UJR 2008, vol XVI, # 4
THE CONTENTS
2008, vol 16, # 4, page 375
R.Yu. Churilin
The peculiarities of acute lung abscess x-ray picture in children
Annotation
Objective: To specify the prognostic criteria of possible development as well as x-ray sings of acute lung abscess in children and adolescents.
Material and Methods: Radiography findings in two projections and tomograms of 28 patients (78.6% boys and 21.4% girls) aged from several months to 17 years (chiefly patients aged 3, 85.7%) were analyzed. All patients underwent dynamic investigation.
Results: It was established that development of acute abscess was possible with large areas of inflammatory infiltration (10.7%) and large an intensive shadow in the centre of infiltration. Unilateral abscesses (100%), involvement of the right lung (78.6%) are typical for young patients. In children and adolescents multiple abscesses are rare (7.1%). Perifocal infiltration in all patients was poorly marked. Sequestrations in 14.3% of cases were massive and occupied 2/3 of the cavity. The abscesses measuring 4-6 cm (57.1%) were more typical, those > 6 cm were less frequent (28.6%). The most typical shape for this age is oval (57.1%). Thick walls (4 cm and more) were determined in 78.6%. Their internal and external outlines were distinct (78.6 and 64.3%). In half of the patients fluid level reached 1/3 of the cavity. Accompanying exudation pleurisy was determined in 14.3%.
Conclusion: The presented findings suggest the possibility to predict acute development of acute lung abscess in children and adolescents based on the data of x-ray investigation. Age-dependent peculiarities of abscess course were established. Their x-ray sings were specified.
Key words: x-ray diagnosis, lung abscess, children, adolescents.
2008, vol 16, # 4, page 380
I.M. Safonova, I.S. Lukjanova, R.J. Abdullaev, R.A. Safonov
Arterial hemodynamics of fetoplacental blood flow in the 3rd pregnancy trimester in women with renal inflammatory diseases
Annotation
Objective: To investigate the fetoplacental arterial hemo-dynamic parameters in pregnant women with renal inflammatory diseases (RID) in the 3rd pregnancy trimester.
Material and Methods: Complex Doppler investigation of arterial fetoplacental hemodynamics was performed in 120 pregnant women with RID and 40 healthy pregnant women (controls) in the 3rd pregnancy trimester. Mean values of fetoplacental arteries vascular resistance indices (VRI) and the frequency of revealing pathological hemodynamic spectrums were compared between the groups. The dependence of some obstetrics complications on the degree of uterine-placental hemodynamic malfunction was analyzed.
Results: The investigation demonstrated different mean values of arterial fetoplacental hemodynamic parameters as well as significant increase of the frequency of pathological spectra of the blood flow in the arteries of the FPC in pregnant with RID. Direct correlation between the degree of disorders of uterine-placental hemodynamics and incidence of several obstetric complications was determined.
Conclusion: In pregnant women with RID, VRI in the thoracic aorta of the fetus increases. Pronounced pathological hemodynamic spectra of the umbilical arteries are seen. The analysis of pregnancy and delivery complications in 83 women with increased VRI of the uterine arteries in the 3rd gestation trimester showed increased of preeclampsia incidence by 38% and pre-term delivery by 48% when compared with the women without uterine-placental hemodynamic disorders.
Key words: Doppler study, fetoplacental complex, vascular resistance indices, pregnancy, renal inflammatory diseases.
2008, vol 16, # 4, page 386
R.Y. Abdullaev, F.N. Gorleku
Ultrasound signs of liver cancer
Annotation
Objective: To determine the most significant ultrasound signs of hepatocellular liver cancer (HLC) using two-dimensional, colored, energetic and pulsed modes.
Material and Methods: Echograms of 47 patients (32 men and 15 women) aged 43-68 (mean age 51±6 years) with HLC were analyzed. CT was performed in 23 cases. Three echographic forms of HLC, i.e. nodular (39 patients - 83,0%), multiple (3 patients - 6.4 %), diffuse (5 patients - 10.8%) were distinguished.
Results: The most prevalent location of nodular primary HLC was its left lobe (38 cases - 80.9%) and paraaortic zone (12 cases - 25.3 %). The tumor was more frequently located in the parenchyma (45 cases - 95.7%) than in the subcapsular zone of the organ ( 2 cases - 4.3 %).
In 51,1% of cases HLC was presented by a solitary formation of mixed or increased echogenicity with a hyperchoic rim (p < 0.01). Multiple tumors occurred more seldom (p<0.001) and resembled liver metastases. Diffuse tumors looked like multiple polymorphous foci disseminated all over the liver. It had to be differentiated from cirrhosis of the liver.
Diffuse HLC was frequently characterized by deformity of the vascular bed of the liver arteries and intrahepatic branches of the portal vein and changes in the images due to local diminishing of the diameter resulting from compression with the tumor nodes.
Energetic Doppler investigation revealed disorders in the structure and location of small branches of the liver vessels and chaotic picture of the tumor vascular network.
Conclusion: HLC is frequently presented by nodular forms, main US signs consisting of uneven structure, mixed echogenicity, presence of a hypoechoic rim, location in the right liver lobe. Diffuse forms are characterized by alternation of disseminated hypo- and hyperechoic foci without distinct outlines with pronounced hypoechoic rim.
Key words: ultrasound diagnosis, hepatocellular liver cancer.
2008, vol 16, # 4, page 392
R.Y. Abdullaev, I.O. Oliynik, M.I. Spuzayk
Ultrasound signs of psoriatic arthritis
Annotation
Objective: To investigate ultrasound signs of psoriatic arthritis (PA) in its various stages.
Material and Methods: Ultrasound investigation (UI) was done in 28 patients with psoriasis (15 men and 13 women aged 19-68). Arthorsonography of the knee, ankle joints as well as those of the hands and feet was performed using Radmir Pro-30 unit according to the generally accepted technique.
Results: 89.3% of the patients had the involvement lasting for 5 years (p<0.001). Knee and hand joints were more frequently involved (53.6% and 28.6%, respectively). In 71.2% of cases the changes in the joints were first revealed by arthrosono-graphy. X-ray investigation did not demonstrate any changes in the joints. USI assessed the stage of the hyaline cartilage, joint capsule, periarticular soft tissue, presence of effusion, changes in the tendons. The study revealed 91 ultrasound signs in 73 investigated joints of the 28 patients.
Early-stage PA changes in the hyaline joint were registered in 41.8% of cases (local thickening and presence of hyperechoic inclusions measuring 0.4-1.3 mm). Indistinct outlines of the subchondral plate (30.8%) were observed in patients with light or medium degree of PA severity.
In 16.5% of observations arthrosonography of the knee joint revealed effusion in the patella bursa measuring 2 x 32 mm. In 2 cases effusion was registered in the posterior portion of the knee joint with formation of the so-called Backer’s cyst. Other US signs of PA of the hand were thickened tendons and their vaginas. Swelling of the paraarticular tissue was observed in 4 (4.4%) of the investigated patients.
Conclusion: The earliest changes are reveled in hyaline cartilage and subchondral zone. Ultrasound investigation has advantages over traditional x-ray examination when revealing early signs of PA.
Key words: ultrasonography, arthrosonography, psoriatic arthritis, knee joint, radiography.
2008, vol 16, # 4, page 397
O.P. Lukashova, O.M. Suhina, O.A. Nemalcova, I.M. Krugova, V.S. Suhin, L.V. Zabobonina
Ultrastructure of squamous-cell cervical cancer after chronomodulated radiochemotherapy
Annotation
Objective: To assess the efficacy of anti-tumor chemoradio-therapy in patients with stage II-III cervical cancer (CC) using the findings of ultrastructure analysis with consideration of the time of treatment.
Material and Methods: Sixteen patients with stage II-III CC were performed chemoradiation therapy using distance irradiation with ROCUS-AM unit and intracavitary irradiation with AGAT-B unit with preliminary synchronization of the tumor cell with 5-fluoriuracil (FF) in two groups of patients: group 1 - administration of 5-FU from 12 a.m. to 12 p.m., group 2 -from 6 p.m. to 6 a.m. 8 hours prior to the irradiation.
Total irradiation dose was 40 Gy, total FU-5 dose was 5 g. The tumor cell ultrastructure was investigated using standard methods of electron microscopy.
Results: Cancer cells the ultrastructure of which suggested preserved morphofunctional state were revealed after the irradiation in a number of cases. But if in intact tumor cells chiefly free ribosomes and polysomes are observed, dilated cisterns of uneven endoplasmic reticulum were present after treatment , which suggested the changes in the protein-synthesis processes. Complex chemoradiation therapy results in considerable reduction of the number of cases of tumor cell survival which suggested a high efficacy of the treatment. But the difference between the two schemes of chronotherapy were not revealed.
Conclusion: Chemoradiation treatment efficacy does not depend on the time of administration. In the both groups of therapy there are cases with preserved tumor cells retaining their viability which may cause disease relapses. The administered therapy causes the changes in the structural functional state of the tumor cells, in particular, switching of protein synthesis from protein substance production to satisfy the own needs to production for “export”.
Key words: cervical cancer, chronotherapy, cells ultrastructure.
2008, vol 16, # 4, page 403
A.V. Svinarenko, T.P. Yashmova
Comparison of pre-operative radiotherapy with modified chronomodulated radiation therapy for rectal cancer: morphology investigation
Annotation
Objective: To determine the character and peculiarities of therapeutic pathomorphism of respectable rectal cancer (RC) after intensive neoadjuvant chronoradiochemotherapy when compared with traditional radiation therapy (RT) at a similar mean focal dose.
Material and Methods: The comparative morphological investigation was performed on the specimens of patients with a respectable stage T1-3N0-1M0, RC as performed of the rectum removed after chronomodulated RT (36 patients, 5 x 5 Gy, irradiation within the period of 8 a.m. - 10 a.m. with a preliminary IV infusion of leukovorin at a dose of 20 mg/m2 and 5-fluorouracil 450 mg/m2 within the period of 0 a.m. - 4 a.m.) or RT 5 x 5 Gy without chemotherapy and consideration of the time of the day (35 patients). Morphology was done using light microscopy.
Results: It was established that complex treatment produced more pronounced effect on the tumor when compared with RT alone (5 x 5 Gy), which manifested by increase of apoptosis index (6.31±1.49 vs. 1.44±0.26, p< 0.05). At chronomodulated radiochemotherapy the volume of the regressing tumors was slightly larger than at traditional therapy, 53.00 vs. 45.50 %. The advantages of chronomodulated radiochemotherapy were especially marked at low differentiation of the tumor, 13.89 % of which demonstrated almost complete therapeutic resorption.
Conclusion: Application of 5-day chronomodulated radiochemotherapy results in more pronounced reduction of the tumor and its mitotic activity in respectable RC when compared with traditional RT at the same MFD, this is especially true for poorly differentiated adenocarcinomas.
Key words: rectal cancer pathomorphism, radiochemotherapy, chronomodulation.
2008, vol 16, # 4, page 409
N.A. Mitrayeva, T.S. Bakay, V.P. Starenkiy, N.O. Babenko, T.V. Segeda
Assessment of the influence of various anti-tumor drugs in combination with radiation therapy on apoptosis ceramide pathway induction in non-small-cell lung cancer
Annotation
Objective: To investigate the influence of combination of preoperative radiation therapy and anti-tumor drugs (Taxotere, Etoposid, Cisplatin) on the amount of sphingolipids, i.e. ceramide (CM) and sphingomyelin (SPM) in the tumor tissue of the patients with non-small-cell lung cancer (NSCLC).
Material and Methods: Sphingolipid amount (ceramide and sphingomyelin) in the tumor tissue (resection material) was determined using chromatography on a thin layer of silica gel on Sorbil plates in patients with NSCLC (stage II) who received pre-operative radiation therapy (5 Gy x 3 fractions) with radioiodine modification using anti-tumor drugs which were administered once before the irradiation (12 persons - Taxotere, 40 mg, 6 persons - Etoposid, 100 mg, 6 persons - Cisplatin, 50 mg).
Results: At Taxotere administration, CM level in the tumors increased 2.8 times, SPM did not change. Administration of Etoposid also induced considerable (2.1 times) increase of CM level against a background of preserved SPM level. The analysis of the results of chemoradiation therapy with Cisplatin revealed increase of CM amount in the tumor by 30% and reduction of CPM amount by 40%.
Conclusion: The reveled effects of Taxotere, Etoposid and Cispaltin on the amount of CM and CPM at pre-operative chemoradiation therapy are associated with different mechanisms of radiomodification action on induction of ceramide apoptosis pathway: at Cispaltin administration CM accumulated by way of CPM hydrolysis, at Taxotere and Etoposid administration as a result of de novo synthesis, Taxotere being the most powerful inducer of apoptosis ceramide pathway in the tumor in the patients with NSCLC.
Key words: non-small-cell lung cancer, radiation therapy, Taxotere, Etoposid, Cisplatin, ceramide, sphingomyelin, apoptosis.
2008, vol 16, # 4, page 413
N.A. Mitrayeva, T.S. Bakay, V.P. Starenkiy, N.O. Babenko, T.V. Segeda, V.I. Starikov
The influence of chemoradiation therapy with different anti-tumor drugs on apoptosis ceramide pathway induction in patients with non-small-cell lung cancer
Annotation
Objective: To study combined influence of pre-operative radiation therapy (RT) and anti-tumor drugs (Taxotere, Eto-posid) on the amount of sphingolipids - ceramide (CM) and its pre-cursor sphingomyelin (SPM) in the blood serum and tumor tissue of the patients with non-small-cell lung cancer (NSCLC).
Material and Methods: Sphingolipid (CM and SPM) amount in the blood serum and tumor tissue (resection specimens) was determined using chromatography in a thin layer of silica gel on Sorbfil plates in patients with stage IIB NSCLC who received pre-operative radiation therapy (5 Gy x 3 fractions) with radiomodification with anti-tumor medication (Taxotere - 12 patients, Etoposid - 6 patients). The controls were the patients with NSCLC (13 patients) who received only pre-operative RT.
Results: At Taxotere administration CM level in the tumor increased 2.8 times, while SPM amount did not change significantly. CM and SPM in the tumor changed similarly at Etoposid administration (CM level increased 2.1 times).
Conclusion: The study of the influence of anti-tumor medication (Taxotere and Etoposid) in combination with radiotherapy on the amount of sphingolipids (CM and SPM) in the tumor and blood serum of the patients with NSCLC reveled a stimulating influence of these drugs on apoptosis ceramide pathway, more pronounced effect was observed at Taxotere administration. Apoptosis in the tumor cells was morphologically proven.
Key words: Non-small-cell lung cancer, radiation therapy, Taxotere, Etoposid, ceramide, sphingomyelin, apoptosis.
2008, vol 16, # 4, page 417
N.O. Karpenko
The analysis of low dose exposure effect on laboratory male rat sexual function
Annotation
Objective: To investigate the influence of chronic low-dose internal or external irradiation on sexual behavior (SB) of male rats.
Material and Methods: In the first series, the animals were irradiated up to total dose of 250 or 750 mGy. SB was studied on days 1, 7, 30 and 48. In the second series, three groups of rats received the water from the well on Block 4 of Chornobyl Atomic Power Plant diluted to a definite 137Cs concentration. For 1.5 and 4 months of the experiment the absorbed dose (AD) was 73 and 150 mGy in group D1, 7 and 15 mGy in group D2, 2 and 4 mGy in group D3.
Results: Similar sexual dysfunctions were noted in the both series of the experiment: reduction of the percentage of males with a full-value sex act, increased latency and decreased frequency of sex reactions. At external exposure SB disorders were noted only at AD of 750 mGy on days 1-7. At chronic accumulation of the radionuclides, in 45 days SB disorders were similar at AD ranging from 2 to 73 mGy (reduction of the frequency of copulations, ejaculations, prolonged latency of all elements of SB, increased coefficient of attempt/ intromission). Four months following the exposure, sex function normalized only in rats with AD of 5 mGy, not 15 and 150 mGy.
Conclusion: The findings suggest the existence of a complicated dependence of development and preservation of male sexual function on the type and duration of the exposure and AD as well as higher biological efficacy of prolonged internal exposure vs. acute external one.
Key words: external ionizing irradiation, internal ionizing irradiation, low doses, male rats, sexual behavior.
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