[Cervicothoracotomy for right upper sleeve lobectomy with carinal resection in the treatment of central lung cancer]. / Kombinirovannyi tserviko-torakotomnyi dostup dlya vypolneniya verkhnei lobektomii sprava s rezektsiei bifurkatsii trakhei pri tsentral'nom rake legkogo.

We demonstrated successful treatment of patients with complicated central lung cancer, who underwent right upper sleeve lobectomy with carinal resection. We have used the following options for carinal reconstruction: anastomosis of trachea with the left main bronchus and anastomosis of intermediate bronchus with the left main bronchus (clinical case No. 1) or with trachea (clinical case No. 2). Cervicothoracotomy provided correct N-staging and mobilization of trachea with left main bronchus. This approach provided compliance with oncological principles of surgical treatment of lung cancer and significantly reduced tension of anastomosis. These aspects are important for satisfactory immediate functional and oncological results after right upper sleeve lobectomy with carinal resection.

[Right upper lobe pulmonary sequestration as a rare cause of recurrent spontaneous pneumothorax]. / Sekvestratsiya verkhnei doli pravogo legkogo ­ redkaya prichina pravostoronnego retsidiviruyushchego spontannogo pnevmotoraksa.

A 19-year-old patient after previous wedge resection of the right upper pulmonary lobe a year ago urgently admitted with recurrent right-sided spontaneous pneumothorax. According to standard management of spontaneous pneumothorax, we performed diagnostic thoracoscopy and drainage of the right pleural cavity with regular X-ray examinations. However, these measures were ineffective. The patient was scheduled for surgery, and we intraoperatively observed an unusual cause of pneumothorax. Thus, we present spontaneous pneumothorax following right upper lobe pulmonary sequestration. The uniqueness of this case is associated with unusual manifestation and non-standard localization of rare lesion. A few cases of pneumothorax in similar patients are described in the world literature. The key limiting factor in diagnosis of such defects (identification of aberrant vessel supplying abnormal lung parenchyma) is the lack of routine CT angiography in patients diagnosed with pneumothorax. That is why CT changes were interpreted as postoperative ones, and the true cause was established only during redo surgery. A thorough inspection of the pleural cavity and alertness regarding unusual appearance of the right upper pulmonary lobe made it possible to suggest a non-standard diagnosis, avoid complications (bleeding from afferent vessel) and perform adequate lung resection.

[Treatment of patients with rare bronchial foreign body - spruce branch]. / Opyt lecheniya bol'nykh s redkim tipom inorodnogo tela bronkhov ­ vetochkoi khvoinogo dereva.

Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging¼ type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive¼ type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3rd case was the most interesting. Initially, the foreign body was «underlying¼, but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.

[Current view on variety of bowel preparation for elective colorectal surgery]. / Sovremennyi vzgliad na optimal'nye sposoby podgotovki tolstoi kishki pered planovymi kolorektal'nymi operatsiiami.

Mechanical bowel preparation used to be a standard procedure for a long time. Nowadays routine use of MBP seems to be debatable thus alternative approaches, e.g. avoiding any bowel preparation completely or using of MBP with oral antibiotics are considered. Data on performing different kinds of bowel preparation is reviewed in this article.

[Influence of anastomotic leakage on the long-term outcomes in patients with colorectal cancer]. / Vliianie nesostoiatel'nosti shvov anastomozov na otdalennye rezul'taty lecheniia bol'nykh kolorektal'nym rakom.

Anastomotic leakage after surgery for colorectal cancer is a widely known factor aggravating immediate outcomes. At the same time, deterioration of oncological results is under much less attention. Long-term consequences of anastomotic leakage and possible mechanism of negative effect of this complication on long-term results are reviewed in the article.

[Modern trends in surgery of gastrointestinal tract tumors].

Development of cancer surgery in recent decades occurs on a background of continuing scientific and technical progress. New technologies after the completion of clinical trials maximally quickly are included in the routine practice of specialized medical centers. At present an escalation of indications for extensive advanced and combined operations in locally advanced and even metastatic tumors goes in parallel with the introduction of minimally invasive interventions, search categories of patients, for whom the radicalism of treatment can be achieved without significant surgical aggression. The study of modern trends of this process will allow seeing the promising areas of scientific research, assuming the image of the future of surgery for cancer.

[Laparoscopic surgery for rectal cancer: a literature review and own experience].

The main treatment option for rectal cancer is surgery, which "gold standard" is the total mesorectumectomy. There are presented literature review and the results of own research devoted to comparative analysis of outcomes of laparoscopic and open total mesorectumectomy. Current data and own experience show the oncological adequacy and safety of laparoscopic approach however the controversy of some results reveal the necessity of further investigation.

[Thoracic endometriosis--the rare pathology in thoracic surgery].

Thoracic hematogenic endometriosis is a rare pathology. A clinical course hasn't pathognomic symptoms, because of it, the diagnosis is established due to histological study. The article presented two cases of female patients, who were suffering from thoracic endometriosis. They were hospitalized to the department of thoracic surgery of Municipal multifield hospital No 2 in Saint-Petersburg. The first patient had a posterior mediastinum tumor with asymptomatic disease course. The second patient was with recurrent catamenial pneumothorax.

[Experience with continuous epidural anesthesia used in the complex of combined anesthesia at gastropancreatoduodenal surgery].

The purpose of this study was to assess the experience with long-term epidural space administration of 1% lidocaine in combination with general anesthesia. Anesthesia based on the long-term epidural lidocaine administration in combination with general anesthesia versus total intravenous anesthesia based in ketamine and ataralgesia was analyzed. The anesthesia based on the long-term epidural lidocaine administration in combination with general anesthesia was shown to provide steady-state hemodynamic parameters and an adequate antinociceptive protection and to contribute to the early activation of patients.

[Anticarcinogenic action of dietary supplement pheocarpin and its active component].

Anticarcinogenic action of dietary supplement Pheocarpin and its active component Natural Coniferous Complex (NCC), in particular, has been studied. Pheocarpin and NCC efficiently inhibited tumorigenesis in the mammary gland, large bowel, skin, cervix uteri and lungs. Pheocarpin offers considerable advantage as a means of reducing the risk of malignant disease.

[Surgical policy in chronic purulent otitis media in children]. / Khirurgicheskaia taktika pri khronicheskom gnoinom srednem otite u detei.

Surgical outcomes in 603 children with otitis media purulenta chronica (OMPC) have shown that early microsurgery (endaural tympano-, attico-, aditotomy) improved or reestablished normal anatomy and physiology of the middle ear in 85% of the patients. One-stage cleansing or plastic surgery is preferable. In operations on mastoid process in the absence of complications, prevention of reoperation seems most effective by autotissue plastic reconstruction of the mastoid bone wound in the end of the operation.

[The inhibitory effect of water-soluble and liposomal beta-carotene on various models of carcinogenesis]. / Ingibiruiushchaia aktivnost' vodorastvorimogo i liposomal'nogo beta-karotina na razlichnykh modeliakh kantserogeneza.

The inhibitory effects of the newly-developed forms of beta-carotene--water-soluble and liposomal--have been studied in rats and mice bearing tumors induced in 4 models of carcinogenesis. Mammary tumors were induced by single injections of 1 mg methylnitrosourea into each gland. Esophageal tumors were induced in male rats by intragastric administration of 3 mg/kg methylbenzylnitrosoamine, thrice a week for 4 weeks. Tumors of the vagina and cervix uteri were induced by intravaginal painting with 25 mkg dimethylbenz(a)anthracene, twice a week for 6 weeks. Tumors of the lung were induced in female mice by intraperitoneal injection of 1 g/kg urethane, once a week for 6 weeks. With models I-III, animals received water-soluble beta-carotene (Aquiton-10) with drinking water (200 mg/I), on completion of carcinogen treatment and for another 9-12 months until the end of experiment. Urethane-treated mice received liposomal beta-carotene with drinking water (60 mg/l) 10 days before the beginning of carcinogen treatment and for another 6 months until the end experiment. Water-soluble beta-carotene failed to influence the carcinogenesis in the mammary gland and esophagus in rats; however, it significantly inhibited carcinoma development in murine vagina and cervix uteri (47.0%). Liposomal beta-carotene significantly inhibited lung adenomas (46.4%) and mammary carcinomas (55.6%) in urethane-treated mice.

[Experimental tests and clinical trials of the biologically active food additive Fibromed]. / Eksperimental'naia i klinicheskaia aprobatsiia biologicheski aktivnoi dobavki k pishche Fibromed.

A biologically active food additive--Fibromed--has been tested experimentally and clinically. The additive made from wheat bran by the Reacon Company contains no less than 40% of dietary fibre (cellulose, hemicellulose and lignin). Its effect on multi-organ carcinogenesis induced by N-methyl-N-nitrosourea (MNU) and lipid metabolism was tested in rats. Tumors were induced by combined intramammary injections and intrarectal infusions of the agent. Fibromed was fed (20% by weight) during post-initiation period. It effectively inhibited the development of mammary and colonic tumors and reduced serum-blood cholesterol, triglycerides and beta-lipoproteids. The influence of Fibromed treatment on stool during early post-operative period was studied in surgical cases of colorectal cancer. When administered in a dose of 60 g, daily, starting from days 4-5, Fibromed restored intestinal function 36 hr earlier than in controls. Fibromed should be recommended for prevention of breast and colonic tumors, lipid metabolism disorders and rehabilitation of patients who underwent surgery for colorectal cancer.

[Gutron studied as an agent for preventing radiation lesions]. / Issledovanie Gutrona kak sredstva profilaktiki luchevykh porazhenii.

Experimentally, with the use of mathematical modeling, a radioprotective effect and optimum usage of alpha-adrenomimetic Gutron was shown on CBA male-mice exposed to radiation. Injections of 1 to 5 mg/kg Gutron to the mice 10 to 40 min and 1 to 4 h before the irradiation with the doses of 6 to 7.5 Gy ensured the survival rates of the exposed animals with the protection coefficient s of 0.6 to 0.7 and 0.4, respectively.

Study of post-natal effect of chemopreventive agents on ethylnitrosourea-induced transplacental carcinogenesis in rats. III. Inhibitory action of indomethacin, voltaren, theophylline and epsilon-aminocaproic acid.

The influence of the arachidonic acid metabolism inhibitors, indomethacin and voltaren; an inhibitor of phosphodiesterase activity, theophylline and the protease inhibitor epsilonaminocaproic acid (EACA) on N-ethyl-N-nitrosourea (ENU)-induced transplacental carcinogenesis was studied in rats. ENU was given to pregnant rats as a single i.v. exposure at a dose of 75 mg/kg body weight on the 21st day after conception. Indomethacin and voltaren (20 p.p.m. in drinking water), theophylline (0.01% in diet) and EACA (1000 p.p.m. in drinking water) were given to the offspring throughout their post-natal life until all survivors were killed at 12 months. In the ENU-only control groups, 100% of the offspring developed tumors of brain, spinal cord, peripheral nervous system or kidneys, with a total average number of 3.1 tumors per rat. The most marked inhibitory effect was exerted by theophylline, which significantly decreased the incidence and multiplicity of total tumors, and at all main sites selectively (brain, spinal cord, peripheral nerves and kidneys). It also prolonged average survival time of the offspring. Indomethacin and voltaren significantly decreased total tumor incidence and multiplicity and brain tumor incidence and multiplicity. Indomethacin also decreased kidney tumor multiplicity and voltaren diminished spinal cord tumor multiplicity. EACA decreased multiplicities of total, brain, peripheral nerve and kidney tumors, and diminished the incidence of brain tumors. These chemopreventive agents decreased tumor incidences 20-33% and tumor multiplicities 1.4-2.7 times, compared with the ENU-only controls.

Action of Ukrain, a cytostatic and immunomodulating drug, on effects of irradiation.

The ability of Ukrain, a cytostatic and immunomodulating semisynthetic compound of thiophosphate-modified alkaloids of Chelidonium majus L., to modify the effects of irradiation was studied in CBA/J mice using the dosage of the drug from 0.2 to 10 mg/kg. Ukrain was found to increase the survival rate of mice by 50-60 percent at irradiation doses from 6.00 to 6.75 Gy with no effect at the dose of 7.5 Gy. Varying the dosage of the drug did not influence the outcome of irradiation under experimental conditions employed. Maximal increase in the survival rate of the mice was noted when the drug was administered within the interval from 6 h before to 3 h after irradiation. It is noteworthy that under no circumstances did the administration of Ukrain result in a decrease in the survival rate of irradiated animals. The main outcome of the present study is the finding that Ukrain is capable of modifying the effects of irradiation when applied in both prophylactic and curative regimens. The effects of Ukrain are evident at doses from 0.2 to 10 mg/kg over the entire time-range studied and under doses of irradiation not exceeding LD 85/30. The drug was also found to be able to modify the effects of prolonged irradiation.

[The inhibiting effect of ortofen and indomethacin in relation to the development of induced nervous system tumors in rats]. / Tormoziashchii éffekt ortofena i indometatsina v otnoshenii razvitiia indutsirovannykh opukholei nervnoi sistemy u krys.

The anticarcinogenic effects of the nonsteroidal antiinflammatory drugs ortophen and indomethacin on carcinogenesis of the nervous and renal systems were studied. Glial tumors of the brain and spinal cord, neurinomas of peripheral nerves and renal mesenchymal tumors were induced in rats through a single transplacental administration of N-ethyl-N-nitrosourea, 75 mg/kg body weight. Ortophen and indomethacin each used in a dose of 20 mg/litre of drinking water in the period of postnatal life were effective in inhibiting the growth of brain and spinal cord tumors, showed a statistically insignificant tendency to suppress the growth of peripheral nervous tumors, but failed to affect the growth of renal tumors.

Individual levels of activity of O6-alkylguanine-DNA alkyltransferase in monkey gastric mucosa during chronic exposure to a gastrocarcinogen N-ethyl-N'-nitro-N-nitrosoguanidine.

The activity of a DNA repair enzyme, O6-alkylguanine-DNA alkyltransferase (AGT), was studied in gastric mucosa of 15 Macaca fascicularis monkeys before and during chronic oral exposure to the ethylating carcinogen N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) in order to investigate possible causes of inter-individual differences in susceptibility to its gastrocarcinogenic effect. A wide range of AGT activity (307-1903 fmol/mg protein, mean 695) was found before treatment and it decreased during the first year of exposure (means 627, 479 and 452 fmol/mg protein respectively at 6, 12 and 18 months after the beginning of the experiment). The carcinogenesis study is under way and to date four monkeys with low initial AGT level in gastric mucosa died of gastric cancer. The relevance of AGT level measurement for prediction of individual susceptibility to ENNG is discussed.

[Inhibition of mammary gland carcinogenesis using a tincture from biomass of ginseng tissue culture]. / Podavlenie kantserogeneza molochnoi zhelezy s pomoshch'iu nastoiki iz biomassy kul'tury tkani zhen'shenia.

The influence of official drug bioginseng produced from cultivated cells of ginseng radix (Panax ginseng C. A. Mey) on carcinogenesis of the mammary gland was studied. Adenocarcinomas of the mammary gland were induced in rats by single intramammary injections of N-methyl-N-nitrosourea (MNU) at a dose of 1 mg per gland into the tissues of all 12 mammary glands. Bioginseng was given per os at a daily dose of 0.5 ml per rat for 27 weeks beginning 1 week after the MNU administration. Bioginseng and the control MNU-group decreased the incidence and multiplicity of the mammary gland tumors at 44 and 62% respectively. By radioimmune assay it was found that bioginseng normalised abnormally high level of estradiol in blood of rats treated by MNU.

[The inhibiting effect of epsilon-aminocaproic acid on the incidence of induced tumors of the esophagus, nervous system and kidneys]. / Tormoziashchee vliianie épsilon-aminokapronovoi kisloty na chastotu indutsirovannykh opukholei pishchevoda, nervnoi sistemy i pochek.

The anticarcinogenic properties of epsilon-aminocaproic acid were studied in two rat models of carcinogenesis. Esophageal tumors were induced by oral instillations of a total dose of 54 mg/kg body weight N-methyl-N-benzylnitrosamine whereas tumors of the nervous system and kidney-by transplacental injection of 75 mg/kg body weight N-ethyl-N-nitrosourea. epsilon-Aminocaproic acid given at a concentration of 1 milligram drinking water at the post-initiation stage of the carcinogenesis was shown to inhibit the induction of cancer and papilloma of the esophagus, brain glioma, peripheral nerve neurinoma and mesenchymal tumors of the kidney.