[Effect of antioxidant use in dietary therapy in patients with chronic athrofic hastritis].

In the 1-year double-blind placebo-controlled intervention trial, it was shown that daily supplementation of patients with gastric premalignant lesions (intestinal metaplasia, IM) with a complex, containing Ester-C with antioxidantsand (2100 mg of Ca-ascorbate + 340 mg of bioflavonoids), produced a sharp decrease of abnormally high ornithine decarboxylase activity in IM gastric mucosa that was accom panied by practically total IM regression in 11 of 18 (61%) patients.

[Autofluorescence diagnosis of malignant tumors of the head and neck]. / Autofliuorestsentnaia diagnostika zlokachestvennykh opukholei golovy i shei.

A new method for diagnosing human malignant tumors is dealt with, which is based on fluorescence of malignant neoplasms and their adjacent normal tissue. To measure the fluorescence spectra, a fiber optic system and a multi-channel optic spectral analyser have been designed. While analysing the resultant spectra, a greater fluorescence excess was observed in the red wave band in the tumors than in normal tissue. Further investigations are required in order to use the method in question in clinical diagnosis.

[The effect of beta-carotene on the dynamics of ornithine decarboxylase activity in atrophic mucous membranes and in stomach polyp tissue]. / Vliianie beta-karotina na dinamiku aktivnosti ornitindekarboksilazy v atroficheskoi slizistoi obolochke i v tkani polipov zheludka.

Activity of ornithine decarboxylase was significantly increased, reaching the maximal values in malignant gastric tissues, in mucosal membrane and polypous tissue of patients with atrophic gastritis as compared with normalcy. Any alterations in the enzymatic activity were not observed in the gastric mucosal membrane of 19 patients with atrophic gastritis within 3 weeks. At the same time, statistically significant decrease of the abnormal high activity of ornithine decarboxylase was detected in atrophic gastric mucosal membrane of 12 patients among 20 patients examined, which were treated with 20 mg of beta-carotene daily within 3 weeks; the enzyme activity was decreased also in polypous tissue of 5 patients in the group of 9 patients studied. Decrease in the ornithine decarboxylase activity after beta-carotene treatment involved improvement of the mucosal membrane state, where hemorrhage disappeared and inflammation reduced. Since the high activity of ornithine decarboxylase is related to promotion of cancerogenesis, beta-carotene appears to exhibit an anticarcinogenic effect as it decreases the enzymatic activity in gastric mucosal membrane.

[Diagnostic and therapeutic tactics in gastric polyps]. / Diagnosticheskaia i lechebnaia taktika pri polipakh zheludka.

During examination and dynamic endoscopic follow-up of 151 patients suffering from polyps of the stomach of various histological structure with various degree of epithelial dysplasia or without it, different types of treatment were undertaken in 61 patients. The results of the treatment are analysed, the efficacy of different methods of biopsy of polypoid structures and alternative methods of treatment of patients with benign and malignant polyps are evaluated, and the recognition of endoscopic polypectomy as a diagnostic and therapeutic intervention is substantiated.

[Endoscopic laser recanalization in the chemo- and radiotherapy of stenosing cancer of the esophagus]. / Endoskopicheskaia lazernaia rekanalizatsiia v khimioluchevom lechenii stenoziruiushchego raka pishchevoda.

The authors analyze the results of endoscopic laser recanalization in 11 patients with stenosing esophageal carcinoma, whose mean age is 61 years. The tumor was located in the upper thoracic portion of the esophagus in 3 patients, in the middle thoracic portion in 6, and in the lower thoracic portion in 2 patients. The diagnosis of carcinoma was morphologically verified. The length of the esophagus involvement was estimated by x-ray data and varied from 5 to 12 cm and longer. Endophytic form predominated--it was diagnosed in 5 patients. The technique of endoscopic laser recanalization by means of Raduga-1 unit with neodymium alumo-yttrium garnet laser as the source of irradiation is described. The method was specified with consideration for the type of tumor growth. The patients were kept on parenteral nutrition during the treatment session. Three-five days after endoscopic laser destruction long-distance open-field gamma-beam therapy was administered to 10 patients and polychemotherapy to 9 of these. After laser destruction dilatation of the stenosed portion of the esophagus from 0.2-0.6 to 1.0-2.0 cm was recorded in 10 patients. Complete regression of the tumor resultant from laser destruction and chemoradiotherapy was achieved in 5 patients, partial regression in the rest 5. The patients were followed up for 5-12 months. No recurrences were recorded in patients with complete regression of the tumor; the process progressed in 3 cases with partial regression. Studies on improvement of recanalization technique, specification of indications for and contraindications against this treatment modality are in progress.

[Riboflavin supply of the Kara-Kalpak ASSr population with pathologic changes of the esophageal mucosa]. / Obespechennost' riboflavinom zhitelei Karakalpakskoi ASSR s patologicheskimi izmeneniiami slizistoi pishchevoda.

Riboflavin supply was studied in 164 adult inhabitants of the Kara-Kalpak ASSR where a high incidence of cancer of the esophagus and precancer changes of the esophageal mucosa were recorded. Endoscopy was used to investigate the morphological picture of the esophageal mucosa. A standard method for evaluation of the activation coefficient (AC) of erythrocytic glutathion-reductase (EC1.6.4.2) in the presence of FAD was used as a criterion of the body supply with riboflavin. Pronounced riboflavin deficiency (AC greater than or equal to 1.30) and B2 hypovitaminosis (AC = 1.20-1.29) were observed in 17 and 23% of the cases, respectively. Statistical analysis of the data obtained evidences that insufficient supply with riboflavin is recorded, on an average, 3.5-5.5 times more frequently in subjects with pronounced catarrhal esophagitis, combined with or without leukoplakia, than in the control group of subjects with out pronounced changes in the esophageal mucosa. No positive statistically significant association between low supply of the body with riboflavin and atrophic esophagitis has been established.

[Relationship between the character of pathological changes in the esophageal mucosa and deficiency of several vitamins in a population with high incidence of esophageal cancer]. / Sviaz' mezhdu kharakterom patologicheskikh izmenenii slizistoi obolochki pishchevoda i defitsitom nekotorykh vitaminov v populiatsii s vysokoi chastotoi raka pishchevoda.

A comparative study of the esophageal mucosa versus vitamin status in the adult male population of Muinak District of the Karakalpak ASSR, characterized by high incidence of esophageal cancer, established a significantly high frequency of chronic esophagitis. The differential evaluation of different pathologies of the esophageal mucosa suggested a link between catarrhal and erosive esophagitis and vitamin B2 deficiency and atrophic esophagitis and vitamin A deficit.

[Epithelial dysplasia and cancer of the stomach]. / Epitelial'naia displaziia i rak zheludka.

Relationships between chronic gastric diseases and gastric cancer are discussed. Mucosal epithelial dysplasia may be regarded as the most reliable sign of increased risk of gastric cancer. Endoscopy with biopsy is the principal method for the assessment of the dysplasia-cancer relationship. A retrospective study of histologic preparations and smear imprints from gastric biopsy specimens and operative samples, obtained from 292 patients with chronic gastritis, gastric ulcers, gastric polyps and polyposis, and conditions following gastric resection for nontumorous diseases and cancer (group 1) and 80 patients with verified gastric cancer (group 2), is reported. In both groups, there was mucosal dysplasia of varying markedness. Endoscopic monitoring revealed gastric cancer in 48 first-group patients. Gastric cancer, combined with dysplasia, was detected in 128 patients from both groups, its early stages, in 37 of those. Convincing evidence in favor of a relationship between dysplasia and cancer is presented.

[The probability of malignant degeneration of stomach polyps]. / Veroiatnost' malignizatsii polipov zheludka.

A retrospective analysis of the endoscopic diagnostic data on 151 cases of gastric polyps of various histological structure was carried out. A relationship between the risk of malignant transformation of gastric polyps, on the one hand, and their histology, presence and degree of dysplasia, on the other, was established. Epithelial dysplasia, in pronounced degree included, was observed in 33.7% of patients with hyperplastic polyps and in all cases of gastric adenoma. Epithelial dysplasia of hyperplastic polyps was mild or moderate in most cases while that of adenomatous polyps was moderate or grave. Gastric cancer as a consequence of malignant transformation of polyps was detected in 15 (9.9%) patients (hyperplastic polyps--2; adenomatous polyps--13). No objective endoscopic criteria for establishing the risk of polyp transformation were developed. Grave epithelial dysplasia, i.e. precancerous lesions in the gastric mucosa, may be suggested as such criterion. Moderate or grave dysplasia of the polyp epithelium should be considered in forming the group at risk first and foremost.

[The role of endoscopic study in the diagnosis of precancerous gastric pathology and identification of a risk group]. / Rol' éndoskopicheskogo issledovaniia v diagnostike predopukholevoi patologii zheludka i formirovanii gruppy riska.

The results of endoscopic diagnosis and case follow-up of 686 patients with precancerous gastric conditions usually identified as a risk group (chronic gastritis, polyps, peptic ulcer, conditions following distal stomach resections) have shown that in patients with symptoms of epithelial dysplasia of gastric mucosa indices of cancer detectability significantly exceeded those in similar pathological conditions without symptoms of epithelial dysplasia. They were 22.0 +/- 2.5% and 2.5 +/- 0.8%, respectively; indices of stage I stomach cancer detectability were 9.9 +/- 1.8% and 0.2 +/- 0.2%, respectively. Patients with precancerous stomach diseases with moderate and severe epithelial dysplasia found in their gastric biopsies, should be attributed to a risk group, and these changes of gastric mucosa must be regarded as the main criterion for the identification of such a group.

[Results of examination of a population from a region with a high incidence of esophageal cancer: precancerous lesions of the esophageal mucosa]. / Rezul'taty obsledovaniia naseleniia v regione s vysokoi zabolevaemost'iu rakom poshchevoda: predrakovye porazheniia slizistoi obolochki pishchevoda.

Esophagoscopic evidence of chronic esophagitis of varying degree was found in 60% of the total number of 1348 examined males living in a region with high incidence of esophageal cancer. The high incidence of chronic esophagitis corroborates the hypothesis that this disease is a precursor of esophageal cancer.

[Use of nonhazardous laser radiation for treating the complications of patients undergoing radical surgery for esophageal and stomach cancer]. / Primenenie nepovrezhdaiushchego lazernogo izlucheniia dlia lecheniia oslozhnenii u bol'nykh, radikal'no operirovannykh po povodu raka pishchevoda i zheludka.

Helium-neon laser irradiation of sparing intensity (fluence 1.5-2.0 x 10(3) W/m2) was given to 15 patients with erosive-ulcerous complications ( anastomositis , reflux-esophagitis and peptic ulcer of anastomosis) following radical surgery on the stomach. Irradiation was delivered via the optical fibre of the endoscope biopsy duct. A pronounced analgetic effect of laser irradiation was observed. In 2 cases, peptic ulcers of anastomoses became completely covered with epithelium. The same effect was obtained in 11 out of 13 cases of erosive reflux-esophagitis.