UJR 2006, vol XIV, # 4
THE CONTENTS
2006, vol 14, # 4, page 419
R. Y. Abdullaev, V. V. Gapchenko, S. O. Ponomarenko
Ultrasound diagnosis of cervical spine intervertebral disks hernia
Annotation
Objective: To determine the capabilities of ultrasonography in diagnosis of cervical spine (CS) intervertebral disks (IVD) hernia.
Material and Methods: Forty-seven patients (35 men and 12 women) aged 27-48 (mean age 36 ± 5 years) with CS IVD hernia selected from a group of 356 patients with osteochondrosis underwent ultrasonography followed by radiography, computed tomo-grphy (CT) or MRI.
Results: At forming disk protrusion the pulpous nucleus shifts to the side of pathologically changed areas of fibrous ring (FR). At instability in the motor segment thickening and two-outlines of FR are observed. Its thinning and rupture (local hyperechoic signals within it) suggest the presence of hernia. Using ultrasonography IVD hernia was diagnosed in 42 patients (89.3%): C5-C6 in 21, C4-C5 in 12, C6-C7 in 8, CT revealed it in 43 patients (91.48 %): С5-С6 in 21,C4-C5 in 12,C6-C7 in 10 cases. 57.14 % (24 cases) were foraminal hernias, 27.65 % (24 cases) paramedial hernias, 10. 63 % (5 cases) median hernias. In 1 patient foraminal hernia of C4-C5 was diagnoses using only ultrasonography. The smallest sizes of the spinal canal were revealed in patients with medial hernias, the greatest narrowing of the radical canals was revealed in patients with paramedian and foraminal hernia. Their mean anteroposterior size was 3. 1 ± 0.4 mm .
Conclusion: The suggested technique allows to use a simple method of visualization, to assess its size and type of hernia protrusion as well as evaluate qualitatively and quantitatively the structure of cervical intervertebral disks, to determine the character of the blood flow in the spinal arteries with optimum results as a screening method in diagnosis of degenerative spine changes.
Due to its accessibility and safety for the patient ultrasonography allows not only to assess the presence and degree of the degenerative changes in the pulpous nucleus and disk FK but also allows to observe the process dynamically.
Key words: ultrasonography, intervertebral disk hernia, spine.
2006, vol 14, # 4, page 423
О. А. Mihanovskiy, О. V. Slobodynuk, L. D. Skripnik, І. М. Kugova, N. M. Shit, V. S. Suhin, O. V. Kazmiruk
Assessment of efficacy of combined treatment for uterus body cancer with and without preoperative distant radiation therapy
Annotation
Objective: To improve the efficacy of multimodality treatment for uterus body cancer (UBC) using radiomodification of preoperative radiation therapy (RT) with 5-fluorouracil (5-FU).
Material and Methods: The study involved 298 patients with UBC. Group 1 consisted of 21 patients treated using radiomodification of pre-operative RT with 5-FU, group 2 - 69 patients who were administered pre-operative RT without radiomodification. The controls were 208 patients who underwent surgery with preoperative RT.
Pre-operative DGT without radiomodification in UBC was delivered using РОКУС -M unit at a total focal dose (TFD) of 24-26 Gy. The dose of pre-operative irradiation in patients with radio-modification was 20 Gy to the pelvis region. 5-FU solution was administered IV 30 min before the irradiation at a dose of 250 mg (TD 2.5 g ). The patients with T1a-bN0M0 UBC were performed uterus and adnexa extirpation, those with T1c-3N0-1M0 - extended extirpation of these organs. After the surgery DGT up to TFD 40-46 Gy was delivered beginning from days 10- 14. In the patients of group 3 TFD of post-operative DGT to the small pelvis was 44-46 Gy. The removed organs were investigated morphologically.
Results: Complete destruction of the endometrium tumor was observed in 3 patients (14.3%) of group 1, which was not observed in group 2. Comparative analysis of 1-year efficacy of multimodality treatment demonstrated significant improvement of immediate results of treatment with modification of pre-operative DGT using 5-FU when compared with the patients who were treated without radiomodification.
Conclusion: Radiomodification of pre-operative RT with 5-FU significantly improves the immediate results of treatment in patients with UBC when compared with the patients treated using multimodality treatment without radiomofification.
Pre-operative RT without radiomodification is not expedient in patients with UBC.
Key words: uterine body cancer, pre-operative radiation therapy, radiomodification.
2006, vol 14, # 4, page 427
N. V. Goryainova, N. M. Tretyak, O. V. Mironova
Association of blood serum thymidine kinase and the disease relapse in patients with acute myeloblastic leukemia
Annotation
Objective: To determine how thymidine kinase (TK) level correlates with the duration of acute myeloblast leukemia (AML) and if it is possible to forecast relapse development based on blood serum TK parameters during the remission.
Material and Methods: The study involved 48 patients with AML during the remission and relapse of the disease. Blood serum TK was determined using radioimmune assay in Kyiv City Center for Radionuclide Diagnosis (Radiology Department of National Medical University).
Results: The investigated group consisted of the patients with M2, M4, M5 variants of AML according to FAB classification (14, 18, 16 cases, respectively). Mean remission duration until the moment of AML relapse diagnosis was 182 ± 4.5 days. TK values in the blood serum at AML relapse development ranged in various patients from 11.45 to 106.9 U/l but were not normal (0-6 U/l). When AML relapse was not diagnosed, mean TK level in patients during the remission did not differ statistically from normal reference parameters of the laboratory (3.1 ± 0.55 U/l) and was 5.11 ± 0.518 U/l. Though all clinical hematological parameters corresponded remission criteria, serum TK activity was considerably elevated (p<0.05) and averaged 15.807 ± 6.103 U/l in patients with AML relapse. The increased blood TK level during the remission can reflect the presence of minimal residual disease.
Conclusion: TK is a sensitive indicator of AML, predicts the relapse development and allows more objective assessment of the treatment outcome.
Key words: acute myeloblast leukemia, thymidine kinase, radioimmune assay, remission, relapse, prognosis.
2006, vol 14, # 4, page 432
N. E. Uzlenkova, E. M. Mamotuk, V. A. Gusakova, O. K. Kononenko
Biochemical and morphological changes in rat lung tissue under the influence of external ionizing radiation
Annotation
Objective: To study the dynamics and character of forming radiation induced biochemical and morphological changes in the connective tissue of the rats at short and long terms after single exposure to x-rays and gamma-radiation.
Material and Methods: The experiments were performed on 84 white male rats weighing 160- 180 g . Single total x-ray and gamma-radiation at minimum and mean lethal doses (2.0, 4.0, 6.2 Gy) were delivered to the animals using РУМ -17 and ГУТ - Со -400 М units in standard technical conditions. The investigation was done on days 3, 7, 14 as well as 1, 3, 6 months after the exposure. Age control in the conditions of a long experiment was used in each period of the study. The amount of total collagen and its fractions in the lungs of the rats was determined using biochemical methods. Histology and ultrastructure of the lung tissue was studied using standard unified techniques. Morphometry of fibrosis development in the rat lungs was done at long terms after the exposure. Spirmen coefficient of ranked correlation was calculated. The obtained findings were processes statistically using Biostatik v.4.03 for Windows.
Results: Single external x-ray exposure at minimum and mean lethal doses was established to cause a long activation of biochemical processes in the connective tissue of the rat lungs, which manifested in an early post-radiation period (days 3 - 14) by increase of type I soluble collagen level and in late period (3-6 months) by increase in total collagen and its insoluble fraction. Morphological and ultra-structure changes in the tissue of the lungs at early terms after x-ray and gamma-radiation exposure were due to development of destructive and degenerative reactions. The long-term changes were characterized by growth of connective tissue and formation of areas of fibrous changes in the structure of the lungs. Positive correlation of the changes in total collagen amount and morphometry indices of pneumofibrosis area in the lungs at long terms after the exposure was revealed.
Conclusion: Biochemical and morphological radiation-induced changes in the lung connective tissue show similar tendencies during the development, do not depend on the dose and type of radiation, and are determined by the time after the exposure.
Key words: external x-ray and gamma-radiation exposure, lungs, connective-tissue matrix, collagen, ultrastructure, histology.
2006, vol 14, # 4, page 439
T. P. Yakimova, S. M. Kartashov, T. V. Skricka
Tumor necrosis factor, apoptosis and clinical morphology of ovarian cancer
Annotation
Objective: To reveal the association between the dynamics of apoptosis, tumor necrosis factor (TNF-a) and progress of ovarian cancer (OC).
Material and Methods: Blood TNF-a and apoptosis index (AI) were investigated in 130 patients, of them 25 with serous cystadenoma of the ovary, the rest 105 with stage II-IV OC (T2a-3cN0-1M0-1). Blood serum TNF-a was determined using an immunoenzyme method. The number of the cells with characteristic apoptosis morphology (nuclear condensation and DNA degradation) was calculated using a fluorescent microscope. The finding was expressed as percentage the cells (of 100 investigated) with the signs of apoptosis, which corresponded to AI.
Results: Apoptosis activity increased with malignization of serous tumors and dissemination of the process up to stage III. When the tumor process exited the abdominal cavity and fluid accumulated in the serous cavities, this inhibited apoptosis activity. Blood TNF-a concentration in patients with OC increased constantly and significantly with malignization of serous benign tumors together with the disease dissemination and increase of the tumor mass. Generalization of OC outside the small pelvis and abdominal cavity with ascites and pleurisy development was accompanied by increase in the cytokine (TNF-a) concentration when compared with the respective concentration in patients without ascites. Increase in the tumor tissue mass on transition from cystic to cystic-solid and solid OC wass accompanied by increase in blood cytokine amount, which could suggest TNF-a participation in OC progress.
Conclusion: Apoptosis plays an insignificant role in the tumor regression and involution including those induced by chemotherapy. A considerable role in the tumor process is played by TNF-a, more pronounced at progress than at regression of the tumor.
Key words: ovarian cancer, morphology, tumor necrosis factor, apoptosis index.
2006, vol 14, # 4, page 444
E. I. Legach
The efficacy of thyroid gland and testes combined transplantation in experimental hypothyrosis
Annotation
Objective: To study the influence of thyroid gland (TG) and testicles (T) organotypic culture combined transplantation on thyroxin level as well as the indices of carbohydrate, protein, lipid metabolism in rats with experimental post-operative hypothyrosis.
Material and Methods: The study involved 70 male rats weighing 150- 200 g , which underwent thyroidectomy followed by transplantation of organotypic TG culture separately or in combination with organotypic T culture. The transplantation was performed under the capsule of the left kidney. To assess the transplant function the kidney was removed on day 120. On day 127 the animals were euthanized. Blood serum thyroxin, cholesterol, albumin, glucose level after carbohydrate load were determined.
Results: Thyroxin level increase (up to 70% of the control parameters) was shown in the blood plasma of rats with experimental hypothyrosis on day 120 after xenotransplantation of organotypic TG culture separately or in combination with organotypic T culture. This effect was not due to regeneration of the proper TG, which was demonstrated at sharp reduction of thyroxin amount after removal of the kidney with the transplant.
Conclusion: Combined transplantation of organotypic TG culture with organotypic T culture elevates blood thyroxin level in rats with post-operative hypothyrosis. Organotypic T culture transplanted in combination not only promotes immune protection but also provides organotypic TG culture functional activity restoration after cryopreservation.
Key words: combined transplantation, thyroid gland, Sertoli cells, testicles.
2006, vol 14, # 4, page 450
L. G. Rozenfeld, E. F. Venger, T. V. Loboda, A. V. Samohin, M. M. Kolotilov, O. G. Kolluh, V. I. Dunaevskiy, V. O. Kravchenko
Remote infra-red thermograph with a matrix photoreceiver and the experience of its clinical application
Annotation
Objective: To study the possibility of application of an infra-red thermograph with a matrix photoreceiver.
Material and Methods: The study was carried out with the use of a remote infra-red thermograph with matrix photoreceiver developed by Institute of Physics of Semiconductors named abter Loshkarev of National Academy of Sciences of Ukraine (NASU), Institute of Monocrystals of NASU and firm “Electron - Optronic” of Russia. The study was carried out in a thermography unit equipped according to the requirements. 125 patients were examined.
Results: The thermograph capabilities are shown on the example of visualization of a chronic venous insufficiency of legs, sensation of pain in the back, breast fibroadenomatosis, pneumonia, metastatic lesions of the liver, distant hypothermia syndrome.
Conclusion: The new thermograph with a matrix photoreceiver has high sensitivity which provides essentially new level and quality of detailed thermography of the skin.
The capability to visualize skin thermography of with temperature gradient (0.07- 0.1 °C ) requirs reconsideration of classical thermosemiotic and significant expansion of diagnostic criteria.
Key words: thermography, matrix photoreceiver, temperature gradient.
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