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Rectal cancer is a malignant tumor of the distal colon of epithelial origin. Every year, more than 30,000 (30 969 - 2018) new cases of Rectal cancer and 16,000 deaths (16 151) are registered in Russia. The index of reliability of accounting (the ratio of the number of dead to sick) is 0,52%. Rectal cancer refers to localities with an average mortality rate. In the North-Western Federal district, more than 3 thousand primary cases of Rectal cancer were registered (3285 - 2018). The state statistics of the Rectal cancer provides data on morbidity and mortality in three categories of ICD-10 together (C19-21). Detailed development of data not only separately for each category of ICD-10, but also for the fourth sign is possible only from the data bases of cancer registers. As of 01.01.2019, the Population cancer register of the North-Western Federal district created by us totaled more than 1 million cases of malignant tumors (1 067 661), including Rectal cancer - 50 745 cases, or 4,8%. The share of the Rectal cancer is close to the national average - 4,9%. The article presents a detailed structure of cancer pathology in Rectal cancer. The leading role of the 3 specified categories belongs to the rectal malignant tumors (C20) - 75,4%, 19,8% falls on the malignant tumors of the rectosigmoid department (C19) and only 4,7% on the C21 - malignant tumors of the anus and anal canal. For all these categories, the dynamics of the structure is presented, which proved to be quite stable.

Cases of dental needle fracture during mandibular block were studied in the last 10 years. Despite dental anesthesia development, the cases of needle fracture occur regularly in the world practice. Some of these complications has iatrogenic nature while others may be attributed to independent reasons like patients' sharp movement and needle manufacturing defect. In most of the cases the needle migrates to surrounding anatomical spaces making operative removing a challenging task. Subsequent surgical removing of a foreign body has severe consequences to patient in the form of a large operating injury, long-term disability and functional limitations. The article presents an algorithm for prevention and emergency care for a patient with dental needle fracture during mandibular block.

In the open, comparative, non-randomized and prospective study conducted from 2007 to 2014 there were included 83 patients who received combined treatment for thoracic esophageal cancer. For a comparative analysis there was used a retrospective control group of 51 patients with esophageal cancer who had undergone surgery alone from 1999 to 2014. Complex treatment of patients with advanced forms of thoracic esophageal cancer included argon-plasma recanalization of the lumen of the esophagus followed by neoadjuvant chemoradiotherapy in two versions. One group of patients (29) received external beam radiotherapy, prescription dose of 40-45 Gy, the other group of patients (54) received intraluminal brachytherapy, 3 sessions of 7 Gy, prescription dose of 21 Gy. All patients synchronously with radiotherapy there were performed two cycles of polychemotherapy on PF scheme. A month after the neoadjuvant treatment there was carried out resection of the esophagus with simultaneous plastics by gastric stem. Complete local tumor regression was achieved in 34,7% of patients in group with intraluminal brachytherapy and 30% in the group with external beam radiotherapy. Long-term results could be traced in 90.8% of patients. Using chemoradiotherapy on preoperative stage we managed to increase disease-free and overall survival of patients with an increase of median of progression-free survival - 27 against 12 months and overall survival - 29 against 14 months in comparison with surgery alone.

Introduction: Malignant tumors of the lip (C00) are rare tumor, and mainly affect men. Annually in Russia there are nearly 3000 new cases of malignant tumors of the lip (2011 - 2013). In 2000 there were registered more than 5000 cases. The positive dynamics of morbidity and mortality from this location was marked. Separately to analyze the dynamics of mortality from malignant tumors of the lip cannot be performed because the State Statistics Committee provides only aggregated data for all three-digit rubrics - malignant tumors of the lip, oral cavity and pharynx (S00-14). From 2000 to 2013 the number of deaths in this group according to both sexes increased from 8980 to 9445 or by 5.2%. According to the International Agency for Research on Cancer (IARC) the incidence rate of the population in various countries is also small (except Australia)., Aims and Objectives: To conduct a study of prevalence of malignant tumors of the lip at the population-based level and to estimate survival rates., Methods: For the first time in Russia there were estimated the rates of morbidity and survival of patients with malignant tumors of the lip by international standards. Paying attention to limited parameters that characterize malignant tumors of the lip in the state report, the main focus was aimed at database of Russia’s first Population-based Cancer Registry of St. Petersburg working according to international standards. For the first time in Russia there is presented dynamics of a 5-year observed and relative survival of patients with malignant tumors of the lip., Results: For the first time in Russia there is provided the structure of morbidity of malignant tumors of the lip according to the 4th digits of ICD-10. There is underlined its stable distribution with decreasing of С00.9 rubrics (undefined parts of lips), showed a significant reduction in morbidity and average relative 5-year survival closed to the European rates.

The development of endoscopic techniques of surgery of patients with early gastric cancer (high and moderately differentiated adenocarcinoma) by endoscopic mucosal resection and endoscopic submucosal dissection with regard to their minimally invasion, high efficiency and quality of life after treatment allowed seriously establishing itself and be accepted for use in worldwide.

To control dysphagia 202 patients with a verified esophageal cancer of stage cT1-4N0-2M0-1 underwent intraluminal brachytherapy with neoadjuvant chemoradiotherapy in the process of combined radiation/chemoradiation therapy and palliative treatment. Duration of event-free period in the group of patients, operated after neoadjuvant chemoradiotherapy was 10,1 ± 2,7 months, after intraluminal brachytherapy at combined radiation/chemoradiation therapy was 6,2 ± 2,6 months and at palliative brachytherapy--4,5 ± 2,0 months. Frequency of complete clinical regressions was 16,7% after neoadjuvant chemoradiotherapy, 19,3% after brachytherapy in the frames of radiation/chemoradiation therapy for esophageal cancer, 15,7% as a result of palliative intraluminal brachytherapy. Complete morphological tumor regression after neoadjuvant chemoradiotherapy using intraluminal brachytherapy was registered in 23,1% patients.

It was evaluated mini-invasive endovideosurgical technologies using in complex treatment of esophagus cancer. The investigation included 28 patients with thoracic esophagus cancer. Age of patients operated in terms from April 2012 to December 2013 was from 42 to 74 years (mean 61.7 ± 8.7 years). Only surgical treatment was used in 10 patients. Neoadjuvant chemotherapy and radiotherapy were performed in 18 patients. Hybrid mini-invasive esophagectomy (laparoscopic stomach mobilization and right-side thoracotomy) were used in 14 cases. The frequency of postoperative complications was 35.5%. Mini-invasive endovideosurgical esophagectomy was done in 14 patients. The frequency of postoperative complications was 57.1%. There were not deaths. Our experience demonstrates good results of mini-invasive technologies using in treatment of patients with esophagus cancer. Endovideosurgical methods permit to perform adequate volume of surgery in case of oncological diseases.

During the period from April 2012 to December 2014 54 patients aged 29-76 years, 36 (66.6%) males and 18 (33.4%) females, with esophageal cancer underwent minimally invasive esophagectomy as final phase of treatment. Squamous cell carcinoma was diagnosed in 50 patients and adenocarcinoma identified in 4 patients. The disease was staged as follows: IA--5 (9.3%) patients, IB--11 (20.4%) patients, IIA-- (16,.%) cases, III -- (3,.%) cases, IIII --8 (33,.%), IIII -- (14,8%), III -- (1,.%). 37 (68,.%) patients had surgery after induction chemoradiation therapy. Of 54 surgical interventions there were 20 hybrid and 34 minimally invasive operations. 19 (35,.%) patients developed complications, postoperative mortality was 2 (3,.)%. Minimally invasive esophagectomy meets basic oncological principles and leads to tolerable short-term results.

For treatment of cancer of the thoracic esophagus, the method of neoadjuvant chemoradiotherapy (CRT) with a use of intraluminal brachytherapy (BT) was performed. The study included 51 patients (mean age 56.9 ± 4.3 years). The length of the primary tumor up to 6 cm was determined in 18 patients, more than 6 cm--33 patients. CRT included three BT sessions (7Gy X 3; q7d) and two cycles of chemotherapy (PF; q28d). After CRT in 30 (62.4%) patients there was marked a complete or partial radiological tumor regression. In 40-45 days after CRT surgery performed. Subtotal resection of esophagus of the Lewis type was performed in 29 cases, transtracheal ex- tirpation of the esophagus--in 2, minimally invasive esopha- gectomy--in 17 cases. Postoperative complications occurred in 22 (44%) patients; one patient died (2%). In 11 (23%) patients morphological investigation revealed a complete regression of the primary tumor. Thus, a use of intraluminal BT in combination with chemotherapy in many cases promoted reducing the size of the primary tumor of the esophagus, which was an effective factor in improving surgical results.

The locally advanced cancer of thoracic esophagus was treated by induction chemo-irradiation therapy (IHRT) with intraluminal medium dose-rate brachytherapy (IMBT). From July 2009 to February 2012 twenty five patients (mean age 54.3 +/- 1.3 years) were included in the study. The length of the primary tumor was up to 6 cm in 10 pts and more than 6 cm in 15 pts. Induction therapy consisted of three IMBT sessions (7 Gy X 3; q7d) and two cycles of chemotherapy (PF; q28d), 26-31 days later the surgery was performed. Subtotal resection of the esophagus type of I Lewis was performed in 23 pts, transtracheal extirpation of the esophagus was performed in 2 pts.In all the cases 3F lymphodissection was performed. After IHRT in 15 of 25 pts. was obtained complete or partial response, in 10 of 25 pts was obtained disease stabilization. Perioperative complications occurred in 17 (68%) patients receiving conservative treatment, one patient (4%) died of treatment complications. In 6 cases (24%) morphology had shown the complete regression of primary tumor. Thus, the combination of intraluminal medium dose-rate brachytherapy and chemotherapy lead to reduction of primary tumor local spread and can be an efficient factor in improving the results of surgical treatment.

This is an analysis of treatment results data for conservative (endosurgical and radiation therapy) treatment of patients with inoperable locally advanced esophageal cancer receiving therapy in 1990-2011. The original treatment tactics including recanalization of tumor-compressed esophageal lumen (argon plasma coagulation +/- high-frequency surgery or chemical tumor necrolysis) with consequent combined radiotherapy resulted in clinical response in 79,5% of cases, 89,3% of patients retained the possibility of enteral nutrition. One-year overall survival (OS) was 68,9% (58,8% in patients receiving combined radiotherapy), 2-year OS was 22,7% and 21,2% respectively.

The loss of hormonal dependency in breast tumor cells is often accompanied by epithelial-mesenchymal transition (EMT) features and an increase in cell metastasizing and invasiveness. Here we studied the role of transcription factors Snail1--the central mediator of EMT, in the progression of hormonal resistance of breast cancer cells. The experiments were performed on the estrogen receptor(ER)-positive estrogen-dependent MCF-7 breast cancer cells, ER-positive estrogen-resistant MCF-7/LS subline generated through long-term cultivation of the parental cells in steroid-free medium, and ER-negative estrogen-resistant HBL-100 breast cancer cells. We found that decrease in the estrogen dependency of breast cancer cells is accompanied by an increase in Snail1 expression and activity, and demonstrated the Snail1 involvement in the negative regulation of ER. NF-kappaB was found to serve as a positive regulator of Snail1 in breast cancer cells, and simultaneous inhibition of NF-kappaB and Snail1 by RNA interference resulted in marked increase of cell response to antiestrogen tamoxifen. In general, the results obtained demonstrate that direct inhibition of NF-kappaB and Snail1 partially restores the estrogen receptor machinery, and show that Snail1 and NF-kappaB may serve as an important targets in the treatment of breast cancer.

The paper deals with evaluation of the literature data and our experience with automated quantitative cytometric examination of sputum for diagnosis of lung cancer and, in particular, early one. This novel procedure uses measurement of quantitative indices which characterise tumors-induced alterations. The LungSign computerized system was employed to scan cellular nuclei. The results were evaluated by linear discriminative analysis with the aid of ROC-curves and underlying areas. The procedures were run in 248 cases and its sensitivity was significantly higher that of a standard cytological one (36.6% and 13.3%, respectively; p = 0.033), albeit a slight decrease in specificity (93.7% and 100%, respectively; p = 0.003). Automated quantitative cytometric indices varied significantly in cohorts of patients with confirmed (-0.275871) and false (-1.24990) diagnosis of lung cancer (p = 0.0001).

The paper evaluates the available data as well as our own on use of autofluorescence bronchoscopy in conjunction with spectrometric examination. We used qualitative and quantitative assessment of images obtained by conventional and autofluorescence (ClearVu Elite) means in real time. Our double-stage study evaluated sensitivity and specificity of autofluorescence bronchoscopy in diagnosing lung cancer as well as constructed spectrometric curves (ROC) and areas under them (AUC). Endoscopy was used in 171 patients with central lung cancer. Autofluorescence bronchoscopy established high sensitivity--94.74% (95%CI: 80.9-99%) and sufficient specificity--79.95% (95%CI: 75.8-83.6%). Application of a wide range of spectrometric coefficients contributed to high specificity thus reducing the number of biopsies as well as the injury from the treatment. The AUC for a best predictive index was 0.89 (99%: 0.83-0.95).

The paper presents our experience with application of a diagnostic procedure which enhanced information potential of endoscopy. Its efficiency increased due to use of an algorithm which included several stages carried out during an endoscopic procedure: routine bronchoscopy, spectroscopy in light (400-700 nm), autofluorescence spectroscopy including nearest infrared spectrum (720-800 nm). During treatment, the latter registered the dynamics of glow intensity ratios in the red (600-680 nm) and green (500-550 nm) spectra. The efficacy of our method was determinated by the precise delineation of the involvement area and its changes in the course of treatment which matched final analysis data.

The paper presents a review of the literature data and our own experience with 25 endotracheabronchial operations for tumor-related stenosis of the central bronchi and/or trachea using hypotensive anesthesia. The latter condition was induced by speeding up propofol injection and maintaining general anesthesia at 4.4-9 mg/kg x hr. Mean arterial pressure was lower than in control (60-65 vs. 70-80 mmHg, respectively). As a result, blood loss fell 138-100 +/- 11 ml whereas gas exchange indices improved (pO2 112-87 mmHg). At intubation stage, rise in mean arterial pressure and heart rate was avoided.

The paper deals with complex treatment for pleural malignancies with concomitant effusions. Cytoreduction and abatement of effusion, protein loss, inflammation, intoxication and pain syndrome were reported after argon-plasma electrocoagulation of the pleura followed by photodynamic therapy and hyperthermal intrapleural chemoperfusion. Stable effusion abatement effect was confirmed in all eight cases by X-ray examination and changes in homeostatic indices and breathing function as well as lowered severity of intoxication and pain. No emergency repeat intervention or pleural puncture was reported.

The report deals with evaluation of the literature and our own data on 65 endotracheobronchial operations for tumor-related obstruction of the main bronchi using high-frequency injection flow ventilation (n = 33; 50.8%) or a combined-frequency one (n = 32; 49.2%). The latter method was significantly more efficient (p < or = 0.05%) due to more effective blood oxygenization (pO2--111.8 +/-13.8 vs. 130.6 +/-26.4 mmHg) and carbon dioxide elimination (pO2--36.1 +/-1.2 vs. 54.3 +/-6.7 mmHg). It also involved lower risk of surgical fire as oxygen concentration in inhaled air mix was monitored. Also, endoscopic examination took less time because it was continuous, while the risk of barotrauma was reduced to minimum owing to adequate selection of ventilation ratings.

Among 112 patients with inoperable esophageal cancer treated with high-dose intraluminal brachytherapy and distant irradiation, objective response was in 84.8%. Predominantly local complications were reported in 78.6%. Recurrences were detected in 63.5% during follow-up, with mean relapse-free period being 107 days. Mean survival time was 15.3 months (1-, 2- and 3-year survival--58.8; 22.3 and 12.9%, respectively) which was comparable to similar results of palliative esophagectomy for gastric cancer.

A comparative evaluation of the efficacy of combined radiotherapy (112 - group 1) carried out in conjunction with a battery of procedures of endoscopic surgery plus combined radiotherapy (76 - group 2) for inoperable cancer of the esophagus was conducted in 118 patients. Maximum local regression was reported in group 2 (77.6%) as compared with only 33.9% in group 1. Relatively longer relapse-free period (133 days) and lower residual growth incidence (44.6%) were in group 2, too, as compared with 107 days and 63.5% in group 1. Mean survival duration was nearly identical in both groups - ca.15 months. Similarly, survival rates in groups 2 and 1 were: 69.2 and 58.8% (year 1), 22.2 and 22.3% (year 2), and 11.3 and 12.9% (year 3), respectively. It was concluded that combinations of endoscopic surgery and combined radiotherapy for inoperable cancer of the esophagus improved immediate results and reduced the rates of residual tumor incidence. However, no significant differences in mean duration or rates of survival were observed.

The content of activated (phosphorylated) form of proteinkinase B in tumors and homologous tissues of 46 patients with breast cancer was measured by enzyme immunoassay. Activity of proteinkinase B was increased in tumors of 48% patients in comparison with homologous histologically unchanged tissue. Activity of proteinkinase B in hormone-dependent mammary tumors was significantly higher than in tumor tissue from patients with negative receptor status.

Fifty-one loop polypectomies assisted by argon-plasma coagulation were performed in 40 patients, aged 18-85. Polyps presented as sitting on a wide pedicle (25), sprawling (19) or spreading flat (7) in rectum (24), sigmoid (18) or colon (9). Polyp diameter ranged 1.0-1.9 cm (12 adenomas), 2-2.9 (18) or 3-5 cm (21). Coagulation was carried out immediately after partial removal of polyp with the aid of diathermic loop. Endoscopic follow-up and biopsy were conducted after 1, 3, 6 and 12 months. Complete destruction of adenomas was achieved by 1-6 coagulations (mean - 1.4) performed at an interval of 3-4 weeks. During follow-up (6-24 months), out of 40 patients with 51 polyps, histologically identifiable villous adenoma was detected in 3 (during 12 months). The latter underwent repeat argon-plasma coagulation. That technique proved more effective and safer than traditional methods in dealing with large polyps of the large bowel having a wide pedicle and/or sprawling.

Patients with inoperable cancer of the esophagus were followed up for 1-3 years after a course of palliative endoscopic destruction of tumor. Residual growth occurred in 88.1% with an average stabilization period of 47 days. Among the unfavorable prognostic factors were partial decomposition of tumor, squamous-cell pattern, size of more than 9 cm, circular extension through the esophagus and stage III stenosis. With the aid of newly-developed methods of outpatient endoscopic destruction, 94.2% could eat throughout their survival period. Mean survival time was 5.6 months or 7.3 months in metastasis-free cases.

Endoscopic surgery including chemical necrolysis, diathermy coagulation and excision, and argon-plasma was conducted in the course of two-stage palliative treatment of 31 patients with gastroesophageal cancer. A total of 273 procedures of tumor destruction were administered. Stenosis was either eliminated or significantly reduced in 28 (90.2%) on completion of stage I. Average stabilization duration was 44 days. During stage II, periodic destruction of tumor foci continued so that peroral feeding could be maintained for another 3 years. Mean survival was 8.7 months (one year--35%, two--20%, three--7.7%). Since no life-threatening complications were reported, our method may be recommended for out-patient hospital applications.

Levels of VEGF, VEGFR-1 and VEGFR-2 were determined by enzyme immunoassay in tumor and adjacent normal tissue samples from 39 breast cancer patients. Those parameters were significantly higher in tumor tissue. Direct correlations were established between VEGF and VEGFR-1, on the one hand, and VEGF and VEGFR-2, on the other. VEGF expression in breast tumor was relatively higher at earlier stages of tumor growth. VEGF and VEGFR-1 expression was consistently higher in progesterone receptor negative tumors.

The immediate and 3-year results were evaluated of application of combined radiotherapy and/or endoscopic argon-plasma coagulation carried out for esophageal cancers 3 cm long or less in 39 patients. Recurrences were reported, in 31.4% ca. 4 months later. Joint use of the modalities was followed by an up to 5-months rise in relapse-free period. Mean survival time was 20.2 months, and it was significantly higher in radiation-treated patients without metastases. One-year survival was 96.6% in those without distant metastases, 2-year--72%, and 3-year--47.6%. Our data point to new vistas in application of our techniques, particularly, for short (up to 3 cm) inoperable esophageal cancers.

An experience with treatment of 21 patients with inoperable cancer of the esophagus allowed determination of indications and contraindications, development of the method and technique of endoscopic implantation of a domestic meshed self-expanding stent. The complications resulting from the process of mounting and the stent itself are analyzed. The methods of eliminating the complications are shown. The immediate and nearest results of endoprosthesing are assessed. Recommendations are given concerned with the cases of ingrowth of tumor into the stent.

Endoscopic management of obstructive tumors of the trachea and main bronchi was carried out using argon-plasma coagulation in 39 patients aged 15-75. Thirty four patients had primary malignancies, 2--secondary tumors and 1- metastasis to the lung. Two patients with benign tumors were cured completely. Lobar bronchus lesions involving the extrapulmonary bronchus were identified in 28 patients; involvement of both main bronchi and trachea--5, intermediate bronchus lesions--3, and involvement of one lobar bronchus--3. Stenosis was complete in most patients and full or partial lumen was restored in all of them. Follow-up checks were conducted at 2-, 4- and 12-week intervals under outpatient conditions. Bleeding from the bronchial arteries broke out in 1 patient during examination and was aborted. Our method may be used in emergency to manage tumor-induced obstruction of the trachea and main bronchi, to raise the quality of life in incurable cases and to improve the results of chemoradiotherapy.

Phophatidylinositol-3-kinase (PI3K) is a major intracellular protein that is responsible for the transmission of an antiapoptotic signal and controls the survival of tumor cells upon exposure to damaging agents. Experiments using different tumor cell cultures have shown that the resistance of cells to the antiproliferative action of dexamethasone, caused by their long cultivation with the hormone, is associated with the activation of PI3K and the transcription factor STATS. The activation of PI3K and STAT3 in the dexamethasone-resistant cells correlates with the increase in the total thyrosine kinase activity and with the decrease in the sensitivity of cells to exogenous proliferative agents, such as 17beta-estradiol. The long exposure of hormone-sensitive cells to nonhormonal factors that activate the PI3K/STAT3 signaling pathway, hypoxia in particular, has been shown to suffice to reduce the degree of hormonal tumor cell dependence. VEGF-A, an angiogenic peptide whose action was partially realizes through the PI3K-signalling pathway, has been demonstrated to be involved in the maintenance of cell growth, including the growth of hormone-independent cells. The findings suggest that complex changes in the antiapoptotic and mitogenic signaling pathways associated with PI3K, which ensures the autonomic, hormone-independent growth of tumor cells, may underlie the decreased hormonal dependence of tumor cells. Whether PI3K may be used to suppress the growth of hormone-independent tumors is discussed.

A procedure of argon-plasma coagulation is suggested to be used alone or in conjunction with chemical necrolysis and high-frequency electrosurgery for endoscopic palliation of dysphagia. Its outstanding impact on tumor-induced dysphagia, involving no life-threatening complications, was demonstrated in a group of 97 patients. A number of basic factors immediately influencing the results of therapy are outlined and relevant recommendations on clinical use are provided.

A randomized double blind placebo-controlled trial of the drug karinat was carried out in patients with chronic multifocal atrophic gastritis. Karinat contains beta-carotene 2.5 mg, alpha-tocopherol 5 mg, ascorbic acid 30 mg and garlic powder 150 mg per tablet. Out of 66 patients, 34 received karinat, 32--placebo. Both karinat and placebo were administered for 6 months, one tablet twice a day. Karinat therapy improved digestion, the fibrogastroscopic pattern of mucosa, inhibited Helicobacter pylori infection, stimulated stomach activity, mitigated intestinal metaplasia and interfered with the epithelial proliferation of gastric mucosa. These therapeutic effects were more pronounced in the study group. On the whole, the effectiveness of the drug was significantly higher (29%). Karinat should be recommended for the management of chronic atrophic gastritis, a precursor of stomach cancer.

The levels of urokinase (uPA) and tissue type (tPA) plasminogen activators and their type 1 inhibitor (PAI-1) were determined by immunoassay in tumor cytosols and samples of histologically unaltered adjacent mucosa in gastric cancer patients. Gastric tumor revealed enhanced uPA and PAI-1 matched by decreased tPA in intact mucosa. The expression of uPA and PAI-1 was particularly was high at the later stages of the disease. The concentrations of uPA in tumor tissue increased with age. No significant correlation was established between levels of plasminogen activation system components, on the one hand, and histopathological grading of tumor, on the other.

Vascular endothelial growth factor (VEGF) and such plasminogen activation system components as uPA, PAI-1 and tPA were determined by enzyme immunoassay methods in endometrial tumors from 121 patients and 18 samples of endometrial hyperplasia of varying degree. Endometrial carcinoma concentrations of uPA vs. PAI-1 were significantly higher than those in hyperplasia. Significant direct correlations--uPA vs. VEGF, uPA vs. PAI-1 and PAI-1 vs. VEGF--were established in endometrial tumors, and inverse ones for tPA vs. uPA and tPA vs. VEGF. A marked correlation with prognostic factors was found for PAI-1 and VEGF: levels of these proteins were relatively higher in cases of tumor progression (FIGO stage and deeper myometrial invasion), poor cell differentiation, and loss of hormone sensitivity. Higher uPA expression was associated with deeper myometrial invasion while, in endometrial tumors with unfavorable prognosis, it was VEGF level alone that was significantly higher.

Video-assisted thoracoscopy for differential and improved diagnosis was successful in 245 out of 249 patients (98.3%) with various chest neoplasms. Video-assisted surgical procedures were performed in 50 (20%). Complications were reported in 4 (1.6%). The method proved highly-effective as well as fairly safe and sparing.

The evidence on the attitude of 60 cancer out-patients to fibrocolonoscopy carried out under general anesthesia was evaluated versus different procedures of intravenous injection. Most patients were scared prior to examination; 83.3% felt sleepy during the procedure while 85% of those anesthetized wouldn't mind receiving narcosis for repeat examination. Propofol (diprivan) alone showed an advantage over midazolam (dormicum) in being more tolerable and cutting stay at hospital by a third. Ketamin proved undesirable due to psychomimetic effects and delayed regaining of consciousness.

Various methods of total anesthesia for colonoscopy in cancer patients, carried out in a outpatient setting, are compared. Diprivane and dormicum were used as monoanesthesia and in combinations with ketamine and fentanyl. Diprivane anesthesia was the optimal as regards the velocity of recovery of psychophysiological functions. Ketamine was acknowledged inefficient because of long awakening and psychotic effects.

The data on 503 cases of ovarian malignancies were evaluated to work out indications for and clinical assessment of revision laparotomies. Second-look surgery was carried out in the following situations: (1) tumor elements found in the washings of the peritoneum in Douglas' space and high blood-serum levels of CA-125 (8 patients with stage I-II tumors, in clinical remission); (2) during remission, after 6-10 courses of polychemotherapy (13 patients with stage III-IV tumors); (3) during remission, after non-radical primary surgery (117); (4) suspected recurrence (144); (5) recurrence-free surgical pathology, e.g. ventral hernia, requiring laparotomy (22). Patients without repeated laparotomy (199) were in control. During remission, surveillance can be carried out using cytologic, ultrasound and immunoradiologic techniques since laparoscopy fails. The latter is useful, for diagnostic purposes, in case of discrepancy between clinical and ultrasound evidence as well as during monitoring in patients in clinical remission who show unfavorable levels of CA-125 and poor results of sonographic. Laparotomy is indicated prior to chemotherapy of inoperable tumors for morphologic verification of diagnosis. Indications for second-look operations can be significantly decreased considering the latest improvements in non-invasive monitoring technique. Laparoscopic examination can effectively serve the same purposes.

The reversing action of verapamil on the effect of chloroquine was found in in vivo experiments by using a model P. berghei resistant to chloroquine, an LNK65 isolate having a naturally lower resistance to the agent, and its polyresistant strain with the acquired resistance to chloroquine and fansidar, as well as by employing the chlorine-resistant P. falciparum isolates from the south of the Socialist Republic of Vietnam. The magnitude of this effect was related to the dose of verapamil, the frequency of administration of a combination of the agents in vivo, while that was associated to the concentration of verapamil and the level of isolate resistance to chloroquine in vitro which was the most pronounced. Taking into account the dose-dependent effect of verapamil, it can be suggested that increasing its concentration in combination with chloroquine can provide a more marked reversing action with lower chloroquine concentrations. The parameters accepted by the authors in evaluating the combined effect enable the effect of the verapamil/chloroquine concentration to be regarded as potentiation.

The role of histocompatibility antigens in the realization of invasions and the nature of its course were studied in 71 patients with Echinococcus granulosus infection and in 18 with E. multilocularis infection. It has been shown that the effects of HLA antigens on the realization of invasion is heterodirectional; the factors predisposing to the occurrence of echinococcosis are HLA-B5, B18, and A28 antigens, whereas those preventing their realization are HLA-B14 antigen. The carriage of HLA-B5 and B18 antigens determines a high risk of E. granulosus infection of the lungs and liver. The realization of the latter is prevented by the carriage of HLA-B27 antigen. The development of E. multilocularis infection of the liver is promoted by that of HLA-A11, whereas the carriage of HLA-A9 antigen prevents the occurrence of this lesion. Solitary hepatic lesion in E. granulosus infection correlates with HLA-A10 and B18 antigens, while multiple lesion with HLA-B5 antigen, but the development of E. multilocularis infection metastases is associated with HLA-B8 antigen. The occurrence of spontaneous cystic ruptures of E. granulosus correlates with HLA-A32, A26, and B5 antigens, which is likely to associated with cystic formation defect due to the influence of these factors.

LCS was performed in 35 patients with mammary cancer, 59 patients with benign breast tumours and 35 healthy people. 39 samples were taken from inhabitants of Odessa, 89 from St.-Petersburg. Differences were discovered between blood plasma spectra of Odessa and St.-Petersburg residents. Spectra of blood plasma in patients with mammary tumours differed from those of healthy people. LCS may be used for screening, for forming the groups of risk and for diagnosis of mammary gland tumours.

Chemotherapy was administered to 53 patients with hydatid disease; to 27 of them it was administered to prevent recurrences. Mebendazole was prescribed by courses lasting for 14 to 30 days with intervals between the courses of 1 to 3 months, in a daily dose of 50 mg/kg to be taken 4 times. The treatment efficacy was assessed in accordance with the criteria suggested by the WHO experts. On the whole our results did not evidence any essential differences in mebendazole therapy efficacy in our patients and in those represented in a WHO report. No recurrences occurred over the period of observation, that lasted for 6 months to 6 years, in the 27 patients who were administered the drug to prevent the disease recurrences. The treatment was fairly effective in 27% of the patients, good effect was attained in 42%, no desirable results were attained in 19%, and lethal outcomes were recorded in 12% of patients.

Chemotherapy was administered to 17 alveolar echinococcosis patients. Two of these patients developed an uncomplicated disease (a subtotal involvement of both liver lobes), fifteen a complicated condition. In 13 patients with the complicated condition metastases to the lungs, peritoneum, as well as diaphragmatic and abdominal organs' growth were detected, in 4 ones jaundice developed. Mebendazole was administered in a daily dose of 50 mg/kg together with the drugs improving its absorption. 30-day courses with 1-3 month intervals were administered. The efficacy of this therapy and its tolerance were assessed from clinical, laboratory and instrumental findings, including serologic tests. Intolerance presenting as alopecia was observed in 4 women, in one of them twice. Mebendazole efficacy in these patients was compared to that in patients administered the drug in a daily dose of 100 mg in 1978-1980. A positive time course was observed in 53% of patients.

The correlations between blood eosinophils, serum immunoglobulins (Ig), circulating immune complexes (CIC) content, alpha- and gamma-interferon (IFN) production and HLA class I antigens were analyzed in 33 patients with hydatid disease aged 37.5 +/- 1.5 years. Direct correlation between the activity of gamma-IFN production, blood eosinophils, IgG and specific IgE content was found in patients with multiple pulmonary damage. In this group the high level of CIC correlated with the high content of IgG and specific IgE. In patients with solitary and multiple cysts in the liver in spite of high alpha- and gamma-IFN production the levels of total and specific IgE were low, IgG and CIC contents were moderate and eosinophils percent was low. In patients with combined damage of the liver and multiple cysts in the abdominal cavity high CIC production correlated directly with high total IgE content. In the total group of patients percent of HLA B5 carriers was significantly higher than in controls: 36.6 and 14.7 respectively (R = 0.01 after Fischer) that correlated with comparatively active gamma-IFN production in patients with the pulmonary and the liver cysts. The possible explanation of the different immune response in patients with the different localisation of the parasite cysts are discussed.

Mebendasole is better absorbed in the gastrointestinal tract if administered together with essential to patients with hydatid disease. Thirty-four patients with alveolar and hydatid echinococcosis were administered mebendasol in a daily dose of 50 mg/kg in 4 doses and essentiale in a daily dose of 600-1000 mg in 4 doses. A total of 86 therapeutic courses, 30 days each, were carried out. The treatment was sufficiently well tolerated. Mebendasole levels in the course of therapy surpassed the minimal effective ones in 2/3 of the patients, that is, they were significantly higher than in administration of mebendasole alone.

Only two of the 75 patients with echinococcosis, treated with mebendazole in a dose of 50 mg/kg b. m. for 30 days (single course) and administered from 1 to 13 courses with intervals of 1 to 3 months, developed agranulocytosis eventuating in death in one female patient. Analysis of blood levels of mebendazole and its metabolites permits a hypothesis that high concentrations thereof may have a toxic effect on the bone marrow, inducing its hypoplasia, in subjects sensitive to these substances.

In 26 patients with hydatid disease interferons (IFN) blood levels by titration method and HLA-antigens by lymphocyte cytotoxicity microtest were estimated. In total group B5 antigen frequency was significantly (p = 0.007 after Fischer) higher than in the control group of 155 practically healthy persons: 38.5% and 14.7% respectively. The determination of possible correlation between IFN-alpha and IFN-gamma production, HLA-antigens specificity and the localisation of Echinococcus granulosus cysts showed that in hydatid disease A2 and B5 antigens carriers are significantly stronger producers of the cytokines as compared with patients having A3 and B13 antigens. The highest titers of IFN-alpha was found in A2 antigen carriers with the liver cysts, the highest level of IFN-gamma had B5 antigen carriers with the lung damage. A3 and B13 antigens carriers had low IFN titers independently of the character of damaged organ. Relatively high IFN-gamma blood titers in B5 antigen carriers with the lung cysts, persons predisposed to hydatid disease, permit supposing the stimulation of the cytokine production by the parasite for cysts formation in the lungs.

In 11 patients with Echinococcus multilocularis infection the blood levels of alpha-interferon (alpha-IF) and gamma-interferon (gamma-IF) were measured using vesical stomatitis virus culture. In patients with the disease the contents of alpha- and gamma-IF were significantly (p less than 0.01) lower than in healthy controls: 392 +/- 101.6 and 101.6 +/- 20.9 U/ml and 1024 +/- 83.2 and 187 +/- 16.9 U/ml, respectively. The lower levels of alpha- and gamma-IF were found in patients with multiorgan damages including the lungs, as compared with the liver and abdomen infestation: alpha-IF 160 +/- 56.6, gamma-IF 88 +/- 24.0 and 525.7 +/- 124.3 and 109 +/- 18.3 (p less than 0.01), respectively. The similar data have been found in patients with hydatid disease (S. N. Suntsov et al., 1990). After 5 to 6 courses of mebendazole therapy in a dose of 50 mg/kg body weight dai y for 30 days with 30-day intervals there was a tendency to a slight elevation of cytokines levels (S. N. Suntsov et al., 1990), as seen in hydatid disease. The estimation of IF levels in multilocular echinococcosis infection may be of prognostic value and perhaps for the evaluation of the efficacy of surgical and chemotherapeutic treatment.

The study was performed in the area of distribution of tropical malaria resistant to 4-aminoquinolines (Vietnam) on 30 patients receiving lariam (mefloquine). The results were compared to the standard therapy with quinine and fansidar. They indicate a high efficacy of and a good tolerance to the drug tested. The use of lariam leads to a more rapid (as compared to the standard treatment) elimination of parasitemia and complete eradication of the disease relapses. The findings make it possible to recommend lariam for the prevention and treatment of tropical malaria.