[Clinico-anatomic characteristics of pancreatic cancer]. / Kliniko-anatomicheskaia kharakteristika raka podzheludochnoi zhelezy.

340 autopsy cases of pancreatic carcinoma from hospitals of St. Petersburg (1990-1991) and Petrozavodsk (1981-1990) have been studied (male/female proportion 1.1:1). The pancreatic head was involved in 75% of cases, including the head only in 61.3%, head and body in 12%, total organ involvement in 2.7%. Pancreatic carcinoma was combined with other tumors in 7 cases, including 4 cases of simultaneous combination. Histological types of carcinoma were represented by: adenocarcinoma (75.2%), undifferentiated carcinoma (10.9%), solid cancer (5.8%), mucosal (4.1%), squamous cell carcinoma (1.7%), glandular-squamous cell carcinoma (0.6%). Metastases occurred most frequently in the liver (52.6%) and lymph nodes (44.7%). Jaundice was registered in 39.1% of cases, primarily in cases of carcinomatous head involvement, and in 12.8% without such involvement (most frequently with metastases to the portal lymph nodes of the liver). Diabetes mellitus was diagnosed in 18 (5.3%) patients, but only in 4 of them as a consequence of pancreatic carcinoma. The diagnosis was found missed in 48% of patients.

[The clinico-morphological characteristics of cancer of the extrahepatic bile ducts (an analysis of 52 autopsy cases)]. / Kliniko-morfologicheskaia kharakteristika raka vnepechenochnykh zhelchnykh protokov (analiz 52 autopsiinykh nabliudenii).

Autopsy records have been analysed for 52 fatal cases of extrahepatic bile ducts cancer. Primary cancer most frequently involved common bile duct (37 cases). Histologically, skirr was found in 1 case, small-cell cancer in 1 case, adenocarcinoma in 50 cases. Radical and palliative surgery was performed in 4 and 24 cases, respectively. The invasion into the adjacent tissues and organs occurred in 34.6%, metastases were found in 32.7% of cases. Another primary lesion arose in 2 patients (sigmoid, thyroid cancer). 92.3% of patients developed jaundice with hepatic or hepatorenal insufficiency. Purulent hepatic disorder, impairment of intrahepatic bile ducts were seen in 40.4%. Focal pneumonia emerged in 32.7% of patients. Accurate lifetime diagnosis was made in 30 of 52 patients only.

[The use of spatial image filtration in the diagnosis of tumors and tumor-like processes of the jaws in children]. / Primenenie prostranstvennoi fil'tratsii izobrazheniia v diagnostike opukholei i opukholepodobnykh protsessov cheliustei u detei.

34 children were examined for tumours and tumor-like jaws diseases odontomas, giant cell tumours, fibrous osteodysplasias, epulides, eosinophilic granulomas. Roentgenograms and tomograms of the patients have undergone space filtration on the device for the DAR-2 roentgenogram analysis with separation of the upper and middle space frequencies of the picture. Space filtration separated features of the picture having differentially diagnostic meaning and characterizing the particularities of the tumour structure, it's bone border, alteration of the surrounding soft tissues.

[X-ray and morphological changes in fibrous osteodysplasias of the jaws in children]. / Rentgenologicheskie i morfologicheskie izmeneniia pri fibroznykh osteodisplaziiakh cheliustei u detei.

Thirty-three children were examined operated on for histologically verified fibrous osteodysplasia. X-ray examinations of the maxilla and mandible were carried out in the nasofrontal and lateral projections, roentgenograms were made in the semiaxial and naso-forehead projections, and intraoral roentgenograms of the teeth and alveolar processes, orthopantomograms of the mandible, and linear tomograms were made. Five variants of an x-ray picture of fibrous dysplasia were distinguished which should be taken into consideration in differential diagnosis.

[The gastrostoma in esophageal cancer: complications and the times and causes of fatal outcomes]. / Gastrostoma pri rake pishchevoda: oslozhneniia, sroki i prichiny letal'nykh iskhodov.

Data of esophageal cancer patients autopsies for 1977-1986 were collected from hospitals of Leningrad and Petrozavodsk and subjected to analysis. Gastrostomy had been carried out in 255 out of 847 (29.1%) cases studied. 83.4% of the operated patients died within one month whereas only 2.1% survived over one year. The majority of patients were evidently operated too late in the course of disease. 148 (58.1%) operated cases died due to progression and the other 107 (41.9%) died of complications of the surgical procedure and postoperative period, mainly pneumonia and peritonitis. 106 cases of the latter group died during the first month following gastrostomy.

[Iatrogenic pathology (on the basis of necropsy materials in Leningrad in 1988)]. / O iatrogennoi patologii (po sektsionnym materialam Leningrada za 1988 g).

The incidence of iatrogenic diseases on the basis of necropsy materials in Leningrad in 1988 is 1.2% (168 of 13928 necropsies). The categories (I, II, III) for the evaluation of the severity degree of iatrogenic diseases are suggested. The I category includes iatrogenic diseases which were the cause of death (58 cases or 0.41% of total number of necropsies). The II category: iatrogeny is not connected directly with the main disease but facilitated the development of severe complications (87 cases--0.62%). The III category: iatrogenic diseases did not play a considerable role in the thanatology. The necessity is underlined to discuss iatrogenic pathology at the clinicopathologic conferences establishing its causes and the degree of severity.

[The structure of iatrogenic diseases based on autopsy data from Moscow and Leningrad]. / Struktura iatrogennykh zabolevanii po sektsionnym dannym Moskvy i Leningrada.

The occurrence and pattern of disorders attributed to diagnosis and treatment were assessed comparatively by autopsy findings obtained in Moscow and Leningrad. The analysis suggested high frequency rate for iatrogenic diseases promoted by surgical interventions and chemotherapy. Some of these can be traced to physician's errors while delivering therapeutic and diagnostic procedures. The authors cover methodological approaches to gaining information, point to a high informative value of autopsy records, argue that iatrogenic diagnosis must be reflected in autopsy protocols and registered all over the country.

[Pathologo-anatomical characteristics of lung cancer (analysis of 2000 autopsy records 1981-1985)]. / Patologoanatomicheskaia kharakteristika raka legkogo (analiz 2000 sektsionnykh kart za 1981-1985).

2000 autopsy protocols have been scrutinized for 1590 males and 410 females who died of lung cancer in Leningrad and Petrozavodsk in 1981-1985. The findings, compared to those for 1953-1957, evidence for older age of the population at the terminal stage of the disease, more frequent cases of associated primary tumors (by 2.19%), greater proportion of squamous and bronchioloalveolar cell carcinoma (a rise from 24.6 and 1.2 to 45.7 and 3%, respectively). The proportion of small cell carcinoma, on the contrary, tended to decrease (from 48.4 to 22.6%). Lung cancer metastases used to emerge with similar frequency in patients subjected to radical operation and those surgically untreated. In 41 out of 144 lethal intraoperative and postoperative outcomes metastases were found to involve the other lung, viscera, mediastinal and distant lymph nodes. Further progress in the diagnosis of metastatic spread and adequate preoperative examination of the patients are thought to promote a valid choice of patients to be operated on.

[Current problems in improving pathologo-anatomic services]. / Aktual'nye zadachi sovershenstvovaniia patologoanatomicheskoi sluzhby.

A number of organizational measures directed to the improvement of pathoanatomic service has been put forward for the discussion. In particular, it is advised to generalize regularly all the autopsy findings according to a unified form, which will be of the greatest scientific and practical importance. The authors necessitate increasing the number of autopsies in cases of death at home. Measures to improve the quality of investigating the biopsy and surgical material are recommended, as well as methods of monitoring this work. The major principles in appointing the Chief regional pathoanatomist are discussed.