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UJR 2005, vol XIII, # 1

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2005, vol 13, # 1, page 9

R.J. Abdullaev, O.M. Hvisuk, V.G. Marhenko, L.A. Kadirova

Capabilities of ultrasound diagnosis in lumbar spine pathology

Annotation

Objective: To study the features of compression fractures of thoracic vertebrae bodies in children.

Material and Methods: The retrospective study involved 122 case histories (49 girls and 73 boys aged 3-15) who were treated in Children's City Traumatology Department for compression fractures of thoracic vertebrae bodies.

Results: It was revealed that the fractures were most frequent in children aged 10-11. The highest fracture incidence in girls was observed in January (16.4 %) and October (14.3 %), in boys — in May (11 %) and October (15.15). Traffic inj uries were revealed in 64.7% of cases, domestic — 13.9 %, sport and school — 10.7 %. Fractures of T5, T6, and T7 were most frequent, 19.9 %, 24.7 %, 17.8 %, respectively. In contrast to the adults, T11 and T12 fractures were observed less frequently, 1 — 2.5 %. 1 st degree compression fractures were diagnosed in 72.5 % of cases, 2 nd degree in 25.3 %, 3 rd degree in 2.2 %.

Conclusion: Compression fractures of the thoracic vertebrae in children have their specific features as to the mechanism of the injury, age, sex, the number of the involved vertebrae, degree of compression, incidence in different months.

Key words: thoracic vertebrae, compression fractures, children.

2005, vol 13, # 1, page 14

M.I. Spuzak, О.P. Sharmazanova, S.М. Spuzak

Compression fractures of thoracic vertebrae bodies in children (retrospective analysis)

Annotation

Objective: To study the features of compression fractures of thoracic vertebrae bodies in children.

Material and Methods: The retrospective study involved 122 case histories (49 girls and 73 boys aged 3-15) who were treated in Children's City Traumatology Department for compression fractures of thoracic vertebrae bodies.

Results: It was revealed that the fractures were most frequent in children aged 10-11. The highest fracture incidence in girls was observed in January (16.4 %) and October (14.3 %), in boys — in May (11 %) and October (15.15). Traffic inj uries were revealed in 64.7% of cases, domestic — 13.9 %, sport and school — 10.7 %. Fractures of T5, T6, and T7 were most frequent, 19.9 %, 24.7 %, 17.8 %, respectively. In contrast to the adults, T11 and T12 fractures were observed less frequently, 1 — 2.5 %. 1 st degree compression fractures were diagnosed in 72.5 % of cases, 2 nd degree in 25.3 %, 3 rd degree in 2.2 %.

Conclusion: Compression fractures of the thoracic vertebrae in children have their specific features as to the mechanism of the injury, age, sex, the number of the involved vertebrae, degree of compression, incidence in different months.

Key words: thoracic vertebrae, compression fractures, children.

2005, vol 13, # 1, page 18

О.І. Prodan, А.G. Gruntovskiy, V.О. Kucenko

Radiogramometric characteristics of stenosing variants of dysplastic spondylolisthesis

Annotation

Objective: To present the findings of radiogramometric studies of stenosing variants of dysplastic spondylolisthesis compared with variants of dysplastic spondylolisthesis without vertebral canal stenosis.

Material and Methods: The study involved 60 patients with stenosing variants of dysplastic spondylolisthesis and 35 patients with dysplastic spondylolisthesis without vertebral canal stenosis. A number of parameters were measured using standard x-ray films, the rest were measured using functional lateral films; the parameters of sagittal vertebropelvic balance were measured according to Duval-Beaupere.

Results: X-ray signs of dysplasia were revealed in all patients. Dysplasia severity was associated with probable stenosis of the vertebral canal with by means of influence on the degree of liner displacement. Mean statistical values of radiometric parameters in group A (spondylolisthesis without stenosis of the vertebral canal), in group В (lysis-free spondylolisthesis), in group С (spon-dyloloptosis with arch lysis) were determined. These values differed considerably and associated with each other in a definite way.

Conclusion: The correlation between the value of linear displacement in dysplastic spondylolisthesis and neurological deficiency severity as well as a number of x-ray parameters was revealed.

Key words: dysplastic spondylolisthesis, stenosis of the vertebral canal, vertebropelvic balance, dysplasia, instability.

2005, vol 13, # 1, page 24

О.U. Merkulov, G.І. Garjuk, S.V. Babanin, V.L. Moshenko, І.L. Bobkova

Influence of anatomical structure of the nose and paranasal sinuses on development of chronic inflammatory diseases of the sinuses

Annotation

Objective: To determine the degree of influence of anatomical structure of the nasal cavity and paranasal sinuses on forming chronic inflammatory diseases of the sinuses.

Material and Methods: CT scans of 115 persons were analyzed. Anatomical structure of the nose and paranasal sinuses as well as the state of the mucous membrane were assessed. Pathological changes of the mucous membrane in the paranasal sinuses were revealed in 98 persons. The controls were 16 patients without the signs of pathology.

Results: Different variants of the anatomical structure of the nasal cavity and paranasal sinuses influenced development of chronic inflammatory diseases of the paranasal sinuses with various degree of correlation.

Conclusion: The findings of CT showed that chronic sinusitis was more frequent in patients with an unfavorable structure of the nose and paranasal sinuses. Significance of different variants of the anatomical structure is various and requires further investigation.

Key words: bulla of the middle turbinated bone (concha bulla), paradoxical curvature of the middle turbinated bone, agger nasi cells, Haller's cells, ethmoidal bulla, osteomeatal complex.

2005, vol 13, # 1, page 30

A.V. Chornobay, V.К. Jugov

Computed tomography in evaluation of neoadjuvant endolymphatic polychemotherapy for rectal cancer

Annotation

Objective: To study the capabilities of computed tomography (CT) in evaluation of the efficacy of neoadjuvant (pre-operative) endolymphatic polychemotherapy (ELPCT) in patients with local rectal cancer (RC).

Material and Methods: CT was used to investigate 14 patients with local RC before and after neoadjuvant (pre-operative) endolymphatic polychemotherapy. The CT changes were studied in dynamics, both in quantitative and qualitative aspects.

Results: It was established that all patients had marked positive changes in the size of the tumor, infiltration of the intestinal wall and pararectal fat by the tumor process, which were characterized by decreased density of the investigated objects. All patients underwent radical surgery. Histology proved the qualitative changes in the tumor parenchyma.

Conclusion: CT is an informative method to study not only the tumor process in the rectum and the state of pelvic fat and lymph nodes but also is an objective method of evaluation of the results of neoadjuvant (pre-operative) polychemotherapy (its endolymphatic variant in particular).

Key words: rectal cancer, neoadjuvant endolymphatic polychemotherapy, computed tomography.

2005, vol 13, # 1, page 33

V.G. Stovba, І.E. Solovjov

The technique of transabdominal ultrasound study of the colon in case of colon ileus

Annotation

Objective: To improve the technique of transabdominal ultrasound study (US) of the large intestine in patients with acute obstruction of the large intestine.

Material and Methods: The study involved 120 urgent patients with acute obstruction of the large intestine within the period of 1999-2004. The findings were processed with the use of sensitivity and specificity parameters.

Results: The use of the suggested technique of transabdominal US of the large intestine allowed to determine the level of obstruction in 73 (87%) of 120 cases (26 cases at the level of the sigmoid colon, 29 - rectosigmoid curvature, 9 - descending colon, 3 - splenic angle, 4 transverse colon, 2 — liver angle). So-called "sign of the affected hollow organ" was revealed in 68 (56.6%) patients, which was an ultrasound sign of the large intestine cancer. In the other cases ileus was of strangulation character (12 cases), due to sigmoid colon volvulus (8), diverticulum disease exacerbation (9), was of dynamic character (18).

Conclusion: It was determined that US is an effective method of diagnosis of the level and cause of large intestine obturation in case of urgent diagnosis of acute obstruction of the large intestine.

Key words: ultrasound study, large intestine obstruction, diagnosis.

2005, vol 13, # 1, page 37

V.I. Grishenko, V.А. Pitko, О.М. Feskov, О.V. Saltovskiy, N.P. Suhina

Dopplerographic evaluation of blood circulation in the system mother-placenta-fetus at late abortion

Annotation

Objective: Doppler ultrasound evaluation of functional and hemodynamic changes in the uterus at administration of local cooling of the hypogastric region (LCHR) for termination of late pregnancy.

Material and Methods: The study involved 45 pregnant women who were indicated artificial termination of the pregnancy according to social and medical indications. Blood circulation in the uterine arteries was studied using ultrasound diagnostic unit Hawk 2102 (Denmark). Measurement and comparative analysis of systolic-diastolic correlation (SDC), pulsation index (PI), resistance index (RI) were done.

Results: Comparative analysis of SDC, PI, RI in pregnant from different groups depending on the method of pregnancy termination was performed. Doppler ultrasound study was proven to be an important diagnostic method allowing evaluating the state of uterine circulation, the character of LCHR influence on the processes of uterus contraction induction.

Conclusion: The changes of uterine hemodynamics is the main pathogenetic link in induction of uterus contraction at termination of late-term pregnancy. Doppler ultrasound parameters allow evaluating objectively the degree of elevation of the parameters of uterine circulation in LCHR, which can be regarded a reliable marker of this technique efficacy.

Key words: local cooling, Doppler ultrasound, pregnancy termination.

2005, vol 13, # 1, page 40

S.А. Amirazjan, М.М. Kohueva, М.E. Slabodchikov, V.О. Stepniy

Clinical x-ray characteristics and morphofunctional state of the heart in patients with sarcoidosis

Annotation

Objective: To generalize the experience of sarcoidosis diagnosis, to discuss the significance of modern methods for administration of the adequate therapy.

Material and Methods: The study involved 32 patients with stage 1 and 2 sarcoidosis. The diagnosis was made as to the changes of clinical x-ray signs and the finding of histology investigation.

The examination included inspection, radiography, computed tomography. The functional state of the cardiovascular system was studied with ECG and echocardiography using spectral Doppler ultrasound.

Results: Acute course of the disease was diagnosed in 2 patients (6.3%), subacute in 9 (28.7%), chronic in 21 (65%). Extrapul- monary manifestations were noted in 13 patients (41%), 3 suffered from stage 1 sarcoidosis, 10 stage 2.

According to heart ultrasound study, the parameters of left ventricle systolic function in patients with sarcoidosis did not differ from those in the controls. The parameters of left ventricle diastolic function demonstrated disturbances in relaxation processes in the myocardium and increased diastolic rigidity (p < 0.05).

Conclusion: Up to 40% of stage 1 and 2 sarcoidosis patients have extrapulmonary manifestations of the disease suggesting generalized pathological process. The frequency of diagnosis of various deviations in the cardiovascular system associated with a high risk of sudden death is high. Further study of the state of heart diastolic function in these patients is necessary for specifying the mecha­nisms of development and optimization of treatment schemes in chronic heart failure.

Key words: sarcoidosis, x-ray diagnosis, diastolic heart function.

2005, vol 13, # 1, page 47

I.M. Ponamorjov

The efficacy of multimodality treatment for breast cancer depending on the surgery volume in menopausal patients

Annotation

Objective: To study the effect of conservative treatment in menopausal patients.

Material and Methods: The study involved 79 patients with breast cancer, of them 40 underwent breast-preserving surgery and 39 Patey's mastectomy. Post-operative chemoradiation therapy was administered according to the standard protocols.

Results: Mean duration of relapse-free and metastasis-free periods differed significantly in the both groups only in T2N1M0 disease. In T1N0M0, 5-year relapse-free survival was 100% as well as relapse-free, metastasis-free and total survival in group 1. In group 2 these parameters were lower, 66.7 and 83.3% respectively. In T1N1M0 5-year relapse-free survival was 85.7 and 80.0% , relapse-free and metastasis-free 64.3 and 80.0%, general 85.7 and 90.0% in groups 1 and 2, respectively. In T2N0M0, general survival was similar in the both groups, i.e. 100% . Relapse-free, relapse-free and metastasis-free 5-year survival was 88.9 and 90.9% . In T2N1M0 relapse-free survival was 81.8 and 83.3% . Relapse-free and metastasis free 5-year survival was 72.7 and 66.7% , total 90.9 and 91.7% .

Conclusion: Irrespective of the volume of surgery, in patients with stage 1 and 2 breast cancer aged over 55, the tumor size (<5 cm), location of the tumor (excluding lower inner quadrant) do not influence considerably survival values. Relapses incidence is similar in groups of organ-preserving surgery and mastectomy. Survival values do not differ significantly between the groups of various volume of surgery.

Key words: breast cancer, organ-preserving surgery, menopause age.

2005, vol 13, # 1, page 53

D.S. Mechev, О.J. Stoljarova

Radiotherapy and peculiarities of immunological reactivity in uterine and cervical cancer

Annotation

Objective: To study the peculiarities of immunological reactivity in uterine and cervical cancer.

Material and Methods: The study involved 94 patients who were administered combination radiation therapy for the above cancer. The level of leukocytes, leukocyte blood count, neutrophil phagocytic activity, IgG, A, M amount, DR, CD3, CD4, CD8, CD22, CD95 expression as well as blood serum TNF-alf a and TGF-betaj levels were investigated before, immediately after the treatment as well as 3 and 6 months later.

Results: Before the treatment, the investigated group of the patients was characterized by the changes in a number of parameters of immunological reactivity (increased IgG, IgA, IgM serum concentrations, reduction of CD3+ and CD4+ amount, increased expression of CD95). The majority of changes were noticed immediately after the radiation therapy. Three and six month later the majority of immunological reactivity parameters did not differ from the respective values in the healthy group.

Conclusion: Investigation of immunological reactivity in patients with uterine and cervical cancer allows to choose adequate treatment for this group of patients and improve its efficacy.

Key words: uterine cancer, radiation therapy, immunological reactivity.

2005, vol 13, # 1, page 58

N.А. Mitrjaeva, L.V. Grebinik, N.E. Uzlenkova, N.О. Babenko, V.А. Gusakova, S.M. Pushkar

Influence of ionizing radiation and Taxotere pathway ceramide pathway on apoptosis activation in Guerin's carcinoma

Annotation

Objective: To study the influence of x-rays, taxol and their simultaneous action on the amount of sphingolipids (ceramide and sphingomyelin) in Guerin's carcinoma.

Material and Methods: The experimental model consisted of rats weighing 160-180 g with subcutaneously inoculated Guerin's carcinoma. The rats were transplanted 0.5 ml of 20% cell suspension from the tumor tissue. The experiment was started on day 10-12 after the inoculation when the size of the tumor was 2.0-2.5 cm. Local x-ray irradiation was delivered in fractions (5 Gy per fraction) with 24-hour intervals up to total dose of 10 Gy using RUM-17 unit. Taxotere was administered intraperitoneally at a dose of 5 mg/kg 24 hours before the exposure. Tissue homogenate was used for lipid extraction according to Folch. Ceramide and sphingomyelin were separated with chromatography in a thin layer of silicagel Woelm (Germany). Ceramide and sphingomyelin standards (Sigma) were used to identify the lipids. Quantitative lipid study was done according to March and Weinstein. Protein was isolated according to Lowry. Morphological evaluation was done using microtome longitudinal and transverse sections of the tumor. The statistical analysis was done using Student's t-test.

Results: It was established that local x-ray exposure did not change ceramide and sphingomyelin amount in the tumor tissue when compared with the controls. It is possible that Guerin's carcinoma is resistant to the used dose or irradiation. Taxotere administration increased ceramide amount in the tumor. Concomitant effect of irradiation and Taxotere on ceramide production increased the effect.

Conclusion: For the first time, influence of x-rays and Taxotere on ceramide and sphingomyelin amount in the tissue of Guerin's carcinoma was studied. Resistance of the carcinoma tissue to the used irradiation mode was revealed. Simultaneous administration of Taxotere and irradiation is a powerful stimulant of ceramide (tumor cell apoptosis inducer) accumulation in the tumor tissue.

Key words: Guerin's carcinoma, ceramide, sphingomyelin, taxol, x-ray exposure.

2005, vol 13, # 1, page 62

S.М. Kartashov, G.G. Uderbaeva, О.А. Beloded

Evaluation of treatment efficacy in cervical cancer depending on apoptosis parameters

Annotation

Objective: To evaluate remission duration in patients with cervical cancer (CC) depending on spontaneous apoptosis index and the tumor histology.

Material and Methods: The study involved 58 stage 1-3 CC patients (TlbNXMO—T3NXM0) in whom spontaneous apoptosis index in the tumor was studied depending the tumor histology, the process dissemination, and remission duration. All patients were administered radiation and chemotherapy. The number of cells with characteristic for apoptosis morphology was calculated with the use of fluorescent microscope.

Results: It was established that in patients with squamous cell carcinoma and those with adenoma of the uterine cervix, remission duration depended on spontaneous apoptosis index. In squamous cell structure, apoptosis index was significantly lower in patients with better treatment results. In patients with adenocarcinoma, reverse dependence was revealed: prognostically more favorable is the presence of larger number of apoptosis cells in the tumor.

Conclusion: Index of spontaneous apoptosis in the tumor of CC patients can be used as a prognostic criterion in the course of the disease with the account of the tumor histology. In patients with squamous cell cancer, lower apoptosis index in the tumor is a criterion of more favorable course of the disease.

Key words: cervical cancer, spontaneous apoptosis, remission duration, tumor histology.

2005, vol 13, # 1, page 66

N. A. Maznyk, V. A. Vinnikov

Retrospective cytogenetic biodosimetry using fluorescence in situ hybridisation (FISH) technique in persons exposed to radiation due to the Chornobyl accident

Annotation

Objective: To carry out cytogenetic biodosimetry of past and chronic radiation exposure to low doses using fluorescence in situ hybridization (FISH) technique in persons exposed due to the Chornobyl accident.

Material and Methods: Blood samples were collected 9.5-14.8 years after Chornobyl accident in 16 liquidators, 18 Ukrainian evacuees from 30 km exclusive zone, 21 Belorussian inhabitants of radioactively contaminated areas and 12 control donors age matched to exposed groups. Cytogenetic analysis was performed in 48 h lymphocyte cultures using FISH technique highlighting chromosome combinations 1, 2 and 4 and 6, 9, 15 and 21 and centromeres of all chromosomes. Unstable and stable chromosome type aberrations were recorded using a conventional-PAINT nomenclature. For biological dose assessment the overspontaneous yields of stable chromosome exchanges in cells with full presense of chromosomal material were calculated in exposed groups and referred to a linear term of calibration dose-response curve constructed in vitro.

Results: The average levels of dicentrics plus centric rings, acentric fragments and deleted chromosomes in all three Chornobyl groups didn not show a statistical difference with control values. The levels of complete translocations were significantly increased in liquidators and evacuees, and the total incomplete translocation yield was elevated above the control in all three exposed groups. Biological dosimetry based on stable chromosome exchange yield provided the dose estimations of 300 mGy in evacuees and 390 mGy in liquidators, that were in a good agreement with dose assessments obtained in these groups soon after irradiation with conventional analysis (360 and 460 mGy, respectively). The FISH survey of young adult inhabitants of contaminated areas allowed detecting the chronic exposure at average dose of 150 mGy.

Conclusion: The results of investigation showed a sufficient applicability of FISH analysis to cohortal biodosimetry of past and chronic radiation exposure to low doses.

Key words: biological dosimetry, lymphocytes, fluorescence in situ hybridization, translocations, Chornobyl accident, past and chronic radiation exposure to low doses.

2005, vol 13, # 1, page 73

L.P. Abramova, О.О. Bobiljova, L.І. Simonova

Long-term parameters of pro- and antioxidant hemostasis state in participants of Chornobyl accident clean-up

Annotation

Objective: To study pro- and antioxidant correlations in participants of Chornobyl accident clean-up 15 years after the accident with the account of increased peroxidation and functional tension of stress-limiting antioxidant systems, one of main mechanisms of cerebrovascular pathology development.

Material ans Methods: The study involved 348 men aged 36- 55 who at the age of 21-30 (group 1, 151 persons) and 31-40 (group 2, 197 persons) participated in Chornobyl accident clean-up in 1986-1987. The documented external exposure dose did not exceed 250 mGy.

The amount of lipid peroxidation (LP) products, i.e. diene conjugates, malonic dialdehyde, as well as activity of antioxidant ( АО ) enzymes, superoxide dismutase, catalase, and glutathione peroxidase, were studied in the blood plasma and erythrocytes.

Results: Fifteen years after the accident, disturbances of oxi- dant-peroxidant homeostasis were revealed in almost 47 % of the liquidators with cardiovascular pathology. The disturbances were more frequently observed in younger persons, which suggested pre-term aging of the organism. Several characteristic types of peroxide processes were revealed in the investigated individuals, this allowed distinguishing clusters of patients within each age group. Depending on the character of LP-AO system reactions, three clusters were distinguished in the group of younger liquidators and 2 in the group of older ones. Different tendencies to free-radical processes disturbances against a background of decreased activity of the АО systems, especially in weakened immunity, increase the probability of malignant cell transformation and may result in future development of oncological diseases.

Conclusion: Significant dysbalance of the studied systems observed in the liquidators as deactivation of АО enzyme link against a background of LP parameters changes suggests weakening of adaptation capabilities of the organism in these patients, which may not only complicate the existing cardiovascular pathology but also cause more considerable disturbances, tumor development in particular, in future.

Key words: participants of Chornobyl accident clean-up, lipid peroxidation, diene conjugates, malonic dialdehyde, antioxidant systems, superoxide dismutase, catalase, and glutathione peroxidase.

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