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UJR 2008, vol XVI, # 1

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2008, vol 16, # 1, page 11

R.Y. Churilin, I.O. Kramniy

Prognostic x-ray criteria of acute lung abscess course

Annotation

Objective: To work out prognostic criteria of acute lung abscess course based on x-ray findings.

Material and Methods: The findings of primary and follow-up investigations (radiography in frontal and auxiliary projections and tomography) of 57 patients (35 adults and 22 children) aged from several months to 62 years were investigated.

Results: X-ray examination allows to predict the course of acute abscess based on the study of the infiltration size, intensity, presence and absence of sequestration, the amount of fluid in the abscess cavity and the rate of its discharge, thickness and unevenness of the wall, the number of abscesses and their size. An essential prognostic criterion is the state of peripheral infiltration, the age of the patients, presence of accompanying diseases especially chronic obstructive, (including chronic bronchitis), diseases of the heart, kidneys, pleural adhesions (especially pneumofibrosis). Significance of dynamic x-ray investigation in prognosis of the disease course is emphasized. Based on the obtained findings an algorithm of radiodiagnosis of the patients with suspected purulent destructive diseases of the lungs was worked out.

Conclusion: Thorough study of the findings obtained during x-ray investigation and tomography of the lungs allows the prognosis of the disease course and working out an optimal treatment protocol to prevent possible complications.

Key words: abscess, x-ray investigation, prognostic criteria of the course.

2008, vol 16, # 1, page 16

I.O. Vorongev

Radiometric assessment of aspiration syndrome severity in newborns with perinatal CNS lesions

Annotation

Objective: To assess objectively aspiration syndrome (AS) severity in newborns with perinatal CNS lesions using radiography findings.

Material and Methods: Chest x-ray films of 87 children (49 boys and 38 girls) with the signs of AS who were treated for hypoxic ischemic and traumatic CNS lesions, aspiration syndrome and pneumonia were included in the study. To verify the diagnosis the patients were performed ultrasonography of the brain and heart, radiography of the skull and cervical spine as well as complete clinical laboratory investigation. 12.6% of the children were performed MRI of the brain and spinal cord.

Results: The performed investigation demonstrated the presence of grade 1 (light) of AS severity in 48.3% of the children which manifested by presence of focal shadows in the mediosuperior portion, location of the diaphragm cupola at the level of the 6-7th ribs, cardiothoracic index = 55-57%. Grade 2 (medium) of AS severity was diagnosed in 37.9 % of the patients; it manifested by focal shadows in the medial portions of the lungs, displacement of the right diaphragm cupola to the 7-8th rib increased cardiothoracic index (CTI) up to 58-60 %. Grade 3 (severe) of AS severity was revealed in 13.8 % of newborns; it manifested by presence of focal shadows all over the lungs, dislocation of the diaphragm cupola beneath the 8th rib, increased cardiothoracic index up to 61 % and more. In 81.6 % of patients AS was complicated with development of focal and focal-confluent pneumonia, in 18.4 % - segment pneumonia. In 39.1 % of cases AS was complicated by atelectases.

Conclusion: Radiography is a leading method allowing to reveal the changes in the chest organs in patients with AS and determine the degree of its severity. The suggested method is objective and informative, is based on radiometric parameters, does not require additional radiation exposure, and allows controlling the treatment efficacy.

Key words: aspiration syndrome, newborns, chest organ radiography, perinatal CNS lesions.

2008, vol 16, # 1, page 20

N.O. Maznik, V.A. Vinnikov, O.E. Irha, O.M. Suhina, O.A. Mihanovskiy, I.M. Krugova

The changes of general cytogenetic findings in patients with uterine body cancer within 12-24 months following radiotherapy

Annotation

Objective: To compare cytogenetic findings in 50-hour lymphocyte cultures in patients with uterine body cancer (UBC) within 12-24 months following radiation therapy (RT) with the cytogenetic effects in the same group of patients investigated before the treatment and at early terms after the irradiation.

Material and Methods: The study involved 25 patients who were administered RT for UBC (distance or combination of intracavitary and distance gamma-therapy). The traditional cytogenetic analysis with detection of chromosomal aberrations and genome disturbances in meta-phases of 50-hour lymphocyte cultures was performed before and 1-2 days, 2, 6, 12-24 months after RT.

Results: The general picture of cytogenetic effects in the patients by the end of RT was characterize by considerable increase of chromosomal aberration level and moderate increase of chromatide aberration level, non-aberrant and aberrant polyploids when compared with the findings before the treatment. Investigation of the findings before the term of 12-24 months revealed that in spite of considerable elimination of chromosomal type aberrations their total frequency (12 %) and level of separate aberrations in particular unstable chromosomal exchanges (5.5 %) considerably exceeded the control findings. The frequency of chromatide type aberrations by the end of the term reduced to the spontaneous level. Against a background of stable moderate frequency of non-aberrant polyploids, the level of aberrant polyploids, in spite of the reduction, considerably exceeded the control findings.

Conclusion: The increased level of aberrant lymphocytes and chromosomal and chromatide aberrations, genome disturbances observed in the patients by the end of radiation therapy decreased with the time, though the level of radiation-induced aberrations and aberrant polyploids within 12-24 months considerably exceeded the spontaneous level. The rate and character of elimination were different for various types of chromosome damage, which suggests the necessity to continue cytogenetic monitoring with simultaneous investigation of the mechanisms of long-term and mediated genetic effects of radiation therapy.

Key words: chromosomal aberration, genome disturbances, lymphocyte culture, radiation therapy, uterine body cancer.

2008, vol 16, # 1, page 27

N.A. Mitriaeva, T.S. Bakay, I.O. Babenko, T.V. Segeda, N.E. Uzlenkova

The influence of ionized radiation and chemotherapy drugs (etoposide, Taxotere, cisplatin) on ceramide pathway of apoptosis in Guerin’s carcinoma

Annotation

Objective: To investigate the influence of ionizing radiation, Taxotere, etoposide, cisplatin as well as combination radiotherapy and x-ray exposure on the amount of sphingolipids (ceramine and sphingomyelin) in the tissue of Guerin’s carcinoma and blood serum of the rats with tumors.

Material and Methods: Wistar rats weighing 160-180 g with subcutaneously inoculated Guerin’s carcinoma were used as an experimental model. Local x-ray irradiation of the zone of the tumor growth was delivered in fractions (5 Gy per fraction) with 24-hour intervals (total dose on the tumor zone -10 Gy) using RUM-17 unit. Antitumor medication was administered intraperitoneally 24 hours before the first exposure in the following doses: cisplatin (Ebewe) - 6 mg/kg of the body mass; Taxotere (Rhone Poulenc Rorer) - 8 mg/kg of the body mass; etoposide (Ebewe) - 5 mg/kg of the body mass. The animals were decapitated 24 hours after the last exposure. Tissue homogenate was used for lipid extraction according to Folch. Ceramide and sphingomyelin were separated by means of chromatography in a thin layer of silica gel on Sorbfil plates (JSS Sorbpolimer, Russia). To identify the lipids, standards of ceramide and sphingomyelin (Sigma) were used. Protein in the tissue homogenate was detected according to Lowry. Statistical analysis was performed using Student’s t-test.

Results: It was established that the most potent modulator of sphsngolipid metabolism in the tissue of Guerin’s carcinoma are Taxotere and etoposide. They increase the amount of pro-apoptosis sphingolipid (ceramide) in the tumor chiefly by means of activation of its synthesis de novo, while cyspaltin stimulates accumulation of ceramide in the tumor cells by activation of phingomyelin cycle. It was shown that at combination of chemo- and radiotherapy ceramide accumulation plays an essential role in apoptosis induction and increase of the tumor cell radiosensitivity, which is important to overcome the tumor resistance to chemoradiation treatment.

Conclusion: Different mechanisms of ceramide accumulation in Guerin’s carcinoma at combination of ionized radiation with antitumor medication were revealed. X-rays in combination with Taxotere or etoposide stimulates ceramide synthesis de novo. Its combination with cispaltin results in accumulation of ceramide due to degradation of sphingomyelin.

Key words: Guerin’s carcinoma, apoptosis, ceramide, sphingomyelin, cisplatin, Taxotere, etoposide, ionized radiation.

2008, vol 16, # 1, page 32

A.V. Svinarenko, E.B. Radishevskay

Chronomodulated   radiochemotherapy for inoperable rectal cancer in combination with Hydrea: findings of 3-year observation

Annotation

Objective: To assess the efficacy of chronomodulated radiation therapy (RT) with chemoradiomodification using Hydrea in patients with inoperable rectal cancer (RC).

Material and Methods: The study involved the patients with inoperable T3-4N M0 RC, in whom surgical treatment or PCT were contraindicated, who were divided into two groups. The main group comprised 37 patients (15 men and 22 women) aged 48-86 (mean age 69) who were administered chronomodulated RT and chemoradiomodification with Hydrea (25 ґ 2 Gy + Hydr): RT to the small pelvis in classic fractions (SFD 2 Gy 5 times/week, MFD 50 Gy) in chronomodulated mode (treatment within a period of 8 a.m. - 10 a.m.) with chemoradiomodification with Hydrea at a single daily dose of 20 mg/kg during the whole course of RT on the days of irradiation. The controls were 47 patients aged 36-83 (mean 65) who were administered RT in a classical mode (25 ґ 2 Gy) up to MFD 50 Gy not considering the time of the day.

Results: Chronomodulated RT with chemoradiomodification with Hydrea did not improve immediate tumor response when compared with the traditional treatment: complete clinical regression in 3 (8.1 %) vs. 2 (4.2 %), partial regression in 21 (56.7 %) vs. 26 (55.3 %), stabilization in 8 (21.6 %) vs. 15 (31.9 %), tumor progression against a background of treatment in 5 (13.5 %) vs. 5 (10.6 %) cases. As to the tumor response to the treatment, the intergroup difference was not significant. Mean time to local progress in the group 25 x 2 Gy + Hydr increased from 12 to 17 months when compared with the traditional RT (p = 0.039). Significant difference in total survival 21 vs. 20.5 months) and duration of the metastasis-free period (21 vs. 19 months) was not detected.

 

Conclusion: Chronomodulated RT with classic fractions up to MFD 50 Gy with chemoradiomodification using Hydrea before the 1st-25th treatments contributes improvement of relapse-free survival in inoperable patients with RC in whom surgery or active systemic chemotherapy are contraindicated. The use of the above protocol increased mean time before the local disease progress from 12 to 17 months (p = 0.039). The described method did not increase total survival and the period before late metastases development.

Key words: rectal cancer, radiation therapy, Hydrea, chronomodulated.

2008, vol 16, # 1, page 37

L.I. Simonova, L.V. Bilogurova, V.Z. Gertman, S.M. Pushkar

Possibility to correct coagulation state in patients with breast cancer during chemotherapy with Taxotere accompanied by a complex of natural remedies

Annotation

Objective: To assess the influence of a complex of biological additives Bipolan and Karinat on the state of coagulation in homeostasis system of the patients with local IIB - IIB breast cancer (BC) during chemoradiation therapy with Taxotere.

Material and Methods: The parameters of coagulation homeostasis and fibrinolysis were investigated using electro-coagulography and biochemical methods in 10 patients aged 30-65 with IIB-IIB BC. The course of chemoradiation therapy included Taxotere at a daily dose of 20 mg 24 hours before irradiation. Ten patients were administered accompanying therapy consisting of a complex of natural biological additives Bipolan and Karinat possessing antioxidant and antithrombogenic properties.

Results: Pronounced disturbances of coagulation homeostasis in the form of hypercoagulation, fibrinolysis inhibition, DVC syndrome were observed in patients with IIB-IIIB BC. A course of radiation therapy with Taxotere alleviated the severity of the above disorders. Administration of biological additives Bipolan and Karinat positively influenced on the state of coagulation homeostasis. At the end of the course of treatment, the parameters of homeostasis normalized with elimination of the signs suggesting DVS syndrome and development of thromboembolic complications in the patients who were administered the antioxidant complex.

Conclusion: Serious disorders in coagulation system (pathological imbalance of coagulation and fibrinolytic links of homeostasis, namely increase of coagulation potential of the blood against a background of reduced fibrinolytic activity with the signs with DVC syndrome) are characteristic for the patients with IIB-IIIB BC. Chemoradiation therapy with Taxotere does not improve the state of homeostasis system in patients with BC.

The use of Bipolan and Karinat as accompanying therapy at radiotherapy of BC positively influences the state of coagulation system, considerably reduces thrombocyte potential of the blood, restores fibrinolysis as well as considerably reduces manifestations of DVC syndrome. Positive effect of the complex of natural remedies with antioxidant and antithrombogenic activity allows to recommend including them in the complex of antitumor treatment.

Key words: breast cancer, coagulation homeostasis, hypercoagulation, DVC syndrome, bioantioxidant complex.

2008, vol 16, # 1, page 42

E.M. Mamotuk, V.A. Gusakova, V.G. Kravchenko, O.V. Nenukova

Experimental assessment of Tabari Noni juice antiradiation effect (preliminary results). Communication II

Annotation

Objective: To assess preventive and therapeutic influence of 100% juice Tabari Noni in two doses on the clinical course of acute radiation sickness.

Material and Methods: The study was performed on 56 white Wistar rats weighing 160-190 g which received orally Tabari Noni juice in a daily dose of 2.5 ml/kg and 5.0 ml/kg of the body weight (5 days before and 10 days after x-ray exposure in standard conditions at a dose of 6.0 Gy).

Results: Administration of the juice in the above dose improved the course of radiation sickness and significantly reduced the death rate in the animals, which was more pronounced at the lower dose of the medication (2.5 ml/kg).

Conclusion: The findings of the research suggest that 100% Tabari Noni juice can be a promising antiradiation remedy.

Key words: Tabari Noni juice, radiation sickness.

2008, vol 16, # 1, page 46

N.E. Uzlenkova

Peculiarities of collagen changes in the organs of rats at single x-ray exposure

Annotation

Objective: To investigate the peculiarities of collagen changes in the lungs and skin of the rats due to single x-ray external irradiation at a minimum and medium lethal doses.

Material and Methods: The experiments were performed on 178 white male rats weighing 160-180 g. The animals were exposed to single total x-ray irradiation using RUM-17 unit under standard conditions. The doses absorbed by soft tissues were 4.0 and 6.2 Gy. Quantitative changes in the collagen in the rat organs were assessed according to the amount of total collagen and collagen of separate fractions in reaction of hydroxyploline oxidation with chloramine-T. Collagenolityc activity as well as free and bound with collagen-like blood protein blood hydroxyplroline were investigated. Collagen hydrolysis rate was estimated according to hydroxyproline level in 2-hour hydrolisates of the tissue at direct acid hydrolysis with hydrochloric acid in molar concentration of 6 mol/ l.The study was performed on days 3, 7, 14 and 1, 3, 6 months after the exposure. Age-matched controls were taken for each term of the study. Statistical processing of the obtained findings was done using Biostatics v.4.03 for Windows.

Results: It was established that the changes of collagen in the organs of rats caused by single external x-ray exposure at a dose of 4.0 and 6.2 Gy in early terms (day 3 - 7) were characterized by disorders in the ratio of several fractions of soluble collagen depending on the type of tissue an as well as 1.7-fold increase of collagen I fractions in the lungs and 1.4-fold increase of collagen II amount in the skin. The revealed changes did not depend on the dose and were accompanied by 2-fold increase of CLA amount with 2.5-fold and 1.8-fold elevation of free and protein-bound hydroxyproline in the blood. In late terms (3-6 month) after the exposure 1.2-fold increase of total collagen amount in the lungs and 1.4-fold increase of its amount in the skin with stable accumulation of insoluble collagen in the both organs were established.

Conclusion: Single external x-ray exposure to minimal lethal and mean lethal doses causes prolonged elevation of collagen metabolism intensity and regular changes of its content in the organs of rats, which do not depend on the dose in character and tendency, but depend on the type of the tissue and time after the exposure.

Key words: external x-ray exposure, lungs, skin, connective-tissue matrix, collagen.

 

2008, vol 16, # 1, page 54

O.V. Kuzmenko, N.A. Nikiforova, I.A. Gromakova, M.O. Ivanenko

Leucopoiesis state in rats with various individual reactivity depending on the time of irradiation

Annotation

Objective: To investigate leucopoiesis restoration with the consideration of hemopoiesis circadian rhythms in rats with various individual reactivity exposed to a single total dose of 4 Gy.

Material and Methods: The experiment was performed on 48 Wistar male rats. Two weeks prior to the exposure the animals survived immobilization stress in a prone position. They were divided into hypo- and hyperreactive ones according to the percentage of lymphocytes and neutrophils in the peripheral blood. The rats were exposed to a single total dose of 4 Gy at 8 a.m. and 8 p.m. To determine the characteristics of nucleus-containing cell circadian rhythms in the peripheral blood the investigation was performed with 6-hour intervals (at 12 p.m., 6 a.m., 12 a.m., 6 p.m.). The changes in leucopoiesis restoration were investigated on day 3, 7, 14, 21, 30 after the exposure.

Results: It was established that irrespective of the time when the animals were exposed to x-rays at a dose of 4 Gy, both hypo-and hyperreactive animals did not demonstrate complete restoration of the total number of leucocytes, relative amount of lymphocytes and neutrophils up to the end of the observation (day 30). Beginning from day 3 the changes in restoration of the white blood quantitative parameters in response to the irradiation at 8 p.m. significantly differed in intensity in hypo- and hyperreactive animals.

Conclusion: Minimal damage of the radiation to the lymphopoiesis and more rapid restoration of circadian characteristics of hematologic parameters (the number of leukocytes, lymphocytes and neutrophils) were revealed in hyporeactive animals irradiated at 8 p.m. when compared with hyperreactive and hyporeactive ones irradiated at 8 a.m. Higher survival of hyporeactive animals vs. hyperreactive ones was established.

Key words: ionizing radiation, circadian rhythms, radio-sensitivity, immobilization stress, leucopoiesis.

2008, vol 16, # 1, page 61

V.G. Knigavko, M.A. Bondarenko, N.S. Ponomarenko, E.B. Radzishevskay

Mathematical simulation of oxygen diffusion and consumption in a flat malignant tumor

Annotation

Objective: To investigate oxygen distribution in a malignant tumor of a flat shape using mathematical simulation of oxygen diffusion in the tumor and its consumption by the tumor cells.

Material and Methods: Available in the literature experimental data about dependence of the rate of oxygen consumption by the cells from its concentration were used. Methods of mathematical simulation were applied.

Results: Mathematical models of oxygen diffusion and consumption in a malignant tumor, normoxic and hypoxic initially, were worked out. Dependence of oxygen concentration in the tumor from the coordinate was obtained.

Conclusion: Distribution of oxygen concentration in different levels of a tumor of a flat-layer shape was determined using mathematical simulation.The obtained findings can be used to estimate radiosensitivity and cell division rate in the layers of the tumor with different oxygenation.

Key words: malignant tumor, mathematical simulation, diffusion, oxygen consumption by the cells.

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