[The histogenesis of stomach cancer].
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Biomedical subjects
Publications and source records attributed to E A Dikshteĭn.
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Vascular bed of the infiltrating mammary gland carcinomas characterized by the incomplete maturity, atypia and polymorphism is studied electron microscopically. Two groups of vascular structures were investigated: avascular part represented by pseudovessels and vascular part with protocapillaries, capillaries, sinusoids and venulae that are distinguished by their morphofunctional properties and the degree of maturity. The vascular bed is characterized by a structural and functional heterogeneity. Ultrastructural properties characterizing the stages of the vascular bed morphogenesis are presented: angiogenesis activation, relative vascular differentiation and regression of some parts which occur asynchronically and are due to the properties of the stromal parenchymal relations in different microareas, and to the heterogeneity of the tumour on the whole.
One case of chronic histoplasmosis of the lung and intrathoracic lymph nodes with subsequent generalization of the disease resulting in the death from the intoxication is described. Clinically, the diagnosis of lung carcinoma was established.
The description of one observation. Female patient was operated on because of presupposed peripheral lung tumour. The lack of changes in other organs allows to consider the local tumour-like amyloidosis as a primary process.
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Upon the analysis of 50 cases of cancer of the stomach, the authors compared the size and composition of stromal cellular infiltrate, the size of active vascular bed in the tumor, mitotic activity of the tumor cells, the severity of regression in adenocarcinomas and signet ring cell polymorphocellular carcinoma of the stomach. The authors established the necessity of a comprehensive investigation of the tumor parenchyma and specificities of parenchymal blood supply for determination of local immune response in the tumor in relation to its efficiency.
The major components of tumor stroma and parenchyma are described and their reciprocal influences are demonstrated. A scheme of parenchyma-stroma relationships is proposed. Knowledge of how the stromal and parenchymal components of a tumor relate to one another is of considerable diagnostic and prognostic value, for it leads to a better understanding of the nature of tumor growth and of the tumor-host relationships.
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The paper is concerned with clinico-laboratory correlations and assessment of short- and long-term results of glucocorticoid therapy (GCT) in 137 patients with diffuse mesangioproliferative glomerulonephritis (DMPGN). It may have different clinical variants and is characterized by a relatively favorable course in the first 10 yrs. A good clinical effect of GCT was observed only in some patients with the nephrotic variant of DMPGN in the absence or presence of insignificant fibroplastic changes, and in the absence or presence of the moderate tubulointerstitial component. In patients with a latent variant of DMPGN GCT made no considerable effect on the clinical symptoms of disease. The 15-year survival in patients on GCT was slightly higher (insignificant statistical difference) than that in patients receiving symptomatic treatment only.
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Proceeding from the results of a study of 139 patients suffering from primary gout with kidney involvement the authors have defined 4 clinicomorphological types of nephropathy which differed both in their course and prognosis. The I proteinuric type was characterized by early signs of stable proteinuria, sometimes with the development of the nephrotic syndrome in which a morphological study revealed mainly glomerular changes. The II urolithic type was characterized by the appearance of renal colics at the onset of nephropathy, frequently with the passage of concrements (a morphological study revealed mainly tubular and stromal lesions). The III hypertensive type was characterized by the appearance of persistent arterial hypertension (a morphological study revealed mainly vascular and interstitial changes). The IV latent type was characterized by the absence of or a transient urinary syndrome (a morphological study showed mainly interstitial changes). The first signs of renal failure in these types of nephropathy developed, on an average, 7, 15, 11 and 12 years later, the 20-year survival was 24, 92, 68 and 100%, respectively.
Kidney biopsies from 18 patients with primary gout were studied. Glomerular changes were found in all cases along with alterations in tubuli and vessels and stromal sclerosis. They were characterized by local thickening of basal membranes of capillaries, increase in the mesangial matrix, focal or diffuse proliferation of mesangial and endothelial cells of various degree of severity. Proliferation and activation of endothelial cells, mesangiocytes, podocytes, signs of podocyte damage, were found electron-microscopically. Subendothelial lucid zones were observed in the basal membrane, possibly at the site of uric acid deposits. The above described alterations resemble those in focal mesangio-capillary or mesangial proliferative glomerulonephritis.
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Immunocompetent cells were studied in the stroma and epithelium of 34 cases of mammary gland dysplasia. The following stainings were used for light microscopy: hematoxylin and eosin, methods of Brachet, van Gieson, Romanovsky-Giemsa, hallocyanine alums, Gomori, PAS-reaction as well as the determination of acid and alkaline phosphatases, glucose-6-phosphate and succinate dehydrogenase were used. 14 cases were studied ultrastructurally. Two types of small B lymphocytes and one type of large lymphocytes, stromal macrophages are described. Their morphofunctional characteristics is given and their properties in proliferating and non-proliferating fibroadenomatosis are shown. Interaction of intraepithelial large granular lymphocytes (normal killers) with immature epithelial cells resulting in the death of these epitheliocytes is described. The results obtained are regarded as a morphological manifestation of the immune surveillance.
Morphological changes in the lung artery and its branches were studied in 20 autopsy cases with carcinoma metastasis into the lung. Certain general lesions in the arteries, such as alteration and sclerosis of their walls due to intoxication and hypoxia as well as local changes in the form of allergic arteritis were detected. Immune genesis of the allergic arteritis is assumed, being a local allergic reaction to the tumour cells in the lumen of blood and lymph vessels. The importance of morphological changes in the lung vessels in the development of cardiopulmonary insufficiency in cases of various carcinomas with lung metastasis is demonstrated.