Disseminated form of the Kaposi sarcoma in HIV-negative patient associated with Hodgkin's lymphoma.

We report a case of a 35-year-old, non-HIV-infected male diagnosed simultaneously with a disseminated form of Kaposi's sarcoma (KS; skin, stomach and colon are involved) and Hodgkin's lymphoma. There is no sign of changes in the immune status, but three herpes viruses were detected in the patient's blood (EBV, HHV6 and HHV8). He received ABVD chemotherapy and achieved complete metabolic remission for Hodgkin's lymphoma. Moreover, the signs of the disseminated KS were resolved. Our observations indicate that a combination of distinct types of viruses may play an important role in triggering the development of angio- and lymphoproliferative disorders in the same person. In addition, treatment with chemotherapy cycles, which included doxorubicin and vinblastine, led to the stable remission of both diseases.

[Variants of retroperitoneal vascular structure in patients with early-stage cervical cancer who underwent systematic paraaortic and pelvic lymphadenectomy].

The aim of this study was to identify variants of retroperitoneal vascular structure during systematic paraaortic lymphadenectomy in patients with early-stage cervical cancer and to investigate the effects of these anomalies in surgical procedures. 79 patients who had undergone systematic paraaortic and bilateral pelvic lymph node dissection between 2006 and 2013 were included. Normal architecture and structural anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were studied. Variants of major retroperitoneal vascular structure were present in 10 patients (12.7%). Variants of renal vessels were identified in 8 patients (10.1%): supernumerary renal arteries and veins observed in 5 patients (6.3%); retroaortic left renal vein type I and II - in 3 patients (3.8%). A rare variant as double vena cava inferior was detected in 1 patient (1.3%). Vessel injury was present no one case in patients with variants of vascular structures and in 1 of 69 (1.4%) patients without variants of retroperitoneal vascular structure. There was no difference in intraoperative hemorrhage, transfusion red blood cell and rate of intraoperative hemoglobin between the groups. Thus the acquisition of knowledge and visualization of vascular variations decrease complications during systematic paraaortic and bilateral pelvic lymphadenectomy.

[Complications of typhoid fever and its causes in an epidemic focus].

Autopsy records, case histories, and archival organ and tissue samples were studied in 109 Soviet military men during the Afghanistan war, who had died of typhoid fever in 1980-1986. Morphological and statistical studies demonstrated that the current pattern and frequency of complications and immediate causes of death with the epidemic incidence in the endemic focus largely corresponded to those in the preantibiotic period. The specific features were the higher rate and early development of enteric complications, infectious myocarditis, and infectious-toxic shock, the higher, as compared with the past years, proportion of deaths from circulatory diseases and a reduction of cases of total intoxication. Acute cardiovascular insufficiency associated with infectious myocarditis and infectious-toxic shock was one of the main causes of death in the first 2 weeks of typhoid fever. Most patients died of perforative peritonitis and pneumonia in the later period.

[Pathomorphology and morphogenesis of myocarditis in typhoid fever].

Archives specimens of the heart, autopsy protocols and disease histories of 16 soldiers and officers of Soviet army who died in Afghanistan of typhoid fever were studied. It is concluded on the basis of morphology and statistics that interstitial myocarditis and sometimes pancarditis develop on the 2nd week of the basic disease. Characteristic features of typhoid fever myocarditis are inflammation of the heart intramural vessels, microcirculatory disturbances, edema and lymphocytic-macrophogeal infiltration of the stroma, sometimes with formation of granulomas, dystrophic and necrotic changes of cardiomyocytes.

[Myocarditis in severe typhoid fever].

The article explains the development of toxic infective myocarditis and, in many cases, pancarditis, in patients with severe typhoid fever (TF) with lethal outcome. The authors present the most frequently found symptoms and ECG signs, the main histological features and possibilities of clinical diagnostics of myocarditis. The latter is of special importance, because a significant number of patients do not have typical clinical presentation. The work is based on the data from 109 autopsy records and 42 case histories as well as the results of morphological study of the heart in archive samples received from 47 military men who died of TF.

[Infectious myocarditis--clinical and morphological diagnosis (a literature review)]. / Infektsionnyi miokardit: osnovy klinicheskoi i morfologicheskoi diagnostiki (obzor literatury).

For comparative evaluation of patient life quality we selected 3 groups depending on methods of surgical treatment of prostate benign hyperplasia. The groups of comparison included the patients who underwent prostate transurethral resection (n = 36), postpubic extravesical adenomectomy (n = 31) and transvesical adenomectomy (n = 35). It was established that informative clinical indices in evaluation of life quality were urination maximal rate, time of urination delay, urination time. Informative psychodiagnostical methods for evaluation of life quality in patients with benign hyperplasia of prostate are "MCF scale", "Asthenia scale", Test for differential self-appraisal of functional state, "Scale of reactive and personal anxiety", "Risk of coronary behavior" and Izenk's questionnaire. Total algorithm was developed permitting to predict the patient life quality with rather high accuracy.

[The clinical morphology of cardiac involvement in typhoid in servicemen in Afghanistan]. / Klinicheskaia morfologiia porazheniia serdtsa pri briushnom tife u voennosluzhashchikh v usloviiakh Afganistana.

The article is based on the results of studies of protocols of 65 autopsies, 42 medical histories and morphological studies of contemporary records of 47 hearts of the deceased servicemen from the Soviet troops in Afghanistan who died of typhoid. It was found out that myocarditis was developed in 61.9 7.3% of cases regardless of the existence and character of complications. The inalienable features of myocarditis were inflammatory changes (vasculitis, basically mononuclear infiltration of stroma, granulomas), vascular malfunctions (microcirculatory disorders, enhanced permeability of vessels, edema of stroma), dystrophic and necrotic changes in cardiomyocytes. Vasculitis had predominant significance in cardiac morphogenesis. Besides myocardium the inflammatory process had proliferated also on epicardium and mural endocardium, i.e. pancarditis.

[Complications and the proximate causes of death in typhoid]. / Oslozhneniia i neposredstvennye prichiny smerti pri briushnom tife.

The article analyses the 65 lethal cases by typhoid in the period 1980-1986 during an outbreak of infection among the servicemen of the 40-th Army. All the deceased had the age of 18-37, 79.8% of them were 18-20 years old. The most frequent complications were: myocarditis (84.6%), pneumonia (75.4%), hemorrhagic syndrome (50.8%), intestinal perforation (49.2%), intestinal ulcer hemorrhage (21.5%), pleuritis (20.0%), purulent complications (11.7%), endotoxic shock (12.3%). The structure of proximate causes of death was as following: perforative peritonitis (30.8%), pneumonia (20.0%), acute heart failure (13.8%), intestinal ulcer hemorrhage (12.3%), suprarenal hemorrhage (7.7%). The results obtained during this study prove the fact that this outbreak of epidemic infection had the features of classical typhoid.