Biomedical subjects
Publications and source records attributed to R I Shmurun.
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.
A rapid transfer of the box with tissues from vial to vial by the AT-4 automate (10 seconds) results in premature contamination of the subsequent reagent with previous one causing excessive use of scarce and expensive reagents. A system of temporary blocking of the transporting device is described which permits one to arrest the box above the vial for 30 sec in which time all the reagents flows back into the vial from the box. The use of the blocking of the transporting device for 360 sec in each cycle of tissue staining (12 vials) does not reduce the working capacity of the AT-4 apparatus but markedly saves the amount of reagents used and improves the quality of treatment.
The laboratory is set up in an "Ikarus-556" bus and has two sections: histological laboratory and an autopsy room equipped with autonomous water supply and sewage systems, heating systems, and necessary medical equipment allowing one to perform autopsies of the fatal cases and histological examinations under field conditions, in district and rural hospitals, and to improve the quality of therapeutic and diagnostic work.
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An inter-district division and inter-district center of pathological anatomy service combining 6 districts of Leningrad region have been organized on the basis of the centralized pathology department of Volkhov central district hospital. The paper describes the principles of organization of the work, arrangement and maintenance of the documentation, scientific organization of the work, rationalization, training of specialists, and the organizational and methodical role of the pathology unit in the work of therapeutic institutions.
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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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