[Impact of age and type of behavior on the course of ulcer disease].

AIM: To study features of ulcer disease (UD) course with reference to a biological age, type of behavior, quality of life for recommendations on psychological rehabilitation of these patients. MATERIAL AND METHODS: Examination of 111 gastroduodenal UD patients determined type of behavior, correlation of biological age (BA) and due biological age (DBA), quality of life (QL). RESULTS: An unfavourable BA/DBA correlation was found in 71.1% cases, in which patients over 45 years of age had a larger ulcer defect size. Behavior type A with shorter scarring was observed in 30.9% patients. Lower QL was explained by sleep disorders, pain, emotional reactions, the demand in continuous treatment, diet, limited physical exercise. UD patients have a low QL index and a high index of the disease severity. These parameters are higher in unfavorable correlations between BA and DBA and in patients with type A behavior. CONCLUSION: UD patients have behavioral peculiarities dependent on BA and affecting the disease course and QL.

[Spitz's nevus: differential diagnosis with malignant skin melanoma]. / Nevus Spitts: differentsial'naia diagnostika so zlokachestvenno' melanomo' kozhi.

Spitz's nevus is one of the most frequent simulators of malignant melanoma of the skin. Histological features of this nevus and differential diagnosis with so-called melanoma with minimum deviation are discussed.

[The immunocompetent structures of the skin and their role in the development of primary skin lymphomas]. / Immunokompetentnye struktury kozhi i ikh rol' v razvitii pervichnykh kozhnykh limfom.

Participation in immune reactions of main morphological skin structures (epidermal cells, skin associated lymphoid tissue, macrophagal and vascular systems) is described. Cooperation of these systems in immune reaction by means of complementary receptors on the cell membranes, adhesive molecules, cytokines and lymphokines is discussed. Primary malignant skin lymphomas are considered as tumors of the skin immune system.

[Primary skin lymphomas: phenotypic characteristics of major clinical variants, classification]. / Pervichnye limfomy kozhi: fenotipicheskaia kharakteristika osnovnykh klinicheskikh form, klassifikatsii.

Clinicomorphological characteristics of the most frequent forms of primary malignant skin lymphoma are given and their place in classifications of systemic diseases of hematopoietic and lymphoid tissue is shown. The use of specialized dermatological classification in practice of dermatologists is recommended.

[Angiolymphoid hyperplasia with eosinophilia (Kimura disease)]. / Angiolimfoidnaia giperplaziia s éozinofiliei (bolezn' Kimura).

Angiolymphoid hyperplasia with eosinophilia (ALHE) is characterized by the appearance of tumour-like nodes on skin and subcutaneous fat. Vascular proliferation with inflammatory infiltration consisting of lymphocytes and eosinophiles, as well as structures of lymphoid follicle type were revealed microscopically. A description is given of a patient, 34 yr. old, with typical clinical and morphological manifestations of ALHE. Basing on the literature and on the own experience the authors suggest that ALHE and Kimura disease are variants of one nosologic form.

[Cancer of the sweat glands (its clinico-morphological characteristics)]. / Rak potovykh zhelez (kliniko-morfologicheskaia kharakteristika).

Based on a review of the literature and the authors' own experience comprising 20 cases, clinical and histological characteristics of sweat gland cancers (SGC) are detailed. Two clinical variants of SGC are distinguished: exophytic (or exophytic-endophytic) with ulceration and endophytic (intradermal). The lapse of time between detection of a SGC and its removal generally ranges from 12 months to 2 or more years. It is shown that diagnostic and prognostic considerations warrant classifying these cancers into two groups: those arising from benign tumors and retaining their histologic and ultrastructural features (one example of such a tumor is malignant poroma) and primary cancers (e. g., mucoid adenocarcinoma). Cancers of the first group, which comprise a majority of all SGC, run a more favorable course.

[Congenital ichthyosiform erythrodermas: aspects of their etiology and pathogenesis]. / Vrozhdennye ikhtioziformnye éritrodermii: nekotorye aspekty étiologii i patogeneza.

The term "inherited ichthyosiform erythrodermia" (IIE) designates a heterogeneous group of inherited disturbances of keratinization. Lamellar ichthyosis (LI), inherited nonbullous ichthyosiform erythrodermia, bullous inherited ichthyosiform erythrodermia (BIIE) and some other conditions. Processes of terminal cell differentiation and epidermal keratinization are affected in all the above conditions. A decrease of transglutaminase activity is observed in L1, this being connected with mutations in chromosomes 14q, 2g33-35. In BIIE which is characterized by dense groups of tonofilaments in the suprabasal layer, mutations of keratin I and X coded by chromosomes 2 and 17 are identified. When sporadic forms of the disease occur, the main question is establishment of the genotype-phenotype correlation which depends on detailed characteristics of each patient and accurate study of the ultrastructural disturbances.

[Acrospiroma (clinico-morphological characteristics and histogenesis)]. / Akrospiroma (kliniko-morfologicheskaia kharakteristika i gistogenez).

Clinico-morphological characteristics of 105 acrospiromas surgically removed within 10 last years is presented. In 6 patients the tumour was considered as a malignant acrospiroma which, according to the literature and the authors' material, is prone to recurrence. The features of a diagnostic significance are discussed in detail: the development of tumour in the cyst, growth of squamous cells and clear (due to the glycogen) cells, formation of structures resembling the sweat glands ducts. Electron-microscopic examination indicates the histogenetic link of acrospiroma with the elements of sweat gland ducts (intracytoplasmic ducts, periluminal cells, the lack of clear signs of secretion). All this relates also to the tumour described in the literature as a clear-cell hydradenoma.

[The significance of epidermal changes in the early diagnosis and development of mycosis fungoides]. / Znachenie izmenenii épidermisa v rannei diagnostike i razvitii gribovidnogo mikoza.

In 47 patients with stage I mycosis fungoides, biopsy of skin has revealed substantial changes in epidermis acanthosis with confluent epidermal processes, focal dystrophy of basal cells, mitoses in various epidermal layers, parakeratotic foci without a granular layer. Histoautoradiographic and immunomorphological studies demonstrated that enhanced proliferative activity of keratinocytes that was more pronounced in stages I and II mycosis fungoides and impaired epidermal differentiation that was predominant in neoplastic stage III underlay the above changes. There was ultrastructural evidence for abnormal epidermal keratinization. It was proposed that epidermal abnormalities made an important contribution to the development of mycosis fungoides.

[Differential diagnosis of basalioma and metatypical skin cancer]. / K differentsial'noi diagnostike bazaliomy i metatipicheskogo raka kozhi.

The WHO histological classification of skin tumors (Geneva, 1980) has first distinguished a new nosologic variety of skin carcinoma, metatypic carcinoma (MTC) being intermediate between basalioma and squamous cell carcinoma. Separation of MTC from the group of basaliomas is important prognostically because this tumor is capable of metastasizing, whereas MTC diagnosis is difficult because it simulates basalioma clinically and morphologically. The study of the mitotic regimen in 13 cases of MTC and 20 cases of basalioma showed this method to be adequate for differential diagnosis of these tumors. The values of the mitotic regimen in MTC always differed from similar values in basalioma: the mitotic activity, the specific content of dividing cells at the stage of metaphase, and the rate of pathologic mitoses increased considerably, there appeared multipolar and monocentric mitoses, bridges, three-phase metaphases.

[Tumors developing in an epidermal cyst]. / Opukholi epidermal'noi kisty.

The paper presents clinical and morphological characteristics of neoplasms arising in epidermal cysts (73 observations). It is emphasized that the epithelium of epidermal cyst may be the source of growth of not only benign cystic epithelioma ("proliferating epidermal cyst" as designated by the foreign authors) but also of squamous cell carcinoma. Cystic epithelioma (54 observations) is a slowly growing tumor represented by outgrowths in the cyst lumen of differentiated squamous epithelium apt to form smaller cysts. A predominance in cystic epithelioma of the basal type cells and complexes of squamous epithelial cells with hyperchromic and slightly polymorphous nuclei (7 observations) is considered to be the initial sign of malignancy of the noninvasive cancer type. Cancer arising in epidermal cyst (11 observations) is characterized by rapid growth, invasion into derma and trend for relapses. Frequently it has the structure of keratinizing squamous cell carcinoma. A malignant tumor is described characterized by a combination of cystic epithelioma, squamous cell carcinoma of pseudosarcomatous structure in some areas and glandular formations whose origin is obscure.

[The clinico-morphological diagnosis of cancer of the sweat glands]. / Kliniko-morfologicheskaia diagnostika raka potovykh zhelez.

Comprehensive clinical, morphologic, and ultrastructural studies of 12 cases with various forms of carcinoma of the sweat glands permitted distinguishing the clinical nodular and papular-cystic forms. Histologically malignant analogs of benign tumors, primary adenocarcinomas, and unclassified tumors are distinguished. The histogenetic appurtenance of the tumors of the latter group may be identified only by ultrastructural studies that help detect a number of organ specificity signs. Electron microscopy used in the diagnosis of poorly differentiated tumors of the skin helps carry out adequate therapeutic strategy and permitted a better validated prediction.

[Development of the caudate nucleus of rats in postnatal ontogenesis and formation of cholinergic mediation in it]. / Razvitie khvostatogo iadra krys v postnatal'nom ontogeneze i stanovlenie kholinergicheskoi mediatsii v nem

Morphological maturation of the rat's caudate nucleus and formation of cholinergic system in it were studied in postnatal ontogenesis. Under investigation were newborn rats, 7, 14, 21 day old rats and adult animals. The growth and maturation of the caudate nucleys were most intesne during the first two postnatal weeks, it was somewhat descreased by the beginning of the third week and continued in later terms as well. The structure of dendrites and axons became complicated during the first two weeks, the axo-dendritic contacts being also formed. The neuron structure in 14 days old rats was similar to that of adult animals. The activity of acetylcholinesterase in the caudate nucleus of 7 and 14 days rats was not great. It sharply increased by the 17th day and reached the level of adults with 3 weeks after birth. Possible correlations of the morpho-chemical maturation of the caudate nucleus and formation of motor activity in rats is discussed.

[Disordered keratinocyte differentiation in epidermal tumors and mycosis fungoides]. / Narushenie differentsirovki keratinotsitov pri épidermal'nykh opukholiakh i gribovidnom mikoze.

The immunocytochemical method with monoclonal antibodies to human and murine epidermis basal-cell antigen (BCAg) has been used in studies on the disorders in keratinocyte differentiation in epidermal tumors and mycosis fungoides. The fluorescence intensity augmented and BCAg distribution in the cytoplasm grew more diffuse as the degree of the tumor cell differentiation lowered. In mycosis fungoides the BCAg reaction has been positive first in the suprabasal layers; as the disease progressed, the fluorescence has involved the entire epidermis. The BCAg test is a sensitive tool for estimating the epidermal cell maturity in processes associated with impaired differentiation of keratinocytes.

[A case of active tertiary syphilis]. / Sluchai aktivnogo tretichnogo sifilisa.

A case of tertiary active syphilis in a 41-year-old male patient is described, who had not been administered specific treatment. Clinical symptoms of the disease manifested without apparent provoking factors; they were characterized by extensive involvement and no visceral abnormalities.

[Combined action of a UHF electromagnetic field and local freezing on biological tissues]. / Sochetannoe deistvie SVCh-élektromagnitnogo polia i lokal'nogo zamorazhivaniia na biotkani.

Experience gained so far by cryogenic surgery indicates that the possibilities of cryodestruction of sizable pathological formations are fairly limited. To overcome this barrier, it is necessary to change the status of the tissues, making them more sensitive to cryodestruction. The theoretical investigations suggest that microwave irradiation is one of the factors capable to change the status of tissues and to raise their sensitivity to cold exposure. Experiments made on the liver and muscles from rabbits, dogs and guinea-pigs have demonstrated that preliminary microwave irradiation followed by local freezing promotes the death of tissues 4-6-fold as compared to control.