2008, vol XVI, # 2
2008, vol 16, # 2, page 135
The questions of working out radiology patterns of portal hypertension
Objective: To create a foundation for radiological patterns of each type of portal hypertension (PH) at various stages of its development.
Material and Methods: Literature data about pathoanatomical and pathophysiological manifestations of portal hypertension were analyzed.
Results: The signs of portal hypertension were divided into 3 groups and shown in the tables. Greater elevation of portal blood pressure was observed in subhepatic PH, the lowest one was observed in suprahepatic PH. Volume blood flow velocity in the portal vein and splenic and hepatic arteries was considerably diminished in subhepatic PH, in suprahepatic PH its reduction is moderate. Splenic and portal vein diameter can change considerably depending on the stage of the pathological process but these changes are more pronounced in subhepatic and hepatic forms. Frequency of various complications is an important parameter: ascites is frequent in subhepatic PH; demonstration of various esophageal veins suggests hepatic PH.
Conclusion: Portal blood pressure, diameter of splenic and portal veins, volume blood flow velocity in the portal and splenic veins, incidence of hypersplenism, enlargement of the caudate lobe of the liver and gallbladder fossa are the most informative in differentiation of various forms of portal hypertension. The changes of both functional and morphological signs are greater in subhepatic PH. This form is also characterized by frequent complications. Laboratory findings in various forms of PH change in a similar manner therefore they cannot be used to verify PH, but can characterize its degree. A foundation for forming radiological patterns of each type of PH at various stages of its development was created.
Key words: portal hypertension, radiological patterns.
2008, vol 16, # 2, page 141
R.Y. Abdullaev, V.V. Grabar, V.D. Dedgo
Infertility diagnosis using transvaginal echography
Objective: To study the capabilities of two-dimensional echography, colored Doppler mapping (CDM), pulsed wave mode at transvaginal approach in women with primary or secondary infertility.
Material and Methods: Transvaginal echography (TE) was performed in 49 infertile women aged 23-37 (mean age 28±2 years). Inability to conception after 12 months of regular sex life without contraception was considered infertility.
In 13 patients (26.5 %) infertility was secondary with 1-3 previous pregnancies terminated with artificial abortions, spontaneous abortion or preterm delivery. Echography findings of the patients with polycyctic ovary (PCO), multifollicular ovaries, ovulation disorders were analyzed.
Results: In all cases classical echographic signs of polycystic ovary were registered as a thickened hyperechoic protein membrane, multiple (>15) follicles with atresia. Colored Doppler investigation demonstrated higher parameters of the blood flow resistance index (over 0.7). In patients with multifollicular ovaries TVE demonstrated more rounded follicles with a thin wall. The dominant follicle was determined in 6 of 7 cases. At colored Doppler investigation weak vascularization of the follicle wall was noted.
In syndrome of luteinization of non-ovulated follicle, slight vascularization of the wall of the dominant follicle was present. Within the period of expected ovulation and after it the diameter of the pre-ovulation follicle did not change though its outline was slightly deformed. Resistance index was 0.49-0.55. During secretory phase the follicle persisted. In the group of the patients with lutein phase insufficiency (LPI), main deviations from the norm were registered at investigation during lutein phase. Yellow body vascularization in the form of a crown was visually more intensive in healthy women, resistance index was significantly lower. In LPI this index was 0.68 ± 0.03 on an average, while in patients with normal ovulation it was 0.51 ± 0.02 (p< 0.001).
Conclusion: Transvaginal echography with CDM allows to reveal deviations from the norm in physiological cyclic changes in the follicular apparatus and diagnose the causes of infertility in the majority of cases.
Key words: infertility, transvaginal echography, color Doppler mapping of the blood flow.
2008, vol 16, # 2, page 146
N.I. Afanaseva, N.I. Luhovickaya
Comparison of informativity of scintigraphy with 99mTc-pertechnetate, 99mTc-MIBI and 99mTc-(V)DMSA at visualization of iodine-negative metastases and/or relapses of differentiated thyroid carcinoma
Objective: To investigate specificity and sensitivity of scintigraphy with 99mТc-pertechnetate, 99mТc-MIBI and 99mТc-(V)DMSA at visualization of iodinenegative metastases and/or relapses of differentiated thyroid cancer.
Material and Methods: Scintigraphy with 99mТc-pertechnetate was performed in 27 patients, 99mТc-MIBI in 48 patients, and 99mТc-(V)DMSA in 47 patients. The study was performed using tomography gammacamera SFECT-1. ААДУ. 94.1351.002. Sensitivity and specificity of the methods was determined using ROC-analysis.
Results: Analysis of radionuclide investigation findings of the patients with iodine negative metastases and/or relapses of TGDC showed that the highest parameters of specificity (85%) and sensitivity (76%) at diagnosis of iodine negative metastases and/or relapses of thyroid cancer were observed at scintigaraphy with 99mТc-(V) DMSA. Scintigraphy with 99mТc-MIBI is also informative, its specificity being 87% and sensitivity 66%. The most widely-used method of diagnosis, scintigraphy with 99mТc-pertechnetate, appeared uninformative due to its low sensitivity (20%).
Conclusion: The most promising and informative method of diagnosis of iodinenegative metastases and/or relapses of thyroid carcinoma is scintigraphy with 99mТc-(V) DMSA.
Key words: thyroid carcinoma, radionuclide diagnosis, iodinenegative metastases and relapses.
2008, vol 16, # 2, page 153
L.I. Simonova, L.V. Bilogurova, V.Z. German, S.M. Pushkar, P.M. Muzikant, G.I. Nesterenko
The prospects of application of natural antioxidants in correction of blood coagulation in patients with breast cancer during radiation therapy
Objective: To assess the efficacy of a natural biologically active antioxidant additive Bipolan in accompanying therapy with the purpose of prevention and restoration of coagulation homeostasis in patients with breast cancer (BC) during postoperative radiation therapy.
Material and Methods: Homeostasis system indices were determined using instrumental (blood count) and biochemical methods. The study involved 47 patients (aged 35-75) with stage I-IIA BC with homeostasis disorders of hypercoagulation type. The controls (26 patients) were administered combination antitumor treatment with the use of generally accepted antithrombogenic drugs. The patients from the experimental group (21 persons) were administered Bipolan during post-operative radiation therapy.
Results: As an accompanying therapy of the patients with BC Bipolan produced positive effect on coagulation homeostasis. By the end of the course of treatment the indices of homeostasis normalized in the experimental group of the patients; manifestations of DIC syndrome and thromboembolic complications were controlled.
Conclusion: Administration of Bipolan during an accompanying therapy at post-operative radiation therapy for BC positively influences the state of coagulation homeostasis and reduces considerably thromogenic potential. In all patients, who received this drug, main parameters of homeostasis normalized with disappearing of the signs of paracoagulation processes. This suggests about decrease of DIC syndrome possibility and minimizes the risk of thromboembolic complications. Positive influence of Bipolan on restoration of coagulation homeostasis system allows including antioxidants and anti-thrombogenic remedies in complex anti-tumor treatment.
Key words: breast cancer, coagulation homeostasis, hypercoagulation, DIC syndrome, bio-antioxidants, Bipolan.
2008, vol 16, # 2, page 158
O.A. Mihanovsky, V.S. Suhin
Clinical characteristics and treatment efficacy in patients with stage IA-IIA, IIIB squamous cell uterine cervix carcinoma
Objective: To analyze the results of treatment of the patients with stage IA-IIA, IIIB (T1a-2aN0-1M0) squamous cell uterine cervix cancer (UCC).
Material and Methods: Retrospective study of patients with stage IA-IIA UCC treated at Grigoriev Institute for Medical Radiology during 1994-2007 was performed. Squamous cell UCC was verified in 153 (76.5 %). The age of the patients was 46.4 (27-78 years), median 46 years. Clinical features of squamous cell UCC were investigated. Different protocols of treatment and outcomes were analyzed.
Results: Stage IA-B (T1a-bN0M0) squamous cell UCC was revealed in 66,7 %, while in 17.6 % - stage IIA (T2aN0M0). Metastases to the regional lymph nodes (stage IIIB) were revealed in 15.7 %. In 66 (43.1 %) cases multimodality treatment started with surgery, in 45 (29.4 %) cases from pre-operative irradiation. Surgery alone was performed in 42 patients with squamous cell UCC (27.5 %). Disease relapse developed in 16 patients with stage IB-IIA, IIIB (T1b-2aN0-1M0) squamous cell UCC within the period of 5-48 months, in 11 of 68 patients (16.2%) in whom the treatment started from surgery, and in 6 of 45 (13.3%) patients in whom multimodality treatment started from pre-operative radiation therapy.
Conclusion: The use of pre-operative radiation therapy in the protocol of special treatment for resectable squamous cell UCC is an important factor reducing 1.8 times the incidence of relapses in stage IIA (T2aN0M0) patients and 1.4 times in stage IIIB (T1b-2aN1M0) patients.
Key words: squamous cell uterine cervix cancer, radiation therapy, relapse incidence.
2008, vol 16, # 2, page 163
O.P. Lukashova, O.A. Mihanovsky, O.V. Slobodanuk
Ultrastructure of uterine body adenocarcinoma cells after different protocols of pre-operative radiation and chemotherapy
Objective: To analyze the ultrastructure of tumor cells of uterine body cancer depending on the character of combination treatment with the purpose to assess the treatment efficacy.
Material and Methods: The tumors (different degree adenocarcinoma) of 21 patients with stage I-II uterine body cancer were investigated after application of various protocols of radiation and chemotherapy. The radiation therapy was delivered in the traditional fractions (2 Gy per fraction up to total focal dose of 20 and 30 Gy). 5-fluorouracil (5-FU) was administered intravenously at a single dose of 250 mg 30 min before each irradiation.
The patients were divided into 4 groups: group 1 - TFD 20 Gy, group 2 - TFD 20 Gy + 5-FU, group 3 - TFD 30 Gy, group 4 TFD 30 Gy + 5 FU . The ultrastructure (US) of the tumor cells was investigated using standard electron microscopy.
Results: It was established that in all groups there were patients with considerable damage of the tumor cells (TC), while in some patients the tumors preserved intact and obviously vital cells. The characteristic signs of the TC ultrastrucutral pathomorphism are cell destruction, abnormal lightening with organelles disappearing, considerable increase of the number of dark forms with a picnotic nucleus and vacuolized cytoplasm, accumulation of lipids, phagosomes and fibrous material in the cytoplasm. Lymphocyte infiltration and growth of collagen fibers among TC was observed. At exposure to TFD of 20 Gy all tumors consisted of TC with damaged US. Increase of TFD to 30 Gy resulted in significant reduction of the number of cases with marked pathomorphism of the TC as well as in group 2 with additional administration of 5-FU (TFD 20 Gy + 5-FU). At simultaneous increase of the dose of radiation and 5-FU resulted in marked damage of the TC in 80% of cases.
Conclusion: A complex of ultrastructural signs of uterine body adenocarcinoma cell damage both at exposure to radiation and chemical factors is particular for each case. The cells of uterine body adenocarcinoma are sensitive to irradiation at a dose of 20 Gy while with TFD increase up to 30 Gy this effect decreases. According to the parameters of ultrastructural pathomorphism pre-operative chemoradiation therapy for uterine body cancer is more effective both at increase of the doses of radiation and 5-FU (TFD 30 Gy + 5-FU).
Key words: uterine body cancer, pre-operative chemoradiation therapy, ultrastructure.
2008, vol 16, # 2, page 171
L.O. Gaysenuk, G.V. Kulinich, L.L. Stadnik, S.M. Fillipova, E.B. Radzishevskaya
The changes in the health condition of medical personnel working with ionizing radiation in Kharkiv and Kharkiv Region (20-year observation)
Objective: To study the changes in the condition of health of medical personnel from Kharkiv and Kharkiv Region working with ionizing radiation depending on the age, duration of work service and accumulated dose using the finding of 20-year observation.
Material and Methods: During the period of 1986-2006 the condition of health of 300 persons from Kharkiv and Kharkiv Region working with ionizing radiation for 5-20 years (accumulated dose for the whole period not exceeding 50 mSv), which corresponded to NRBU-97 for category A of personnel, was monitored by Central Follow-up Commission of Grigoriev Institute for Radiology using medical dosimetry registry for this category of medical professionals.
Results: A complex of changes in the condition of health of the professional suggesting the presence of cardiovascular, nervous, endocrine and digestive system as wall as female sex organs and eye pathology were revealed in this group. The incidence of cardiovascular diseases (hypertension, coronary artery disease) made up 52-56 %. Prevalence of nervous system diseases (vegetovascular disorders, asthenic and neurasthenic syndromes, stage 1 dyscirculatory encephalopathy) was characterized by relatively stable indices and made up 32-33 %.
Female reproductive system pathology was registered in 34-67 % of cases (uterus fibromyoma and chronic adnexitis, relatively). Eye diseases (myopia, astigmatism) reached 33 %. A tendency to increase of the disease incidence with the increase of duration of service and accumulated dose was noted.
Conclusion: The statistical analysis of the findings of follow-up of the medical personnel working with ionized radiation revealed pathology in the main organs and systems in this category of professionals as well as a tendency to increase of diseases of the cardiovascular, nervous system, eye with the increase of duration of work service and dose.
To obtain more significant findings it is necessary to continue the investigation on the larger patient groups.
Key words: medical personnel, professional exposure doses, follow-up, changes in the condition of health.
2008, vol 16, # 2, page 178
Influence of the type of rat reaction on the course of acute radiation sickness
Objective: To reveal the association between the types of reaction determined according to the behavior in “open filed” unit and the course of acute radiation sickness in the animals.
Material and Methods: The study was performed on 670 male Wistar rats divided into the types of reaction in “open field” unit, and exposed to standard x-ray radiation at lethal doses (5.9 and 6.5 Gy). Mortality and frequency of acute radiation sickness manifestations were analyzed.
Results: The analysis of behavior reactions allowed to distinguish 3 types of reaction: weak (type 1), medium (type 2), severe (type 3) with different resistance to ionizing radiation. The most resistant were the rats with type 2 of reaction. In types 1 and 3 acute radiation sickness was more severe with higher incidence of manifestations.
Objective: To reveal the association between the types of reaction determined according to the behavior in “open filed” unit and the course of acute radiation sickness in the animals.
Conclusion: The experience of application of “open field” unit demonstrated stability of distribution of the rats from the same animal retainer into three types of reactivity (weak, medium, severe) with the ratio (1.3-1.4) : (1.6-2.0) : 1. X-ray exposure of the animals at a dose of 5.9 and 6.5 Gy revealed higher resistance of the animals with type 2 reactivity which significantly differed in death arte and frequency of clinical syndromes from the marginal types. This phenomenon is more pronounced at the lower dose. The presence of association between the types of the organism reactivity and radiosensi-tivity can be used to work out the methods of testing in humans.
Key words: individual radiosensitivity, radiation damage, reaction types, “open field” unit, radiation sickness.
2008, vol 16, # 2, page 183
N.A. Nikiforova, O.V. Kuzmenko, I.A. Gromakova, M.O. Ivanenko
Individual features of leucopoiesis restoration in rats after total single x-ray exposure
Objective: To investigate leucopoiesis restoration in rats after total single x-ray exposure at a dose of 6 Gy in the morning and evening depending on individual reaction of the animals to stress test.
Material and Methods: The experiment was performed on Wistar 68 male rats. Two weeks prior to the exposure the animals were exposed to 3-hour immobilization stress in prone position. The rats were divided into hypo- and hyperreactive animals with the consideration of lymphocyte to neutrophil ratio. The animals were exposed to a single dose of 6 Gy at 8 a.m. and 8 p.m. The influence on leucopoiesis was investigated on days 3, 7, 14, 21, 30 after the exposure.
Results: Individual variation in the reaction of the animals to stress was determined by the degree of post-radiation disorders of the peripheral blood white sprout beginning from day 3 after the exposure. The changes in quantitative parameters of the blood of the rats irradiated at 8 p.m. significantly differed between hypo- and hyperreactive animals at all terms of the observation. It was established that irrespective or the time of the day x-ray exposure of both hypo- and hyperreactive animals, complete restoration of total amount of leukocytes, relative amount of lymphocytes and neutrophils were not observed until the end of the study (day 30).
Conclusion: Minimal damage of leucopoiesis was revealed in hyporeactive animals irradiated at 8 p.m. when compared with hyperreactive animals and all animals (irrespective of their reaction) irradiated at 8 a.m. Higher survival of hyporeactive animals vs hyperreactive ones was established.
Key words: immobilization stress, ionizing radiation, individual reaction, leucopoiesis.
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.
Since 1993 the Institute became the founder and publisher of "Ukrainian Journal of Radiology”: