[Efficacy and Safety of Combined Treament with Ivabradine and Metoprolol in Patients with Stable Angina Pectoris - a Systematic Review].

This article presents results of a systematic review, which was designed for evaluating the effect of combination treatment with ivabradine and metoprolol on heart rate, frequency of angina attacks, frequency of using short-acting nitrates, and angina severity. The analysis included data from three large observational studies on efficacy of the ivabradine and metoprolol tartrate combination in patients with chronic angina. Results of the analysis supported the efficacy of the metoprolol and ivabradine combination in clinical practice, which provided effective decreases in the heart rate, frequency of angina attacks, requirement for short-acting nitrates, and alleviation of angina severity. The studies demonstrated good tolerability of this treatment.

[An experience gained with mantle irradiation in Hodgkin's disease vs. various regimes of dose fractionation].

Primary patients with stage II-III AB Hodgkin's disease (255) received either standard-fractionated mantle irradiation (SFMI), accelerated hyperfractionation (AHF) or combined treatment using polychemotherapy (CTPT) (1985-1997). Out of 110 patients, 33 (30.0%) were given radiotherapy alone and 77 (70.0%)--combined treatment. Out of 145 patients treated with AHF, that therapy alone was given to 48 (33.1%) and combined treatmento 97 (66.9%). Objective response to primary therapy was reported in 90.0% of SFMI-treated patients and 87.6% of AHF-treated patients. On the whole, the recurrence rates in the SFMI group were higher than in the AHF group (25.5% and 14.5%, respectively, p < 0.05). In the latter group, out of 28 (25.4%) cases of pulmonitis, 10 (30.3%) received radiotherapy alone and 18 (23.4%)--combined treatment. AHF patients developed 19 (13.1%) pulmonites which occurred in that group in 3 (6.3%) SFMI patients and in 16 (16.5%) combined treatment patients. Pericarditis was reported in 11 (4.3%): SFMI- 8 (7.3%), AHF -3-(2.1%), p=0 . 04. To summarize, daily fractionated regimes were followed both by lower rates of relapse and cardiopulmonary complications.

[Proliferation kinetics of NK/Ly tumor cells after single and fractionated irradiation with fast electrons]. / Kinetika proliferatsii kletok opukholi NK/Ly posle odnokratnogo i fraktsionirovannykh obluchenii bystrymi élektronami

With single irradiation, the inhibition of tumor cell division and DNA synthesis was more pronounced than with fractionation irradiation. In fractionated schedules, the dose increase per fraction, and the interval prolongation between fractions, with decrease of the number of fractions (within the same time of irradiation), enhanced the effect of radiation. Yield of pahologic mitoses and extent of morphologic injury of cells was less expressed with fractionated irradiation and did not depend on the schedule of fractionation of the total dose.

[The suppression of the repair of radio-induced DNA damage in Escherichia coli cells by indazolin derivatives and proksifein]. / Podavlenie reparatsii radioindutsiruemykh povrezhdenii DNK v kletkakh Escherichia coli proizvodnymi indazolina i proksifeinom.

A study was made of the postradiation effect of five indasoline derivatives and proxyfeine on the survival rate and repair of DNA single-strand breaks in E. coli exposed to gamma-irradiation. Some indasoline derivatives (three substances) and proxyfeine added in postradiation medium in nontoxic concentrations decreased the survival rate of radioresistant strains WP2 hcr+, Hr30 and Hs30, but do not influence survival rate of radiosensitive mutant Bs-1. These substances inhibit the repair of DNA single-strand breaks in E. coli WP2 hcr+. Substances, which do not inhibit the survival rate of radioresistant strains, do not inhibit the repair of breaks. Proxyfeine in non-toxic concentrations in non-irradiated cells induces DNA degradation. Indazoline derivatives do not induce DNA degradation. Data presented suggest that indasolines are new class inhibitors of DNA repair. It is possible that proxyfeine is too an inhibitor of DNA repair.

[Effect of fractionation dosage of fast electrons on the cell cycle of ascites tumor NK/Ly]. / Vliianie fraktsionirovaniia dozy bystrykh elektronov na kletochnyi tsikl astsitnoi opukholi NK/Ly.

It was found that irradiation increases the duration of the cell cycle (Tc) and decreases the proliferative pool (Pc) in ascites tumor NK/Ly. In fractionated schedules Tc was dependent on the dosage per fraction, while for Pc no such dependence was noted.

[Effect of a fractionated dose of fast electrons on mitotic activity and the number of DNA-synthesizing cells of tumor NK/Ly]. / Vliianie fraktsionirovaniia dozy bystrykh élektronov na mitoticheskuiu aktivnost' i chislo DNK-sinteziruiushchikh kletok opukholi NK/Ly

The mitotic activity and DNA synthesis in cells of NK/LY tumors in mice were studied after irradiation with fast electrons in fractionation of the dosage in 3 regimens having similar total dosage (1000 rad) and the total time of irradiation (5 days) but different single doses, the number of fractions and an interval between them. A marked decrease in mitotic indices values (MI) was observed with all three regimens during the first hours after irradiation. 3--6 hours after irradiation the period of their restoration started, which was mostly intensive in daily irradiation with 200 rad. A dependence between the time of MI restoration and the dosage per fraction and number of fractions is described as an exponential function with an index 1.47. The kinetics of variations in the number of labelled cells showed a similar character, but it was less pronounced, whereas peaks of rising of the label index in all regimens did not exceed the control level.

[Results of radiotherapy in patients with stage-II Hodgkin's lymphoma with mediastinal lymph node involvement]. / Rezul'taty luchevogo lecheniia bol'nykh limfomoi Hodzhkina II stadii s porazheniem limfatisheckikh uzlov sredosteniia.

Depending on size of intrathoracic lymph nodes, 65 patients with Hodgkin's disease (stage II) were divided into two groups using the mediastinal-thoracic index (MTI): MTI = 0.22-0.3 prior to irradiation and MTI (0.3. Mediastinal nodes showed complete regression immediately after therapy (34-49 Gy aimed at mediastinum) in 12.3% only. In 44 patients (67.6%), complete response was not observed until 3-6 months after treatment, sometimes 24 months. Tumor recurred outside area of exposure 2-4 years in 4 (10.8%) in group I and 2 (7%) in group II (p(3.841). No correlation between recurrence rates and intrathoracic lymph node size was established. 10-year survival in both groups was 89.1 and 92.8%, respectively.

[Influence of fast electrons on the nucleic acid level and the biosynthsis of RNA in cells of the ascites tumor NK/Ly and the spleen of tumor-bearing mice]. / Vliianie bystrykh élektronov na soderzhanie nukleinovykh kislot i biosintez RNK v kletkakh astsitnoi opukholi NK/Ly i selezenke myshei-opukholemositelei

The results of investigations on total nucleic acids content and RNA turnover in the cells of tumor NK/Ly and of the spleen in tumor-bearing mice after single exposure to fast electrons are described. In every case the irradiation results in reliable changes of parameters under study. The pattern of changes in nucleic acids content and turnover in the spleen after the exposure to fast electrons is in a good agreement with the available data concerning the influence of x- and y-radiation. The irradiation action on nucleic acids content and turnover in ascites tumor NK/Ly cells is qualitatively and quantitatively similar to that in splenic cells.

[Radiobiological assessment of radiation injuries in various regimens of total body irradiation]. / Radiobiologicheskie otsenki luchevykh oslozhnenii pri razlichnykh rezhimakh total'nogo oblucheniia tela.

A radiobiological evaluation of dose-time regimens of total body irradiation (TBI) using a single-exposure multi-target (MM) and a linear-quadratic (LQM) models of cell destruction has been carried out. An equivalent of single dose of acute irradiation was used as a criterion of biological effect of LQM. The latter proved useful in analyzing all kinds of dose-time regimens of TBI including those employing different doses. Practically speaking, single exposure to 5 Gy and irradiation by three daily fractions in a total dose of 10 Gy may be recommended for wide clinical application.

[The use of cycloferon in experimental radiotherapy of tumors]. / Primenenie tsikloferona pri éksperimental'noi luchevoi terapii opukholei.

The biological activity of cycloferon (CF) used in interferon manufacture has been investigated for its therapeutic and prophylactic properties which may be used for radiotherapy of glioma. It was demonstrated in experiments on rats that use of CF is most effective at an early stage of irradiation due to decrease in tumor mass which does not occur in case of irradiation alone. When used at a later stage, CF caused certain hematological indices of immunity to rise. CF did not produce an antitumor effect of its own. It successfully competed with Leukomax when used to bring blood indices in irradiated tumor-bearing animals back to normal.

[Radical mastectomy technics]. / Tekhnika radikal'noi mastéktomii.

The authors elaborated a new approach to radical mastectomy which, combined with nonoperative measures makes it possible to prevent the development of postmastectomy-induced edema by means of a lympho-venous anastomosis (LVA). The choice of the level of LVA formation and their number is substantiated. With due regard for the conditions named, the cubital fossa and the lower third of the upper arm on the anterointernal surface is the most rational zone. To accelerate lymph drainage through the collaterals and reduce lymph loss, goal-oriented ligation of the lymph vessels which are divided during mastectomy is additionally carried out; this is successfully done when they have been stained. As a result, wound lymphorrhea ceases practically at days 4 to 5.

[A choice of reconstructive plastic surgery with endoprosthesis of the breast after radical mastectomy]. / Vybor rekonstruktivno-plasticheskoi operatsii s éndoprotezirovaniem molochnoi zhelezy posle radikalnoi mastéktomii.

The creation of silicone endoprosthesis led to new approaches in solving the problems of plastic replacement of the breast after radical mastectomy. Two variants of reconstructive plastic operations with endoprosthetics of the breast were employed: group one--the formation of the seat of the endoprosthesis using a transposed musculocutaneous flap from the latissimus dorsi muscle; group two--the formation of the seat of the endoprosthesis by stretching the skin with a specially designed stretcher-expander and subsequent implantation of the endoprosthesis. The first method is rather injurious, sometimes cannot be performed because of anatomical contraindications, and is fraught with the development of necroses in the transposed tissues. Among 34 patients operated on by the first method two had marginal necrosis of the skin above the endoprosthesis. No complications were recorded among the 46 patients who underwent operation by the second method. The condition of the endoprosthesis and the tissues surrounding it was appraised in the immediate and late periods by radiological and ultrasonic examination. The variants of endoprosthetics of the breast which we applied may be employed with competence in clinical practice, but a reconstructive-plastic operation with the use of a skin expander is preferable.

[Hemostatic potential during the development of post-mastectomy edema]. / Gemostaticheskii potentsial pri razvitii postmastéktomicheskogo oteka.

The work deals with the study of the mosaic character of the hemostatic potential, connected with the development of a localized pathological process, taking postmastectomy edema in illustration. It is shown that this condition is an example of the manifestation of the RASK system mosaics in one organism in pathology. It should be pointed out that the degree of the development of the local DVS syndrome changes significantly some of the RASK system parameters at the level of the whole organism. This is evidence that normalization of the microcirculatory processes in the edematous extremity will be an important measure in complex treatment of postmastectomy edema. It will considerably lower the risk of general disorders of the RASK system. Parameters determined in the blood collected from the extremity on the side of the operation will serve as controls of the efficacy of the applied therapeutic measures.