[The psychological characteristics of interaction between patient and physician of traumatology department].

The actual conditions of "physician-patient" interaction in hospital department presents high requirements to quality and rate of provided services. The development of conflicts because of misunderstanding of behavior motivation of physician and patient in hospital department determined purpose of actual study. The standardized psychological questionnaire "Big Five" and Myers-Briggs questionnaire were used to obtain needed data. The study results were statistically processed using Student's test. The statistical analysis established in physicians and patients' reliable difference in indices of "attachment - isolation" (p=0.035), prevalence in physicians of mental processes (p=0.001) and sensuous component in social interaction of patients (p=0.025). The physician of orthopedic department seeks to keep exact logical sequence of actions. The patients fully rely on their feelings in their decision making. The established hypersensitivity of patients and inner strive to move "not according plan" results in disagreements concerning therapeutic strategy and failure in strict applications of all physician recommendations that frequently becomes a cause of uncoordinated actions and conflict situations.

[Immunomorphologic characterization of various parameters of stomach cancer invasion]. / Immunomorfologicheskaia kharakteristika nekotorykh parametrov invazii raka zheludka.

25 cases of advanced stomach carcinoma were studied immunomorphologically with the use of the antibodies panel to the carcinoembryonic antigen and meconian antigen B1, collagen types IV, I and III, laminin, Ki-67, P-105, factor VIII. Secretory and proliferative activity of tumor cells was shown unrelated to histological structure and degree of tumor differentiation. The more was proliferative activity the weaker was the secretory function. Formation of the basal membrane (BM), the degree of collagen formation and angiogenesis in the tubular adenocarcinoma did not depend on the differentiation level and the degree of tumor cells secretory activity. On the contrary, carcinoid component was characterized by pronounced angiogenesis and tendency to correlation between the degree of differentiation and the degree of BM formation. Stomach carcinoma is a heterogeneous group of tumors whose various morphological features may have an independent prognostic value.

[Immunomorphologic markers in breast cancer]. / Nekotorye immunomorfologicheskie markery pri rake molocnoi zhelezy.

Mammary carcinoma (MC) of various histological structure are studied immunomorphologically. Positive reaction with proliferative cells nuclear antigen (PCNA) oncoprotein cerbB-2, carcinoembryonic antigen (CEA), trophoblastic beta 1 globulin (TBG) and tissue protein ferritin (Fe) was observed in one third, and with cyprein in half of MC cases. Clear-cut dependence of immunomorphological parameters upon histologic structure and degree of malignancy was not established. An increase of PCNA content with the tumor size increase was observed. There is a tendency to more frequent observation of CEA, Fe, TBG in the presence of the lymph nodes metastases. Most unfavourable for the prognosis are combinations of positive reactions of CEA with TBG, CEA with OCNA, CEA with cerbB-2 as well as PCNA, cerbB-2, CEA.

[Neuroendocrine stomach carcinoma]. / Neiroéndokrinnyi rak zheludka.

Morphology of the neuroendocrine stomach tumours, including carcinoid tumours (CT) and so-called carcinoids of complex structure is studied (189 tumours of patients operated in the Institute), 164 tumours are studied using routine histological methods including Grimelius methods. Immunophenotyping with the use of antibodies to VIII type keratin, carcinoembryonic antigen, meconial intestinal antigen B1MA, Factor VIII, IV-type collagen and laminin were performed in 25 cases. Neuroendocrine carcinomas represented a group of 86 tumours (45.5%), 28 (14.4%) of them were carcinoid tumours and 58 (30.7%)--complex carcinoids. Among CT, moderately differentiated tumours predominated (18), 4 tumours were poorly differentiated and there was a combination of structures in 6 tumours. The conclusion is made that neuroendocrine stomach carcinomas are epithelial tumours with a complex functional differentiation manifesting in different types of secretion: neuroendocrine and non-endocrine characteristic of stomach epithelium.

[Monoclonal antibodies to neuron-specific enolase in phenotyping lung cancer]. / Monoklonal'nye antitela k neironspetsificheskoi énolaze v fenotipirovanii raka legkogo.

Morphological assessment of two samples of monoclonal antibodies (mcAB) to gamma-unit of neurospecific human enolase (NSE) is performed. It is established that mcABs interact in the tissue sections with neurons of the brain and spinal cord, gangliocytes of the central and peripheral nervous system this proving their specificity. 56 cases of lung carcinoma are studied using these mcABs; endocrine carcinoma was found in 11 cases, nonendocrine--in 45 cases. Neuroendocrine differentiation is revealed in 8 of 45 cases of non-small cell carcinoma; in all observations of small cell carcinoma NSE was found.

[Sources of vascularization of the interventricular septum and septal papillary muscles in various types of blood supply in humans]. / Istochniki vaskuliarizatsii mezhzheludochkovoi peregorodki i peregorodochnykh sosochkovykh myshts serdtsa pri razlichnykh tipakh ego krovosnabzheniia u cheloveka.

Using the preparation method, roentgenoangiography by means of contrast lead mass and polychromic injection of the coronary vessels, vascularization of the interventricular septum (IVS) and the septal papillary muscles (SPM) has been studied on 49 preparations of human hearts (age 19-89) The data are presented on distribution pattern of the IVS and SPM of the coronary arteries branches at various types of the cardiac blood supply. Angioarchitectonics of the IVS is described along its whole length. Topographic peculiarities of the SPM blood supply on dependence of their position on the IVS are noted.

[A comparative immunohistochemical and biochemical study of estrogen receptors in breast cancer]. / Sravnitel'noe immunogistokhimicheskoe i biokhimicheskoe izuchenie retseptorov éstrogenov v rake molochnykh zhelez.

The authors review the results of a comparative study of 25 mammary carcinomas, examined by the immunohistochemical method (IHM) with the use of ER-D5 monoclonal antibodies (Amersham) and by the cytosol receptor protein binding of a labeled ligand followed by the unbound hormone adsorption on dexteran-coated coal (DCM). Pap test with the above antibodies has been employed in immunohistochemical studies. The IHM has been highly specific. The results coincided in 21 of the 25 cases (83.3%). The reaction has been heterogenous in the same tumor. Quantitative values obtained by the two methods coincided in many cases. The IHM may have a wide practical application, provided the reagents are available, for it does not require sophisticated equipment and is simple to perform.

Monoclonal antibody mapping of keratins 8 and 17 and of vimentin in normal human mammary gland, benign tumors, dysplasias and breast cancer.

The distribution of keratins 8 and 17 and of vimentin in 28 normal human mammary tissue samples, 16 benign tumors, 26 fibrocytic diseases and 52 malignant breast tumors have been studied using monoclonal antibodies HI, E3 and NT30, respectively. Three cell populations in normal mammary epithelium have been identified: luminal epithelium containing keratin 8, myoepithelium of the lobular structures positive for vimentin, and myoepithelium of extralobular ducts positive for keratin 17. In different kinds of benign tumor and dysplastic proliferation a mosaic of cells with all normal phenotypes has been observed. The majority of cells co-expressed keratins 8 and 17 or vimentin. In the overwhelming majority of carcinomas, cells did not contain myoepithelial markers (keratin 17 and vimentin) but expressed only keratin 8 specific to normal luminal epithelium.

[Merkel cell cancer]. / Rak iz kletok Merkelia.

The authors analyze 3 cases of Merkel-cell carcinoma, examined by light and electron microscopy with the use of the immunomorphologic method. The diagnosis of this type of carcinoma is based largely on microscopic examination of the tumor. The principal morphologic sign is the presence of relatively monomorphous cells characterized by a definite growth pattern; trabeculae, strands, separated by connective tissue laminae. Electron microscopy ranks second in informative value; it detects the endocrine granules, provided the number of the examined samples is sufficient. Immunomorphologic detection of cytokeratins confirms only the epithelial nature of the tumor.

[Age-related characteristics of the distribution and attachment of chordae tendineae to the valves of the human heart]. / Vozrastnye osobennosti raspredeleniia i prikrepleniia k klapanam sukhozhil'nykh khord serdtsa cheloveka.

In 50 cardiac preparations of persons of various age (children, teenagers, adolescents, persons of mature and elderly age) distribution of various branches of the tendinous chordae (basic, marginal, commissural, rough zone) and level of their fixation to the ventricular surface of the right and left cusps of the atrioventricular valves have been studied. The tendinous chordae in direction from the apex of the papillary muscles towards the cusps of the atrioventricular valves are divided into the branches of the 2d--9th orders. Total quantity increase of the tendinous chordae is noted in the mature age, especially those of the 1st order in the left ventricle, and their decrease in the elderly age with an increase of the chordae of the 4th, 5th and 6th orders. Single chordae of the 8th and 9th orders can be found in elderly persons. Certain age specificities are revealed in fixation of various tendinous chordae to the cusps of the atrioventricular valves; they are surely connected with functional peculiarities of their different zones, that ensure air-tightness of the atrioventricular openings. There are quantitative differences of the tendinous chordae, fixed to certain cusps of the left (anterior) and right (anterior, posterior) atrioventricular valves; this is evidently connected with the role of the cusps mentioned in the mechanism of the valves closing.

Basement membrane components produced by a mouse ascites teratocarcinoma TB24. Analysis with monoclonal and polyclonal antibodies.

Monoclonal antibodies were produced against two basement membrane glycoproteins, laminin and entactin. The specificity of the antibodies and the absence of cross-reactivity were established by radio-immunoprecipitation of mouse ascites teratocarcinoma cell lysates. This teratocarcinoma, TB24, formed large embryoid bodies filled with extracellular matrix. The major component of the matrix was laminin. Abundant entactin, substantial amounts of fibronectin and rather little collagen type IV were also found in the matrix by biochemical and immunofluorescence analyses. TB24 teratocarcinoma appears to be a good model to test anti-basement membrane antibodies and to isolate certain extracellular matrix components in preparative quantities.

[Immunohistochemical research on human breast tumors using monoclonal antibodies to intermediate filament proteins. Cancer of the breast]. / Immunogistokhimicheskoe issledovanie opukholei molochnoi zhelezy cheloveka s pomoshch'iu monoklonal'nykh antitel k belkam promezhutochnykh filamentov. Rak molochnoi zhelezy.

Immunomorphologic study of 29 breast cancer cases using monoclonal antibodies to proteins of intermediate filaments shown to differentiate the lining epithelium from myoepithelium in the non-proliferating epithelial structures of the mamma, has shown the cells in the majority of tumours (according to the International WHO Classification defined as infiltrating ductal, lobular, and tubular cancer forms) to contain prekeratin (PK) C12, specific for normal lining epithelium, but not for the myoepithelium. In cases of cancer with chondroid metaplasia (a malignant variant of the so-called "mixed tumour") the cells contained PK E3, vimentin and structural myosin, normally specific for myoepithelium. The cell heterogenicity in PK C12 content or its absence noted in the infiltrating cancers with predominance of a solid component can indicate a high degree of tumour anaplasia. It is concluded that usage of monoclonal antibodies to PK C12, invariably found in the cells of fibrotic invasion foci, can be a useful indicator for early diagnosis of infiltrative tumour growth.

[Reaction of cellular-tissue components of osteogenic sarcoma to the combined action of adriamycin and irradiation]. / Reaktsiia kletochno-tkanevykh komponentov osteogennoi sarkomy na sochetannoe vozdeistvie adriamitsina i oblucheniia.

The study was concerned with the analysis of peculiarities of pathomorphism development in osteogenic sarcoma under different therapeutic modalities. Material was obtained from 229 cases of tumor treated within 1955-1981. Electron microscopic examination of tumor was performed in 20 patients who had had no preoperative treatment and in 3 patients who had received adriamycin intraarterially and distant 60Co teletherapy (total focal dose 36 Gy) prior to surgery. Chondroid zones revealed posttreatment changes similar to spontaneous ones. Degenerative changes displayed by cells of osteo- and fibroplastic zones differed from spontaneous ones. They manifested themselves in the development of "posttreatment forms" with signs of lipophanerosis and hyperpermeability of nuclear and cytoplasmic membranes resulting in cell edema. Rupture of membrane pointed to an irreversible character of cell damage.

[Immunomorphological research on human breast tumors using monoclonal antibodies to intermediate filament proteins. The proliferative epithelial structures in fibrocystic disease (dysplasia) and benign tumors]. / Immunomorfologicheskoe issledovanie opukholei molochnoi zhelezy cheloveka s pomoshch'iu monoklonal'nykh antitel k belkam promezhutochnykh filamentov. Proliferiruiushchie épitelial'nye struktury pri fibrozno-kistoznoi bolezni (displazii) i dobrokachestvennykh opukholei.

Proliferating epithelial structures were studied immunomorphologically in 16 cases of fibrocystic disease and benign tumours. Monoclonal antibodies were used to prekeratin (PK) C12, normally specific for the lining epithelium, to prekeratin (PK) E3 and to the protein of intermediate filaments in mesenchymal cells--vimentin, normally specific for myoepithelium. The immunofluorescent analysis of the most common proliferating structures has shown that there are elements with a variable combination of PK C12, PK E3 and vimentin among the proliferating cells. While there are cells similar to normal lining epithelium (PK C12) or myoepithelium (PK E3) and/or vimentin), many cells have no analogues either among normal cells, or among cells from ductal, lobular and tubular tumour forms. Since in the most common forms of breast cancer only cells containing PK C12 were found, the immunofluorescent study with the application of monoclonal antibodies to PK C12, PK E3 and vimentin can be recommended in difficult and dubious cases for the recognition of carcinogenic or dysplastic nature of morphologically similar proliferating structures.

[Features of the angioarchitectonics of the papillary muscles and the chordae tendineae of the human heart]. / Osobennosti angioarkhitektoniki sosochlovykh myshts i sukhozhil'nykh khord serdtsa cheloveka.

In persons of mature, elderly and old age vascularization of the papillary muscles and tendinous chordae in the right and left cardiac ventricles has been studied depending on peculiarities of their structure and sources of their blood supply using injection, macro-microscopical, roentgenoangiographic methods, and silver nitrate impregnation. Certain data concerning the distribution zones in the papillary muscles of the coronary artery branches at various types of the cardiac blood supply are presented. Angioarchitectonics of the papillary muscles are described along their whole extention--in the basal area, in the middle part and at the apex. Architectonic peculiarities of the blood vessels in the muscular-tendinous part of the papillary muscles and in some tendinous chordae are described.

[Human melanoma strains transplantable into athymic mice and rats]. / Shtammy melanomy cheloveka, transplantiruemykh na bestimusnykh myshakh i krysakh.

Malignant melanoma operative specimens from 3 patients, containing a substantial proportion of melanin as well as the MeWo cell line also containing the pigment, gave rise to human melanoma strains transplanted to nude mice and rats. All the strains demonstrated a rapid decrease in melanin production compared to the original material. The pigment was detectable by electron microscopy alone.

[Immunohistochemical study of human breast tumors using monoclonal antibodies to intermediate filament proteins (nonproliferating epithelial structures in breast dysplasia)]. / Immunogistokhimicheskoe issledovanie opukholei molochnoi zhelezy cheloveka s pomoshch'iu monoklonal'nykh antitel k belkam promezhutochnykh filamentov (neproliferiruiushchie épitelial'nye struktury pri displazii molochnykh zhelez).

An immunohistochemical analysis of nonproliferating epithelial structures was carried out in 10 samples of human breast dysplasia and in 4 samples of tissue surrounding mammary gland carcinoma. Monoclonal mouse antibodies against individual prekeratins of rat monolayer epithelial antibodies of clone C12 against rat prekeratin with the molecular mass 49 kilodalton and antibodies of clone E3 against rat prekeratin with the molecular mass 40 kilodalton-monoclonal antibodies against vimentin (clone 30), as well as polyclonal antibodies against smooth muscle myosin and against the basement membrane glycoprotein laminin were used. The lining epithelium of all glandular structures reacted only with C12 antibodies. Two variants of myoepithelial cells containing myosin were detected. Variant I contains myosin and vimentin and is localized in intralobular ducts. Variant 2 contains myosin and prekeratin, recognized by E3 antibodies and is found in extralobular ducts.

[Morphological characteristics of mesenchymal chondrosarcoma]. / Morfologicheskaia kharakteristika mezenkhimal'noi khondrosarkomy.

Complex morphological examination of 11 cases of mesenchymal chondrosarcoma is performed. This tumour has sufficiently characteristic clinical and morphological features distinguishing it from a usual chondrosarcoma. Clinically, mesenchymal chondrosarcoma is characterised by a shorter anamnesis of the disease, a rapid course and shorter life-span. It occurs more frequently during the 2nd and 3rd decades of life. Histologically, apart from the structures characteristic of typical chondrosarcoma, poorly differentiated areas resembling hemangiopericytoma occur and sometimes predominate. Electron microscopic examination of the differentiated parts of mesenchymal chondrosarcoma revealed the presence of cells with chondroid direction of the structurally-functional differentiation while in the areas with pericytal structures there were found structurally and functionally undifferentiated cells.

[Myofibroblasts in desmoids]. / Miofibroblasty v desmoidakh.

Ten desmoids are examined electron-microscopically and by the fluorescent antibody method. The cells with the ultrastructural signs of myofibroblasts are found in tumours. Immunomorphologically these cells were found to contain cytoplasmic myosin occurring in the cells of both muscular and non-muscular origin. The structural myosin of smooth muscle cells was not detected in these elements. The above cells are considered to be the modification of fibroblasts which have no relation to the smooth muscle cells. Non-homogeneity of myofibroblast population is noted.