UJR 2011, vol XIX, # 1
THE CONTENTS
2011, vol XIX, # 1, page 5
M.I. Spuzyak, YU.A. Kolomiychenko, O.P. Sharmazanova, S.M. Spuzyak, I.V. Laponin
The peculiarities of x-ray picture of atlas rotation subluxation and its complications in children aged 3-16
Objective: To investigate age-dependent peculiarities of x-ray picture of the atlas rotation subluxation.
Material and Methods: The analysis involved x-ray films of the cervical spine in two projections, spot films through the open mouth and functional x-ray films of 84 patients aged 3-16 who were treated in Pediatric Traumatology Department of General City Hospital No. 17 (Kharkiv). The patients were divided into 6 age groups. The study was perfumed on Integron 10 unit. To assess the changes both visual and metric analysis was used.
Results: The complaints of the patients were similar: pain, forced position of the head, limited movement. The majority of the patients were girls. About 44% of the patients had a past history of similar clinical signs.
The analysis of x-ray manifestations showed asymmetry of the lateral masses of the atlas, changes of the axis in the cervical spins, presence of spondylolistesis, widening of the prevertebral soft tissues, fusiform divergence of the posterior C1-C2 arches, uneven height of the articular clefts in the lateral atlantoaxial joints and presence of arthrosis of various degrees.
Conclusion: Rotation subluxation of the atlas is more common in girls. Its signs are asymmetry of lateral masses of the atlas, widening of the articular cleft of Cruveilhier's joint. Indirect and direct signs also exist: uneven height of articular clefts of lateral atlantoaxial joints, fan-like divergence of the posterior C1-C2 arches. Rotation subluxation can be complicated by arthosis which progresses with the age; rotation subluxation, spondylolistesis, the changes of the axis and presence of arthritis can be the sign of connective tissue dysplasia.
Key words: rotation subluxation of the atlas, upper cervical spine, radiography, children.
2011, vol XIX, # 1, page 14
L.H. Rozenfeld, M.M. Kolotilov, H.T. Bozhko, T.M. Babkina
A method of radiation therapy efficacy assessment in maxillary sinus cancer
Objective: To work out a method of assessment of vascularizartion and radiosensitivity of maxillary sinuses malignancies by means of histographic analysis of native and x-ray contrasted structure of the tumor on CT images.
Material and Methods: CT findings of 36 patients aged 33-59 with squamous-cell non-keratinized T2N0M0 tumors of the maxillary sinuses were analyzed. Diagnostic CT images obtained before and after x-ray contrast administration were processed using Evaluate ROI function. At least 3 slices crossing maximum tumor diameter were used. A relatively homogeneous zone in the center of the tumor was chosen. A square zone of interest measuring 0.5 om' ± 5 %% was drawn manually. Minimum, mean arithmetic and maximum x-ray density (Dmin Dmean, Dmax ) were measured at least 3 times. The above stages of image analysis were performed after x-ray contrast administration.
Results: The main CT sign of the tumor involvement was presence of a soft-tissue formation with the following densitometric characteristics
D . = (28.0 ± 0.3) HU;
D™„ = (45.0 ± 3.8) HU;
D™x°= (56.0 ± 0.4) HU in the maxillary sinus.
Hypoxic cell population in various subvolumes of the tumor determined its radiorisistance, hyperoxic - radiosensitivity.
Conclusion: A method of prognosis of radiosensitivity of maxillary sinus cancer was worked out.
Key words: cancer, maxillary sinus, CT, radiosensitivity, histographic analysis.
2011, vol XIX, # 1, page 20
L.I. Simonova, A.M. Korobov, YA.E. Vikman, B.Z. Hertman, L.V. Bilohurova, C.M. Pushkar, H.V. Kulinich, V.P. Lavryk
Ultrasound investigation as a method of the skin state assessment in patients at photomodification of irradiation zone at radiation therapy for breast cancer
Objective: To investigate the use of ultrasound investigation in assessment of the skin state at photomodification of the irradiation area during radiation therapy in patients with breast cancer.
Material and Methods: The study involved 40 patients aged 3565 with stage IIB-IIIA breast cancer who were administered a standard course of post-operative radiation therapy (RT). The patients were divided into 3 groups: controls 25 patients who were administered only radiation therapy, group 1 - 7 patients who received red right phototherapy — 660 nm) together with RT; group 2 - 8 patients who received blue light phototherapy( Xmax — 470 nm).
The optic radiation was delivered to supra-, subclavicular and parasternal area as well as the area of the scar. The areas of projection of cubital veins, thymus, spleen, and liver were also irradiated. A photomatrix unit Barva-Flex was used as an optic generator. Ultrasound skin investigation was performed on day 3, 7, 15 and 30 using Sonoline G 50 (Siemens) unit with 10 MHz probe.
Results: In the controls, the signs of radiation reaction (erythema and edema) appeared on day 3-4 after the exposure. The echograms demonstrated reduction of the skin thickness and subcutaneous fat echogenicity. These changes persisted up to 30 days suggesting a stable inflammation. At the end of RT course the echograms showed uneven tissue structure with foci of increased echogenicity, which suggested possible fibrous and scar changes in the future.
At red light phototherapy, echography demonstrated moderate changes persisting up to day 30 only in 4 patients. Blue light treatment resulted in minimal changes in the skin and the adjacent tissues: inconsiderable reduction of echogenicity in the zone of irradiation, uneven tissues. By day 30 these signs disappeared. The areas of increased echogenicity suggesting possible fibrous changes were not detected after phototherapy.
Conclusion: Ultrasound findings about the state of the skin in the area of radiation exposure are informative and allow visualizing post-irradiation changes in the skin. Echographic criteria which allow to determine the degree of radiation reactions and possibility of prognosis were established. Ultrasonography findings allow to state that photomodification with red and blue light improved the course of radiation skin reactions, postponed the terms of their development and accelerated their resolution.
Key words: phototherapy, light diodes, ultrasound skin investigation, breast cancer, radiation therapy, radiation skin reactions.
2011, vol XIX, # 1, page 25
M.I. Spuzyak, H.A. Oliynyk, T.H. Hryhor'yeva, Z.L. Gavrikova
Morphometric and x-ray densitometric indices of the state of short tubular bones in patients with local cold injury
Objective: To investigate morphometric and x-ray densitometric parameters of the state of short tubular bones and the adjacent tissues in patients with local cold injury (frostbite) within different periods of cold injury.
Material and Methods: Morphometric and densitometric indices of the state of the bone tissue of short tubular bones and the adjacent tissue were investigated in 79 patents (73 men and 6 women aged 19-73 hospitalized to burn department of Kharkiv City Clinical Hospital for Urgent and Emergency Medical Aid. The investigation was performed within the pre-reactive period of the course of local cold injury and during the disease (within the early reactive and reactive periods). The group of the patients included 40 subjects with involved upper extremities and 39 - with lower extremities. The controls were 15 healthy subjects: 12 men and 3 women. The patients were measured mean parameters of the shadow intensity (SI) (brightness) of the bone tissue in the narrowest portions of the phalanges of the fingers and toes.
Results: X-ray densitometric changes of the bone tissue of short tubular bones (reduction of the shadow intensity (brightness) were revealed in 61 (77.2%) patients with local cold injury (frostbite) hospitalized within the pre-reactive period of the disease. Dynamic observation within the early reactive and reactive periods revealed SI normalization in 46 (75.4%) patients with an uncomplicated disease course, which suggested restoration of the blood supply in the involved segments following the administered conservative therapy. Preservation of low indices of SI and especially its reduction suggested formation of deep frostbites, which required changes in the tactics of treatment and active surgical interventions (necrotomy, necrofasciotomy).
Conclusion: Local cold injury (frostbite) is a dynamic process. Timely and adequate conservative and surgical treatment facilitates reversibility of local complications and prevents formation of deep frostbites. Determining morphometric and x-ray densitometric parameters of the state of short tubular bones within various periods of the disease course allows timely administration of active surgical treatment.
Key words: morphometry, x-ray densitometry, frostbite, active surgical tactics.
2011, vol XIX, # 1, page 30
S.V. Khyzhnyak, L.I. Stepanova, L.V. Hrubska, A.O. Prokhorova, B.M. Voytsitskiy
Influence of low-dose ionizing radiation on mitochondrial membrane lipid composition of small intestine enterocytes in rats
Objective: To investigate lipid composition of mitochondria inner membrane (MIM) of the small intestine enterocytes in rats at different terms after single (0.1 and 1.0 Gy) and chronic (total dose 1.0 Gy) exposure to low-dose ionizing radiation.
Material and Methods: The study was performed on MIM specimens of small intestine enterocytes in rats 1, 12, 24 hours after x-ray exposure of the animals to absorbed doses of 0.1 and 1.0 Gy (55 mGy/min) as well as after chronic exposure to total absorbed dose 1.0 Gy (5 мGy/min). Membrane lipids were extracted; cholesterol (CS), total lipids and phospholipids (PL) amount was determined. Phospholipids were separated by thin-layer chromatography; their fatty-acid composition was determined using gasfluid chromatography.
Results: The peculiarities of quantitative changes of mitochondrial membrane lipids after single exposure depended on the absorbed exposure dose (0.1 and 1.0 Gy). Ionizing radiation at a dose of 0.1 Gy resulted in reduction of CS amount and increase of individual PL (with prevailing nonsaturated acid amount). The dose of 1.0 Gy caused increase of CS amount, separate fractions of PL (especially minor component and lisoforms of PL), redistribution of fatty acids of PL. Chronic exposure resulted in reduction of CS amount in the membrane and redistribution of phospholipids content: considerable reduction of main (phosphatidylcholine, phosphatidylethanolamine, cardiolipin) as well as increase of lisoforms and minor component of membrane phospholipids.
Conclusion: The peculiarities of reconstruction of lipid component of MIM in the small intestine enterocytes of rats characterize the specificity of the effects of low-dose ionizing radiation for different types (x-ray, gamma-rays), conditions (single or chronic) and absorbed doses of radiation.
Key words: ionizing radiation, absorbed dose, mitochondria membrane, lipids, phospholipids, fatty acids.
2011, vol XIX, # 1, page 37
R.YA. Abdullayev, T.A. Dudnyk
Ultrasound diagnosis of rotatory cuff complete rupture
Objective: To investigate ultrasonographic signs of rotatory cuff (RC) complete rupture.
Material and Methods: The findings of ultrasonography of shoulder joints were analyzed in 54 patients (32 men and 22 women) aged 20-73 operated for RC complete rupture. The controls were 19 patients without any complaints of pain in the shoulder joint and limited motion in it. Besides, the findings of ultrasonography of the healthy shoulder of the patients were considered. All patients were performed MRI and radiography of the shoulder joint.
Results: It was established that in19 (35.2 %) patients the remoteness of the injury was 6 months, in 35 (64.8 %) over 6 months. This indicates that RC rupture against a background of chronic lesion occurred significantly more frequently (Р < 0.05) than at acute injury. Absence of the tendon visualization in the typical place with denuded outlines of the shoulder bone head and adjacent deltoid muscle was revealed in 70% of cases of massive rupture of RC. Interrupted tendon outlines with visualization of the ruptured ends and anastomosis with subdeltoid-subacromial sac was registered in 29 % cases. Color Doppler ultrasound revealed increased blood flow in the zone of the tendon injury in 24 cases. Complete CR rupture in 96 % of cases was accompanied by effusion in the subdeltoid-subacromial sac. In 90% of cases it had an uneven structure with hyperechoic inclusions or hyperechoic areas; in 57% of cases they had increased vascularization. In 11 % of patients detachment of the fragments of the shoulder bone head cartilage was registered. Effusion in the synovial vagina of the tendon of the biceps was revealed in 77% of cases as an indirect sign of complete SRC rupture.
Conclusion: The direct sign of rotatory cuff complete rupture is absence of tendon visualization in the typical place with denuded outlines of the head and adherence of the deltoid muscle to it. Effusion in the sacs with an uneven structure and increased parietal vascularization is an indirect sign of a complete rupture. Effusion in the synovial vagina of the biceps tendon after shoulder injury also increase the probability of RC rupture. The capabilities of MRI and ultrasonography in diagnosis of complete RC rupture are equal, in separate cases the disadvantages of one can be compensated by the use of the other method, ultrasonography being more acceptable method of monitoring.
Key words: ultrasonography, shoulder joint, rotatory calf.
2011, vol XIX, # 1, page 42
R.YA. Abdullayev, A.YA. Senchuk, T.I. Tamm, O. V. Dolenko, A.YU. Shcherbakov
Comparison of ultrasound and laboratory investigation informativity in diagnosis of the functional state of the ovaries and endometrium
Objective: To compare the informativity of hormone test and ultrasound investigation for assessment of ovulation efficacy and quality of cyclic transformations of the endometrium in the secretory phase.
Material and Methods: The findings of hormone assessment and ultrasound investigation were compared in 23 women (aged 21-35) with anovulation and 25 fertile women with ovulation. The level of FSH, LH, and estradiol (Е2) were compared on days 11-14 of the cycle, while progesterone on days 21-23. Transvaginal ultrasound investigation was performed.
Results: In all 25 healthy fertile women, the dominant follicle was visualized. The tubercle of fecundation as ovulation pre-cursor was registered in 22 (88.0 ± 6.6 %), while in anovulation it was seen in 6 (26.1 ± 9.4 %, р < 0.001). Peak systolic blood flow velocity (Vs) in the follicle walls was 21.8 ± 2.4 and 12.6 ± 1.8 cm/s, resistance index (RI) 0.52 ± 0.03 and 0.43 ± 0.02, respectively (р < 0.001 and р < 0.05).
LH, FSH, and Е2 concentration on days 11-14 of the cycle in women with anovulation and ovulation differed insignificantly (р > 0.05) , 46.7 ± 14.2 IU/l and 89.4 ± 18.3 IU/l, 6.4 ± 2.3 IU/l and 14.7 ± 3.8 IU/l, 0.31 ± 0.07 nmol/l and 0.53 ± 0.09 nmol/l, respectively. Mean progesterone level at luteinization of non- ovulated follicle was 18.3 ± 4.5 nmol/l, in the fertile women it was 36,3 ± 8,9 nmol/l (р > 0.05), respectively. Transvaginal ultrasound investigation revealed significant (р < 0.01) difference between M-echo thickness in the fertile women and those with luteinization of non-ovulated follicle (13.2 ± 1.3 mm and 8.1 ± 1.1 mm, respectively). Vs in the spiral arteries of the fertile women was 9.1 ± 0.6 cm/s, while in luteinization of non-ovulated follicle - 6.8 ± 0,7 cm/s (р < 0.05), RI — 0.49 ± 0.02 and 0.58 ± 0.03 (р < 0.05), respectively.
Conclusion: Great variation of reference values of the reproductive system hormones does not facilitate interpretations of the obtained findings. Transvaginal ultrasound investigation is an accessible and informative method of assessment of the correspondence between the functional state of the ovary and endometrium to the phase of the menstrual cycle.
Key words: reproductive system, hormone assessment, ultrasound investigation, ovary and endometrium.
2011, vol XIX, # 1, page 48
N.I. Afanasyeva, O.V. Muzhychuk, O.A. Radchenko
Morphological indications to radioiodine therapy for thyroid microcarcinoma
Objective: To determine the indications to radioiodine therapy considering the morphological signs of thyroid microcancer aggression.
Material and Methods: Morphological properties of thyroid microcarcinoma were investigated in the thyroid gland (TG) microspecimens containing a tumor removed from 104 patients. The data were compared with 67 controls having T1 carcinoma measuring 1.1-2.0 om. Histology investigation was performed using a traditional technique applied in all hospitals and suitable for determining the morphological variant of TG tumor and analysis of its growth peculiarities. To determine morphological characteristics of microcarcinoma and larger thyroid differentiated tumors (controls), histology of the specimens and analysis of the removed microspecimens of the TG included determining its histological variant, investigation of the incidence of the tumor and the gland capsule invasion by the tumor, presence of multicentric growth, intraorgan metastases, bilaterization of the disease, metastases to the lymph nodes. A sclerosing form of the tumor was distinguished. The state of the background thyroid parenchyma on which the tumor developed was determined separately.
Statistical processing of the obtained findings was done using the methods of variation statistics and calculation of mean values for percents (P) and standard square error of the mean (p).To assess the significance of the revealed measurements Student's t-criterion was used. Difference of mean values at р < 0.05 was considered significant. Statistical calculation was performed using Microsoft Office Excel software.
Results: It was determined that by the character of morphological signs of the tumor aggression microcarcnomas did not differ from cancer measuring less than 2.0 cm. By some signs (multifocal involvement, invasion to the parenchyma of the TG) they were "ahead" of the larger tumors. But invasive cancer at microcarcinoma as well as metastases to the cervical nodes were significantly less frequent.
Conclusion: Our study suggests that it is reasonable to administer radioiodine therapy considering individual peculiarities of each clinical case of thyroid microcarcinoma as well as such parameters as the patient's age, tumor morphology, presence of invasive microcancer with multicentric bilateral dissemination, intraorgan metastases, invasion to the parenchyma, TG capsule and extraorgan tumor growth.
Key words: thyroid microcarcinoma, radioiodine therapy.
2011, vol XIX, # 1, page 54
B.G. Knihavko, C.Yu. Protasenya, N.O. Gordiyenko, I.V. Shuba
Mathematical simulation of the processes determining dependence of survival of exposed tumor cells on the degree of their oxygenation
Objective: Simulation of cell radiosensitivity dependence on their oxygenation with the purpose to calculate survival of the tumor cells in different layers with various degrees of oxygenation.
Material and Methods: Methods of mathematical simulation.
Results: Mathematical models were built. Analytical expressions for calculation of dependence of survival of exposed to x-ray or gamma-rays tumor cells on oxygen concentration in the pericellular environment and irradiation dose were obtained. These models are based on the contemporary ideas about the mechanisms of reparation of radiation lesions and the processes realizing oxygen effect using the criterion of survival of eukaryotic cells.
Conclusion: Dependence on oxygen concentration in the pericellular environment of the values determining the probability of forming two-thread DNA raptures and probability of reparation of these lesions was established.
Key words: mathematical simulation, malignant tumor, survival of exposed cells, dose dependence, oxygen effect.
2011, vol XIX, # 1, page 59
N.O. Maznyk, T.S. Sypko, V.A. Vinnikov
Cytogenetic effects in human lymphocytes at high-dose in vitro gamma-irradiation
Objective: To determine the peculiarities of forming the picture of cytogenetic lesions and its variability in human blood lymphocytes at exposure to high-dose (up to 20 Gy) y-radiation in vitro.
Material and Methods: The whole human peripheral blood was exposed in vitro to 60Со radiation at a dose of 2, 4, 6, 8, 10, 16 and 20 Gy (dose rate of 1 Gy/min). At experimental points 2, 4 and 6 Gy the blood of 2-3 donors was used with the respective non- irradiated control from each person. Lymphocytes were cultivated using a standard technique. All types of chromosomal aberrations in normoploid metaphases of the first mitosis were determined by cytogenetic analysis of the specimens stained according to fluorescent + Giemsa method. Statistical processing of the data was used to assess mean frequency of various types of aberrations. Cell distribution of aberrations was characterized according to ratio of dispersion to mean and using Papworth u-test. Mean values of cytogenetic parameters were assessed using Student's t-criterion for independent phenomena.
Results: Dose-dependent increase of aberration frequency chiefly due to the lesions of chromosomal type occured in the irradiated lymphocytes. The frequency of dicentrics with an accompanying fragment significantly increased at increase of the absorbed dose per each 2 Gy within the range from 0 to 10 Gy and similarly within the range of 10-16 and 16-20 Gy. In addition, moderate but significant increase of the frequency of chromatid lesions occurred, their contribution to the total level of aberrations was 2-6% at all dose points. Distribution of chromosomal aberrations in the cells at all point was close to Poisson with the tendency to lack of dispersion (in particular for dicentrics) in the dose interval 6-16 Gy. Variability of cytogenetic lesions output in the cells of various donors in the controls and in points of 2, 4 and 6 Gy was moderate. The lowest individual discrepancies were noted for the frequency of dicentrics with an accompanying fragment. After irradiation at a dose of 20 Gy all metaphases were overloaded with chromosomal lesions, from 13 to 67 aberrations per one cell, which complicated their analysis. This resulted in discrepancies in the assessment of different operators as to the frequency of chromatid aberrations (50-113 per 100 cells), being less pronounced for free dicentrics (1000-1148 per 100 cells). The values of dicentric output were very close (14421450 per 100 cells).
Conclusion: For the first time in Europe and the USA, the peculiarities of cytogenetic effect in human blood lymphocytes were established during in vitro experiment at exposure to high-dose y-radiation (up to 20 Gy). Inter-donor variability and divergence of the assessment by different operators for radiation induction of dicentrics were moderate, namely they were interrupted by dispersion associated with stochastic nature of the parameter. This indicated the possibility of a wide use of dose-effect curves for chromosomal dosimetry in vitro. The obtained findings allow to build an empiric calibration curve covering a wide range of clinically significant radiation doses.
Key words: chromosomal aberrations, dicentrics, lymphocyte culture, high-dose irradiation.
2011, vol XIX, # 1, page 69
T.P. Yakymova, L.Ya Vasylyev
A case of primary multiple malignant tumors of four locations
2011, vol XIX, # 1, page 73
O.M. Sukhina, V.P. Starenkiy, A.V. Svynarenko, B.S. Sukhin, A.I. Hranovska
Advisability of chemoradiotherapy at cervical cancer treatment
2011, vol XIX, # 1, page 79
I.O. Kramniy, I.O. Voronzhev, R.Yu. Churylin
Clinical x-ray characteristics of contemporary course of acute pneumonia
Communication 2. Community-acquired pneumonia
2011, vol XIX, # 1, page 85
I.A. Gromakova, P.P. Sorochan, N.E. Prokhach, O.M. Sukhina, I.M. Ponomaryov, O.V. Kuzmenko
Transcription NF-КВ factor as an objective of overcoming tumor radioresistance
2011, vol XIX, # 1, page 100
E.G. Rusanova, K.V. Rusanov
S.P. Grigoriev in context of radiology development
2011, vol XIX, # 1, page 108
M.M. Tkachenko, T.V. Topchiy
From the plead of pioneers: рrofessor Eugen F. Weber
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