Purpose of the study. Investigation of possible optimization of treatment in patients with breast cancer and cervical cancer with low-dose xenon therapy.

Patients and methods. The study included 156 patients with pT1В2N0M0 cervical cancer (CC) and pT2N1M0 breast cancer (BC) of the reproductive age (29–45 years) after radical treatment, including forced surgical castration in hormone-positive breast cancer with concomitant gynecological pathology. Since the formation of pathological syndromes, 1 cycle (5 sessions) of low-dose xenon inhalation therapy (XT) was performed, with an algorithm for xenon dose calculation and exposure according to the exponential pattern of decreasing concentration and increasing exposure, with an individual approach. Together with general clinical and laboratory examinations, we used international scales for assessing the severity of the patient condition by the Kupperman menopausal index (MMI), ESAS, quality of life (MOS-SF-36), in a modification of the Russian International Center, pain (VAS); the types of general adaptive reactions were identified by the method of L.Kh. Garkavi.

Results. Important advantages of a new method associated with a rapid regression of pathological psychosomatic symptoms were revealed after XT. MMI values (p<0.05) decreased, 96.8% of patients reported no pain at all on activity, manifestations of neurovegetative disorders significantly decreased (p=0.02–0.04), and the coefficient of antistress reactions to stress increased, which was congruent with the data on improving the quality of life. Conclusion. High efficiency of the technology demonstrated possible prevention of surgical menopause development and clinical manifestations of postcastration syndrome in order to improve the quality of life and social rehabilitation of young patients with gynecological cancers.

Purpose of the study. Improving the results of surgical treatment of melanoma of the skin of the extremities by using skin-fascial flaps on perforating vessels.

Patients and methods. In 42 patients with limb skin melanoma T1–3N0M0, the closure of a skin defect was performed by islet flaps on perforating vessels. Perforating vessels of the donor zone were detected with an assessment of the blood supply of the flaps in the pre- and postoperative period using ultrasound and marking of perforants with adjustment of the preliminary marking of the flaps.

Results. Permanent perforating vessels with a diameter of more than 1 mm were used. After excision of the tumor, on the opposite sides of the wound defect, taking into account the location of the perforating vessels, flaps were taken, with further mobilization by excision of the fiber and muscle fascia, they were separated from the underlying tissues while maintaining the integrity of the supply vessels. The circulatory state of the selected flaps was determined by skin color and capillary response to digital pressure. The flaps were displaced to the center, covered the area of the defect and sutured with single sutures, the edges of the donor wound were mobilized, sutured with single sutures until light tension appeared and sutured into the remaining wound defect. In the postoperative period, the determination of the parameters of the blood flow of perforating vessels showed the absence of hemodynamically significant violations of the blood flow during the movement of the flap. Transient ischemia of one of the oncoming flaps after surgery developed in 11.9%, marginal necrosis of the distal flap — in 7.1% of cases. A normotrophic scar was formed, with a width of not more than 0.3 cm, which aesthetically satisfied 92.8% of patients. Assessment of two-year relapse-free survival showed a complete absence of local relapses.

Conclusion. The flaps vascularized by perforating vessels have high viability, are identical in color and texture to the skin of the recipient area, and the close proximity to the receiving area contributes to minimal deformation of the donor area, which increases the radicality of the operation, reduces the incidence of postoperative complications and improves аesthetic and functional results.

Purpose of the study. To evaluate the features of morphological and immunophenotypic characteristics of the lymphoid population with different restriction of light chains of immunoglobulins in patients with chronic lymphocytic leukemia (CLL).

Materials and methods. The study included 30 CLL patients aged 47–79 years (20 men and 10 women). All patients underwent a General clinical blood test (SysmexXE 2100, Japan), morphological examination of the bone marrow (BioVision; Micros, Austria), immunophenotyping of bone marrow and peripheral blood by flow cytofluorometry (Navios10/3, Beckman Coulter, USA). B-cell clonality established by detection of restriction of light chains of surface immunoglobulins kappa or lambda. Morphological analysis of lymphocytes that differ in the expression of light chains of surface immunoglobulins: kappa (k) — group I (22 people — 73,3%), lambda (λ) — group II (8 people — 26,7%).

Results. Determination of cell types by values of direct (FSC) and lateral (SSC) light scattering during immunophenotyping of peripheral blood and bone marrow samples showed that in patients of group I (CD19k+/CD5+/CD23+) on the light scattering diagram, the lymphoid population had low parameters: on the FSC scale — from 200 to 400, on the SSC — from 10 to 160 units, which indicates morphological uniformity of cells. In group II (CD19λ+/CD5+/CD23+), on the contrary, on the light scattering sketogram, the lymphoid zone was heterogeneous and stretched: on the FSC scale — from 200 to 1000, on the SSC — from 10 to 400 units, which indicates morphological polymorphism of cells. There were also differences in the expression of the common leukocyte antigen CD45. In group I, the expression is higher: the population of B-lymphocytes in terms of fluorescence intensity is on the dot graph on the CD45 scale in the second half of the third decade and in the fourth decade — to the right, than in group II, in which B-lymphocytes lie in the third decade. The data indicate that the CD19k+/CD5+/CD23+ population is represented by Mature cells, while the Cd19k+/CD5+/CD23+ population is represented by less Mature and / or intermediate forms. Significant morphological differences in lymphocyte populations were also observed in microscopic studies of blood and bone marrow preparations.

Conclusion. The established immunophenotypic and morphological differences in lymphoid populations expressing either kappa — or lambda-light chains of immunoglobulins may be important for identifying risk groups among patients with biologically heterogeneous variants of chronic lymphocytic leukemia.

Over the past decades, transplantable cell lines have been an affordable model for studying the biology and effect of chemotherapeutic drugs on tumors. However, numerous studies have shown that these cell lines are not heterogeneous enough and cannot reflect the drug resistance of tumors that occurs in some patients. Primary cell line cultures isolated from solid tumors have become widespread in personalized cancer therapy. This review discusses the basic methods for the preparation and cultivation of primary cell lines. A brief description is given of the methods for the disaggregation of tumor material using enzymatic, chemical and mechanical dissociation. The systems of cultivation of primary cell cultures. The selection of an appropriate dissociation method and cultivation is important to preserve the benefits of primary culture in preclinical studies.

Primary bone lymphoma is a rare presentation of non-Hodgkin lymphoma. It accounts for a maximum of 1–2% of all non-Hodgkin lymphomas in adults. Primary bone lymphoma is diagnosed in focal lesions of one or more bones; soft tissue and regional lymph nodes may be involved too. The exclusion criteria are only bone marrow damage and involvement of distant lymph nodes. The first symptoms include intractable bone pain often accompanied by local edema, the formation of a tumor mass in the affected area; B symptoms occasionally join. Local lesions of long tubular bones in the diaphysis and metadiaphysis regions are more common (80%), while multifocal lesions are less frequent (20%). Diagnosis of lesions of the bone tissue in its primary and secondary involvement is based on the use of all available research methods (radiography; computed, magnetic resonance and positron emission tomography). Differential diagnosis requires an immunohistochemical study with determination of the expression of total leukocyte antigen, B-cell and T-cell markers, and clonality in one of immunoglobulin light chains κ or λ, bcl 2 and bcl 6, ALK, proliferative activity of Ki-67. Evaluation of the effectiveness of various treatments for primary bone lymphoma is complicated by a small number of observations and the absence of a uniform treatment strategy. CHOP-like chemotherapy cycles are often used as first-line therapy. Personalized therapy involves immunochemotherapy, radiation therapy and surgical treatment — endoprosthetics.

Сraniotomy is an integral part of modern elective neurosurgery which involves cutting a free bone flap to provide access to pathological intracranial structures with its reimplantation at the end of surgery.

Bone flap grafting in the trepanation window with various fixation methods in the end of elective neurosurgery in the absence of severe cerebral edema or cancer-induced bone destruction is a standard procedure that restores the skull shape, cerebrospinal fluid dynamics and cerebral perfusion.

According to the literature, the incidence of aseptic inflammation with subsequent resorption of the bone flap after craniotomy in elective neurosurgery is not clearly defined.

An analysis of medical publications in the PUBMED database showed few reports of bone flap resorption after elective craniotomy, and no reports were found after the search in the eLibrary database.

Thus, the number of reports on the bone flap resorption after craniotomy in elective neurosurgery is limited, and the pathophysiology of this process remains unclear.

However, the described complication of craniotomy can lead to the dislocation of a bone flap, the development of a local pain syndrome, a cosmetic defect, and disturbances in cerebrospinal fluid dynamics.

The article describes an example of partial resorption of a bone flap after craniotomy for the removal of meningioma in the middle third of the superior sagittal sinus, which required a number of repeated neurosurgical interventions. The treatment was finished with the removal of a partially resorbed bone flap and implantation of an individual titanium mesh implant.

Ovarian cancer is one of the most common cancers in women. Growth and extension of the tumor are associated with active neoangiogenesis regulated by vascular endothelial growth factor (VEGF). Bevacizumab decreases VEGF activity and inhibits the tumor growth.

Purpose of the study. The aim of the study was to evaluate results of bevacizumab in maintenance therapy for ovarian cancer.

Materials and methods. 26 patients with ovarian cancer received maintenance therapy with drop infusions of bevacizumab 15 mg/kg once a day for 21 days in 2014–2019 after completing chemotherapy for relapses.

Results. Bevacizumab mainterned partial response or stabilization in 76.9% of patients. The adverse events were mainly of grades 1–2 (in 88.5% of all adverse events) and could be managed by an appropriate medical correction. Hemorrhagic complications caused the cancellation of bevacizumab in one patient.

Conclusions. Bevacizumab in maintenance therapy after completing chemotherapy for ovarian cancer relapses (both platinum-sensitive and platinum-resistant) significantly improves the treatment results. The toxicity profile of bevacizumab in maintenance treatment is acceptable.