Biomedical subjects
Publications and source records attributed to A M Marchevsky.
A 60-year-old woman with a mediastinal carcinoid of probable thymic origin, widely metastatic, had associated parathyroid hyperplasia, medullary carcinoma of thyroid with amyloid stroma and an adrenal neuroma. This case demonstrated features of an incomplete Sipple's syndrome (MEA II). The relationship of these diverse tumors is consistent with the concept of the APUD system and neurocristopathies.
The case of a 44-year-old woman wih bilateral ovarian malignancies in association with endometriosis is presented. A carcinosarcoma was present in the right ovary, and a well-differentiated endometrioid carcinoma in the left ovary. This case is, to the authors' knowledge, unique.
OBJECTIVE: To provide a detailed discussion of the aetiology and pathophysiology of hiatal hernia in both humans and small animals, and review current medical and surgical treatments. DESIGN: Review article. SUMMARY: Hiatal hernia is not completely understood in humans or animals. It has a complex multifactorial aetiology and pathophysiology. A primary disturbance of the lower oesophageal sphincter has not been shown in humans or animals. Knowledge of pathophysiology is necessary to institute appropriate treatment. Medical and/or surgical therapy is not indicated in asymptomatic cases. Medical treatment should be used for up to 1 month in stable cases of sliding hiatal hernia. Paraoesophageal hiatal hernias and any large sliding hiatal hernia should be considered for prompt surgical treatment. Surgical techniques used depend on the type of hiatal hernia present. Surgical treatment of hiatal hernia cases should be performed by experienced surgeons, and must include hiatal closure and gastropexy. The Nissen fundoplication procedure has been discontinued in the veterinary field due to poor success rates, coupled with the published view that there is a marked difference in pathophysiology between humans and dogs. Reported complications associated with the original Nissen fundoplication technique are identical in the human and veterinary literature. There have been no complications reported with use of the modified or 'floppy' Nissen fundoplication in dogs. Both oesophagopexy and Nissen fundoplication require further evaluation in small animals.
Forty-two bronchial brushing cytology specimens were evaluated by a video-based computerized interactive morphometry (CIM) system with an interactive peripheral consisting of a touch-sensitive screen mounted over a high-resolution video monitor. The system was programmed to allow a trained observer to rapidly measure nuclear and cytoplasmic profile diameters of randomly selected cells and to calculate their nuclear-cytoplasmic ratios. The specimens included 13 cytologic slides with no malignant cells present, 14 with non-small cell carcinoma cells and 15 with small cell carcinoma cells. The cases were divided into two groups: a training set composed of slides with "known diagnosis" and a test set of slides with "unknown diagnosis". A data set was constructed with the measurements from the cases with "known diagnosis," and an algorithm that allowed the classification of cases by hierarchical analysis was developed. The data was also analyzed with statistical methods of classificatory discriminant analysis. Utilizing the information in the data base, the slides with "unknown diagnosis" were classified individually; all cases were correctly classified by the procedures. Potential applications of CIM in cytology are discussed.
A morphometric study of cytologic preparations from patients with benign and malignant (mesothelioma and carcinoma) pleural effusions is reported. The routine cytologic smears from these specimens were studied with a new system of video-based computerized interactive morphometry (CIM) that allows the measurements of real-time images of cell profiles by the simple procedure of touching the two extreme points of a diameter of interest on a touch-sensitive screen. For each cell, the nuclear profile diameter (NPD) and the cytoplasmic profile diameter (CPD) are measured and categorized into classes with 2-microns intervals; the NPD/CPD ratio is also calculated. The mean NPD is calculated for the specimen after measurement of 100 cells. The data were interpreted by two independent methods: a statistical method of discriminant analysis that classifies the lesions as benign, carcinoma or mesothelioma and provides a probability statement of membership in a particular diagnostic class and an ad-hoc algorithm that categorizes the effusions as benign or malignant based on hierarchic analysis. A data base derived from study of the first 24 cases was constructed and utilized for the test classification of the second 24 cases, which were treated as specimens of unknown diagnosis. The discriminant analysis correctly classified 21 of the 24 test cases into their proper diagnostic groups. The algorithm for a computer-generated pathologic diagnosis correctly identified 47 of the 48 cases as benign or malignant. The technical advantages of video-based CIM over the existing morphometric methods are discussed.