[Correlation of immunological disorders with histological changes in Kaposi's disease].
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Biomedical subjects
Publications and source records attributed to S A Kalashnikov.
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The article presents comparative morphological data on the healing of operative wounds on the stomach of rabbits made by an ordinary, laser and ultrasound scalpels. In all the cases the wound was sutured by a one-row interrupted sero-muscular stitches. Clear distinctions in the healing of postoperative gastric wounds made by different scalpels were established. The formation of a zone of coagulative necrosis, followed by rejection of necrotic masses was invariably noted after the laser and ultrasound scalpels. These zones were not so considerable after dissecting the stomach with an ordinary scalpel. No incompetent sutures, failure of their hermetic quality or any other complications in the process of scar formation were detected in all the series.
Having studied the results of investigation of 132 patients with Icenko-Cushing syndrome (68 out of them with different structural variants of adrenal tumours, 68--without adrenal tumours), the authors came to the conclusion that adenomas of dark and mixed polymorphic cells belong to hormonally active adrenal tumours, while light-cell monomorphic adenomas belong to hormonally inactive tumours. An electron-microscopic study provides identification of signs of functional activity in adenomas and cancer tumours, to clear up the additional criteria of anaplasia in them. In patients with Icenko-Cushing syndrome, but without a tumour in the adrenal cortex ultrastructural changes in corticocytes are characteristic of the increase of cellular proliferation and the decrease of incretory activity. The follow-up results of surgical treatment were studied in all cases.
Based on an analysis of clinical and laboratory data, results of histological examination of removed adrenals and tumors of the cortical layer as well as an assessment of the functional state of the hypothalamo-hypophyseal-adrenal system in 132 patients the authors discuss some debatable questions of pathogenesis and selection of methods of treatment of the disease known as the Icenko--Cushing disease and syndrome.
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Clinical observations and experiments in animals enabled the authors to conclude that after operations on hollow organs of the abdominal cavity the healing of wounds made by a usual scalpel developed more favorably than of those made by a laser scalpel.
On the basis of 34 observations the authors reject the common opinion of a rare formation of bile stones on suture threads. The complication was not often recognized because the concrements removed in repeated operations were not subjected to destruction and thorough examination. To prevent the formation of stones on suture threads in operations on bile pathways threads of a slowly resolving material should be used.
Morphological features of the chromaffin tissue tumours removed surgically were studied in detail. The complex of the histological and cytological signs characterizing morphological criteria of the pheochromocytoma malignancy is recommended to be used in the everyday diagnostic practice. It is suggested that pheochromocytomas should be divided into the three main variants which seem to be stages of the neoplastic process: so-called benign, borderline malignant, and malignant tumours. The latter may be metastasizing or without visible metastasis but having all the features of morphological malignancy identical to those in the metastasizing neoplasms. The group of the borderline malignant pheochromocytoma is of importance not only theoretically but practically as well, since it complements our concepts of the neoplastic process dynamics and in many cases may be the indication of the possible prognosis of the disease.
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The data of remote observations of 39 operated patients with adrenal cortex tumors were analyzed as well as the functional state of the hypothalamo-hypophysial system and morphological investigations of the adrenals removed. In the light of the results obtained the questions of surgical methods and choice of the operation volume are discussed which can liberate the patients of the Itsenko-Cushing syndrome.
The authors have studied the prognostic value of such convincing morphological signs of tumor malignancy as cellular and nuclear polymorphism, the mitotic activity, the invasion of tumor cells into the vascular lumen, the presence of metastases in 28 operated patients with a hormone-active tumor of chromaffin tissue. The results of late-term observations within the period from 2 to 17 years indicated that all the patients subjected to radical surgery are alive. Detecting in a histological assay of pheochromocytoma of the aforementioned signs of malignancy except metastases is not an obligatory prognostically unfavourable factor. Such tumor cannot be called pheochromoblastoma, but it should be defined as pheochromocytoma with the morphological signs of malignancy.
Two cases of glomangiomas of the stomach are described in detail. Moreover 8 cases of mixed glomus tumors of the stomach were clinically observed, one of them being previously described. The analysis of clinico-radiological and morphological features of these diseases, based both on the personal authors' and literature material enabled the conclusion to be drawn on the presence of a number of signs, which could contribute to differentiating between glomangiomas (Barre-Masson tumors) and epitheliod leiomyomas of the stomach. These differences may be of some practical value in selecting the therapeutic tactics and formulating the prognosis.
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The ultrastructural intactness of secretory granules in the cells of ulcerogenic tumours, insuloma and carcinoid were demonstrated in the operation material embedded in paraffin. Feature of similarity and differences in the tumours under study with respect to the size and shape, and distribution of granules in the cells were established.
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