Impact of liquid metal surface on plasma-surface interaction in experiments with lithium and tin capillary porous systems

The lithium and tin capillary-porous systems (CPSs) were tested with steady-state plasma in the PLM plasma device which is the divertor simulator with plasma parameters relevant to divertor and SOL plasma of tokamaks. The CPS consists of tin/lithium tile fixed between two molybdenum meshs constructed in the module faced to plasma. Steady-state plasma load of 0.1 - 1 MW/m(2) on the CPS during more than 200 min was achieved in experiments on PLM which is a modeling far scrapeoff- layer and far zone of divertor plasma of a large tokamak. The heating of the CPS was controlled remotely including biasing technique which allows to regulate evaporated metal influx to plasma. After exposure, the materials of the tin and lithium CPSs were inspected and analyzed with optic and scanning electron micriscopy. Experiments have demonstrated sustainability of the tin and lithium CPSs to the high heat steady state plasma load expected in a large scale tokamak. The effect of evaporated lithium and tin on the plasma transport/radiation was studied with spectroscopy to evaluate changes of plasma properties and plasma-surface interaction

ГЕТЕРОГЕННОСТЬ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ I СТАДИИ: БИОЛОГИЧЕСКОЕ И ПРОГНОСТИЧЕСКОЕ ЗНАЧЕНИЕ

The introduction of breast cancer screening programs worldwide led not only to the increase of non-invasive carcinoma and stage I breast cancer percentage but also to the redistribution of biological tumor subtypes in female population screened. The proportion of stage I breast cancer is only 21,4% in our country; biological and predictive value of tumor size (T1a, T1b and T1c) is still undefined. We analyzed clinical and morphological characteristics as well as tumor size prognostic value (T1a-c) for the recurrence and death from progression risk determination in 1341 breast cancer patients with stage I tumors. We revealed progressive increase of “small” tumors proportion (T1a and T1b) in stage I breast cancer population within the last 25 years. The percentage of microinvasive carcinomas raised from 0,3% to 4,3% while T1bN0M0 proportion increased from 8,7% to 22,1%; this is the evidence of early breast cancer diagnostics improvement. Stage I breast cancer is the heterogeneous group of tumors with favorable prognosis in case of T1a (≤5 mm) and more aggressive behavior in T1b (6–10 mm) and T1c (11–20 mm). Only T1a tumors have favorable biological profile (huge proportion of luminal A subtype) which reflects upon the long-term treatment results (minimum recurrences and cancer deaths, improved overall survival). Biological behavior of T1b and T1c tumors is more aggressive with high rates of ductal carcinoma, luminal B and triple negative subtypes which significantly worsen the prognosis. The  biology of “small” tumors should be considered when choosing the optimal adjuvant treatment algorithm for breast cancer patients.Введение программ ранней диагностики РМЖ в мире привело не только к увеличению доли неинвазивных карцином и рака молочной железы I стадии, но и к перераспределению биологических подтипов опухолей в популяции скринируемых женщин. В нашей стране доля рака молочной железы I стадии составляет всего 21,4%; биологическое и прогностическое значение размера опухоли (T1a, T1b и T1c) является неизученным. Мы проанализировали клинические и морфологические характеристики, а также прогностическое значение размера опухоли (T1a-b-c) для риска развития рецидива болезни и смерти от ее прогрессирования у 1341 больной раком молочной железы I стадии. Нами выявлено прогрессивное увеличение доли «малых» опухолей (T1a и T1b) в структуре РМЖ I стадии в течение последних 25 лет: доля микрокарцином T1aN0M0 увеличилась с 0,3% до 4,3%; доля опухолей T1bN0M0 — с 8,7 до 22,1%, что говорит об улучшении ранней диагностики заболевания. Рак молочной железы I стадии является гетерогенной группой с благоприятным течением болезни при микрокарциномах размером T1a (≤5мм) и более агрессивном — при опухолях размером T1b (6–10мм) и T1c (11–20мм). Только опухоли размером T1a имеют благоприятный биологический «портрет» (высокую долю люминального А подтипа РМЖ), что отражается на долгосрочных результатах лечения (минимальная доля рецидивов болезни и смертей от рака и лучшие показатели отдаленной выживаемости). Биологические характеристики опухолей размером T1b и T1c являются более агрессивными и представлены высокой частотой протокового рака с люминальным В и тройным негативным иммунофенотипом рака, что существенно ухудшает прогноз болезни. Биология «малых» опухолей должна учитываться при выборе наиболее оптимального адъювантного лечебного алгоритма при раке молочной железы

МЕТАСТАЗ РАКА ПОЧКИ В ЛЕВОЙ МОЛОЧНОЙ ЖЕЛЕЗЕ: ОПИСАНИЕ КЛИНИЧЕСКОГО НАБЛЮДЕНИЯ

The main method of treatment of local stages of clear cell renal cancer is surgical. The question of conducting adjuvant irradiation and chemotherapy after radical operations is open. Patients with solitary distant metastases and a favorable prognosis may become candidates for surgical treatment. Surgical removal of isolated solitary metastases allows to achieve 35–60  % of 5-year overall survival. The patient, observed in N.N.  Blokhin National Medical Research Center of Oncology with metastasis of renal cancer in the pancreas, and then in the breast is an extremely rare clinical case presented in this article.Основным методом лечения локальных стадий рака почки является хирургический. Вопрос о проведении адъювантного лечения после радикальных операций остается нерешенным. Пациенты с солитарными отдаленными метастазами могут стать кандидатами для хирургического лечения. Хирургическое удаление изолированных солитарных метастазов позволяет достигнуть 35–60  % 5-летней общей выживаемости. Больная, наблюдавшаяся в НМИЦ  онкологии им. Н.Н. Блохина с метастазом рака почки в поджелудочной железе, а затем в молочной железе и мягких тканях правого плеча, является крайне редким клиническим случаем, представленным в данной статье

Хирургическое лечение «раннего» рака молочной железы: что изменилось? (опыт международного сотрудничества)

The study included patients with noninvasive cancer and stage T1a-b-cN0M0 invasive breast cancer who were treated between 1985 to 2009 in Russia (at the N.N. Blokhin Russian Cancer Research Center and at the Clinic of the Russian Medical Academy of Postgraduate Training, 1036 patients), and in the Netherlands (LUMC, 560 patients, National Cancer Register, 22196 patients). The comparative analysis of surgery types between countries was carried out. The frequency of organ-preserving surgeries for early breast cancer in Russian and in the Netherlands was identical (53.7 % and 52.5 %). The percentage of organ-preserving surgeries over the past 20 years in Russia was not significantly changed, whereas the decrease in the rate of organ-preserving treatment from 56.2 % to 41.2 % was observed in the Netherlands.This is most likely due to an increase in the number of patients in postmenopause (>60 years) from 53.1 % to 63.8 %. The main type of organ-preserving treatment in Russia is radical resection of the breast. In the Netherlands, lumpectomy with sentinel lymph node biopsy or axillary lymphodissection is the most common form of breast-conserving surgery today.В исследование включены пациентки с неинвазивным раком и раком молочной железы c T1a-b-cN0M0 стадией, получившие лечение с 1985 по 2009 г. в России (РОНЦ им. Н.Н. Блохина РАМН и Клиника РМАПО – 1036 больных) и в Нидерландах (LUMC – 560 пациенток, Национальный Канцрегистр – 22196 больных). Проведен сравнительный анализ типов выполненных операций по странам, а также во временных подгруппах. Частота органосохраняющего лечения при «раннем» раке молочной железы вРоссии и Нидерландах идентична – 53,7 % и 52,5 %. Доля органосохраняющих операций в течение 20 лет в России существенно не изменилась, тогда как в Нидерландах отмечено уменьшение доли органосохраняющего лечения с 56,2 % до 41,2 %, что, вероятнее всего, объясняется увеличением числа пациенток, находящихся в постменопаузе (>60 лет) с 53,1 % до 63,8 %. Основным вариантом органосохраняющего лечения в России является радикальная резекция молочной железы, в Нидерландах – лампэктомия с БСЛУ или аксиллярной лимфодиссекцией, причем БСЛУ и в настоящее время не является «рутинной» операцией во всей стране

Theoretical prerequisites and results of removal of primary tumor in patients with first detected stage IV breast cancer

The treatment of patients with primarily disseminated breast cancer (PDBC) is based on chemo- and radiotherapy. Removal of primary tumor is not usually recommended. The goal of surgery is to prevent local complications. However, in recent years, there have been reports of a number of trials suggesting that surgical treatment is warranted. The paper presents the biological aspects of metastasis and the results of removing a primary tumor in PDBC patients with ECOG 0-1

PHYLLOIDES TUMOR OF THE PROSTATE: A REVIEW OF LITERATURE AND A CASE REPORT

Phyllodes tumor of the prostate is a rare neoplasm with poorly understood pathogenesis. Histologically, it resembles phyllodes tumor of the breast with hyperplastic epithelium lined cysts and channels embedded in a variably cellular stroma. A variety of terms have been used to describe these lesions, including phyllodes type of atypical hyperplasia, cystosarcoma phyllodes. The malignant potential of this tumor is unclear and has resulted in confusion in terms of prognosis and treatment.</p

Therapeutic pathomorphism of malignancies: Clinical and morphological criteria. Classifications. Prognostic value of therapeutic pathomorphism in breast cancer and other tumors

Pathomorphism is one of the most important prognostic factors for breast cancer . The paper gives the notion of pathomorphism an d its types and the most commonly used classifications of tumor pathomorphological changes. It also considers the long-term results of neoadjuvant treatment in relation to pathomorphism

LAPAROSCOPIC SURGERY ON UTERUS AND ITS APPENDAGES IN PATIENTS WITH BREAST CANCER

One of the components of pathogenetic treatment of patients with breast cancer is castration. The aim of research is to investigate the significance of video assisted laparoscopic surgery on female reproductive organs in the treatment of breast cancer patients. The study is based on analysis of treatment results of 320 breast cancer patients with noncompromised menstruation and presence of steroid hor- mone receptors in tumor tissue. In comparison to surgical techniques used earlier, video assisted endoscopic surgery allows to decrease the aggressiveness of operation, accelerate the rehabilitation of patients, and lower the length of hospital stay. Radiation castration is not always effective: menstruation recovered in some patients. Besides, radiotherapy can not be recommended for patients with patho- logically transformed ovaries. Chemical castration with Zoladex or other analogous drugs is inaccessible for most patients in Russia

Video-assisted surgery in the treatment of early corpus uteri cancer

The immediate and late results of surgical treatment were assessed in patients with early corpus uteri cancer (CUC), by applying endo- scopic procedures. The paper gives comparative data on 2 comparable groups of patients with Т1-2N0М0 CUC, who have undergone laparoscopic (n=47) or open-access (n=50) surgery. The comparative analysis has demonstrated the advantages of an endoscopic technique over a laparotomic access in its immediate results, the duration of surgical intervention, the volume of intraoperative blood loss, the pattern and incidence of complications, the reduction in the length of hospital stay, and its cosmetic effect. The patients were found to have better quality of life after laparoscopic extirpation of the uterus. Overall and relapse-free survival rates were comparable in the two groups and did not depend on the technique of surgical intervention