,Z PThis is a real picture. At SKB Banka d.d. we operate according to the demands of the modem world. Our domestic and foreign currency exchange services are available to everyone -from large scale enterprises to private citizens. For the client with more specific needs, we trade in securities, provide credit card services and we've expanded to include investment, real estate transactions and transactions involving safes, consignments, works of art and gold. Complete banking services are available at each of the branch offices located throughout Slovenia. Just choose the service you need. 1111 1 11 111 1111 SKB BANKA D,D, Ajdovšcina 4, 61000 Ljubljana, Slovenija telephone +38 61 302 027, 132 132, telefax +38 61 302 808, telex 39144 Proving what we can do. RADIOLOGY AND ONCOLOGY Established in 1964 as Radiologia Iugoslavica in Ljubljana, Slovenia. Radiology and Oncology is a journal devoted to publication of original contributions in diagnostic and interventional radiology, computerized tomography, ultrasound, magnetic resonance, nuclear medicine, radiotherapy, clinical and experimental oncology, radiophysics and radiation protection. Editor in chief Tomaž Benulic Ljubljana, Slovenia Associate editors Gregor Serša Ljubljana, Slovenia Viljem Kovac Ljubljana, Slovenia Editorial board Marija Auersperg Andrija Hebrang Branko Palcic Ljubljana, Slovenia Zagreb, Croatia Vancouver, Canada Matija Bistrovic Durtla Horvat Jurica Papa Zagreb, Croatia Zagreb, Croatia Zagreb, Croatia Haris Boko Berta Jereb Dušan Pavcnik Zagreb, Croatia Ljubljana, Slovenia Ljubljana, Slovenia Malte Clausen Vladimir Jevtic Stojan Plesnicar Kiel, Germany Ljubljana, Slovenia Ljubljana, Slovenia Christoph Clemm H. Dieter Kogelnik Ervin B. 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Indexed and abstracted by: BIOMEDICINA SLOVENICA CHEMICAL ABSTRACTS EXCERPTA MEDICAIELECTRONIC PUBLISHING DIV/SION TABLE OF CONTENTS DIAGNOSTIC RADIOLOGY Morphological characteristics of renal arteries related to the position and size of the kidney Bobinac D, Schnurrer T, Dujmovic M 5 Rare localizations of Crohn's disease in the gastrointestinal tract Frkovic M, Vuckovic R, Mandic A 16 ULTRASOUND Pulsed-wave and color-doppler in the assessment of native kidneys with urinary tract obstruction Brkljacic B, Drinkovic I, Soldo D, Vidjak V, Odak D, Hebrang A 21 Contribution to the treatment of lymphoceles after renal transplantation Fuckar Ž, Maricic A, Mozetic V, Dimec D, Miletic D 27 NUCLEAR MEDICINE Renal blood flow measurement from first pass time-activity curves in patients undergoing routine bone scintigraphy Huic D, Grošev D, Dodig D, Poropat M, lvancevic D 31 CLINICAL AND EXPERIMENTAL ONCOLOGY To the problem of second primary tumor in long-term survivors of small-cell lung cancer Debevec M 36 The rate of natura! killer cells and their cytotoxic activity in patients with advanced pharyngeal and laryngeal cancer Šmid L, Žargi M, Rok B, Župevc A, Kotnik V, Ihan A, Rode M 39 Effectc of irradiation and THP-Adriamycin on the proteinase activity profiles in cultured V 79 cells Petrovic D, Ferle-Vidovic A, Škrk J, Suhar A, Turk V 44 LETIER TO THE EDITOR Postirradiation intraabdominal adhesions Snoj M 49 NOTICES 51 Radio! Oncol 1993; 27: 5-15. Morphological characteristics of renal arteries related to the position and size of the kidney Dragica Bobinac, Tea Schnurrer, Milivoj Dujmovic Medica! Faculty, University of Rijeka, Croatia The number and diameter of arteries supplying the kidney, and the extension of the main artery to the hilus have been investigated by means of real angiography. We wanted to correlate these data with the size and position of the kidney. It was found that in a certain percentage (in our cases in 14%) the kidneys were irrigated by more than one artery. The diameter of the main artery varied from 5 to 7 mm in females and from 6 to 8 mm in males. The diameter accessory arteries was markedly smaller, ranging from 3.5 to 4 mm. The measured length and width of the kidneys showed that these were smaller in females than in males. As a rule, the right kidney was smaller that the lep one. There was no correlation established between the main artery diameter and the size of the corresponding kidney, indicating that the diameter did not depend on the organ size. Generally, the course of the arteries was tortuous, extending caudally at first, and then making a bend with clownward convexity, and ending with the ascending segment approximately in the horizontal plane. This segment was also found to correspond to a normal anatomical position of the kidney, and such a course was invariably associated with the mentioned position. Key words: kidney anatomy and histology; renal artery radiography, renal size, renal position, renal artery diameter Introduction According to the data reported in literature, morphological characteristics of the renal arte­ries and the kidney are independent entities that cannot be correlated to each other. Thus, the data on the number of renal arteries, the leve! of their arising from the aorta and their further progression are most frequently associa- Corrcspondenee to: Assist. Prof. Dragica Bobinae, MD, Medica! Faeulty, University of Rijeka, Olge Ban 20, 51000 Rijcka, Croatia. ted with segmenta! distribution of the renal 5 parenchyma. 1-As for the kidneys, there are reports on their size and skeletopic relations pointing to the position of the kidney.6-9 The purpose of this study was to establish whether there was a correlation between the number and diameter of renal arteries, i. e. the tran­sverse section assessed from the diameter and the renal sectional area regarding variable dia­meters and the number of these blood vessels, and the organ size showing numerous varia­tions.10 Furthermore, we were interested in the relation between the direction and the way of renal artery extension, and the kidney position UDC: 611:611-01:611.136.7-073.75 because of individual differences related to that; Bobinac D et al. as reported in literature, kidney position may range from cranial vertebral level, or caudally from the common skeletopy of the right and left kidney. We wanted to find out whether, and in what way, the extension direction adju­sted to the kidney placed somewhat higher or lower from the ordinary position, or whether all the arteries would behave in the same way in the case of congenital organ position. Material and methods Radiograms of patients treated at the Clinic of Radiology, Clinical Center in Rijeka were used in our study. They were taken during renal angiography, imaging the kidneys with their arteries and aorta along with other visceral and parietal branches, and the terminal ramification of the aorta to common lateral arteries. From a great mumber of renal angiograms surveyed, those with neither signs of vascular changes nor renal parenchyma alterations were selected. Thus a sample of 50 patients, 30 males and 20 females, with kidneys and renal arteries within the physiological range was obtained. Radiograms were taken in a standard a. p. projection with focus-film distance of 75 cm. The number of renal arteries of the right and left kidney, respective of the fact whether the kidney had a single artery or there were also accessory arteries present, was assessed on X­ray images of the arterial phase of renal angio­graphy. Afterwards, the arterial diameter was measured at 1 cm distance from the arising point from the aorta. Mutual relation between the height of the left and right renal arteries arising points from the aorta was also observed. The angles indicating the course, i. e. the ordi­nary arterial extension, were measured on the same radiogram: a) the angle between the aorta extension direction at the height of the arising point of the renal artery and the direction of the initial part of the same artery; b) the angle between the aorta direction at the height of the renal artery arising point and the line connecting the arising point with the point of the first ramification of the same artery. This connection line represents the ordi­ nary arterial direction. Renal length and width were measured du­ ring the nephrographic phase because of clearly delineated organ shadow. The renal length was measured as the dis­ tance between the most projecting polar points. Because of the suprarenal gland position above the upper pole of the kidney, being in close relation with it, we had to define the upper pole of the kidney carefully. The renal width was measured at its widest part perpendicularly to its length. Because of its anatomical position, the kidney was slightly rotated in the fronta! plane, facing ventrally and laterally with its anterior surface, and the organ width measured on radiogram was so­mewhat lesser than its real size. The frontal -renal sectional area was calculated from known values of length and width using the formula for ellipse area evaluation. At the same tirne, the position of the inferior pole of the right kidney was marked in relation to the left one, and to the lateral ridge if the inferior pole was sufficiently low to cross it. Finally, the longitudinal sectional area of the kidney was correlated with the sectional area of the artery diameter, or arteries in the case of accessory vessels presence. Cross-sectional area of the artery was obtained by means of the formula for circular area calculation from a known diameter, i. e. the diameter of the artery. The 0.05). Twenty one subjects were without evidence of any renal disease, with both normal kidneys. A mean RBF/CO value for both kid­neys was 20.9 % ± 3.4. RBF obtained on the right Jung ROi was Iess than that obtained on the LV ROls, with a mean ratio of 0.86 ± 0.11, thus being significan­ tly different (p < 0.001). RBF based on the abdominal aorta was greater than that obtained on the LV ROi, with the mean ratio of 1.05 ± 0.13, which is also significantly different (p < 0.01). The delayed renal images correspond­ed well with the RBF/CO values and early renal images in 75 (91 % ) kidneys. Seven kidneys Rena/ blood flow measurement 33 (X 10000) CORRECTION OF SYRINGE COUNTS DEAD-TIME LOSSES FOR Fitt¦d Actual 16 12 ,.. • n. LINEAR RESPONSE . o 9 N=6939xmCi 0 3 6 9 12 CX 10000) TRUE COUNTRATE, NCcp•> Figure l. Curve fitted through experimental data-points of true vs. observed syringe count rates along with linear response. The obtained curve served for estimation of the true count rate from the observed by iterative method. Huic Det al. ,00--­ ­ •o CPS B) 600 RAW ARTERIAL CURVES 500 o. 10 16 20 25 400 Time(seconda) A) AORTA -AOATA{lltr.d) 300 200 3000.-----­ 3000 100 2000 C) 2000 o o 5 10 15 20 25 1600 TIME(sec) ,ooo -LUNG -+-LV ----1<----AORTA 600 o'--"'a=o,=__.-.-. -­ O 6 10 15 20 25 . J5 Tlme(sec) . L11no --·LV -Aort• -Alohlkldn-v Figure 2. A) Raw arterial curves drawn from corresponding ROis. 8) Smoothed LV curve along with fitted gamma-variate curve. C) Integrated fitted arterial curves multiplied by corresponding gklga ratio to obtain parallelism with the upslope of kidney curve. (9 % ) appeared normal during bone scintigra­difference between left and right kidneys was phy, but their RBF/CO values were low. significant, probably resulting from splenic overlap.4• 7 The splenic inflow appears early and sometimes it is very difficult to distinguish Discussion the left kidney margin from the splenic margin. In the study performed with Tc-99m Mag3 the Our results with 99m Tc-MDP confirmed the RBF/CO the values were similar (right kidney postulate that noninvasive measurement of or­ 8.5 % ± 1.1; left kidney 9.7 % ± 0.8; both gan blood flow which is based on the principle normal kidneys 18.3 % ± 1.5).9 of fractionation of cardiac output is applicable with any recirculating gamma emitting tracer.4 We obtained a similar difference between the In our investigation, the mean RBF/CO value RBF values based on Jung, LV, and aorta ROis from the normal left kidney was greater than like Bell and Peters, but our Jung/ LV ratio was the value obtained from the normal right kid­smaller. They report Jung/LV ratio 0.94 ± 0.14; ney, but not significantly (p>0.05). A. M. (p < 0.001), and aorta/LV ratio 1.05 ± 0.18; Peters et al. obtained RBF/CO value for the (p < 0.01).8 We did not correct the LV curve normal left kidney 10.4 % ± 1.2 and 11.4 ± for the Jung activity because that procedure 1.3 by using Tc-99m DTP A in two separate decreases statistical accuracy and it is probably 10 papers. RBF/CO value for the normal right the reason for our lower value . kidney was 9.0% ± 1.1 and 9.9% ± 1.1. The It is important to say that the Jung time-acti­ Rena/ blood f/ow measurement 35 vity curves were very easy to fit and gave the cleanest curves (relatively later appearance of re-circulation). The LV curve is contaminated by activity in the left base of the Jung whiJe the aortic curve is often contaminated by the acti­vity from the inferior vena cava. So in the case that the LV and aortic curves are too noisy, RBF vaJue from Jung curve shouJd be multiplied by factor 1.16 (1/0.86) and 1.22 (1.05/0.86) to get a correct LV and aortic RBF/CO value, respectively. It is really surprising that even 26 (32 % ) kidneys were poorly dispJayed, with low RBF/ CO values in patients without evidence of renal disease. The reasonable expJanations could be patients' age, primary disease and side effects of therapy. The simplicity of the procedure and results in physiologicaJ units render this method usefuJ in clinical practice, and it could be useful in patients undergoing routine bone scintigraphy if they are under suspicion of poor renal blood flow. It is possible to get indirect information about RBF from static renal images obtained during bone scintigraphy. In such evaluation one should be very careful with respect fo the fact that seven normal appearing kidneys had low RBF/ CO values in our investigation. References l. Vieras F, Achong DM, Tulchinsky M, Smith JJ. Quantitation of Differential Rena! Function with Tc-99m MDP. Ciin Nucl Med 1991; 16: 649-51. 2. Glass EC, De Nardo GL, Hines HH. Immediate renal imaging and renography with 99m-Tc methy­lene diphosponate to asses renal blood flow, excre­tory function, and anatomy. Radiology 1980; 135: 187-90. 3. Peters AM, Brown J, Hartnell GG, Myers MJ, Haskell C, Lavender JP. Noninvasive measure­ment of renal blood flow with 99mTc DTP A: comparison with radiollabelled microspheres. Car­diovasc Res 1987; 830-4. ji 4. Peters AM, Gunasekera RD, Henderson BL, Brown J, Lavender JP, Souza MDe, Ash JM, Gilday DL. Noninvasive measurement of blood flow and extraction fraction. Nucl Med Commun 1987; 8: 823-37. 5. Peters AM, George P, Brown J, Lavender JP. Filtration fraction: noninvasive measurement with Tc-99m DTP A and changes induced by angioten­sin converting enzyme inhibition in hypertension. Nephron 1989; 51: 470-3. 6. Ash J, De Sousa M, Peters M, Wilmot D, Hausen D, Gilday D. Quantitative assessment of blood flow in pediatric recipients of renal transplants. J Nuclear Med 1990; 31: 580-5. 7. Peters AM, Brown J, Crossman D, Brady AJ, Hemingway AP, Roddie ME, Allison DJ. Non-in­vasive measurement of renal blood flow with Tc-99m DTPA in the evaluation of patients with suspected renovascular hypertension. J Nucl Med 1990; 31: 180-5. 8. Peters AM, Heckmatt JZ, Hasson N, Henderson BL, El-Meleigy D, Rose ML, Dubowitz V. Rena! hemodynamics of cyclosporin A nephrotoxicity in children with juvenile dermatomyositis. Ciin Sci 1991; 81: 153-9. 9. Kynaston H, Grime S, Taylor B, Jenkins SA, Parsons K, Cricthley M. Quantification of renal blood flow (RBF) and extraction fraction (EF) using MAG 3: a clinical study (abstract). Eur J Nucl Med 1992; 19: 618. 10. Bell SD, Peters AM. Blood flow measurement from first pass time/activity curves: influence of bolus spreading. Nucl Med Commun 1990; 11 477-80. Radio! Oncol 1993; 27: 36-8. To the problem of second primary tumor in long-term survivors of small-cell Jung cancer Miha Debevec Institute of Oncology, Ljubljana, Slovenia Two cases of second primary tumor (SPT) of the lung after multimodality treatment of small-cell lung cancer (SCLC) are presented. In both of them non small-cell lung cancer (NSCLC) was stated. The frequency of lung SPT is discussed. Key words: lung neoplasms; carcinoma, non-small celi lung; neoplasms, second primary Introductiou Warren and Gates1 stated that a cancer patient may be "cancer prone" and tends to develop new primary cancer more frequently than do patients their first cancer. On the other side, the cases of multiple primary carcinomas in the same region and elsewhere in the body are becoming increasingly common. Current multimodality approaches to the ma­nagement of patients with small-cell lung cancer (SCLC) improved their survival rates. With an improved potential for care and accrual of long-term survivors of SCLC, the adverse effect of chemo-and radiotherapy, and a higher inci­dence of second primary tumors (SCT) have become apparent. In the article two cases of SCLC patients are presented; in one of them SPT was metachro­nous 11011 small-cell lung cancer (NSCLC), and in another patient it was probably synchronous Correspondence to: Prof. Miha Debevec, MD, Ph. D. Institute of Oncology, Zaloška 2, 61105 Ljubljana, Slovenia. double lung cancer. The problem of frequency of SPT of the lung is discussed. Case No. I A 68-year old male patient (Pat. rec. # 6718/82) was operated on for a 2-cm peripheral SCLC of the upper left lobe in September 1982. The stage of tumor was pT1N0M0. Postoperatively, sev en applications of chemotherapy ( cyclophos­phamide, vinblastine, methotrexate, 5-fluoro­uracil) were performed. In September 1988, tumorous infiltration of the left hilus was evi­dent on chest x-ray. In December 1988, bron­choscopy was performed: there were signs of lower left bronchial tumor and large-cell carci­noma confirmed. The patient died in December 1990 due to progression of Jung cancer and !iver metastases, i. e. 99 months after surgery for small-cell carcinoma, and 27 months after the diagnosis of large-cell carcinoma. Case No. 2 In May 1989, a 65-year old male patient (Pat. rec. # 2195/89) presented with small cell carci­noma of the lower right robe (Figure 1). Clinical UDC: 616.24-006.6-039.35 stage of the tumor was cT2N2M0 (limited disea­ To the problem of second primary tumor in long-term survivors of small-cell Lung cancer Figure l. se). After six applications of chemotherapy ( cyclophosphamide, doxorubicin, vincristine) radiation therapy with TD 45 Gy (2.5 Gy daily, split course regimen) was performed. On bron­choscopy in February 1990 there were no more signs of bronchial tumor, but brushing of the right lower lobe showed cells of large celi carcinoma, whereas chest x-ray was unsuspi­cious (Figure 2). The patient was observed, and in January 1993 bronchoscopy was performed because of a progressing tumor of the left hilus, which revealed large-cell carcinoma in the api­cal segment of the lower left bronchus. In the right bronchial tree there. were no signs of tumor (Figure 3). So, the cytological diagnosis of NSCLC was established 9 months after diag­nosis of SCLC. Discussion The lung is one of the organs in which multiple primary cancers occur very often. Moreover, the Jung is the most common site in patients with double cancer.2 Improved survival of SCLC patients after therapy results in an increased number of SPT cases. Criteria for the differentation of new lung lesion as SPT are: 1) different histological type, 2) different lobe, and 3) tirne interval of at least two3 or three4 years. Sagman et a!.5 found 30 SPT in 800 SCLC patients -in 6 of them the SPT was NSCLC, and suggested that increased predisposition to SPT may be attributed to secondary effects of multimodality treatment and biological conside­rations although 2/6 SPT were classified as synchronous, i. e. SPT developed within 1 year. Heyne et al.6 estimated 14 SPT in 446 patients with SCLC, 6 of them NSCLC, and considered long-term survivors of SCLC as excellent candi­dates for chemoprevention trials. Osterlind et al.7 reported 13 SPT among 72 SCLC long-term survivors; 5/13 were NSCLC. Souhami and Law8 found only 8 SPT in 217 two-year survivors with SCLC; 1/8 was NSCLC. M Debevec Case No. 1 is undoubtedly a secondary pri­mary NSCLC after successful treatment for SCLC: different histology, different lobe, and more than 3-year interval between the appea­rance of both tumors. Case No. 2: it would have corresponded to these criteria too, had there not been bronchos­copy performed 9 months after the diagnosis of SCLC. Although NSCLC cells were taken by brushing biopsy from the right site, probably they arise from the tumor of the left lower lobe verified 3 years later. Therefore, this case is most probably synchronous double primary Jung tumor. Regarding the doubling tirne of Jung cancer, Marmorschtein et al.9 consider ali Jung tumors found within 3 years as synchro­nous. So, we could not regard Case No. 2 as SPT due to chemo-and radiotherapy for SCLC. Accordingly, the relative risk of development of NSCLC as SPT, calculated in patients before 6 7 three years from diagnosis of SCLC,5• • seems to be exaggerated. References l. Warren S, Gates O. Multiple primary malignant tumors. A survey of the literature and a statistical study Am J Cancer 1932; 16: 1358--414. 2. Caham W. Multiple primary cancers of the lung, esophagus, and other sites. Cancer 1977; 40: 1954­60. 3. Martini M, Melamed M. Multiple primary lung cancers. J Thorac Cardiovasc Surg 1975; 70: 606­12. 4. van Bodegom PC, Wagenaar SS, Corrin B, Baak JP, Berke! J, Vanderschueren RS. Second primary lung cancer: importance of long term follow-up. Thorax 1989; 44: 788-93. 5. Sagman U, Lishner M, Maki E, Shepherd FA, Haddad R, Evans WK, DeBoer G, Payne D, Pringle JF, Yeah JL, Ginsberg R, Feld R. Second primary malignancies following diagnosis of small­cell Jung cancer. J Ciin Oncol 1992; 10: 1525-33. 6. Heyne KH, Lippman SM, Lee JJ, Lee JJ, Hong WK. The incidence of second primary tumors in long-term survivors of small-cell Jung cancer. J Ciin Oncol 1992; 10: 1519-24. 7. Osterlind K, Hansen HH, Hansen M, Dombernow­sky P. Mortality and morbidity in long-term survi­ving patients treated with chemotherapy with or without irradiation for small-cell Jung cancer. J Ciin Oncol 1986; 4: 1044-52. 8. Souhami RL, Law K. Longevity in small celi Jung cancer. Br J Cancer 1990; 61: 584-9. 9. Marmorschtein SJ, Slesareva RJ, Gamburg JL. Lungentumor bei Kehlkopfkarzinom. Fragen der Synchronitaet und der Artdiagnostik. Rad Diagn 1970; 11: 205-11 . Radio/ Oncol 1993; 27: 39-43. The rate of natural killer cells and their cytotoxic activity in patients with advanced pharyngeal and laryngeal cancer Lojze Šmid, M Žargi, B Rok, A Župevc, V Kotnik, A Ihan, M Rode University Department of Otorhinolaryngology and Cervicofacial Surgery, Clinical Center Ljubljana, Slovenia The activity of natura[ killer (NK) cells was assessed In 46 patients with previously untreated advanced squamous cell carcinoma of the head and neck region. The mean NK cell activity of these patients was lower than that observed in a group of 32 age-matched controls (62.5 vs 90), however, the difference was not statistically significant. Patients with regional metastases that grew through the lymph node capsule and those with primary tumor directly invading the surrounding tissue had significantly lower values of NK cell activity than patients with locoregionally controlled tumors (p = 0.02). Key words: pharyngeal neoplasms; laryngeal neoplasms; killer cells, natura) Introduction The role of natura! killer (NK) cells in patients with malignomas of the head and neck has not been fully explained yet. Many facts support their possible influence in the destruction of circulating tumor cells, 1 and some authors be­lieve that a decreased cytotoxic activity (CA) of these cells attributes to the appearance of 25 distant metastases.-The latter observation seems to be of particular importance and inte­rest in the case of patients with head and neck tumors, as such indicators of the probability of distant metastatic spread would be very helpful for correct treatment selection. Correspondence to: L. Šmid, MD, University Depart­ment of Otorhinolaryngology and Cervicofacial Surge­ry, Zaloška 2, 61105 Ljubljana, Slovenia In our prospective study we were determining the number of NK cells and their CA in the peripheral blood of patients with advanced la­ryngeal and pharyngeal cancer, in order to asses their possible relevance for prognosing the course of disease. Methods The study was carried out in 46 patients, 40-81 years of age, with previously untreated and histologically confirmed advanced carcinoma of the pharynx and larynx. The disease was classi­fied as stage 3 or 4 in ali patients.6 In 23 of them the site of origin was the oropharynx, in 15 hypopharynx and in 8 larynx. The prevailing histologic type was poorly differentiated or non­keratinizing planocellular carcinoma (37 pa­tients), whereas well differentiated keratinizing UDC: 616.321-006.6-097:616.22-006.6-097 planocellular carcinoma was established in 9 Šmid Letal. cases. Twenty-two patients were treated by radiotherapy, 20 were operated on -of these 18 also received postoperative irradiation, and 4 patients were treated by a combined radio­and chemotherapy. The control group consisted of 32 patients admitted to the University Department of Oto­rhinolaryngology and Cervicofacial Surgery be­cause of some other, non-malignant diseases; the controls were matched to the studied cancer patients by age and sex. CA of NK cells was determined by means of K 562 tumor cell killing test. These cells were mixed with lymphocytes isolated from the peri­pheral blood of patients with laryngeal and pharyngeal cancer. After 4-hour incubation, the rate of killed target cells was evaluated, and calculated in lithic units, where their higher value was associated with a higher K 562 tumor cell killing potential of NK cells. Results and discussion In patients with advanced cancer NK activity is usually depressed.7-11 Also in our patients, the average CA of NK cells was lower than that observed in the control group (62.5 vs 90), though the difference between both groups was not statistically significant. The average rate of NK cells in patients with laryngeal and pharyn­geal cancer was 16.1 % , being lower from that in the control group, though the difference between both groups was not statistically signi­ficant. Comparison of the average rates of NK celi counts and their cytotoxic activity by tumor site and histologic type did not show statistically significant differences, and neither confirmed a correlation between the average rate of these cells and their CA. Similarly, data from single­cell cytotoxicity assays suggest that the defect rests in the activity and not in the number of NK cells.12 Since our investigation was aimed to asses a possible prognostic relevance of NK cells, and since in patients with laryngeal and pharyngeal cancer the best indicator of the probability of distant dissemination is known to be local and regional tumor spread,13-15 our analysis of the results was centred particularly on these issues. The available literary data on the CA of NK cells in patients with head and neck carcinomas are relatively scarce. There are, however, even less reports on the role and significance of CA of these cells for the appearance of local meta­stases. Cortesina et al.16 report a decreased CA of NK cells in advanced head and neck cancers. Pross and Baines 7 established a decreased CA in patients with metastases in comparison with cases without regional tumor dissemination. Schantz and coworkers,17 however, found an increased CA of NK cells in patients with local or regional tumor invasion of the surrounding tissue. In our study, the average CA of NK cells in patients with regional metastases in N3 and N2 was found to be significantly lower than that in the control group (p = 0.04 and 0.05 respective­ly), whereas in patients with NO and Nl no statistically significant difference could be esta­blished (Figure 1). The extent of local dissemi­nation (control group -N0-Nl-N2-N3 was in correlation with the values of average CA in individual groups: thus, a 5 % risk was associa­ted with negative correlation (KK = -0.274). The comparison of NK cell rates and their CA in the group of patients with local or regional spread, and those without evidence of dissemination revealed interesting differences. In the cases when tumor did not show evidence of local or regional invasion into the surround­ing tissues the rate of NK cells was on average lower than that in the group with local infiltra­tion (13.5 vs 18.2), though the difference was not statistically significant (p = 0.08). An ave­rage CA of NK cells in the group of patients with local tumor invasion (39) was significantly lower than the relevant values in the control group (90) (p = 0.01), and borderline signifi­cantly lower than in patients without local infil­tration (73) (p = 0.07) (Figure 2). Also, an average CA in the group of patients with regio­nal invasion (44) was significantly Iower than that in the control group (90) (p = 0.02) and borderline significantly lower than in the group NK cells in. patien.ts with advan.ced pharyn.geal an.d laryn.geal can.cer 125 1 1 T p=0.05 /2 -­ ...) 75 CG NO Nl N2 N3 Figure l. Mean CA of NK cells according to N stage (CG = control group). 125 100 [/) 75 a (.) ..., 50 25 o rr. LTl WLTl Figure 2. Mean CA of NK cells according to local tumor infiltration into surrounding tissue (CG = con­trol group; LTI = local tumor infiltration; WLTI = wit­hout local tumor infiltration). Šmid Letal. 125 .--------------. [/J ...., ·a :=i () ·­ :>-, e..:i o CG LRTI WLRTI Figure 4. Mean CA of NK cells according to Iocal and regional tumor infiltration into surrounding tissue (CG = control group; LRTI local and/or rcgional tumor infiltration into surrounding tissuc; WLRTI =± without local and/or rcgional tumor infiltration into surrounding tissue). without regional invasion (75) (p 0.07) (Fi­gure 3). The difference is apparent also in the group of operated patients in whom the remo­ved lymph nodes were histologically examined. When the average CA in the group without locoregional invasion into the surrounding tis­sues was compared with that found in the group with locally and regionally infiltrating tumor the difference was statistically significant (p = 0.02) (Figure 4). These findings can be presented from yet another aspect: in only one of 18 patients without evidence of locoregional invasion CA was lower than 30 lithic units (LU) (5.5 % ). On the other hand, in the group of 28 patients with tumor invasion into the surroun­ding tissues CA was below 30 LE in as many as 17 patients (61 %). Therefore CA lower than 30 LE could be considered as unfavourable prognostic sign. Conclusion The findings of our investigation indirectly sup­port the hypothesis that in patients with laryn­geal and pharyngeal cancer the course of di­sease in reflected in the CA leve! of NK cells. Nevertheless, it should be kept in mind that our results are only preliminary, and therefore their fina! evaluation would require further follow up of the patients. Only in this way the hypothetical correlation between the CA of NK cells and prognosis of the disease could be confirmed. References l. Gorelik E, Fogcl M, Segal M, Feldman S. Diffe­rcnccs in resistance of metastatic tumor cclls and cclls from local tumor growth to cytotoxicity of natura! killcr cclls. J Natl Cancer Inst 1979; 63: 1397-404. 2. Gorclik E, Wiltrout RH, Okumura K, Habu S, Hcrbcrman RB. Role of NK cells in the control of metastatic sprcad and growth of tumor cclls in micc. Int J Cancer 1982; 30: 107-12. 3. Hanna N. Exprcssion of mctastatic potential of tumor cclls in young nude micc is corrclatcd with low levels of natura! killcr cell-mcdiatcd cytotoxi­city. Int J Cancer 1980; 26: 675-80. 4. Hanna N, Fidler l. Role of natura! killer cells in the destruction of circulating tumor cmboli. J Natl Cancer Jnst 1980; 65: 800-12. 5. Talmadge J, Meycrs K, Pricur D, Starkcy J. Role of NK cells in tumor growth and mctastasis in beigc mice. Nature (Lond) 1980; 284: 622-24. 6. TNM classification of malignant tumors. Intcrna­tional Union Against Canccr, Genevc 1987. 7. Pross HF, Baincs MG. Spontaneous human lym­phocytc-mediatcd cytotoxicity against tumor tar­gct cells. The effect of malignant diseasc. Int J Cancer 1976; 18: 593-8. 8. Takasugi M, Ramscyer A, Takasugi J. Decline of natura] nonsclective cell-mediatcd cytotoxicity in patients with tumor progrcssion. Cancer Res 1977; 37: 413-9. 9. Cunningham-Rundlcs S, Filippa DA, Braun DW, Antonclli P, Ashikari H. Natura! cytotoxicity of peripheral blood lymphocytcs and regional lymph node cells in brcast cancer in women. J Natl Cancer Inst 1981; 67: 585-92. 10. Kadish AS, Doyle AT, Teinhauer EH, Ghossein NA. Natura! cytotoxicity and interferon product­ion in human cancer: deficicnt natura! killcr acti­vity and normal interferon production in patients with advanced disease. J lmmunol 1981; 127: 1817-22. 11. Pandolfi T, Semcnzato G, De Rossi G, Strong DM, Quinti L, Pezzutto A, Mandelli F, Aiuti F. Heterogeneity of T-CLL defined by monoclonal antibodics in ninc paticnts. Ciin Immunol Immu­nopathol 1982; 24: 330-5. NK cells in patients with advanced pharyngeal and laryngeal cancer 12. Steinhauer EH, Doyle AT, Reed J, Kadish AS. Defective natura! cytotoxicity in patients with can­cer: normal number of effeetor cells but decreased recycling capacity in patients with advanced disea­se. J Immunol 1982; 129: 2255-32. 13. Merino OR, Lindberg RD, Fletchcr GH. An analysis of distant metastases from squamous celi carcinoma of the upper respiratory and digestive tracts. Cancer 1977; 40: 145-51. 14. Johnson JT, Barmes EL, Myers EN. The extra­capsular sprcad of tumors in cervical node meta­stases. Arch Otolaryngol Head Neck Surg 1981; 107: 725-9. 15. Vikram B, Strong EW, Shah JP. Failure at distant sites following multimodality treatment for advan­ced head and neck cancer. Head Neck Surg 1984; 6: 730-3. 16. Cortesina G, Sartoris A, Di Fortunato V. Natura! killer-mediated cytotoxicity in patients with laryn­geal carcinoma. Ann Oto/ Rhinol Laryngol 1984; 3: 189-91. 17. Schantz SP, Poisson L. Natura! killer celi re­sponse to regional lymph node metastases. Arch Otolaryngol Head Neck Surg 1986; 112: 45-51. Radio/ Oncol 1993; 27: 44-8. Effects of irradiation and THP-Adriamycin on the proteinase activity profiles in cultured V79 cells Danilo Petrovic,1 Ana Ferle-Vidovic,1 Janez Škrk,2 Alojz Suhar,3 Vito Turk3 1Ruder Boškovic Institute, Zagreb, Croatia 2Institute of Oncology, Ljubljana, Slovenia 3 Jnstitute Jožef Stefan, Ljubljana, Slovenia In the present work the changes of the activities of three types of proteinases (aspartic, cystein and neutral) in proliferative Chinese hamster lung fibroblasts (V79), treated by gamma irradiation or by the cytostatic agent 4-0-tetrahydropyranil (THP) Adriamycin, were followed. Our results show, that the activities of different enzymes tested, were changed by each of the two treatments in a different way. Key words: fibroblasts; radiation effects; dexorubicin; peptide peptidohydrolases Introduction about proteinases influencing the repair of po­ Proteolytic enzymes are essential in the cell metabolism and physiology, but they are also of crucial importance in processes involved in cellular proliferation kinetics and cell death. 1• 2 They are an important part of gene regulation processes. 3 Their activity therefore, if measured when cells are in various physiological states or if they are exposed to damaging agents, may provide certain evidence about some molecular events occurring in the cells under particular circumstances. In our previous papers we presented results indicating a correlation between the activity of intracellular proteinases and irradiation4 and Corespondence to: dr. Danilo Petrovic, Ruder Boško­vic Institute, Bijenicka 54, Zagreb, Croatia. UDC: 612. 75 .014.469 .015 .12 tentially lethal damage.5• 6 In this work we present some changes of the activities of three types of proteinases ( aspartic, cystein and neutral) in proliferating Chinese hamster lung fibroblasts (V79), treated by gamma irradiation or by the cytostatic agent 4-0-tetrahydropyranil (THP) Adriamycin. The results show pronounced changes in the activi­ties of neutral and cystein proteinases following irradiation, and changes in the activity of acid proteinases which are different and related to the particular agent. They also suggest their involvment in repair processes. Materials and methods Celi cultures and experimental procedure Chinese hamster Jung fibroblasts (V79), were cultured as monolayers in Eagle's minimal es­ Proteinase activity profiles in cultured V79 cells sential medi um, supplemented with 10 % calf serum. Cell cultures were prepared by plating 106 cells per Petri dish of 10 cm in diameter, and after two days of exponential growth ( doub­ling tirne 12 hours), before full confluency was reached, cells were either irradiated or treated by THP-Adriamycin. Following treatment, cell fVI s l CYSTEIN PROTEINASES :,;. 04 L __ ?o3r -§----1 ]02. ' r . 01 Log PHASE/ / / / / / / / STAC. PHASE ....::.li.==.='===-­ ­ ­ - E > ' C 1­ 1 ­ ll: os ­ o r/ Log PHASE/ / / / // // STAC PHASE -·-0.8 '-0. 8 E 20 t--E ­ <( C ;:, z 18 E 1--(:t: ­ o E 16i A u ­ 1 1 . <( ­C IL (:t: 14 o ­ E o.6 . 0.6 1--12 > > 1--10 u u <( <( 8 0.5 2. Proteinase act1V1ty profiles in cultures of V79 cells after gamma irradiation or treatment with Figure THP-Adriamycin. C -Control values. y -Cumulative data obtained by doses from 3-lOOGy gamma rays 60 minutes following irradiation. A -Cumulative data obtained by 0.5 µg per ml THP-Adriamycin treatment for one hour. Proteinase activity was determined 60 minutes following the end of treatment. three proteinases show a less intensive but similar decrease, and therefore this region of the culture age, with cells at the end of the exponential phase of growth was selected for treatment and proteinase activity assays. It was assumed that in this phase of cell growth the activities of all three proteinases have the most simillar patterns, thus being most convenient ACID PROTEINASES "' 1.2 ·.; C a. 1.1 c:n E 1.0 ' C 0.9 ' E a:: for comparison of the effects caused by various treatments. Overall effects of gamma irradiation and of THP-Adriamycin on activity profiles of acid, neutral and cystein proteinases are presented in Figure 2, in order to show how treatment of each of those two agents will affect the activity of the proteinases in general. It is evident that ACID PROTEINASES C ·.; o .a. ! -. c:n E ' 1.0 C E ' 0.9 a:: 0.8 ­ ;; E 0.6 C >-0.5 t:::: 2'.: ­ u <( o E 0.6 C >-0.5 THP -Adriamycin t:::: lf -irradiation > ­ u 10 20 30 ,o 50 60 10 20 30 ,o 50 60 INCUBATION TIME AFTER TREATMENT min.) INCUBATION TIME AFTER IRRADIATION I min.) Figure 3. Time-dependent changes of acid proteinase act1V1ty cultures of V79 cells following treatment by THP-Adriamycin (a) or gamma irradiation (b). Cells were treated by THP-Adriamycin (O.S µg per ml) for one hour, washed, and incubated in fresh medium. Dose of gamma irradiation was 15 Gy. Proteinase activity profiles in cultured V79 cells if assayed 60 minutes following treatment, acid proteinases are little affected, cystein protein­ases reveal increased activity while neutral pro­teinases are signifficantly depressed if compared to their controls . In Figure 3 we analysed the effects of gamma irradiation and of THP-Adriamycin on the acid proteinase activity during the first hour follow­ing treatment. The reason for selecting this particular proteinase was the apparent absence of effects of two agents on it. The two curves show clearly, however, that the patterns of tirne ACIO PROTEINASES . 2 C> E 1.1 C: E ' 1.0 '· -,,1, o. O.B E L 0.7 > 0.6 o.s dependent effects are different. THP-Adriamy­cin did not influence the activity of the acid proteinase, irrespective of the tirne when the activity was measured during the one-hour pe­riod. The pattern of the effects obtain by irra­diation however, shows a clear tirne dependence with a decrease at the 15th minute and an increase up to the 60 min. post treatment. Figure 4 shows that there is also dose-depen­dence of the activities of acid and cystein pro­teinases, if they are assayed one hour after irradiation with diferent doses of gamma rays. CYSTEIN PROTEINASES 13 "' C: 1.2 .. L a. 1.1 o, ' E 1.0 '= 0.9 E ' <( z 0.8 0.7 C: ­ ,-. 0.6 > ,-. o.s <( 10 20 30 40 50 60 70 80 90 100 10 20 JO 1.0 50 60 70 80 90 100 gamma ray dose I Gy) gamma ray dose I Gy) Figure 4. Dose-dependent changes of acid (a) and cystein (b) proteinase activity in cultures of V79 cells 60 minutes following gamma irradiation. Cells were irradiated, incubated for 60 minutes and then collected for proteinase activity assay. Although they reveal different patterns, both proteinases have increased activities, significan­tly above the control levels, but with their maxima at different doses (50 and 15 Gy respectively), and with the tendency of decrease in the higher dose region. The results show that the intensity of protein­ase activity is dependent on the age of the cell culture, that THP-Adriamycin and gamma irra­diation generally increase cystein proteinase activity and depress neutral proteinase activity, but have little influence on the acid proteinases. THP-Adriamycin has little influence on the acid proteinase activity for the first 60 minutes following treatment, but in opposite, gamma irradiation does change that activity, and final­ly, acid and cystein proteinase activities vary at different doses of irradiation, but in different patterns. Genotoxic agents such as ionizing irradiation and cytostatics, commonly used in tumor thera­py, damage and kill cells through different molecular mechanisms. Ionizing irradiation pro­duces breaks in DNA molecules and this indu­ces repair processes through activation of speci­fic enzymes. Adriamycin, for instance as an Petrovic D et al. intercalating agent and so by distorting the DNA molecule inhibits the transcription of RNA (9). In that case there is no repair, at Ieast not in that sense as after irradiation. Therefore, certain agent-related differences of the activities of intracellular proteinases were expected. According to the results presented in this work the activities of the three groups of intracellular proteinases responded in different ways to the treatments, and in brief, it can be concluded that they are an integral component of response of mammalian cells to irradiation and Adriamycin-produced damage. Which pro­teinases specifically are really envolved in these process, is the subject of furtner investigation. Acknowledgement We thank Mrs. Ljiljana Krajcar for her excel­lent technical assistance. This project was sup­ported by the Ministry of Science of the Repub­lic of Croatia and the Ministry of Science and Technology of Republic of Slovenia. References l. Scott GK. Mini-review: Proteinases and eucariotic celi growth. Cornp Biochern Physiol 1987; 87B: 1-10. 2. Korbelik M, Škrk J, Suhar A, Turk V. The role of proteinases, interferons and hormones in prolife­rative activities of nonmalignant and malignant cells. Neoplasrna 1988; 35: 555--63. 3. Reich E, Rifkin DB, Shaw E (eds). Proteases and biological control Cold Spring Laboratory, New York, 1975. 4. Korbelik M, Suhar A, Osmak M, Škrk J, Turk V. Dynamics of postirradiation intracellular cysteine and aspartic proteinases profiles in proliferating and nonproliferating mamalian cells. Strahlenther Onkol 1990; 116: 402-4. 5. Osmak M, Korbelik M, Suhar A, Škrk J, Turk V. The influence of cathepsin B and leupeptin on potentially lethal damage repair in mammalian cells. lnt J Radiation Oncology Biol Phys 1989; 16: 707-14. 6. Korbelik M, Suhar A, Osmak M, Škrk J, Turk V, Petrovic D. Modification of potentially lethal da­mage repair by some intrinsic intra-and extracellu­lar agents: I Proteinases and proteinase inhibitors. lnt J Radiat Biol 1988; 54: 461-74. 7. Suhar A, Marks N, Turk V, Benuk M. On the metabolism of opiate peptides by brain proteolytic enzymes. In: Turk V, Vitale Lj, eds., Proteinases and their inhibitors. 1981, Mladinska knjiga, Perga­mon Press, Ljubljana, Oxford, 33-43. 8. Suhar A, Kopitar M, Turk V. The isolation of liver serine proteinase by affinity chromatography on 4-phenyl-buthylamine sepharose. Acta Biolrned Germ 1982; 41: 61-8. 9. Calendi E, Dimarco A, Regiani M. On physicoche­mical interactions between Daunomycin and nucleic acids. Biochern Biophys Acta 1965; 103: 25-49. Radio! Oncol 1993; 27: 49-51. Letter to the editor Postirradiation intraabdominal adhesions Marko Snoj Department of Surgery, Institute of Oncology, Ljubljana, Slovenia Introduction Intraabdominal adhesions are most frequent cause of small bowel obstruction1 and female infertility.2 They can be localised in any part of the bowel, but most usually they are found in the small bowel. 1 They occur most frequently after surgery in the abdominal cavity, seldom they are caused by peritoneal infection and even more rarely they follow irradiation of this region.3 Various experiments have been conducted for intraabdominal adhesion prevention in the past, but none gave satisfactory result.4 Recent­ly, two new, more physiologically oriented ap­proaches were introduced. The first is based on local administration of recombinant tissue pla­sminogen activator5 and the second on the use of surface active material. 6 In the present article we would like to discuss the problem of postir­radiation intraabdominal adhesions in the light of the use of surface active materials. Postirradiation intraabdominal adhesions Chronic postirradiation enteritis is most often a disease of middle aged women treated by irradiation for gynecologic carcinoma.7 Less fre- Correspondence to: Marko Snoj MD, PhD, Institute of Oncology, Department of Surgery, Zaloška 2, 61105 Ljubljana, Slovenia. quently it is observed in older men treated for prostatic cancer8 and in younger men treated for malignant testicular tumors. 9 The latent period between irradiation and appearance of the first symptoms of irradiation enteritis is very variable: it ranges form half a year to 31 years, being about 6 years on average.10 In the past, little attention was devoted to the problem of postirradiation adhesions. The bulk of the research on chronic postirradiation enteritis was centred on the mucosa or the bowel wall. Thus, chronic postirradiation ente­ritis was found to appear as a mucosal damage (ulcerations and fissures), or as a generalised fibrosis of the bowel wall with special emphasis on the submucous layer, and as a damage of the vessels resembling those at atherosclero­sis.10 The injury is frequently localised as jeju­nitis, ileitis or proctitis, but most often it is a combination of ali previously mentioned locali­sations. It is expressed clinically as malabsorp­tion, or bowel obstruction, which is mainly due to intraabdominal adhesions, or as bleeding on the stool. At operation, the surgeon is faced by a difficult situation. At the beginning of surgery, slow and meticulous adhesiolysis is done; after­wards, resection and anastomosis of the bowel are performed if necessary. After this first intervention there are frequently recurrences of adhesive ileus. In these cases, subsequent sur­ 50 Snoj M gery is even more difficult than the first one and carries significant mortality. Therefore it would be highly warranted to prevent the recur­rence of adhesive ileus. Recently, it was realised that the studying of bowel serosa is the key to the solution of the problem of adhesive obstruction after irradia­tion. 3 Thus, it was observed in a rat model tha·t intraabdominal adhesions began to from two months after abdominal irradiation with a sin­gle-dose of 13.5 -17.5 Gy. They were associa­ted with a concurrent serosal destruction. Po­stirradiation adhesions were even more expres­sed when there was inflammation present, or after a surgical procedure in this region.11 Surface active materials Surface active materials are present in the peri­toneal fluid in a concentration from 11 to 25 mg/L. Its relative concentration is: 81 % phos­phatidylcholine, 5 % lysophosphatidylcholines, 6.5 % sphyngomyelines, 3.5 % phosphatidylino­sitols and 4 % phosphatidyletanolamines.12 It was postulated that phospholipid adheres to both parietal and visceral peritoneal surfaces and is held in place by the attraction of the positive charge of choline head to the negative charge of peritoneal surface. To the cavity long-chain fatty acids are presented and interac­ting with their counterparts from opposing side 12 provide lubrication . We have found out in animal experiments that the surface active materials effectively pre­vent adhesions after surgery ,6 adhesions after intestinal anastomosis13 and those after bacte­rial peritonitis. t4 Therefore they could be instil­led in the peritoneal cavity after the adhesiolysis in postirradiation adhesive ileus. Postirradiation adhesions prevention by surface active materials Surface active materials efficiently prevent in­traabdominal adhesion formation only when instilled intraperitoneally, but not when applied intravenously. 6 When applied intraperitoneally, special attention should be paid to possible formation of intestinal anastomosis, since too high a dosis could lead to anastomotic dehis­cence and peritonitis.13 The next question applies to the appropriate timing of surface active material application. Thus, application after irradiation does not seem wise since only about 5 % of patients Jater develop chronic irradiation enteritis. It seems much more possible to use them after the adhesiolysis for adhesive obstruction. In this case they could be instilled intraperitoneally at the end of the operation. This would be in line with experimental evidence that single dose of surface active material at the end of operation is as efficient as three doses in three consecutive days.13 It seems that surface active materials could play an important role in postirradiation adhe­sion prevention. Therefore, they bring the new light of hope for patients with this grave and often fatal disease. References 1. Bizer LS, Leibling RW, Delany HM, Gliedman ML Small bowel obstruction: The role of nonope­rative treatment in simple intestinal obstruction and predictive criteria for strangulation obstruc­tion. Surgery 1981; 89: 407-13, 2. Holtz G. Prevention of postoperative adhesions. Rep Med 1980; 24: 141-45. 3. McBride WH, Mason KA, Davis C, Withers HR, Smathers JB. Adhesion formation in experimental chronic radiation enteropathy. Jnt J Rad Oncol Biol Phys 1989; 16: 737-43. 4. Ellis H. The causes and prevention of intestinal adhesions. Br J Surg 1982; 69: 241-3. 5. Menzies D, Ellis H. Intraabdominal adhesions and their prevention by topical tissue plasminogen activator. J Lab Ciin Med 1989; 101: 921-9. 6. Ar'Rajab A, Ahren B, Rozga J, Bengmark S. Phosphatidylcholine prevents postoperative peri­toneal adhesions. J Surg Res 1991; 50: 212-5. 7. De Cosse JJ, Rhodes RS, Wentz WB, et al. The natural history and management of radiation indu­ced injury of the gastrointestinal tract. Ann Surg 1969; 170: 369-84. 8. Duggan FJ, Sanford EJ, Rohner TJ. Radiation enteritis following radiotherapy for prostatic carci­noma. Br J Uro/ 1975; 47: 441-4. Postirradiation intraabdominal adhesions 9. Roswit B, Malsky 11, Reid CB. Severe radiation injuries of the stomach, small intestine, colon and rectum. Am 1 Roentgenol 1972; 114: 460-75. 10. Galland RB, Spencer 1. Radiation enteritis. Ed­ward Arnold 1990. 11. McBride WH, Mason K, Withers R, Davis C. Effect of interleukin 1, inflammation, and surgery on the incidence of adhesion formation after abdo­minal irradiation in mice. Cancer Res 1989; 49: 169-73. 12. Grahame GR, Torchia MG, Dankewich KA, Fer­guson IA. Surface active material in peritoneal eftluent of CAPD patients. Buli Periton Dial 1985; 5: 109-11. 13. Snoj M, Ar'Rajab A, Arhen B, Bengmark S. Effect of phosphatidylcholine on postoperative adhesions after small bowel anastomosis in the rat. Br 1 Surg 1992; 79: 427-9. 14. Snoj M, Ar'Rajab A, Arhen B, Larson K, Beng­mark S. Phospholipase resistant phosphatidylcho­line reduces intraabdominal adhesions induced by bacterial peritonitis. Res Exp Med 1993 in press. Radio[ Oncol 1993; 27: 52-3. Notices Notices submitted for publication should contain a mailing address and phone number of a contact person or department. Role of radiotherapy in the management of cancer The ESTRO teaching course will take place in Prague, Czecho-Slovakia, October 3-7, 1993. Contact the ESTRO Secretariat -University Hospi­tal St. Rafael, Radiotherapy Department, Capucijnen­voer 35, 3000 Leuven, Belgium; or call + 32 16 33-64-13. Fax: + 32 16 33 64 28. Basic clinical radiobiology The ESTRO teaching course will take place in Tours, France, October, 1993. Contact the ESTRO Secretariat -University Hospi­tal St. Rafael, Radiotherapy Department, Capucijnen­ voer 35, 3000 Leuven, Belgium; or call + 32 16 33-64-13. Fax: + 32 16 33 64 28. Psycho-oncology The ESO training course "5th psycho-oncology update: psychosocial factors in morbidity and mortality" will take place in New York, USA, October 2-4, 1993. Contact CME office-MSKCC / 1275 York Avenue, 10021 New York, USA; or call + 1 212 6396754. Fax: + 1 212 7173140. Breast cancer The ESO course will be held in Orla San Giulio, Italy, October 4-8, 1993. Contact European School of Oncology, Via Vene­zian, 18 20133 Milan, Italy; or call + 39 2 70635923 or 2364283'. Fax: + 39 2 2664662. Publishing Contact European School of Oncology -Athens Office, 2 Adrianiu St. & Papada ST., 118 25 Athens, Greece; or call + 30 1 6496 620. Fax: + 30 1 6924 372. Therapeutic radiology and oncology The annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) will be held in New Orleans, L. A., USA, October 11-15, 1993. Lymphomas The ESO training course for the Balkans and Middle East will be held in Athens, Greece, October 18-22, 1993. Contact European School of Oncology -Athens Office, 2 Adrianiu St. & Papada ST., 118 25 Athens, Greece; or call + 30 1 6496 620. Fax: + 30 1 6924 372. Cancer clinical trials The ESO training course jointly organised with EORTC will take place in ... , October 18-22, 1993. Contact European School of Oncology -Brussels Office, Avenue Mounier, 83, 1200 Brussels; or call + 32 2 7724 621. Fax: + 32 2 7726 233. Growth factors The ESO seminar "Growth factors: from basic science to the clinic" will be offered in Venice, Italy, October 19-21, 1993. Contact European School of Oncology, Via Vene­zian, 18 20133 Milan, Italy; or call + 39 2 70635923 or 2364283. Fax: + 39 2 2664662. Radiation oncology The Annual Meeting of the Austrian Society for The ESO training course for the Balkans and Middle Radia ti on Oncology, Radiobiology and Medica! Ra­ East titled "the scientific writer, editor, referee or diophysics will be held in Linz, Austria, October publisher" will take place in Athens, Greece, October 23-24, 1993. 6-9, 1993. Notices Contact Dr. J. Hammer, Barmherzige Schwestern, Linz, Austria; or call + 43 732 7677 ext. 7320. Fax: + 43 732 7677 ext. 7200. Clinical oncology & cancer nursing The 7th European conference will take place in Jeru­salem, Israel, November 13-19, 1993. Contact FECS Secretariat, ECCO-7, Dept of Ra­diotherapy, University Hospital St Rafael, B-3000 · Leuven, Belgium; or call + 32 16 33-64-13. Fax: + 32 16 33 64 28. The 12th annual ESTRO meeting The meeting will be held during ECCO-7 in Jerusalem, Israel, November 13-19, 1993. Contact the ESTRO Secretariat, Radiotherapy De­partment, University Hospital St Rafael, B-3000 Leu­ven, Belgium; or call + 32 16 33-64-13. Fax: + 32 16 33 64 28. Cancer "llth The Asia Pacific Cancer Conference will be offered in Bangkok, Thailand, November 16-19, 1993. Contact Phisit phanthumachinda, Oncological So­ciety of Thailand, 5th Floor, National Cancer Institute, Rama VI Rd., Bangkok, Thailand 10400. Fax: + 66 2 24 79 428. Radiology The 79th Scientific Assembly and Annual Meeting of the Radiological Society of Norih America (RSNA) will take place in Chicago, USA, November 28 to December 3, 1993. Contact the RSNA Secretariat 2021 Sprong Road, Ste. 600, Oak Brook, IL 60521, USA; or call 708 571 2670. Fax: 708 571 7837. Acknowledgment Unit of Nuclear Medicine of the Institute of Oncology, Ljubljana, Slovenia, is very grateful to Professor Doctor Bojan Varl from Ljubljana, Slovenia, and to Professor Doctor Otto Eber from Graz, Austria, far their gift-Medica[ isotope spectrometer MIS 002/50 ( BITT NUCLEAR) with computer and printer support. FIRST ANNOUNCEMENT 2nd Central European Conference on Lung Cancer LUNG CANCER -BIOLOGY AND CLINICAL ASPECTS LJUBLJANA -SLOVENIA April 13-16, 1994 Sponsored by The International Association for the Study of Lung Cancer Organized by Slovenian Surgical Association Slovenian Respiratory Society Slovenian Cancerologic Association WELCOME MESSAGE Dear Colleagues, Slovenia has the honour to host and organize the 2nd Central European Conference on Lung Cancer under the auspices of the International Organization for the Study of Lung Cancer. The Conference will take place in Ljubljana on April 13 to 16, 1994. The aim of the meeting is to bring together in a stimulating and agreeable environment researches and clinicians from Europe concerned with various pro­blems of lung cancer. Plenary lectures given by invited speakers from distinguished medica! schools will throw light on the state of the art in ali aspects of lung cancer. Specialists in different disciplines will report their experience and results. Colleagues involved in the diagnosis, therapy and epidemiology of the disease, as well as those working in biology, pathology and other related fields are invited to participate. The Conference will be held in a modern Congress centre in Ljubljana, the capital of our young independent Republic of Slovenia. The Organizing committee will spare no effort to make your attendance professionally and socially rewarding. Our objectives are to provide you with an opportunity to update your knowledge, present the results of your research and clinical work, and meet colleagues in a pleasant, relaxed atmosphere. We hope to welcome you to our Conference in Ljubljana and look forward to showing you our lovely country, situated in the south of Central Europe, on the sunny side of the Alps, touching the Mediterranean. J. Orel Chairman of the Organizing Committee Organizing Committee Chairman J. Orel Secretary M. Bitenc Treasurer M. Sok Epidemiology of Jung cancer Biological aspects Immunological aspects Experimental aspects and research Screening methods Staging of Jung cancer Pathology and cytology Early detection Diagnostic methods Diagnostic imaging Endoscopic techniques Invasive diagnostic methods Laser endoscopy in lunger cancer Evaluation of patient for surgery Members B. Hrabar V. Kovac T. Rott F. Šifrer S. Vidmar Main Topics Surgery of NSCLC Radiation therapy of NSCLC Chemotherapy of NSCLC Multimodality treatment of NSCLC Immunotherapy of NSCLC Brachytherapy of Jung cancer Chemotherapy of SCLC Radiation therapy of SCLC Indications for surgery of SCLC Treatment of secondary Jung cancer Surgery for lung metastases Therapy of Jung cancer in the elderly Quality of lite after surgery Prevention of Jung cancer Conference Dates Conference Venue Conference Language Secretariat Conference Organizers General Information April 13-16, 1994 CANKARJEV DOM Cultural and Congress Centre Prešernova 10 61000 Ljubljana, Slovenia English J. Orel (Chairman) M. Bitenc (Secretary) Department of Thoracic Surgery Medica! Centre Zaloška 7 61105 Ljubljana, Slovenia Tel.: + 38 61 317 582 Fax: + 38 61 116 006 Telex: 062 31499 Yuklicen CANKARJEV DOM Congress Department Prešernova 10 61000 Ljubljana, Slovenia Tel.: + 38 61 210 956 Fax: + 38 61 217 431 BLED -SLOVENIA 2nd Congress o/ the European Bioelectromagnetics Association December 9-11, 1993 The goal of the Congress is to bring together a multidisciplinary, international group of researchers, clinicians, engineers and manufacturers engaged in ali aspects of electromagnetic fields and currents interaction with living systems. Tentative topics ofthe Congress are (but not limited to) Oncology, Immunology, Soft tissue & Nerve regeneration, Bone & Cartilage, Clinical applications, Epidemiology, Health risk effects, Devices & technology, Fundamental mechanisms and Theory & models. The Congress will serve as the platform for presentation of the latest research and clinical results, establishment of guidelines for future development and improvement of scientific co-operation. Presented contributions will be printed in Transactions of the Congress which will be available at the site. The selection of the papers will be published afterwards in a peer-reviewed journal indexed in Current Contents. Researchers, clinicians, engineers and manufacturers working or interested in the field of bioelectromagnetics are invited to participate in the Congress. For more information please do not hesitate to contact Secretariat -E.B.E.A. Congress Faculty ofElectrical and Computer Engineering University ofLjubljana Tržaška 25 61000 Ljubljana SLOVENIA Phone: +386 1 265 161 Fax: +386 1 264 990 IMPORTANT DATES Submission of abstracts: 15th July 1993 Notification of acceptance: 15th September 1993 Early registration: 15th October 1993 Prestilix DRS Advantx AFM Vectra GENERAL ELECTRIC CGR : Zagreb, Croatia Tei: /041) 43 71 59-Fax: /041) 42 55 12 WJ NAJ BO ZDRAVLJENJE MALIGNIH BOLEZNI MANJ NEPRIJETNO Novo zdravilo za preprecevanje bruhanja in slabosti Skraišana infarmaciia a preparatu: lndikaciie: Slabost in bruhanje povzroceno s kemoterapijo oli z radioterapijo. Dozira.nie: Odrasli: Visokoemetageno kemoteropiia: Dozo po 8 mg s pocasno iv. iniekcijo neposredno pred kemoterapijo in še dve iv. dozi po 8 mg v presledku po dve do štiri ure, ali nepretrgana inluziia l mg/uro do 24 ur. Za zašcito pred zakasnelim bruha­niem, po preteku prvih 24 ur, nadaljuiemo z oralnim dajanjem Zofrana po 8 mg 2-krat dnevno do 5 dni po ciklusu zdravljenja. Emetogena kemoterapiia in radioterapiia: Zolran po 8 mg dajemo v pocasni iv. injekciji neposredno pred ciklusom zdravljenja ali oralno eno do dve uri pred ciklusom in nadaljujemo z oralnim dajanjem po 8 mg vsakih dvanaist ur. Za zašcito pred zakas­nelim bruhanjem, po preteku prvih 24 ur, nadaljujemo z oralnim dajanjem Zolrana po 8 mg 2-krat dnevno do 5 dni po ciklusu zdravljenja. Otroci: Otrokom dajemo eno iv. injekcijo po 5mg/m2 neposredno pred kemoterapijo in 12 ur kasneje nadaljujemo z dozo po 4 mg oralno. Dajanje po 4 mg 2-krat dnevno nadaliujemo do 5 dni po ciklusu zdravlienja. Kontraindikaciie: Preobcutljivost za katerokoli sestavino pripravka. Previdnost: Nosecnost in dojenje. Stranski poiavi: Glavobol, obcutek vrocine ali toplote v glavi in epigastriju, zaprtje, prehodno zvišanje aminotransferaz, zelo redko reakcije preobcutljivosti. Oprema: Zofran za injekcije: ampule po 2 in 4 ml v škatlicah po pet. Zolran tablete (4 mg): zavojcki po lO in 30 tablet. Zolran tablete (8 mg): zavojcki po l O in 30 tablet. Podrobnejše informacije dobite pri: Glaxo Expol1limited Predstavništvo v Ljubljani, Tržaška 132, 61 l l l Ljubljana tel. (06 l) 272 570, 272-491,fax (06 l) 272 569 Ab a kt a ampoules 400 mg (pefloxacin) A new potent drug against infections • May be given orally and parenterally • Effecive in life-threatening infections caused by nosocomial strains resistant to many drugs • May be given to patients hypersensitive to penicillins and cephalosporins • lts favourable pharmacokinetic properties allow twice-a-day dosage • 1s very well tolerated Contraindications Pefloxacin is contraindicated in patients with known hypersensitivity to quinolones, in preg­ nant women, nursing mothers, children under 15 years of age, and patients with inborn glucose-6-phosphate dehydrogenase deficiency. Precautions During pefloxacin therapy exposure to strong sunlight should be avoided because of the risk of photosensitivity reactions. In patients with a severe !iver disorder dosage of pefloxa­cin should be adjusted. Side effects Gastro-intestinal disturbances, muscle and/or connective tissue pains, photosensitivity reactions, neurologic disturbances (headache, insomnia), and thrombocytopenia (at doses of 1600 mg daily) may occur. Dosage and administration The average daily dosage far adults and children over 15 years of age is 800 mg. Oral: 1 tablet twice daily after meals. Parenteral: the content of 1 ampoule 400 mg diluted in 250 ml of 5 % glucose as a slow 1-hour infusion twice daily. The maximum daily dosage is 8 mg of pefloxacin per kg body­weight. In severe hepatic insufficiency pefloxacin is administered only once daily (jaundice), once every 36 hours (ascites), and once every 48 hours (jaundice and ascites). @ lek Pharmaceutical and Chemical Company d.d. Ljubljana Klimicin ® (Clindamycin) Klimicin is an effective It stimulates the action bactericidal or of polymorphonuclear bacteriostatic as leukocytes (PMN) evidenced by the principal factors in MIC/MBC ratio. host immune system. PMN leukocyte . " , o M· Anaerobes Aerobes Bacteroides spp. (including Bacteroides fragilis) Streptococcus spp. (including Fusobacterium spp. Streptococcus pyogenes), except Propionibacterium Enterococcus Eubacterium Actinomyces spp. Pneumococcus spp. Peptococcus spp. Staphylococcus spp. (including Peptostreptococcus spp. B-lactamase producing strains) Clostridium perfringens Contraindications: In patients hypersensitive to lincomycin and clindamycin. Precautlons: Klimicin should be prescribed with caution to elderly patients and to individuals with a history of gastrointestinal disease, particularly colitis. Side Effects: Gastrointestinal disturbances (abdominal pain, nausea, vomiting, diarrhea). When significant diarrhea occurs, the drug should be discontinued or continued only with close observation of the patient. The posibility of pseudo­ membranous colitis must be ruled out. @ lek Pharmaceutical and Chemical Company d.d. Ljubljana lopami,[Q 150 -200 -300 -370 mgl/ml FOR ALL RADIOLOGICAL EXAMINATIONS MYELOGRAPHY ANGIOGRAPHY UROGRAPHY C.T. D.S.A. THE· FIRST WATER· SOtJJBLE; READ. TO llJSE NON-IONIC-CONTRAST MEDIUM Manufacturer: Distributer: Bracco s.p.a. Agorest s.r.l. Via E. Folli, 50 Via S. Michele, 334 20134 -Milan -(1) Fax: (02) 26410678 Telex: 311185 Bracco 1 Phone: (02) 21771 e 34170 -Gorizia -(1) Fax: (0481) 20719 Telex: 460690 AF-GO 1 Phone: (0481) 21711 © Eastman Kodak Company, 1990 Kodak systems provide dependable performance for advanced diagnostic imaging. Our quality components are made to work together from exposure to viewbox. Kodak X-Omat processors are the most respected in the field. Kodak X-Omatic cassettes are known the world over for unexce//ed screen-film contact and dura­bility. Kodak multiloaders have eamed an enviable reputation for reliability. The Kodak Ektascan laser printer is changing the look of digital imaging. The list goes on. There are quality Kodak products throughout the imaging chain. Equally important, they are made to work together to achieve remarkable performance and diagnostic quality. Contact your Kodak representative for more information. 1 NI injekcije im./iv., tablete, prašek za pripravo suspenzije antibiotik širokega spektra -rešitev problema bakterijske rezistence ® ampicilin, zašciten s sulbaktamom -zato odporen proti delovanju beta laktamaz . razširja antibakterijsko delovanje ampicilina na po Gramu pozitivne bakterije, ki izlocajo penicilinazo, na po Gramu negativne in anaerobne bakterije, vkljucno Bacteroides fragilis, ter tako povecuje klinicno uporabnost in ucinkovitost ampicilina ® visoko ucinkovit v ambulantnem in bolnišnicnem zdravljenju infekcij zgornjih in spodnjih dihal, secil, rodil, kože ter mehkih tkiv ® možnost oralne in parenteralne uporabe . izkljucuje potrebo po kombiniranem zdravljenju . ucinkovito preprecuje pooperativne infekcije ® dobro prenašanje .."ľ."W,.."W,...%..%..... Podrobnejše informacije in literaturo dobite pri proizvajalcu. . (. KRKt\ @ tovarna zdravil, p.o., Novo mesto, Slovenija izdelan iz aktivnih ucinkovin firme Pfizer "" """" "'.= """""""""'...................... lram81 tramadol HCI zanesljiv analgetik s centralnim delovanjem v travmatologiji in ortopediji v interni medicini Oblike: Tramal 50: 5 ampul po 50 mg tramadola/ml Tramal 100: 5 ampul po 100 mg tramadola/2 ml Tramal kapljice: 10 ml raztopine (100 mg tramadola /ml) Tramal kapsule: 20 kapsul po 50 mg tramadola Tramal svecke: 5 sveck po 100 mg tramadola Izdeluje: Bayer Pharma d.o.o. Ljubljana po licenci Griinenthal GmbH A Bristol-Myers Squibb Company Vodilni svetovni proizvajalec pripomockov za nego slome VALENCIA -STOMA MEDICAL d.o.o. Županciceva 10, 61000 Ljubljana, Slovenija Tel. 061214-959 Posvetovalnica za slomisle deluje v naših prostorih vsak delovnik med 9. in 16. uro. PHILIPS 1 1 teledirigirani univerzalni stativ, kompaktni sistem Philips Medical Systems, za rentgensko slikanje diagnosticni in terapevtski rentgenski aparati; CT, MR, ultrazvocni aparati ... DSI sistem za digitalno rentgensko slikanje prinaša številne prednosti, med drugim uporabnikom olajša delo, zmanjšuje doze, znižuje stroške in avtoteh..401et krajša preiskave AVTOTEHNA d.d. Ljubljana, Slovenska 54; telefon: (061) 320 767, telefaks: (061) 322 377 @©...b\ .[Q).ffi\W©IYWb\ Jl. lN!l... lN!l.[L@@. EiRLU L J u B L J A N A d. d. ZAUPAJO NAM NAŠI KUPCI IN DOBAVITELJI, ZNANI PROIZVAJALCI IZ TUJINE PA SO NAM ZAUPALI TUDI ZASTOPSTVA IN KONSIGNACIJE: ZASTOPSTVA IN KONSIGNACIJE: KONSIGNACIJE: -BAXTER EXPORT CORPORATION -HOECHST AG -BOEHRINGER INGELHEIM -HOFFMANN LA ROCHE -NOVO NORDISK -SANDOZ -ORTHO DIAGNOSTIC SYSTEMS -SCHERING & PLOUGH ­ ESSEX CHEMIE SALUS LJUBLJANA d: d. -61000 LJUBLJANA, MAŠERA SPASICEVA 10, TELEFON: N.C. (061) 181-144, TELEFAX: (061) 181-022 Visokoucinkovit, varen in preskušen oralni cefalosporinski antibiotik druge generacije . .· ·· ., .® kapsule, suspenzija cefaklor u'f, Spekter Taracefa zajema vecino po Gramu pozitivnih in po Gramu negativnih mikroorganizmov. Odlikuje ga mocno inhibicijsko delovanje na Haemophilus influenzae in druge povzrocitelje dihalnih infekcij. Hrana bistveno ne moti absorpcije Taracefa. Taracef dobro prodira v tkiva in telesne tekocine, kjer hitro doseže terapevticne koncentracije. Taracef zagotavlja uspešno zdravljenje dihalnih, urinarnih in kožnih infekcij. Varen in preskušen je tudi v pediatriji. Bolniki ga odlicno prenašajo. ,I' # ill Podrobnejše informacije in literaturo dobite pri proizvajalcu. f .. l(RK. tovarna zdravil, p.o., Novo mesto, Slovenija Cigaletova 9, Ljubljana Tel.: 061/317-355, 133-231 Fax: 061/325-395, 132-147 Telex: 31668 ZNANJE IN IZKUŠNJE • STROKOVNO IZOBRAŽEN KADER • RACUNALNIŠKO PODPRT INFORMACIJSKI SISTEM • 40-LETNA TRADICIJA ZAUPANJE • REFERENCE • TRAJNE POGODBE O POSLOVNEM SODELOVANJU PRIZNANI TUJI PARTNERJI KODAK, AGFA GEVAERT, POLAROID, 3M, NICHOLAS, BYK GULDEN, MAVIG, CAWO, SIEMENS, GENERAL ELECTRIC • rentgenski filmi in kemikalije • kontrastna sredstva • rentgenska zašcitna sredstva • rentgenski aparati, stroji za avtomatsko razvijanje in druga oprema za rentgen POKLICITE IN VPRAŠAJTE NAS, Ml PA VAM BOMO SVETOVALI IN NAŠLI NAJUSTREZNEJŠO REŠITEV. Antibiotik z izrednimi farmakokineticnimi lastnostmi Sumamed® azitromicin ... po resorpciji azitromicin hitro prehaja iz seruma v tkiva, kjer na mestu vnetja dosega visoko koncentracijo. Posledica dalj casa prisotnih visokih koncentracij v tkivih je kontinuirano baktericidno delovanje na patogene mikroorganizme ... s tem je mogoce pojasniti izredno terapevtsko ucinkovitost azitromicina. Oprema: kapsule 250mg tablete 125 mg in 500 mg sirupi 100mg/5ml in 200mg/5ml PLIVA p.o. ZAGREB Marketing farmaceutike m PLIVA LJUBLJANA d.o.o. 61000 Ljubljana, Poljanski nasip 28 telefon: (061) 322-660, telefaks: (061) 302-850 Y our Partner in Radiology ACTIV A International Sri Tel. 040-212856 Via di Prosecco, 2 Telefax 040-213493 34016 Opicina -Trieste Telex 460250 I Italy veterinarske ustanove vecino svojih nakupov opravijo pri nas. Uspeh našega poslovanja temelji na kakovostni ponudbi, ki pokriva vsa podrocja humane medicine in veterine, pa tudi na hitrem in natancnem odzivu na zahteve naših kupcev. KEMOFARMACIJA -VAŠ ZANESLJIVI DOBAVITELJ! KEMOFARMACIJA Veletrgovina zo oskrbo zdravstvo, p.o. / 61001 Ljubljano, Cesto na Brdo 100 Telefon: 06 l 268-145 / T elex: 31334 KEMFAR / T elefox 271-362 TOSAMA Tovarna sanitetnega materiala p.o. 61230v Domžale p.p. 128 Vir, Saranoviceva 35 telefon: (061) 714-611 telefax: (061) 714-660 telex: 39-804 IZDELUJE: SANITETNI PROGRAM -tkane, rezane, elasticne povoje -mavcne in sadrona povoje -sanitetno mrežo Virfix -konfekcionirano gazo -konfekcionirano vato -celulozno vato in izdelke -obliže -sanitetne torbice, omarice -avtomobilske in motorske apoteke PROGRAM IZDELKOV ZA OSEBNO HIGIENO -higienski vložki VIR -higienski tamponi VIRTAMP higiensko in cik-cak vato -Jasmin vato -Jasmin blazinice -bebi palcke OTROŠKI PROGRAM -tekstilne plenice -nocne plenice TOSAMA -hlacne plenice SAMO Super bebi plenicne predloge -povijalne rutice -zašcitne hlacke PROGRAM MEDICINSKE PLASTIKE -Virko! vrecke -urinske vrecke VIRTEKS PROGRAM -posteljno perilo -zdravniške maske -kape -bolniške, ortopedske, zdravniške -operacijski plašci, halje, predpasniki -prevleke za obuvala -rute za operirance -operacijska pregrinjala INKO PROGRAM -Inko podloge -Inko povijalne rute -Inko hlacke -podloge za bolnike PROGRAM IZDELKOV ZA DOM -vecnamenska krpa Bistrica polirna vata -vrteks -vrtnarska vlaknovina Radio/ Oncol 1993; 27: 78 Instructions to authors The journal Radiology and Oncology publishes ori­ginal scientific papers, professional papers, review ar­ticles, case reports and varia (reviews, short communi­cations, professional information, ect.) pertinent to diagnostic and interventional radiology, computerised tomography, magnctic resonance, nuclear medicine, radiotherapy, clinical and experimental oncology, ra­diobiology, radiophysics and radiation protection. Submission of manuscript to Editorial Board implics that the paper has not bcen published or submitted for publication elsewhere: the authors are responsible for ali statements in their papers. Accepted articles become thc property of the journal and therefore cannot be published elsewhere without written permis­sion from the Editorial Board. Manuscripts written in English should be sent to the Editorial Office: Radiology and Oncology, Institute of Oncology, Vrazov trg 4, 61000 Ljubljana, Slovenia; Phone; +38 61314 970; Fax: +38 61329 177. Radiology and Oncology will consider manuscripts prepared according to the Vancouver Agreement (N Engl J, Med 1991; 324: 424-8.; BMJ 1991; 302: 6772.). Ali articles are subjected to editorial review and review by two indcpendent refcrces selected by the Editorial Board. Manuscripts which do not comply with the technical requirements stated herc will be returned to the authors for correction before the review of the referees. Rejected manuscripts are gene­rally returned to authors, however, the journal cannot be held responsible for their loss. The Editorial Board reserves the right to require from the authors to make appropriate changes in thc content as well as gramma­tical and stylistic corrections when necessary. The expenses of additional editorial work and requests for reprints will be charged to the authors. General instructions: Type the manuscript double spa­ced on one side with a 4 cm margin at the top and left hand side of the sheet. Write the paper in grammati­cally and stylistically correct language. Avoid abbrevia­tions unless previously explained. The technical