Biomedical subjects
Publications and source records attributed to V A Samsonov.
Disorders in restructuring of T-cell receptor gamma-chain in DNA from skin biopsy specimens and peripheral blood lymphocyte of patients with malignant skin lymphomas at different stages of the disease were detected by PCR. Nucleotide sequences of monoclonal T-cell receptors were determined. The study showed that DNA sequences from the skin and lymphocytes did not coincide in some cases.
The concentrations of tumor necrosis factor-alpha, interleukin-1beta, interleukin-2, interleukin-4, and the content of antibodies to H1 histone fraction in peripheral blood lymphocytes, epidermis, and serum were evaluated in patients with mycosis fungoides. It was found that as the disease progresses, cytokine synthesis is switched from Th1 to Th2 class and production of proinflammatory cytokines increases, which indirectly promotes the development of the autoimmune reaction.
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Primary multiple malignancies were identified in 67 cases (3.55%) as a result of evaluation of 2,000 autopsy reports on deaths from lung cancer filed in Petrozavodsk and St. Petersburg. Eighty eight cases of primary multiple malignancies of the lung are discussed. A second tumor was found to be localized most frequently in the organs of respiration and digestion.
Autopsy-based data on complications involved in lung cancer untreated by surgery are presented.
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Autopsy records have been analysed for 52 fatal cases of extrahepatic bile ducts cancer. Primary cancer most frequently involved common bile duct (37 cases). Histologically, skirr was found in 1 case, small-cell cancer in 1 case, adenocarcinoma in 50 cases. Radical and palliative surgery was performed in 4 and 24 cases, respectively. The invasion into the adjacent tissues and organs occurred in 34.6%, metastases were found in 32.7% of cases. Another primary lesion arose in 2 patients (sigmoid, thyroid cancer). 92.3% of patients developed jaundice with hepatic or hepatorenal insufficiency. Purulent hepatic disorder, impairment of intrahepatic bile ducts were seen in 40.4%. Focal pneumonia emerged in 32.7% of patients. Accurate lifetime diagnosis was made in 30 of 52 patients only.
The co-operative investigation of two clinics on the basis of examination and treatment of 78 patients with the thoracic outlet syndrome for 5 years is presented. The comparative assessment of the two main methods for surgical treatment--1st rib resection and resection of the anterior scalene muscle has been performed. The results of less traumatic operation of the anterior scalene muscle resection employed in certain forms of the disease are similar to those in performance of more radical operation, the incidence of complications is lower.
Data of esophageal cancer patients autopsies for 1977-1986 were collected from hospitals of Leningrad and Petrozavodsk and subjected to analysis. Gastrostomy had been carried out in 255 out of 847 (29.1%) cases studied. 83.4% of the operated patients died within one month whereas only 2.1% survived over one year. The majority of patients were evidently operated too late in the course of disease. 148 (58.1%) operated cases died due to progression and the other 107 (41.9%) died of complications of the surgical procedure and postoperative period, mainly pneumonia and peritonitis. 106 cases of the latter group died during the first month following gastrostomy.
An observation of a clear-cell lung tumour in a girl of 14 is described. The segment of the right lung with the tumour, 3 cm in diameter, was removed during the operation. Histologically, the tumour node consisted of clear cells with a number of thin-walled vessels and rare branching tubular structures lined with monolayer epithelium. Glycogen but no lipids or argyrophilic neurosecretory granules were found in the cytoplasm of tumour cells. The neoplasm is considered to be a hamartoma.
A 42-year-old patient suffered for many years from chronic bronchitis and chronic right-side pneumonia. A tumour obturating the right main bronchus was diagnosed tomographically and fiber bronchoscopically. Ovoid tumour, 2 x 3 cm in size, originating from the distal bronchus, was removed during the operation (bronchotomy). Histologically, an encapsulated tumour was found consisting of lipocytes with rare bronchial glands and narrow spaces and channels lined with one layer of the respiratory epithelium. Bone inclusions attributed to metaplasia were found in the capsule.
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Differences in the interferon status of various nature were revealed in patients with lymphoproliferative diseases of the skin and with Kaposi's sarcoma, whose interferon system was examined in respect of its three major parameters. Such data are a sufficient basis for the correction of the detected changes by interferon preparations combined with other chemical drugs. Two parameters of the interferon system may serve as criteria of interferon therapy efficacy: increased alpha-interferon level and, more so, normalization of the gamma component of interferon production, tested by the gamma parameter.
Elevated levels of autoantibodies to types I-V collagens were detected in local scleroderma patients. In 75 percent of cases the levels of autoantibodies to types I and III collagens were elevated, in 30 percent to type II collagens, in 25 percent to type IV collagens, and in 20 percent to type V collagens. Anticollagen autoantibody levels did not differ from the normal values in the patients with a prolonged (for more than a year) remission. A reduction of these antibody levels almost to the normal values was achieved in 10-12 months after tigason therapy during a prolonged clinical remission. The ratio between autoantibodies to types I and II collagens was found to be a constant both in the donors and patients with local scleroderma.
Elevated blood serum concentrations of R protein were revealed in the patients with malignant lymphomas of the skin and with Kaposi's sarcoma. In both conditions the level of R protein was elevated as against the norm and related to some cellular and humoral immunity parameters. Measurement of R protein concentrations and of the levels of some cellular and humoral immunity parameters in malignant lymphomas of the skin and Kaposi's sarcoma evidence a prognostic value of R proteins.
The authors review literature on the clinical picture and possible pathogenesis of Kimura's disease, as well as on therapy of the condition. They describe a case of this disease. A woman aged 37 has developed this condition with typical clinical and histological signs.