Biomedical subjects
Publications and source records attributed to A A Nikonov.
For a period of 1987-1995 yrs. the operations on a peritoneal cavity organs were performed in 14,718 patients. In 87 reoperated patients 93 relaparotomies were conducted. After relaparotomy 36 (41.3%) patients died.
42 patients with discirculatory and posttraumatic encephalopathy were treated with betaserk. Ultrasonic dopplerography and acoustic evoked potentials were used for assessment of the treatment results. It was established that betaserk was quite effective both for arrest of acute vertigo attacks and for prophylaxis of vertigo relapses. A decrease in frequency of vertigo attacks (by 60%, on the average) as well as in their duration and intensity were accompanied by an increase in blood flow through the arteries of vertebro-basilar system and by normalization of the parameters of acoustic evoked potentials.
The analysis included 187 cases of infantile non-Hodgkin's disease. It has identified Ann Arbor System stage and histological pattern of tumor (Lukes-Collins and Kiel) as a reliable and significant factor of prognosis.
NMR-tomography data and clinical topographic parallels were followed up in 27 multiple sclerosis patients on treatment. Primary NMR tomography identified disseminated foci of more intensive signal in the brain and spinal cord of 78% of the patients. In 6 patients the diagnosis was not confirmed, in 21 patients there was tomographic evidence of various disorders: foci of hyperintensity associated with ventricular system enlargement, cerebral atrophy, hyperintensity zones. The number of more intensive signal foci correlated with the disease severity. Hemispheric foci of hyperintensity were clinically most important. Most of the foci were localized in periventricular region. Changes in the above parameters were observed only 1-2 years after the treatment. It is inferred that NMR tomography is both diagnostic and follow-up tool in multiple sclerosis.
A case of primary breast lymphosarcoma with axillary lymph node involvement and a local relapse after radical mastectomy has been described. The patient was a 43-year-old woman. Histologically, the primary tumour showed nodular (follicular) growth of prolymphocytes (centrocytes) and lymphoblasts (centroblasts) whereas the lymph node involved and relapsed tumour were characterized by diffuse proliferation of lymphoblasts (centroblasts). Immunocytochemistry revealed B-lymphocytic nature of the tumour cells. There were some difficulties in histological interpretation of this tumour due to both artificial structures and so-called lymphoepithelial lesions--remnants of ductal and lobular structures in the tumour tissue. The follicular type of growth of the primary breast lymphosarcoma is not in concordance with the current concept of histogenesis of the mucosa-associated lymphoid tissue lymphomas.
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Two hundred and seventy-two scrapings of the endometrium and histologic sections of seven removed uteri obtained from 30 hospitals of Leningrad were reviewed at the pathology departments of the Institute and Oncologic Dispensary. Disagreement in diagnostic conclusions (malignancy, border-line condition, other pathology or normal tissue) was registered in 51%. Disagreement ranged from 15% (hydatidiform mole) to 71% (atypical hyperplasia of the endometrium). The extent of disagreement between staff members of the two medical establishments and that between the said specialists and other consultants was of the same order.
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One should differentiate apudomas, two-component tumors (a combination of apudoma with a non-endocrine tumor), apudoma-like tumors and non-endocrine ones with admixture of APUD cells among the tumors with cells possessing the properties of APUD cells. Apudomas in their turn are represented by microapudomas and high- and low-differentiated macroapudomas. Routine light microscopy in most cases provides for apudoma verification, estimation of its differentiation and tissue origin, occasional identification of a secreted hormone.
Information on the first observation of the hypophyseal hemangiopericytoma having the clinical symptoms of hypophyseal adenoma is presented. It is noted that such tumours can be mistakingly diagnosed as adenomas. Therefore on the basis of light microscopical, histochemical and electronmicroscopical data a tactical diagnostical algorithm is worked out and proposed that facilitates the distinguishing of hemangiopericytoma among other tumours of the hypophysis anterior lobe.
The following general principles are necessary for achieving the maximum efficiency in the postgraduate training of pathologists in the histological diagnostics of various diseases particularly that of precancer and early forms of cancer: 1) specification of the optimal working classification clinically (prognostically) significant and corresponding to the methodological possibilities of pathologists; 2) use of the most informative diagnostical criteria; 3) formation of visual images of the diagnostical criteria including the stages of transition from the stereometric representation into the plane one, the differentiation between the feature and structural formations that imitate it, elaboration of criteria for the evaluation of the degree of semiquantitative signs; 4) placing the diagnostical criteria in the optimal order; 5) finding the criteria of the correctness of the diagnosis in question. The development of the above criteria is important in teaching, in working out methodological literature and in postgraduate selfeducation.
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Macro- and microscopic examinations of 64 randomly selected hypophyses were carried out to evaluate the dependence of the frequency of findings of hypophysis microadenomas in the section material upon the method of morphological examination and to solve the problems of differential diagnosis of microadenomas and other focal accumulations of adenocytes. Of the 7 microadenomas found 6 were detected only by microscopy. The frequency of finding of microadenomas was determined by the number of sections (blocks) examined from each hypophysis: 2 +/- 2% with 1-2 blocks per hypophysis, and 38 +/- 12% with 3-4 blocks. In addition to the previously described diagnostic criteria for microadenomas, two cytologic signs are described: cytoplasmic degranulation and a high nucleus-cytoplasm ratio in tumor cells.
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Goblet-cell carcinoid of the vermiform process is a well-differentiated epithelial tumor consisting predominantly of mucus-forming cells among which endocrine and Paneth's cells are found not infrequently. Despite the invasive nature of the tumor growth, the prognosis of the disease is most frequently favourable, although not as much as in carcinoid of the vermiform process. Considering the cell composition and the level of the tumor tissue differentiation, the so-called goblet-cell carcinoid should be regarded as a peculiar invasive mucous adenoma but not as a variety of carcinoid (apudoma).
Synthesis of biologically active amines and peptides, and accumulation of them in the cytoplasm in the form of secretory granules of "neuroendocrine" type are among the most important characteristics of APUD cells. Apudomas, tumors consisting of cells with the properties of APUD elements, have many common morphological and functional features, although they are quite heterogeneous by clinical behavior and histogenesis. Histological diagnosis of apudomas requires the assessment of the endocrine function of the tumor cells for which histochemical and electron microscopic methods must be employed, as well as consideration of the clinical and biochemical indices of the hormonal activity of the tumors.