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L L Kapuller

Publications and source records attributed to L L Kapuller.

At least 19 recordsLinked to original sources
PubMed2005

[Modification of Svenson's biopsy of rectal wall in diagnosis of malformations of intramural nervous system in adults].

Thirty-five autopsied specimens of rectum's distal part and anal canal part were studied. It was revealed that length of physiological hypogangliosis zone ranged from 7.5 to 50.0 mm (mean 24.4+/-10.9 mm). With regard to this wide range the modification of transanal Svenson's biopsy of rectal wall was proposed for diagnosis of malformations of intramural nervous system of the colon. The method was used in 21 patients with megacolon. The results demonstrate accuracy and safety of this diagnostic method.

Adult↗
PubMed1995

[Differential diagnosis of non-epithelial rectal neoplasms].

Experience in the treatment of 118 patients with nonepithelial new growths of the rectum has been accumulated at the Scientific Research Institute of Proctology in the period from 1970 to 1991. They accounted for 1.5% of all benign and malignant tumors of this organ. Leiomyoma was diagnosed in 44, leiomyosarcoma in 18, lipoma in 30, fibroma in 17, neurinoma in 7 and rhabdomyoma in 2 of these patients. A differential diagnosis was made between benign and malignant tumors, as well as with other nonepithelial new growth of the rectum. On the basis of the clinical picture and the results of digital and instrumental (radiological, endoscopic, and ultrasonic) examination of the rectum the correct preoperative diagnosis may be established with certain probability. This influences directly the choice of the volume of the operative intervention in various types of nonepithelial rectal tumors. Morphological verification of the tumor is the principal method of examination in establishing the differential diagnosis in the preoperative and postoperative periods.

Adult↗
PubMed1994

[Long-term results of formation of smooth muscle sphincter in the perineal colostomy area in patients after rectal extirpation].

The authors discuss an original method for formation of a smooth-muscle cuff from the wall of a pulled-through colon in the region of a perineal colostoma. It was applied in 89 patients who had undergone extirpation of the rectum for malignant neoplasms. The smooth-muscle sphincter was formed during removal of the rectum in 72 patients and no earlier than 2 years after the extirpation in 17 patients. Inflammatory complications developed in the region of the perineal colostoa in the early postoperative period in 13.5% of cases. They were due to necrosis of the distal part of the pulled-through intestine in 3.4% of cases. There were no fatal outcomes. The late-term results were studied in follow-up periods of up to 7.5 years. Satisfactory functional results were produced in 83% of the patients. Physiological examination showed the presence of a functioning sphincter in the region of the perineal colostoma.

Adult↗
PubMed1992

Distribution of individual components of basement membrane in human colon polyps and adenocarcinomas as revealed by monoclonal antibodies.

Double-label immunofluorescence was used to monitor basement-membrane composition and integrity in 22 human colon polyps, 36 adenocarcinomas and 2 metastases. Cryostat sections were stained with polyclonal anti-laminin anti-serum combined with monoclonal antibodies (MAbs) to all major basement-membrane components (laminin, entactin/nidogen, collagen type IV and large heparan sulfate proteoglycan), as well as to keratin 8. In all adenocarcinomas, including mucinous, basement membranes were altered more at the invasive front than in the parenchyma. The degree of this alteration was inversely correlated with the level of tumor differentiation. An uncoordinated loss of basement membrane components (dissociation of markers), previously described by us in rat colon adenocarcinomas, was also found in human tumors. In the great majority of adenocarcinomas a pronounced stromal reaction was seen. It was manifested by the presence of fibrillar deposits of basement-membrane components, mainly of collagen type IV and/or heparan sulfate proteoglycan. This reaction was never observed in polyps and may be derived from myofibroblasts reported to accumulate in colon cancer stroma. The combined use of antibodies to basement-membrane components and to a specific keratin may constitute an adequate immunohistochemical test for the presence of invasion, and may be useful in the histologic analysis of polyps, especially in dubious cases.

Adenocarcinoma↗
PubMed1992

Surgical treatment of benign, myomatous rectal tumors.

Between 1972 and 1990, 36 patients with leiomyoma of the rectum underwent surgery at the Proctology Institute (Moscow). There were 13 male (36.1 percent) and 23 female (63.9 percent) patients. Their median age was 52.1 years. Electroexcision of the tumors measuring below 1 cm was performed through the endoscope in 12 patients. Leiomyomas with a diameter of 2.5 to 5 cm were removed transanally in 10 patients. Six patients underwent excision of the tumor through the pararectal approach, whereas leiomyomas located in the rectovaginal wall were removed through the vagina in one patient. Abdominoperineal extirpation and abdominoanal resection of the rectum was performed in seven patients with tumors measuring from 8 to 20 cm. Recurrences were noted in nine patients after transanal, pararectal, or transvaginal excision of leiomyomas. In seven of them, malignant transformation of the tumor occurred at terms ranging from 9 months to 9.5 years.

Adult↗
PubMed1992

[The surgical treatment of benign smooth-muscle tumors of the rectum].

From analysis of the surgical treatment of 36 patients with rectal leiomyoma the authors suggest and substantiate the indications for various types of operative interventions according to the size and location of the tumor. The late-term results of the treatment were studied in all patients who underwent surgery and a brief review of literature on the methods of diagnosis and surgical management of benign smooth-muscle tumors of the rectum is given.

Adult↗
PubMed1992

[Morphologic characteristics of microadenomas of the large intestine].

Tissue and cellular atypia, changes of the mucus chemical composition, protein secreting function, ATPase activity, differentiation of the epithelial cells and DNA replication with the widening of proliferation zone were registered morphologically in colon microadenomas. A pronounced increase of labelled small lymphocytes capable of proliferation is observed in the stroma. Fibrocytes are practically absent, fibroblasts are represented by young 3H-labelled forms. All these changes are considered as dysplastic.

Adenoma↗
PubMed1991

[Hyperplastic changes in the mucosa in colon cancer].

67 segments of rectum and sigmoid removed surgically because of carcinoma were examined: the surface of intestinal mucosa stained with methylene-blue was studied in order to determine the number and localization of focal changes in the macroscopically unchanged areas. Colon microscopy was performed clinically in 24 patients with carcinoma of the rectum and in 24 control individuals. 28 hyperplastic polyps and 1037 microscopic hyperplastic foci were found in operative material. An active metabolism is established by means of electron autoradiography in the cells of hyperplastic focus. Areas of dysplastic epithelium were rarely found in big hyperplastic polyps. Areas of diffuse hyperplasia (transitional mucosa) with crypt deepening and presence of a high number of goblet cells were found near tumour. A certain role of hyperplastic processes in carcinogenesis is forwarded. Numerous microscopic changes in the mucosa epithelium may testify against the carcinoma development de novo.

Adult↗
PubMed1989

Microendoscopic features of the surface epithelium in patients with colonic tumors.

Vital studies of the colonic mucosa in 127 patients using the method of colonomicroscopy have allowed us to establish that the surface epithelium has a heterogeneous structure. It was possible to single out three main types of cell organization. Correlation has also been detected between types of cell organization of surface epithelium and morphological structure of the most common neoplasms of the colon.

Adult↗
PubMed1988

[Morphostatistical characteristics of adenomas of the large intestine based on the data from 1915 autopsies].

Large intestine polyps have been revealed in 1372 cases of 1915 autopsies. 4.1% of these have been hyperplastic polyps, 86.2% tubular adenomas, 11.1% tubular-villous and 2.7% villous adenomas. Solitary adenomas have been less frequent than multiple one (42 vs. 58%). The adenomas have been equally incident in the right and left portions of the large intestine, but they have been larger and characterized by a higher degree of epithelial dysplasia in the sigmoid and rectum. Malignant adenomas made up 0.8% of the total number of tumors. Adenomas have been revealed twice more frequently in the patients who died in hospital than in the group of forensic medical autopsies. Multifactorial analysis has demonstrated a correlation between adenoma detection rate and some chronic diseases.

Adenoma↗
PubMed1988

[Morphogenesis of polyps in diffuse polyposis of the colon].

Sixty operative specimens of the colon or its fragments removed for diffuse juvenile polyposis (the diagnosis was clinical) were evaluated morphologically. A structural study of the polyps ranging in size from the smallest to large lobular formations elicited a significant role of inflammation in polyp morphogenesis. Large polyps often show fragments of typical adenomatous structure. These adenomatous sites mark a higher risk of malignant transformation which develops in polyps of mixed structure in diffuse juvenile colon polyposis. Structurally, there are more reasons for referring juvenile polyps to adenomas than to hamartomas.

Adenocarcinoma↗
PubMed1987

[Cancer of the small intestine at the site of an ileostomy].

A rather rare case of tubular-villous adenoma located on the small intestine mucosa in the ileostomy area and its transformation into adenocarcinoma is described. The patient had undergone previously a two-stage colectomy for a giant creeping large intestinal tumor with malignancy in the left and right colic flexure and in the rectum 7 cm apart from the anal margin. Adenocarcinoma of the small intestine developed 5 years later in the ileostomy zone. Ileostomy was reconstructed with the excision of 15 cm of the small intestine. The tumor structure at the site of ileostomy was that of adenocarcinoma, and it infiltrated the muscular layer of the small intestinal wall.

Adenocarcinoma↗
PubMed1986

Results of the removal of malignant colonic polyps.

Two-hundred-and-twenty-six patients, aged 26 to 80, had 238 malignant polyps removed. According to the WHO classification, only those lesions in which invasive growth is detected, are termed malignant polyps. Immediately after receiving the histological report, eight patients were operated on. Later, over periods of up to 18 months following the removal of polyps, eight more patients were operated upon for recurrences. The results of follow-up over periods of up to 10 years indicate the efficiency of endoscopic removal of malignant polyps irrespective of the grade of the invasive growth. Taking their experience as a basis, the authors suggest that the plan of approach to further stages of treatment should be based not on the pathological findings in the removed polyps, but on the results of regular follow-up of the patients.

Adult↗
PubMed1986

[Results of removal of malignant polyps of the large intestine].

As a result of endoscopic removal of 238 malignant polyps of the large bowel, malignant tumors in other parts of this organ were found in 6 out of 142 cases (67.7%) followed-up during terms ranging 6 months--10 years. More polyps in different parts of the bowel were found during operation in 27 cases. A procedure for follow-up of cases of malignant polyps is discussed. Endoscopic removal of malignant polyps of the large bowel should be used as a method of choice, particularly, in aged patients suffering concomitant grave diseases.

Adult↗
PubMed1985

[Morphological criteria of hyperplasia, dysplasia and incipient cancer of the large intestine].

Early stages of adenomas and hyperplastic polyps are observed when the surface of mucous membrane from 76 surgically removed colons was examined under binocular microscope and when biopsies obtained by means of the endomicroscope were studied. A close link between adenomatous and hyperplastic polyps is established and this may indicate the involvement of the latter in carcinogenesis. Besides this, it is shown that epithelial dysplasia in the adenomas may spread to the goblet cells this being followed by the development of peculiar clear cell adenomas which are mainly formed of the goblet cells with signs of altered differentiation. The observation of the adenoma remnants in 38% of the incipient carcinoma cases indicates the close connection between the adenomas and carcinoma.

Adenoma↗