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UJR 2013, vol XXI, # 1

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THE CONTENTS

 

2013, vol XXI, # 1, page 19

O.M. Tarasenko, L.V. Mironchuk

Radiation diagnosis of spinal injury consequences in practice of medical social expertise

 

Objective: To determine the efficacy of methods of disorders radiation diagnosis in patients with spinal injuriy consequences.

Material and Methods: The study involved 43 patients with spinal injury consequences who were examined at Neurology and Traumatology Departments of Ukrainian State Research Institute for Medical Social Problems of Disability (Ministry of health of Ukraine) in 2011-2012.

Results: The patients were performed spondylography (100 %) of the involved portion of the vertebral column, in 34 (79 %) cases multispiral computed tomography (MSCT) was done. In 24 (55 %) cases it was complemented by magnetic resonance imaging (MRI). Spondylography allowed revealing traumatic bone changes in the patients with spinal injury consequences. When secondary dislocations of the fragments to the spinal canal were suspected, MSCT and MRI were performed to specify the level of neurocomplessions syndrome.

Conclusion: The methods of choice at assessment of the consequences of spinal injuries are spondylography (at analysis of changes and instability of the vertebral column, MSCT (at analysis of secondary changes of the bone system), MRI (at investigation of secondary changes in the nervous system and paravertebral soft tissues).

Key words: radiation diagnosis, injury, informativity.

 

2013, vol XXI, # 1, page 22

O.P. Sharmazanova, M.I. Spuzyak, O. V. Volkovs'ka, I.M. Kozirev

X-ray staging of spondyloarthrosis deformans of the lumbar spine

Objective: To determine x-ray criteria of the grades of spondyloarthrosis deformans of the lumbar spine.

Material and Methods: Clinical x-ray investigation of 227 patients aged 18-82 with vertebralgia, radicular neurological signs, and disorders of the gait was performed. All patients were done survey films, when necessary spot, 3/4 and functional films. Sixty-four patients were done multispiral computed tomography of the lumbar spine. The condition of 908 ver-tebromotor segments was analyzed.

Results: X-ray signs of spondyloarthrosis deformans were revealed in 27.8 % of young patients (under 35 years of age), 52.4 % — aged 36-48, 76.2 % — aged 49-60 and 89.6 % over 60. The lesions of 619 segments were detected (68.2 %). Most frequently spondyloarthrosis was present in the intervertebral joints of L4-L5 (32.8 %), Lg-Sj (30.2 %) (p < 0.05), less frequently in L3-L4 (22.8 %) і L2-L3 (14.2 %). The performed investigation allowed to distinguish x-ray signs of four stages of spondyloarthrosis deformans.

Conclusion: Staging of spondyloarthrosis deformans gives more complete information allowing determining of the dystrophic process progression in the intervertebral joints of the lumbar spine, which should be considered at dynamic observation of the patients as well as at medical social expertise of the patients.

Key words: spondyloarthrosis deformans, intervertebral processes, radiography.

 

2013, vol XXI, # 1, page 28

S.G. Mazur, M.R. Kostyuk, I.M. Dikan

Surgery efficacy assessment at carotid artery stenosis using ultrasound duplex scanning

 

Objective: To perform dynamic assessment of the changes in the passability of carotid arteries and parameters of cerebral hemodynamics using ultrasound duplex scanning after operative correction of high-grade carotid artery stenosis.

Material and Methods: Sixty-two patients aged 43-84 with high-grade carotid stenosis who in 2003-2011 were performed carotid angioplasty and stent grafting (CAS), of them in 5 with carotid endarterectomy (CEA), were investigated. According to the protocol, ultrasound investigation was performed one week before the surgery, during week 1 after CAS and 6-8 months later.

The character of atherosclerotic lesion and stenosis degree were investigated using ultrasound duplex scanning and cerebral angiography. Linear and volume velocity of the blood flow were determined. The value of general cerebral volume blood flow, carotid-carotid index were determined.

Results: The patients with occlusive carotid stenosis requiring surgical correction develop considerable disorders of hemodynamics (development of stenotic blood flow, increase of carotid-carotid index). Surgical methods (CAS, when necessary with CEA) improved hemodynamic parameters after the surgery, restored the artery passability in the area of the involvement, eliminated stenotic blood flow acceleration, normalized carotid-carotid index.

Ultrasound duplex scanning was accurate and informative in diagnosis of stenotic lesions of the carotid artery, assessment of the stent state and passability of the inner carotid artery (ICA) after the surgery, which reflected the surgery efficacy. The patients with combined stenosis of the both ICA (high-grade stenosis + occlusion of the collateral ICA) developed characteristic positive changes in the blood flow in the carotid and vertebrobasilar basins after stenosis correction.

Conclusion: The patients with occlusive carotid stenosis requiring surgical correction develop considerable disorders in hemodynamic indices. Surgery improves them eliminating stenotic blood flow acceleration and normalizing carotid-carotid index.

The patients with occlusive lesions of the collateral ICA develop characteristic positive changes in the carotid and vertewbrobasilar blood flow which reflect compensation-adaptation mechanisms of brain blood flow autoregulation.

Key words: artery stenosis, ultrasound scanning, surgery.

 

2013, vol XXI, # 1, page 36

N.E. Prokhach

Influence of accompanying immunocorrecting therapy on the quality of life of breast cancer patients at post-operative radiation therapy

 

Objective: To investigate the influence of accompanying immunotherapy on the parameters of the quality of life (QL) of the patients with breast cancer (BC) with various profiles of cytokines at post-operative radiation therapy (RT).

Material and Methods: The study was performed on 30 BC patients at stages of combination therapy. To assess the level of QL SF-36 questionnaire was used. Blood serum cytokine amount was determined using the kits for immunoenzyme analysis (Russia, Vektor-Best).

Results: The patients were distributed into two groups by the variants of cytokine profiles. Group 1 included the patients with higher levels of anti-inflammatory cytokine; group 2 included the patients with pro-inflammatory cytokines prevailing in the cytokine profile. In the both groups QL parameters were analyzed at the stages of anti-tumor therapy. After the surgery the patients were divided into the controls and main group. The patients from the control subgroups were administered RT after the surgery, those of the main subgroups were administered RT accompanied by immunocorrecting treatment. Comparison of QL parameters in the patients after RT demonstrated most favorable effect in the subgroup of the patients with increased levels of pre-inflammatory cytokines.

Conclusion: It is reasonable to administer accompanying immune-correcting treatment with Galavit and melatonin to the patients with BC patients with prevailing pro-inflammatory cytokines in the cytokine profile.

Key words: breast cancer, radiation therapy, immuno-correcting therapy, cytokine profile, quality of life.

 

2013, vol XXI, # 1, page 41

V.M. Pasyuga, E.M. Mamotyuk, V.A. Gusakova

Antiradiation effect of Hawaii Noni juice at local oral cavity irradiation in rats

 

Objective: To present the findings of morphometry of the peculiarities of radiation lesion development in locally irradiated buccal mucosa after local irrigation of the oral mucosa with Hawaii Noni juice.

Material and Methods: Radiation model of x-ray exposure of the right cheek of 20 mongrel white rats weighing 200 g at a dose of 20.0 Gy with РУМ-17м unit was used. Macroscopy was performed to investigate the areas of the oral mucosa lining the inner surface of the right cheek of the rats, intact (biological control, BC), exposed animals (5) and exposed animals (5) which were daily irrigated the oral cavity with 0.5 ml of Hawaii Noni juice 2 days before and 10 days after the exposure. The state of the mucous membrane was investigated on day 5 and 15 after the exposure. Relative area of horny and cellular layers and coefficient of epithelium erosion of the buccal mucosa were determined using InkScape 0.48.0:r9654 for Linux Ubuntu 10.10.

Results: Thinning of the cellular layer was observed in the buccal mucosa on day 5 after x-ray exposure. The cells of the granular layer died, those of spinous and basal layers demonstrated polymorphism. The horny layer was almost absent. On day 15, partial restoration of the cellular and horny layers was observed. Considerable growth of the cellular layer was observed. Its elongated sprouts penetrated deeply the muscular fibers. The rats which mucosa was irrigated with Noni juice on day 5 demonstrated thinning of the cellular and horny layers. The cells of the glandular layer dies, the cells of the spinous layer were more adequate morphologically when compared with the animals after the exposure. On day 15 after the exposure and administration of Noni juice the oral mucosa was normal.

Conclusion: Local external application of Hawaii Noni juice is an effective antiradiation remedy. Administration of the juice resulted in reduction of manifestations of radiation lesions of the oral mucosa. The possibility of external application of the juice is shown, which allows more capabilities for prevention and treatment of superficial local radiation lesions.

Key words: radiation lesions, mucous membrane, Hawaii Noni juice, external use of anti radiation remedy.

 

2013, vol XXI, # 1, page 48

N.E. Uzlenkova, G.S. Grigor’eva, N.F. Konakhovich

Assessment of antioxidant properties of Esmin at total external x-ray exposure of the patients

 

Objective: To assess antioxidant properties of Esmin at single total external x-ray exposure of the patients to minimal lethal and sublethal doses.

Material and Methods: The investigation was performed on 182 white male rats weighing 160-180 g. Single total x-ray irradiation of the animals was performed using РУМ-17 unit in standard technical conditions. The investigation was done on days 3, 7, 14, 30, 90, 180 after the exposure. Esmin was administered orally at a dose of 75 mg/kg and 25 mg/kg according to the original protocol. The state of oxidation homeostasis was assessed by way of determining thiobarbituric acid active products (TBS-AP), activity of main antioxidant enzymes: superoxide dismutase (Cu/ZnSOD) (1.15.1.1.), catalase (CT) (1.11.1.6.), glutathione peroxidase (SeGPO) (1.11.1.9) and amount of glutathione (GSH) in the blood and organs of the animals. The obtained findings were statistically processes using Biostatistics v.4.03 for Windows.

Results: Pronounced antioxidant properties of Esmin were determined by normalization of TBS-AP amount, prevention of exhaustion of запобіганням виснаженню активності Cu/ ZnSOD, CT and SeGPO activity and preserved endogenic GSH in the blood, lungs, and skin of the rats at early and long terms after total external x-ray exposure tat the dose of 4.0 and 6.2 Gy.

Efficacy of Esmin administration with the purpose to prevent development of prolonged oxidation stress and normalization of disorders of oxidation homeostasis developing at acute radiation exposure was revealed.

Conclusion: Esmin demonstrates pronounced antioxidant properties at total external x-ray exposure at a dose of 4.0 and 6.2 Gy.

Key words: total external x-ray exposure, oxidation homeostasis, Esmin, antioxidant properties.

 

2013, vol XXI, # 1, page 56

O.P. Lukashova

The effect of ionizing radiation and etoposide on apoptosis and ultrastructure of Guerin's carcinoma cells

 

Objective: To perform electron microscopy of separate and combination effect of irradiation and chemotherapy with etoposide on the ultrastructure of Guerin's carcinoma cells and apoptosis development at various terms.

Material and Methods: Standard methods of electron microscopy were used to investigate the ultrastructure of Guerin's carcinoma cells after local x-ray exposure at a dose of 5 Gy, administration of etoposide at a dose of 8 mg/kg, and combination of chemotherapy and radiation therapy (irradiation at a dose of 5 Gy 18 hours after etoposide administration). The investigation was performed 3, 6, and 24 hours after the exposure. Intact tumors served as controls.

Results: It was determined that irradiation resulted in occurrence of the cells in the state of apoptosis death 3 hours after the irradiation. Their ultrastructure was characterized by nucleus with chromatin accumulating like dark masses along the nucleus membrane while granular protein substance (obviously enzymes of protein metabolism) appeared in the karyo-plasms. The cytoplasm created scalloped processes and apop-tosis bodies, the structure of its organelles was damaged. Six hours after the exposure apoptosis processes decelerated, 24 hours later tumor cells (TC) in this state were not observed. Under the influence of etoposide apoptotic death of TC was not distinct and this was not observed 6 hours later. Considerably greater effect was produced by combination use of chemotherapy and radiation therapy. With this apoptosis index significantly increased at all terms of the investigation with its maximum 6 hours after the exposure. Various stages of its development were observed: from TC with almost normal cytoplasm to the cells with fragmented cytoplasm, or cell death occurred. Apoptosis processes finished 24 hours after the exposure.

It was determined that etoposide administration inhibited division processes, especially 24 hours after the administration, which corresponded to the mechanism of its action. Considerable mitotic activities were observed in all terms after chemo-radiation treatment.

Conclusion: Irradiation and etoposide used separately are weak inductors of apoptosis in Guerin's carcinoma. Etoposide administered 18 hours before irradiation creates conditions for considerable stimulation of apoptosis processes at early terms after the exposure with pronounced maximum 6 hours after the exposure. Etoposide decelerates mitotic activity of Guerin's carcinoma cells which manifests 24 hours after the administration both at separate use and in combination with irradiation and is accompanied by increase of the number of small TC. Radiation effect on the Guerin's carcinoma ultrastructure is appearance of bi- and polynuclear cells as well as those with micronuclei.

Key words: radiation, etoposide, Guerin's carcinoma, ultrastructure, apoptosis.

 

2013, vol XXI, # 1, page 64

T.V. Segeda, N.A. Mítryaeva, T.S. Bakay, L.V. Grebínik, N.A. Babenko

Influence of simultaneous action of ionizing radiation and etoposide on sphingomyelin cycle in the blood serum of tumor carrying rats

 

Objective: To investigate the influence of ionizing radiation and etoposide on sphsngomyelin cycle (activity of acid Zn2+-dependent sphingomyelinase, ceramide and sphingomyelin) in the blood serum of the rats with inoculated Guerin's carcinoma.

Material and Methods: Wistar rats weighing 160-180 g with subcutaneously inoculated Guerin's carcinoma were used as an experimental model. The zone of the tumor growth was irradiated using РУМ-17 unit (x-rays) and Clinac 600 С unit (high-energy photons) in fractions with 24-hour intervals, absorbed dose per fraction 5 Gy, total dose on the tumor growth zone 10 Gy.

An antitumor drug etoposide (Teva) was administered intraperitoneally 24 hours before the first course of irradiation at a dose of 8 mg/kg body mass. Decapitation was performed 24 hours after the last irradiation. To determine sphingomyelin enzyme activity in the blood serum of rats, [cholin-methyl -14С] sphsngomyelin (1924 MBq/mmol, PerkinElmer, USA) was used as a substrate. Lipid extraction from the serum was done using Folch technique. To identify lipids standard ceramide and sphingomyelin (Sigma) were used.

Radioactivity of the samples was measured using БЕТА-1 counter (Medpribor, Kyiv). Statistical analysis was done using non-parametric methods for small samples and criterion Wilcoxon-Mann-Whitney criterion.

Results: It was shown that etoposide significantly increased activity of sphingomyelin cycle in the blood serum when compared with the controls. At separate action of irradiation, the changes in the activity of sphingomyelin cycle were not observed. It was established that simultaneous action of x-rays or high-energy photons and etoposide, activity of acid Zn2+-dependent sphingomyelinase increased by 81 and 91 % , respectively, with this the level of proapoptosis ceramide increased 4.4 and в 4.7 times and the level of apoptotic sphingomyelin decreased 2.6 and 2.5 times, respectively, when compared with the controls.

Conclusion: Simultaneous action of radiation and etoposide results in increased activity of acid Zn2+-dependent sphingomyelinase, which results in accumulation of proapoptosis lipid ceramide in the lipoproteids of the blood serum in tumor-carrying rats, which, in turn, can induce cell death in the microvascular epithelium and thus promotes tumor regression.

Key words: Guerin's carcinoma, ceramide, sphingomyelin, acid Zn2+-dependent sphingomyelinase, etoposide, ionizing radiation, apoptosis.

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