Comparison of chemotherapy and X-ray therapy with Ukrain monotherapy for colorectal cancer.

Ninety six colorectal carcinoma patients were included in a randomised study, 48 were treated with Ukrain monotherapy (15 with metastatic and 33 with nonmetastatic colorectal carcinoma) and 48 with 5-fluorouracil (5-FU) and X-ray therapy (the same randomised groups). The results of therapy including clinical, haematological, immunological and biochemical parameters show that Ukrain has favourable properties in the treatment of colon and rectal cancer as a monotherapy because of its malignotoxic and immunomodulating action. Objective response rate in the group of metastatic colorectal cancer treated by Ukrain was 40%. There was no registered tumour regression in the group treated by 5-FU. Operability is strongly facilitated by pretreatment with Ukrain. The survival rate (up to 21 months) in the Ukrain-treated patients with nonmetastatic colorectal cancer was 78.6% and 33.3% in a corresponding control group. Ukrain is a new effective drug in the therapy of colorectal cancer. It can be useful both for the therapy of metastatic colorectal cancer and for neoadjuvant therapy of nonmetastatic colorectal cancer.

Ukrain (NSC-631570) in the treatment of pancreas cancer.

The aim of this study was to investigate the effects of Ukrain in the treatment of pancreatic cancer. Most patients with advanced pancreas cancer experience pain and have to limit their daily activities because of tumor-related symptoms. Currently, there is no satisfactory treatment for pancreas cancer. The 12-month survival rate is approximately 18% for patients treated with gemcitabine and only around 2% for those treated with 5-fluorouracil. Between January 1, 1996 and December 31, 1999 42 patients with advanced symptomatic pancreas cancer were randomly assigned to receive either vitamin C (5.4 g every second day, repeated 10 times) and Ukrain (10 mg every second day, repeated 10 times) (21 patients), or vitamin C (5.4 g every second day x 10) and normal saline (10 ml) (control group, 21 patients). The primary measure of efficacy was overall survival. Other evaluation criteria included change in body weight, pain intensity (measured by analgesic consumption) and Kamofsky performance status. The one-year survival was 81% in the Ukrain group compared with 14% in the control group. The 2-year survival was 43% in the Ukrain group compared with 5% in the control group. In a recent study of 126 patients treated with gemcitabine or 5-fluorouracil, none of the patients survived beyond 19 months. The longest survival in the Ukrain group was 54 months after the start of therapy (from March 1996 to date). The last follow-up of other patients was on September 6, 2000. Median survival was 17.17 months for Ukrain-treated patients and 6.97 months for the control group and mean survival was 21.86 and 8.92 months for the Ukrain and control groups, respectively (p = 0.001). Ukrain treatment was well tolerated. We conclude that Ukrain prolongs survival of pancreas cancer patients. To determine whether and to what extent this drug can be used as standard therapy in pancreas cancer, a phase III study should be carried out.

[Surgical treatment of pancreatic cancer]. / Khirurgicheskoe lechenie raka podzheludochnoi zhelezy.

An experience with 16 radical operations for cancer of the pancreatic body and tail is analysed. The increased resectability and reduced mortality was gained by elaborating and introducing into clinical practice some new original methods of surgery: an extensive left-sided resection of the pancreas, performed in 5 patients with one case of mortality, and the combined left-sided pancreatectomy, performed in 3 patients without lethal issues. A 3-year survival was noted in 3 patients, a 5-year survival--in 1.

[Surgical treatment of malignant liver tumors]. / Khirurgicheskoe lechenie pri zlokachestvennykh opukholiakh pecheni.

One hundred and nineteen patients were operated upon, 89--for primary cancer of the liver, 30--for cancer metastases. Radical operations for primary cancer of the liver were performed in 5 of 89 patients, and in 8 of 30 patients with metastatic involvement of the liver. In radical operations for malignant hepatic neoplasms frequently there would arise the necessity of a temporary exclusion of the organ from the portal and caval circulation.

[Surgical treatment of cancer of the hepatic duct]. / O khirurgicheskom lechenii raka pechenochnogo protoka.

The authors experience with 96 patients treated for cancer of the hepatic porta arising from the hepatic duct is discussed. The most resultant technics of investigation in this pathology are retrograde endoscopic cholangio-cholecystography (in 30 patients) and transjugular cholangiography (in 3 patients). Thirteen patients were radically operated upon, they were subjected to a circular resection of the common bile duct the site of hepatic ducts branching with subsequent hepaticojejunostomy. It is believed that a higher degree of resectability in tumors of this zone may be possible on account of perfection of early diagnosis and widening of an extent of surgery.

[The effect of chronic internal irradiation from incorporated radionuclides on liver function]. / Vliianie khronicheskogo vnutrennego oblucheniia inkorporirovannymi radionuklidami na funktsional'noe sostoianie pecheni.

On chronic supply to the body of a mixture of nuclear division products lanthanum-140, barium-140, tellurium-132, neodymium-147, neptunium-239, zirconium-95, niobium-95, iodine-131, cerium-141, -144, cesium-134, -137, and ruthenium-103 are detectable in liver tissue within the first months. In the 2 to 4 years following the disaster, liver tissue primarily accumulates cerium-144, radium-226, thorium-228, -232, ruthenium-106, antimony-125, and europium-154. Within the first periods the liver radionuclide content was 19 to 31% higher than that in the blood, and in the following years it was 24 to 38% higher. The radionuclides indicated were actively excreted with the bile into the gastrointestinal lumen. Within the first months after the chronic internal radiation the functional liver disorders were detectable in 30 to 40% of the patients. Later on diverse acute and chronic diseases of the liver, gallbladder and pancreas were detectable in 20 to 30% of the patients. The radionuclide content in the body was found to be in parallel with functional liver disorders. Acceleration of radionuclide excretion from the body results in liver function improvement.

[Reoperations in patients with pyloroduodenal ulcers]. / Povtornye operatsii u bol'nykh piloroduodenal'nymi iazvami.

From analysis of the results of treatment of 35 patients who underwent previously unsuccessful operations for pyloroduodenal ulcers, the authors discuss the term and the most adequate method of surgical correction. Poor results in the early period after the operation are mainly due to technical errors made during the performance of the first operation. Affection of organs adjacent to the stomach prevail in the later periods. The use of methods of surgical correction suggested by the authors made it possible to achieve adequate medical, social, and occupational rehabilitation in 26 patients.

[The combined treatment of acute destructive pancreatitis]. / Kompleksnoe lechenie ostrogo destruktivnogo pankreatita.

Extensive resection of the pancreas is shown to be accompanied by a high case-fatality rate and unsatisfactory late results such as formation of postpancreatectomy syndrome. Expediency is proved of employment of conservative treatment (pancreatic secretion blockers, antioxidants, antibiotics, different kinds of extracorporal and intracorporal detoxication etc.). Indications to operative treatment of destructive pancreatitis are determined, which include progressive polyorgan incompetence that does not respond to adequate intensive therapy for 48 to 72 hours, progression of biliary pancreatitis (surgery is performed during the first 24-hour period), infected necroses (at day 15 to 17). The above treatment option was associated with a decline in the general case mortality down to 6.15% and in the postoperative mortality down to 15%.

[Non-clostridial anaerobes in the etiopathogenesis of perivesical cholangiogenic abscesses of the liver]. / Neklostridial'nye anaéroby v étiopatogeneze perivezikal'nykh kolangiogennykh abstsessov pecheni.

The authors had under observation 318 patients who were subjected to operation and suffered from various inflammatory diseases of the bile tract; perivesical and cholangiogenic abscesses of the liver were found in 33 of them. Bacteriological tests of the contents of the abscesses demonstrated most frequently the presence of Bacteroides fragilis as a monoculture in cholangiogenic abscesses and associations of anaerobic and aerobic bacteria in perivesical abscesses. Early operation with obligatory consideration for the anaerobic component of the microflora is recommended.

[Vascular-surgical operations in a general surgery clinic]. / Angiokhirurgicheskie vmeshatel'stva v usloviiakh kliniki obshchei khirurgii.

From experience with 37 vascular operations performed on 31 patients in a general surgical clinic, the authors claim that the reserve in improving the quality of treatment consists not only in specialization and professional mastering of this narrow field of surgery. It is shown that manipulations of temporary hemostasis must be mastered and general surgeons must be trained specially in the problems of emergency angiosurgery. The authors obtained poorer results when embolic complications in myocardial infarction compelled them to resort to operations.

[The pathomorphogenetic characteristics of the wall of the common bile duct in cholestasis]. / Osobennosti patomorfogeneza stenki obshchego zhelchnogo protoka pri kholestaze.

Data are presented on the reversibility of pathological changes of the common bile duct, causes and criteria of reversibility. Consideration of four stages of pathomorphogenesis of the common bile duct wall may be of help in the choice of surgical tactics in surgical intervention on the common bile duct.

[The initial experience of using the preparation Ukrain in treating cancer patients in Ukraine]. / Pershyi dosvid zastosuvannia preparatu "Ukrain" v likuvanni onkolohichnykh khvorykh v Ukraïni.

The chair of general surgery and the chair of oncology of the Ukrainian State Medical University have made a study into the use of the preparation "Ukrain" in the treatment of oncological patients. Early results of therapy of 23 patients confirm the evidence suggesting to us that "Ukrain" is endowed with cancerostatic activity, has immunopotentiating effect with no toxicity.

[Various problems of surgery of the extrahepatic bile ducts]. / Nekotorye voprosy khirurgii vnepechenochnykh zhelchnykh protokov.

Debatable questions of indications to choledochotomy and placing bile-eliminating anastomoses are discussed on the basis of personal experiences and data of literature. It is supposed that the amount of choledochotomies should be restricted at the expense of wider use for the revision of extrahepatic bile ducts of the cystic duct stump. In cases when bile-elimination anastomoses are not supposed oblique choledochotomy should be preferred through the cystic duct stump. Indications to the creation of bile-elimination anastomoses should not be wider. In doubtful cases the question should be solved in favour of external drainage of the common bile duct.

[Drainage of the thoracic lymphatic duct and lymphosorption in the combined treatment of obstruction of the bile ducts and liver failure]. / Drenirovanie grudnogo limfaticheskogo protoka i limfosorbtsiia v kompleksnom lechenii bol'nykh s neprokhodimost'iu zhelchevyvodiashchikh protokov i pechenochnoi nedostatochnost'iu.

Results of the application of the method of drainage of the lymphatic duct and lymphosorption in the complex treatment of 108 patients with obstruction of the bile eliminating ducts complicated by mechanical jaundice and hepatic insufficiency are described. Activated charcoal SKN, SUGS and SKT-6A were used for the sorption lymph detoxication. A pronounced detoxication effect of the sorption purification of the lymph with the activated charcoal and its reinfusion to the patient in the pre- and postoperative periods is shown.

[Non-clostridial anaerobic infection in complicated cholecystitis]. / Neklostridial'naia anaerobnaia infektsiia pri oslozhnennom kholetsistite.

Results of bacteriological investigations and treatment of 112 patients with complicated forms of acute cholecystitis are described. It was found that in complicated forms of acute cholecystitis an important part was played by associations of bacteria among which neclostridial anaerobes were of leading importance responsible for the aggravation of the inflammatory process and course of the postoperative period. The intracholedochal antibacterial therapy with Dioxidin in combination with antibiotics is thought to be expedient.

[Hemocoagulation disorder in patients with destructive pancreatitis: the role in pathogenesis and ways of its correction]. / Porushennia hemokoahuliatsiï pry destruktyvnomu pankreatyti: rol' v patohenezi ta shliakhy korektsiï.

The dynamics of hemocoagulation system changes in patients with different clinical forms of destructive pancreatitis (DP) was evaluated. The necessity of use of directed hemocoagulation therapy and hemocorrection, in particular, the use of low-molecular weight heparins, in complex program of treatment of DP is proved.

[The influence of clexane on the fibronectin content in the blood plasma in patients with destructive pancreatitis]. / Vliianie kleksana na soderzhanie fibronektina v plazme krovi u bol'nykh destruktivnym pankreatitom.

The fibronectin content dynamics in the blood serum was estimated in patients with various clinical forms of an acute pancreatitis. The fibronectin level lowering may be a predictor of occurrence and diagnostical criterion for infective complications in patients with destructive pancreatitis. Application of clexane had promoted the fibronectin level raising in the blood serum in patients with sterile and infected pancreatic necrosis.

[Polycystosis of the liver]. / Polikistoz pecheni.

The authors operated 15 cases with polycystotic liver. The diagnostic value of ultrasound echolocation and hepatoscanning in polycystosis was noted. In authors' opinion the surgical treatment of polycystotic liver should be carried out in due time during the clinical manifestations phase and ought to be radical enough to yield satisfactory results.

[Causes, diagnosis and treatment of the "postcholecystectomy syndrome"]. / Prichiny diagnostika i lechenie "postkholetsistéktomicheskogo sindroma".

On the basis of clinical examinations and treatment of 174 patients the authors substantiate the importance of using special and instrumental means of diagnosis as well as the expediency of exploratory laparotomy for establishing the real cause of the disease. The efficiency of selective vagotomy in persistent spasm of the major duodenal papilla is shown.

[Errors and complications in external drainage of the common bile duct]. / Oshibki i oslozhneniia pri naruzhnom drenirovanii obshchego zhelchnogo protoka.

Errors and complications taking place in external drainage of the common bile duct were analyzed in 484 patients. They appear due to choice of a wrong drainage tube. The authors describe their method of fixation the drain when draining through the stump of the bladder duct. In the postoperative period it is necessary to perform intracholedochal therapy with antibiotics for treatment of purulent cholangitis and for preventing a secondary infection of the bile ducts. Time of the removal of the drain depends on the state of the pancreas and on the data of transdrainage cholangiography.