UJR 2009, vol XVII, # 1
THE CONTENTS
2009, vol 17, # 1, page 13
M.I. Spuzjak, I.O. Oleynik
X-ray changes in the bones and joints in arthropathic psoriasis
Annotation
Objective: To study the peculiarities of manifestations of lesions in the osseo-articular apparatus in psoriasis.
Material and Methods: Dynamic x-ray investigation was performed in 136 patients aged 16-64 (85 men and 51 women) at Institute for Dermatology and Venereology (Academy of Medical Sciences of Ukraine). X-ray investigation was done when pain syndrome was present. It included radiography of the spine, hands, feet, pelvis, hip, knee, ankle, radiocarpal, metatarsal and sometimes shoulder and elbow joints.
Results: Isolated inflammatory signs of the bone and joint lesions were revealed in 29 (21.3%) patients with arthropathic psoriasis, those of isolated degenerative dystrophic lesions in 14 (10.3%) patients, combined (inflammatory and degenera-tive-dystrophic lesions) in 93 (68.4%) patients, that is in the majority of cases they were combined. Thus, bone and joint lesions are characterized by their peculiar signs (multiple joint involvement, location in the joints of the hands and feet as well as hip joints, combination of inflammatory and degenerative-dystrophic changes).
Conclusion: Osseoarticular psoriasis (arthropathic) manifests in three forms of the disease: inflammatory (psoriatic arthritis), degenerative-dystrophic (psoriatic arthrosis, psoriatic osteoarthropathy) and combined. Determining the disease and x-ray signs of the bone and joint lesions in psoriasis can promote adequate therapy as well as is important in patient’s performance expertise.
Key words: arthropathic psoriasis, x-ray diagnosis.
2009, vol 17, # 1, page 18
O.Yu. Chuvashova
Pre-operative mapping of brain cortex sensomotor zone with functional MRI at intracerebral tumors
Annotation
Objective: Methodological work-out of pre-operative mapping of motor zones of the brain (B) cortex and creation of activation maps of sensomotor cortex in patients with glial tumors of B hemispheres.
Material and Methods: MRI and functional MRI (fMRI) were performed using 1.5T magnetic resonance tomograph Magnetron Vision plus (Siemens, Germany). The study involved 7 patients (5 men and 2 women) with grade II-IV gliomas verified histologically.
Results: Block model of investigation was used when performing fMRI. To obtain activation maps, statistical analysis of fMRI findings and their co-registration with high resolution anatomical tomograms followed by construction of a 3D model were performed.
Conclusion: fMRI with the use of block model allows to investigate sensomotor (motor) function of the brain cortex and determine activation zones of functionally significant areas in patients with gliomas of B hemispheres. To obtain highquality activation maps at fMRI it is necessary to perform statistical analysis of preliminary data consisting in data subtraction, general linear model, integration of anatomical and functional data. Co-registering of fMRI maps with high quality anatomical images and their visualization on the reconstructed outlines of the B cortex are necessary for accurate localization of activation zones and pre-operative mapping of the patient’s brain.
Key words: functional MRI, gliomas, motor zones of the brain cortex, mapping.
2009, vol 17, # 1, page 25
R.Ya. Abdullaev, V.I. Starikov
Ultrasound differential diagnosis of capillary hemangioma and liver metastases
Annotation
Objective: To determine the most significant differential diagnosis ultrasonography criteria of capillary hemangioma and hyperechoic metastases to the liver.
Material and Methods: Retrospective analysis of the findings of ultrasound investigation of 39 patients with capillary heman-gioama and 22 patients with liver metastases with the nodes measuring < 30 mm (29 men and 32 women aged 43-68, mean age 51 ± 4, was performed.
Results: Capillary hemangiomas measuring < 20 mm were present in 58.9% of cases, liver metastases in 27.3 % (p<0.01). Subcapsular location of hemangiomas was noted in 71.8% of cases, that of metastases in 77.3 % of cases (p<0.05). Even and distinct outlines were more frequent in hemangiomas than in metastases (p<0.05).
Hypoechoic outline was more frequent in metastases than in hemangioma, while network structure was less frequent (p<0.001). Solitary foci of hemangiomas were noted in 74.3% of cases, liver metastases - 31.8% (p<0.001). 2-4 metastases were present in 36.4% of cases, hemangiomas - in 18.2%, over 4 were present in 31.8% and 10.3%, respectively (p<0.05). Weak dorsal pseudo-increase was registered in 43.6% of hemangioma cases and 22.7% of liver metastases (p<0.05). Energetic Doppler investigation revealed that minimal circulation was significantly more frequent (p<0.05) in metastases than in hemangiomas (20.5% vs 4.5%).
On primary examination, sensitivity of USI was 85.3 и 82.4 %, specificity 60.0 и 40.0 %; accuracy 82.1 и 72.7 % at differentiation of capillary hemangioma and hyperechoic metastases. Dynamic observation for 3 months increased USI sensitivity in diagnosis of capillary hemangioma up to 97.4 %, metastases - 94.7%, specificity 100.0 and 50.0%, accuracy 97.4 and 90.5%.
Conclusion: Sensitivity of primary US differentiation of capillary hemangioma and hyperechoic liver metastases measuring < 30 mm is 85.3 and 82.4%, specificity - 60.0 and 40.0%, accuracy 82.1 and 72.7%. Sensitivity of repeated USI 3 months later is 97.4 и 94.7 %; specificity - 100.0 и 50.0 %; accuracy - 97.4 и 90.5 %.
Key words: ultrasound diagnosis, capillary liver hemangioma, liver metastases.
2009, vol 17, # 1, page 29
E.B. Radzishevskay, L.Ya. Vasilyev, Ya.E. Vikman, O.O. Solodovnikova
Statistical analysis of some aspects of the course and consequences of uterine body cancer using case history data
Annotation
Objective: To assess the course and consequences of uterine body cancer (UBC) using case history data and modern computer technologies.
Material and Methods: Patients with stage M0 UBC (482 persons) who were treated at the hospital of Grigoriev Institute for Medical Radiology during the period of 1980-2003. The information was analyzed using the methods of nonparametric statistics and survival analysis.
Results: The assertion that absence of delivery, presence of cardiovascular diseases and late menarche are risk factors of UBC was refuted. It was shown that radiation therapy did not influence considerably the fact of development of remote metastases. The most significant factor of remote metastases development is the stage but in situ stage does not guarantee absence of remote metastases. The peak of metastases development is registered within the period 5 -12 years following surgery.
Conclusion: The use of modern computer methods of mathematical data processing allows to obtain additional information from traditional databases, in particular, about the course of the disease in the case histories. The information about some risk factors of UBC was checked in the literature. The problem of determining risk factors of remote metastases was analyzed. Time peaks of their development were assessed.
Key words: uterine body cancer, risk factors, remote metastases, methods of mathematical assessment.
2009, vol 17, # 1, page 35
O.M. Tarasova
Comparison of methods of cancer treatment prom the perspective of harmful effects degree
Annotation
Objective: To determine the capability of different systems for harmful effect registering to promote significance of comparison of various cancer therapy techniques from the perspective of the effect severity.
Material and Methods: The study involved 74 patients with breast cancer (BC) divided into 2 groups: group 1, controls, 34 patients, group 2, study group, 40 patients. All the patients were administered the treatment according to the generally accepted protocols. The patients form group 2 were additionally administered alginates. The treatment influence of the state of hemopoiesis and hepatocytes as well as toxicity reduction due to alginate administration were investigated by means of determining the amount of hemoglobin, thrombocytes, leukocytes, bilirubin, ALT and AST in the peripheral blood before the treatment, in the middle of the course and after the treatment.
Toxicity severity was determined according to the changes of mean values of the investigated parameters in the process of treatment and using the system of registering harmful effects CTC v. 3.0. Toxicity was compared between groups 1 and 2 at the respective treatment stages.
Results: Statistical comparative analysis of mean values of the criteria of hemopoiesis (amount of hemoglobin, thrombocytes and leukocytes in the peripheral blood) and hepatocytes (bilirubin, ALT and AST in the blood plasma) and the same criteria ranged according to CTC v. 3.0 system in the both groups of patients with BC showed that treatment complications severity registering using mean values results in erroneous conclusions.
Conclusion: It is not correct to determine the degree of unfavorable effects of chemotherapy (CT) in cancer patients according to the changes in mean values (amount of hemoglobin, erythrocytes, thrombocytes, leukocytes, parameters of hepatocytes state and metabolism) as individual peculiarities of reactions of definite organs and systems are characterized by a considerable dispersion which can result in false conclusions when mean values are used to assess unfavorable CT effects. The only system for assessment of unfavorable effects of treatment can be CTC system (v.3.0 and newer versions in future) which allows considering even single cases of unfavorable reactions as assess their severity and clinical significance using a single scale.
Key words: cancer treatment, toxicity, system of registering harmful effects.
2009, vol 17, # 1, page 43
O.P. Lukashova, V.S. Suhin, O.A. Mihanovskiy, I.M. Krugova, I.M. Teslenko
Peculiarities of squamous cell cervical cancer ultrastructure after different protocols of pre-operative chemoradiation therapy
Annotation
Objective: To analyze the efficacy of pre-operative antitumor chemoradiotherapy in patients with stage Ib-IIа cervical cancer (CC) based on the changes in the tumor cells ultrastructure depending on the methods of treatment.
Material and Methods: Standard methods of electron microscopy were used to investigate the tumors of 38 patients with T1b-2aN0-1M0 CC, of them 17 were administered chemoradiotherapy (distance irradiation using РОКУС-АМ unit and intracavitary irradiation using АГАТ-В unit at a total dose of 20, 30 and 40 Gy with traditional fractionation and fluorpyrimidine administration at a dose of 500 mg: Ftorafur - tid, Xeloda bid during the whole course of irradiation). Radiation therapy alone at TFD of 20 , 30 and 40 Gy was administered to 21 patients. Histology verified squamous cell carcinoma of different differentiation in all cases.
Results: The patients with vital cells in the tumors were revealed in all groups after radiation and chemoradiation therapy. The number of these cases decreased with the increase of the dose. After the exposure to 30 and 40 Gy, chiefly poorly differentiated forms were revealed among the survived tumor cells (TC). Their main function was growth and division, which could be an unfavorable sign of the treatment prognosis. After chemoradiation therapy, cells with sufficiently developed specific functions prevailed among TC, suggested by their fine structure as well as TC with pleomorphic nuclei, which could result from interaction of the medication with the nucleus DNA. It was established that intact cells were revealed in all investigated tumors after irradiation at TFD of 20 Gy and drug administration in contrast to the cells, which were only irradiated at this dose. Increase of the dose of irradiation and drug reduced the number of cases with vital TC. This can suggest that chemoradiation therapy with the dose > 30 Gy is most effective.
Conclusion: The cases of intact vital cells are revealed in all groups following radiation and chemoradiation therapy. After radiation therapy at TFD of 20 Gy vital TC are revealed in all patients, which does not allow to recommend this treatment protocol.
Intact chiefly poorly differentiated cells are revealed after irradiation at high doses (30 and 40 Gy), while differentiated cells and those with pleomorphic nuclei are revealed at chemoradiation therapy in the population of TC.
Key words: squamous cell cervical cancer, radiochemotherapy, tumor cell ultrastructure.
2009, vol 17, # 1, page 50
L.I. Simonova, P.M. Muzikant, N.A. Mitrayeva, V.Z. Gertman, L.V. Bilogurova, V.I. Evdokimenko, S.M. Pushkar
Efficacy of biologically active substance Bipolan made of seaweeds at treatment of fibrous cystic disease of the breast
Annotation
Objective: To assess clinical and hormonal metabolic effect of administration of biologically active substance Bipolan in patients with diffuse and diffuse focal fibrous cystic disease (FCD) of the breast.
Material and Methods: The study involved 40 patients with fibrous cystic disease, of them 20 had diffuse FCD (group 1), 20 -diffuse focal disease (group 2). The controls were 15 healthy subjects. The patients were examined before and after (month 2 and 6) the treatment. The examination included inspection, ultrasound investigation of the breast, determining main sex hormones in the serum (estradiol, progesterone, prolactin). Treatment with Bipolan was administered as two 20-day courses for the first two months.
Results: Two courses of Bipolan treatment for two months considerably influenced the state of the patients with FCD. All patients from group 1 showed reduction (in some even complete relief) of pain by the end of the treatment. Ultrasound examination (UE) demonstrated positive changes of the breast echostructure. By the end of the treatment in group 1 it did not differ form that in the intact breast. After the end of the course of treatment with Bipolan the balance of sex hormones also restored. These effects were present in the majority of the patients (75%) 6 months after the treatment beginning.
Treatment with Bipolan for diffuse focal FCD (group 2) also positively influenced the state of the patients. In half of the patients (10 women) complete restoration of the normal state of breast was noted at clinical and ultrasound examination as well as balance and normal level of sex hormones. The rest demonstrated reduced manifestations of clinical morphological signs of the disease but in 4 of them (20%) diffuse focal disease was diagnosed again 6 months after the treatment.
Conclusion: Bipolan positively influences the state of the patients with FCD both diffuse and diffuse focal mastopathy. The whole complex of noted positive effects of the performed treatment, first of all improvement of the clinical signs and sonography findings in patients with FCD who were administered Bipolan suggests about efficacy of this biologically active remedy in treatment of initial forms of mastopathy.
Key words: breast, fibrous cystic disease, mastopathy, ultrasound examination, sex hormones, Bipolan.
2009, vol 17, # 1, page 57
N.E. Uzlenkova
Disorders of oxidation homeostasis in the blood and organs of rats under the influence of external x-ray exposure
Annotation
Objective: To investigate the changes in the state of oxidation homeostasis in the organism of the rats due to single external exposure to x-rays at a minimal and medial lethal dose.
Material and Methods: The study was performed in the blood and organs (lungs and skin) of male rats weighing 160-180 g. The experimental exposure of the animals was performed using РУМ-17 unit at standard technical conditions. The animals were decapitated according to the rules of euthanasia at early (days 3, 7, 14) and long terms (months 1, 3, 6) after the exposure. The controls were used for each term of the investigation. The state of oxidation homeostasis was assessed using the methods of determining the level of TBA Active products (according to MDA level), SOD, catalase, glutathione peroxidase (GPO) and reduced glutathione activity in the blood and organs of the animals. Total antioxidant activity of the blood was also evaluated. The obtained findings were processes statistically using Statistica v.5.0 software.
Results: It was determined that the exposure elevated the amount of TBA -active products: 1.5 times in the blood, 1.5 and 1.8 times in the lungs, 1.5 and 1.7 times in the skin in the early and late terms following the exposure, respectively. SOD and catatase activity decreased by 30%, AOA in the blood decreased by 25%. Compensatory increase of GPO activity in the blood by 1.5 times and skin in 1.2 and 1.4 times was observed, which occurred against a background of considerable reduction (by 20% on an average) of reduced glutathione content.
Conclusion: Single external x-ray exposure to minimal and medial lethal doses causes stable disorders in oxidation homeostasis resulting in peroxidation state and development of chronic oxidative stress in the organism of the exposed rats.
Key words: external x-ray exposure, oxidation homeostasis, oxidative stress.
2009, vol 17, # 1, page 65
E.M. Mamotuk, V.A. Gusakova, N.E. Uzlenkova, S.I. Revenkova, O.V. Nenukova, V.N. Ivashenko, R.Yu. Ciganok, V.G. Borodin
Experimental investigation of radioprotective properties of nanodiamonds
Annotation
Objective: To assess experimentally radioprotective effect of ultradisperse nanodiamonds of detonation synthesis.
Material and Methods: Radioprotective effect of oral administration of water suspension of nanodiamonds (ND) before x-ray exposure at a dose of 6.0 Gy was analyzed experimentally on white mongrel female rats weighing 180-210 g. The effects were traced on day 3, 7, 14, 30 using radiobiological, hematological, biochemical and pathoanatomical methods.
Results: It was established that two oral administrations of ND suspension to the rats (0.5 mg/kg) 1 and 16 hours before x-ray exposure (LD 70/30) relieved the course of radiation sickness, reduced manifestations of gastrointestinal syndrome and significantly decreased mortality (LD30 36 8/30). Hematological and biochemical investigations demonstrated less protective effect, which could be associated with the peculiarities of local contact mechanism of ND particles interaction with the cells of the gastrointestinal epithelium of the animals.
Conclusion: Owing to radiation protection of the cells of the gastrointestinal tract, water suspension of ultradisperse diamonds of detonation synthesis possesses a marked radioprotective effect on the rats exposed to lethal dose. The state of other inner organs, hemopoietic system and the levels of a number of metabolism parameters in the exposed animals depend less on preliminary administration of ND.
Key words: nanodiamons, ultradisperse diamonds of detonation synthesis, ionizing radiation, radioprotective effect.
2009, vol 17, # 1, page 72
V.E. Orel, I.I. Dzyatkovskaya, M.O. Nikolov, A.V. Romanov, N.M. Dzyatkovskaya, G.I. Kulik, I.M. Todor, N.M. Hranovskaya, O.I. Skachkova
Influence of spatially uneven electromagnetic field on anti-tumor activity of Cisplatin at its action on resistant to it substrain of lung carcinoma Lewis
Annotation
Objective: To investigate the influence of electromagnetic irradiation (EI) with spatially uneven electromagnetic field (EMF) on antitumor and antimetastatic activity of Cisplatin in animals with lung carcinoma Lewis with induced resistance to Cisplatin.
Material and Methods: Three groups of animals (male mice C57BL/6) with a substrain of lung carcinoma Lewis resistant to Cisplatin: group 1 - controls (without Cisplatin administration and without EI); group 2 - Cisplatin administration, group 3 - Cisplatin administration and EI. Irradiation was delivered using a prototype of Magniterm unit (Radmir, Ukraine) with the following EI parameters: frequency 40 MHz, output 60 Wt. Cisplatin was administered to the animals of groups 2 and 3 at a dose of 1.2 mg/kg. The course consisted of 5 injections and 5 treatments with EI. Irradiation was delivered for 15 minutes immediately after Cisplatin administration. The kinetics of the intratumor temperature elevation, temperature entropy distribution over the tumor surface, metastases development as well changes in the phases of cellular cycle of the tumor cells were investigated.
Results: Intratumor temperature elevation was not linear; it reached 38.1 °С for 15 min of EI. Temperature distribution entropy over the tumor surface increased by 17%. Maximal antitumor activity caused combined action of Cisplatin and EI initiating inhibition of the growth of the substrain of lung carcinoma Lewis resistant to Cisplatin by 29% (p<0.05) when compared with the group of animals which were administered Cisplatin alone. Lung metastases inhibition index after combined action of Cisplatin and EI was 11% higher than in the experiments with the drug only. After Cisplatin administration and EI, the number of cells of the substrain of lung carcinoma Lewis resistant to Cisplatin in G2/M phase reduced by 61% (p<0.001) when compared with the controls.
Conclusion: Combined action of Cisplatin and EI with spatially uneven EMF results in the highest antitumor activity and inhibition of metastases development in the animals with substrains of lung carcinoma Lewis resistant to Cisplatin.
Key words: spatially uneven electromagnetic field, resistant to Cisplatin strain of lung carcinoma Lewis, Cisplatin.
2009, vol 17, # 1, page 78
M.M.E. Taha, E. E. Sulieman
Evaluation of asymmetry collimator for a new generation of telecobalt machine
Annotation
Objective: Evaluation of the dose distribution and of the reference dose rate of the symmetry and asymmetric fields.
Material and Methods: A new model of the telecobalt unit, Theratron Equinox-100, (MDS Nordion, Canada) equipped with a single 60 degree motorized wedge and upper (X) and lower (Y) asymmetric jaws have been evaluated. Symmetrical jaws were commissioned in Pinnacle3 (Philips), the 3D treatment planning system (TPS). The profiles and central axis depth dose (CADD) were measured with Wellhofer Blue Water Phantom for various field sizes using 0.13 cc thimble ionization chamber (Scanditronix Wellhofer, Uppsala, Sweden) and the data were commissioned in Pinnacle3.
Results: The profiles and CADD for symmetry jaws were compared with asymmetry jaws for various field sizes. Also beam profiles for 5x5, 10x10 and 20x20 cm2 for symmetry and asymmetry field sizes at 5 and 10 cm depths measured with 2D-Array (two dimensional detector array with 729 vented ionization chambers with a size of 5x5 mm2, PTW, Germany), are compared. A homogeneous phantom generated in Pinnacle3 .The dose calculated in this phantom at 10 cm depth for various field sizes of symmetry and asymmetry jaws using collapse cone convolution (cc convolution) model with a grid size of 4 mm , and compared with measured dose in a water phantom at 10 cm depth with a 0.6 cc thimble ion chamber FC-65-G and DOSE1 electrometer for field sizes of 5x5, 10x10 and 20x20 cm2 using IAEA dosimetry protocol TRS-398.The variation of measured and calculated doses at 10 cm depth were within 1%.
The asymmetry jaws were successfully commissioned in Pinnacle3.
Conclusion: A dose distribution for small field sizes is a same for a symmetry and asymmetry field sizes. For large fields deviations between symmetry and asymmetry beams values were found to be more than 1%.
Depth-dose characteristics for asymmetric fields are similar to those of symmetric fields for the different collimator openings.
Absolute dose measurements in the water phantom for the symmetry and asymmetry beams show that there is no significant difference for all the field sizes used, the percentage deviation was never larger than 1%.
The Pinnacle3 TPS uses the same beam data for symmetric collimator setting and models the dose distribution for any shaped field, with symmetric or asymmetric collimator setting, without special correction factors and does not require additional measurements for off-axis fields.
Key words: telecobalt, symmetry beam, asymmetry beam, treatment planning and commissioning.
2009, vol 17, # 1, page 86
N.V. Shlahova
The state of immune system in children from participants of Chornobyl accident clean-up at the final state of sexual maturation
Objective: To study the state of immune system in children aged 16-18 born of fathers who participated in Chornobyl accident cleanup with the consideration of the gender and date of the father’s stay in the zone of nuclear contamination.
Material and Methods: The study involved 240 persons aged 16-18 whose fathers participated in Chornobyl accident clean-up in 1986-1987 (study group) and 70 persons of the same age (pupils of Kharkiv schools) whose fathers were not exposed to radiation.
Investigation of the immune state included investigation of relative amount of CD3+, CD4+, CD8+, CD22+-lymphocytes, concentration of circulating immune complexes (CIC), complement hemolytic activity (CHA), serum globulins (Ig G, A, M) amount. Phagocytes were assessed using neutrophil phagocyte activity (NPA), phagocyte number (PN), spontaneous and induced NST-test (NST , NST).
Results: The obtained findings suggest that 60% of the persons from the study group have changes in the immune state. Irrespective of the gender, the children of this group demonstrated significant reduction of relative amount of CD3+, CD4+ и CD8+-lymphocytes and PN. Besides, the males showed increase of parameters of spontaneous and induced NST-test (p < 0.05). The changes in the humoral link depended on the gender and were characterized by significant increase of CD22+-lymphocytes in males and reduction of IgA and M in females.
Conclusion: The changes in the immune system involving all links of the immunity are three times more frequent in children whose fathers participated in Chornobyl accident clean-up. Disorders of humoral and phagocyte links are gender-dependent. Significant difference in the level of immunological parameters depending on the year of the father’s stay in the zone was not revealed.
Key words: children of fathers who participated in Chornobyl accident clean-up, immune state.
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We are proud to announce the annual scientific conference of young scientists with the international participation, dedicated to the Day of Science in Ukraine. The conference will be held on 20th of May, 2016 and hosted by L.T. Malaya National Therapy Institute, NAMS of Ukraine together with Grigoriev Institute for medical Radiology, NAMS of Ukraine. The leading topic of conference is prophylaxis of the non-infectious disease in different branched of medicine.
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We are proud to announce the scientific conference of young scientists with the international participation, dedicated to the Science Day in Ukraine that is scheduled to take place May 15, 2014 at the GI “L.T. Malaya National Therapy Institute of the National academy of medical sciences of Ukraine”. The conference program will include the symposium "From nutrition to healthy lifestyle: a view of young scientists" dedicated to the 169th anniversary of the I.I. Mechnikov.
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