[Diagnostics and treatment of the functional autonomy of the thyroid gland].

Functional autonomy of the thyroid gland (FATG) remains an important problem due to iodine deficiency over the whole territory of Russian Federation and the fact that iodine prophylaxis has not been conducted for a long period of time. Since iodine deficiency affects the thyroid gland (TG) as a whole, the formation of nodules is not limited to a single lobe, but leads to the development of multinodular goiter, the main feature of which is morphological and functional heterogeneity of TG tissue. Active cell proliferation in the iodine deficiency related goiter is associated with an elevated risk of somatic mutations, including activating mutations leading to thyrocyte functional autonomy.

[Galectin-3 in differential diagnosis and prognosis of follicular tumors of the thyroid gland].

Differential diagnosis between follicular thyroid tumours (FTT) is difficult both at cytological and histological levels. Infiltrative growth is authentic criterion of malignancy. Immunohistochemical reaction (PAP-method) with galectin-3 antibodies was used.

[Osteopathy in diabetic foot syndrome].

Morphological characteristics of bone tissues were studied in the feet of patients with diabetes mellitus type 1 and 2 (DM1 and DM2). Osteoblasts and osteoclasts prevalence, the presence of collagen type III in the composition of newly formed bone were characteristic for DM1. Osteocytes prevalence and abundant granulation tissue in newly formed bone was a feature of DM2.

[Target thin-needle puncture biopsy in diagnosis of thyroid cancer].

One hundred medical histories of patients with thyroid cancer (TC) were analyzed. Patients were divided into two groups depending on the variant of thin-needle biopsy technique (TNB). In group 1TNB was performed with "blind" method (with palpation control)--43 cases, in group 2 target TNB (ultrasound-guided) was carried out--57 cases.

[Clinical and morphological characteristics of thyroid adenomatosis].

Surgical (374 cases) and puncture (6148 cases) material from patients with multinodular goiter was studied. Definitions and a working classification characterizing morphological and cytological signs of adenomatous goiter were formulated. Prognostic significance of thyroid adenomatosis and approaches to its treatment in multinodular goiter are shown.

[Pathogenesis and clinical morphology of congenital disorders of sex differentiation].

Bisexual structure of genitalia presents difficulties for clinical diagnosis. Therefore, knowledge of pathogenesis and clinical morphology of congenital disturbances of sexual differentiation helps to establish earlier hermaphroditism variant, appropriate surgery for complete social-psychological adaptation of this group of patients.

[Clinical morphology of hormonally-inactive adrenal neoplasms].

94 patients with primary diagnosis "adrenal incidentaloma" were operated. Ultrasound investigation, MR-tomography, computed tomography, hormonal tests were made in examination of these patients. The results were compared with morphology and histochemistry of the removed adrenals.

[Functional morphology and prognosis of hormonally-active pituitary adenomas].

This paper is a review of literature on the etiology, pathogenesis and morphogenesis (electron microscopy, immunocytochemistry) of pituitary adenomas (PA). Clinical manifestations of PA are considered depending on their structure. Approaches to the clinico-morphological classification of PA and factors of their prognosis are discussed.

[Functional morphology of the hypophyseal-adrenal-gonad system in different variants of prostatic hyperplasia].

Two forms of prostatic hyperplasia are distinguished: fibro-glandular (FGH) and glandular-fibrous (GFH). An increase in the number of adenohypophysis cells producing gonadotrophic hormone, hyperplasia of the adrenal reticular zone, hyperplasia and hypertrophy of Leydig and Sertoli cells in the testis were observed in FGH. Signs of enhanced functional activity were observed in all cases of hyperplasia.

[Role of endocrine factors in the development of stomach cancer].

Current information on hormone-sensitivity and hormone-activity of stomach carcinoma is presented. The development of this tumor is shown to depend on the functional state of the pituitary, adrenals and gonads. The study of hormone-sensitivity and hormone-activity of stomach cancer will help in new approaches to its prevention, early diagnosis, radical pathogenetic treatment and adequate clinical prognosis.

[Functional morphology of the adrenals in stomach cancer and precancer].

Adrenal glands were studied histochemically in 110 autopsy cases with stomach precancer and cancer. Glucocorticoids, mineralocorticoids and catecholamines can be considered, with a high degree of probability, as factors of antitumor protection while sex hormones as stimulators of stomach carcinoma development and progression. Scirrhous carcinomas were non-homogeneous in regard to the adrenal gland changes.

[Functional morphology of the adenohypophysis in gastric precancer and cancer].

135 hypophyses of patients who had died of stomach precancer and cancer versus those of healthy controls were studied by histochemical methods allowing to distinguish various hormone producing cells. Participation of ACTH, TTH in the antitumor protection and that of FSH, LM, LTH and STH in the promotion and progression of stomach cancer is shown.

[Sex hormone receptors in the gastric mucosa in gastric precancer and cancer].

Sex hormones receptors from 240 patients with stomach cancer and precancer were studied using an immunoperoxidase method. Reception of steroid hormones was shown to influence stomach cancer development while the "perversion" of this reaction may determine unfavourable prognosis.

[Dependence of stomach cancer prognosis on features of regional lymph node metastasis and mechanisms of further dissemination of the tumor].

The study of section and operative samples from 280 patients with gastric cancer has established the relationships between characteristics of regional lymphogenic metastases and tumor prognosis, location of regional lymphogenic metastases, probability of distant metastases and survival of the patients. The discussion covers some ways and mechanisms of lymphogenic metastasizing of gastric cancer.

[Dependence of the features of distant metastases and prognosis of stomach cancer on the histologic type of the primary tumor and the volume of regional lymph node metastases].

Necropsy and surgical material (280 cases of gastric cancer) was studied. Histological types producing the largest number of metastases are revealed. Likewise a "border-line" involvement of regional lymph nodes is established in which distant metastasizing occurs in 100% of cases that is not dependent upon histologic type of tumour.

[Analysis of stomach cancer according to data of the autopsy room at the I.M. Sechenov Moscow Medical Academy from 1941-1994].

Analysis of the above material showed the association of the unfavorable clinico-morphological indices and poor prognosis with the periods of a socioeconomic instability, and the participation of a pathological hormonal background in the development of some variants of undifferentiated carcinoma of the stomach.

[Clinico-morphologic criteria for prognosis of stomach cancer].

New criteria of prognosis are established on the basis of study of 265 surgically removed stomach carcinomas. The factors of an unfavourable prognosis are as follows: young age, dysproteinemia, low blood coagulability, high leucocytosis and reaction of erythrocyte sedimentation, endocrine diseases, eosinophilic infiltration of stroma with high content of collagen type V and fibronectin, high expression of pepsinogen C, gastrin and carcino-embryonic antigen in the tumour parenchyma.

[Comparative clinico-morphologic characteristics and prognosis of forms of ulcerated stomach cancer].

300 cases of ulcerated and non-ulcerated stomach carcinoma and chronic stomach ulcer are analyzed. New criteria for a differential diagnosis and prognosis of ulcerated carcinomas are found.

[Duodenal gastrinoma with the development of Zollinger-Ellison syndrome].

Gastrinoma consisting of eosinophilic gastrin--producing cells (this was proven electron--microscopically and immunohistochemically) was found in a 32-year-old female. The tumour, 1 x 1 x 1.5 cm in size, was located in the submucosa of the horizontal part of the duodenum.

[Possible markers of the progression and ulcerogenesis of stomach cancer].

The stomachs from 40 patients operated on for gastric cancer and chronic ulcer were studied immunohistochemically using antibodies to CEA, galactosyl transferase, pepsinogens A and C, gastrin, alpha 1-antitrypsin. CEA and galactosyl transferase of the cancer parenchyma are shown to mark tumor progression. The ratio of alpha 1-antitrypsin to pepsinogens in gastric epithelium and cancer cells probably plays a role in ulcerogenesis of normal mucosa and tumor tissue.

[Extracellular matrix in various forms of ulcerated stomach cancer, their differential diagnosis and morphogenesis].

Immunohistochemical study of the extracellular matrix in ulcerated stomach carcinoma has been performed. Material is taken from 70 patients having either ulcerated or non-ulcerated carcinoma, and from 10 patients with chronic stomach ulcer. Results of the study revealed additional criteria for a differential diagnosis of various forms of ulcerated stomach carcinoma and gave a description of their morphogenesis.

[Diagnostic criteria of pyloric helicobacter infection in peptic ulcer].

Helicobacter pylori (HP) in 41 patients (10 with stomach ulcer and 31 with duodenum ulcer) was found in gastro-biopsies from the stomach antrum before and after the treatment. The following methods to reveal HP were used: Giemsa staining, immunoperoxidase reaction with polyclonal monospecific antibodies against HP, urease rapid test. HP was also revealed in the blood serum by antibodies against HP by means of enzyme immunoassay.

[Lung carcinosarcoma].

Lung carcinoma in a 72-year-old man smoker is described. Tumour, 12x8x8 sm in size, was located in the middle lobe of the right lung. Metastases were in the regional lymph nodes, soft tissue of the anterior abdominal wall, gastric mucosa and left adrenal.

[The immunohistochemistry of cellular oncogenes in precancer and cancer of the lung].

Operative material obtained from patients with lung cancer and precancer, carcinoids, secondary tuberculosis, chronic nonspecific diseases and pulmonary lymphosarcoma was examined immunohistochemically. Expression of the oncogenes was higher in lung carcinoma than in the foci of lung epithelium regeneration, metaplasia and dysplasia. All the oncogenes in precancer and cancer may be divided into two groups by the degree of their expression: oncogenes the activation of which occurs in the same way at certain stages of tumour progression regardless of the lung carcinoma histogenesis and oncogenes expressed at certain stages depending upon the carcinoma histogenesis.