[Videothoracoscopic collagen pleurodesis in malignant pleural effusion]. / Videotorakoskopicheskii kollagenovyi plevrodez pri zlokachestvennom plevral'nom vypote.

AIM: To devise the technique and evaluate the efficacy of videothoracoscopic collagen pleurodesis (VCP) in malignant pleural exudates (MPE). MATERIAL AND METHODS: VCP was performed in 24 patients with recurrent MPE. 20 patients were diagnosed to have non-small-cell cancer of the lung, 4 patients--breast cancer. The operation included videothoracoscopic revision of the pleural cavity under endobronchial anesthesia, pleural biopsy, liquid evacuation, dispersion of powder collagen (1 g) and drainage of the pleural cavity. RESULTS: Videothoracoscopy macroscopically diagnoses pleural carcinomatosis in 100% patients. Pathomorphological examination of the biopsies defined a histological type of the tumor in all 24 patients. A positive clinicoroentgenological effect with a compete disappearance of pleural exudates was achieved in all the cases. The recurrence was absent in 18 of 24 patients. Short- and long-term results, survival and quality of life are outlined. CONCLUSION: VCP is a simple and effective method of palliative treatment improving quality of life in patients with malignant pleural exudates.

[Diagnostic tactics in localized fibroadenomatosis of the breast]. / Diagnosticheskaia taktika pri lokalizovannom fibroadenomatoze molochnoi zhelezy.

Results of the examination and treatment of 203 patients with localized fibroadenomatosis of the mammary gland are described. The authors give an estimation of diagnostic algorithms used when detecting the physical signs of the disease. It was shown that the examination of patients with the palpation signs of nodular mastopathy should necessarily include mammography which can eliminate unwarranted risk of hypodiagnosing carcinoma of the mammary gland and determine the group of patients in whom the emergency operation is not necessary.

[Treatment of metastatic pleural effusion with intrapleural administration of bleomycetin]. / Lechenie metastaticheskikh opukholevykh éksudativnykh plevritov vnutripolostnym vvedeniem bleomitsetina.

The report presents data on conservative treatment of pleuritis induced by metastases from tumors of different localization by bleomycetin. After the pleural cavity was drained dry in 24 patients, bleomycetin 45 mg was introduced into it. The latter procedure was repeated in 6 cases because profuse exudation continued. The results were evaluated by clinical and roentgenological means. Bleomycetin treatment was painless. Mean drainage duration was 3.8 days, admission time--6.2 days. Stable remission was recorded in 16 patients, partial--7. Pneumonia (2) and chronic empyema (1) were observed as complications. Bleomycetin-induced pleurodesis correlated with exudate pH: a pH value in excess of 7.3 made a patient good candidate for carrying out the procedure. According to Karnofsky index for long-term results, life quality of the patients improved. Eleven patients survived for 1 year after pleurodesis, and 2--more than two years.

[Aromatase activity in lymphocytes of cancer patients and healthy subjects]. / Aktivnost' aromatazy v limfotsitakh onkologicheskikh bol'nykh i zdorovykh liudei.

Conversion of androgens (aromatization) to estrogens in lymphocytes of cancer patients and healthy subjects in vitro was discovered. Aromatase activity in lymphocytes was comparable to that of fat and breast tumor tissues. It was completely suppressed in one out of two breast cancer patients receiving orimeten (aminoglutethimide). The activity in large bowel cancer was lower than in adenoma patients; however, the two groups were not balanced for age.

[Results of a cooperative clinical study of the Russian antineoplastic antibiotic bleomycetin]. / Rezul'taty kooperirovannogo klinicheskogo izucheniia otechestvennogo protivoopukholevogo antibiotika bleomitsetina.

Cooperative clinical trials of a newly-developed antibiotic--bleomycetin (a purified fraction of bleomycin A5) conducted in 172 patients at 7 oncological centers revealed a spectrum of antitumor activities similar to that displayed by Japanese-made bleomycin. When administered by intravenous or intramuscular injection in single or total doses amounting to only 50-70% of those of bleomycin (bleocin), bleomycetin proved effective in the treatment of extended squamous cell carcinoma of the head and neck, skin, cervix uteri, embryonal cancer of the testicle and, particularly, recurrent Hodgkin's disease and non-Hodgkin's lymphoma. Single administration of 15-50 mg bleomycetin (total dose--50-150 mg) to serous cavities was followed by the cure of specific pleurisy and ascites in 47%. Unlike bleomycin, bleomycetin treatment was free of pulmonary toxicity, and skin hyperpigmentation, hyperkeratosis, vomiting and alopecia were significantly less frequent.

[Bone involvement in lymphogranulomatosis (clinical, x-ray and thermographic studies)]. / Porazheniia kostei pri limfogranulematoze (klinicheskie, rentgenologicheskie i termograficheskie issledovaniia).

Clinico-roentgenologic and thermographic signs of bone involvement were studied in 53 cases of Hodgkin's disease. Although radionuclide and X-ray procedures were found to be diagnostically superior over thermography, the latter is complication-free, time-saving and can be used repeatedly. It, therefore, may be recommended as the first diagnostic procedure when bone involvement is suspected. As a result of the treatment, regression was observed in 50% and stabilisation--in 30.6% of pathologic foci. Radiation-induced hyperthermia accounts for low reliability of thermography in evaluating response.

[Use of tamoxifen in patients with disseminated and local breast neoplasms]. / Primenenie tamoksifena pri lechenii bol'nykh disseminirovannymi i mestno-rasprostranennymi formami raka molochnoi zhelezy.

The efficacy of tamoxifen treatment was studied in 46 postmenopausal patients with localized and disseminated breast cancer. Objective remissions were observed in 47.8, stabilization of tumor process-in 21.7%, mostly in cases of metastasis into the skin, subcutaneous fat, lymph nodes, pleura and bones. Tamoxifen proved sufficiently effective both in primary treatment and as a measure taken when the effect of a specific therapy (radiation, cytostatic or hormonal) was over. Side-effects were slight and were registered in 19.6%.

[Thermography in the combined diagnosis of minimal breast cancer]. / Termografiia v kompleksnoi diagnostike minimal'nykh rakov molochnoi zhelezy.

A group including 65 patients with minimal form of breast cancer (less than 1 cm in dia) was used in a study on the scope of application of thermographic procedures for diagnosis. Correct preoperative diagnosis of cancer was established on the basis of thermographs in 40 out of 65 cases (61.5%), clinical data--53 out of 65 cases (81.5%) and mammographs--in 23 out of 39 cases (59.0%). Application of these diagnostic procedures yielded false negative predictions in 2 cases (5.1%) only. Thermographs showed minimal cancers of the breast chiefly as chaotic vascularization in 60%. The frequency of identification of pathologic alterations by means of thermography is determined by the size of tumor focus, presence of regional metastases and malignity of tumor process. Since thermography appeared to provide a sufficiently reliable means for identification of minimal cancers of the breast, this procedure should be recommended for use in mass screenings.

[Use of prospidin in the combination chemotherapy of recurrences of generalized forms of lymphogranulomatosis]. / Primenenie prospidina v kombinirovannoi khimioterapii retsidivov generalizovannykh form limfogranulematoza.

Combined chemotherapy (prospidin, cyclophosphamide, vincristine and prednisolone) (PCVP) was given to 32 patients with recurrent generalized forms of Hodgkin's disease. Remission was reliably established in 75% of patients; its mean duration was 2.8 months. 15 patients received repeated courses of complex chemotherapy, including prospidin; it proved effective in 12 of them. Mean duration of remission was 2.7 months. Toxic side--effects were insignificant and subsided quickly. The results of the study point to the effectiveness of PCVP scheme application in patients with recurrent generalized forms of Hodgkin's disease.

[Results of the clinical study of the antineoplastic antibiotic bleomycetin]. / Rezul'taty klinicheskogo izucheniia protivoopukholevogo antibiotika bleomitsetina.

Bleomycetin was applied to the treatment of 68 patients with common forms of malignant tumors. The objective therapeutic effect was observed in 21 patients (31 per cent). The frequency of the favourable therapeutic effects was the most significant in the group of patients with generalized forms of lymphogranulomatosis: objective remissions for 1 to 4 months and stabilization of the tumor process were attained in 12 (41 per cent) and 8 out of 29 patients, respectively, in 9 patients (31 per cent) treated with bleomycetin progression of the underlying disease was recorded. A less pronounced therapeutic effect (33 per cent of the remissions) was recorded in the patients with nonlymphogranulomatous lymphomas. The use of bleomycetin in 48 out of 68 patients was complicated by certain adverse reactions. Intravenous infusions of bleomycetin in a dose of 10-15 mg twice a week (the total dose up to 125 mg) may be recommended as the initial therapeutic regimen in the oncological practice. The trials have showed that bleomycetin made in the USSR has a sufficiently pronounced activity against lymphogranulomatosis and nonlymphogranulomatous lymphomas. In this respect it is not inferior to the bleomycin analog made in Japan.

[Use of preparation VM 26 (epipodophyllotoxin) for treating lymphomas in children and adults]. / Primenenie preparata VM-26 (épipodofillotoksi n) dlia lecheniia limfom u detei i vzroslykh.

A coordinated clinical trial (phase II) of preparation VM-26 supplied by Sandos (Switzerland) was carried out at 5 clinics in a total of 61 patients with lymphoma. Two regimens of VM-26 administration were employed: (1) 5-day courses of 30 mg/m2 iv with 7-14 day intervals, or (2) two injections of 50 mg/m2 a week, within 4-6 weeks, depending on drug tolerance Out of 15 children with Hodgkin's disease, 50% of cases showed complete or partial remission. Out of 27 adults with Hodgkin's disease, response was registered in 69.9 and a pronounced effect--in 1 26.1%. Out of 14 patients with lymphosarcomas, response was observed in 78.5 and a pronounced effect--in 57.2%. Toxic effect was not the cause of treatment suspension in most cases.

[Effect of hydroxyprogesterone caproate on immunological skin tests and on the T-lymphocytes in cancer of the corpus uteri]. / Vliianie oksiprogesteron-kapronata na kozhnye immunologicheskie testy i T-limfotsity u bol'nykh rakom tela matki.

Under study was the effect of oxyprogesterone-capronate (500 mg daily, total dosage of 10 g) on delayed cutaneous hypersensitivity reaction (DCHR) to tuberculin and candidine as well as the level of T-lymphocytes and cortisol in the peripheral blood in 34 patients with primary cancer of the corpus uteri. Prior to the treatment there was a considerable negative correlation between metabolic and immunological indices. Under OPC exposure DCHR enhanced in 62% of observations. In 7 of 12 patients the level of T-lymphocytes was increased and blood cortiol level decreased in 6 of 11 patients. 58 per cent of the observations showed a parallelism between the effect of OPC on the skin tests and the tumor histostructure, and in 8 of 12 patients on the level of T-lymphocytes and the tumor histostructure.

[Effect of fenformin and miscleron on the delayed hypersensitivity reaction in breast cancer patients]. / Vliianie fenformina i misklerona na reaktsiiu giperchuvstvitel'nosti zamedlennogo tipa u bol'nykh rakom molochnoi zhelezy.

Some preliminary results of using phenformin and miscleron in 17 breast cancer patients, previously radically operated upon, have been assessed as being characterized by metabolic disturbances associated with the reduced cell immunity level. The treatment of patients during 15--7 months was shown to result both in the correction of endocrine-metabolic disorders and stimulation of delayed hypersensitivity response, determined by skin tests with dinitro-chlorbenzene, tuberculin and Candida. The necessity to liquidate metabolic metabolic immunodepression with the aim of prophylaxis and treatment of the tuumor process is discussed. Some other routes of metabolic immunotherapy in addition to using phenformin and miscleron are considered. It seems rational to study the effect of a continuous administration of such kind of drugs on the results of treatment of oncological patients.

[Possibilities of preventing cardiotoxic complications in chemotherapy with carminomycin]. / Vozmozhnosti preduprezhdeniia kardiotoksicheskikh oslozhnenii pri khimioterapii karminomitsinom.

Carminomycin chemotherapy of the patients with malignant tumors is often complicated with cardiopathy which is sometimes assymptomic and registered only electrocardiographycally. Chemotherapy on the background of reparative regeneration stimulators from the series of synthetic pyrrimidine derivatives, such as methyluracyl for oral use and a soluble salt of methyluracyl for parenteral administration significantly decreased the rate of the cardiotoxic complications and promoted a decrease in their level. The use of methyluracyl and its soluble salt did not decrease the therapeutic effect of carminomycin. Methyluracyl and its soluble salt may be recommended for prophylaxis of cardiotoxic complications in chemotherapy of malignant tumors with carminomycin.

[Immunologic reactivity of breast cancer patients]. / Immunologicheskaia reaktivnost' u bol'nykh rakom molochnoi zhelezy.

An attempt was made to further characterize some conditions determining the decrease of immunological responsiveness in patients with mammary gland cancer. To reveal the delayed-type cell hypersensitivity, the antigens of Mycobacterium tuberculosis, staphylococcus, fungi Candida were employed as well as a contact allergen--dinitrochlorobenzene. Tests were made prior to the treatment and in different terms after it. To determine T-lymphocytes the rosette-formation test with sheep erythrocytes was used. Also, the degree of lymphoplasmocytic infiltration of the tumor and the amount of peripheral blood lymphocytes were estimated. Under examination were 126-patients with mammary gland cancer, 56--with benign tumors and 73--practically healthy subjects. The frequency of positive skin tests for any of the antigens under study was lower in breast cancer patients than in the group with benign tumors and healthy subjects. There was no manifest inhibition of the immune response in the initial stages of mammary gland cancer.

[Thermography in differential diagnosis of lymphostasis in the lower limbs]. / Teplovidenie v differentsial'noi diagnostike limfostazov nizhnikh konechnostei

The authors report the data concerning the use of lymphography and thermography with the purpose of establishing the differential diagnosis in 42 patients with edema of the lower limbs of a different origin. A comparative estimation of different methods of the differential diagnosis indicated the advantages of infra-red thermography.