Vol 81, No 4 (2000)

Malignant neoplasms in Russia: statistics, scientific achievements, problems

Chissov V.I., Starinskiy V.V., Kovalev B.N., Merabishvili V.M., Petrova G.V., Alexandrova L.M., Kharchenko N.V., Gretsova O.P., Filippova E.R.


Malignant neoplasms are one of the main causes of death and disability in the population of developed, and in recent years, developing countries. A significant loss of working capacity of a part of the population associated with this morbidity takes it beyond the scope of a purely medical problem. The annual steady increase in the absolute number of patients with a diagnosis of a malignant neoplasm established for the first time in their life is due to an improvement in diagnosis and registration, an increase in the number of older people, and a true increase in the incidence of a number of nosological groups.

Kazan medical journal. 2000;81(4):241-248
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Theoretical and clinical medicine

Modern medical technologies in pediatric oncology: organ-preserving treatment for malignant solid tumors

Durnov L.A., Goldobenko G.V., Sharoev T.A., Polyakov V.G., Ivanova N.M., Kazantsev A.P.


The successes achieved by pediatric oncologists represent the realization of the scientific and technological progress of modern times. The results of treatment of nephroblastoma, retinoblastoma, and bone sarcomas look especially demonstratively. The fact that at least 95% of children recover in the treatment of localized forms of nephroblastoma and retinoblastoma, and more than 50% of patients with bone sarcomas is considered commonplace and does not surprise pediatric oncologists. Unfortunately, the price of such results of therapy is often too high. A child whom we consider to have recovered from a malignant tumor, in fact, remains disabled since childhood due to the loss of a kidney or vision, or a limb.

Kazan medical journal. 2000;81(4):249-253
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Modern strategy of abdominal thoraco oncosurgery

Davydov M.I.


The methods of performing lymphodissection in various diseases are analyzed. The experience of more than 20 interventions in 9 examinations combining the radical removal of the primary tumor with the aortocoronary by ass surgery is described. The combination of comprehensive operations with subsequent hyperthermic intraperitoneal chemotherapy should be considered as one of the most promising lines in the treatment of the locally widespread and disseminated abdominal cavity tumors. It is emphasized that the surgical intervention is the basic treatment component of any one of the epithelial malignant tumor of the thoracal and abdominal localization and the integration of widespread interventions with the additional effect on tumor cells based on the current scientific achievements.


Kazan medical journal. 2000;81(4):254-257
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Primary lung cancer in young patients

Vorontsov A.Y., Terentiev I.G., Ozherelyev A.S., Pavlunin A.V.


The peculiarities in the clinical picture, diagnosis and treatment results of young patients with lung cancer are revealed. In patients of the given age group the low-and nondifferentiated cancer forms prevail distinguishing them from patients of other age groups. The nonsatisfactory results of the surgical treatment of the lung cancer in young patients made to us use the combined treatment with extended surgery which caused improvement in remote results.


Kazan medical journal. 2000;81(4):258-260
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Long-term results of radiation therapy in patients with lung cancer

Volodin G.I., Vakhitov V.I., Sadykov M.R., Sevastyanova G.D., Timofeev A.A.


The results of the radiation therapy of the nonmicrocystic lung cancer in 26 patients are analyzed. It is noted that the life duration of patients with regard to the initial somatic state depends on the process spreading, tumor histologic state and radiation therapy type. The 5-year survival of patients with the first and second stage of the nonmicrocystic lung cancer receiving the radiation therapy according to the radial program.


Kazan medical journal. 2000;81(4):261-262
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Ozone therapy in the early postoperative period in the surgical treatment of lung cancer

Potanin V.P., Belopukhov V.M., Taziev R.M., Mustafin M.K., Khalimov I.D.


The ozonotherapy influence on the postoperative treatment in patients after the radical lung resection due to the lung cancer is analyzed. The studies were performed from 1996 to 1999. The patients were divided into two group: the patients of the first group (40 persons) were treated with the standard infusion therapy in the postoperative period, the patients of the second group (160 persons) werw treated with ozoned crystalloids combined with the standard therapy. Due to the ozonotherapy the purulent complications in the second group reduced by a factor of 12,5 and mortality reduced by a factor of 2,6.


Kazan medical journal. 2000;81(4):263-264
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Markers of tumor cell proliferation in cancerous tumors of the larynx

Petrov S.V., Kulagin R.N., Tsyplakov D.E., Nefedov O.V., Saveliev V.V., Utkuzov A.R., Raikhlin N.T.


The cell proliferative process in the larynx cancer is studied. Contrary to the classical mitotic index the Ki-67 and PCNA indices are reliable and reproducible on the clinical material by the proliferative cell activity indices of the larynx tumors. There is a reverse connection between the proliferation index in cells of the squamous larynx cancer and the tumor differentiation. The direct correlation of the cell proliferation index of the squamous laxynx cancer with the disease stage is revealed. The preoperative radiation therapy significantly decreases the cell proliferation rates of the squamous larynx cancer.


Kazan medical journal. 2000;81(4):265-268
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Microvesiculas in blood of patients with acute leukoses

Zubairov D.M., Andrushko I.A., Zubairova L.D., Svintenok G.Y., Akhmadeev A.R., Grigoriev V.N., Nekhoroshkova Z.M.


The significant increase of the content of microvesiculas both in the heparinized plasma and in blood serum in patients with acute myeloblastic and acute lymphoblastic leukemia is revealed. Polychemotherapy didn’t show normalizing effect on the microvesiculation manifistation. In contrast to acute leucemia in the multiple myeloma the low level of microvesiculas is found. The possible mechanisms of invoking microvesiculas in the clinical picture of the disseminated intravascular blood coagulability syndrome in leukemia as well as in the regulation of the interaction of leukenic cell with the other blood cell and endothelium are discuss

Kazan medical journal. 2000;81(4):269-271
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New approaches to surgical treatment of patients with locally advanced cancer of the laryngopharynx and cervical esophagus

Seagal E.I., Chernyshev V.A., Utkuzov A.R.


As many as 20 patients with the locally widespread cancer of the laringopharynx and esophagus cervical part with T4N0—2M0 were operated. The total laringopharyngoesophagectomy with the one-moment esophagopharyngoplasty by the isoperistaltic petiole out of the greater curvature of the stomach and the imposition of the pharyngogastroanastomosis on the neck was performed to all the patients. Inefficiency of the pharyngogastroanastomosis was found in 11 patients. In the postoperative period four patients died of mediastinitus, peritonitis, pneumonia and pulmonary and cardiac insufficiency. The remote results were estimated by the Kaplan—Maier method. The three-year and five-year survical rates were 33% and 11%, respectively.


Kazan medical journal. 2000;81(4):272-275
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Possibilities of immunocytochemistry in differential cytogenetic diagnosis of thyroid cancer and its metastases

Afanas'yeva Z.A., Petrov S.V., Khairutdinova G.N., Balatenko I.V., Guryanova T.V.


To determine the diagnostic value of immunocytochemistry in the thyroid cancer the immunomorphological examinations (immunocytochemical and immunohistochemical) are carried out in 61 patients with the thyroid cancer, thyroid lymphoma and cancer metastases without the primary focus. Immunocytochemistry is combined with fine needle aspiration biopsy under ultrasonic control in some patients with nonpalpable tumors to receive representative material. The true diagnosis of the thyroid cancer is determined in 92% and 100% of the cases with the help of immunocytochemistry and postoperative immunohistochemistry, respectively. The high information value of immunochemistry is proved in the diagnosis of the thyroid cancer, thyroid lymphosarcomas and in searching the primary focus in metastatic carcinoma without the primary focus.


Kazan medical journal. 2000;81(4):276-280
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Transpectoral surgical approach to the subclavian lymph nodes in mastectomy for breast cancer

Druzhkov O.B., Druzhkov B.K., Malygin I.V.


The functional operations — the Pateu’s modified radical mastectomies were widely used in the surgical treatment of the mammary gland cancer in recent years. In contrast to the widespread Kholsted’s mastectomy the major pectoralis muscle is preserved. The original access to the subclavicular lymph nodes through the bifid musculus pectoralis major ensuring radicalism of the subclavicular lymphatic dissection as well as retention of the anatomic and functional full value of the musculus pectoralis major is suggested.


Kazan medical journal. 2000;81(4):281-283
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Experience of using the ABBI biopsy procedure in the diagnosis of non-palpable breast masses

Gubaidullin H.M., Seagal E.I., Khasanov R.S., Nagumanov E.V., Ismagilov A.K.


The Advanced Breast Biopsy Instrumentation procedure — the improved biopsy csystem of the mammary gland was performed in 13 women aged 34 to 72 with nonpalpable mammographic lesions. It is a stereoscopic table making it possible to perform biopsy of the mammagraphic lesions of the mammary gland tissue by cannulas diameter up to 2 sm in under X-ray control. Microcalcinates are found in 3 patients (22,8%), the local tissue change — in 3 patients (22,8%) focal shadows — in 7 patients (53,2%).

The lesion size >5 mm is found in 16% of the patients, from 5,1 to 10 mm — in 25% of the patients, from 10,1 to 20 mm — in 59% of the patients. The cancer was diagnosed in 3 cases (22,8%) on the 7 and 10 mm sites, the atypical hyperplasia — in 2 cases (8,3%), other benign pathology — in 53,2% of the cases. In all the cases the foci removal nas corfirmed by histology. The high efficiency of the biopsy stereotaxic method of the mammary gland which removes the roentgenosus-picious site as the single tissue preparation.


Kazan medical journal. 2000;81(4):284-286
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The use of radiomodification to expand the indications for radical radiation treatment of patients with locally advanced forms of cervical cancer

Boyko A.V., Demidova L.V., Teleus T.A., Dunaeva E.A., Yakubovskaya R.I., Nemtsova E.R., Sergeeva T.V.


The experience of the treatment of cervical cancer with the use of the dynamic fractioning scheme is given. The higher five-year survival rate in the third disease stage compared with the classical functioning regime is noted. The original chemicoradiation treatment method improving the treatment results and improving the survival rate and life quality is suggested.


Kazan medical journal. 2000;81(4):287-289
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Clinical evaluation of the possibilities of modern conformal brachytherapy in the treatment of cancer of the female genital organs

Kanaev S.V., Turkevich V.G.


The data on 137 patients with metastases of the cervical cancer to the vagina and on 132 patients with metastases of the uterus body cancer to the vagina after radiation treatment are analyerd. It is concluded that to estimate the biological effect of radiation on tissue it is more rational to use the time-dose- fractioning factor comparing with the cumulative radiation effect or linear and square law modehit is simpler, it is appleid in radiation oncology, it is as good as the latter models in predicting the probality of early and late radiation complications.


Kazan medical journal. 2000;81(4):290-296
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To the question of the treatment of endometrial cancer in young people

O. V. Chulkova O.V., Novikov E.G.


The necessity to develop the orga saving treatment methods with preserved menstrual functions and fertility, to avoid the postoperative radiation therapy with grave compli-cations is emphasized. The treatment and rehabilitation schemes with had the encouraging remote results are suggested. The combined approach to the early diagnosis of the endometrium cancer wich is the necessary for the organ saving treatment is recommended.


Kazan medical journal. 2000;81(4):297-300
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Lymph node dissection in the surgical treatment of cancer of the esophagus and cardioesophageal region

Khairutdinov R.V., Tukfatullin R.K.


The results of lymphadenectomy in esophagus resection and cardioesophageal cancer are studied. During the period from 1990 to 1998 112 patients were operated because of the cancer of esophagus and cardial part of the stomach. Metastases were found in less than half of the patients with increased the lymphnodes during the operation. In some cases metastases were found in the absence of their visible increase. It is concluded that the esophagus resection because of the cancer with one — moment esophagoplasty should be accompanied by lymphadenectomy from regional lymphatic collectors. The adequate determination of the esophagus cancer, resectability, optimal choice of approach and methods of operation supplied by enlarged lymphadenectomy gave the encouraging results.


Kazan medical journal. 2000;81(4):301-302
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New abdominal wall lift for laparoscopic volume interventions

Akhmetzyanov F.S., Sungatullin A.G., Melnikov E.A.


In order to diminish the negative effect of the prolonged pneumoperitoneum in performing volumetric laparoscopic operations the cheap and simple abdominal wall elevator with the basis of the M.Z. Sigal’s and K.V. Kobanov’s retractor is developed. Using this elevator by partially or fully ingaseous method 18 operations were performed successfully including the volumetric operations such as the rectum extirpation and large bowel resection.


Kazan medical journal. 2000;81(4):303-305
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Surgical aspects of radical treatment of cancer of the pancreas and pancreatoduodenal zone

Aglullin I.R., Taziev R.M.


As many as 119 pancreatoduodenal resections are analyzed. The specific complications of the pancreatoduodenal resections are the postoperative pancreatitis development and incompetence of the pancreatojejunal anastomosis sutures. The introduction of the new treatment method of the pancreas and formation of the intussucceptional pancreatojejunal anastomosis made it possible to decrease the rate of the postoperative pancreatitis and incompetence of the pancreatojejunal anastomosis sutures up to 0,7% and the postoperative mortality up to 3,1%.


Kazan medical journal. 2000;81(4):306-308
pages 306-308 views

Computed tomography, angiographic and scintigraphic semiotics of diseases of the kidneys and adrenal glands

Kamalov I.I., Korobov V.V., Rumyantsev S.L., Akhunzyanov A.A., Kamalova L.I.


The computer tomographic, angiographic and scintigraphic examination of patients with renal and adrenal tumprs is performed and their semiotics is covered comprehensively. The computer tomographic densitometry makes it possible to perform the differential diagnosis of the cystic formations of kidneys. The characteristic of secondary lesions of kidneys in metastatic speading or malignant tumor growth from other organs is given. The computer tomographic, angiographic and scintigraphic examinations in revealing the diseases of kidneys, adrenal glands and ureters have high resolution. The angiography is used on its own or as a significant addition to the computer tomography in evaluation of patients with renal and adrenal diseases.


Kazan medical journal. 2000;81(4):309-312
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Diagnostic possibilities of intraoperative transillumination endoscopy of the colon in colorectal cancer

Gataullin I.G., Samigullin M.F.


Relapses in the anastomosis region are one cause of the unfavourable remote results in the treatment of the colorectal cancer. This is connected with the fact that the tumor boundaries determined by palpation and visually do not always coincide with true ones. The tumor infiltration in some cases is found only in urgent planned examination. In this connection in cancer revealing, its localization, its spreading degr^ are of importance. The use of the reverse transillumn national endoscopy during gives the operation such possibility.


Kazan medical journal. 2000;81(4):313-316
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Modern views on the problem of treatment of osteosarcoma of the extremities

Trapeznikov N.N., Aliyev M.D., Machak G.N., Solovyov Y.N., Sinyukov P.A., Kushlinsky N.E.


According to the analysis results of the longterm treatment experience of more than 800 patients with osteosarcomas the authors began to perform the new record of the osteosarcoma treatment, the basic aims of which are the increase of the number of patients with promunced medicinal pathomorphism at the expence of more intensive preoperative chemotherapy. After chemotherapy intensification the incidence of side effects increases. The data on the osteosarcoma pathogenesis with the sexual steroid hormones are obtained. It is emphasized that the immediate and remote results of the extremity osteosarcoma treatment can be achieved only in the highly specialized centers provided with current diagnosis methods, treatment monitoring and supporting therapy measures.

Kazan medical journal. 2000;81(4):317-318
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Comparative analysis of the effect of timolol-maleate and xalatan on the hydrodynamics of the glaucomatous eye

Trubilin M.A., Shevchenko M.V.


The estimation of the efficiency and safety of xalatane as monotherapy in comparison with thymolol-maleate is performed as well as the possibilities of combining of both drugs in the treatment of patients with primary open-angle glaucoma are studied. Higher efficiency of thymolol-maleate with regard to the intraocular pressure level is revealed. The combined use of xalatane and thymolol makes it possible to reduce the intraocular pressure level by 26%.


Kazan medical journal. 2000;81(4):319-321
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Molecular genetic approaches to the prevention, diagnosis and treatment of neoplasms

Imyanitov E.N., Pozharissky K.M., Hanson K.P.


The last 25 years have been marked by truly revolutionary events in fundamental oncology. The rapid development of molecular genetics, in particular, the discovery of oncogenes and antioncogenes, has radically changed the understanding of the mechanisms of the onset of neoplasms [2, 15]. Nevertheless, it is generally accepted that progress in the theoretical field has had little effect on the state of affairs in clinical oncology. The content of this review is intended to demonstrate the groundlessness of such assertions.

Kazan medical journal. 2000;81(4):322-326
pages 322-326 views

Short articles

A case of successful treatment of myasthenic syndrome after surgery for malignant thymoma

Baisheva N.A., Kuzmin A.A., Tokarev S.P., Ustimova K.V.


The management of patients with thymoma complicated by myasthenic syndrome presents significant difficulties for practitioners. Filed by M.I. Cousin, mortality among patients with myasthenia gravis with thymomas is 72.8%. The causes of death include aggravation of myasthenic disorders, dissemination of thymoma, cardiovascular disorders, etc.

Kazan medical journal. 2000;81(4):327-328
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Cases of vulvar cancer after laser vaporization of leukoplakia lesions

Mavlyutova Z.V., Saveliev E.V.


In the literature of the 80-90s. there are reports of the use of lasers to evaporate foci of vulvar leukoplakia after cytological and histological studies of the biopsy with good immediate results. However, we did not find an analysis of the long-term results of treatment of such patients.

Kazan medical journal. 2000;81(4):328-328
pages 328-328 views

Social hygiene and healthcare management

Dynamics of the incidence of malignant neoplasms in the Republic of Tatarstan for the period from 1993 to 1998

Khasanov R.S., Nizamov I.G., Shakirov K.T., Tregubova R.Z.


The basic laws of malignant tumor formations in rural and industrial regions in Tatarstan Republic comparing with the world standards are analyzed. The increase of the malignant tumor incidence especially among women more often than among men is noted. The growth of the malignant tumor incidence in rural regions is significantly higher than in industrial regions. The predominance of the malignant tumors of lung, stomach and mammory gland is noted.

Kazan medical journal. 2000;81(4):329-332
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Environmental aspects of the carcinogenic situation in developed industrial region

Karpenko L.G., Gataullin I.G., Gabdrakhmanov R.F., Ozol A.A.


The cancerous situation in Tatarstan Republic, in particular, the data on the disease incidence, mortality are estimated. The data on the content of some toxic substances in environment are analyzed. The necessity of studying the role of anthropogenous factors in population health formation is emphasized. The use of geochemical investigation methods in medicine is necessary to solve the topical problem — to reveal the relation between environmental pollution and growth of the malignant tumor incidence.


Kazan medical journal. 2000;81(4):333-335
pages 333-335 views

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