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The results of the long term work of the Russian Scientific Centre of Roentgenology and Radiology on me- dical investigation of the participants in the liquidation of the consequences of Chernobyl power plant acci- dent have been summarized. It has been stated that circulatory system and tumor diseases occupy the leading position in the disease rate among the affected liquidators. The important role of cytogenetic investigation was pointed out. It allows us not only to determine the efficient impact on the human body but also to evaluate the effective dose of radiation, the information about which allows us to predict the development of distant post-irradiation pathology. The results of cytogenetic investigations testify to the interrelation between the level of chromosomal abnormalities and cardiovascular diseases and confirm the clinical data on the non- neoplastic.pathology among the liquidators of the accident.

Conducting postoperative radiotherapy in a mode of hypofranctionation with SFD-3Gy to TFD-36-39Gy (EQD2 = 43,246,8Gy) in combined treatment of patients with non-small cell lung cancer allows significantly increasing a 5-year disease-free survival at IIB-IIIB stages of the disease (pN1-2) as well as the central cancer, squamous cell morphological type of tumor after surgery in a volume of lob-bilobectomy. The clearest effect of postoperative radiotherapy is assessed by survival without locoregional recurrence where radiation therapy in the adjuvant setting allows achieving a statistically significant increase in local control of the disease to the level of 85-95% regardless of stage of the disease, tumor size, regional lymph nodes lesion and the surgical treatment.

The paper deals with the importance of treatment of primary cancer of the trachea and, in particular, the experience of the Center in using radical therapy for inoperable squamous cell tumors and adenoid cystic carcinoma. An original system of tumor staging developed at the Center draws on international classifications (TNIVI) and methods of radiotherapy depending on tumor localization. It is shown that tracheal malignancies, especially adenoid cystic carcinomas, are characterized by relatively high radiosensitivity.

Our study was conducted in patients with primary squamous cell carcinoma of the trachea and adenoid cystic carcinoma (191) (radical surgery--90; combined treatment--101). The former pathology was relatively more aggressive. Combined treatment proved more effective as compared with surgery alone (5- and 10-year survival after surgery was 79 and 64%; combined treatment--92 and 79%, respectively).

The paper deals with immediate and end results of surgical treatment of 435 elderly patients (70-years-old or older) with gastric cancer and the specifics of postoperative complications influencing the postoperative course of the disease. Metastasis to the regional lymph nodes appeared to be a prognostic factor of crucial importance in the latter period: 5-year recurrence-free (N0) survival was 60.3% +/- 5.2 vs. 17.6% +/- 10.3 (in 1-6 lymph nodes) and 5.2% +/- 5.0 (in 7-15 lymph nodes) (N1).

Multivariate analysis of risk of locally-advanced breast cancer IA-IIIB progression was carried out in 444 patients 10 years after mastectomy in the framework of two randomized studies. Combination therapy (median 156.3 months) included mastectomy, different modalities of neoadjuvant and adjuvant chemohormonal and radiotherapy.

The study was concerned with antitumor action of internalized peptide incorporating a fragment of p161INK4a using a model of short-lived human tumor cultures sampled from resected material. Renal cancer sample showed the greatest therapeutic interval.

A 40-year experience of use of surgical and combined treatment of lung cancer is discussed (n=3,687; surgery--26.7%, combined treatment--73.3%). Eight protocols were used depending on stage of tumor, dose of radiation and fractionation pattern. Role and effectiveness of reconstruction surgery involved in lung cancer treatment are established and end results vis-à-vis main prognostic factors presented. Failed treatment and rationale for systemic chemotherapy as a component of combined treatment are evaluated.

A comparison was made of chemoradiation lesions of lower urinary tract mucosa in urinary bladder (UB) cancer at stage T1-3N0-1MO and approaches to their treatment. An optimal algorithm of examination and treatment of the above patients with consideration of the disease stage and somatic status is proposed.

The paper considers the problems of enhancing the efficiency of diagnosis and treatment of Vater's papilla cancer complicated by jaundice, by maximally realizing the capacities of instrumental studies and by improving the procedures of combination treatment and radiotherapy for this disease. The achieved treatment results show it expedient to use combination treatment and, if radical surgery is contraindicated, radiotherapy for Vater's papilla cancer.

The study is concerned with proapoptotic properties of chimera peptides which incorporate sequences of inhibitors of cyclin kinases p161NK4a and p21CIP/WAF1 as well as internalized sequences (Antp and tat). Sequences of the p16 type appeared to be more cytotoxic than the p21 one. Cytotoxic effect proved dependent on orientation with respect to the C or N terminal point of a polypeptide chain rather than on chimera sequence extent. Although p16 endogenous synthesis did not influence chimera peptide levels, apoptosis did not take place in certain cellular lines. Due to the rather unsophisticated nature of such synthesis, it might be used in designing individually-tailored chemotherapeutic drugs.

Patients receiving radical surgery or combined radiotherapy suffer from such grave postoperative urological complications as radiation-related cystitis, urinary bladder dysfunction, "shrunken" bladder, fistula, chronic renal failure, ureteral stricture and sexual disorders which affect the quality of life. Changes in function of the urinary tracts in patients with endometrial and cervical carcinoma were followed throughout the course of combined treatment. Complex examination comprised urological history, ureteral features, urinalysis, blood count, ultrasound, combined urodynamic study, nephroscintigraphy combined with excretory urography, and cystoscopy, when required. Due to all those measures, complication rates decreased while the quality of life improved.

The present study deals with the ultrasound differential diagnosis of thyroid lesions. A hundred and ninety-two patients, including 130 patients with benign diseases (nodular colloidal goiter) (36.9%), chronic autoimmune thyroiditis (30.7%), and adenomas (32.3%) and 62 patients with malignant diseases (thyroid cancer (88%), lymphoproliferative diseases (6.4%), and recurrent thyroid cancer) (4.8%), were clinically examined. Ultrasound studies (USS) were performed in the B- and (see text symbols) modes. The diagnosis was verified from cytological and histological findings with mandatory morphological confirmation. Interdisease comparison has shown that USS is both a screening and diagnostic technique in revealing thyroid changes and determining their site, sizes, and structure. Ultrasound pathognomonic signs were detected in different morphological types of adenomas, thyroiditis, and nodular colloidal goiter, in the classical, pseudoadenomatous and pseudocystic types of thyroid cancer. At the same time there were characteristic ultrasound parameters at the stage of pronounced changes in undifferentiated thyroid cancer (pseudothyroiditis), lymphoproliferative diseases, and acute thyroiditis. The exception was the diffuse form of chronic autoimmune thyroiditis in which both thyroid lobes were always altered.

The paper describes the developmental stages of radiological diagnosis from the solution of health problems, by studying the substrate "shadow", to the possibility of investigating superfine changes at the level of molecular radiology. A number of lines forming a service in relation to the country's economic, technological, and social development are identified. Priority strategic tasks are defined.

The paper presents the results of color duplex scanning (CDS) in 7 patients treated at the Unit of Vascular Surgery, Clinical Hospital No. 83, from 2002 to 2006, in whom 5 Hemobahn grafting stents and 2 Viabahm ones were implanted into the lower limb arterial aneurysms and the proximal anastomoses of the iliofemoral alloshunts "Gore-tex". A grafting stent was individually selected for each specific case. All the examinees were males. The patients' age was 60 to 70 years. The results of endovascular interventions were assessed, by analyzing color duplex scanning (CDS) of a grafting stent implantation area in early postoperative periods (days 1-3), further by the scheme following 1, 3, 6, and 12 months and then twice a year. Endovascular intervention areas were studied by the standard procedure on Logic-500 and Vivid-700 ultrasound apparatuses (USA) with a 7.5-MHz linear transducer and a 3.5-MHz convection transducer. In the postoperative period, multiprojection scanning was used to detect stent configuration impairments. According to the data of examination using the CDS technique, a surgical success was noted in 100% of cases. In all cases, stage, adequate aneurysmal stenting along with the restoration of the geometry of proximal anastomoses of iliofemoral alloshunts, iliac and superficial femoral arteries with exclusion of aneurysms from blood flow was diagnosed at a hospital stage. Follow-up ultrasonography revealed no changes in the area of endovascular intervention. Thus, as a highly informative, noninvasive technique, CDS can assess the results of implantation of grafting stents into the arteries and shunts of the lower extremities in both early and late postoperative periods.

Data are presented on our 5-year experience with combination chemotherapy of stage II-IV Hodgkin's disease (110), the unfavorable prognosis group, using a novel regimen of chemotherapy--CEA/ABVD (belustin, etoposide, doxorubicin, bleomycin, vinblastine, dacarbazine). Complete remission after 4 courses of CEA/ABVD chemotherapy was reported in 31.8%, unconfirmed complete remission--45.5%, objective effect--100% and an 80% regression of tumor mass--93.2%. No chemo-resistant forms were identified. Five-year actuarial relapse-free survival was 96.4%; overall 5-year survival--97.7%. Death from complications recorded during medication period occurred in 2.3% (1 out of 44), recurrence--2.3% (1 out of 44). Recurrence-free survival rose by 25% (p < 0.05) while overall survival--by 20% (p = 0.04 in year 3), as compared with COOP(MOPP)/ABVD (179 patients with poor prognosis). Our regimen opens up new vistas in managing Hodgkin's disease.

Recurrence-free survival rate after conservative treatment of penile carcinoma was as high as 81%. The best results were obtained with use of combined radiotherapy (monotherapy and telegamma therapy concurrent with penile resection or circumcision) (91.6 and 75%, respectively). Organ-saving treatment was most effective in T1-T2 penile carcinoma while MRI yielded the most reliable diagnostic evidence on depth of primary tumor invasion and regional lymph node involvement.

Data on 668 patients receiving 4-8 cycles of chemotherapy were used to suggest the following approach to complex therapy of Hodgkin's disease: devise a simplified model for Hodgkin's disease, develop a new modality of chemotherapy, demonstrate feasibility of only four chemotherapy cycles in the poor prognosis group, partial response as the ultimate goal of chemotherapy as well as the importance of subtotal dosage under 26-36 Gy sufficient for irradiation of the entire lymphatic collector. Said measures will, in their totality, offer fresh opportunities in treatment of Hodgkin's disease.

The flexion-extension mobility of the thoracic spine was studied by examining 120 patients who had no complaints about the thoracic spine. Its quantitative characteristics that assess the contribution of some segments to the movements of the thoracic spine were developed. Sexual differences of the developed quantitative characteristics of the motor function of the thoracic spine were defined. The specific features of changes in the motor function were analyzed in adult females and males.

An assessment of the densitometry data on 76 patients established a progressively falling level of minerals in the skeleton as a result of treatment with hormones for prostate cancer. The basal mineral levels had been identified by means of dual-energy X-ray absorptiometry. While said changes were immediately caused by maximum androgen deprivation, tumor influence and medication contributed too.

The study was undertaken to enhance the efficiency of diagnosis of breast cancer shown up as calcium micromasses since breast diseases appear as clusters of 50-600-um calciferous inclusions that are not inclined to the formation of conglomerates without a visible node on a X-ray film, may be a manifestation of both sclerosing adenosis and nonpalpable cancer. Of the examined 4500 females aged 15 to 83 years, breast calcium masses were detected in 207. Of them, 39 females were found to have clustered calcium micromasses without a node on a X-ray film; in them cancer and sclerosing adenosis were diagnosed in 28 (71.8%) and 11 (28.2%) females, respectively. Examination was made by using clinical, mammographic, and sonographic studies. Intervention radiology and pathomorphological studies were studied. This has yielded a number of signs that are characteristic of malignant and benign diseases attended by clusters of calcium micromasses in a restricted area without a visible node on X-ray films that assist in making a correct preoperative conclusion with a greater probability in 80%.

Radiowave hemostasis was used for endoscopic stopping of bleeding from gastric and duodenal ulcers in 96 patients. Primary single radiowave hemostasis permitted to achieve stable effect in 80 (83.3%) patients. After repeated radiowave hemostasis bleeding was completely stopped in 14 (14.6%) patients, 2 (2.1%) patients of this group underwent urgent surgery. On day 10 after radiowave hemostasis 95% of mucosal defects epithialized.

The study deals with a complex radiation diagnosis of mass lesions of the distopic thyroid. Forty five patients with mass lesions of the anterior mediastenum were examined. They were 28 with retrosternal and intrathoracic goiter, 6 with teratodermoid tumors, 11 with cysts of the anterior mediastenum. A complex radiation study included serial routine X-ray tomography in 2 standard projects, sonography, computed tomography. The diagnosis was verified on the basis of transthoracic and transbronchial needle biopsy with compulsory morphological confirmation. An intergroup comparison has shown that X-ray study is a screening method to detect a tumor, to define its site and its relationship with the adjacent organs. Ultrasound study reveals pathognomonic signs of the distopic goiter. Of the greatest informative value is X-ray CT which allows one to state about the structure of a tumor and its densitometric signs.

Gastroduodenal disorders were studied endoscopically for 5 years in 159 Chernobyl wreckers and were compared to subjects unexposed to ionising radiation. Upper gastroduodenal tract was examined with esophagogastroduodenoscopy to avoid additional radiation load. It was found that 8-12 years after irradiation, many examinees had gastroduodenal mucosa erosions the rate of which was persistently high. Incidences of malignant and benign tumors in the study and control groups did not differ significantly.

The data on 25 cases of histologically verified bronchioloalveolar carcinoma and papillary adenocarcinoma are discussed. Reliable differential diagnostic cytological features of both diseases were established using a statistical, program and fine-needle biopsy findings. Statistical analysis data pointed to the sets of cytological features: "serial pattern--clear cell boundaries" and "serial pattern--presence of macrovacuoles" as a major factor of accuracy of bronchiolo-alveolar carcinoma and papillary adenocarcinoma diagnosis. These cytological features may be used for reliable diagnosis of the diseases.

Scanning osteodensitometry helped to study mineral saturation of lumbar vertebra in individuals who liquidated Chernobyl accident consequences. Bone mineral density appeared to depend on radiation dose obtained by the examinees. High risk of osteoporosis revealed in the examinees who participated in the liquidation in 1986. The authors stress that the examinees should be covered by the skeletal state monitoring possible only with osteodensitometry. The article justify that biphotonic scanning osteodensitometers are expedient in Health Care Centers for individuals who liquidated Chernobyl accident consequences.

The data on the surgical and combined treatment of 35 cases of lung cancer associated with pleural effusion detected during surgery have been evaluated. Mean 5-year survival was 68.5%, pleural effusion--70%.

The paper analyzes the results of examination of 260 patients with bronchioloalveolar cancer (BAC) who were followed up at the Russian Research Center of Radiology and Roentgenology for 30 years. It provides its clinical, X-ray, and morphological manifestations and classification and the methodological aspects of differential diagnosis. An optimum radiation diagnosis programme has been drawn up, which involves currently available procedures, including computed tomography. The morphological forms of BAC are given in detail.

The study was undertaken to enhance the efficiency of diagnosis of pancreatobiliary cancer complicated by jaundice by using the potentialities of currently available instrumental studies at most. The data of examination of 256 patients with this disease are presented. Based on diagnostic findings, the authors have constructed a diagnostic model of precision recognition of cancer of the extrahepatic bile ducts, pancreatic head, Vater's papilla.

The paper based on the analysis of computed tomographic data in 40 patients again underlines the importance of accurate and timely diagnosis of thoracic changes in the postoperative period. It shows that CT can provide information on thoracic organs and parts and presents the tomographic pattern of a postoperative uncomplicated period.