[Morphopathology of myocardial hypoxic-ischemic injuries in newborns at 22-27 weeks' gestation]. / Patomorfologiya gipoksicheski-ishemicheskikh povrezhdenii miokarda u novorozhdennykh 22­27 nedel' gestatsii.

OBJECTIVE: To determine the parameters of myocardial structural injuries developed in chronic intrauterine hypoxia conditions in newborns at 22-27 weeks' gestation. MATERIAL AND METHODS: A battery of morphological techniques, including organometry studies and separate weighing of the heart; 3D histology; morphometry with the determination of the area of cardiomyocyte nuclei, the specific area of the muscular and interstitial components of the right ventricular myocardium; immunohistochemistry with monoclonal antibodies to transforming growth factor ßi (TGF-ßi), cardiac troponin T (cTnT), and transmission electron microscopy, was used to examine heart samples from 30 deceased newborns at 22-27 weeks' gestation who developed in chronic intrauterine hypoxia conditions. A control group consisted of hearts from 20 extremely low body weight (ELBW) newborns, the main cause of whose death was asphyxia caused by the premature detachment of a normally positioned placenta. RESULTS: Analysis of the organometric parameters of heart samples from newborns at 22-27 weeks' gestation, who had experienced chronic intrauterine hypoxia, revealed right ventricular hypertrophy with increases in the area of cardiomyocyte nuclei and in the specific area of the muscle component compared to the control group. Impaired myocardial microcirculation and destructive changes in cardiomyocytes were diagnosed in conjunction with the decreased troponin T and increased TGF-ß1 expressions. Incomplete differentiation of cardiomyocytes and their myofibrillar component was revealed at the myocardial ultrastructural level in ELBW newborns who had experienced chronic intrauterine hypoxia. CONCLUSION: The parameters of myocardial structural rearrangement in ELBW newborns who had experienced chronic intrauterine hypoxia are compensatory right ventricular hypertrophy, microcirculatory disorders, destructive changes in cardiomyocytes, decreased cTnT and increased TGF-ß1 expressions in conjunction with impaired cardiomyocyte differentiation.

[Congenital immature teratomas. Two case reports]. / Vrozhdennye nezrelye teratomy. Opisanie dvukh nablyudenii.

Teratomas belong to a group of germ cell tumors and consist of tissues that are derived from 3 germ layers. The localization of teratomas is extremely diverse. The main task of a morphological study is to diagnose the type of teratoma. According to the WHO classification, there are mature and immature teratomas (ICD-O codes 9080/0 and 9080/3, respectively). It is deemed that the disease prognosis does not depend on the composition of mature tissue components. This paper describes two sectional observations of congenital immature teratomas in a premature live birth infant and a stillborn one. One teratoma, such as epignathus, is a very rare tumor in localization. Emphasis is laid on the need for a thorough teratoma morphological study that defines the tactics of patient management. The described observations demonstrate the importance of timely prenatal diagnosis and an interdisciplinary approach, as well as the need for clear routing of patients with diagnosed fetal space-occupying lesions.

[Pathomorphology of extraplacental membranes in their premature rupture and undifferentiated connectivetissue dysplasia in women]. / Patomorfologiia vneplatsentarnykh obolochek pri ikh prezhdevremennom razryve i nedifferentsirovannoi displazii soedinitel'noi tkani u zhenshchin.

AIM: to investigate the morphological features of the extraplacental membranes (EPM) of the placentas obtained from women with undifferentiated connective tissue dystrophy (UCTD) and premature rupture of the fetal membranes (PROFM). MATERIAL AND METHODS: EPMs of 65 placentas, including 55 from study group women and 10 from control women (having no manifestations of UCTD and PROFM), underwent morphological examination (visual examination, histological and immunohistochemical studies, and electron microscopy). RESULTS: There was subamniotic edema, disorientation and fragmentation of collagen structures in the compact layer, a structural change in the brush border of the amniotic epithelium, and a predominance of vacuolated cytotrophoblast forms in the structure of EPM of the placentas from of women with UCTD. Structural changes were accompanied by the altered function of EPM cells and identified by immunohistochemistry as higher MMP-9 expression by amniocytes and cytotrophoblast cells. PROFM was typified by the proliferation of amniotic epithelium; by the ordered arrangement of collagen fibers, and by large, longitudinally oriented fibroblasts. The structural changes in UCTD and PROFM were also accompanied by the altered function in the EPM cells as higher MMP-9 expression in amniocytes and cytotrophoblast cells. The latter was accompanied by the enhanced proteolysis of the extracellular matrix and can serve as one of the mechanisms, which triggers PROFM. CONCLUSION: Impaired histoarchitectonics and higher MMP-9 expression in the EPM cells should be considered as a manifestation of connective tissue disorganization and may be considered as one of the components in the pathogenesis of PROFM in the presence of UCTD.

[Pathomorphology of the ventricular germinal zone and neocortex in newborn infants with posthemorrhagic hydrocephalus]. / Patomorfologiia ventrikuliarnoi germinativnoi zony i neokorteksa u novorozhdennykh pri postgemorragicheskoi gidrotsefalii.

AIM: Тo study the morphological features of the ventricular germinal zone and neocortex in newborns at 22-40 weeks' gestation with posthemorrhagic hydrocephalus. MATERIAL AND METHODS: The brains of fetuses and newborns at 22-40 weeks' gestation with posthemorrhagic hydrocephalus (n=12) were examined; a control group included the brains with a lateral ventricle lumen width of not more than 0.5 cm (n=30). The investigators conducted a comprehensive pathomorphological study of the ventricular germinal zone and neocortex in the projection field No. 6. RESULTS: Posthemorrhagic hydrocephalus is characterized by a deceleration in the reduction of the ventricular germinal zone and by the corresponding level of differentiation of the cortex and neurons to gestational age in the presence of the physiological expression of reelin in the Cajal-Retzius neurons and in that of the impaired expression of matrix metalloproteinase 9 (a decrease) and the glial protein S-100 (an increase) in the cells of the ventricular germinal zone. CONCLUSION: The morphological features of the ventricular germinal zone and neocortex of fetuses and newborns at 22-40 weeks' gestation with posthemorrhagic hydrocephalus should be considered as morphological differential diagnostic criteria for the disease.

[Immunomorphological aspects of miscarriage at late gestational ages].

AIM: to reveal the morphological features of placentas and to define a role of the lectin pathway for activation of the complement system in the development of premature birth. MATERIAL AND METHODS: A complex morphological study was conducted to examine 37 placentas, 25 of which were obtained from women with clinical signs of threatened miscarriage and 12 placentas from apparently healthy pregnant women. RESULTS: Placental tissue CD59 expression was ascertained to be significantly less in the women with threatened miscarriage than in those having full-term babies. CONCLUSION: Decreased CD59 expression in threatened miscarriage at late gestational ages leads to additional activation of a maternal immune response and serves as a possible predictor for premature birth.

[A case of hypertrophic cardiomyopathy in an 8-month-old baby].

The paper analyzes a death due to undiagnosed asymmetric hypertrophic cardiomyopathy in an 8-month-old baby. The peculiarities of this case are the extent of myocardial damage, the irreversibility of structural injuries in the absence of clinical symptoms, and a concurrence of hypertrophic cardiomyopathy and severe pneumonia and meningoencephalitis.

[Primary cardiomyopathies].

The paper provides a review of literature on primary cardiomyopathy yet referring to as an inadequately studied abnormality that is diagnosed with difficulty by clinicians and frequently missed by pathologists at autopsy.