Feasibility study of high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver.

This study evaluates the feasibility of using high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver. HIFU ablation was carried out in 62 patients with echinococcosis of the liver. The mean age of patients was 40.76±14.84 (range: 17-72 years). The effectiveness of the treatment was monitored in real-time by changes in the gray-scale, and by morphological studies, computed tomography, magnetic resonance imaging, and ultrasound. Criteria for evaluating the effectiveness of treatment in real time were outlines. Cytomorphological picture of destructive changes of parasitic elements was presented as well. Loss of embryonic elements of the parasite was observed at the subcellular level after HIFU-ablation and underlines the effectiveness of HIFU.

Treatment of liver alveococcosis with high-intensity focused ultrasound.

This study evaluates the feasibility of using high intensity focused ultrasound (HIFU) for the treatment of liver alveococcosis. HIFU ablation was carried out in 36 patients with alveococcosis of the liver. The median age of patients was 39.24±12, 93 years (range: 20-66 years). The efficiency of treatment was monitored in real time with morphological evaluation, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), and with morphological cytological and electron microscopy studies. HIFU ablation has shown effectiveness in destroying the protoscolexes, laminar and cell elements of the cuticular and germinal membrane of the alveococcosis larvocyst, causing the death of the cells of initial metamorphosis of alveococcosis, which is responsible for the dissemination of the parasite in the liver. Therefore HIFU-therapy is a promising and effective treatment for liver alveococcosis.

[Fine-needle aspiration biopsy in the diagnostics of nodular thyroid lesions].

The use of the improved puncture needle was evaluated on the basis of 126 biopsies of thyroid nodular lesions. Benign lesions were diagnosed in 114 (90,5%) patients, malignant tumors - in 10 (7,9%) cases. The method proved to be highly effective and provided correct preoperative diagnosis in 96,8% of patients with nodular goiter. Sensitivity of thin-needle aspiration thyroid biopsy was 100%, specificity - 99,95%.

[Morphologic changes in the esophagus in chronic hemodialysis and after kidney transplantation]. / Morfologicheskie izmeneniia pishchevoda pri khronicheskom gemodialize i posle peresadki pochki.

Oesophageal biopsies were studied in 80 patients with terminal stage of chronic kidney failure (CKF) treated with programmed hemodialysis and in 27 kidney transplant recipients. The following changes in the oesophagus were found: chronic oesophagitis, degenerative changes (oedema with balloon degeneration), intercellular oedema with formation of cavities filled with oedematous liquid, calcium deposits in the mucosa and submucosa. Degenerative changes occur more frequently in patients treated with hemodialysis and soon after the kidney transplantation. This can explain more frequent occurrence of Mallori-Weiss syndrome and erosions and ulcer of the oesophagus at CKF.

[Clinico-morphological evaluation of pathogenetic mechanisms of bouginage and intubation on cicatricial esophageal stenosis after chemical burns]. / Kliniko-morfologicheskaia otsenka patogeneticheskikh mekhanizmov vozdeistviia buzhirovaniia i intubatsii na posleozhogovye khimicheskie rubtsovye suzheniia pishchevoda.

The article deals with the clinico-morphological appraisal of bougienage and intubation of patients with cicatricial constriction of the esophagus after chemical burns. Endoscopic and morphological studies were carried out in 38 patients before and during treatment. Bioptic material collected from the esophageal mucosa was studied on a light-optic and ultrastructural level. The results of the study showed that bougienage of the epithelialized strictures causes protracted stimulation of intracellular regenerative processes and thus facilitates the development of leukoplakia of the squamous epithelium. The prevention of esophageal precancer in this case consists in radical maintenance bougienage and regular medical examination. Bougienage of ++non-epithelialized strictures stimulates the formation of young granulation tissue, while subsequent intubation stimulates reparative processes, creating in this manner conditions for adequate epithelialization of the ulcerated esophageal strictures.

[Electron microscopic verification of adenocarcinoma of the cardioesophageal area]. / Ob élektronno-mikroskopicheskoi verifikatsii adenokartsinomy kardioézofageal'noi zony.

Normal gastric and esophageal cardiac glands as well as proper esophageal glands were studied electron-microscopically. Cardiac gastric and esophageal glands were found to differ by chief cells available in the gastric glands and greater amounts of endocrine cells registered in the esophageal glands. The evidence can provide grounds for electron microscopic verification of cardioesophageal adenocarcinoma permitting the pathologist to rest upon the presence of cells resembling those of proper gastric glands and epigastric fossa. In addition, it can promote specification of the morphologic type of adenogenic esophageal cancer comprising squamous epithelial component and secretory granules typical of proper esophageal glands.

[Electron microscopic study of the histogenesis of dimorphous adenosquamous cell cancer of the esophagus]. / Elektronno-mikroskopicheskoe issledovanie gistogeneza dimorfnogo zhelezisto-ploskokletochnogo raka pishchevoda.

The report discusses a comparison of the results of electron microscopic study of glandular-squamous cell carcinoma of the esophagus, normal mucous gland tissues of the same organ and those in reserve cell proliferation. Glandular-squamous cell cancer tissues were found to contain tumor squamous-epithelial cells, glandular cells with secretory grains inherent in the mucous glands proper of the esophagus as well as chimera cells revealing the ultrastructural characteristics of the two cellular type. Further support was obtained for the previously suggested view on the bipotent epithelium of ducts of the mucous glands proper as a source of glandular-squamous cell carcinoma of the esophagus.

[Prognostic value of ultrastructural characteristics of dysplastic changes in the esophagus]. / Prognosticheskoe znachenie ul'trastrukturnykh osobennostei displasticheskikh izmenenii v pishchevode.

Dysplasia foci in the esophageal squamous epithelium against the background of various reactions of proliferation were studied by electron microscopy. Slightly altered tissue showed diverse cellularity, with dark cambial elements invariably present. With dysplasia advancing, the cell composition became uniform, with a high nuclear-cytoplasmic index. The dark cell pattern with numerous ribosomes was seen more often than that of keratinized clear cells. Small-cell focal proliferations are highly suggestive of precancer. Electron microscopy may be instrumental in eliciting more information on the risk of esophageal squamous epithelium precancer progressing to cancer since it provides data on cell composition, degree of cell differentiation and polysome formation as well as early signs of keratinization.

[Histological and ultrastructural characteristics of esophagitis in chronic kidney failure]. / Gistologicheskaia i ul'trastrukturnaia kharakteristika ézofagita pri khronicheskoi pochechnoi nedostatochnosti.

Examination of biopsy specimens secured during endoscopy of 70 patients in the terminal stage of chronic renal failure revealed abnormalities characteristic of chronic esophagitis, viz. hyper- and parakeratosis, basal-cell proliferation, acanthotic outgrowths, epithelial thickening, vacuolated cells (with balloon cells being present in some cases), presence of calcium crystals, cisternal widening in the rough endoplasmic reticulum, and mitochondrial swelling with cytoplasmic rupture and hyaloplasmic edema. These dystrophic changes may account for the relatively frequent occurrence of erosional and ulcerous lesions in the esophagus during the terminal stage of the disease.

[Ultrastructure of squamous epithelium in esophageal dysplasia and squamous cell cancer]. / Ul'trastruktura ploskogo épiteliia pri displazii i ploskokletochnom rake pishchevoda.

Electron microscopic examination of the oesophageal squamous cell carcinoma revealed the presence in the tumour of both undifferentiated and differentiated squamous cells. Keratinocytes appeared and the signs of keratinization were more pronounced in the cytoplasm of differentiated cells. Dysplastic changes were observed at the periphery of the primary node. Two main variants of dysplasia (dark-cell and clear-cell) were distinguished, this at the ultrastructural level being the reflection of the direction of differentiation and the degree of cell maturity in the dysplastic foci. With the exception of few cases with a cell polymorphism in the foci of a severe dysplasia, dysplastic changes of the squamous epithelium were characterized by a monotonous ultrastructural cell composition. The dysplastic cells were distinguished by a degree of differentiation and high synthetic activity.

[Morphological variants of glandulo-squamous cell cancer of the esophagus]. / Morfologicheskie varianty zhelezisto-ploskokletochnogo raka pishchevoda.

Microscopical examination of glandular-squamous cell carcinoma of the esophagus (20 cases) showed the variability of its structure. The following morphological varieties of the glandular tumour component are established: tubular, papillary, cystic, mixed. The degree of the tumour component differentiation can vary and this should be reflected in the histological diagnosis. The ultrastructural features characteristic of squamous and glandular epithelium are identified by electron microscopy.

[Ultrastructural changes in tissues in postburn cicatricial esophageal stenosis during bougienage and prolonged intubation]. / Ul'trastrukturnye izmeneniia tkanei v posleozhogovykh rubtsovykh suzheniiakh pishchevoda pri buzhirovanii i dlitel'noi intubatsii.

The ultrastructure of tissues in postburn esophageal strictures was studied in 24 patients varying in ages from 23 to 70 years with the postburn period ranging from 1 1/2 months to 36 years. Biopsy samples for the study were collected during fibroesophagoscopies before treatment, after bougienage and longterm intubation with the Tkachenko tube. Before treatment, pathologically altered granulation tissue forming the surface of ulcerated esophageal strictures was found to contain such mature forms of fibroblasts as collagenoblasts with moderate collagen-producing activity, myofibroblasts, and fibrocytes. Mechanical effects of bougienage and intubation of the esophagus stimulated formation of young granulation tissue in the area of ulcerated strictures, intubation of the strictures stimulating both biosynthesis and catabolism of collagen. Mature forms of fibroblasts of young granulation tissue formed in bougienage were represented by collagenoblasts with intensive collagen-producing activity, myofibroblasts, fibrocytes, and after long-term esophageal intubation also by fibroclasts.