[Clinical observations and echocardiographic features of mural thrombi in the left ventricle during myocardial infarction].

The incidence and changes in the mural thrombi in left ventricle in ECHO-2D in the acute myocardial infarction as well as relationship between clinical parameters and echocardiographic indices of the left cardiac ventricle contractability asynergy and dynamics of changes in mural thrombi have been investigated. The studies included 137 consecutive patients (98 males and 39 females) treated for the acute myocardial infarction. Patients' age ranged from 35 to 87 years (mean 62 years). Infarction of the anterior and/or lateral wall was diagnosed in 67 patients, and infarction of the inferior and/or posterior wall in 70 patients. Mural thrombi were diagnosed in 42 (31%) patients. Eighteen thrombi (43%) were liquefied during hospitalization. Comparative analysis of patients in whom mural thrombi underwent liquefaction in the hospital and a group of patients with myocardial infarction and persisting mural thrombi showed that return of left ventricle movements with subsequent contractability facilitate liquefaction of mural thrombi. Higher mortality rate in the group of patients with myocardial infarction with mural thrombi is due to extension of the infarction accompanied by marked asynergy of left ventricular contractions which does not decrease in sequential examinations, and increasing congestive heart failure.


[Late outcome of patients with myocardial infarction complicated by mural thrombi in the left heart ventricle].

The study was aimed at the evaluating of the remote clinical course and death rate in patients with myocardial infarction, in whom mural thrombi in the left cardiac ventricle were diagnosed during hospitalization. During a 24-month follow up, 23 (20%) out of 116 patients died, including 10 (43.5%) patients with myocardial infarction complicated with mural thrombi during hospitalization. There were 39% of sudden deaths. Ninety three (80%) patients, including 27 (29%) patients of the group with myocardial infarction complicated with mural thrombi in left ventricle during hospitalization, were reported for the ambulatory examination. Features of the postinfarction heart failure, cardiac arrhythmias, the second myocardial infarction or exacerbations of the coronary disease which required hospitalization were significantly more frequent in this group.


[Blood viscosity factor in persons with high and low risk of ischemic heart disease].

In the years 1986-1987, the blood viscosity factor, the content of haemoglobin in erythrocytes, the concentration of glucose in blood, the lipids and the blood coagulation system were examined in 180 subjects. They were divided into three groups according to the exposure to risk factors: group performing light manual work (L), group performing hard manual work (C) and group of engine drivers (M). No statistically significant differences in regard to age, employment period, number of cigarettes smoked, as well as arterial systolic and diastolic blood pressure were found between the subjects. Workers from group M had the highest body weight (P > 99%) and increased concentration in blood of triglycerides (P > 99% and Apo B (P > 99%. Subjects from group C had the lowest concentration of cholesterol in blood (P > 99%) and the smallest number of members with hypertensions (3.8%) and overweight (7.5%). Group L included the highest percentage of persons with arterial hypertension (17.5%), the highest, among all examined, blood viscosity factor determined at the coagulation rate of 18.6 s-1, and the lowest prothrombin factor (P > 99%).


[Time of day and occurrence of myocardial ischemia].

A 24-hour Holter ECG was registered in 130 patients with the ischemic heart disease with or without the history of myocardial infarction treated in out-patient clinic. Two hundred thirty seven episodes of myocardial ischemia were detected. These episodes developed between 6.00 and 8.00 a.m., 12.00 and 4.00 p.m., and 6.00 and 8.00 p.m.


[The fate of young individuals with a history of myocardial infarction].

The fate of young individuals (to 45 years) with a history of myocardial infarction during 12 years was analysed with the aid of a questionnaire containing questions of both social and medical character. Sudden cardiac death or the second infarction were the most frequent causes of death during the first two years following myocardial infarction. Change in the physical activity mainly involved the return to work. Only 47% of young men and 29.8% of women started full-time jobs. They mainly belonged to so-called white collars. The lack of patients' physicians permission was a main cause of the abstinence of young men from the occupation. A position within the family and social activity usually remained unchanged in the majority of patients, but every third patient greatly reduced sexual activity. Every third patients continued smoking, and did not observe recommended diet despite the systematical medical check-ups. The course of the disease is unclear in the majority of young patients. It is often deformed and requires further, detailed information on young patients' style of life.


[Coexistence of von Willebrand's disease with mitral valve prolapse].

The authors present the case of mitral valve prolapse. In a young woman with three-year history of systematically treated epilepsia mitral valve prolapse with a spurious string within left ventricle has been diagnosed echocardiographically in coincidence with the symptoms of haemorrhagic diathesis of von Willebrand type in form of haemoptysis and or/massive haemorrhages in mouth occasionally being preceded by heart rhythm disturbances. No local changes have been observed in otorhinolaryngologic examination, bronchoscopy and gastroscopy. Possible mutual dependence of 3 above stated abnormalities is being discussed. It is not excluded, that mitral prolapse may constitute the primary entity and epilepsia is of secondary character as a result of cerebral ischaemic incidents or of cerebral embolism. It is also a matter of discussion to what extent abrupt haemodynamic disturbances connected with critical fall of systemic blood pressure due to mitral prolapse may influence the haemorrhagic episodes.


[Inotropic drugs in treatment of heart failure--advantages and adverse reactions].

Mechanism of action, hemodynamic effects, efficacy of both shortterm and chronic administration of available inotropic drugs are discussed. An emphasis is on the possible mechanism of detrimental sequelae of the chronic inotropic stimulation of the failing heart.


[Certain aspects of acute arterial thrombosis].

An analysis included 228 patients with the acute arterial thrombosis in the extremities. Over 33% of patients reported to the treatment later than 24 hours after the onset. This delay markedly worsened the results of therapy. Sixty two percent of limbs was saved. Mortality rate was 15%. The author analyse the results of therapy in relation to the localization of thrombi and type of the treatment--surgical, use of vasodilators with heparin or streptokinase. In case of thrombosis localized in the end segment of aorta the results were less promising than in case of more peripheral arterial involvement. Excellent and favourable results in this group amounted to 32%, the limb was amputated in 13% of patients and 28% of patients died. Hundred eighty patients were operated. Arteriosclerotic lesions to the arterial wall were detected in 97%. Excellent and favourable results of surgery were achieved in 45%, amputations amounted to 22%, and mortality rate was 16%. Vasodilators combined with heparin produced an improvement in 13% of patients in whom surgery could be postponed. The best results were achieved in patients treated with fibrinolytic agents with subsequent surgery or without it. In this group excellent and favourable results amounted to 57%, amputations--24%, and mortality rate--8%.


[Dissecting aneurysm as a cause of acute non-traumatic ischemia of the lower limbs].

The results of the treatment the acute non-traumatic ischemia of the lower limbs caused by dissecting aneurysm are discussed. Out of 726 analysed patients 8 of them suffered from dissecting aneurysm, i.e. 1.1%. Dissecting aneurysm was more frequent in male patients. All patients with lower limbs ischemia caused by the dissecting aneurysm were operated. Vascular prosthesis was used in 6 cases, and restoration of arterial patency in 2 cases. Seven patients died during the early postoperative period and one was released home with proper blood flow.


[Early results of acute non-traumatic ischemia of the limbs].

The results of therapy of 726 patients with the acute non-traumatic ischemia of the limbs are discussed. These patients were treated in the 11 centres of vascular surgery in Poland between 1986 and 1988. Out of causes of the acute non-traumatic ischemia of the limbs arterial embolism was diagnosed in 450 patients, thrombosis in 229 cases, and dissecting aneurysm in 8 patients as well as phlegmasia coerulea dolens in 1 patient Surgical treatment included 665 patients, and the remaining 383 patients were treated conservatively. The results of the conservative and surgical treatment were scored with a 5-point scale. Excellent results with the return of complete functioning of the affected limb and presence of peripheral pulse were achieved in 291 patients, positive result, i.e. lack of the peripheral pulse, in 197 cases, moderate result in 80 patients in whom complete functioning of the limb has not been restored. In case of 64 patients an amputaion proved necessary. Nine four patients died.


[Thrombolytic therapy in arterial thrombosis producing acute ischemia of the lower limbs].

Efficiency of the thrombolytic therapy in the acute arterial thrombosis (producing an acute ischemia of the lower limbs) with streptokinase has been assessed in 35 patients treated in the selected departments of vascular surgery in Poland. Complete recovery has been noted in 9 patients (25.7%) in whom limb functioning with detectable peripheral pulse have been restored. An improvement has been achieved in 12 (34.3%) patients and moderate result in 4 (11.4%) patients. The limb has been amputated in 7 (20%) patients, and 3 patients (8.6%) died. Similar results have been observed in case of ischemia of duration period below 12 hours, between 12 and 24 hours, and between 24 and 72 hours. The results have been worse when thrombolytic therapy was introduced after 72 hours.


[Clinical assessment of treatment results for atherosclerotic ischemia of the lower extremities with intraarterial ozone injections].

Ten injections of O3 into femoral arteries were administered to 50 patients with atherosclerotic ischemia of the lower extremities and to 49 diabetic patients. All patients were assessed clinically with the ankle-arm index, measurement of intermittent claudication distance prior to and after the treatment. The treatment showed a significant improvement in both groups manifested by an increase in ankle-arm index, and prolongation of the intermittent claudication distance by more than twice. The treatment of atherosclerotic ischemia of the lower extremities with O3 is both valuable and safe.


[Early and late results of treating peripheral arterial injuries].

Forty six patients with injuries to the great peripheral arteries were treated at the III Department of Surgery, Medical Academy in Cracow in 1968-1987. An injury to the blood vessels was accompanied by bone fractures or joint dislocation in 9 (19.5%) patients whereas 35 (76%) patients suffered also from vein injuries and nervous trunks trauma. In 13 (28%) cases an accident took place when the victims were drunk. Favourable result of the treatment, i.e. return of peripheral pulse, was achieved in 33 (75%) patients, acceptable result, i.e. an increase in limb temperature, in 11 (23%) patients. Two patients underwent an amputation of the limb because of its necrosis. One patient died. Anti-thrombolytic agents were given intra- and postoperatively, and in 9 patients with extensive contusions fasciotomy proved successful. Late results were similar to early ones.


Immunohistochemical analysis of the distribution of a breast tumor associated antigen recognized by a monoclonal antibody.

A new monoclonal antibody (MoAb), MM 1-80, recognizing a tumor associated epitope of a breast high molecular weight mucin molecule was tested, using the avidin biotin immunoperoxidase method on normal and pathological mammary tissues. The normal mammary ducts and lobules were negative. Fibroadenomas showed a strong intracytoplasmic staining. In apocrine metaplasia, adenosis, and papillomatosis, scattered cells showed intracytoplasmic, luminal border or secretion reactivity. In lobular and ductal hyperplasia the cells showed intracytoplasmic immunoreactivity which, however, became more intense and homogeneous in atypical lesions, i.e. lobular and ductal in-situ carcinomas. The infiltrating carcinomas of different histotype expressed positivity on 98% of the cases (113/115) and axillary metastatic lymph nodes were always positive (20/20). The MoAb was tested on 175 human neoplasias of different origin which were in the majority of the cases negative with the exception of adenocarcinomas of the lung, ovary and bladder. MM1-80 appears to react preferentially with mammary cells undergoing hyperplastic, metaplastic and neoplastic processes. The 1-80 epitope distribution is different in these lesions starting with a predominant luminal expression in benign lesions and becoming strong and cytoplasmic in the malignant breast cell.


Correlation of nucleolar organizer regions and nuclear morphometry assessed by automatic image analysis in breast cancer with aneuploidy, K167 immunostaining, histopathologic grade and lymph node involvement.

Silver-stained nucleolar organizer regions (AgNORs) in human breast carcinoma were studied using a computer-assisted system of image analysis. Standardized, automatic measurements of 7 morphometric parameters (area, perimeter, shape factor, bend energy, angle, and small and large diameters) performed on paraffin sections and cell imprint were compared and correlated with nuclear morphometry, histopathological grading, tumor growth fraction, (monoclonal Ki67-immunostaining), DNA nuclear content (stoechiometric Feulgen staining) and axillary lymph node invasion. The major findings were as follows: (i) variations in AgNORs and nuclear parameters were correlated, (ii) the ratio of AgNOR area/nuclear area was significantly different in low and high grade tumors, (iii) mean AgNOR parameter values increased significantly with the tumor growth fraction and tumor hyperploidy and were significantly higher in patients with axillary lymph node metastases and (iv) AgNOR evaluation was more accurate for cell preparations than for tissue sections.


Adenomas arising in Barrett's esophagus with adenocarcinoma. Report of three cases.

Adenocarcinoma of the esophagus is a well known complication of Barrett's esophagus, and results from a dysplasia-carcinoma sequence. This report describes 3 patients with adenomatous polyps arising in Barrett's esophagus. One patient presented with multiple sessile or pedunculated polyps giving a polyposis appearance; the other two patients had single polyps associated with distinct adenocarcinoma arising in Barrett's esophagus. Polyps consisted of adenomatous proliferation with adenocarcinoma in the 3 patients. Review of the literature identified twelve previously reported cases. These cases show that although rare, adenomas may arise in Barrett's esophagus, and are most likely premalignant lesions such as other adenomas of the gastrointestinal tract.


Electron microscopic study on cell-to-cell interactions in oral lichen planus.

Ultrastructural analysis of oral lichen planus was performed in 18 cases, focusing on cell-to-cell interactions. In the peripheral portion of the lesion, the most consistent findings were a widening of intercellular spaces, separation of the basement membrane (BM) from basal cells and scarce inflammatory cells. In the central portion of the lesions basal cells and BM showed severe damage and numerous inflammatory cells infiltrated into both the epithelium and subepithelial stroma. The infiltrates predominantly consisted of T-lymphocytes, a few Langerhans cells (LC) and macrophages. Most lymphocytes were large and positive for CD45RO. Dendritic LC and macrophages with cytoplasm containing abundant organelles were seen in the epithelium and subepithelial stroma, respectively. Close contacts of lymphocytes with LCs, macrophages and also with keratinocytes were sometimes observed in the central portion. In the subepithelial stroma, some lymphocytes contacted an HLA-DR+ dendritic cell, which was possibly a macrophage, forming a rosette-like arrangement. Conjugations between CD4 cells and dendritic cells (possibly LC) and also between CD8 cells and basal cells were observed in the epithelium. These T cells were large in size, and the CD8 cells which made contact with degenerated keratinocytes possessed cytoplasm containing numerous polarized organelles and a nucleus toward and contrary to the contact side, respectively. These lymphocytes expressed LFA-1 on the cell surface, and many basal cells exhibited ICAM-1. These findings indicate that T cells may receive information from LC and macrophages concerning degenerative keratinocytes, and that informed T cells attack perhaps the keratinocytes.


Histomorphometry in paraffin sections of thyroid tumors.

Planimetric features of cell nuclei in paraffin-embedded histological sections of benign and malignant thyroid tumors, as well as normal thyroid tissue as control, were determined by means of a semiautomatic system. The main aim was to objectify possible quantitative differences between adenomas and carcinomas of the thyroid gland, which had recently been reported by several authors. For each nuclear profile, the area, the maximum diameter as well as two form factors were calculated. Statistical analyses of morphometric differences between normal controls, oxyphilic adenomas and carcinomas, and between follicular adenomas and carcinomas were performed using the T-test, a multivariate test, and a discriminant analysis. The tests revealed significant differences between controls and all other groups. The most striking result, however, was the total discrimination between follicular adenomas and carcinomas, with no false reclassification. Carcinomas had a higher mean nuclear area and diameter and a lower form factor. A similar reliability of discrimination could be obtained by comparing these morphometric values in oxyphilic adenomas and carcinomas. When using a test set of 9 cases (4 adenomas, 5 carcinomas), only one adenoma was falsely reclassified as a carcinoma by the discriminant analysis. Our results thus allow the conclusion that planimetric nuclear measurements indeed seem to be useful for the objectivation of cytomorphologic differences between adenomas and carcinomas of the thyroid gland.


Fibrous hamartoma of infancy. A study of eight cases with immunohistochemical and electron microscopical findings.

Eight cases of fibrous hamartomas of infancy are presented. Actin positivity and desmin negativity in collagen forming spindle-shaped cells and electron microscopical findings point to the myofibroblastic nature of this entity. "Dark cells" which spread regularly in all but one of our tumors were immunohistochemically determined to be a mixture of B and T cell lymphocytes. Their selective location and possible role are discussed.


Myofibroblastic pseudotumor mimicking epididymal sarcoma. A clinicopathologic study of three cases.

The clinical and pathologic features of three cases of epididymal pseudotumor are described with emphasis on its differential diagnosis and histopathogenesis. The first lesion was found histologically worrisome in the region of ductus epididymis by a torsioned testis in an 8-month-old boy, although the lesion was clinically indistinctive, and grossly not remarked. Histodiagnostic difficulties are encountered because this lesion forms numerous infiltrative spindle cells in haphazard arrangement. Ultrastructurally, the cell components of this lesion are predominantly myofibroblasts, intermediate cells between fibroblasts and myocytes. Similar epididymal lesions with the same cell components were identified in the two other infantile cases on the review of 36 consecutive orchiectomy specimens all obtained for testicular torsion. These three boys were found to present with a relatively gradual clinical course of the testicular torsion. It is suggested that myofibroblastic proliferation in the epididymal location histologically reminiscent of sarcomas occurs under ischemic circumstances.


Giant cell granuloma of the lung.

In a 50-year-old man without bronchopulmonary symptoms a round mass lesion close to the hilum of the right lung was detected in a routine chest x-ray and confirmed by computed tomography. Histological examination of two biopsy specimens did not result in a definitive diagnosis. Therefore thoracotomy with enucleation of the focus was performed. The histological picture of the lesion is characterized by connective tissue proliferation, multinucleated giant cells, ossification, localised hemorrhage, deposits of hemosiderin and foci of foam cells. The findings are interpreted as a giant cell granuloma of the lung.


Granular cell tumor in differential diagnosis of tumors of the breast. The role of fine needle aspiration cytology.

The granular cell tumor (GCT) represents a rare but important lesion in the differential diagnosis of breast tumors. Since this generally benign tumor may be misdiagnosed as malignant in clinical investigation, mammography, sonography, and even in frozen sections, a preoperative diagnosis is of utmost importance. Two cases illustrate that fine needle aspiration cytology (FNAC) may be the method of choice in achieving a correct preoperative diagnosis. The histogenesis of GCT is examined by means of immunohistochemical stainings. The results confirm that this tumor arises from the peripheral nerve tissue. Most likely the Schwann cells and not the nerve cells constitute the origin of GCT.


Extra-adrenal pheochromocytoma-ganglioneuroma. A case report.

A case of rare extra-adrenal tumor composed of pheochromocytoma-ganglioneuroma which developed in a 48-year-old Japanese male is reported. Histologically, the tumor contained equal proportion of two distinct patterns, pheochromocytoma and ganglioneuroma. Immunohistochemical examination revealed that pheochromocytoma cells were positive for Leu-7 and ganglion cells in ganglioneuroma were positive for vasoactive intestinal peptide (VIP), respectively. Neuron specific enolase (NSE) was positive in the neoplastic cells of both components, and S-100 protein was also positive in fibers around ganglion cells. Ultrastructural examination revealed that neurosecretory granules were present in the neoplastic cells.


What's new in the role of cytokines on osteoblast proliferation and differentiation?

This review assesses recent data concerning the role of cytokines produced by a variety of cells in bone on osteoblast function. The following themes are presumed: (1) osteoblasts are mesenchymal cells which act as either the major cellular agents of bone formation or as modulators of bone resorption by osteoclasts. The regulation of osteoblast proliferation and differentiation may involve a negative feedback process resulting in phenotype suppression; (2) cytokines including platelet-derived growth factors (PDGF), parathyroid hormone-related proteins (PTHrP), bone morphogenic proteins (BMP), transforming growth factor beta (TGF beta), fibroblast growth factors (FGF), insulin-like growth factors (IGF), epidermal growth factors (EGF), interleukin-1 and 6, tumour necrosis factors (TNF), interferon and haematopoietic growth factors have effects on osteoblast differentiation and proliferation but their effectiveness may not be identical in vitro and in vivo; (3) finally, therapeutic strategies for cytokine use in clinical practice are considered.


Neurofibromatosis involving the small bowel associated with adenocarcinoma of the ileum with a neuroendocrine component.

A patient with neurofibromatosis involving the small bowel who developed adenocarcinoma in an area of the ileum showing diffuse involvement of the disease is presented. Unlike the five cases with this association previously described, the present case shows a neuroendocrine component within the adenocarcinoma. The relation between neurofibromatosis of the bowel wall and adenocarcinoma may be explained by a decreased intestinal transit time in this patient. The presence of a carcinoid tumor in the ileum is not unusual in a patient with von Recklinghausen's disease, although the location of the carcinoid in the duodenum is described more frequently in these patients. The appearance of endocrine/neuroendocrine features within an adenocarcinoma already involved by diffuse neurofibromatosis is exceptional and may not be a chance event.


Progressive multifocal leukoencephalopathy and gliomas in a HIV-negative patient.

A case of progressive multifocal leukoencephalopathy (PML) is reported, detected at autopsy of a 30-year-old patient. The clinical picture was characterized by a progressive course of mental deterioration and ingravescent neurological symptoms. The patient was HIV-negative. He died of bronchopneumonia, after a clinical course of 13 months. Autopsy disclosed pulmonary tuberculosis with involvement of regional lymph nodes. In the brain, besides numerous PML-foci of varying age and structure, a pleomorphic astrocytoma was found in the white matter of the right parietal lobe. In the brain stem glial proliferation resembling diffuse gliomatosis was also present. In situ hybridization revealed Papova-virus (JCV) in oligoglial nuclei, but not in neoplastic astrocytes. This is the third report on the concomitant occurrence of PML and glioma in man.


Clonal Ig-gene rearrangement in some cases of gastric RLH detected by PCR method.

Clonal immunoglobulin (Ig) heavy chain gene rearrangement in gastric reactive lymphoid hyperplasia (RLH) cases was investigated by means of the 'double' polymerase chain reaction (PCR) using formalin-fixed and paraffin-embedded tissue. Rearranged DNA sequences, formed by combinations of variable (VH) and joining (JH) regions, were amplified with oligomeric primers. One microgram of DNA extracted from formalin-fixed and paraffin-embedded tissue was applied as the 'first PCR' template and one ten-thousandth of the first PCR product was used as the 'second PCR' template. As a control study for the double PCR method, DNA isolated from frank B cell gastric malignant lymphomas was assessed. Clear single bands between 100 and 150 base pair markers in length were evident on agarose gel electrophoresis in 10 out of 13 cases (76.9%) of malignant lymphomas while 2 out of 22 cases (9%) of RLHs revealed clear single bands of the same length, suggesting malignant lymphomas; however, no histologic features of malignant lymphomas were present. It is concluded that even gastric RLH cases satisfying histopathologic criteria for benign lymphoid hyperplasia may contain occult monoclonal B cell populations suggesting a continuous and progressive spectrum of lesions contributing to B cell neoplasia.


Intra-abdominal desmoplastic small-cell tumours with divergent differentiation. Report of two cases and review of the literature.

Two intraabdominal desmoplastic small cell tumours presenting in young adult males and involving the entire peritoneum, with no evident single primary site, have been studied. The histological pattern was suggestive of a metastatic small cell epithelial neoplasm, but immunohistochemical study revealed strong reactivity for cytokeratins, vimentin and desmin indicating synchronous epithelial and myogenous differentiation. In addition epithelial membrane antigen and neuron specific enolase were also positive. Electron microscopy showed fairly undifferentiated tumour cells with striking desmosome-like junctions, containing prominent paranuclear whorls of intermediate filaments, and a typical myofibroblastic stroma around neoplastic islands. Although the histogenesis of these recently described and rare tumours still remains uncertain, it seems that they constitute a reproducible entity which requires differential diagnosis from other small cell tumours of childhood and young adulthood.


Langerhans cells and lymphocyte subsets in human gastrointestinal carcinomas. An immunohistological study on frozen sections.

In an immunohistochemical study of 38 human gastric and 40 human colonic carcinomas Langerhans cells, suppressor and helper lymphocytes were identified on frozen sections by using anti-CD1, anti-CD8 and anti-CD4 monoclonal antibodies. Tumours were divided into those with few (< 3 per high power field) and those with many (> 3 per high power field) Langerhans cells as well as into those with high number of CD4 and CD8 cells (> 30 per high power field). No significant difference in the number of Langerhans cells regarding histologic types, degree of differentiation and metastatic/non-metastatic groups of either gastric or colonic carcinomas was found. On the contrary the numbers of Langerhans cells related significantly (p < 0.05) to density of T-cell and especially CD4 cell infiltrations of gastric and colonic carcinomas. This finding supports the role of Langerhans cells as antigen presenting cells and their involvement in T-cell activation against neoplastic cells of human gastrointestinal carcinomas.


Macrophages (phagocytic-histiocytic reticular cells) in reactive-inflammatory lesions of the bone marrow and in myelodysplastic syndromes (MDS). An immunohistochemical and morphometric study by use of a new monoclonal antibody (PG-M1).

An immunohistochemical and morphometric study was performed on trephine biopsies of the bone marrow in 52 patients (28 males/24 females; age 68 years) with various subtypes of myelodysplastic syndromes (MDS) to determine the number of macrophages (phagocytic-histiocytic reticular cells). Quantifications included the haemosiderin-storing subpopulation (Prussian-blue reaction) of this lineage as well as the iron-free compartment. The latter was identified by a new monoclonal antibody (PG-M1) which is specifically directed against histiocytic reticular cells. Bone marrow specimens of individuals without haematological disorders and those showing reactive lesions served as controls. In comparison with the normal bone marrow and inflammatory changes (i.e. rheumatoid arthritis) 23 of the 52 patients with MDS revealed a significant increase in macrophages. This increase encompassed not only the iron-laden subpopulation but also the total number of phagocytic reticular cells. Accumulation of macrophages in MDS was speculated to be due to a premature and enforced degradation of dysplastic cell elements leading to phagocytosis of haemosiderin and debris material. Moreover, cells of the monocyte-macrophage system could be involved in the complex pathomechanism of fibrillogenesis, since in a considerable percentage of patients with MDS, an increase in reticulin (argyrophilic) fibres was noticeable. Our finding of an expansion of the macrophage compartment in about half of the patients with MDS is in keeping with results of cell culture studies on colony formation of granulocyte-macrophage precursors (CFU-GM).


[Cephalosporin antibiotics from the firm Glaxo in treatment of patients with complications after trauma].

The most serious complications in the treatment of open fractures and after procedures on bone tissue are infections. The broad spectrum antibiotics are usually used in the treatment of soft-tissue and bone infections. Effect of the compound treatment with cephalosporins produced by Glaxo administrated intravenously and with Septopal-locally were estimated basing on radioisotopic bone examination. In compound treatment cephalosporins and gentamicin in form of Septopal renal function evaluation is demanded and recovery process should be documented by the radioisotopic image.


[Use of septopal in treatment of serious infections of the fingers].

Serious purulent infections of fingers often lead to deformation, handicap of functions or amputation of fingers. Filling the place with Gentamycin-Septopal after removing the slough and infected tissues gives high local concentration of antibiotic and regeneration of the anatomic shape of the finger. 21 patients have been treated. In all cases the wound healed quickly. The remote cosmetic results and the function of the hand were acknowledged as positive by both the patients as the treating team.


[Septopal from E. Merck in the prevention and treatment of bone and soft tissue infections].

On the basis of the many years usage of Gentamycin-Septopal in treatment of blood-derived and traumatic inflammation of bones we can say that in both forms of inflammation fully satisfying results were achieved. In chronic traumatic inflammations of bones with active stomias where the inflammatory process lasted many weeks, and from the purulent matter two or more tribes with various sensitiveness to antibiotics, associated treatment was also used with application of large doses cephalosporin antibiotics of Glaxo-Zinacef of Fortum firms. It should be stressed that in treatment of a patient with that disease correct radioisotopic diagnostic of the focus of inflammation and the evaluation of the immunity state of the organism of the patient, especially during long-lasting disease, is, among others, important.


[Radiologic evaluation of changes occurring in bone under the influence of gentamycin-septopal].

On the basis of several-year experience it was acknowledged that in treatment of chronic blood-derived and traumatic inflammations of bones the introduction of chains of Septopal to treatment was an obvious progress. The changes occurring in the bones of the patients for whom Septopal was left for good in the marrow cavity under the influence of antibiotic were evaluated. The observation included 89 patients for whom X-ray examinations were made many times in various intervals. Initially the chains of antibiotic were surrounded with a thin layer of connective tissue, and after several new-generating osseous tissue grew into them. In none of the observed cases any reaction indicating recoil of the carrier of the antibiotic was noticed.


[Effect of septopal on kidney function during treatment of traumatic chronic inflammation of bones].

Treatments included 20 patients for whom in the marrow cavity 1 chain of Septopal was inserted, and 10 patients for whom 2-4 chains were inserted. Before the planned operation the mark of the level of urea and of creatinine in the blood serum was made for the patients, and the clearance of creatinine was calculated. It was stated that usage of Gentamycin-Septopal for people who do not let know about the suffering from a kidney disease in the past, and the laboratory tests before the operation do not show deviations from the standard is a safe treatment recommended in prophylaxis and in treatment of blood-derived and traumatic inflammations of bones. Because of nephrotoxicity of Gentamycin the function of kidneys should be monitored before and during treatment with that medicine. Gentamycin can be connected with other antibiotics in order to improve the efficiency of its work.


[Use of septopal in treatment of acute blood-borne inflammation of bones in children].

The authors are presenting 70 cases of acute blood-derived inflammation of bones in children treated in the Clinic of Children's Surgery in the Academy of Medicine in Wrocław in the last 10 years. Gentamicin balls were used for 21 children including 18 newborns and babies. In 16 cases implantation of gentamicin balls was the only way of local treatment, and in 5 cases it was preceded with short-lasting (3-7 days) flowing drain of the inflammatory focus. Implantation of gentamicin balls was renewed after 14-18 days achieving in all cases sterilization of the inflammatory focus within the bone. The applied treatment allowed to reject quickly the general antibiotic therapy. After operational course for all children was normal.


[Application of mini-septopal in surgery of the hand].

Successful application of the Septopal in treatment of osteomyelitis has created the demand for this form of drug available for implantation into the small operation field, e.c. in the hand. The Chair and Clinic for Traumatology of the Medical Academy in Wrocław has been chosen to cooperate in the clinical trial on application of the Septopal-minichains in surgery of hand. There were 76 patients treated with the Mini-Septopal implantation. In 18 cases the osteomyelitis or active bacterial soft tissue infection gave indications for this type of treatment. In 58 cases Mini-Septopal was implanted because of high risk of infection in contaminated wounds. In both groups bacteriological examinations have been performed and statistical study revealed successful results even in primary resistant for gentamicin bacteries. Very good results of treatment let us estimate very high the usefulness of Mini-Septopal in bone and soft-tissue infections treatment, if the proper surgical procedures are performed to clean the focus of infection.


Changes in knowledge, attitudes and behavior of women participating in a community outreach education program on breast cancer screening.

A community-based intervention project on Long Island was supported by the National Cancer Institute to increase the use of mammography and breast physical examination among older women. During a 1-year period 526 women aged 50 and older attended educational sessions presented by the project staff conducted in the community in a variety of settings. Sixty-eight percent (355) of the women who participated provided identifying data and completed pre- and post-session surveys while 40% (210) also completed a mail survey 6-12 months later. Screening behavior improved subsequent to the intervention, at follow-up 61% had taken some related action. More than half of the 109 women who had a mammogram after attending the session indicated that the presentation influenced them to do so. The use of a game created a positive atmosphere for conveying information about a sensitive subject and encouraged discussion among women who had a variety of experiences with screening.


Reasons related to adherence in community-based field studies.

This study identified participants' reasons for good, marginal or poor adherence, or withdrawing from community-based clinical studies using a dietary and/or drug intervention. Adults aged 48-75 years participated in one of three studies related to decreasing colon polyp recurrence. Qualitative data from progress notes (N = 675) and end-of-study evaluations (N = 87) were coded using constant comparative analysis with 100% content validity panel agreement. Most common reasons for non-adherence were barriers such as side-effects, interference with vacation plans, unrelated illness, forgetting and competing outside stressors. Participation motivators were benefits such as altruism, medical benefits, free service and staff rapport. Findings supported the Health Behavior in Cancer Prevention model-based approach to adherence interventions and provided directions for adherence promotion in future community-based clinical studies.


Patient education and compliance: a pharmacist's perspective.

Pharmacists are becoming more involved with patient education due to the increased emphasis being placed on primary patient care. Existing research in the area of patient education and compliance can provide pharmacists with the knowledge to enhance patient compliance. Changing noncompliant behavior can make a positive impact on patient's treatment plan. Such interventions involve the education of patients, whether it be during an outpatient consultation session or an inpatient education program. Of the five compliance theories identified in the literature, the Communication Model describes the best mechanism for pharmacists to educate their patients. During consultation sessions, essential knowledge and skills can be communicated to the patient that will maximize compliance. Monitoring medication refills is the most accessible method for pharmacists to identify noncompliant behavior. Determining patient noncompliance and making adjustments with patient education tactics will enable pharmacists to expand their professional role while improving patient outcomes.


Registered dietitians' teaching and adherence promotion skills during routine patient education.

Even following education sessions, dietary adherence among medical patients is generally poor. One contributor to this problem may be the quality of teaching and adherence promotion skills employed by Registered Dietitians, whose behavior during routine patient interactions was evaluated in this observational study. Thirty dietitians were videotaped with one of their patients. Twenty operationally defined skills were rated on a scale from 0 (skill absent) to 3 (excellent). Dietitians' interpersonal skills were good (mean = 2.1, S.D. = 0.35), but all other skills were performed significantly less well (mean scores less than 1.0). Adherence promotion skills were rarely observed. Dietitians need supplemental training to improve teaching and adherence promotion skills.


Pupil's knowledge about health and illness.

Three hundred twenty high school pupils were evaluated concerning their knowledge about health and disease. The knowledge of 170 students in the first school in which they received lectures and had regular talks about health topics was higher in comparison with the knowledge of 150 students in the second high school who did not receive these lectures. We recommended that health topics be integrated in the school program starting at the first grade and continuing until graduation from high school.


Inoculation of C6 glioma cell suspension into the brain of adult rats: morphological study.

The C6 astrocytoma cell line was inoculated intracerebrally as suspension into the rat brain. Tumors were allowed to grow 2 to 60 days and their development was studied on coronal sections at these survival times. Tumor cells developed intraparenchymal solid tumor at the implantation site. C6 cells also filled out the needle track-area and spread into meninges. At 2 days postimplantation (2 DPI), tumor cells were observed to infiltrate recipient's brain directly from the implantation site or via perivascular spaces of adjacent cerebral blood vessels. Some cells escaped from the implantation channel during transplantation. They spread diffusely via cerebrospinal fluid (CSF) in leptomeningeal regions over the brain surface. At 10 DPI, the tumor mass invaded the adjacent brain parenchyma as well as cerebral ventricles (CV) and C6 cells could spread intraventricularly. At 30 DPI, tumor extremely increased its size and its growth was expansive. It exhibited areas of necrosis and later on, at 60 DPI, inoculated rat brains revealed large empty pseudocysts resulting from decay of necrotic tumor masses.


Transplantation immunology of the brain as a privileged site for neural grafting.

The course of intracerebral transplant rejection differs from rejection of grafts placed elsewhere in the body. There are many factors which may modulate immune responses in the central nervous system (CNS). Low expression of major histocompatibility gene complex (MHC) products on nervous tissue and the existence of the blood - brain barrier (BBB) seem to be the central components of this immune protection. Lymphatic drainage of the brain is limited, yet antigens introduced into the brain are drained to the lymph nodes. Some investigators highlight a lack of dendritic cells in the CNS, however, microglia, astrocytes and probably endothelial cells may act as antigen presenting cells in certain circumstances. Brain residual perivascular macrophages found in the Virchow-Robin spaces may be also involved in the process of graft recognition and rejection. Some neural cells (e.g. astrocytes) produce local immunosuppressive factors which may also contribute to prolonged neural graft survival. All these factors are not able to protect neural allo- and xenografts from rejection response. The rejection of neural intracerebral allo- and xenografts occurs suggesting the brain immune privilege is not absolute.


The effects of chelating agents on the left ventricular dP/dtmax. of the paced and non-paced heart in rabbits in vivo.

The effects of i. v. administration of Na2H2EDTA and a novel chelator MgNa2EDTA (both drugs in doses of 0.05 and 0.1 mg. kg-1) on the left ventricular dP/dtmax. of the paced and non-paced heart were investigated in rabbits in vivo. Both chelators induced a decrease in cardiac contractility which was, especially after the lower doses of the drugs, significantly less pronounced after MgNa2EDTA (max. 69.6% in the non-paced and 75.2% in the paced heart) in comparison with Na2H2EDTA (max. 51.3% in the non-paced and 52.9% in the paced heart). The decrease in dP/dtmax. was similar both under the paced and non-paced heart conditions after administration of both doses of the drugs. On the basis of the results obtained, it is possible to assume that the negative inotropic effects of the new chelator MgNa2EDTA may be lower in comparison with those of Na2H2EDTA and that cardiac pacing does not influence the inotropic response to the chelators in a negative manner. Premature deaths of a number of animals after the administration of both chelators show a necessity of further studies concerning especially cardiac intracellular ion concentrations.


An evaluation of continual determination of blood cholinesterase activity for inhibition studies.

Simple method of continual monitoring of the rat blood cholinesterase activity in vivo was used to demonstrate its inhibition following i. m. administration of acridine and carbamate inhibitors. Another type of inhibition was demonstrated for different routes of administration of highly toxic organophosphate, VX. Reactivation of the blood cholinesterase was also monitored following intoxication with VX and soman and treated with obidoxime and atropine. This continual determination of cholinesterase activity represents an useful approach to study effects of cholinesterase inhibitors.


2-Dialkylaminoalkyl-(dialkylamido)-fluorophosphates: acute toxicities.

Toxicities expressed as LD50 values of 2-dialkylaminoalkyl-(dialkylamid) o-fluorophophates for rats and mice (i. m. administration) were determined. Rats were more sensitive to these compounds than mice: LD50 values varied from 17 to 261 micrograms/kg for rats and from 30.5 to 1222 micrograms/kg for mice, respectively. Different routes of administration in one derivative of this group substituted by methyl groups only were compared. The highest toxicity (lowest LD50 value) in intravenous administration (11 micrograms/kg) and the lowest one in percutaneous (1366 micrograms/kg) were found.


Cuticular spinning structures reveal evolutionary relationships in araneomorph spiders.

The present paper reviews the results from the study of spigots, i.e. cuticular spinning structures obtained by the scanning of 52 genera belonging to 28 families of araneomorph spiders. The finding of eight morphologically different forms of these structures being attached to ducts of the pyriform type of silk glands is of fundamental importance for the final conclusions. The comparative observations enable me to create a hypothesis dealing with the existence of several evolutionary lines of spiders, each of which is represented with their own form of spigots. Nevertheless the character of these spigots undoubtedly reflects phylogenetic relationships between the spider taxa. The detection of a special mechanoreceptive field on top of the anterolateral spinnerets increases the knowledge of the functional morphology of the spider's spinning apparatus.


[The use of Latin in German scientific language].

Science is of international nature. The development of technical languages in the individual branches of science is connected with frequent borrowing of foreign-language lexical material which is mostly of Latin or Greek origin. Latin has had an effect on vocabulary, word formation and syntax. The existence of a foreign scientific language above a national one is the main cause of the frequent penetration of foreign and borrowed words into German. Greek and Latin represent the traditional language material to be used in medical terminology. In scientific communication, Latin and Greek terms and also equivalents in a native language are used.


[The role of ultraviolet rays in the etiopathogenesis of malignant melanoma].

The aim of the study was to elucidate the role of UV radiation in the etiology of malignant melanoma within the conditions of East Bohemia region. In selected patients with malignant melanoma, anamnestic data pertinent to the frequency of sun-bathing as well as a bulk of the occupational indoor exposures brought about the action of UV-light artificial sources have been withdrawn from past history. Constitutional features for suspected photosensitivity such as the fair skin complexion and skin phototype, were investigated. The object of assumption was also the site of anatomical localization (i. e. body site distribution) of primary malignant melanoma. In a selected group of patients, routine phototesting followed by the above-threshold skin phototests were carried out with the aim to assess the capacity of reparative processes essentially occurring in the irradiated skin. In the epidemiologically oriented part of study, presumable relationships between the year's maxima of sunlight radiation and the increases in the incidence of malignant melanoma were treated statistically. It followed from the results obtained that sunlight itself is not a decisive factor and cannot explain an increased incidence of malignant melanoma in East Bohemia region.


SSI case closures.

In 1990, about 800,000 persons receiving payments from the Supplemental Security Income (SSI) program had their cases closed and their payments stopped. The most frequently cited reasons for these case closures were excess income and death. Of those cases closed for reasons other than death, about 43 percent eventually returned to payment status. This study presents an analysis of a 1-percent sample of SSI recipients whose cases were closed during 1990. Longitudinal data on closures were collected by merging a series of monthly 1-percent sample files containing SSI administrative data. These are the first published data on reasons for SSI case closures.


The development and history of the poverty thresholds.

In recent years there has been renewed interest in the United States in the definition and measurement of poverty. In early 1992, the Committee on National Statistics of the National Academy of Sciences began a 30-month study requested by Congress that includes an examination of statistical issues involved in measuring and understanding poverty. Some 2 years earlier, in January 1990, the Administration had approved an initiative on improving the quality of economic statistics. The current poverty measure was one of several dozen statistical series examined as part of that initiative. In April 1990, Urban Institute economist Patricia Ruggles published a book that urged the revision of the poverty line to reflect changes in consumption patterns and changing concepts of what constitutes a minimally adequate standard of living. In July 1990, two private organizations concerned with the poor and the elderly issued a report reviewing current poverty measurement procedures and describing a Gallup poll in which a nationally representative sample of Americans set an average dollar figure for the poverty line that was higher than the current official poverty line. In view of these and other examples, it may be useful to reexamine the development and subsequent history of the current official poverty thresholds.


Developments and trends in Social Security, 1990-1992: overview of principal trends.

The article that follows is a reprint of Part I of a report presented by Dalmer D. Hoskins, Secretary General of the International Social Security Association (ISSA), to the organization's XXIVth General Assembly (November 1992, Acapulco). It identifies and interprets the major trends currently influencing the evolution of social security programs around the world, and analyzes these developments against the backdrop of the current economic, demographic, and social environment in which these programs operate. (Part II of the report analyzes the changes according to each major branch of social security; an annex to the report provides more detailed information and source citations in reference to these changes.) The ISSA is a nongovernmental international organization headquartered in Geneva, Switzerland. It is made up of 321 social security-related institutions, including the U.S. Social Security Administration, in 122 countries. The Association's aim is to protect, promote, and develop social security worldwide.


The development and use of industry data by the Social Security Administration.

Over the past few years the Social Security Bulletin has published a series of technical articles that describe various Social Security Administration (SSA) data files. This article provides an overview of SSA's industry-related data files and statistical systems from both a current and a historical perspective. The author begins by explaining how SSA first collected business data from employers (starting in 1937) as a by-product of the requirement that employers report employee wages for benefit computation purposes. She describes the administrative methods by which the data are collected, SSA's coordination of its activities with other agencies, the data collection forms used, the scheme by which the data are coded, and the employer files into which the data are classified. In her closing, the author provides examples of the various uses of the industry data and the ways that these data relate to SSA's statistical program needs and to those of other agencies as well.


Incidence of transient bacteremia following dental surgery--prophylactic use of cefuroxime, ceftriaxone or clindamycin.

The incidence of transient bacteremia after dental surgery as examined in 15 ml of venous blood has been previously found to amount to 69%. In this study, cefuroxime (1.5g), ceftriaxone (1.0g) or clindamycin (0.6g) was used for chemoprophylaxis to investigate the rate of transient bacteremia after dental surgery. The concentrations of these antimicrobial agents in peripheral blood and an effusion from the tooth extraction wound were measured. The incidence of transient bacteremia was limited to 4.2% by cefuroxime, 0% by ceftriaxone and 5.9% by clindamycin.


A corrected transposition of the great arteries with situs inversus visceralis and cleft palate, but without other cardiac defects.

A 17-year-old female admitted for cleft palate surgery was referred for further evaluation of her cardiac condition. The patient had been diagnosed as dextrocardia at birth, without any cardiac murmurs. She has led a normal life. The apical impulse was felt at the fifth intercostal space at the right mid-clavicular line. The ECG and chest x-rays were strongly suggestive of corrected transposition of the great arteries (CTGA) with situs inversus visceralis. Findings of the two-dimensional and Dopplar echocardiograms showed CTGA with a mild morphologic tricuspid regurgitation without any other complicated cardiac anomalies. In the Japanese literature, 36 CTGA patients without associated cardiac defects have been reported. Of these, four patients revealed dextrocardia. To our knowledge, our patient is the first reported adult case without any cardiac defects, only minimal tricuspid regurgitation, situs inversus totalis and cleft palate.


Accidents in childhood. Review of cases in the emergency room and hospitalized cases.

Accident mortality in childhood is a big problem not only in Japan but also in many other countries. We have reviewed our experience of 4,502 patients below 18 years of age who visited our emergency room in the fiscal year 1990. The number of cases of accidents other than traffic accidents was 243 and was almost double the 131 children involved in traffic accidents. Children with ordinary injuries (trauma) were excluded from accident patients. The most common non-traffic accident in childhood was foreign body ingestion or inhalation. The gastrointestinal tract was the most common site of foreign body ingestion or inhalation. Forty-two children with bronchial foreign bodies and 38 cases of near-drowning who were admitted to our hospital from 1975 to 1991 were also studies. Among the bronchial foreign bodies, we had a high rate of peanut inhalation. Foodstuffs including peanut accounted for more than 80% of the bronchial foreign bodies. Among the 38 near-drowning cases, we had five fatal cases, three cases were severe neurological sequelae and 30 intact survivals. Bathtubs at home were the most common site of near-drowning, particularly for young children.


Two cases of adenolipoma of the breast.

Adenolipoma of the breast is a rare tumor. Two cases are described here and the literature is reviewed. Case 1 was a 52-year-old woman who had a 3-cm-long elastic hard tumor in the left breast. Case 2 was a 40-year-old woman who had a 3-cm-long elastic soft tumor in the left breast. In each case, mammography revealed well demarcated soft tissue density. Ultrasonography demonstrated well defined tumors composed of echogenic and sonolucent areas. These tumors were easily enucleated at surgery. Histologically, the tumors consisted of mammary ducts, fibrous stroma and adipose tissue, findings which are characteristic of mammary adenolipoma. An adenolipoma may still be misdiagnosed as a fibroadenoma or a fibrocystic disease. Characteristic findings of mammography and ultrasonography are emphasized.


Wood stove effects on indoor air quality in Brazilian homes: carcinogens, suspended particulate matter, and nitrogen dioxide analysis.

The effects of wood burning stoves on indoor air quality was investigated in a rural community of southern Brazil, during the winter season of 1991. The concentrations of polycyclic aromatic hydrocarbons (PAHs), nitrogen dioxide (NO2) and suspended particulate matter (SPM) were assessed in houses with wood stoves and the results compared with levels found in houses with gas stoves. Strikingly higher (p < 0.01) levels of PAHs, and much higher (p = 0.07) levels of SPM were found in the kitchens with wood stoves. In contrast, NO2 concentrations in the kitchen as well in personal exposure, were found to be slightly higher in houses with gas stoves. All these differences were minimally affected by smoking, outdoor air pollution or other emissions from indoor combustion products. These findings appear to support the hypothesis that domestic wood burning stoves are risk factors for some upper digestive and respiratory tract cancers in Brazil.


Assessment of speech and language skills in children.

A speech and language assessment procedure was developed to study different aspects of speech and language skills in children 6.5 years old who had needed intensive care in the neonatal period. It was required that the procedure could be carried out at one examination session and that it should characterize a broad spectrum of language skills and permit detection of deviations in language development. The assessment comprises three parts. Part A is an evaluation of the child's spontaneous speech during a 10- to 15-minute conversation between the child and the assessor. Eight different variables are assessed, and an overview of the child's conversational behaviour is obtained. Part B is an assessment of speech and language skills. A set procedure is used to assess auditory discrimination, interaction between auditory and speech motor capacity, different comprehension functions, vocabulary and word fluency. Some motor tasks are included to elucidate the relationship between speech and non-linguistic fine motor activity. Part C is an interview with the parents. A control group of 40 children was tested. The assessment protocol is now being applied for follow-up examination of children who have needed neonatal intensive care at Uppsala University Hospital, Sweden.


Visual impairment of open angle glaucomas at first presentation and after a five to ten year follow-up.

Of all patients attended to in a clinic during 1986, 441 had open angle glaucoma diagnosed during 1974-1986 on the basis of either a verified visual field defect, a glaucomatous disc, or a repeated intraocular pressure value of at least 35 mm Hg. At first presentation of recent cases 1984-1986 (N = 128) 65 per cent were more than 70 years old. Capsular glaucomas were twice as common as simple glaucomas (low tension cases included). 62 per cent of capsular but only 26 per cent of simple glaucomas had an initial pressure of 35 mm Hg or more (p < 0.001). One third of both capsular and simple glaucomas had an advanced visual field defect with breakthrough to the periphery in the worse eye already at first presentation. This was more common if the initial pressure was 35 mm Hg or more (p < 0.05). Almost half remained unilateral cases, and the rate of severely impaired visual function in the better eye did not exceed 15 per cent. While generally 30-50 per cent of glaucomatous field defects had progressed in five years, the progression in early detected cases was only three per cent (p < 0.05). Visual field defects with breakthrough to the periphery already at first presentation progressed more often than circumscribed scotomas (p < 0.02).


An outbreak of gonadal hypoplasia in a sheep flock: clinical, pathological and endocrinological features, and aetiological studies.

In 1984, 31 per cent of 437 ram lambs reared on one property were found to have either bilateral or unilateral testicular hypoplasia. Similar numbers of ram lambs were reared in the next three years and 13, 2 and 0.5 per cent were affected. Severely abnormal testicles typically produced no spermatozoa and presented a 'Sertoli cell only' picture. Sixty-six of 200 ewe lambs born in 1984 were not marked by a harnessed teaser before mating; 12 of these were examined further and eight were found to have bilateral ovarian hypoplasia. The ovaries were very small and contained no oocytes or follicles. Plasma gonadotrophin levels were higher than normal in bilaterally affected rams and ewes but plasma testosterone and inhibin concentrations in rams with bilateral hypoplasia were not significantly different from those in normal rams. A genetic cause of the gonadal hypoplasia was considered unlikely in view of the pattern of occurrence and an examination of the flock pedigrees. No environmental cause was found. Two environmental sources of toxins were considered worthy of further investigation; onion grass (Romulea species) with its leaf spot fungus Helminthosporium biseptatum and the water supply which could have contained high concentrations of arsenic or other toxins during the period when the mothers of the affected lambs were in early pregnancy.


[The risk factors for breast cancer (a prospective controlled study)].

Preliminary results of a prospective study of known risk factors for breast cancer are discussed in the paper. The study included 42,785 females aged 40-64 years who were followed for 2-5 years (mean--3.1 years). Within this period, 146 cases of breast cancer were registered. A significant (p < 0.05) increase in the relative risk (RR) of breast cancer was established for females aged over 50 (50-59 years--RR-1.4; 95% CI--1.0-2.0 and 60-64 years-RR--2.4; 95% CI 1.6-3.7), overweight patients (RR--1.5; 95% CI--1.1-2.1), subjects who developed menopause after the age of 50 (RR--1.6; 95% CI--1.1-2.2) and those with a ten-year or longer history of liver or bile ducts pathologies (RR--1.7; 95% CI--1.1-2.7). The role of certain factors differed significantly in different age groups. At the age of 40-49 years, the RR of breast cancer rose significantly for overweight subjects (RR--2.0; 95% CI--1.2-3.4) and those with liver pathologies (RR--2.5; 95% CI--1.3-4.6), at the age of 50-59-for subjects with late (after the age of 50) menopause (RR--2.0; 95% CI--1.2-3.4) and at the age of 60-64 years-for nulligravidae (RR--2.8; 95% CI--1.1-6.8).


[The use of the carbon dioxide laser in the surgical treatment of breast cancer].

The paper discusses peculiarities of breast cancer surgery using high-energy CO2 laser. Advantages of laser scalpel are discussed. CO2 laser was employed in 120 cases of breast surgery including 70 operations for cancer (radical mastectomy and radical resection--35 cases each). Operative blood loss was reduced by half (from 350 to 140 ml). The duration of surgery and wound healing did not increase. Postoperative pain was less severe. The study is in progress.


[The treatment of edematous-infiltrative forms of breast cancer by using thermochemo- and thermoradiotherapy].

The study included 157 patients with edematous-infiltrative breast cancer. Thermochemo- and thermoradiotherapy were shown to modify (increase) cancer cell sensitivity to antitumor treatment and thus improve tumor response.


[Blood triboluminescence in patients with cancer of the proximal stomach and esophagus].

Total triboluminescence, i.e. optic radiation induced as a result of mechanic activation of venous blood in a TPA-2 triboluminometer, was measured in patients with cancer of the gastric cardia and esophagus, and in healthy subjects. The parameter was assessed in control water samples, too. In the 252-649 nm range, five bands of emission were registered with peaks at 262, 280, 360, 422 and 649 nm subject to variation in certain segments of blood spectrum. Triboluminescence of the venous blood at 280 nm determines for the total triboluminescence registered in the entire spectrum. The triboluminescence of capillary blood at 302 and 418 nm calculated using K coefficient facilitates differentiating between inflammation and cancer. This express test takes less than 1 minute and requires a small blood sample (0.02 ml). The accuracy proved 88%.


[The assessment of the hormonal sensitivity of tumors of the large intestine in the adenylate cyclase test].

Sensitivity of 142 human large bowel malignancies to gastroenteropancreatic hormones (VIP, glucagon and pentogastrin) and calcitonin was studied using in vitro adenylate cyclase reaction of tumor. At least 40-55% of the tumors proved hormone sensitive. Heteroresponse (reaction to calcitonin) was most characteristic for colonic tumors whereas weak reaction to VIP and glucagon-for rectal neoplasms. A certain relationship was established between adenylate cyclase reaction to hormone stimulation, on the one hand, and peculiarities of tumor (degree of cell differentiation) and the body (gender), on the other. In patients who survived over 4 years, tumor adenylate cyclase had initially been more sensitive to hormone stimulation than in those who died over that period. It is concluded that tumor adenylate cyclase reaction to hormone stimulation is quite a reliable test for evaluating hormone sensitivity of large bowel tumors and, possibly, for choosing hormonal therapy.


[The inhibiting effect of epsilon-aminocaproic acid on the incidence of induced tumors of the esophagus, nervous system and kidneys].

The anticarcinogenic properties of epsilon-aminocaproic acid were studied in two rat models of carcinogenesis. Esophageal tumors were induced by oral instillations of a total dose of 54 mg/kg body weight N-methyl-N-benzylnitrosamine whereas tumors of the nervous system and kidney-by transplacental injection of 75 mg/kg body weight N-ethyl-N-nitrosourea. epsilon-Aminocaproic acid given at a concentration of 1 milligram drinking water at the post-initiation stage of the carcinogenesis was shown to inhibit the induction of cancer and papilloma of the esophagus, brain glioma, peripheral nerve neurinoma and mesenchymal tumors of the kidney.


[An analysis of the visits of breast cancer patients for medical care].

One-hundred and three breast cancer patients were questioned. As few as 35% of them had been regularly checked-up. 52% of patients took medical advice immediately after tumor detection. In 25% of patients, the period between the first examination and referral to a hospital was longer than 1 month whereas 59.2% of patients waited for 1 month to be hospitalized. Inadequate and prolonged examination and malpractice accounted for delayed diagnosis of breast cancer in 64.2%.


[Saving the musculus pectoralis minor in radical mastectomy].

Eighty-five patients were surgically treated for postmastectomy edema of the upper extremity. In 20 of them, phlebolysis of the subclavian vein was performed. It was established that the vein was most often compressed by a long stump of the small pectoral muscle. Surgery and subsequent radiation treatment create unfavorable conditions for the muscle leading to its morphologic restructuring. Classic mastectomy after Halsted-Meier is recommended.


[The possibilities for improving the quality of life of cancer patients].

The authors emphasize the need for the society and its formations to participate in social rehabilitation of cancer patients. Participation of volunteers from groups of social-psychological support might be a way toward the solution of the problem.


[The rehabilitation of breast cancer patients].

Immediate and long-term anatomic, functional, psychologic and social results of radical treatment of breast cancer were assessed in 2 groups of patients who had either undergone or not undergone rehabilitation. The study showed that purposeful rehabilitative treatment and organizational measures assured a decrease in invalidism rate in working age patients from 75 to 43.6% and better quality of life.


[The reasons for patients with stomach cancer refusing surgical treatment].

Refusal of treatment was analysed in gastric cancer patients registered in the whole region (12.9%) and in the oncologic dispensary (12.1%). Two hundred and two patients refused treatment, 43 of them agreed to be operated 2 or more months later. Fewer refusals were registered among male and adult patients. The number of refusals increased with age. Reason for refusal were analysed. Explanatory work was carried out and some of them were informed of their diagnosis. Patients were invited for repeated explanation. Low level of medical education of the population, particularly, in the field of oncology was shown to be the main reason to refuse surgery.


[The role of endogenous and exogenous factors in the etiology of skin melanoma].

The results of case-control study of skin melanoma carried out in Moscow are presented. They point to considerable influence of endogenous factors on the relative risk of melanoma. The risk of melanoma is increased by such factors as light color of the skin, presence of freckles and moles. Exposure to UV-radiation raised the risk of melanoma, however, after relevant adjustment for the said factors relative risk was reduced. Consumption of greens and high blood levels of alpha-tocopherol significantly decreased the risk of melanoma. Female users of oral contraceptives had significantly lower risk of skin melanoma.


[The use of diksafen for curing the neurotoxic reactions of cancer patients undergoing radiation and chemotherapy].

The paper discusses a clinical trial of a newly developed Soviet preparation--dixaphen which was administered to 40 patients who had received radiation and chemotherapy for Hodgkin's disease and tumors at other sites. A single intramuscular injection of 1.0 ml was found to abort emesis in 80-90% and asthenic syndrome--in 60-75%. The drug was well tolerated; it is recommended for treatment of malignant tumors.


[The hematopoietic characteristics of laryngeal cancer patients undergoing thermoradiosensitization].

Peripheral blood and bone marrow were studied in 46 patients suffering laryngeal cancer. Two schedules of radiotherapy with and without local hyperthermia were used. Complex hematologic study included electron microscopy of the bone marrow. Apart from general hematologic parameters, partial erythro- and granulocytograms of the bone marrow, mitotic index of karyocytes and morphologic anomalies of erythrokaryocytes were studied. Hematologic studies were conducted both before and after a course of radiotherapy. Adverse effect of hyperthermia and radiation therapy on cells of the granulocytic and immunologic component of hemopoiesis was established.


[Chromosome fragile sites in patients with multiple primary tumors and familial forms of breast cancer].

An analysis was carried out of chromosomal site-fragility in patients with primary multiple tumors and familial breast cancer. A possible correlation is discussed between fragile sites, breakpoints in chromosome rearrangements in cancer patients and the localization of oncogenes mapped in chromosomal regions involved in said rearrangements.


[The criteria of the hormonal sensitivity of breast cancer].

The study deals with a complex approach to prognosis of hormone sensitivity in breast cancer patients on the basis of certain biological characteristics of tumor and the host. A number of clinical and morphological parameters were tested in 71 patients suffering breast tumors. The said parameters proved useful in determining hormone sensitivity and were used as a basis for indirect assay of estrogen receptors levels. Levels of estrogen (ER) and progesterone (PR) receptors and tumor sex chromatin (SC) were measured in 46 patients. Indirect determination of ER level should be recommended as an additional criterion for evaluating hormone sensitivity in breast cancer patients considering its findings matching (76-78.2%) those obtained in ER and PR assay by the labeled ligand binding method which uses dextran-covered charcoal. Close correlations (80.4%) and (sensitivity +1) were obtained for ER and PR, on the one hand, and that of sex chromatin, on the other, particularly, in ER+PR(+)-tumors. High concentration of sex chromatin in tumor is one of the most reliable criteria of measuring hormone sensitivity levels in breast cancer patients.


[Changes in the cytostatic and cytotoxic activities of the peripheral blood lymphocytes in the surgical treatment of lung cancer patients].

Cytostatic and cytotoxic activity of peripheral blood lymphocytes was studied in 30 cases of lung cancer. Enhanced cytostatic activity of lymphocytes was initially recorded. The level of natural antitumor resistance was maintained by means of neurovegetative inhibition used to prevent surgical stress.


[Salivary lysozyme in the screening for stomach cancer].

The study was concerned with measurement of lysozyme activity of saliva in healthy subjects and patients with different pathologies of the stomach including precancer and cancer. It established a considerable decrease in this parameter in cancer and precancer as compared with healthy controls. Assay of saliva lysozyme activity was found to yield more specific and prognostic data than clinical symptoms and examination of the patient. This procedure proved highly valuable in forming groups at risk for stomach cancer, due to providing significant differences in saliva lysozyme activity indices between "healthy subjects--stomach pathology" and "precancer--precancerous changes--stomach cancer" groups.


[The oxidative metabolism of the blood neutrophilic granulocytes in precancer and cancer of the stomach].

The results of investigation of blood polymorphonuclear leukocytes oxidative metabolism by nitroblue tetrazolium (NBT) test and luminol-dependent chemiluminescence in patients with gastric precancer and cancer are presented. Chemiluminescence was increased in the patients of both groups as compared with control. Disturbances in oxidative metabolism of neutrophils was detectable by NBT test when functional test was used.


[The determination of the concentration of the carcinoembryonic and meconial antigens in the gastric juice of patients with stomach pathology].

Beta-I-MA and CEA concentration in gastric juice was studied in 74 patients with gastric pathology and healthy subjects. Elevated concentrations of beta-I-MA and CEA were found more often in the gastric juice of cancer patients and less often in that of patients without malignant pathology. No significant differences in the concentration of each antigen were found between the "cancer" and "polyp" groups. The combined use of the two test procedures was shown to sufficiently complement the CEA test. The difference in the probability of high concentrations of both antigens in gastric juice in cancer and low ones in other pathologies was highly significant (chi 2 = 15.3, p. 0.00015).


[Carcinogenesis induced by the neonatal administration of 5-bromo-2'-deoxyuridine and subsequent exposure to N-nitrosomethylurea in rats].

Shorter life span, higher frequency and multiplicity of tumor, and shorter latency period as compared with intact controls were observed in LIO rats, which were injected, sc, 3.2 mg 5-bromo-2-deoxyuridine (BrdU)--a synthetic analog of thymidine--at days 1, 3, 7 and 21 after birth. Single intravenous injection of 50 mg/kg N-nitrosomethylurea (NMU) into 3 month-old rats treated neonatally with BrdU was followed by a significant increase in the frequency and multiplicity of tumors of certain localizations matched by a shorter latency period as compared with rats pretreated with either BrdU or NMU alone. It is suggested that BrdU-induced damage to DNA is sufficient for initiation and development of tumor growth and raising the level of sensitivity to other carcinogenic agents.


[The efficacy of polychemotherapy with cisplatin, methotrexate and 5-fluorouracil in inoperable forms of squamous cell cancer of the head and neck area].

The results of treatment of 19 cases of inoperable squamous cell tumors of the head and neck are discussed. The treatment schedule used three drugs: 100 mg/m2 cisplatin at day 1, 25 mg/m2 methotrexate, intravenously, at day 4, and a total of 1000 mg/m2 5-fluorouracil, at days 4-8 of treatment, by continuous 120 hour-long infusion. Effect was observed in 15 patients. The treatment was effective in 47.4% (complete regression--in 1 case, morphologically confirmed and partial regression--in 8 cases), stabilization--in 26.3 (5 patients) and further progression--in 26.3% (5 patients). Among the untoward side-effects were nausea, vomiting, anorexia, stomatitis and diarrhea. The toxicity proved tolerable.


[The plastic repair of extensive wound defects with vascularized flaps in treating tumors of the skin and soft tissues].

The study was concerned with comparison of the results of application of two procedures of plastic surgery using vascularized flaps for treatment of localized recurrent malignant tumors of the skin, soft tissues of the head, arms, legs and the trunk. According to one procedure (28 patients), large wound defects caused by extensive excision of tumor were treated using tissue flaps and microvascular anastomosis. In the other group of 10 patients, large defects were treated with skin-muscular flaps sitting on a fixed vascular-neural pedicle. But for these two procedures, some cases would not have been operated on at all due to considerable local extension of tumor.


[The current status of the problem and the treatment possibilities in disseminated malignant neoplasms of the maxilla].

A study of the results of treatment of 170 patients makes a case for combined electrosurgical resection of the maxilla and local chemotherapy with deposited cytostatic drugs for localized malignant tumors of this site. No recurrences were detected within the first 12 months in 75.4% of patients and 52%--in control. Three-year survival in treated patients and controls was 67 and 48%, respectively.


[The clinical significance of bone involvement in patients with primary lymphogranulomatosis].

A retrospective analysis of 2450 case histories of primary Hodgkin's disease established bone lesions incidence at 3.8%. They occurred in cases of general symptoms (6%) rather than otherwise (1.6%). Bone involvement came about chiefly via the blood flow pathway (59%), with several bones being involved in most cases. Dissemination through contact was less frequent 39%), the breast bone or vertebrae being involved relatively more often. Both radiation and polychemotherapy caused local healing effect which would lead to full recovery of bone structure in some cases. Therefore, combined (polychemotherapy + radiation) treatment should be recommended in cases of single lesions whereas treatment for multiple lesions may be limited to medication.


[Esophagogastroduodenoscopy in the diagnosis of benign nonepithelial tumors of the esophagus, stomach and duodenum].

Benign non-epithelial tumors cannot be detected unless endoscopy is used. When coupled with certain other procedures and biopsy it provides means for detection of these tumors as well as identification of their size, site, type of growth and concomitant complications. Single tumors were found in 156 and multiple ones in 4 cases. During the follow-up study, growth of tumor from 1 to 10 mm was observed in 11 cases only.


[Sex and pituitary hormone secretion in normal-height and tall adolescents with primary osteogenic sarcoma].

The paper deals with a comparison of basal levels of secretion of total testosterone (T) and estradiol-17 beta (E2), their free and albumin and sex-steroid-binding globulin fractions as well as LH, FSH, prolactin and STH in blood serum of 60 normal height and 60 tall healthy adolescents and those with primary osteogenic sarcoma of bones at different stages of puberty. The study established a significantly higher level of testosterone and free androgen index and a lowered concentration of sex-steroid-binding globulin in blood serum of both normal and tall adolescent patients with osteogenic sarcoma at different stages of puberty. No significant differences were found in said indexes of estrogens between sarcoma patients and a specific group chosen for comparison, as far as physical status is concerned. The role of sex steroid hormones and, particularly, that of androgens in the pathogenetical mechanisms of osteogenic sarcoma growth is discussed.


[Enzyme and isoenzyme activity in patients with malignant tumors of the oral mucosa].

The activity and isoenzyme profile of lactate dehydrogenase (LDH), alkaline and acid phosphatase were studied in tumors of the tongue, cheek, oral floor, soft palate and palatine tonsils (n = 100), leukoplakia (n = 7) and in the oral mucosa at corresponding sites in healthy subjects (n = 66), to develop tests for early detection, monitoring and prognosis of oral cancer. Levels of alpha-amylase and acid phosphatase were measured in saliva and blood serum of patients with oral cancer and healthy subjects. The activity of LDH and alkaline and acid phosphatase in oral malignancies were 1.5-6 times that in normal mucosa, depending on tumor site. Changes in LDH isoenzyme profile consisted in an increased level of M-subunits (LDH-4 and 5) and a decreased concentration of N-subunits (LDH-1 and 2). With regards to acid phosphatase, an increase in the activity of its tartrate-inhibited fraction was observed. An increase in LDH and alkaline phosphatase activity was registered for oral precancer (leukoplakia), too, although it was less pronounced than in cancer. Changes in LDH isoenzyme profile matched those in cancer patients. A significant increase in the activity of alpha-amylase, acid phosphatase and the latter's tartrate-inhibited fraction was registered in saliva of oral cancer patients (86-96%). The credibility of enzyme activity measurement in saliva for evaluation of response and prognosis is discussed.


[The positron spectroscopy of neoplasms].

The feasibility of positron spectroscopy of malignant tumors is discussed. Characteristics of the method and its information capacity are briefly discussed. The results of examination of several malignant tumors (cancers of the stomach, rectum, breast and lung and skin malignant melanoma) showed marked differences in the positron spectra of malignant and corresponding normal tissues.


[Carcinogenesis induced by the neonatal administration of 5-bromo-2'-deoxyuridine and subsequent exposure to estradiol benzoate in female BALB/c mice].

Female BALB/c mice were given 1 mg 5-bromo-2'-deoxyuridine (BDU) subcutaneously on days 1, 3 and 7 after birth or 5 mg estradiol benzoate (EB) 15 times weekly starting at the age of 3 months or both. Combined application of BDU and EB potentiated the carcinogenic effect of each agent on breast tissue: breast cancer occurred in 80.6% of animals as compared to 15.8, 9.7 and 0% in groups treated with EB or BDU alone and controls, respectively (p < 0.001). Treatment with BDU induced a slightly (but significantly, p < 0.02) higher overall tumor occurrence as well as higher occurrence of primary multiple and malignant tumors and breast cancer as compared to controls. It is suggested that BDU-induced accumulation of DNA errors contributes to initiation of neoplastic changes in the cell and cancer development which is further stimulated by EB.


[5-Iodo-2'-deoxyuridine in the assessment of the individual reaction of experimental tumors to irradiation].

C57BL/6 male mice bearing subcutaneously transplanted melanoma B-16 were used to study the applicability of 5-iodine-2'-deoxyuridine labeled with iodine 125 and 131 radionuclides to assess individual tumor response to radiation. The experiments using intact animals and those locally irradiated in the dose of 10 Gy revealed a correlation between excretion of the above-mentioned radioactive labels from tumor area and tumor growth rate for each mouse (correlation coefficient r = 0.93-0.97). 5-Iodine-2'-deoxyuridine excretion rate measurement can be used in express (24-48 hr) tests of individual tumor response to radiation.


[Functional research structures and the efficiency of science management in oncology].

The paper discusses feasibility of assessment of the state of the art in research in oncology using information technology and computed functional research structures. This structure allows to identify polar areas of interest, viz. active and passive research. Neutral directions of research serve to exchange information between the two polar areas. This approach allows quantitative evaluation of the importance of the research areas and their interrelationship and offers advantage over expert assessment methods. A critical area of research-genetic peculiarities of the malignant cell (tumor genetics)-is identified. The comparative data on the costs involved in analysis of planned research programs using experts and information technology are discussed.


[The polychemotherapy of patients with multiple myeloma].

The paper deals with the analysis of the results of chemotherapy of 78 patients with multiple myeloma using various combinations of cytotoxic drugs such as vincristine, cyclophosphamide, sarcolysine (melphalan), rubomycin (adriamycin) and prednisolone (dexamethasone). Reaferon was added in some cases. Response was evaluated according to standard criteria. Survival and response were assessed versus treatment modality and immunochemical type of disease. The most effective chemotherapeutic regimens for multiple myeloma are discussed. It is recommended that remission induction be followed by courses of consolidation treatment and then by maintenance therapy. Reaferon used as a component of complex treatment for multiple myeloma was shown to markedly potentiate the antitumor effect.


[The effect of a stay under central highlands conditions on the dynamic indices of the peripheral blood in children receiving treatment for cancer].

The study deals with the effect of rehabilitative treatment given at a medium altitude mountain resort on peripheral blood count in 54 children radically treated for cancer. Hemopoiesis was studied versus type of tumor, treatment modality and follow-up period. Disorders of hemopoiesis were identified in 45 out of 54 children examined. Rehabilitative treatment under said conditions was shown to improve blood count. A statistically significant increase in RBC, hemoglobin and platelet, leukocyte and lymphocyte counts (p < 0.05) was observed. In 42 out of 45 patients with anemia, thrombocytopenia, leuko- and lymphopenia, the indexes returned to normal.


[A temporary extracorporeal cavo-caval shunt in the treatment of malignant mediastinal tumors complicated by compression of the superior vena cava].

Gamma-ray teletherapy remains the mainstay in the treatment of mediastinal malignancies complicated by superior vena caval compression. However, patients presenting with severe circulatory disorders die of hypoxia before the effect of radiotherapy sets in. Temporary extracorporeal cava-caval shunt is intended to release blood from the vena cava superior network and then to return it back to the heart by vena cava inferior. The shunt obviates fatal consequences of circulatory disorders and supports the patient until radiotherapy starts to pick up. The method was successfully tested in 7 patients.


[Lysosomal proteolytic enzymes in the processes of melanoma invasion and metastasis].

Spectrofluorimetry was used to study the activity of lysosomal and membrane-binding endopeptidases such as cathepsins B (CB), D (CD) and L (CL) in 72 patients with skin malignant melanoma. Lysosomal endopeptidases were measured separately in the primary tumor, normal skin adjacent to tumor and intact and metastatic lymph nodes. The activity of lysosomal CB in the primary tumor was higher than in the adjacent normal skin. The peak activity of membrane-binding KB was established in metastatic lymph nodes. A significant increase in the activity of lysosomal KB was observed in involved regional lymph nodes as compared to intact ones. The activity of membrane-binding KB in metastatic lymph nodes was 6 times that in metastasis-free ones. A significant increase in the activity of lysosomal KD was established in primary melanoma nodes compared to adjacent normal skin as well as in metastatic lymph nodes compared to intact ones. Preoperative chemo- and radiation therapy was followed by a decrease in lysosomal KB and KL activity in metastatic lymph nodes which, however, did not reach the level established for intact lymph nodes. The pathogenetic role of proteolytic endopeptidases in invasion and dissemination of malignant melanoma is discussed as well as the value of their level measurement for assessing metastatic potential of tumor and prognosis of disease on the basis of tumor site, degree of invasion regional lymph node status.


[Sex and pituitary hormone secretion in adolescents with osteogenic sarcoma and retarded sexual development].

Basal levels of secretion of total testosterone, estradiol-17 beta, their free, albumin-binding and sex steroid-binding globulin (SSBG)--binding fractions, luteinizing hormone, follicle-stimulating hormone, prolactin and somatotropic hormone were measured in blood serum in the following groups of adolescents: (1) healthy, (2) suffering primary osteogenic sarcoma of the bone, (3) osteogenic sarcoma patients with pubertal retardation, and (4) pubertal retardation. A significant increase in total testosterone fraction, free androgen index and a decrease in blood SSBG level were established in osteogenic sarcoma patients as compared to corresponding controls, irrespective of pubertal status. No difference in the above indexes for estrogens was established between osteogenic sarcoma patients and controls in both pubertal status subgroups. The role of sex steroid hormones, particularly, androgens in the pathogenesis of osteogenic sarcoma is discussed.


[Tumor markers MCA and CA-125 in the diagnosis and monitoring of breast cancer].

The value of MCA and CA-25 tumor marker assays for diagnosis and treatment of breast cancer was analysed on the basis of measurements made in 320 healthy females and 85 breast cancer patients. A procedure for DK assay with anticipated specificity, sensitivity and reliability is described. MCA measurement was shown to be important for breast cancer diagnosis. The reliability of the latter test for diagnosing progression in the course of follow-up was 91%. Progression of the disease was shown to be associated with an increase in blood CA-125 level in 60% of cases.


[Estradiol-17beta, sex steroid-binding globulin and the cellular and humoral immunity indices in young women with breast cancer].

Blood serum levels of sex steroid-binding globulin (SSBG), free and SSBG- and albumin-binding fractions of estradiol-17 beta as well as some indexes of cellular and humoral immunity were compared in 25 young female patients with stage 1-3 breast cancer and controls. No significant difference in SSBG and free estradiol-17 beta fraction as well as free estrogen index was established between patients and controls. In the patient group, a direct correlation was established between free estradiol-17 beta fraction level and that of mature T-cells expressing CD3 antigen and between SSBG level, on the one hand, and total level of T-cells (CD7 antigen) and that of T-suppressors (CD8 antigen-containing cytotoxic lymphocytes), on the other. An inverse correlation was established in the same group between SSBG level and that of B-cell markers expressing CD3 and 7 antigens and IgM mu-chain. In the follicular and lutein phases of the menstrual cycle, a difference in the degree of correlation between total estradiol-17 beta level and immunologic indexes was established between breast cancer patients and controls.


[The effect of an infection due to the hepatitis B virus on the treatment results in breast cancer patients with bone metastases].

The study deals with the influence of persistent hepatitis B virus infection on immediate and end results of chemotherapy for breast cancer with bony metastases. The infection was shown to be associated with lower complete and partial remission rates, lower 3-year survival rate and higher rate of combination chemotherapy toxic effects such as nausea, vomiting and increased activity of aminotransferases.


[The effect of the synthetic immunomodulator thymogen on radiation-induced carcinogenesis in rats].

Five month-old female rats were given a mixture of Sr-90 and Cs-137 in drinking water in the dose of 0.1 and 0.2 microCi/day per animal over 12 months. Some animals received 12 monthly courses of a synthetic immunomodulating dipeptide--thymogen in the dose of 5 micrograms/animal for 5 consecutive days. Radionuclide-treated rats showed higher occurrence of tumors on the whole and of breast adenocarcinoma, in particular. Thymogen was shown to inhibit Sr-90- and Cs-137-induced radiation carcinogenesis, namely, a decrease in the total tumor and cancer occurrence was observed. The animals receiving thymogen alone showed longer life span, slower rate of aging and lower overall tumor and cancer occurrence. In this study, the ability of a synthetic peptide immunomodulator--thymogen to inhibit spontaneous and radionuclide-induced carcinogenesis in female rats was first established.


[Esophageal tumor induction in monkeys].

The experiment used eight monkeys who had received such esophagotropic carcinogens as ethyl ester of N-nitrososarcosine and methyl-N-benzyl-N-nitrosamine. The animals were followed for 4 years. The former agent failed to induce cancer where as 3 monkeys who had received methyl-N-benzyl-N-nitrosamine in the total dose of 600, 625 and 720 mg developed esophageal tumors (papilloma-2 and squamous cell carcinoma-1) at days 527, 725 and 880 after the start of treatment. The biological and histological features of the tumors were close to those of their human counterparts.


[Steroid hormone receptors in spontaneous testicular tumors in dogs].

Cytoplasmic receptors to androgens (AR), estrogens (ER), progesterone (PR) and glucocorticoids (GR) were studied in tumors and normal tissue of the testis in dogs. Peculiarities of distribution of receptors were assessed versus age and tumor histology. Benign Leydig cell tumors failed to reveal AR and ER. ER were more often detected in benign Sertoli cell tumors. Malignant seminomas and Sertoli cell tumors were characterized by higher occurrence and levels of AR, GR and PR than their benign counterparts. The results obtained can be used in studies of the activity of newly developed hormonal antitumor drugs against testicular tumors in dogs.


[Microsurgical tissue autotransplantation in treating malignant neoplasms of the head and neck].

Results of postoperative reconstruction of surgical defects using microsurgical autotransplants were studied in 72 patients in whom resection of head and neck cancer had been performed. The transplant took root in 64 (87.5%) cases. Musculocutaneous, cutaneous-fascial, cutaneous-osseous and abdominal transplants were used. Microsurgical autotransplantation of tissue complexes assured more rapid rehabilitation and better results of treatment for head and neck cancer.


[The problem of the participation of women in a program for the early detection of breast cancer using self-examination].

The USSR/WHO program in Leningrad which included 120000 females aged 40-64 years showed the percentage of breast self-examinees to drop from 82.0 to 55.8, and from 52.3 to 17.9% in those who performed monthly self-examination. This is accounted for by the lack of interest in this problem in the mass media.


[The role of the dispensary care of patients with dyshormonal breast diseases in the early detection of cancer].

The results of regular check-ups of 154 patients with dyshormonal pathology of the breast are discussed. 24.2% of patients were cured. Cancer was detected in 11.3%, with 84.4% of tumors being at early stages. It was concluded that patients with dyshormonal pathology be examined every 3 months.


[The diagnostic and treatment characteristics of rectal cancer in young persons].

The causes of advancement and results of treatment of 191 patients (aged under 40 years) with rectal cancer seen in 1967-1987 were analysed. The peculiarities of the disease in young age were identified. Timely diagnosis and better results of treatment of rectal cancer in the young can be assured with better educational activities and mandatory rectal examination during oncological check-ups.