Histological and electron microscopic features of the extracellular matrix of invasive breast ductal carcinoma of no special type. Report of 5 cases and literature review.

Invasive ductal carcinoma of no special type is the most common type of breast cancer. In light of the above, many authors have reported the histological and electron microscopic characteristics of these tumors. On the other hand, a limited number of works exist where the authors have concentrated on investigating the extracellular matrix. This article presents data received as the results of light and electron microscopic examination of the extracellular matrix, angiogenesis, and cellular microenvironment of invasive breast ductal carcinoma of no special type. The authors have shown that the processes of stroma formation in the IDC NOS type are associated with the presence of fibroblasts, macrophages, dendritic cells, lymphocytes, and other cells. It was also shown the detailed interaction of the above cells with each other, as well as with vessels and fibrillar proteins such as collagen and elastin. The microcirculatory component is characterized by histophysiological heterogeneity, which manifests as the activation of angiogenesis, relative vascular differentiation, and regression of individual microcirculation components.

[Pathoanatomical algorithm for differential diagnosis of Paget's disease of the breast]. / Patologo-anatomicheskii algoritm differentsial'noi diagnostiki bolezni Pedzheta molochnoi zhelezy.

Paget's disease of the breast is a rare type of cancer that affects the skin of the nipple and usually the areola. At the same time, most patients also have one or more tumors in the immediate vicinity of the focus of mammary Paget's disease. This tumor must be distinguished from normal or atypical Toker cells, and also differentiated from diseases such as Bowen's disease of the nipple and melanocytic lesions of the nipple and areola region, including nipple melanoma and BAP1-inactivated nevus (Wiesner nevus). Currently, there is no routine pathological diagnostic algorithm for these conditions. The aim of the work is to formulate a clear clinical and morphological algorithm for diagnosing Paget's disease of the breast and Toker cells, Bowen's disease of the nipple and areola, as well as melanoma and BAP1-inactivated nevi of the above localizations. Surgical material obtained from patients with Paget's disease of the breast (18), Toker cells of the nipple (2), Bowen's disease of the nipple (6), melanoma of the nipple (1), BAP1-inactivated nevus (1) was studied. The material was examined histologically with hematoxylin and eosin staining, Alcian blue and PAS reaction, as well as immunohistochemically with the following panel of antibodies: CD138, p53, CK8, CK7, HER2/neu, EMA, HMB-45, Melan A, S-100, p63, p16 and BAP1. An easy-to-learn pathoanatomical algorithm for diagnosing Paget's cancer has been developed, which will be especially useful for pathologists who encounter pathology of the nipple and areola in their work.

[Primary choriocarcinoma of the liver in a 36-year-old male patient. A case report and literature review]. / Pervichnaya khoriokartsinoma pecheni u muzhchiny 36 let. Klinicheskoe nablyudenie i obzor literatury.

The article presents a case of primary liver choriocarcinoma in a 36-year-old man. The patient was admitted to the hospital with signs of rapidly developing multiple organ failure, in connection with which the diagnosis was verified at autopsy according to histological and immunohistochemical studies. Diagnostic criteria and treatment options for this disease are insufficiently developed due to its rarity. To date, 11 clinical cases of primary choriocarcinoma of the liver in males have been described in the international literature. The article presents a review of the literature, as well as describes all published clinical observations of the disease.

Mitochondria in Lewis lung carcinoma cells under the effect of magnetosensitive nanocomplex and radiofrequency hyperthermia.

Electron microscopic study of Lewis lung carcinoma cell mitochondria after intravenous injection of a magnetosensitive nanocomplex based on ferric oxide (Fe3O4) nanoparticles and doxorubicin followed by radiofrequency hyperthermia showed that a common increase of the electron density of the cytoplasm was paralleled by mitochondrial edema in comparison with organelles of animals receiving doxorubicin alone. These changes were accompanied by virtually total lysis of the cristae and sharp clarification of mitochondrial matrix, which was seen from appreciable increase in mitochondria image brightness. Morphometric analysis showed lesser perimeter, area, and mean radius of the tumor cell mitochondria in animals receiving the injection of magnetosensitive nanocomplex and exposed to radiofrequency hyperthermia in comparison with those injected with doxorubicin alone. Histograms of distribution of the perimeter, area, and mean radius of the mitochondria after combined exposure to the nanocomplex and hyperthermia showed bimodal asymmetrical distribution. Injection of the magnetosensitive nanocomplex followed by radiosensitive hyperthermia led to more significant impairment of the tumor cell mitochondrial ultrastructure than doxorubicin alone.

[Effect of doxorubicine and heterogenous electromagnetic and thermal fields on the nonlinear dynamics of carcinoma Guerin development].

While local hyperthermia application the intratumoral blood flow is enhancing, leading to oxygenation and vascular permeability for antitumoral medicines. The work objective was to investigate the dependence of the development kinetics in carcinoma Gereni (CG) from combined action of doxorubicin (DR) and the kind of thermal impact, a contact one--due to a contact delivery of heat from a water heater and without contact - due to the tumor electromagnetic irradiation (EMI) using heterogenous electromagnetic field (EMF). DR was injected to the animals in a mass concentration of 1,5 mg on 1 kg of their body mass. The DR injection, a contact heating and EMI were started on the 8th day after the tumor reinoculation and kept on conducting once a 2 days. The course had included 5 injections and/or 5 seances of a contact heating and/or EMF. The combined action of DR and EMI, using spatially heterogenous EMF of applicator in environment of physiological hyperthermia, have had influenced mostly the inhibition of a nonlinear dynamics in CG development. Antitumoral action of DR in the animals with CG was influenced by thermal and nonthermal effects, which were initiated by spatially heterogenous EMF. Nonlinear dynamics of a CG development in animals did not depend from horizontal direction of isolines of a spatially heterogenous EMF of inductive applicator towards the tumor and duration of the irradiation procedure (15 or 30 minutes) after DR injection. The data obtained were exploited in clinical practice for the inductothermy optimal regimes elaboration while conducting complex treatment of patients, suffering oncological diseases.

The effect of electromagnetic field and local inductive hyperthermia on nonlinear dynamics of the growth of transplanted animal tumors.

AIM: To examine the effects of electromagnetic field with amplified magnetic component and local inductive hyperthermia (IH) on nonlinear dynamics of the growth of animal tumors. MATERIALS AND METHODS: Guerin carcinoma, Lewis lung carcinoma, sarcoma 45, Walker 256 carcinosarcoma and Pliss lymphosarcoma were studied. The animal tumors were exposed inside of loop aerial, 3 cm in diameter locally for 30 min. Parameters of electromagnetic irradiation (EI): frequency 40 MHz, magnetic intensity 72 A/m, electric intensity 200 V/m and the output power 50 W. The temperature measured by immersion of thermocouple inside the center of the tumor didn't exceed 38.5-39.5 degrees C. Nonlinear dynamics of the growth of animal tumors was analyzed by autocatalytic equation. The heterogeneity of ultrasonic image of the tumor was analyzed by Moran spatial autocorrelation. RESULTS: The strongest inhibition effect under the influence of EI was in Pliss lymphosarcoma and sarcoma 45. The growth stimulation of animal tumors after EI was recorded in Walker 256 carcinosarcoma. The use of mild IH increased the blood flow in the tumor of Guerin carcinoma. CONCLUSION: These results are important for clinical application because they testify the necessity of optimization of schemes for local EI during anticancer neoadjuvant therapy with the use of drugs or magnetic nanoparticles. The use of mild IH as a basis for the monotherapy of malignant tumors is not expedient.

Mechanochemically activated doxorubicin nanoparticles in combination with 40 MHz frequency irradiation on A-549 lung carcinoma cells.

Targeting of mechanochemically activated doxorubicin (MA DOXO) nanoparticles, conventional doxorubicin, and electromagnetic irradiation (EMI) at A-549 lung carcinoma cells in vitro was investigated. Conventional DOXO was micronized using an input energy of 20 W/g for 5 min resulting in positively charged MA DOXO particles 10 times smaller than conventional DOXO. Mechanochemical activation gives rise to additional free quinone radicals. High performance liquid chromatograph analyses demonstrate that conventional and MA DOXO are quantitatively similar. Tumor cells were exposed to 40 MHz electromagnetic irradiation at a power density of 2 W/cm2. The lethal dose LD50 values of MA DOXO were 5 times greater than conventional doxorubicin. MA DOXO in combination with EMI at 37 degrees C demonstrates improved drug delivery to A-549 human lung carcinoma and greater cell kill than does conventional DOXO.

[The NMR spin-echo method is used for measurements of the translational water diffusion selectively along the apoplast and the vacuolar and cytoplasmic symplasts of plant tissue]. / Metod spin-ékho IAMR v issledovaniiakh transliatsionnoi diffuzii vody selektivno po apoplastu, tsitoplazmaticheskomu i vakuoliarnomu simplastu rastenii.

Simple methods for the registration of translational diffusion of water in apoplast and vacuolar and cytoplasmic symplasts were developed. The methods are based on spin-echo NMR with a pulsed magnetic field gradient and are realized by preliminary inversion of magnetization and the use of paramagnetic doping. It was shown that the diffusion of a part of root water in segments of mais roots is more enhanced than that for the bulk water. The results are explained by the appearance of the rotational movement of the protoplasm and in terms of the hypothesis of water transfer along the apoplast, which balances the cytoplasmic symplast.

Effects of mechanochemically activated doxorubicin and 40 MHz frequency irradiation on human A-549 lung carcinoma cells.

AIM: To study in vitro influence of mechanochemically activated (MA) doxorubicin (DOXO) and electromagnetic irradiation (EMI) on human lung carcinoma A-549 cells. METHODS: Solid state DOXO was MA by input energy 20 W/g during 5 min. Tumor cells were exposed to 40 MHz EMI with power density 2 W/cm(2) at temperature 37 degrees C. RESULTS: Particles of MA DOXO have sizes 10 time smaller than officinal DOXO, high performance liquid chromatography analysis showed that parameters of officinal and MA DOXO were quantitatively equal. Mechanochemical activation initiated in the drug formation of free radicals with g = 2.005, g = 2.003 and g = 1.97. LD(50) values of MA DOXO were 5 times lower than that of officinal drug. Cell survival decreased in the following way after effects EMI --> officinal DOXO --> MA DOXO --> officinal DOXO + EMI --> MA DOXO + EMI. CONCLUSION: Treatment by MA DOXO and drug with EMI at 37 degrees C showed better targeting of drug in human lung carcinoma A-549 cells outcomes than officinal DOXO.

[Artificial esophagus in children]. / Iskusstvennyi pishchevid u detei.

The aims of the study were: 1) to formulate up-to-date principles of coloesophagoplasty (CEP) and to compare methods of CEP; 2) to determine the optimal age for esophagoplasty in children with esophageal atresia; 3) to evaluate quality of life and long term results after esophagoplasty performed in childhood; 4) to present results of surgical treatment of pharynx stenosis in children. Over the last 50 years more than 2 thousand surgeries on the esophagus in children were performed including more than 600 operations of artificial esophagus creation. From 1995 in some patients we carried out extirpation of the esophagus with one-stage plastic operation coloesophagoplasty taken the transplant in the posterior mediastinum. From 1992 on the pharynx with free revascularized intestinal segment was performed in isolated stenosis of the pharynx. Case histories of 54 children aged from 3 months to 15 years were analyzed to compare methods of esophagoplasty when the esophagus was taken behind the sternum and in posterior mediastinum. Case histories of 27 children with atresia of the esophagus were analyzed for determination of optimal age for coloesophagoplasty. Responses to questionnaires were analyzed to evaluate quality of life. From 1980 ive hase operated 28 patients with scarry stenosis of the pharynx (isolated or in combination with esophageal stenosis). Current policy of surgical treatment of pharyngeal stenosis which is considered as surgery of choice-pharyngoplasty with a free intestinal transplant--is described. Development and clinical appliance of up-to-date principles of CEP permitted to reduce the number of complications and to decrease lethality from 3 to 0.5%. After introduction of antireflux cologastroanastomosis the number of complications due to reflux reduced. Extirpation of the esophagus may be valid in peptic stenosis, Barrett's metaplasia, tumors, portal hypertension or angiodisplasia, and in the majority of cases of scarry stenosis of the esophagus.

[Predictive outcome of surgery of gastroesophageal reflux disease]. / Prohnozuvannia rezul'tativ khirurhichnoho likuvannia refliuksnoï khvoroby stravokhodu.

The operative treatment results were studied in 706 patients with wide-spread clinical forms of gastroesophageal reflux disease (GERD), using elaborated criterions for two probabilities in the case of depending frequencies, one of them, based on confiding limits for unknown probability, the second--on confiding interval, which was built in accordance to the 2s rule. The data obtained had testified that their interpretation, using elaborated statistical criterions, permitted to prognosticate consequences and expediency of fundoplication operation performance in patients with GERD.

[Thoracoscopic and video-assisted surgeries on thoracic organs of children]. / Torakoskopicheskie i videoassistirovannye operatsii na organakh grudnoi kletki u detei.

Forty-seven video-surgical thoracic operations performed in children are analyzed. Age of children ranged from 4 days to 14.5 years, body weight--from 700 g to 54 kg. Two types of surgeries are singled out--thoracoscopic and video-assisted (when minithoracotomy was performed in addition to thoracoscopic technique). There were no severe complications during surgery. One child died due to non-diagnosed penumothorax on the 4th day after surgery. Problems of anesthesia and surgical technique in children are considered.

The device and algorithm for estimation of the mechanoemisson chaos in blood of patients with gastric cancer.

The mechanoemission (ME) of blood is developed as a result of mechanochemical activation of a sample which is layered onto chromatographic paper. This paper describes computer-controlled device, aimed for generation, detection and analysis of ME data in the blood of the persons investigated. The original algorithm for estimation of ME chaos in blood is developed. For gastric cancer patients an increase of ME chaos is observed in comparison with healthy individuals and patients with inflammation of gastric mucosa. The concept of deterministic chaos is biohierarchical for the host of a cancer patient. In the light of this we have calculated that spatial chaos for gastric cancer patients is also increased in the geometrical structure of tumor cells and magnetic resonance imaging of the stomach. The concept of deterministic chaos may find an application in the development of new multi-computer organizations for medical diagnostic equipment.

[Bouginage in chemical burns of the esophagus in children]. / Buzhirovanie pri khimicheskikh ozhogakh pishchevoda u detei.

851 children suspected to have chemical burn of the esophagus were treated from 1996 to 2000. Use of esophageal bouginage along the guiding string has changed medical policy for esophageal burns. We completely rejected early bouginage. Late bouginage was necessary for 22% patients with II-III degree of chemical burns (3.8% of all hospitalized children). Results of the new policy depended on chemical agent. The best results were achieved after acetic acid burns. It is difficult to treat alkali burns leading to prolonged esophageal stenosis, and manganese crystal burns leading to pharynx injuries.

[Plastic surgery of the pharynx and cervical esophagus using a revascularized intestinal segment in children]. / Plastika glotki i sheinogo otdela pishchevoda revaskuliarizirovannym segmentom kishki u detei.

Three children with isolated cicatricial stenosis of the pharynx and cervical esophagus were subjected to operation for segmental plasty with a free intestinal segment (2 jejunal and one sigmoid). In all cases the segment was anastomosed with the side of the carotid and internal jugular vein on the neck under 3.2 magnification. No complications occurred. The results of the operation showed a high effectiveness of segmental plasty in stenosis of the cervical esophagus. In cicatricial stenosis of the pharynx, in addition to restoration of normal deglutition, breathing through the pharynx must be fully restored, which makes segmental reconstruction of the pharynx in children more difficult.

[Treatment of short esophageal stricture in children]. / Lechenie korotkikh striktur pishchevoda u detei.

The authors find it necessary to identify a nosological entity of short esophageal strictures, up to 1.5-2.0 cm long, from the specific features of their formation, clinical manifestations and from the possibility of widely using transesophageal methods of treatment. Among them, a procedure for intraesophageal compression of the scarring ring by using two types of devices in 64 patients was analysed. There was a positive result in 86% of the patients. The remaining children underwent surgical interventions: resection of an esophageal portion with esophagus-esophagus anastomosis and colesophagoplasty. No deaths were recorded. To objectivize the indications for either method of treatment, the authors recommend esophageal NMR tomography.