[Assessment of oncologic risk of breast reconstruction simultaneous with surgery for breast cancer].

The report deals with retrospective research in possible induction of relapse by breast reconstruction carried out simultaneously with surgery for breast cancer. The end results were compared between cases of modification of radical mastectomy combined with reconstruction (n=124) and controls who underwent surgery for cancer alone (n=379). Standard radio- and systemic therapy was used. Median follow-up was 64 months. Local and general recurrence as well as relapse-free and overall survival rates were identical. Multivariate analysis failed to establish any correlation between primary breast reconstruction and relapse. Nor did it increase the risk of the development of the latter.

The use of TLD-700H dosemeters in the assessment of external doses at the former Semipalatinsk nuclear test site.

The joint projects performed since 1995 by the Jülich Research Centre in co-operation with the Kazakh National Nuclear Centre in the area of the former nuclear test site near Semipalatinsk, in eastern Kazakhstan, have assessed the current dose rate of the population at and around the test site, as well as determining retrospectively the dose rate of persons affected by the atmospheric tests. Measurements of the population by personal dosemeters depend on reliably wearing these dosemeters over prolonged periods of time, and of a sufficient dosemeter return. In the past, such measurements have been particularly successful whenever short wearing times were possible. This requires high sensitivity of the dosemeters. The suitability of the highly sensitive TLD material of the BICRON TLD 700H type for such personal dosimetry measurements was investigated. It was tested in practical field application at the Semipalatinsk nuclear test site in September 2000. Initial results are available from individual doses received by a group of geologists and a group of herdsmen at the test site. For the first time, the individual dose was measured directly in these population groups. Detection limits below 1 microSv permit informative measurements for wearing times of less than two weeks. Most individual doses did not arise significantly out of local fluctuations of natural background. A conservative assessment from the aspect of practical health physics yielded a mean personal dose of 0.55 microSv per day for the herdsmen, whereas the geologists received a mean personal dose of 0.45 microSv per day. For an annual exposure period of typically, about three months, the radiation dose received by the persons investigated, in addition to the natural radiation exposure, is thus well below the international limit value of 1 mSv x a(-1) for the population dose.

Cytogenetic biomonitoring carried out in a village (Dolon) adjacent to the Semipalatinsk nuclear weapon test site.

The Semipalatinsk region (Kazakhstan Republic) has been affected by extensive radioactive contamination due to more than 450 nuclear tests of which almost 100 were exploded in the atmosphere. The present results refer to cytogenetic assessments in a study cohort of the population of Dolon, a settlement located on the NE boundary of the nuclear weapon test site, which was exposed to elevated doses of ionising radiation primarily due to the first Soviet nuclear test in 1949. Conventional cytogenetic analyses were carried out on 21 blood samples from individuals (more than 50 years old) living in Dolon since the very beginning of nuclear testing. A matched control group included 20 individuals living in non-contaminated areas. Higher frequencies of chromosome aberrations were found in the Dolon cohort compared to the control group, even though they remain within the range of the background levels reported for large normal human population studies on elderly individuals.

[The effectiveness of breast-conserving surgery in T1-2N0M0 breast cancer]. / Effektivnost' organosokhraniaiushchikh operatsii pri rake molochnoi zhelezy T1-2N0M0.

A retrospective analysis of the end results of surgical treatment of 1.417 patients with T1-2N0-1M0 breast tumors is presented: local recurrence after radical surgery (1.151)-2.4% after radical resection (165)-5.5%, and after lumpectomy combined with axillary lymphadenectomy (101)-4.0%. In the T1N0M0 group, the end results of radical resection and radical mastectomy were identical. In the T1N0M0 and T2N0M0 groups, in which lumpectomy combined with axillary lymphadenectomy was performed, the end results were inferior to those radical mastectomy. There was a correlation between tumor cell detection in the blood and lymph vessels and extent of intervention: radical mastectomy-6%; radical resection-13% and lumpectomy combined with axillary lymphadenectomy-17%. The latter index tended to rise in cases of recurrence after breast-conserving surgery.

[Immediate results of the use of prospidin in a cyanoacrylate glue compound in cancer of the esophagus]. / Neposredstvennye rezul'taty primeneniia prospidina, deponirovannogo tsianakrilatnoi kleevoi kompozitsiei, pri rake pishchevoda.

Antitumor efficacy of a medical adhesive MK-8-based polymer drug composition with prospidin has been studied in 49 Wistar rats, and the kinetics of the drug elimination has been followed up in 112 rats. The findings evidence a prolongation of a relapse-free period and a longer survival of the animals. Clinical trials of the composition have been carried out. Of the 70 patients with esophageal carcinomas 52 ones had local disseminated forms, conforming to T4P3-4 indices. Application of the adhesive composition has not increased the rate of postoperative complications and in some cases considerably prolonged the life span of patients after palliative surgery.

[New approach to the analysis of surgical activities of oncological establishments]. / Novyi podkhod k analizu khirurgicheskoi aktivnosti onkologicheskikh uchrezhdenii.

A new approach to analysis of surgical activity in surgical oncological establishments is suggested which is based on work measurement in surgeon/hours. The unit of measurement is "a unit operation" which is, in turn, an equivalent of six surgeon/hours. The surgical activity of seven oncological departments was analysed. The new method was compared to those available and its advantage was shown. The procedure is applicable in any surgical activity assessment situation.

[Comparative evaluation of prostaglandins E1 and E2 in patients with hypertension]. / Sravnitel'naia otsenka deistviia prostaglandinov E1 i E2 u bol'nykh gipertonicheskoi bolezn'iu.

Changes in ABP, ECG, cerebral and peripheral hemodynamics were examined in 29 patients with second-stage essential hypertension before and within 1 or 2 days after PGE1 and PGE2 infusions administered during follow-up or in the presence of a hypotensive therapy. PGE were shown to be active vasodilators increasing cerebral and peripheral circulation. Vascular PG effects persisted for 1 or 2 days after the administration. Hypertensive patients demonstrated two patterns of hemodynamic response to PGE. The patients with higher total peripheral resistance (TPR) and low stroke and cardiac indices (SI and CI) during follow-up or hypotensive treatment were more sensitive to PGE, their ABP falling because of declining TPR. The patients with high SI and normal or slightly elevated TPR were less sensitive to PGE, their ABP falling mostly at the expense of declining SI. Most patients showed changed end portion of the ventricular complex immediately after PGE administration that vanished within one or two days. In coronary patients, angina of effort occurred less frequently after PGE infusion.

[Renal prostaglandins and hypertension]. / Prostaglandiny pochek i gipertonicheskaia bolezn'.

A total of 154 patients with essential hypertension (EH), 24 patients with renovascular hypertension (RVH), and 130 Wistar rats were investigated. PGE2 and PGF2 alpha levels were assayed radioimmunologically in renal venous blood and urine of the patients, and the synthesis of PGE2 and PGF2 alpha in renal tissue, renal PGE-9-ketoreductase activity and urinary PG excretion were measured in rats. It was demonstrated that the PGE2 synthesis was depressed in the vascular channel and the renal uropoietic system, with elevated F/E rations, in patients with arterial hypertension. Clinical and experimental studies showed prolonged and excessive salt consumption to be a cause of these changes, rooted in suppressed renal biosynthesis of both PGs and increased conversion of PGE2 to PGF2 alpha. In addition, renal PGE2 inactivation was increased in EH patients, as compared to those with RVH. PGE2 produced in the kidneys of EH patients is always a depressor natriuretic substance, whereas the role of PGF2 alpha is dependent on the water-salt balance. Furosemide and, to a smaller extent, other diuretics, as well as some hypotensive agents, increase urinary PG excretion and depress the F/E ratio in the urine. Repeated PGE2 infusions are shown to enhance the sensitivity of EH patients to hypotensive drugs, so they can be used for the treatment of refractory EH cases.

[Use of series E prostaglandins in the treatment of essential hypertension]. / Ispol'zovanie prostaglandinov serii E dlia lecheniia bol'nykh gipertonicheskoi bolezn'iu.

Fifty-four hypertensive patients with the average BP level of 208 +/- 3.2/125 +/- 2.4 mm Hg were infused 2 doses of PGE. Forty patients received PGE2 in the form of protein (USA) and 14 patients were administered PGE1 in the form of alprostadil (USA). Each patient received on the average 3.5 mg of PGE2 or 0.7 mg of PGE1 during 48 hours. PGE infusion by the devised scheme induced no significant side-effects, was attended by an increase in the diuresis and natriuresis as well as a BP decrease (more pronounced with PGE1) not only in the period of the infusion but also during the 2-3 days following it. The hypotensive effect and BP fall in the orthostatic position were more marked following PGE2 infusion. PGE enhanced the sensitivity of the patients to obsidan, clophelin, hydrochlorothiazide and to a lesser degree to corinfar. Infusion of PGE2 to patients with essential hypertension resistant to hypotensive agents reduced the BP and made it possible to diminish the number of the drugs prescribed and their doses. The hypotensive effect of the drugs administered persisted for up to 5-7 months. It can be expected that repeated infusions of PGE2 every 6 months, will contribute to an alleviation of arterial hypertension, the patient's clinical improvement and the lowering of doses of hypotensive drugs.

On the problem of gastric carcinoma cluster determination.

In the present study the author describes a method for the determination of a limited area (group of population) for carrying out epidemiological investigations into the occurrence of gastric cancer. The area thus determined is referred to as a focus or a cluster of gastric carcinoma occurrence. These clusters are derived from the comparison of the minimum population number (N-) in which there may develop, with 99% probability, kappa cases of gastric cancer at the given incidence rate, with the actual population number. All the necessary calculations were made using specially designed tables. If the actual population (with a rural Soviet) taken as a territorial unit) was less than N- at kappa cases of the disease, the author concludes that the occurrence of the given number of the disease cases at the corresponding Soviet exceeds the limit of chance and that in such a case it would be justified to undertake detailed analytical epidemiological investigations to review the hypotheses as to the genesis of gastric carcinoma.

[Surgical treatment of patients with malignant non-epithelial tumors of the stomach]. / Opyt khirurgicheskogo lecheniia bol'nykh zlokachestvennymi neépitelial'nymi opukholiami zheludka

Under study were the data obtained in 29 patients with malignant nonepithelial gastric tumors, which indicated a high incidence of this affection in persons under 50. Gastric reticulosarcomas are most frequently observed. The diagnosis is very difficult to establish both before and during laparatomy. Favourable late results were most frequently noted in patients subjected to radical surgical interventions. Radical and tentative laparotomies may be followed by chemo-or radiotherapy.