[Results of surgical and combined treatment for nonsmall cell lung cancer with postoperative radiation therapy in a mode of hypofranctionation. Post II. Relapse-free survival and survival without locoregional recurrence].

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.

[Middle fraction radiotherapy for non-small cell lung cancer. Effect of increasing the total focal dose].

There were evaluated retrospectively the immediate and long-term results of radiotherapy in 259 patients with non-small cell lung cancer stages I-IV who had contraindications to surgery. Irradiation was carried out by middle fraction with single focal dose 3-4 Gr. We compared the results of treatment in two groups of patients differed in volume of total focal dose: I group (124 patients)--45 Gy, II group (125 patients)--60 Gy. An increase of total focal dose from 45 Gy to 60 Gy did not lead to an increase of the toxicity to vital organs including patients older than 60 years and patients with initially poorer somatic status. Disease-free survival significantly increased in total in the group with total focal dose 60 Gy and predominantly in tumors over 5 cm, in patients with ECOG 2-3 and in III-IV stage disease. An increase of total focal dose to 60 Gy in the group was significantly prolonged survival without local recurrences from 37% to 50% and by one-third reduced the frequency of locoregional recurrences. Identified benefits in overall and disease-specific survival the groups of non-small cell lung cancer patients with total focal dose 60 Gy compared with a group of non-small cell lung cancer patients who received radiotherapy in total focal dose 45 Gy at terms more than 5 years did not reach statistical significance.

[Negative inotropic and vasoconstrictor effects of oxidized phospholipids]. / Otritsate'lnyi inotropnyi i vazokonstriktornyi éffekty okislennykh fosfolipidov.

Effects of oxidized yolk phospholipids (PL) on the coronary perfusion rate (CPR) and myocardial contractility were studied in the experiments with the isolated or isolated and 30-minute ischemia-induced heart of the rat or isolated myocardial strip of the frog. The oxidized PL were demonstrated to possess a more pronounced and steady negative inotropic effect than unoxidized PL, which was due to their direct dose-dependent damaging action on myocardial contractility. The oxidized PL also made the unrestored CPR worse in the early postischemic period, the concomitant administration of aspirin producing no effects and that of the antioxidant ionol making ischemic myocardial contractility better. The findings suggest that the circulating oxidized PL may contribute to the impairment of coronary tone and contractility of the intact or ischemic myocardium and the induction of endogenous processes of lipid peroxidation plays a role in showing these effects.

[The effect of the antioxidant ionol as a liposome component on the function of the isolated and ischemic heart]. / Vliianie antioksidanta ionola v sostav liposom na funktsiiu izolirovannogo i ishemizirovannogo serdtsa.

The anti-ischemic and toxic effects of different doses of the antioxidant ionol (butyl hydroxytoluene, BHT) introduced into the Krebs-Henseleit medium composed of monolayer liposomes of egg phospholipids before or 30 minutes after total ischemia of the heart were studied on a model of perfusion of isolated Wistar rat heart by the method of Langendorff-Fallen. It has been demonstrated that ionol, after its addition to the perfusate in the preischemic period, exerts an anti-ischemic effect in concentrations of 10(-6), 3 x 10(-6) and 10(-5) M; in the postischemic period, in concentrations of 3 x 10(-6) and 10(-5); the protective effect of ionol in the postischemic period is less pronounced. In higher doses (3 x 10(-5) and 10(-4) M) ionol produces a toxic action which is more remarkable and is less reversible in respect to the ischemized than to the nonischemized heart, and is realized rather through the dysfunction of heart muscle relaxation. The conclusion is drawn that there is a possibility of using ionol in doses of 10(-6) to 10(-5) M as a constituent of liposomes for addition to perfusion, conservant and cardioplegic solutions as an anti-ischemic remedy.

[A variant of an operation of varicose veins of the esophagus and cardia in patients with portal hypertension syndrome]. / Variant operatsii na rasshirennykh ven pischevoda i kardii u bol'nykh s sindromom portal'noi gipertenzii.

On analysing universal experience, the authors suggest their variant of operation on varicose veins of the esophagus and cardia with the use of Doppler ultrasonography and intraoperative packing of the veins with a radiocontrast foamy polymer. With this method the flow of blood in the venous collaterals of the stomach and esophagus can be arrested more radically during the operation, which considerably reduces the percentage of recurrent bleeding from these veins.

[A method of suturing of dilated cardial veins in patients with portal hypertension]. / Metodika proshivaniia rasshirennykh ven kardii u bo'lnykh s porta'lnoigipertenziei.

Ultrasonic fluorometry used in 22 patients with portal hypertension facilitates the detection, marking the venous trunks of the cardia with inflammatory alterations of the mucosa. Intraoperative control of surgical treatment with the help of ultrasonic fluorometry allows operations to be performed more radically and to considerably reduce the intraoperative blood loss.

[Effect of phospholipids of different compositions on coronary vessel tonus and myocardial contractility]. / Vliianie fosfolidipidov razlichnogo sostava na tonus koronarnykh sosudov i sokratitel'nuiu sposobnost' miokarda.

In experiments on perfused isolated Wistar rat hearts and frog myocardial strips it has been shown that the injection of egg phospholipid liposomes in the perfusion solution leads to a decrease in the volume velocity of the coronary perfusion and to worsening of the contractile myocardial function. Negative inotropic effect of phospholipids on the perfused heart may be linked not only with the decrease in the coronary perfusion but also with their direct inhibitory action on the contractile ability of myocardiocytes.

[Anti-ischemic action of a 1-hydroxy-2,2,6,6-tetramethylpiperidine derivative from a series of nitroxyl bioantioxidants]. / Protivoishemicheskoe deistvie 1-gidroksi-proizvodnogo 2,2,6,6-tetrametilpiperidina iz riada nitroksil'nykh bioantioksidantov.

The experiments have been performed on 216 Wistar rats to examine anti-ischaemic action of the 1-hydroxy-2,2,6,6-tetramethyl-piperidine derivative (I), whose antioxidant properties were, earlier shown for model systems. Introduction of I (10(-4) M) into the perfusion medium and the subsequent storage (37 degrees C) of isolated liver was shown to decrease the accumulation of lipid peroxidation products (MDA). Compound I administrated (5 x 10(-6)-10(-5) M) in perfuse medium of isolated (Langendorff method) and ischemized (30 min, 37 degrees C) heart improves contractile function (Pmax) and decreases end-diastolic pressure at postischaemic period. In vivo injection of I increases (12 mg/kg, i.p.) the number of rats survival after sublethal time (2.5 h) of liver total ischaemia, increase (35 mg/kg, i.p.) the number of rats survival and improves parameters of heart function after ischaemic shock (6 h ischaemia and reperfusion of limbs). The analog of I, corresponding amine, possessing no antioxidant properties also fails to exhibit any anti-ischaemic effect.

[Disorders of cardiac contractile function in ischemic shock; the protective effect of antioxidants and liposomes made from egg phospholipids]. / Narusheniia sokratitel'noi funktsii serdtsa pri ishemicheskom shoke; zashchitnyi éffekt antioksidantov i liposom iz iaichnykh fosfolipidov.

Experiments were made on Wistar rats with 6h tourniqueting of the hind limbs to study animal survival rate, myocardial contractile function and protective action of antioxidants and egg phospholipid liposomes during ischemic shock. It has been shown that reperfusion of the limbs leads to a high animal lethality, make lower myocardial contractile function and coronary flow of the hearts isolated from rats following a 6h reperfusion of the limbs. Well-known antioxidant butylated hydroxytoluene and a new antioxidant tetramethylpiperidine derivative bring animal lethality down and improve coronary flow and contractile function of the isolated heart. Phospholipid liposomes increase survival rate moderately but have no any effect on the heart contractile function. It has been deduced that lipid peroxidation takes part in the disturbance of heart contractile function and genesis of the death within ischemic shock.