[Therapy of patients with isolated metastasis in regional lymph nodes after primary treatment for skin melanoma].

The total of 186 metastatic skin melanoma patients with regional lymph nodes involvement (locoregional stage) received neoadjuvant chemotherapy and irradiation followed by extended lymphodissection. This therapy allowed obtaining favorable overall survival in most patients. Social aspect of the problem should also be noted - the tenacity in treatment of unfavorable prognosis patients using all treatment modalities available allows giving back the hope and extending the lifespan of many patients.

[Somatic mutagenesis at T-cell receptor locus in inhabitants of radiation polluted regions as a result of the Chernobyl disaster].

In the period of 2001-2004, frequency of cells bearing mutations at T-cell receptor (TCR) locus was assessed in 553 inhabitants of radiation polluted regions of the Russian Federation and 154 unexposed control persons. The inhabitants were divided into three groups according to age at the moment of the Chernobyl disaster and 137Cs pollution density: 1) in utero, 37-555 kBq/m2; 2) 0-14 years old, 20-555 kBq/m2; 3) 18 and more years old, highest 137Cs density (185 more than 555 kBq/m2). The most intense changes of the TCR-mutant cell frequency were observed in the group of persons exposed to ionizing radiation in utero. The mean frequency of the mutant cells was higher in the first group than in age-matched control group by about 1.5-fold: 4.0 x 10(-4) vs 2.7 x 10(-4) accordingly (p < 0.0001). Elevation in the mean TCR-mutant cell frequency was less expressed in group of inhabitants aged 0-14 years at the moment of irradiation start: 1.3-fold increase in comparison to age-matched control (3.8 x 10(-4) vs 2.9 x 10(-4), p = 0.0002). It was not found significant differences in mutant cell frequencies between control group and adults consisting in the third group (18 and more years old at the moment of the Chernobyl accident). The changes of the TCR-mutant cell frequency in persons exposed in pre- and postnatal periods differ not only quantitatively, but qualitatively. In the fist case all persons react to irradiation by increasing number of the TCR-mutant cells in some degree. In the second case - only a part of population. Proportion of reacting persons depends on age at the start of irradiation and, perhaps, on dose absorbed. The TCR-mutant frequency was significantly higher in persons with benign tumors of different localizations and nodules in thyroid gland than in persons without this pathology.

[The comparative analysis of gene and structural somatic mutations in inhabitants of Orel district areas contaminated with radionuclides as a result of Chernobyl accident].

The results of comparative analysis of gene and structural mutations found in peripheral blood lymphocytes of inhabitants of Orel district areas contaminated with radionuclides as a result of Chernobyl accident are presented. The average level of 137Cs contamination in those areas ranged about 22-113 kBq/m2. In the study group was found the enhanced frequency of somatic cells with gene and structural mutations compared with laboratory control level by synchronous applying a T-cell receptor (TCR) loci mutation assay and cytogenetic analysis of unstable aberrations. The case-control comparison was carried out using the measured mutation frequencies and cases of various thyroid gland sickness recognized by ultrasonic examination. The cytogenetic assay did not show the statistical difference between healthy group and subjects with thyroid gland sickness. The average frequency of TCR loci mutation cells in the subjects with thyroid gland sickness was found to be statistically higher comparing with healthy persons. This finding was true for each study region and for Orel district in total. The subgroup of subject exposed in utero in 1986, soon after accident was analyzed. Both cytogenetic and TCR loci mutation assays shown enhancement of average mutation frequency in somatic cells in the subjects of this subgroup with thyroid gland sickness comparing with healthy persons.

[The possibilities for 2-stage instrumental screening in the detection of thyroid diseases in an endemic focus]. / Vozmozhnosti dvukhétapnogo instrumental'nogo skrininga v vyiavlenii zabolevanii shchitovidnoi zhelezy v éndemicheskom ochage.

The approbation and comparative assessment of the methods of early active detection of thyroid diseases were performed among the population of the endemic region. The ultrasound examination of the thyroid gland is thought to be the most effective method at the first stage of the screening examination since it is very exact (98%), specific (99%) and sensitive (99%) when detecting both diffuse and nodular alterations of the organ. The possibility to combine the ultrasound examination with the thin-needle aspiration puncture biopsy allows not only to detect the patients and form the groups of risk of probable diseases, but also to make the diagnosis and determine the methods of treatment during the mass examination.

[Relationship of the size of the thyroid gland and anthropometric parameters of physical development]. / Sviaz' velichiny ob"ema shchitovidnoi zhelezy s antropometricheskimi parametrami fizicheskogo razvitiia.

The size of the thyroid was determined in 10,839 individuals (5074 males and 5765 females) aged 3-25 years from life-time echography. The correlation analysis was used to examine the relationship between the size of the thyroid and the anthropometric values of their physical development (body weight, length, and surface area). The relationship was found for males and females by using the regression analysis.

[Parameters of thyroid status in children and adolescents living in one of the Kaluga regions contaminated with radionuclides]. / Nekotorye pokazateli, kharakterizuiushchie sostoianie shchitovidnoi zhelezy u detei i podrostkov, prozhivaiushchikh v odnom iz zagriaznennykh radionuklidami raionov Kaluzhskoi oblasti.

Thyroid status was examined in 1214 children living in the Ulyanov district of the Kaluga region contaminated with radionuclides. Thyroid size and structure were assessed using ultrasonic examination, its function was characterized based on thyrotropin and free thyroxin measurements. Specific autoimmunity was evaluated from assays of antibodies to microsomal antigen and thyroglobulin. The resultant values were assessed with due consideration for the individual dose of 131I absorbed by the thyroid. Thyroid enlargement was detected in 21.2%, nodular goiter in 0.79% of the examinees. A reliable positive correlation was found between the degree of thyroid enlargement and 131I absorbed dose. Functional parameters (thyrotropin and free thyroxin) were within the normal range, no correlation was detected between hormonal parameters, thyroid size, and 131I absorbed dose. Antibodies to microsomal antigen were detected in 4.3%, to thyroglobulin in 7.2%, to both in 2.8% of the examinees, this being within the normal range in the population; but a relationship was detected between antibody production and absorbed dose of 131I. Hence, though no noticeable changes in the thyroid status were detected 5 years after the accident in the population examined, the revealed correlations between thyroid enlargement, presence of antithyroid antibodies, and 131I dose may be indicative of a possible growth of thyroid morbidity.

[Immunologic methods in epidemiologic monitoring of population, affected by radioactive iodine as a result of the accident at the Chernobyl nuclear plant]. / Immunologicheskie metody v épidemiologicheskom monitoringe naseleniia podvergshegosiavozdeistviiu radioaktivnogo ioda v rezultate avarii na ChAES.

Ultrasound investigations of the thyroid gland and determinations of microsomal antibodies have been performed in persons who lived in the town of Korosten (Zhitomir Region) during the Chernobyl accident. A high correlation has been found between ultrasound and immunological results. The immunological screening of the population suffered from the Chernobyl disaster might be successfully used for the autoimmune thyroiditis detection. These data complete those obtained by the ultrasound tests.

[A case of the ultrasonic detection of familial autoimmune thyroiditis]. / Sluchai ul'trazvukogo vyiavleniia semeinogo autoimmunnogo tireoidita.

During mass screening of 22,053 persons a case of familial autoimmune thyroiditis was detected by ultrasound investigation. Diagnosis was based on characteristic ultrasound signs of thyroiditis and was reaffirmed by cytological and immunological methods of investigation.

[Development of the method of ultrasound topometry of the thyroid gland and computer programs in the planning of radioactive iodine therapy]. / Razrabotka metoda ul'trazvukovoi topometrii shchitovidnoi zhelezy i ego vychislitel'no-programmnogo obespecheniia dlia planirovaniia terapii radioaktivnym iodom.

The paper is concerned with the problem of stereological volumenometry applied to the problems of ultrasound topometry of the thyroid. The organ surfaces are tightened on the basis of information obtained from echotomographic films using a method of cubic spline-interpolation, parametric function setting and methods of computer graphics. Images of sections can be obtained with an arbitrary step and an angle of inclination to the organ longitudinal axis. The main sources of errors of the method were estimated, and their numeric values were given.

[Technical methodologic aspects of clinical dosimetry in radionuclide therapy]. / Tekhniko-metodicheskie aspekty klinicheskoi dozimetrii pri radionuklidnoi terapii.

The paper is devoted to the solution of problems related to clinical dosimetry in radiation therapy with open radionuclides, i.e. technical methodological problems of measurement of an absorbed therapeutic dose of radiation in targets in volume distribution of a radionuclide. The developed methods and means of measurement include a large activity radiometer for measuring therapeutic and diagnostic activities, a topometric ultrasound unit (Aloka) and software. The main features of the method were illustrated on a clinical example of the assessment of an absorbed therapeutic dose of 131I radiation in thyroid tissue during therapy of patients with thyrotoxicosis. The accuracy of the method was assessed.

[Measuring the volume of the thyroid gland in healthy children and adolescents by an ultrasonic method]. / Opredelenie ob''ema shchitovidnoi zhelezy u zdorovykh detei i u podrostkov s pomoshch'iu ul'trazvukovogo metoda.

The paper is concerned with ultrasonic measurements of the thyroid volume. The findings obtained may be used in the diagnosis of hypo- and hyperplasias in children and adolescents living in the middle zone of the European part of the USSR.

[Ultrasonic scanning in the diagnosis of rheumatoid lesions of the knee joints]. / Ul'trazvukovoe skanirovanie v diagnostike revmatoidnogo porazheniia kolennykh sustavov.

A total of 60 patients with rheumatoid arthritis were examined. On the basis of ultrasound scanning of the knee joints 2 groups of patients were identified: with the prevalence of exudative-proliferative processes and with proliferative-sclerotic changes. Color coding of images was performed using a UAR-1 unit. A high informative value of ultrasound investigation was shown.

[Multicollector lymphography and phlebography in lower limb edema following radiation and combination therapy]. / Mnogokollektornaia limfografiia i flebografiia pri otekakh nizhnikh konechnostei posle luchevogo i kombinirovannogo lecheniia.

A multimodality x-ray study of the lymphatic and venous vessels was performed in 50 patients with secondary edema of the lower limbs. A complete block of the limb superficial lymphatic collectors was observed in 44% of the patients, a partial block in 26%. In 80% of the cases the level of partial or complete occlusion of the lymphatic vessels was noted in the ilioinguinal region and in 20% on the femur and leg. Distrubed permeability of the deep vessels of the femur and ilioinguinal region in the form of a complete or partial block was noted in 46% of the cases. In disturbed peripheral lymphodynamics different compensatory adaptation mechanisms like the functioning of the collateral tracts, lymphovenous anastomoses, the overflow of a radiographic contrast agent from the superficial vessels into the deep ones were observed in 60% of the patients. Indications for multicollector lymphography were defined. In secondary edema of the lower limbs, combined injuries of the lymphatic and venous systems were marked in 62%, an isolated disorder of the outflow of the peripheral lymph through the collector vessels was marked in 38%.