[Firs Case Report of Intraoperative Radiotherapy (IORT) for Early Breast Cancer in Bulgaria].

The intraoperative radiotherapy (IORT) is an innovative method for treatment of breast cancer, which can be used as a substitute of postoperative external beam radiotherapy )EBRT), or boost treatment to EBRT (1). Radiobiological advantages of IORT compared to EBRT are higher relative biologic effectiveness of low-dose radiation therapy and the presence of high dose in the tumor bed (where the possibility of remaining vital tumor cells is the highest), as this dose reduces rapidly with the distance from the applicator (2). Important feature of IORT alone is that it can be applied as a single fraction during the surgical intervention and spares 3 to 5 weeks of following radiation therapy. This means less time spent in hospital for the patients and for the radiotherapeutical units - reduced waiting lists and more machine time for other patients. Prolonged operative time as well as the need of additional staff are assumed as relative flaws of IORT (3). The INTRABEAM® system (Carl Zeiss Surgical Gmbh, Oberkochen, Germany) uses a single high dose of low-energy X-rays (mas 50kV), applied to the tumor bed immediately after the surgical excision of the tumor. These rays have high degree of absorption and low penetrating ability. This determines their advantage in comparison to EBRT to protect the surrounding healthy tissues (2). The data from the Targeted Intraoperative radioTherapy (TARGIT-A) and the Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomized controlled equivalence trial show that when following the recommendations of The Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) Breast Cancer Working Group (2009) for an accelerated partial breast irradiation (APBI), IORT can be used as an equivalent of the postoperative radiotherapy (1,4,5,6). The purpose of this article is to show the results of the performed on 15 December 2015 for the first time in Bulgaria breast conserving surgery with intraoperative radiotherapy on a patient with early breast cancer.

ADP/ATP and protein phosphorylation dependence of phototransformable protochlorophyllide in isolated etioplast membranes.

The effects of modulated ADP/ATP and NADPH/NADP(+) ratios, and of protein kinase inhibitors, on the in vitro reformation of phototransformable protochlorophyllide, i.e. the aggregated ternary complexes between NADPH, protochlorophyllide, and NADPH-protochlorophyllide oxidoreductase (POR, EC 1.3.1.33), in etioplast membranes isolated from dark-grown wheat (Triticum aestivum) were investigated. Low temperature fluorescence emission spectra (-196 degrees C) were used to determine the state of the pigments. The presence of spectral intermediates of protochlorophyllide and the reformation of phototransformable protochlorophyllide were reduced at high ATP, but favoured by high ADP. Increased ADP level partly prevented the chlorophyllide blue-shift. The protein kinase inhibitor K252a prevented reformation of phototransformable protochlorophyllide without showing any effect on the chlorophyllide blue-shift. Addition of NADPH did not overcome the inhibition. The results indicate that protein phosphorylation plays a role in the conversion of the non-phototransformable protochlorophyllide to POR-associated phototransformable protochlorophyllide. The possible presence of a plastid ADP-dependent kinase, the activity of which favours the formation of PLBs, is discussed. Reversible protein phosphorylation is suggested as a regulatory mechanism in the prolamellar body formation and its light-dependent dispersal by affecting the membrane association of POR. By the presence of a high concentration of phototransformable protochlorophyllide, prolamellar bodies can act as light sensors for plastid development. The modulation of plastid protein kinase and protein phosphatase activities by the NADPH/NADP(+) ratio is suggested.

Lipid peroxidation in rat lung induced by neuroleptanalgesia and its components.

The aim of the present work was to determine the likelihood of lipid peroxidation in the lungs of rats subjected to neuroleptanalgesia and its components. In particular, the effect of fentanyl, droperidol, a nitrous oxide/oxygen mixture when used separately or in combination, on the lung level of lipid peroxidation was investigated. The in vitro antioxidant properties of fentanyl and droperidol were also tested. Lipid peroxidation was evidenced by the endogenously generated conjugated dienes and fluorescent products of lipid peroxidation and the decrease in lung vitamin E content. It was found that fentanyl and droperidol, used separately or in combination, did not induce lipid peroxidation in the rat lung, while the exposure of rats for 120 min to a nitrous oxide/oxygen mixture (2:1 v/v) led to well-expressed peroxidation. The (N2O + O2)-pro-oxidant action was significantly inhibited in rats previously injected with fentanyl and/or droperidol. The results show that the application of fentanyl, droperidol and (N2O + O2), as in neuroleptanalgesia, ensures minimal lipid peroxidation in the lung. In addition, we found that fentanyl and droperidol were able to inhibit the Fe(2+)-catalysed lipid peroxidation in lung homogenate. We speculate that the inhibitory effect of fentanyl and/or droperidol on the (N2O + O2)-induced lipid peroxidation in the rat lung may be caused directly by their antioxidant properties. However, another explanation seems to be possible. The free radicals that are produced during the metabolism of fentanyl and droperidol may react with the radicals generated during the one-electron reduction of nitrous oxide. Such reactions will obviously reduce the free radical concentration in the organism and, hence, the likelihood of initiating lipid peroxidation.

Pulmonary xanthine oxidase activity of rats exposed to prolonged immobilization stress.

This study was designed to study xanthine oxidase (XO) and xanthine dehydrogenase (XD) activity in the lung of rats exposed to prolonged restraining immobilization stress. Immobilization caused more than twofold increase of xanthine oxidase activity in the rat lung. The activity of xanthine oxidase decreased in lung homogenates incubated at -20 degrees C for 24 h. The same incubation of homogenates from control rats caused a non-significant increase of the activity. No measurable NAD(+)-dependent xanthine dehydrogenase activity could be established in the lungs of both control rats and rats subjected to immobilization. All rats revealed methylene blue-dependent xanthine dehydrogenase activity which was more than two-times higher in the immobilized animals. Incubation at -20 degrees C for 24 h increased the methylene blue-dependent xanthine dehydrogenase activity in homogenates from control rats and decreased the enzyme activity in homogenates from immobilized rats. A working hypothesis was proposed for the sequence of events explaining the results obtained: XO-catalyzed generation of activated oxygen species may take place in the initiation of lipid peroxidation in the lung of rats immobilized for prolonged periods of time.

Lipid peroxidation in the lung of rats exposed to endotoxin: effect of vitamin E supplementation.

The aim of this work was to investigate the possibility for development of peroxidation in the lung of rats injected with endotoxin. The effect of vitamin E supplementation of the rats was also investigated. Vitamin E supplementation by itself did not cause visible differences or any pathological changes in the lung structure of rats as shown by routine histological examinations. The endotoxin-induced alterations of the lung structures were well expressed in vitamin E-non-supplemented rats, while they were rather negligible in vitamin E-supplemented rats. It was established also that endotoxin caused a 50% increase of the conjugated dienes in the lung of vitamin E-non-supplemented rats. For vitamin E-supplemented rats this increase was less than 13.5%. The fluorescent lipofuscine-like products of lipid peroxidation (known as one of the end products of lipid peroxidation) increased by 120% in vitamin E-non-supplemented rats after exposure to endotoxin, while in vitamin E-supplemented rats this increase did not exceed 26%. Exposure to endotoxin of both vitamin E-non-supplemented and vitamin E-supplemented rats did not lead to significant changes of the lung fatty acid composition. On the basis of these results we assumed that the endotoxin-induced changes of lung structures involve, at least in part, free radical-mediated damage of the lung membrane lipids and proteins.

Lipid peroxidation in lung of rat stressed by immobilization: effects of vitamin E supplementation.

This study was carried out to examine the possibility of initiation of lipid peroxidation in the lung of Wistar albino male rats stressed by immobilization. The effects of vitamin E supplementation were also investigated. We found that immobilization of rats with normal pulmonary content of vitamin E caused lipid peroxidation in the lung. Decrease of the lung content of unsaturated fatty acids and vitamin E was also established. The immobilization-induced changes of all of these parameters were significantly inhibited by vitamin E injection (100 mg/kg body weight) for 7 days. A possible sequence of events leading to the initiation of lipid peroxidation and lung cell membrane damage in rats stressed by immobilization is discussed.

High lung uptake of 99mTc-multilamellar liposomes after intravenous administration in rats and rabbits.

The study presents the results of our efforts to prepare liposomes with high lung uptake by modifying the liposome composition and size. Multilamellar liposomes composed of soya phosphatidylcholine and cholesterol (molar ratio 1:1), negatively charged with 0.1 mol sodium cholate were initially prepared. They were treated with SnF2 before (Lp) and after (Lp2) lyophilization and both types were labelled with 99mTc-NaTcO4 in saline solution. A fraction of small 99mTc-Lp2 was obtained by extrusion of negatively charged 99mTc liposomes through membrane filter (type 10 PCTE membranes) pore size 0.4 micron. The biodistribution of the 99mTc-Lp and 99mTc-Lp2 was compared after i.v. injection to rats [0.1 ml/2 mg lipid (3-4 MBq) per 100 g body weight]. After decapitation blood, liver and lung samples were collected and the relative concentrations of activity (RC) were obtained. 99mTc-Lp2 showed more prolonged blood circulation than 99mTc-Lp with a secondary moderate increase of the activity about 3 h and about 6 h postdose for 99mTc-Lp and 99mTc-Lp2, respectively. The lung localization of the 99mTc-Lp2 was clearly more intensive than the 99mTc-Lp localization (ratio of their maximal RC values 7:1). On the contrary, the 99mTc-Lp accumulated more intensively in the liver than the 99mTc-Lp2 (ratio of the RC values 5:1). The higher affinity of the smaller liposomes (99mTc-Lp2) to the lung was observed also in rabbits after i.v. administration of the extruded 99mTc-Lp2 fraction in the ear vein [0.1 ml/2 mg lipid (3-4 MBq) per 100 g body weight].(ABSTRACT TRUNCATED AT 250 WORDS)

[The use of labelled leukocytes in the diagnosis of traumatic osteomyelitis]. / Primenenie mechennykh leikotsitov v diagnostike travmaticheskogo osteomielita.

A total of 20 patients with posttraumatic osteomyelitis were investigated with 99mTc- and 111In-labeled leukocytes. Their elevated accumulation in inflammatory zones were detected on scintigrams of 12 patients. Osteomyelitis in 11 of them was confirmed on the basis of routine clinico-laboratory investigations. This method is a highly specific test in the diagnosis of posttraumatic osteomyelitis and in the assessment of the efficacy of its therapy.

[Thrombokinetic study of patients with idiopathic thrombocytopenic purpura]. / Issledovanie trombokinetiki u bol'nykh idiopaticheskoi trombotsitopenicheskoi purpuroi.

The kinetics of 111In-oxine-labeled platelets was studied in 37 patients with idiopathic thrombocytopenic purpura and in 12 control subjects using gamma-chamber. A comparison was made of the parameters of the kinetics, survival and sequestration type of platelets, as well as their recovery and exchange. In less severe processes the splenic type, while in more severe disease--the hepatic type of sequestration prevailed.

[Thrombocyte kinetics in patients with thrombocytopenia]. / Kinetika trombotsitov u bo'lnykh trombotsitopeniei.

Investigation of the kinetics of blood platelets is of paramount importance in cases where it is necessary to differentiate the cause of thrombocytopenia in patients: reduction of the output, changes in organ distribution or increase of sequestration of blood platelets. Using the method of labeling own blood platelets and a gamma-chamber, the kinetics of blood platelets (organ distribution, recovery and survival) was studied and computed in 40 patients with hypoplastic anemia, hypersplenism and thrombocytopenic purpura. A complex of the parameters characterizing the given disease has been defined.

[Determination of angiotensin-converting enzyme activity in internal diseases]. / Opredeliane na aktivnostta na angiotenzinprevrushtashtiia enzim pri niakoi vutreshni zaboliavaniia.

A convenient and reliable colorimetric method for determination of serum angiotensin-converting enzyme is worked out by modifying the method of Niels and al. Reference serum ranges of 15.45-191.2 ME/L are established in a control group of 46 healthy persons. In pulmonary sarcoidosis statistically significantly higher angiotensin-converting enzyme activity than in the healthy controls is found while in pulmonary cancer and other pulmonary diseases the angiotensin-converting enzyme activity is in the reference ranges. The importance of angiotensin-converting enzyme as a laboratory index for the early diagnosis of pulmonary sarcoidosis is discussed.

Assessment of the extent of bone marrow haemopoietic activity in normal subjects.

A method, introduced by the authors, for assessment of the extent of bone marrow haemopoietic activity in normal subjects is reported. 99mTc-sulfur colloid is injected, and the bone marrow visualized on gamma camera, type Phogamma-HP, which is equipped with 4096 channel analyzer (Nuclear Chicago). By use of a standard and by registering the activity in "zones of interest" from the arm, forearm, thigh and lower leg bones, indices and mean normal values in 26 normal subjects were calculated and reported.