: antioxidants, lipid peroxidation, liver, sodium fluoride, radiation, energy metabolism.
2001, vol 9, № 4, page 418
O.V. Nedzvetskaya, I.V. Pastuh, T.M. Zimina, Abbas Fadi
Experimental x-ray contrast study of magnetic laser hemotherapy influence on the eye lymphatic drainage
Annotation
Objective: To conduct an experimental study of the influence of general and regional magnetic laser therapy on the rate of the eye lymphatic drainage.
Material and Methods: The experiment involved 10 Chinchilla rabbits. 1% Triombrast, a water-soluble contrast substance, was injected to the suprachorioid space of one eye of the rabbits of groups 1 and 2. Immediately before the injection of the contrast substance the animals from group 2 were performed transcutaneous contact magnetic laser treatment in the area of the auricular and supraorbital veins using Barva unit (wave length 630 nm, radiating power 20 mW, magnetic field 5 mT).
Results: 1 % Triombrast, a water-soluble x-ray contrast substance, is excreted from the suprachorioid space of the rabbit eye both through the anterior and posterior prelymphatic ways of outflow. Considerable acceleration of the contrast substance excretion from the suprachorioid space of the eye caused by general and regional transcutaneous magnetic laser hemotherapy due to activation of the eye lymphatic drainage was established.
Conclusion: The use of general and regional transcutaneous magnetic laser hemotherapy provides acceleration of lymphatic drainage from the suprachorioid space of the eye.
Key words: x-ray contrast, lymphatic drainage of the eye.
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