[Data on an evaluation of cancer care and the quality of clinical diagnosis at central district and district hospitals].
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Biomedical subjects
Publications and source records attributed to R I Shmurun.
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Two accelerated chloroform-paraffin processings of materials with the use of ultrasound (US) and microwave (MW) irradiation in the stove "Electronica" as well as a combined method with US- and MW-irradiation are proposed to shorten drastically the duration of the prehistologic processing.
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Specific conditions of pathological service in rural areas confined to a single prosectorium per two or more distant hospitals with limited facilities for dissection and biopsy processing when one specialist on the staff, call for an appropriate organizational frame-work. It involves regional centralization, provision with travelling laboratories for autopsy and rapid biopsy evaluation, additional personnel admission to reduce overwork. A standard notice is developed for registration of the discrepancy between a clinical and pathological diagnosis aimed at perfection of statistically significant estimation of misdiagnosis with a lethal outcome. To ensure a radical change in rural pathologic service and its material supply, it is necessary to establish its independent status under the control of central regional or republican pathologic bureaus and relevant all-union research institute.
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The description of a histological laboratory based on the sanitary car "RAF-22031" is presented. Such a laboratory is created for the first time and ensures an urgent histological diagnostics during surgical operations in the hospital in which the department of pathology with a histological laboratory is lacking.
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In a man of 48 who had suffered for a long time from a high arterial blood pressure, the autopsy revealed corticosteroma of the left and diffuse-nodular hyperplasia of the right adrenal glands. Both adrenals also had tumours of the sympathetic nervous system considered to be a gangliocytoneurilemmoma (angliocytic neurilemmoma) on the left and gangliocytoma on the right. The combination of morphological lesions, clinical data and laboratory examinations permit to state a combination of hypercorticism and hypercatecholaminemia.
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At autopsy there was found extra-adrenal pheochromocytoma, bilateral diffuse-nodulous and adenomatous hyperplasia of the adrenal cortex in a female patient who had suffered for a long time from high arterial pressure. In the enlarged thyroid gland there was revealed micro-macrofollicular colloid goiter with basedowification. The morphological changes and results of an investigation of the liquor (drop in the content of potassium) justify the assumption that in this case there is a combination of extra-adrenal pheochromocytoma with hormonally active rearrangement of the adrenal cortex--primary hyperaldosteronism and basedowified goiter.
When studying the morphology of the adrenals sufficiently exact criteria for their evaluation are necessary. Some of them may be obtained from complex macro- and microscopical investigations with the use of biometry and mathematical statistics. The work analyzes macroscopical (weight, volume, specific gravity) and microscopical (qualitative -- plethora, content of lipids, foci of cytolysis, mosaity etc. and quantitative -- absolute and relative dimensions of zones, cyto- and karyometry, interrelationship of zones, their relationship with KNP as a whole) data. On their grounds the estimation of the functional state of the adrenal cortex is made depending on the mechanism and causes of death as well as on duration of the disease.
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During the post-mortem examination of a 15-year patient who had died after the operation connected with incision of commissures a distorted form of the hypophysis was noted. Histological, histochemical and morphometric investigations showed that there was basophilic adenoma of adenohypophysis and prolapse of the tissue (beyond the borders of the adenoma) through a fistula against the background of changes characteristic of chronic diseases in childhood. Oxyphilic shift, moreover, was noted not only in the first zone of the adenohypophysis, but in other zones, as well as with a simultaneous increase in number of basophiles in I--III zones. Prolapse of the tissue, the latter being normal as far as the tumours growth was concerned, through the fistula took place at a considerable distance from the adenoma, which justifies the consideration of this process as a result of hyperplasia not connected with adenoma. Edges of the fistula bordering the prolapse, haemorrhages were to be seen.
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