[The importance of vascular surgery and path morphology in therapy of parasympathetic chemodectomas].

Was closely studied the material of 28 extracted chemodectomas. On the basis of modern methods of morphological investigation (histological, electronic-microscopic methods) were ascertained criterions of their malignant nature; for the first time was described the phenomenon of vessels overgrowing.

[Dermal cysts participate in reparative regeneration of epidermis in Hr(hr)/Hr(hr) mice].

One of the phenotypic effects of mutation in the Hr gene in mice is disintegration of hair follicles and their degeneration into open funnel-shaped structures (utricles) opened on skin surface and cysts located in the depth of the dermis. The aim of the current study consists in analysis of the process of reparative regeneration of skin in homozygotous mice with one of the mutant alleles of the Hr gene-Hr(hr). It is shown that epithelial cells that constitute the inner pavement of cysts take part in the process of epithelization of deep skin wounds. This indicates that the competence of ectodermal cells in relation to inductive signals from injured skin remains in Hrr homozygote mice, in spite of the significant anatomic abnormalities of the hair follicles.

Ultrastructural characteristics of chemodectomas.

We present results of morphological study of chemodectoma samples obtained during surgery. Specific ultrastructural features and protein-synthesizing and proliferative activity of light and dark cells were demonstrated using data of electron radioautography.

[Treatment of IIIa grade burns with the biologic band].

The biologic band is created on the base of type I collagen and platelet derived growth factor. It was applied for extensive burns of IIIa grade at 1-2nd day after a trauma, which led to epidermis reconstruction at 5-7th day. Authors assume that the effect of the band is determined by the time of its use--1-2nd day, when stimulating exudation qualities combine with healing properties of the bandage. The effectiveness of the collagen band showed to be equal to those of fibroblast transplantation.

Heterokaryon formation as a method for neuron regeneration in postischemic injury to cerebral cortex in rats.

Rat prefrontal cortex was examined by light and electron microscopy after stroke induced by photothrombosis. An appreciable number of binuclear neurons with morphologically similar and different nuclei was detected in the perifocal zone and adjacent intact tissue. The satellite oligodendrocyte nucleus was frequently the second nucleus in binuclear neuron. Control specimens also had binuclear neurons, but their number was much lower. It is hypothesized that neuron fusion normally and after injury is a manifestation of physiological and reparative regeneration of these cells.

[Morphological characteristics of distensible tissues with use of expanders of various types].

Distension of the skin stimulates the synthetic and protein-synthetic and proliferative activity of fibriblasts and cells of the microvascular wall (endoteliocytes and pericytes) of the dermis. The thickness of the skin increases by 2-2.5 times. The type of an expander did not depend on the capsular structure. Silicon expanders produced a less intensive inflammation than latex ones.

Radioautographic study of palatine tonsillar cells.

Proliferative and functional (protein producing) activities of palatine tonsillar cells were studied by light radioautography (semithin sections). 3H-Thymidine incorporation demonstrated the dynamics of renewal of palatine tonsillar cell populations in various pathological states. 3H-Uridine labeling objectively evaluated functional activity of different cells and more accurately showed distribution of destructive processes in the organ.

[Morphological radioautographic study of the palatine tonsils in chronic tonsillitis and healthy subjects].

A pilot morphological (radioautographic) study of healthy and affected palatine tonsils (in hypertrophy and toxic-allergic form of chronic tonsillitis) in children and adults has shown that intensity of biosynthetic processes (protein-synthetic -- RNA synthesis and proliferative activity -- DNA synthesis) in the cells of palatine tonsils and structural changes of their tissues depend on characteristics of pathological process. Microbial penetration into the tonsils with formation of an active focus of chronic infection is traced.

Proliferative activity of adipocytes in adipose tissue tumors.

Electron-autoradiographic study of normal and tumor-transformed adipose tissue (common lipoma and destructive lipoma, i.e. infiltrating and degrading lipoma) showed the capacity of adipose tissue cells in lipomas, especially in destructive lipomas, to proliferation and differentiation. In vivo synthesis of DNA in mature adipocytes not observed previously is described. The role of microvascular wall cells as mesenchymal multipotent precursors in the formation of the adipose tissue is discussed. The involvement of the bone marrow mesenchymal stem cell in this process cannot be ruled out.

[Proliferation of fat cells in lipomas]. / O proliferatsii zhirovykh kletok v lipomakh.

Common lipomas and destructive ones (intramuscular, infiltrating, necrotizing and destroying surrounding tissues) were studied in 9 patients electron-microscopically and radioautographically. The adequacy of necrotizing processes and regeneration was observed: normal fat tissue-lipoma-destructive lipoma. In the latter besides pronounced destruction of tissue (adipocytes, vessels, muscles at the border with tumour), there was accelerated differentiation of preadipocytes from the cells-precursors (fibroblasts and undifferentiated cells of the vascular wall), hypertrophy of preadipocytes (their size and number of nuclei increase) and their proliferation. The process of malignant transformation in a destructive lipoma may be so much pronounced that DNA synthesis may be observed in the mature lipocyte (this has not been described so far).

Autoradiographic study of parasympathetic paragangliomas (chemodectomas) of the neck.

Study of the morphofunctional characteristics of chemodectomas of the neck by photoautoradiography (semithin sections) showed the absence of protein-producing and proliferative activity in light and dark tumor cells against the background of strained biosynthetic processes in stromal cells. Invasion of capillary walls by tumor cells with their release into the capillary lumen is a prerequisite for metastases of these tumors.

[Electron-radioautographic study of parasympathetic paragangliomas (chemodectomas) of the neck]. / élektronno-radiograficheskoeissledovanie parasimpaticheskikh paragangliom (khemodectom) shei.

Chemodectomas, after the surgery, were studied in 7 patients. Morphologically their malignancy is proven on the basis of pronounced cell polymorphism, atypia, invasion of tumour cells through the vessel wall into their lumen. Besides rare mitoses, proliferative (DNA synthesis) and protein synthetic (RNA synthesis) activity in clear and dark cells was not observed in the presence of intensive biosynthetic processes in the stroma cells.

[Efficacy of clinical-serologic diagnosis of wound infection in burned patients]. / Izuchenie éffektivnosti kliniko-serologicheskoi diagnostiki ranevoi infektsii u obozhzhennykh.

Titer of antibodies to microorganisms obtained from wound and blood of 46 patients with burns of IIIAB--IV degree was studied. The majority of the burned patients have ability to synthesize antibodies. Agglutination of the bacteria by antibodies promoted location of infectious agent in primary focus and impeded bacteria to spread into blood and generalization of process. Not all microorganisms of wound provoke antibodies synthesis, i.e. wound infection. Therefore bacteriologic study must be supplemented by serum diagnosis. Detection of bacteria in the blood without serologic data do not permit to consider these bacteria as etiologic factor of wound infection.

[Immune status in diabetic patients with pyo-necrotic lesions of lower extremities]. / Sostoianie immuniteta u bol'nykh sakharnym diabetom s gnoino-nekroticheskim porazheniem nizhnikh konechnostei.

Long-term and severe pyonecrotic processes in diabetic patients testify to severe disorders of immune system in this disease. High titer of antibodies to tested autostrain demonstrated its etiologic role in infectious process. The study group consisted of 29 patients (with diabetic pyonecrotic foot lesions), control group--17 patients with burns of III a, b--IV stage affecting from 20 to 60% of body surface. In diabetic patients antibodies titer to the most encountered infectious agents Staphilococcus aureus and Pseudomonas aeroginosa was lower than in burn patients with immunity deficiency. Decrease of antibodies titer in diabetic patients testifies to high insufficiency of B-immunity.

Morphological changes in burn wounds after transplantation of allogenic fibroblasts.

Cultured allogenic fibroblasts labeled with fluorescent acridine orange and transplanted onto burn wound virtually completely disappear from the wound surface within 2 days (are destroyed). Study of wound morphology by light autoradiography and quantitative analysis showed a stimulating effect of transplanted fibroblasts on wound healing. This effect, irrespective of the initial state of the wound, is always directed at accelerated formation of connective tissue similar to the derma and capable of epithelialization.

[Morphological examinations of infected burn wounds]. / Morfologicheskoe izuchenie infitsirovaniia ozhogovykh ran.

Electron microscopical and electron radioautographic methods have been used for morphological examination. This allowed to raise sensitivity of the tests facilitating detection of living solitary bacterial cells (by intensive mark above them). Radioautography showed functional status of wound bacteria (the intensity of the metabolism and reproduction). It was determined that in living tissues, not damaged by the burn and unchanged morphologically bacteria do not penetrate. Especially massive accumulations of the microorganisms are found in necrotic tissues, under the scab, at the external border of demarcation protuberance, and they represent colonization of the wound. When modern methods of treatment and early necrectomy are used, morphological examination usually does not reveal pathogenic microorganisms. Only inflammatory reaction of the wound tissues could be seen: oedema, hyperemia, hemorrhages, cellular infiltrates. The development of granulation tissue indicated cessation of wound infection. Especially favourable feature, demonstrating healing of the wound, was appearance and reproduction of young cells of fat tissue (indusion of labelled thymidine). The results of the study have confirmed the advantage of new electronic methods for microscopy in infected burn wounds.

[Substantiation and varieties of complex surgical treatment tactics for pyo-necrotic forms of diabetic foot]. / Obosnovanie i varianty taktiki kompleksnogo khirurgicheskogo lecheniia gnoino-nekroticheskikh form "diabeticheskoi stopy".

For the period from 1996 to 1998 in the Division of wounds and wound infection of A.V. Vishnevsky Institute of Surgery 92 patients with pyonecrotic forms of "diabetic foot" underwent thorough examination and treatment. The patients were divided into groups by the form of "diabetic foot": with pyonecrotic forms of "diabetic foot" without critical ischemia (group 1) and with it (group 2). In 18 patients of both groups the data of electron autoradiography were used to reveal peculiarities of the wound process. Group 1 patients had at admittance a large number of neutrophiles in various stages of destruction in biopsies of the wound. In patients of group 2 a great majority of the vessels in biopsies of the wound were in different stages of destruction with lost connections between their separate cells or some of their part absent. Separate cells (endotheliocytes and pericytes) which make up the walls of destroying vessels, were synthesizing RNA and were functionally active. In both groups, the studied parts of the wound before plastic repair of its defect usually represented as well developed granulation tissues with a number of microvessels and cells. Intensive synthesis of PNA in the cells of microvascular wall evidenced of their high functional activity, and the synthesis of DNA in them showed their ability for proliferation, i.g.--for growth. Thus, microangiopathy was reversible, and the solution of the problem of critical ischemia should be considered in the light of macroangiopathy. Thus, in patients of group 1 the cause of pyonecrotic damage consists in infection process, while in patients of group 2--in combination of infection with ischemia of the extremity. In both groups pyonecrotic disease of the extremity ruses at the background of severe disturbances of cellular immunity.

[A morphological and electron radioautographic study of the wound in the diabetic foot syndrome]. / Morfologicheskoe i élektronno-radioavtograficheskoe izuchenie rany pri sindrome diabeticheskoi stopy.

Two groups of patients with a grave form of diabetes mellitus type I and II with diabetic foot syndrome have been examined. Group 1 (21 cases) consisted of patients whose foot was amputated. The cause of the necrotic process was ischemia produced by alteration of the arterial vessels aggravated by infection. Patients of group 2 (18 cases) were treated with resultant wound healing and foot preservation. The material was subdivided into two subgroups: 1) tissue from the "infectious" foot with great amount of bacteria and inflammation reaction; 2) tissue from the "ischemic" foot with considerable alterations of microvessels structure. In both groups well developed granulation tissue was observed after the treatment; almost all the cells of this tissue included 3H-uridin and labelling with 3H-thymidine was increased in fibroblasts, endotheliocytes and pericytes.