Biomedical subjects
Publications and source records attributed to A F Tsyb.
The paper is concerned with ultrasonic measurements of the thyroid volume. The findings obtained may be used in the diagnosis of hypo- and hyperplasias in children and adolescents living in the middle zone of the European part of the USSR.
The paper represents some results of a joint commission, organized by the USSR Ministry of Health by order of the USSR Council of Ministers at public requests. The commission worked in the area neighbouring the proving ground at Semipalatinsk in the period of May-July 1988. A radiological situation there was investigated after underground nuclear testing on July 8, 1989. The results of measurements and archive data were used to estimate doses of radiation exposure of the population in the period of 1949 (nuclear testing on the ground and in the atmosphere) and in the period of underground testing, It was shown that in the period of 1949-1963 approximately 10,000 people received increased doses of external and internal irradiation. A high level of radiation-induced chromosome aberrations was noted among them. The highest effective equivalent doses of external and internal irradiation were received by the residents in the villages of Folon' (1.6 Gy during the first testing in 1949), Karaul (0.37 Gy), Sarzhal (0.20 Gy), Semenovka (0.02 Gy). The annual effective equivalent doses at that period did not exceed 0.0056 Gy (the highest value) for the Semipalatinsk residents. Proceeding from the values of collective doses probable long-term effects (malignant tumors) were assessed. Recommendations and conclusions of the commission are presented.
The diagnostic effectiveness of ultrasound and lymphographic investigations was assessed in 89 rectal cancer patients. Lymphography was shown to be a more informative method as it permitted the detection of metastases in 6 patients in whom USI results were negative, metastatic involvement in 2 patients, specifying the type of pathological changes of the enlarged lymph nodes in 14 patients. In a normal lymphographic picture metastatic involvement was detected in 37 cases using echography. More extended metastatic spreading was found on USI (as compared to lymphography) in one patient. The combined use of echography and lymphography improved the diagnosis of rectal cancer lymphogenous metastases.
Fine-needle puncture aspiration biopsy was performed in 182 patients with various visceral tumors. The results were negative in 4 (2.2%) cases only. The malignant nature of tumor was established in 140 cases whereas benign--in 38. The histogenetic type of tumor was reliably established in 75% of patients. In 25% of cases, biopsy revealed a malignancy but failed to identify its origin.
The article deals with the results of ultrasonic examination (USE) of 39 patients with secondary edema of the lower extremities. The authors developed a USE method which yields objective data characterizing changes of the structure, thickness, boundaries, and firmness of the soft tissues in lymphedema of the lower extremities of various severity. It was established that lymphostasis produced a characteristic ultrasonic pattern, which, as claimed by the author, may be used in differential diagnosis of lymphatic and venous edema of the extremities.
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Analysis of the problems involving the design and application of Soviet-made radiocontrast agents showed that the synthesis of such drugs as Iodamid, Triombrast, Etiotrast, Bilimin, and Bilignost in this country made it possible to eliminate the arrears in this field. Together with the elaboration of topics concerning the pharmacokinetics and adverse effects of the above contrast agents, this helped to create a sound scientific base for further work on the unsolved problems, primarily, (1) to synthesize Soviet non-ionogenic radiocontrast agents; (2) to prepare and introduce Soviet ultrasonographic contrast agents into practice; (3) to prepare and introduce magnetic resonance contrast ones into practice; and (4) to introduce unique radiocontrast agents such as triombrast as oil emulsion, oleoferrotrast, fine-dispersion barium sulphate, and chromoetiotrast into clinical practice and to set up their production.
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The results of prolonged intra-arterial chemotherapy in 61 patients with locally advanced bladder cancer (T3-T4) are discussed. Regional internal iliac artery infusion of chemotherapeutic agents was done daily for 5 or 7 days at a rate of 1 to 3 ml/h over an 18-20-h period. The total dosages of each course were 60-120 mg/m2 adriamycin, 2.5-3.5 g/m2 5-fluorouracil (5-FU), 20-40 mg/m2 methotrexate or 30-50 mg/m2 cisplatin. At 3 to 4 weeks after the completion of infusional chemotherapy the results were evaluated, based on data from control cystoscopy and sonography. One patient (1.6%) was free of tumor; an objective response of greater than 50% reduction in tumor size occurred in 26 (42.7%) patients; 34 (55.7%) demonstrated objective responses of less than 50%. No further increase in tumor size during the management was detected. Hematuria, dysuria and urine infection were controlled and pain was relieved. The use of cytostatics and prolonged iliac artery catheterization did not incur any serious complications.
In order to determine the staging of urinary bladder tumors accurately, it is very important to choose a suitable method of treatment and to reach the correct prognosis. In 1974, Watanabe and Holm performed the first transurethral and transrectal ultrasonography. They obtained sonograms of the involved bladder wall by radial scanning using a rotation transducer. The only weak point of this method is the difficulty of staging tumors in the apex, the neck, and the fundus of the bladder by transverse scanning. In 1982, Sekine et al repeated the results of testing a new transrectal transducer for electronic linear scanning in a urologic clinic. However, to our knowledge, no description of the transvaginal technique for routine vesical ultrasonography has appeared in the English-written literature. The purpose of this study is to visualize bladder tumors by longitudinal transvaginal scanning and to evaluate the new method for the staging of urinary bladder tumors.
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MR-imaging of surgically excised enlarged and non-enlarged human lymph nodes was studied in patients with and without malignant metastatic lymphadenopathy. NMR tomograms were performed at frequency of 200 MHz using the CPMG sequence. Space resolution was up to 0.1 mm. "In vitro" NMR-tomograms of both non-enlarged and enlarged lymph nodes disclosed tiny foci of metastatic deposits. It is proposed that use of T2 differences for localization of a pathologic focus is an effective mode of visualization during NMR tomography at high frequency.
A model of a system of dosimetric design of radiotherapy on the basis of SM-4 and ES-1033 computers has been developed and is being tested. Radiotherapy for over 600 patients with tumors of different sites was designed within 1 year. The simplicity of the system allowed a radiologist to take an active part in the choice of a favourable radiotherapy design. Four variants of dose distributions on an average were computed for each patient. A study of the time characteristics of the system has shown that the time of input of the data on a patient and beam parameters does not practically depend on the computer speed and lasts for an average of 15 min. Dose field computation and optimization of inputs vary from 0.4 to 6 min. depending on a volume of computation and computer type. A one-task computer system with one working place and memory is able to meet the requirements in dosimetric design for 2-3 radiotherapeutic units. More units will require multitask and all-purpose computers with 2 and more working places. Minimum standards of computer memory and speed are the same as in the first case.
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Lymphographic studies were carried out in 1070 patients to identify patterns of lymphogenic dissemination of cancer of the cervix and corpus uteri, prostate, urinary, bladder and rectum. A direct correlation between the frequency and degree of metastatic spread and local extension of tumor process was established. The most frequent sites for metastasis were the external and common iliac lymph nodes. Whatever the site of primary tumor or the predominant direction of its growth, these lymph nodes on both sides of the pelvis and lumbar area were involved. The significance of lymphographic results for selecting and planning treatment modalities as well as indications for lymphography were identified.